Workplace health promotion - 523 entradas encontradas
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Sepulveda M., Goetz A., Grana J.
Medición del sesgo de selección del segundo grado en un programa de promoción de la salud en el medio laboral
Measuring second-order selection bias in a work site health program [en inglés]
Evaluación sobre una muestra de 93.807 participantes en un programa voluntario de evaluación de la salud en una empresa informática, de la amplitud y dirección de la distorsión de los resultados debida a la autoselección por comparación entre individuos con participación única (grupo A) e individuos con participación múltiple (grupo B y sesgo de segundo grado). Los sujetos del grupo B presentaban diferencias sistemáticas, pero no uniformes, en numerosas características de salud. En este grupo, se observó una mejora significativa en los comportamientos asociados al riesgo y en el grado de riesgo de daño para la salud. La simulación de un sesgo de selección mediante la exclusión de los participantes más sanos o menos sanos de la muestra de los participantes del grupo B no impidió que se produjera la mejora. Un sesgo de selección de segundo grado no podría ser considerado como automáticamente susceptible de reforzar la mejora o de una amplitud suficiente como para falsear las conclusiones relativas a los efectos del programa. La simulación es un instrumento útil para la determinación de la direccion y la extensión del sesgo de selección.
Journal of Occupational Medicine, mar. 1994, vol.36, n°3, p.326-333. 11 ref.
Balance 1994: Programa Nacional de prevención en la construcción y obras públicas
1994 Fact Book: National program for occupational safety and health in construction [en inglés]
Este documento presenta una serie de fichas descriptivas de los proyectos realizados en el marco de un programa nacional de higiene y seguridad para el sector de la construcción y las obras públicas en Estados Unidos. Los proyectos comprenden: programas sobre conservación del oido; evaluaciones ergonómicas de los riesgos; identificación y control de las sustancias peligrosas (plomo, vapores de bitumen, productos de sustitución del amianto, sílice); riesgos de afecciones respiratorias causadas por polvos tóxicos; servicios de información; evaluaciones de los riesgos en la construcción y las obras públicas realizadas por oficios; alteraciones del aparato locomotor; formación sobre seguridad y salud. Se presenta un resumen de cada uno de los proyectos junto a una descripción de las medidas de prevención.
Publications Dissemination, DSDTT, National Institute for Occupational Safety and Health, 4676 Columbia Parkway, Cincinnati, Ohio 45226, USA, mar. 1994. xiii, 127p. 6 ref. Indice.
Cockroft A., Gooch C., Ellinghouse C., Johnston M., Michie S.
Evaluation of a programme of health measurements and advice among hospital staff
In a pilot health promotion initiative, hospital staff were invited throughout one week to attend for health screening and advice. Staff who attended completed a questionnaire about their lifestyle and their health and were randomly divided into groups where they received advice and targets were set for changing their lifestyle or simply received their results. The invitation to attend health screening to help them improve their general health received a positive response but clearly missed some important target groups; health attitudes and beliefs are important determinants of programme participation. Results indicate that while it is difficult to achieve wide participation in health promotion activities, a simple intervention can have useful effects.
Occupational Medicine, May 1994, Vol.44, No.2, p.70-76. Illus. 12 ref.
Sorensen G., Lando H., Pechacek T.F.
Promoción de la erradicación del tabaquismo en el medio laboral. Resultados del estudio de una intervención controlada sobre individuos bajo riesgo
Promoting smoking cessation at the workplace - Results of a randomized controlled intervention study [en inglés]
En el curso del estudio de un programa de lucha contra el tabaquismo de tres meses de duración, se han elegido al azar un total de ocho centros de trabajo, en los que se han aplicado medidas anti-tabaco, y otros tantos sin tales medidas utilizados como controles. El programa de intervención constaba de una consulta a los trabajadores a fin de adoptar un reglamento anti-tabaco, la formación de los no fumadores para que aprendieran la manera de ayudar a los fumadores que quisieran dejar el hábito, y un curso de lucha contra el tabaquismo dirigido a los fumadores. Las evaluaciones efectuadas después de un mes y seis meses desde el comienzo del estudio han revelado que la tasa de éxitos había sido superior en las empresas donde se implantó un programa de intervención que en las utilizadas como controles. El abandono del hábito de fumar fue más frecuente en aquellos centros de trabajo donde los compañeros les pedían que dejaran de fumar y en aquellos donde la proporción de no fumadores era más alta.
Journal of Occupational Medicine, feb. 1993, vol.35, n°2, p.121-126. 20 ref.
Fraser V., Spitznagel E., Medoff G., Dunagan W.C.
Resultados de un programa de protección contra la rubeola entre el personal de hospitales - Balance de cinco años (1986-1990)
Results of a rubella screening program for hospital employees - A five-year review (1986-1990) [en inglés]
Evaluación de un programa de protección contra la rubeola entre el personal de hospitales de los Estados Unidos durante un período de cinco años (1986-1990). En total, 6.115 nuevos empleados se sometieron a controles inmunitarios contra la rubeola. Se realizaron tests serológicos de la rubeola en 5.893 (96,4 %) de los trabajadores sometidos al programa, mientras que 222 (3,6 %) tenían antecendentes de anteriores vacunaciones o infecciones de rubeola. Se constató la ausencia de inmunidad en 325 empleados (5,3 %). Un análisis por regresión logística reveló la existencia de una correlación significativa entre los grupos de individuos nacidos durante el mismo período quinquenal y el estatus serológico. Los trabajadores nacidos entre 1960 y 1964 tenían menor probabilidad de ser seronegativos, y los nacidos en 1970 o más tarde eran más propensos a ser seronegativos. Este estudio revela una tasa de seronegatividad inferior a la de estudios anteriores. Se identifican los grupos de trabajadores que pueden escapar del programa de protección contra la rubeola y las tasas bajas de protección vacunal. El aumento de la seronegatividad entre los individuos nacidos después de 1964 está relacionado con el aumento de la tasa de casos de rubeola en los Estados Unidos.
