Biomedical subjects

D C Cole

Publications and source records attributed to D C Cole.

At least 19 recordsLinked to original sources

PubMed2004

A multi-method approach to assessing deadlines and workload variation among newspaper workers.

OBJECTIVES: Working under frequent deadlines was previously found to be associated with upper limb work-related musculoskeletal disorders (WMSDs) in newspaper workers. Further investigation was required so that concrete recommendations for change could be offered to the workplace parties (labour and management of a large metropolitan newspaper). STUDY DESIGN: The assessment was based on three methods. A questionnaire was used to clarify time-related aspects of work on deadlines for a larger group of workers. Experience sampling was used to document temporal variation in various aspects of physical and psychological demands over work shifts and deadline cycles. Focus groups were also conducted. RESULTS: Differences were found between the "High" and "Low" deadline groups: Those working with frequent deadlines more frequently were required: to work together with others, to perform tasks on a specific schedule and specific order, to work at a fast paced, to perceive their work as hectic and "hard". Experience sampling showed differential trends in workload across daily, weekly, and no deadline days. The lack of breaks for extended periods of time leading up to a deadline was noticeable. The focus groups were useful in highlighting issues not addressed by the other two methods and to understand the feasibility of various possible interventions. CONCLUSIONS: The integration of results from all methods lead to recommendations for issues upon which to focus prevention related activities where deadlines are present: delays in work flow from others, interruptions from technology related problems, excessive work, insufficient staff/insufficient time, extra/unexpected work, compromising of work quality for speed, and lack of time for breaks.

Cumulative Trauma Disorders↗

PubMed2003

Early prognostic factors for duration on temporary total benefits in the first year among workers with compensated occupational soft tissue injuries.

AIMS: To develop a model of prognosis for time receiving workers' compensation wage replacement benefits in the first year. METHODS: A prospective cohort of 907 injured workers off work because of soft tissue injuries was followed for one year through structured telephone interviews and administrative data sources. Workers were recruited at workers' compensation claim registration. Only those still off work at four weeks post-registration were included in the analysis. Data from several domains (demographics, clinical factors, workplace factors, recovery expectations) were collected at approximately two weeks and a subset again at four weeks. Outcome was duration on total temporary wage replacement benefits. Variable selection was carried out in two steps using content experts and backward elimination with the Cox model. RESULTS: Body region specific functional status, change in pain, workplace offers of arrangements for return to work, and recovery expectations were independently predictive of time on benefits. Change in pain and workplace offers interacted, so the largest mutual association occurred for those whose pain was getting worse-that is, reduction in median duration from 112.5 to 32.5 days. Across observed values, widely different recovery profiles of groups of workers resulted; for example, at four months, only one third of the highest risk group had gone off benefits while over 95% of the lowest risk group had done so. CONCLUSIONS: Focus on a relatively small set of prognostic factors should enable occupational health practitioners to triage injured workers within the first month and concentrate on those requiring additional assistance to return to work.

Accidents, Occupational↗

PubMed2001

Does how you do depend on how you think you'll do? A systematic review of the evidence for a relation between patients' recovery expectations and health outcomes.

BACKGROUND: Most clinicians would probably agree that what patients think will happen can influence what does happen over the clinical course. Yet despite useful narrative reviews on expectancy of therapeutic gain and the mechanisms by which expectancy can affect health outcomes, we were unable to locate a systematic review of the predictive relation between patients' recovery expectations and their health outcomes. METHODS: We searched MEDLINE for English-language articles published from 1966 to June 1998 with a title or abstract containing at least 1 of the medical subject headings (MeSH) "self-assessment," "self-concept" or "attitude to health," or the MeSH subheading "psychology," and at least 1 word from each of 3 sets: "patient" and similar words; a form of "expectation," "belief" or "prediction"; and a form of "recover," "outcome," "survival" or "improve." Relevant articles contained original research data, measured patients' recovery expectations, independently measured a subsequent health outcome and analyzed the relation between expectations and outcomes. We assessed internal validity using quality criteria for prognostic studies based on 6 categories (case definition; patient selection; extent of follow-up; objective outcome criteria; measurement and reporting of recovery expectations; and analysis). RESULTS: A total of 1243 titles or abstracts were identified through the computer search, and 93 full-text articles were retrieved. Forty-one of these articles met the relevance criteria, along with 4 additional articles identified through other means. Agreement beyond chance on quality assessments of 18 randomly selected articles was high (kappa = 0.87, p = 0.001). Sixteen of the 45 articles provided moderate-quality evidence and included a range of clinical conditions and study designs; 15 of the 16 showed that positive expectations were associated with better health outcomes. The strength of the relation depended on the clinical conditions and the measured used. INTERPRETATION: Consistency across the studies reviewed and the evidence they provided support the need for clinicians to clarify patients' expectations and to assist them in having appropriate expectations of recovery. The understanding of the nature, extent and clinical implications of the relation between expectations and outcomes could be enhanced by more conceptually driven and methodologically sound research, including evaluations of intervention effectiveness.

