Certification and occupational health nursing. An historical perspective.

This article is based on excerpts from the Catherine Dempsey Lecture (American Occupational Health Conference, 1997), delivered by A. Brian Verrall, Chairman, American Board for Occupational Health Nurses, Inc. (ABOHN) in recognition of the 25th anniversary of ABOHN. The Catherine Dempsey Lecture honors the first president of AAOHN. The article is second in a series of three articles addressing credentialing to appear in AAOHN Journal. The first article, "Credentialing: Concerns and Issues Affecting Occupational Health Nursing," by Olson, Verrall, and Lundvall appeared in the May 1997 issue [45(5):231-238].

Occupational sensitization to lactase.

Occupational sensitization to lactase is reported in workers formulating and packaging this consumer product, which is used for the relief of gastrointestinal symptoms caused by intolerance to lactose. Allergic rhinitis, conjunctivitis, and some cases of asthma were noted. There was suggestive evidence that atopic individuals may be at greater risk of sensitization. Lactase should be added to the list of potential occupational respiratory sensitizers.

Use of noseclips in pulmonary function tests.

Spirometry was performed on 136 male industrial workers experienced in undergoing pulmonary function testing for the purpose of studying the effects of the use of noseclips on forced vital capacity (FVC) maneuvers. A cross-over design was employed with each subject serving as his own reference. Forced expiratory volume in 1 second (FEV1) and FVC measurements were recorded adhering closely to the guidelines set down by the American Thoracic Society. Assuming that a 30-ml difference in FVC and FEV1 is not important, we conclude that these measurements are not significantly affected by the use of noseclips. However, trial order was found to affect the outcome. The FVC and FEV1 values on the first trial were consistently lower than those on the second regardless of noseclip use. Many subjects experienced discomfort from noseclips and their use is not recommended for routine purposes.

Aesthesiometric threshold changes over the course of a workshift in miners exposed to hand-arm vibration.

The objective of this study was to investigate whether aesthesiometric threshold changes occur over the course of a workshift in vibration exposed hard rock miners relative to workers unexposed to vibration during the shift. The subjects were 99 miners and 40 smelter workers; four subjects declined to participate and nine were excluded from the analysis because of apparent failure to comprehend the testing procedure. Two point discrimination and depth sense aesthesiometry were conducted at the beginning and at the end of the workshift in all digits of both hands excluding the thumbs. In addition to the use of a vibrating tool during the shift, age, digital temperature, signs of arm injury, presence of fingertip callus, and handedness were documented. In the analysis the difference between postshift and preshift readings was studied in relation to these variables, particularly exposure to the jackleg drill during the shift. With the exception of exposure of the jackleg drill, no associations were observed between these variables and change over the workshift in aesthesiometric results, on both unadjusted comparison of means and backward elimination regression analysis. A statistically significant association, however, was found between the use of a jackleg drill and change in two point discrimination and in depth sense aesthesiometric results over the course of the shift, for the right hand. Evidence of the occurrence of a learning effect, particularly for two point discrimination aesthesiometry, was observed. The occurrence of an effect in the right, but not the left, hand reflects dominant handedness and relatively greater vibration exposure in the right hand in our subjects. This study supports the incorporation of an exposure free interval before aesthesiometric testing of vibration exposed workers.