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Biomedical subjects

Anthony D LaMontagne

Publications and source records attributed to Anthony D LaMontagne.

10 recordsLinked to original sources

Psychosocial and other working conditions in relation to body mass index in a representative sample of Australian workers.

BACKGROUND: The aim of the study was to examine the relationship between psychosocial and other working conditions and body-mass index (BMI) in a working population. This study contributes to the approximately dozen investigations of job stress, which have demonstrated mixed positive and negative results in relation to obesity, overweight and BMI. METHODS: A cross-sectional population-based survey was conducted among working Australians in the state of Victoria. Participants were contacted by telephone from a random sample of phone book listings. Information on body mass index was self-reported as were psychosocial work conditions assessed using the demand/control and effort/reward imbalance models. Other working conditions measured included working hours, shift work, and physical demand. Separate linear regression analyses were undertaken for males and females, with adjustment for potential confounders. RESULTS: A total of 1101 interviews (526 men and 575 women) were completed. Multivariate models (adjusted for socio-demographics) demonstrated no associations between job strain, as measured using the demand/control model, or ERI using the effort/reward imbalance model (after further adjustment for over commitment) and BMI among men and women. Multivariate models demonstrated a negative association between low reward and BMI among women. Among men, multivariate models demonstrated positive associations between high effort, high psychological demand, long working hours and BMI and a negative association between high physical demand and BMI. After controlling for the effort/reward imbalance or the demand/control model, the association between physical demand and working longer hours and BMI remained. CONCLUSION: Among men and women the were differing patterns of both exposures to psychosocial working conditions and associations with BMI. Among men, working long hours was positively associated with higher BMI and this association was partly independent of job stress. Among men physical demand was negatively associated with BMI and this association was independent of job stress.

Adolescent↗

Process evaluation of an integrated health promotion/occupational health model in WellWorks-2.

Disparities in chronic disease risk by occupation call for new approaches to health promotion. Well Works-2 was a randomized, controlled study comparing the effectiveness of a health promotion/occupational health program (HP/OHS) with a standard intervention (HP). Interventions in both studies were based on the same theoretical foundations. Results from process evaluation revealed that a similar number of activities were offered in both conditions and that in the HP/OHS condition there were higher levels of worker participation using three measures: mean participation per activity (HP: 14.2% vs. HP/OHS: 21.2%), mean minutes of worker exposure to the intervention/site (HP: 14.9 vs. HP/OHS: 33.3), and overall mean participation per site (HP: 34.4% vs. HP/ OHS: 45.8%). There were a greater number of contacts with management (HP: 8.8 vs. HP/OHS: 24.9) in the HP/ OHS condition. Addressing occupational health may have contributed to higher levels of worker and management participation and smoking cessation among blue-collar workers.

Diet↗

Assessment of occupational safety and health programs in small businesses.

BACKGROUND: Occupational safety and health (OSH) programs are a strategy for protecting workers' health, yet there are few peer-reviewed reports on methods for assessing them, or on the prevalent characteristics of OSH programs, especially in small businesses. METHODS: We adapted an occupational safety and health administration (OSHA) survey instrument to assess: management commitment and employee participation, workplace analysis, hazard prevention and control, and education and training. This was supplemented by a series of open-ended questions. We administered the survey in 25 small worksites. RESULTS: Scores for each element ranged widely, with distribution of most scores being positively skewed. Barriers to addressing OSH included lack of time and in-house expertise, and production pressures. External agents, including corporate parents, liability insurers, and OSHA, played an important role in motivating OSH programs. CONCLUSIONS: Small businesses were able to mount comprehensive programs, however, they may rely on outside resources for this task. Being small may not be a barrier to meeting the requirements of an OSHA program management rule.

Commerce↗

Long-term ethylene oxide exposure trends in US hospitals: relationship with OSHA regulatory and enforcement actions.