American Journal of Epidemiology, nov. 1994, vol.138, n°9, p.756-764. Ilus. 21 ref.
Servicios de medicina de empresa - Estrategias prácticas para mejorar la calidad y controlar los costes
Occupational health services - Practical strategies for improving quality and controlling costs [en inglés]
Esta guía trata de los factores específicos que caracterizan la eficacia de los programas de medicina de empresa. En el sumario: estado actual de esos programas; mejora de la calidad; elaboración de un núcleo común en materia de medicina de empresa; mejora de la salud en el lugar de trabajo; programas financieramente ventajosos para los empresarios; cumplimientos de los requisitos legales en los reconocimientos de selección de personal; valoración y mejora del rendimiento financiero; tendencias significativas en la evolución de los programas de medicina de empresa.
American Hospital Publishing Inc., 737 North Michigan Avenue, Suite 700, Chicago, IL 60611-2615, USA, 1993. xix, 307p. Ref.bibl. Indice. Precio: USD 56,95 (USD 44,95 para los miembros de la AHA) más USD 8,95 (USD 7,95) para los gastos de envío.
Gomel M., Oldenburg B., Simpson J.M., Owen N.
Work-site cardiovascular risk reduction - A randomized trial of health risk assessment, education, counseling, and incentives
This study reports an efficacy trial of four worksite health promotion programmes in Australia. Twenty-eight worksites were randomly allocated to a health risk assessment, risk factor education, behavioural counselling, or behavioural counselling plus incentives intervention. Participants were assessed before the intervention and at three, six, and 12 months. Compared with the average of the health risk assessment and risk factor education conditions, there were significantly higher validated continuous smoking cessation rates and smaller increases in body mass index and estimated percentage of body fat in the two behavioural counselling conditions. The behavioural counselling condition was associated with a greater reduction in mean blood pressure than was the behavioural counselling plus incentives condition. On average among all groups, there was a short-term increase in aerobic capacity followed by a return to baseline levels.
American Journal of Public Health, Sep. 1993, Vol.83, No.9, p.1231-1238. Illus. 23 ref.
DeJoy D.M., Southern D.J.
An integrative perspective on work-site health promotion
Health promotion efforts, particularly those directed at resistant and high-risk workers, should be integrated into a corporate health strategy in which equal concern is expressed for individual lifestyle modification and the provision of safe and healthful working condition. The principal goal of integrative programming is to devise complementary behavioural and environmental interventions to reduce workplace health problems. Implementation of such a programme has three phases: development of an appropriate health policy and enlistment of management support; identification of specific problems; design, implementation and evaluation of interventions.
Journal of Occupational Medicine, Dec. 1993, Vol.35, No.12, p.1221-1230. Illus. 43 ref.
Health promotion in the workplace: Alcohol and drug abuse
Promotion de la santé sur les lieux de travail: abus de l'alcool et des drogues [en francés]
Report of a WHO Expert Committee which met in Geneva, Switzerland, 4-8 November 1991. Contents: basic definitions and concepts concerning alcohol- and drug-related problems in the workplace; requirements and strategies of national and international programmes; the nature and extent of alcohol- and drug-related problems and contributing factors; review of relevant health promotion initiatives (historical and cross-cultural review, nature of such initiatives, development and implementation, the regulatory context, drug screening and testing); health programme evaluation; multicultural situations; problems of developing countries. The report concludes with a number of recommendations.
World Health Organization, Distribution and Sales Service, 1211 Genève 27, Switzerland, 1993. v, 35p. 54 ref. Price: CHF 7.00 (CHF 4.90 in developing countries).
Jeffery R.W., Forster J.L., French S.A., Kelder S.H., Lando H.A., McGovern P.G., Jacobs D.R., Baxter J.E.
The healthy worker project - A work-site intervention for weight control and smoking cessation
A randomized trial was conducted to evaluate the effectiveness of a work-site health promotion programme in reducing obesity and cigarette smoking. Thirty-two worksites were randomized to treatment or no treatment for two years. Treatment consisted of health education classes combined with a payroll-based incentive system. Evaluation was based on cohort and cross-sectional surveys. Results showed that of 10,000 total employees in treatment worksites, 2,041 and 270 participated in weight control and smoking cessation programmes, respectively. Weight loss averaged 4.8lbs, and 43% of smoking participants quit. Net two-year reductions in smoking prevalence in treatment compared to control worksites were 4.0% and 2.1% in cross-sectional and cohort surveys, respectively. No treatment effect was found for weight. Treatment effects for smoking prevalence and weight were both positively correlated with participation rates in the intervention programmes (r=0.45 for smoking and r=0.55 for weight).
American Journal of Public Health, Mar. 1993, Vol.83, No.3, p.395-401. 54 ref.
Hallauer J., Kane M., McCloy E.
Viral Hepatitis Prevention Board
Eliminating hepatitis B as an occupational hazard
Proceedings of an international conference on hepatitis B as an occupational hazard held in Vienna, Austria, 10-12 March 1993. Papers are presented under the following headings: hepatitis B and occupational risk; prevention of hepatitis B in the workplace (safe work practices, vaccination, education and successful prevention programmes); economic implications of hepatitis B in the workplace; implementation of effective prevention programmes in various countries; current policies and the way forward. Summaries of regional workshops provide information on the current situation in a number of countries.
