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Biomedical subjects

Derek R Smith

Publications and source records attributed to Derek R Smith.

At least 19 recordsLinked to original sources

A detailed analysis of musculoskeletal disorder risk factors among Japanese nurses.

INTRODUCTION: Although Musculoskeletal Disorders (MSD) represent a common occupational problem, few epidemiological studies have investigated MSD risk factors among Asian nurses, particularly those in Japan. METHOD: We administered a modified Japanese-language version of the Standardized Nordic Questionnaire to 1,162 nurses from a large teaching hospital. MSD categories focused on the neck, shoulder, upper back, and lower back regions. RESULTS: A total of 844 completed questionnaires were analyzed (response rate: 72.6%). The 12-month period-prevalence of MSD at any body site was 85.5%. MSD was most commonly reported at the shoulder (71.9%), followed by the lower back (71.3%), neck (54.7%), and upper back (33.9%). Alcohol consumption, tobacco smoking, and having children were shown to be significant risk factors, with adjusted Odds Ratios of 1.87 (95%CI: 1.17-2.96), 2.45 (95%CI: 1.43-4.35), and 2.53 (95%CI: 1.32-4.91), respectively. Workplace risk factors included manually handling patients (OR: 2.07 to 11.97) and undertaking physically laborious work (OR: 2.09 to 2.76). Nurses reporting pre-menstrual tension were 1.66 and 1.94 times more likely to suffer from lower back and upper back MSD, respectively. High mental pressure was also identified as a significant risk factor for MSD of the neck (OR: 1.53) and shoulder (OR: 2.07). IMPACT ON INDUSTRY: The complex nature of MSD risk factors identified during this study suggests that remediation strategies which focus only on manual handling tasks would probably be suboptimal in reducing MSD among nurses. Therefore, to help alleviate their considerable MSD burden, a greater emphasis will need to be placed on job satisfaction, work organization, and occupational stress, as well as the more traditional hazard reduction strategies such as manual handling, work tasks, and other occupational factors.

Adult↗

Needlestick and sharps injuries among a cross-section of physicians in Mainland China.

BACKGROUND: Although needlestick and sharps injuries (NSI) represent a significant occupational hazard for physicians worldwide, their epidemiology has not been previously examined in Mainland China. This study describes the prevalence, distribution, and risk factors for NSI among a cross-section of Chinese physicians. METHODS: Data was obtained by an anonymous, self-reporting survey administered to all 361 physicians at a university teaching hospital, during 2004. RESULTS: Seventy-nine percent of the physicians responded. Among them, 64% had experienced an NSI in the previous 12 months, 50.3% of which involved contaminated devices. By device, 22.8% were caused by hollow-bore syringe needles, 19.1% by suture needles, and 12.1% by scalpel blades. Surgical procedures accounted for 27.9% of all injuries. Only 15.3% of physicians had officially reported their NSI to management, of which 10% went unreported because the individual felt they were not unlucky enough to get a disease. A statistically significant correlation was demonstrated between NSI and working in the intensive care unit (adjusted odds ratio: 5.3, 95% CI: 1.7-23.4). CONCLUSIONS: Although this study suggests that NSI are an important workplace hazard for Chinese physicians, future measures should consider the unique cultural beliefs of Chinese people and its effect on preventive behaviors. The concept of "luck," and its relationship with NSI reporting in particular, may also need to be addressed.

Accidents, Occupational↗

Recent trends in ILO conventions related to occupational safety and health.

The present study was conducted to analyze the ratification status of International Labour Organization (ILO) conventions related to occupational safety and health (OSH) by ILO member states in terms of national indicators (length of ILO membership and national income status) and regional affiliation. 17 conventions designated as OSH-related by the 2003 International Labour Conference were examined. In general, countries with longer ILO membership ratified higher numbers of conventions related to OSH. With some variation, long-membership countries had the largest number of ratifications, followed by middle- and short-membership countries in all regions. There were also incremental increases in the number of ratifications for OSH-related conventions according to the national income status. Common regional characteristics that could not be explained by the factors studied also existed. Future efforts to increase ratification at an international level will need to consider the factors influencing ratification practice among the member states.

Congresses as Topic↗

Dermatitis and aircrew.

Dermatitis is a common problem both in the workplace and in the general community. Airline personnel represent a novel occupational group as they are also exposed to a wide range of potential chemical irritants and other aggravating factors, such as low relative humidity and airborne pollutants. Common skin irritants include dielectric fluids from electrodischarge machining, 'prepreg' materials and sealants in aircraft manufacture, kerosene and various jet-fuel components. Commercial jet fuel is a complex mixture of aliphatic and aromatic compounds, and there is potential for dermal exposure among refueling and maintenance crew. Low relative humidity appears to exacerbate dermatitis amongst aircrew, especially on longer flight durations. Pilots may also be exposed to additional skin irritants outside of the cabin environment, such as ethylene glycol, hydraulic fluid or jet fuel, all of which may be encountered during routine inspections of aircraft before and after flight. Given these factors, preventive measures must carefully consider the undoubted potential for contact with irritants and allergens, which may lead to dermatitis in airline personnel.

Air Pollution, Indoor↗

Tobacco smoking habits among a cross-section of rural physicians in China.