OBJECTIVES: We assessed long-term trends in ethylene oxide (EtO) worker exposures for the purposes of exposure surveillance and evaluation of the impacts of the Occupational Safety and Health Administration (OSHA) 1984 and 1988 EtO standards. METHODS: We obtained exposure data from a large commercial vendor and processor of EtO passive dosimeters. Personal samples (87,582 workshift [8-hr] and 46,097 short-term [15-min] samples) from 2265 US hospitals were analyzed for time trends from 1984 through 2001 and compared with OSHA enforcement data. RESULTS: Exposures declined steadily for the first several years after the OSHA standards were set. Workshift exposures continued to taper off and have remained low and constant through 2001. However, since 1996, the probability of exceeding the short-term excursion limit has increased. This trend coincides with a decline in enforcement of the EtO standard. CONCLUSIONS: Results indicate the need for renewed intervention efforts to preserve gains made following the passage and implementation of the 1984 and 1988 EtO standards.

Central Supply, Hospital↗

An exposure prevention rating method for intervention needs assessment and effectiveness evaluation.

This article describes a new method for (1) systematically prioritizing needs for intervention on hazardous substance exposures in manufacturing work sites, and (2) evaluating intervention effectiveness. We developed a checklist containing six unique sets of yes/no variables organized in a 2 x 3 matrix of exposure potential versus protection (two columns) at the levels of materials, processes, and human interface (three rows). The three levels correspond to a simplified hierarchy of controls. Each of the six sets of indicator variables was reduced to a high/moderate/low rating. Ratings from the matrix were then combined to generate a single overall exposure prevention rating for each area. Reflecting the hierarchy of controls, material factors were weighted highest, followed by process, and then human interface. The checklist was filled out by an industrial hygienist while conducting a walk-through inspection (N = 131 manufacturing processes/areas in 17 large work sites). One area or process per manufacturing department was assessed and rated. Based on the resulting Exposure Prevention ratings, we concluded that exposures were well controlled in the majority of areas assessed (64% with rating of 1 or 2 on a 6-point scale), that there is some room for improvement in 26 percent of areas (rating of 3 or 4), and that roughly 10 percent of the areas assessed are urgently in need of intervention (rated as 5 or 6). A second hygienist independently assessed a subset of areas to evaluate inter-rater reliability. The reliability of the overall exposure prevention ratings was excellent (weighted kappa = 0.84). The rating scheme has good discriminatory power and reliability and shows promise as a broadly applicable and inexpensive tool for intervention needs assessment and effectiveness evaluation. Validation studies are needed as a next step. This assessment method complements quantitative exposure assessment with an upstream prevention focus.

Adult↗

A comprehensive worksite cancer prevention intervention: behavior change results from a randomized controlled trial (United States).

OBJECTIVE: Workplace cancer prevention initiatives have been least successful with blue-collar workers. This study assesses whether an intervention integrating health promotion with occupational health and safety results in significant and meaningful increases in smoking cessation and consumption of fruits and vegetables, compared to a standard health promotion intervention, for workers overall and for blue-collar workers in particular. METHODS: A randomized controlled design was used, with 15 manufacturing worksites assigned to a health promotion (HP) or a health promotion plus occupational health and safety intervention (HP/OHS), and compared from baseline (1997) to final (1999). The response rates to the survey were 80% at baseline (n = 9019) and 65% at final (n = 7327). Both groups targeted smoking and diet; the HP/OHS condition additionally incorporated reduction of occupational exposures. RESULTS: Smoking quit rates among blue-collar workers in the HP/OHS condition more than doubled relative to those in the HP condition (OR = 2.13, p = 0.04), and were comparable to quit rates of white-collar workers. No statistically significant differences between groups were found for mean changes in fruits and vegetables. CONCLUSIONS: Integration of occupational health and safety and health promotion may be an essential means of enhancing the effectiveness of worksite tobacco control initiatives with blue-collar workers.

Adult↗

A comprehensive worksite cancer prevention intervention: behavior change results from a randomized controlled trial (United States).