Medical Imprint, 22 Lancaster Gate, London W2 3LY, United Kingdom, 1993. 114p. Bibl.ref.
Jeffery R.W., Forster J.L., Dunn B.V., French S.A., McGovern P.G., Lando H.A.
Effects of work-site health promotion on illness-related absenteeism
This study examined the effects of work-site health promotion on employee absenteeism. Thirty-two work sites were randomized to programmes for weight control and smoking cessation or to no treatment for two years. The prevalence of self-reported absences from work was assessed at baseline and follow-up. Results using work site as the unit of analysis showed a reduction in the proportion of workers reporting a sick day in the last month in treatment versus control work sites. The rate of participation in smoking but not weight programmes was positively associated with change in sick day prevalence and this effect was strongest in baseline smokers. Work-site smoking cessation programmes may yield important short-term economic benefits by reducing employee absenteeism.
Journal of Occupational Medicine, Nov. 1993, Vol.35, No.11, p.1142-1146. 15 ref.
Conway H., Simmons J., Talbert T.
The Occupational Safety and Health Administration's 1990-1991 Survey of Occupational Medical Surveillance. I - Prevalence and type of current practices; II - The purposes of ... surveillance in US industry ...; III - Effects of ... programs as perceived by respondents to the Survey
Three-part series reporting on the results of a survey of current medical surveillance practices in the US, conducted by the Occupational Safety and Health Administration (OSHA) in 1990-1991. The study involved a detailed telephone survey of 7177 establishments of all sizes and in various industries (Phase I), as well as a follow-up survey of 238 establishments with medical surveillance programmes (Phase II) and 25 site visits to locations with such programmes (Phase III). These articles, richly illustrated with statistics, discuss various aspects of these practices: their prevalence (most common among larger establishments), purpose (health protection, establishment of physical aptitude for the job) and effects (improvements in employee relations, and reductions in injury rates and insurance costs). Further commentary on the survey is provided in an article on pp.698-700 by Hathaway J.A., entitled Medical surveillance: Extent and effectiveness?
Journal of Occupational Medicine, July 1993, Vol.35, No.7, p.659-700.
Heirich M.A., Foote A., Erfurt J.C., Konopka B.
Work-site physical fitness programs - Comparing the impact of different program designs on cardiovascular risks
The relative impact of three different approaches to physical fitness at the worksite on cardiovascular risk reduction is examined. The three approaches tested were: (1) a staffed physical fitness facility; (2) one-to-one counselling with at-risk employees; and (3) a combination of one-to-one counselling with employees plus encouragement of peer support and exercise at work. A fourth site was used as a control site. The programme involving a physical fitness facility had little measurable impact on cardiovascular risks. Both the other programmes were more effective, with the combination of counselling and plant organization providing the best health outcomes in terms of frequency of exercise, adequacy of blood pressure control (among hypertensives), weight loss (among the overweight), and smoking cessation. These results indicate that systematic, ongoing outreach to enlist employees in various types of exercise programmes is more effective than the presence of fitness facilities without such outreach.
Journal of Occupational Medicine, May 1993, Vol.35, No.5, p.510-517. 14 ref.
Your guide to an effective hearing conservation programme
Contents of this guide: objectives and components of a hearing conservation programme; deciding when a hearing conservation programme is needed; noise measurement and evaluation; noise control measures; selection, provision and usage of personal hearing protectors; medical examinations and record-keeping; training and education of workers. Appendices include maximum permissible exposure duration for different noise levels, an example of a company policy for a hearing conservation programme and examples of medical examination report forms.
Department of Industrial Health, Ministry of Labour, 18 Havelock Road #05-01, Singapore 0105, no date. 42p. Illus.
van Dijk F.J.H., Hulshof C.T.J., Verbeek J.H.A.M.
Development and evaluation of an occupational health services programme on the prevention and control of effects of vibration
A study in occupational health services (OHS) on the prevention and control of effects of whole-body vibration is described and preliminary results are presented. The study comprises an inventory of current activities of occupational health services in vibration-related issues, the development of a specific OHS programme and the evaluation of this programme. Results of the inventory, a questionnaire survey in occupational health services (n=112, response 67%), show that the impact of OHS in the prevention and control of adverse health effects is small. The development and evaluation of a specific OHS programme may be useful in setting up a preventive approach. Some methodological problems are also discussed.
Occupational Medicine, 1993, Vol.43, Suppl.1, p.38-42. 20 ref.
van Dijk F.J.H., Hulshof C.T.J., Kroon P.J., Verbeek J.H.A.M.
Evaluation of an occupational health programme - Negative results, positive results or a failure?
Among personnel of the city of Amsterdam (Netherlands) the incidence of disability as a result of musculoskeletal problems amounts to 15 per 1,000 person-years in the refuse collecting department. A disability prevention programme in accordance with literature was started to decrease this high incidence of disability. In the process-evaluation after two years from the outset of the project it appeared that only three of the ten preventive measures advocated were realized. These meagre results were explained by strategic factors such as lack of motivation among management and the fact that policy on worker health protection was isolated from the overall company policy. Recommendations for future evaluation research are given.
Occupational Medicine, 1993, Vol.43, Suppl.1, p.34-37. 27 ref.
Porru S., Donato F., Apostoli P., Coniglio L., Duca P., Alessio L.
