Work-related skin disease in the plastics industry.

In a survey of a representative sample of workers taken at each of four different plastics manufacturers, 122 completed self-administered questionnaires were obtained. Twenty-six respondents (21.3%) met the case definition for having a work-related skin disorder during the preceding year. Sixteen (61.5%) cases indicated that their skin problems were present for 11 or more days, and 50% reported that their normal daily activities were at least somewhat affected. Risk of disease was elevated for workers who reported skin contact with formaldehyde (OR = 3.30; 95% CI = 1.02-10.69) or with polyvinyl-chlorides (PVCs) or their precursors (OR = 4.08; CI = 1.19-14.06), used barrier creams (OR = 4.51; CI = 1.22-16.68), were female (OR = 5.42; CI = 0.97-30.22), were 35 or younger (OR = 4.65; CI = 1.53-14.19), and for each use of hand cleaner at work (OR = 1.22; CI = 1.05-1.41). These findings should be considered when designing programs to reduce the incidence of skin disease among workers in the plastics industry.

Silicosis surveillance--Michigan, New Jersey, Ohio, and Wisconsin, 1987-1990.

PROBLEM/CONDITION: Improved surveillance for silicosis is needed to target interventions to prevent this occupational lung disease caused by the inhalation of crystalline silica dust. REPORTING PERIOD COVERED: 1987-1990. DESCRIPTION OF SYSTEMS: State-based silicosis surveillance and intervention programs have been developed in Michigan, New Jersey, Ohio, and Wisconsin as part of the Sentinel Event Notification System for Occupational Risks (SENSOR) Program, initiated in 1987 by the National Institute for Occupational Safety and Health (NIOSH). RESULTS: From 1987 through 1990, the SENSOR program confirmed a total of 430 cases of silicosis reported from these four states. Overall, approximately 60% of these cases were in workers employed in primary metal industries, although the types of industries in which cases occurred varied by state. Some cases were attributable to relatively recent exposure, including new cases in seven persons first exposed since 1980 in New Jersey. Silicosis case reports have prompted measurement of respirable silica concentrations at 25 Michigan work sites, and 14 (56%) of these sites were found to have levels that exceeded the legally permissible exposure level. INTERPRETATION: The silicosis surveillance and intervention strategies piloted by state health departments in the NIOSH-funded SENSOR Program have demonstrated the feasibility and effectiveness of identifying specific silica-using work sites that need preventive intervention. ACTIONS TAKEN: On the basis of initial experience in these four states, NIOSH developed guidelines for state-based silicosis surveillance and awarded SENSOR cooperative agreements to three additional states where the applicability of these surveillance methods will be further evaluated.

The role of the agricultural health nurse: bringing together community and occupational health.

1. Agricultural work is one of the most hazardous occupations in the United States. However, an occupational safety and health agenda for agriculture is lacking. 2. The agricultural health nurse draws on knowledge of community health and occupational health nursing to meet the needs of the farm work force. 3. The agricultural health nurse uses creative approaches to gather data about the farm work force and the work environment. 4. Community based strategies, such as coalition building, are important to develop programs that address agricultural safety and health problems.

Developing quality assurance programs in the occupational health setting.

It is important in the delivery of quality nursing care to have a system in place to evaluate the care administered. It is the responsibility of the profession to develop such a system, which is done in nursing through quality assurance programs. Quality assurance programs are based on standards of practice and peer review systems. Occupational health nurses are somewhat unique in their work situations and often need to develop creative strategies for quality assurance programs. The criteria used to evaluate nursing care may be developed to look at the structure, process, or outcome of nursing care. The model for implementation of quality assurance programs involves seven steps.