Hand dermatitis in intensive care units.

An investigation of the prevalence of occupational hand dermatitis in two intensive care units at a large teaching hospital was conducted. Information concerning the presence of occupational hand dermatitis, frequency of hand-washing, severity of the rash, aggravating conditions, history of atopy, and demographic factors (age, race, gender, and occupation) was collected via a self-administered questionnaire. The prevalence of occupational hand dermatitis was found to be 55.6% in the total reporting population of the units and was 69.7% in the most highly exposed workers (those reporting a frequency of hand-washing exceeding 35 times per shift). No relationship was found between occupational hand dermatitis and reported age, gender, race, atopic status, history of previous hand dermatitis, and duration of employment. Hand-washing frequency greater than 35 times per shift was strongly associated with occupational hand dermatitis (odds ratio = 4.13, P < 0.005). The high prevalence of occupational hand dermatitis found in this study of intensive care unit workers causes concern regarding the risk of health care workers in such units when exposed to blood-borne diseases.

Health risk influence on medical care costs and utilization among 2,898 municipal employees.

INTRODUCTION: Although worksite health promotion programs are credited with stabilizing medical benefits costs, research is needed to characterize the medical costs of cohorts with selected health risk factors. The purpose of this study was to compare medical cost outcomes in City of Birmingham, Alabama, employees who differ on selected health risk factors. METHODS: Health risk appraisal and medical claims cost data were examined in 2,898 employees participating in health screening during 1992 and 1993. Probit analysis was employed to test the null hypotheses that there are no differences in (1) probability of medical service utilization and (2) probability of medical service cost quartile (high, moderate, and low) between groups characterized by risks. Age, gender, race, education, marital status, and diabetes were included as covariates in each model examined. In addition, smoking habits was included as a covariate in models involving risk taking behavior and psychosocial risk. RESULTS: Significant differences in medical care utilization and costs were found between risk groups based on psychosocial risk, cardiovascular disease risk, and total risk. No association was found between risk-taking behavior and utilization and costs. CONCLUSION: Subjects reporting psychosocial, cardiovascular disease, and total risk factors were more likely to use medical services and to be in the high or high/moderate cost categories.

Reactive airways dysfunction syndrome: occurrence after exposure to a refractory ceramic fiber-phosphoric acid binder mixture.

A previously healthy, 47-year-old millwright was exposed to high airborne levels of a refractory ceramic fiber-phosphoric acid binder mixture; after acute bronchospasm, he required hospitalization. During the next 4 years, he had recurrent acute bronchospasm requiring emergency department visits and three hospitalizations. Review of the patient's medical and occupational history and extensive clinical investigation failed to provide alternate explanations for this hyperresponsive airways disease. This is believed to be the first reported case of reactive airways dysfunction syndrome (RADS) after exposure to a refractory ceramic fiber-phosphoric acid binder mixture. Physicians should be aware of this possibility when examining patients exposed to such materials.

Personal health-risk predictors of occupational injury among 3415 municipal employees.

Little information exists about the effectiveness of health-promotion programs in reducing occupational injury rates. A historical cohort study was conducted to examine the relationship between personal health-risk factors and risk of occupational injury. Workers were grouped on the basis of nonoccupational risk-taking behaviors, psychosocial risks, cardiovascular risk factors, and a total risk-factor variable. All analyses were controlled for sex, smoking status, age, and job classification. An increased risk of occupational injury (P < .0001) was found to be significantly associated with nonoccupational risk-taking behavior. This association may be the result of continued risk-taking behavior in the occupational environment, or assignment of risk-taking individuals to more hazardous job tasks. Psychosocial, cardiovascular, and total risk-factor variables were not associated with an increased risk of occupational injury.

Rubber contact urticaria.

Contact urticaria has been recognized since the 19th century, but rubber contact urticaria was not described until 1979. This sensitivity to rubber gloves, which often affects health care and cleaning workers, is now considered an occupationally related disease that must be considered in the diagnosis of contact urticaria.