The utility of health education among lead workers - The experience of one program
This study evaluates the effectiveness of a health education programme in 50 workers exposed to inorganic lead employed in seven small factories. It was performed in three phases over one year. Before the programme, blood lead levels were measured and a questionnaire was administered in order to evaluate the baseline knowledge of the workers about lead poisoning and its prevention. After the health education programme, the blood lead levels decreased (from 38.2 to 32.3µg/dL) and the questionnaire scores improved in a highly significant manner (p<0.001). These results were obtained both in the short-term (4 months) and the medium-term (1 yr). The reduction of blood lead concentrations seemed to be due to changes in hygiene behaviour and life habits, such as alcohol consumption or cigarette smoking, probably induced by an increase in specific knowledge about the prevention of lead damages.
American Journal of Industrial Medicine, Mar. 1993, Vol.23, No.3, p.473-481. 16 ref.
Work-related diseases: Prevention and health promotion - Proceedings
Arbeitsbedingte Erkrankungen: Prävention und Gesundheitsförderung - Schlußbericht [en alemán]
Maladies liées au travail: mesures préventives et promotion de la santé - Actes du symposium [en francés]
Proceedings of the International symposium on work-related diseases - Prevention and health promotion held in Linz, Austria, 27-30 October 1992. Papers are presented under the following headings: keynote addresses (practical approaches for the control of work-related health risks; health promotion through the prevention of work related disease; the perspective of developing countries; the situation in Austria); national systems - an international comparison; work-related disorders and diseases; health promotion concepts; concrete actions at enterprise level. Papers are presented in English, French or German with summaries in the other two languages.
Allgemeine Unfallversicherungsanstalt, Kongressbüro, Adalbert-Stifter-Strasse 65, 1200 Wien, Austria, 1993. 235p. Illus. Bibl.ref.
Feldstein A., Valanis B., Vollmer W., Stevens N., Overton C.
The Back Injury Prevention Project pilot study - Assessing the effectiveness of back attack, an injury prevention program among nurses, aides, and orderlies
The Back Injury Prevention Project, an educational programme designed to prevent back injuries among nurses, nurses' aides, and orderlies, was conducted in two hospitals of a large health maintenance organisation. A pilot study involving 55 employees tested programme feasibility, developed and tested instruments, and generated preliminary data measuring programme effectiveness. Intervention group scores on the composite back-pain and composite fatigue scales decreased relative to the control group, but this did not reach statistical significance. A 19% improvement in scores for quality of patient transfer was observed for the intervention group (P<0.0003), while the control group did not show any significant improvement during the same time period. Results indicated that the programme changes behaviour at least in the short term. Further study will be necessary to determine if the behaviour change persists and back-pain and injury rates are subsequently reduced.
Journal of Occupational Medicine, Feb. 1993, Vol. 35, No. 2, p.114-120. 30 ref.
Políticas sanitarias en las compañías multinacionales: evolución en la Comunidad Europea y los Estados Unidos
Health policies in multinational companies: developments in the European Community and USA [en inglés]
Este informe se ha basado en las entrevistas realizadas en nueve compañías multinacionales que operan en siete países de la Unión Europea y en los Estados Unidos. Se comentan los siguientes aspectos de sus respectivas políticas sanitarias: estudio de la relación entre los tipos de organización y las medidas concertadas en cuanto a la salud, tanto en el caso de sociedades como de grupos individuales; influencia que ejerce la participación en la elaboración de una política sanitaria de empresa; y la orientación de las actividades desde la perspectiva del individuo y del contenido. Igualmente, se revisan los factores específicos de cada país con capacidad para influir sobre la política de la empresa en materia de salud. Se proponen algunos medios que pueden utilizar las compañías en la tarea de mejorar la salud en el lugar de trabajo.
Fondation européenne pour l'amélioration des conditions de vie et de travail, Loughlinstown House, Shankill, Co. Dublin, Irlanda, 1992. ii, 38p. 9 ref.
Clarkson J., Blower E., Moore L.
Medidas innovadoras para mejorar la salud en el lugar de trabajo: mecanismos para promover iniciativas. Reino Unido
Innovative workplace action for health: mechanisms for establishing initiatives. United Kingdom [en inglés]
Este informe presenta los resultados de una encuesta por cuestionario efectuada en empresas británicas (231 participantes) con el fin de identificar los ejemplos de acciones de mejora de la salud en el lugar de trabajo, y analizar cómo y porqué se han llevado a cabo. También se llevaron a cabo entrevistas detalladas en las sedes mismas de cuatro multinacionales. Se examinan los resultados y se formulan numerosas propuestas. De todo ello se deduce que son necesarias estructuras definidas, recursos y formación adecuados para desarrollar esas acciones. Paralelamente a estos factores, resulta esencial crear una "cultura" en materia de salud en el centro de trabajo. Queda patente la necesidad de asegurar la participación del personal en la toma de decisiones.
Fondation européenne pour l'amélioration des conditions de vie et de travail, Loughlinstown House, Shankill, Co. Dublin, Irlanda, 1992. vii, 97p. Ilus. 3 ref.
Sorensen G., Hsieh J., Hunt M.K., Morris D.H., Harris D.R., Fitzgerald G.
Employee advisory boards as a vehicle for organizing worksite health promotion programmes
Employee advisory committees were organized to facilitate implementation of a worksite nutrition programme called Treatwell. A survey of committee members and other employees at these sites showed that the average number of hours board members spent on the committee was directly related to the proportion of employees aware of the nutrition programme. Conflicts between committee and job responsibilities was the primary factor reported as limiting the boards' effectiveness. Professionals and managers were over-represented on boards compared to non-managers.
American Journal of Health Promotion, July-Aug. 1992, Vol.6, No.6, p.443-450. Illus. 15 ref.
Drug abuse at work - A guide for employers
This booklet provides information to employers on the risks of drug abuse along with guidance on the establishment of policies to minimize drug abuse and encourage employees with drug problems to come forward for treatment. Contents: the effects of drugs; signs of drug abuse; the need for action; essentials of a policy on drug abuse at work; implementing the policy; screening for drugs. Appendices include a list of commonly used drugs and their harmful effects and an outline of the principal legislation controlling drug use.