Humans↗

PubMed2001

Environmental risk and (re)action: air quality, health, and civic involvement in an urban industrial neighbourhood.

This paper explores the links between (perceived) environmental risk and community (re) action in an urban industrial neighbourhood in Hamilton, Ontario, Canada. In-depth interviews were conducted with residents of an area with a documented history of adverse air quality, in order to determine the relative influence of social capital (networks, norms, and social trust) and place attachment (sense of belonging in a neighbourhood) in deciding to take civic action around this particular environmental issue. The interviews illustrate the complexity of lay understandings of air pollution, and indicate that social capital is a primary contributor to the decision to take certain kinds of action, while attachment to place plays a lesser role.

Adult↗

PubMed2001

Health care utilization and workplace interventions for neck and upper limb problems among newspaper workers.

Data on the use of various therapeutic interventions among working populations at risk for musculoskeletal disorders are rare, despite the need for such information in assessing adherence to best practices. Using the results of a cross-sectional survey of newspaper workers who reported neck and upper limb pain or discomfort (n = 309), we describe the prevalence of a wide range of clinical and workplace interventions. Information/education, exercises, and physical treatments were the most common interventions, and work changes were less prevalent. Those with more frequent, longer-duration, and/or more severe symptoms more commonly reported visits to physiotherapists and health practitioners at work and use of physical treatments, medications, and devices. The multiplicity of interventions used pose evaluation challenges for occupational health practitioners and researchers.

Adult↗

PubMed2001

Modified work: prevalence and characteristics in a sample of workers with soft-tissue injuries.

Modified-work programs are designed to facilitate the return to work for employees with a work-related injury. Although extensive published literature exists that describes and evaluates "ideal" programs, to date there is a paucity of data describing practice. To address this pertinent issue, we administered a survey to a large sample of 1833 workers with soft-tissue injuries in Ontario, Canada, and asked them detailed questions about modified work and employer contact. Our results reveal that most workers (66%) were contacted by someone from their workplace to check on how they were doing. However, only a minority (36%) were offered arrangements by their employer to help them return to work after developing a work-related soft-tissue injury. Most arrangements that were offered to injured workers consisted of such temporary modifications as reduced hours (24%), flexible work hours (25%), or a lighter job (57%) rather than more permanent changes to the way that work is conducted, such as changes to the work layout or equipment (8%). Merely being contacted by the workplace to check on how the worker was doing was not associated with reduced compensation benefit duration. Workplace offers of arrangements to help the worker return to work were associated with reduced compensation benefit duration but were not statistically associated with workers' pain grade.

Disability Evaluation↗

PubMed2001

Work correlates of back problems and activity restriction due to musculoskeletal disorders in the Canadian national population health survey (NPHS) 1994-5 data.

