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Biomedical subjects

David Gimeno

Publications and source records attributed to David Gimeno.

7 recordsLinked to original sources

Occupational risk factors and asthma among health care professionals.

RATIONALE: Recent U.S. data suggest an increased risk of work-related asthma among health care workers, yet only a few specific determinants have been elucidated. OBJECTIVES: To evaluate associations of asthma prevalence with occupational exposures in a cross-sectional survey of health care professionals. METHODS: A detailed questionnaire was mailed to a random sample (n=5,600) of all Texas physicians, nurses, respiratory therapists, and occupational therapists with active licenses in 2003. Information on asthma symptoms and nonoccupational asthma risk factors obtained from the questionnaire was linked to occupational exposures derived through an industry-specific job-exposure matrix. MEASUREMENTS: There were two a priori defined outcomes: (1) physician-diagnosed asthma with onset after entry into health care ("reported asthma") and (2) "bronchial hyperresponsiveness-related symptoms," defined through an 8-item symptom-based predictor. MAIN RESULTS: Overall response rate was 66%. The final study population consisted of 862 physicians, 941 nurses, 968 occupational therapists, and 879 respiratory therapists (n=3,650). Reported asthma was associated with medical instrument cleaning (odds ratio [OR], 2.22; 95% confidence interval [CI], 1.34-3.67), general cleaning (OR, 2.02; 95% CI, 1.20-3.40), use of powdered latex gloves between 1992 and 2000 (OR, 2.17; 95% CI, 1.27-3.73), and administration of aerosolized medications (OR, 1.72; 95% CI, 1.05-2.83). The risk associated with latex glove use was not apparent after 2000. Bronchial hyperresponsiveness-related symptoms were associated with general cleaning (OR, 1.63; 95% CI, 1.21-2.19), aerosolized medication administration (OR, 1.40; 95% CI, 1.06-1.84), use of adhesives on patients (OR, 1.65; 95% CI, 1.22-2.24), and exposure to a chemical spill (OR, 2.02; 95% CI, 1.28-3.21). CONCLUSIONS: The contribution of occupational exposures to asthma in health care professionals is not trivial, meriting both implementation of appropriate controls and further study.

Asthma↗

Certification of occupational diseases as common diseases in a primary health care setting.

BACKGROUND: It is often difficult to discern whether a disease is an occupational or common disease, especially in a primary care setting. METHODS: From a randomly selected sample of 322 workers attending a Primary Health Care Center, 207 workers (response rate of 64.3%) agreed to participate. An occupational questionnaire was administered. General practitioners provided medical records for each worker. Medical records and occupational questionnaires were independently reviewed by three professionals. They assessed whether a relationship between disease and working conditions was probable or improbable. RESULTS: Thirty-three of the 207 cases (15.9%) were considered probably related to working conditions according to the expert's opinion. The most frequent were musculoskeletal diseases (20 cases). Of the 207 workers, 74 (35.7%) judged that their diseases could be related to their working conditions. CONCLUSIONS: A significant proportion of diseases attended in primary care setting was not recognized as occupational, and they were hence not reflected in official statistics.

Adult↗

Types of employment and health in the European union: changes from 1995 to 2000.

BACKGROUND: This study compares associations between types of employment and health indicators in the Second (ES1995) and the Third European Survey on Working Conditions (ES2000) by gender, adjusting for individual and country-level confounders. METHODS: Two cross-sectional surveys of a representative sample of the European Union (EU) total active population (n=15,146 workers in ES1995 and n=21,703 workers in ES2000). Based on their comparability in both surveys four health indicators were considered: job dissatisfaction, stress, fatigue and backache. RESULTS: Non-permanent employment reported high percentages of job dissatisfaction but low levels of stress. Small employers were more likely to report fatigue and stress but less likely to report job dissatisfaction. Sole traders were more likely to report fatigue and backache. Workers in full-time employment almost always reported worse levels of health indicators than part-time. Two exceptions for part-time were found: temporary employment regarding job dissatisfaction, and in ES2000, sole traders with regard to job dissatisfaction, fatigue and backache. By and large, results by gender were similar in both surveys, although the magnitude of associations decreased in ES2000. Associations remained unchanged after adjustment. CONCLUSION: This study has compared for the first time the associations between various types of employment and four health indicators for the EU in ES1995 and ES2000, by gender. Overall, a slight increase in all health indicators was observed in the ES2000 compared to ES1995, and results were very consistent between both surveys. Similar findings in both surveys suggest that causal interpretation may be enhanced.

Adolescent↗

Psychosocial factors and work related sickness absence among permanent and non-permanent employees.

STUDY OBJECTIVE: To examine the association between psychosocial work factors and work related sickness absence among permanent and non-permanent employees by sex. DESIGN: A cross sectional survey conducted in 2000 of a representative sample of the European Union total active population, aged 15 years and older. The independent variables were psychological job demands and job control as measures of psychosocial work environment, and work related sickness absence as the main outcome. Poisson regression models were used to compute sickness absence days' rate ratios. SETTING: 15 countries of the European Union. PARTICIPANTS: A sample of permanent (n = 12 875) and non-permanent (n = 1203) workers from the Third European Survey on Working Conditions. RESULTS: High psychological job demands, low job control, and high strain and passive work were associated with higher work related sickness absence. The risks were more pronounced in non-permanent compared with permanent employees and men compared with women. CONCLUSIONS: This work extends previous research on employment contracts and sickness absence, suggesting different effects depending on psychosocial working conditions and sex.

Adolescent↗

External validation of psychological job demands in a bus driver sample.

Psychosocial risk factors have been considered as characteristics of the work environment rather than an individual issue, but their presence in the workplace is usually measured by self-reported questionnaires, based on worker attitudes. The objective of the study was to compare a self-reported measure of psychological job demands in a bus driver sample with selected indicators of bus company activity, as external 'objective' indicators, in order to assess its external validity. The final sample included 713 drivers in 41 routes. Self-reported measures of psychosocial work risk factors were obtained by the Job Content Questionnaire (JCQ). Four external indicators were available for each route: passengers, break times, bus incidents, and regulating actions. Spearman's correlation coefficient was estimated to assess the validity. Correlation coefficients showed that self-reported psychological demands were statistically significant correlated (p<0.05) with two external indicators: bus incidents (rho=0.397), and regulating actions (rho=0.475). Self-reported psychosocial risk factors have been compared with independent external indicators of the psychosocial work environment, trying to avoid any subject's perception. According to our results, psychological demands measured by the JCQ seem to reflect the actual psychosocial work environment. Other studies are necessary to confirm these results and to assess job control and job social support. This would be another step in improving our knowledge of the quality of measurement of psychosocial risk factors.

Adult↗

Funding of pilot projects in Latin America: a tool for capacity building in occupational health research.

There is a global need for trained researchers who can address the increasing burden of illness and injury and prepare future generations of researchers. Developing countries have a special need for practical, action-oriented interventions to address workplace problems, based on identification of needs and priorities, development of locally available solutions, and consideration of the sociopolitical context of work and how best to translate research findings into policies. Effective translation and application of research products from industrialized nations to developing countries is essential, but differences in the contexts and local realities of other nations limit extrapolating such research. Funding pilot research projects in developing countries is an effective, practical, and useful tool for training new investigators in research techniques and developing collaborative relationships among countries.

Financing, Organized↗