HSE Information Centre, Broad Lane, Sheffield S3 7HQ, United Kingdom, Nov. 1992. 17p. 6 ref.
Upfal M.J., Markell B.
Training and proficiency in the medical review of job applicant drug screens
A survey was conducted to examine the proficiency of urine drug screen medical review officers (MROs) and the effect of training upon their performance. 139 attendees of the American College of Occupational and Environmental Medicine basic MRO training course, and 82 attendees of the advanced course completed both pre-course and post-course surveys. The questionnaires included 10 vignettes with positive analytical results, of which only half should be reported as positive to management. The mean number of correct responses among the 10 cases presented were: basic pre-test - 4.91; basic post-test - 7.45; advanced pre-test - 6.68; advanced post-test - 7.33. Differences between all four groups were significant (P<0.001 to P=0.003), except for the basic post-test versus the advanced post-test, for which there was no significant difference. It is concluded that: (1) inadequate knowledge and skill in the medical review of drug screens may contribute to errors in reports to management; (2) physicians' performance can be improved with training; (3) certification of MROs in both the private and public sectors should be considered.
Journal of Occupational Medicine, Dec. 1992, Vol.34, No.12, p.1189-1196. Illus. 10 ref.
Golaszewski T., Snow D., Lynch W., Yen L., Solomita D.
A benefit-to-cost analysis of a worksite health promotion program
An analysis of the benefit-to-cost ratio of a major health promotion programme within an insurance company was conducted for the years 1986 through 1990, with projections to the year 2000. Programme costs for personnel, capital expenses, materials, and rent were determined and compared with programme benefits (discounted to account for increasing pension liability) for health care cost savings, increased productivity, decreased absenteeism, decreased life insurance claims, and programme-generated income. After adjusting future monies to net present value, a benefit-to-cost ratio of 3.4 was estimated for the programme. Despite the limitations of the study design, it was concluded that the programme realizes a positive return on its investment. Several programme recommendations are presented to increase the probability of achieving positive benefit-to-cost ratios in future programme offerings.
Journal of Occupational Medicine, Dec. 1992, Vol.34, No.12, p.1164-1172. 31 ref.
Maes S., Kittel F., Scholten H., Verhoeven C.
"Healthier Work at Brabantia", a comprehensive approach to wellness at the worksite
As American worksite health promotion projects claim to have not only favourable effects on well-being, safety and health, but also on absenteeism and productivity of employees, many European countries and enterprises have become interested in starting similar projects. However, most American programmes focus on the modification of individual behaviour rather than on the creation of health-promoting work environments and it is therefore argued that American programmes may be inefficient and socially unacceptable from a European perspective. This paper describes in detail the implementation of a Dutch project "Healthier Work at Brabantia" which, in contrast to the American approach, aims at promoting well-being, health and safety by means of changes at the individual as well as at the organisational and environmental level. The results will show the effects of interventions at the organisational and environmental level, including effects on work-related stress, absenteeism, accidents, and disability.
Safety Science, Nov. 1992, Vol.15, Nos.4-6, Special issue, p.351-366. 20 ref.
Bascom R., Ford E.
Don't just "do spirometry" - Closing the loop in the workplace spirometry programs
This article describes how to use spirometry as an active part of an on-site workplace occupational health programme, the emphasis of which is on knowing where and how to look for signs of occupational lung disease. The paper offers an outline of a practical programme for spirometry surveillance, and includes questions to be asked in planning for one.
Occupational Medicine: State of the Art Reviews, Apr.-June 1992, Vol.7, No.2, p.347-363. Illus. 6 ref.
Surveillance for lung disease - Quality assurance using computers and a team approach
An occupational pulmonary surveillance programme will detect the lung diseases that affect about 20% of the general population: asthma, chronic bronchitis, emphysema, restrictive respiratory disorders, and lung cancer. Annual spirometry testing and standardised respiratory questionnaires are useful components of all programmes, but because many problems with spirometry testing and interpretation occur, a team approach is recommended. A description is given of a team approach to pulmonary surveillance involving the following individuals: the corporate medical director; the corporate medical surveillance coordinator; the medical director of a large pulmonary function (PF) laboratory; a computer system analyst with PF experience; plant nurses with spirometry experience.
Occupational Medicine: State of the Art Reviews, Apr.-June 1992, Vol.7, No.2, p.209-225. Illus. 23 ref.
Althouse R.B., Castellan R.M., Wagner G.R.
Pneumoconioses in the United States - Highlights of surveillance data from NIOSH and other federal sources
This paper reviews information from the US National Institute for Occupational Health and Safety (NIOSH) programmes and some other federal data sources that can be used to help target preventive efforts for coal workers' pneumoconiosis, silicosis, and asbestosis and to track progress toward their elimination. The data sources reviewed include: the NIOSH Sentinel Event Notification System for Occupational Risks (SENSOR) Program; the NIOSH Coal Workers' X-ray Surveillance Program (CWXSP); the National Center for Health Statistics (NCHS) multiple-cause-of-death mortality data tapes; the National Hospital Discharge Survey (NHDS) conducted by NCHS; the Medicare Provider and Analysis Review (MEDPAR) files of the Health Care Financing Administration (HCFA); the Bureau of Labor Statistics (BLS) reports of occupational injuries and illnesses.
Occupational Medicine: State of the Art Reviews, Apr.-June 1992, Vol.7, No.2, p.197-208. Illus. 22 ref.
Wilson M.G., Edmunson J., DeJoy D.M.