OBJECTIVES: To describe the prevalence of musculoskeletal problems in the Canadian working population and to determine cross sectional associations between such problems and work factors, particularly job strain and physical demand variables. METHODS: The Canadian 1994 national population health survey (NPHS) sampled 4230 working men and 4043 working women (ages 18-64) who answered an abbreviated version of the job content questionnaire. Workers were classified into four strain categories: high, passive, active, and low. Outcomes were restricted activity due to musculoskeletal disorders and the diagnosis of a back problem (both yes or no). Survey weights were incorporated to allow for different probabilities of selection. Logistic regression analyses were carried out separately for women and men, controlling for sociodemographic factors. RESULTS: Prevalence of chronic back problems diagnosed by a health practitioner was 14.5% among men and 12.5% among women. Men had a 6.6% prevalence of restricted activity due to musculoskeletal disorders, whereas the corresponding figure for women was 5.3%. Women, but not men, in high strain jobs were more likely to report both back problems (odds ratio (OR) 1.60, 95% confidence interval (95% CI) 1.14 to 2.28) and restricted activity (OR 1.98, 95% CI 1.16 to 3.48) compared with those in low strain jobs. High physical exertion was an independent predictor of back problems in both sexes. For both men and women, low social support at work and high job insecurity were independent predictors of restricted activity due to musculoskeletal disorders. Conversely, chronic back problems contributed to explanation of high job strain among women (OR 1.76, 95% CI 1.30 to 2.39) and high physical exertion among men (OR 1.39, 95% CI 1.09 to 1.77), whereas restricted activity due to musculoskeletal disorders contributed to explanation of high job insecurity in both sexes. CONCLUSIONS: Associations of interest between work stressors and musculoskeletal problems in this cross sectional study provide evidence for physical and psychosocial factors both affecting disability and being affected by disability in a working population.

Activities of Daily Living↗

PubMed2001

Job strain and self-reported health among working women and men: an analysis of the 1994/5 Canadian National Population Health Survey.

This paper explores the associations, for working women and men, of high strain jobs with self-rated health in the 1994/95 Canadian National Population Health Survey (NPHS). NPHS data were obtained on men (n = 4230) and women (n = 4043), aged 18-64 who answered an abbreviated version oF the job content questionnaire (JCQ). Using the upper and lower tertiles of psychological demands and decision latitude as cut points we classified workers into high strain and other jobs. Self-rated health was the outcome. We used polytomous logistic regression analyses and controlled for potential personal and home confounders; two risk parameters were estimated: for the odds of reporting poor/fair and good health both vs. very good/excellent health. High strain work was reported by 11% of women and 9% of men. After adjusting for potential confounders, high job strain was consistently associated with worse self-rated health in both models for each gender.

Adolescent↗

PubMed2000

Economic burden of illness from pesticide poisonings in highland Ecuador.

Active surveillance of acute pesticide poisonings in a potato-growing region of highland Ecuador during 1991-1992 uncovered a rate of 171/100,000, due predominantly to occupational exposures to organophosphate and carbamate pesticides. Occupational exposure among agricultural workers was the most common reason for poisoning (32 male workers and 1 female worker, out of a total of 50 cases). Of these 33 cases, 28 of them reported pesticide application as the work task just prior to poisoning, with over 80% citing the use of World Health Organization Hazard Category I pesticides. The suicide rate of 17.1/100,000 and the overall mortality rate of 20.5/100,000 that we found are among the highest reported anywhere in the world. At the exchange rates prevailing at that time, median costs associated with these poisonings were estimated as follows: public and social security health care direct costs of US$ 9.85/case; private health costs of US$ 8.33/case; and lost-time indirect costs of US$ 8.33/agricultural worker. Each one of those costs was over five times the daily agricultural wage, which was then about US$ 1.50. Further costing of pesticide poisonings should be carried out in other settings to provide appropriate information for decisions about pesticide use. In addition, integrated pest management should be further evaluated as an appropriate technology to reduce the economic burden of illness from pesticide poisonings in developing countries.

Animals↗

PubMed1999

Blood PCB, p,p'-DDE, and mirex levels in Great Lakes fish and waterfowl consumers in two Ontario communities.

PCB, p,p'-DDE, and mirex levels were examined in blood plasma samples of 232 anglers from Cornwall and Mississauga, Ontario, in a pilot study to establish the feasibility and suitability of using a cohort of Ontario fish license holders for large-scale health studies. Great Lakes fish, waterfowl, and ocean fish consumption were examined as predictors of contaminant levels using regression analysis, with adjustment for age, gender, and community. Levels of Great Lakes fish and waterfowl consumption and contaminant levels were generally low in comparison with those observed in other Great Lakes studies. However, even within these low levels, Great Lakes fish consumption was associated with increased blood plasma PCB levels in men and mirex levels in both men and women. Waterfowl consumption was associated with higher plasma PCB (men and women), DDE (men only), and mirex levels (men and Cornwall women), and requires further exploration. We conclude that other study designs are required (to identify high consumers) for carrying out studies of health effects associated with high levels of Great Lakes fish and waterfowl consumption.