OBJECTIVE: Workplace cancer prevention initiatives have been least successful with blue-collar workers. This study assess whether an intervention integrating health promotion with occupational health and safety results in significant and meaningful increases in smoking cessation and consumption of fruits and vegetables, compared to a standard health promotion intervention, for workers overall and for blue-collar workers in particular. METHODS: A randomized controlled design was used, with 15 manufacturing worksites assigned to a health promotion (HP) or a health promotion plus occupational health and safety intervention (HP/OHS), and compared from baseline (1997) to final (1999). The response rates to the survey were 80% at baseline (n = 9019) and 65% at final (n = 7327). Both groups targeted smoking and diet; the HP/OHS condition additionally incorporated reduction of occupational exposures. RESULTS: Smoking quit rates among blue-collar workers in the HP/OHS condition more than doubled relative to those in the HP condition (OR = 2.13, p = 0.04), and were comparable to quit rates of white-collar workers. No statistically significant differences between groups were found for mean changes in fruits and vegetables. CONCLUSIONS: Integration of occupational health and safety and health promotion may be an essential means of enhancing the effectiveness of worksite tobacco control initiatives with blue-collar workers.

Adult↗

Exposure databases and exposure surveillance: promise and practice.

Based on recent developments in occupational health and a review of industry practices, it is argued that integrated exposure database and surveillance systems hold considerable promise for improving workplace health and safety. A foundation from which to build practical and effective exposure surveillance systems is proposed based on the integration of recent developments in electronic exposure databases, the codification of exposure assessment practice, and the theory and practice of public health surveillance. The merging of parallel, but until now largely separate, efforts in these areas into exposure surveillance systems combines unique strengths from each subdiscipline. The promise of exposure database and surveillance systems, however, is yet to be realized. Exposure surveillance practices in general industry are reviewed based on the published literature as well as an Internet survey of three prominent industrial hygiene e-mail lists. Although the benefits of exposure surveillance are many, relatively few organizations use electronic exposure databases, and even fewer have active exposure surveillance systems. Implementation of exposure databases and surveillance systems can likely be improved by the development of systems that are more responsive to workplace or organizational-level needs. An overview of exposure database software packages provides guidance to readers considering the implementation of commercially available systems. Strategies for improving the implementation of exposure database and surveillance systems are outlined. A companion report in this issue on the development and pilot testing of a workplace-level exposure surveillance system concretely illustrates the application of the conceptual framework proposed.

Databases, Factual↗

Development and piloting of an exposure database and surveillance system for DOE cleanup operations. Department of Energy.

An industrial hygiene exposure database and surveillance system was developed in partnership between National Institute for Occupational Safety and Health (NIOSH)-funded independent investigators and practicing industrial hygienists at the Rocky Flats Environmental Technology Site (RFETS) in Golden, Colo. RFETS is a former U.S. Department of Energy nuclear weapons plant that is now in cleanup phase. This project is presented as a case study in the development of an exposure database and surveillance system in terms that are generalizable to most other industries and work contexts. Steps include gaining organizational support; defining system purpose and scope; defining database elements and coding; planning practical and efficient analysis strategies; incorporating reporting capabilities; and anticipating communication strategies that maximize the probability that surveillance findings will feed back to preventive applications. For each of these topics, the authors describe both general considerations as well as the specific choices made for this system. An important feature of the system is a two-tier task-coding scheme comprising 33 categories of task groups. Examples of grouped analyses of exposure data captured during the system pilot period demonstrate applications to exposure control, medical surveillance, and other preventive measures.

Databases, Factual↗

Norms and their relationship to behavior in worksite settings: an application of the Jackson Return Potential Model.

OBJECTIVES: To measure health norms and assess their influence on behavior among 2541 employees in 16 manufacturing worksites using an adapted Jackson's Return Potential Model (RPM). METHODS: Worksite-level norm intensity, crystallization, and normative power were calculated for several behaviors; linear regression analyses tested whether normative power was related to each health behavior. RESULTS: Norms about safe work practices and smoking were most intense; norms about safe work practices were most crystallized. Safe work practices and smoking held the highest normative power; healthy eating held the least normative power. CONCLUSIONS: Comparing norm characteristics across health behaviors leads to important leverage points for intervening to influence norms and improve worker health.

Data Collection↗