Cost effectiveness of work-site cholesterol screening and intervention programs
An evaluation was conducted of the cost effectiveness of behavioural interventions designed to reduce high serum cholesterol levels in a forest products manufacturing population. Four intervention groups and a control group were studied. All four intervention groups received an educational programme of varying length (1 or 3 months). Two of these groups also received incentives. The one-month educational programme coupled with an outcome-based incentive and the three-month educational programme were the most cost-effective means for reducing cholesterol in borderline high or high-risk employees. The three-month educational programme coupled with a behaviour-based incentive was the least cost-effective means for achieving the objective. However, in terms of effectiveness per dollar spent and cost per unit of effectiveness, the control group (no intervention) demonstrated effectiveness somewhat close to the most effective interventions.
Journal of Occupational Medicine, June 1992, Vol.34, No.6, p.642-649. 14 ref.
Heirich M.A., Erfurt J.C., Foote A.
The core technology of work-site wellness
This paper discusses the following 10 dimensions of worksite wellness programmes: (1) establishment of programme policy; (2) work force health status assessment; (3) linkage of worksite with service providers; (4) linkage of individual employees with appropriate services; (5) provision of options for behaviour change strategies and interventions; (6) engagement of employees in these interventions; (7) organisation of worksite-wide activities to support health improvement; (8) review and alteration of organisational policies to make the work environment more supportive of health; (9) on-going programme evaluation; (10) periodic assessment of longer-term programme results. Two future dimensions are described that require further evidence of impact.
Journal of Occupational Medicine, June 1992, Vol.34, No.6, p.627-637. 53 ref.
Cropper M.L., Aydede S.K., Portney P.R.
Public preferences for life saving
Results are presented of a study in which 3000 members of the general public were asked to choose between pairs of hypothetical life-saving pollution control programmes. In some cases the choices involved programmes that would save persons at different points in time, in other cases the choice was between programmes that would save persons of different ages. The relationship between people's discount rate for money and their discount rate for lives was also investigated. Results are discussed and substantiated by comparison with other surveys and it is concluded that the findings, although preliminary, have important policy implications.
Resources for the Future, 1616 P Street NW, Washington, D.C. 20036, USA, May 1992. 78p. Illus. 3 ref.
The past and present of the Polish national health services. Reform project
Short historical outline of the national health service (NHS) system in Poland. Consecutive stages of the NHS system reform are described (up to October 1991), including the period of early 80's. The general principles of the project of the Polish NHS system reform, which is intended to be implemented with support from the World Bank, are presented. These principles are related particularly to the scope of the questions assigned to the task forces established to solve the basic problems of the present system which includes health promotion, primary health care, occupational health, a health information system, cost accounting, resource allocation, pharmaceutical monitoring and drug control, management development and regional health service task forces.
Polish Journal of Occupational Medicine and Environmental Health, 1992, Vol.5, No.1, p.1-11. 8 ref.
Developing your health and safety policy and program - A guide for employers
This guide is designed to help employers meet the legal requirement of preparing and reviewing a written occupational health and safety policy and developing and maintaining a programme to implement that policy. Guidelines are provided to help define policy objectives and develop programme activities needed to meet such objectives.
Industrial Accident Prevention Association, 250 Yonge Street, 28th Floor, Toronto, Ontario M5B 2N4, Canada, 1992. 24p. Price: CAD 8.95 (CAD 6.95 IAPA members).
Burton W.N., Erickson D., Briones J.
Programas de salud para mujeres en el lugar de trabajo
Women's health programs at the workplace [en inglés]
Se describe brevemente un programa completo de salud dirigido a las mujeres desarrollado por el First National Bank de Chicago. El programa incluye: casos de educación prenatal, reconocimientos ginecológicos, consultas y la obligación de obtener la opinión de un segundo especialista para algunas operaciones quirúrgicas de obstetricia o ginecología. El programa permite ofrecer ayuda económica y contribuir a mejorar la salud de las empleadas.
Journal of Occupational Medicine, mar. 1991, vol.33, n°3, p.349-350. 5 ref.
Burton W.N., Conti D.J.
Gestión racional de la prestación de cuidados de salud mental
Value-managed mental health benefits [en inglés]
Se describe un programa completo de salud mental, con análisis de costo-beneficio, para los empleados del First National Bank de Chicago y sus familiares. El programa consta de: la asistencia a los empleados; un estudio del recurso a hospitales psiquiátricos; la posibilidad de consultar con un psiquiatra; los cambios en el diseño de pólizas de seguro. Se ha realizado un estudio de este programa a lo largo de cuatro años, tras el cual se ha confirmado una mejora de la gestión de los costes globales sanitarios en salud mental, una reducción de los costos de hospitalización en servicios de psiquiatría; y una reducción de la duración media de las incapacidades laborales de corta duración derivadas de procesos psiquiátricos.
Journal of Occupational Medicine, mar. 1991, vol.33, n°3, p.311-313. 1 ref.
Mattila M., Korpinen L.
An information system about job loads and hazards for occupational health care
A systematic job load and hazard analysis (JLHA) method for workplace investigation is described. The method involves information collection, evaluation of findings, development of occupational health care measures and follow-up. Physical and chemical hazards, physical workloads, mental stress factors and risks of injury are assessed on a three-point rating scale. A computer program was developed to collect and process the JLHA data and provide detailed outputs on job assessments, job rankings based on load and hazards, and appropriate health care programmes.
In: Industrial health and safety, Proceedings of the second international workshop on personal computers and databases in occupational health, Official Pubications of the European Communities, 2895 Luxembourg, Grand Duchy of Luxembourg, 1991, p.245-250. 6 ref.