Adult↗

PubMed1999

The power of perception: health risk attributed to air pollution in an urban industrial neighbourhood.

This paper describes a multi-stakeholder process designed to assess the potential health risks associated with adverse air quality in an urban industrial neighborhood. The paper briefly describes the quantitative health risk assessment conducted by scientific experts, with input by a grassroots community group concerned about the impacts of adverse air quality on their health and quality of life. In this case, rather than accept the views of the scientific experts, the community used their powers of perception to advantage by successfully advocating for a professionally conducted community health survey. This survey was designed to document, systematically and rigorously, the health risk perceptions community members associated with exposure to adverse air quality in their neighborhood. This paper describes the institutional and community contexts within which the research is situated as well as the design, administration, analysis, and results of the community health survey administered to 402 households living in an urban industrial neighborhood in Hamilton, Ontario, Canada. These survey results served to legitimate the community's concerns about air quality and to help broaden operational definitions of 'health.' In addition, the results of both health risk assessment exercises served to keep issues of air quality on the local political agenda. Implications of these findings for our understanding of the environmental justice process as well as the ability of communities to influence environmental health policy are discussed.

Air Pollution↗

PubMed1998

Indicators of human health in ecosystems: what do we measure?

Increasingly, scientists are being called upon to assist in the development of indicators for monitoring ecosystem health. For human health indicators, they may draw on environmental exposure, human morbidity/mortality or well-being and sustainability approaches. To improve the rigour of indicators, we propose six scientific criteria for indicator selection: (1) data availability, suitability and representativeness (of populations), (2) indicator validity (face, construct, predictive and convergent) and reliability; (3) indicator responsiveness to change; (4) indicator desegregation capability (across personal and community characteristics); (5) indicator comparability (across populations and jurisdictions); and (6) indicator representativeness (across important dimensions of concern). We comment on our current capacity to adhere to such criteria with examples of measures of environmental exposure, human health and sustainability. We recognize the considerable work still required on documenting environment-human health relationships and on monitoring potential indicators in similar ways over time. Yet we argue that such work is essential in order for science to inform policy decisions which affect the health of ecosystems and human health.

Biomarkers↗

PubMed1998

Assessment of peripheral nerve function in an Ecuadorian rural population exposed to pesticides.

To explore the peripheral nervous system effects of regular agricultural pesticide use, a cross-sectional survey was conducted in highland Ecuador. Participants were 144 occupationally exposed farm members, 30 female farm members with little direct exposure, and 72 unexposed local town residents, frequency matched to the exposed people on age, sex, and education. Organophosphorus and carbamate insecticides and dithiocarbamate fungicides accounted for the majority of pesticide applications, with leaking backpack sprayers, minimal use of personal protective equipment, and frequent dermal contact being the norm. In polytomous logistic regression analyses, applicators had significantly greater odds for more current peripheral nerve symptoms (odds ratio OR = 3.1), signs of poor coordination (OR = 4.3), abnormal deep tendon reflexes (OR = 2.9), and reduced power (OR = 2.1) compared to controls. Mean toe vibration threshold scores, on a logarithmic scale, were significantly higher among applicators (beta = 0.035) and those reporting previous pesticide poisonings (beta = 0.074). Such indicators of peripheral nervous system effects may be due to a variety of factors, including high pesticide exposure conditions.

Adult↗

PubMed1998

Perspectives on prognosis of soft tissue musculoskeletal disorders.

This paper reflects on the state of evidence related to the prognosis of soft tissue musculoskeletal disorders. Prediction of the likely clinical course, duration and outcomes for individuals with such disorders is an important task of rehabilitation clinicians. Criteria used to evaluate the validity of evidence on prognosis are reviewed. Application of these criteria to the literature on three soft tissue disorders reveals methodological weaknesses in the majority of existing studies. Yet strengthening the rigour of future research according to clinical epidemiological criteria may not capture the important factors which prolong disability in individuals with soft tissue injuries. Specific considerations related to case definitions, prognostic factors, study design, conceptual frameworks and study setting are recommended.

Disability Evaluation↗

PubMed1998

On PMWs and two-stroke engines.

On Saturday, August 24, 1996, a 40-year-old man from Edmonton was riding a personal motorized watercraft (PMW, a Seadoo or Jet Ski type of machine) on Shuswap Lake, in south-central British Columbia. He was approximately 200 m offshore. The man motioned to his sister, who was riding another PMW, to follow him across the lake. She did so, but as the turned her head to check for other boat traffic, her brother suddenly slowed down and her machine rode right up on his back, crushing him against his handlebars. His sister, a nurse, held her brother's head above water until help arrived but, 48 minutes after the moment of impact, he was pronounced dead at the Shuswap Lake General Hospital. He had suffered a ruptured aorta.

Accident Prevention↗

PubMed1997

Upper limb work-related musculoskeletal disorders among newspaper employees: cross-sectional survey results.

At a metropolitan newspaper office in Canada with extensive video display terminal (VDT) use, researchers carried out a survey (n = 1,007, 84% response) to establish baseline prevalence of work-related musculoskeletal disorders (WMSDs) and to identify demographic, postural, task, and psychosocial factors associated with WMSD symptoms. One-fifth of the respondents reported moderate or worse upper limb pain recurring at least monthly or lasting more than a week over the previous year. Logistic regression showed that employees who faced frequent deadlines and high psychological demands (fast work pace and conflicting demands), had low skill discretion and social support, spent more time keyboarding, or who had their screen in a non-optimal position were more likely to report moderate to severe symptoms. Women reported significantly higher levels of symptoms than men.

Adult↗

PubMed1997

Dermatitis in Ecuadorean farm workers.

Using a cross-sectional survey of potato farm workers in northern Ecuador, we examined the relationship between pesticide exposure and skin disorders. From a farm population census, all pesticide applicators and 1/2 of exposed field workers were selected. Controls were age-matched from urban occupations. Individual exposure measures included overall years and current hours working with pesticides. Farm-level measures included numbers of applications over the last 6 months and an application practices score (range 0-4). Each participant underwent a clinical skin examination, with patch tests to maneb on a sample of dermatitis cases. Exposure-related increases in conjunctivitis (7% of applicators, 0% in other groups), dermatitis (68% of exposed and 55% of applicators versus 31% of controls, p < 0.001) and pigmentation disorders (25% of exposed and applicators vs 10% controls, p = 0.06) were found. Among dermatitis cases (n = 117), 5% were positive to maneb on patch testing. In logistic regression analysis, significant predictors (p < 0.1) of dermatitis included years using fungicides (OR = 1.12 per year) and poor application practices (OR = 1.42 per score unit). Agricultural fungicide application in high-exposure situations can contribute to dermatitis prevalence among farm populations.

Adult↗

PubMed1996

Design, synthesis, and biological activity of a potent inhibitor of the neuropeptidase N-acetylated alpha-linked acidic dipeptidase.

A series of substituted phosphonate derivatives were designed and synthesized in order to study the ability of these compounds to inhibit the neuropeptidase N-acetylated alpha-linked acidic dipeptidase (NAALADase). The molecules were shown to act as inhibitors of the enzyme, with the most potent (compound 3) having a Ki of 0.275 nM. The potency of this compound is more than 1000 times greater than that of previously reported inhibitors of the enzyme. NAALADase is responsible for the catabolism of the abundant neuropeptide N-acetyl-aspartylglutamate (NAAG) into N-acetylaspartate and glutamate. NAAG has been proposed to be a neurotransmitter at a subpopulation of glutamate receptors; alternatively, NAAG has been suggested to act as a storage form of synaptic glutamate. As a result, inhibition of NAALADase may show utility as a therapeutic intervention in diseases in which altered levels of glutamate are thought to be involved.

Acetylation↗