Mattila M., Kivi P.
Hazard screening and proposals for prevention by occupational health service: An experiment with job load and hazard analysis at a Finnish construction company
A systematic survey method for risk assessment at the workplace (job load and hazard analysis) was developed and tested as part of the regular occupational health care procedures in the construction industry. The method comprises the identification and assessment of health hazards and conclusions and proposals as to their prevention and follow-up. Tests carried out over a 2.5-year period showed that the method worked well as a central component of preventive health care. The contents of the occupational health care programme were enhanced, the number of preventive measures increased and the organizational climate improved.
Journal of Social and Occupational Medicine, 1991, Vol.41, No.1, p.17-22. Illus. 23 ref.
Stange K.C., Strecher V.J., Schoenbach V.J., Strogatz D., Dalton B., Cross A.W.
Psychosocial predictors of participation in a work site health-promotion program
This study used questionnaires to measure employees' perception of programme efficacy, health attitudes, beliefs, social support, and stress prior to the introduction of a comprehensive health promotion programme at a research and development worksite. The association of these factors with enrollment in the programme was then prospectively determined. In addition, open-ended questionnaires were used retrospectively to determine additional factors associated with participation. Of the above factors, only programme efficacy was signficantly associated with participation in the entire sample. Perceived social support was associated with participation among non-white employees. In open-ended questionnaires, a desire for health information, a desire for help with behaviour change, and concern about health status were the most commonly given reasons for participating. The study findings imply that environmental factors operating during the enrollment period at the worksite may be more powerful than pre-existing attitudes and beliefs in determining participation.
Journal of Occupational Medicine, Apr. 1991, Vol.33, No.4, p.479-485. 48 ref.
Stange K.C., Strogatz D., Schoenbach V.J., Shy C., Dalton B., Cross A.W.
Demographic and health characteristics of participants and nonparticipants in a work site health-promotion program
The potential impact of worksite health promotion programmes is limited by non-participation, especially among demographic subgroups and those who could most benefit from a health behaviour change. The study prospectively examined the relationship of personnel data and self-reported health habits and health status to participation in a health-promotion programme. White employees were 2.47 times as likely to participate as non-whites. Those with health maintenance organisation health insurance were 1.43 times as likely to participate as were employees with fee-for-service insurance. There was no difference between participants and non-participants in self-reported health status, and only slightly more positive health habits were noted among participants. The study results demonstrated that health-related programmes do not enroll only the very healthy or those with healthy habits. However, the diminished enrollment of non-whites supports concern that such programmes may not reach all workforce segments equally.
Journal of Occupational Medicine, Apr. 1991, Vol.33, No.4, p.474-478. 48 ref.
Udasin I.G., Buckler G., Gochfeld M.
Quality assurance audits of medical surveillance programs for hazardous waste workers
The US Occupational Safety and Health Administration (OSHA) Hazardous Waste Operations and Emergency Response Regulation (29 CFR 1910.120, see CIS 89-1420) requires medical surveillance examinations for hazardous waste workers. The consistency and appropriateness of the services provided under the Regulation were investigated as part of a quality control audit. The medical surveillance examinations performed by various clinical facilities for the employees of several environmental consulting firms were audited. The study revealed that in most cases the required paperwork was completed. However, many components of a complete occupational history were not performed. Spirometric examinations were often performed incorrectly. Documentation of baseline tests was not uniformly done, nor were patients always informed of their examination findings. This suggests that further efforts should be made to educate physicians and nurses providing medical surveillance and other services to hazardous waste workers.
Journal of Occupational Medicine, Nov. 1991, Vol.33, No.11, p.1170-1174. 14 ref.
Fielding J.E., Knight K.K., Goetzel R.Z., Laouri M.
Utilization of preventive health services by an employed population
The responses of 18,053 health profile participants were analysed to determine the utilisation rates of selected preventive services in an employed population. Overall utilisation rates for preventive services were high: 86.0% of respondents had their blood pressure checked, 94.0% of all women had a Pap smear and 81.3% had clinical breast examinations, 42.4% of respondents aged 40 and older had a rectal examination, 31.8% of those aged 50 and older had a test for occult blood in the stool, and 33.7% had a routine sigmoidoscopy. With the exception of blood pressure screening, the percentage of respondents utilising preventive services was considerably higher than the corresponding percentages in the US population as reported in the National Health Interview Survey. Nevertheless, the results suggest substantial opportunity for employers to encourage the appropriate use of preventive health services among employees.
Journal of Occupational Medicine, Sep. 1991, Vol.33, No.9, p.985-990. 13 ref.
Sorensen G., Rosen A., Pinney J., Rudolph J., Doyle N.
Work-site smoking policies in small businesses
This study describes the experiences of small work-sites in the US in implementing policies restricting smoking. Two hundred and sixteen work sites employing 120 or fewer persons were surveyed by telephone in 1987. Compared with companies without policies, companies with policies were larger and reported having fewer smokers and more management support for smoking policies. Seventy-three percent of work sites without a smoking policy said they would be very likely to implement a policy if it were required by law; 42% of work sites with a policy reported offering smoking cessation assistance to their employees. Overall satisfaction and compliance with the smoking policy was high among work sites with a policy. The findings of this study have key implications for other small businesses considering implementing a smoking policy.
Journal of Occupational Medicine, Sep. 1991, Vol.33, No.9, p.980-984. 17 ref.
Erfurt J.C., Foote A., Heirich M.A.
The cost-effectiveness of work-site wellness programs for hypertension control, weight loss, and smoking cessation
The cost-effectiveness of work-site wellness programmes for reducing cardiovascular disease risks of employees was examined at 3 manufacturing plants. A fourth plant was used as a control site to estimate levels of risk reduction achieved from wellness screening and pre-existing services, without further interventions. The disease risks studied were hypertension, obesity, and cigarette smoking. Two of the 3 experimental sites were more effective and cost effective than the other, both in terms of engaging employees at risk of cardiovascular disease into treatment or programme participation and of reducing their risks or preventing relapse. Programme costs were held constant in this report for comparison across programme models.
Journal of Occupational Medicine, Sep. 1991, Vol.33, No.9, p.962-970. 29 ref.
The manager's role in employees' successful return to work following back injury
This study reports on the short-term effects of an educational programme for immediate supervisors on employees' back pain problems. The course was designed to help supervisors in dealing more effectively with employees returning to work after being treated for back pain. 47 supervisors who had personnel undergoing treatment for back pain problems were invited to attend a one-day course. This educational package consisted of information about back pain and stressed specific behaviours which supervisors could use to help their employees successfully return to work. The results showed that 78% of the supervisors found the course to be satisfactory enough to recommend it to a colleague without hesitation. It is concluded that an educational programme which alters specific supervisory behaviours may be an effective method of assisting return to work after treatment for back pain.
Work and Stress, July-Sep. 1991, Vol.5, No.3, p.189-195. Illus. 10 ref.
Workplace health system: The small business health model
Système de promotion de la santé en milieu de travail - Modèle pour les petites entreprises [en francés]
This overview describes the steps in establishing a health promotion programme in small businesses and answers the most common questions about the Small Business Health Model. Steps covered: orientation, getting organised, needs assessment, workplace health profile, small business health plan programme action plan, and progress review.
Health Promotion in the Workplace Unit, Health Promotion Directorate, Health and Welfare Canada, 4th Floor, Jeanne Mance Building, Tunney's Pasture, Ottawa, Ontario K1A 1B4, Canada, 1991. 12p.
Work-site health promotion: An economic model
A theoretical model of the economic effects of corporate health programmes is offered. The financial model presented views the firm as a value-maximising enterprise and evaluates health promotion as a use of corporate assets. The benefits and costs of a 7-year health promotion programme are projected under a variety of assumptions regarding the employee mix and the effects of the programme on health and productivity. The analysis reveals that the base case assumption results in a programme that creates value for the firm when the cost is less than USD 193 per participating employee per year. Firms with a highly productive, difficult to replace, and older employee group are most likely to find health promotion a good investment. Productivity gains produce the majority of the economic benefits. Effects on health care expense alone are projected to be relatively small. Gains from reduction in employee mortality or retiree health expense are found to be insignificant.
Journal of Occupational Medicine, Aug. 1991, Vol.33, No.8, p.868-873. 23 ref.
Cowles S.R., Bennett J.M., Ross C.E.
Medical surveillance for leukemia at a petrochemical manufacturing complex: Four-year summary
Four-year results are presented on 2086 participants of a medical surveillance programme of current and retired employees. Annual complete blood cell count testing and intensive follow-up of all out-of-normal range results began on a voluntary basis. The programme to date has not identified any evidence for an unusual distribution of out-of-range complete blood cell count results. Active employees with out-of-range count values had no increase in adverse health outcomes compared with those with in-range values. Retired employees with out-of-range values were more likely to have a serious underlying medical condition, but this appeared to be more a function of age than of occupational exposure. The lack of correlation of out-of-range complete blood cell count results in active employees with serious haematologic disease raises significant questions about the utility of such surveillance for chemically exposed groups when exposure levels are low and well controlled.
Journal of Occupational Medicine, July 1991, Vol.33, No.7, p.808-812. 8 ref.
Harris A.A., Daly-Gawenda D., Hudson E.K.
Vaccine choice and program participation rates when two hepatitis B vaccines are offered
Participation rates of health care workers in voluntary free hepatitis B virus immunisation programmes are 35% to 40%. University teaching hospital employees at risk for hepatitis B virus and presenting for immunisation were surveyed as to vaccine preference. Both plasma-derived and recombinant hepatitis B virus vaccines were available. During a 10-month period, 173 health care workers enrolled in the study. One hundred seventeen received recombinant vaccine, and 56 received plasma-derived vaccine; 66 were immunised post-exposure. Concern of a relationship of human immunodeficiency virus to hepatitis B virus plasma-derived vaccine was acknowledged by a small number of health care workers as important in vaccine selection. Recombinant hepatitis B virus vaccine rapidly and substantially supplanted plasma-derived vaccine but did not increase programme participation. It is suspected that mandatory immunisation or proof of immunity will be necessary if hepatitis B virus protection rates in health care workers are to improve.
Journal of Occupational Medicine, July 1991, Vol.33, No.7, p.804-807. 13 ref.
Brossard B., Durand P., Marquis S.
Management views of health promotion needs
Etude de besoins en matière de promotion de la santé - La perspective de dirigeants d'entreprises [en francés]
A questionnaire was administered to 52 high-ranking executives to study management views on health promotion needs. Executives listed anti-smoking, nutrition and physical activities as being the most beneficial health promotion areas to their enterprise and its employees. Twenty-five executives mentioned the profitability of their enterprise and 19 the improvement of employees' health as being their main reasons for undertaking such activities. Results from a logistic regression analysis showed individual characteristics of the enterprise to have an influence on the existence of worksite health promotion activities but not on the willingness of executives to collaborate in their implementation. It appears that these activities are considered justified by the majority of high-ranking officers interviewed but that many of them are reluctant to engage in such activities until efficiency criteria are established.
Travail et santé, Spring 1991, Vol.7, No.1, p.S-2 to S-9. Illus. 26 ref.
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