OBJECTIVE: To investigate the prevalence and distribution of tobacco smoking among rural Chinese physicians. DESIGN: A self-reporting survey adapted from previous international studies. SETTING: A teaching hospital in Hebei Province, China. SUBJECTS: A complete cross-section of 361 physicians working in all hospital departments. RESULTS: The overall response rate was 79.2%, among whom 15.7% (95% confidence interval (CI) 12.0-20.4) were current smokers and 1.0% ex-smokers (95% CI 0.4-3.1). There were no female smokers when stratified by sex, although the prevalence rate among male physicians was 31.9% (95% CI 24.8-40.0). The prevalence of smoking varied widely by hospital department, ranging from zero in the obstetrics and gynaecology department, to 32.6% in the surgical unit. Smoking rates also varied by age, with physicians younger than 25 years having the lowest prevalence (6.3%). Although they only accounted for 7.1% of the entire group by number, the highest smoking prevalence was seen among physicians aged 50-54 years (31.6%). CONCLUSIONS: Although our study suggests that smoking is an important health issue for rural Chinese physicians, the distribution of risk is not uniform. Future preventive measures will, therefore, need to consider the individual situation of physicians who smoke, particularly those in the older age groups.

Adult↗

Needlestick and sharps injuries among nurses in a tropical Australian hospital.

Although needlestick and sharps injuries (NSI) represent a major hazard in nursing practice, most studies rely on officially reported data and none have yet been undertaken in tropical environments. Therefore, we conducted a cross-sectional NSI survey targeting all nurses within a tropical Australian hospital, regardless of whether they had experienced an NSI or not. Our overall response rate was 76.7%. A total of 39 nurses reported 43 NSI events in the previous 12 months. The most common causative device was a normal syringe needle, followed by insulin syringe needles, i.v. needles or kits and blood collection needles. Half of the nurses' NSI events occurred beside the patient's bed: drawing up medication was the most common reason. Nurses working in the maternity/neonatal wards were only 0.3 times as likely to have experienced an NSI as their counterparts in the medical or surgical wards. Overall, our study has shown that NSI events represent an important workplace issue for tropical Australian nurses. Their actual rate might also be higher than official reports suggest.

Accidents, Occupational↗

Hand dermatitis among Korean nursing students.

We used a previously validated questionnaire survey, which was translated into Korean and given to 270 students from a university-based nursing school in Seoul. A total of 202 questionnaires were received. The students' hand dermatitis prevalence ranged from 6.9% in the first year to 22.9% in the fourth year. Logistic regression indicated that students with systemic allergies were 4.2 times as likely to suffer from hand dermatitis. Year of study and living arrangements were also shown to have statistically significant correlations with hand dermatitis. Overall, this study suggests that hand dermatitis might be less prevalent among Korean nursing students when compared with their international counterparts. However, the identification of systemic allergies as a significant risk factor was consistent with previous reports from other countries.

Adult↗

Prevalence of hand dermatoses related to latex exposure amongst dentists in Queensland, Australia.

OBJECTIVES: To investigate the epidemiology of hand dermatoses symptoms and allergies, particularly those that suggested possible latex allergy. METHODS: In 2004, a self-reporting questionnaire was mailed to a random sample of 400 dentists from the Queensland Branch of the Australian Dental Association. RESULTS: A total of 285 questionnaires (73.1%) were completed and returned. Of the respondents, 73.3% were male and 26.7% female, with a mean age of 45.2 years (SD = 11.9 years) of whom 89.1% were general dentists, the remainder being specialists. Almost one third (29.1%) had experienced symptoms of hand dermatoses at some stage during the previous 12 months, with 15.1% experiencing symptoms during the previous three weeks. The most common symptom or sign was dry and cracked hands or fingers (22.5%). Only 2.1% of dentists had been medically diagnosed with latex allergy. The most common symptom or sign following the use of latex products was dermatitis (11.2%). CONCLUSIONS: Overall, this study showed that occupational dermatoses constitute a major occupational health problem among dentists in Queensland, Australia. Symptoms appear to be reported at a similar prevalence to other studies in developed countries. The identification of atopic dermatitis as a significant risk factor again stresses the importance of allergic disease and its relationship with occupational skin conditions. Although reducing exposure to potential allergens and irritants is an important minimisation strategy, further research is needed to identify occupational and non-occupational factors associated with occupational dermatoses in dental personnel.

Adult↗

A comparison of tobacco smoking among dentists in 15 countries.

This study was conducted as a systematic review of all modern literature describing the prevalence and associations of tobacco smoking among dentists. A keyword search of appropriate MeSH terms was initially undertaken to identify relevant material. Reference lists of manuscripts were also examined to locate further publications. A total of 35 English-language studies published in the past 25 years met the inclusion criteria. Results suggest that the prevalence of smoking is generally quite low among dentists, and that it has also declined in many countries during recent years. The lowest rates were documented in the United States (USA), Thailand, Finland, Australia and Canada. When multiple studies were examined over time, it appears that dentists in Australia and the USA consistently report the lowest prevalence. Overall, this review suggests that dentists have one of the lowest smoking rates among all health professionals. There were a few exceptions however, namely Italy and Jordan, where dentists appear to be smoking at fairly high rates. Nevertheless, it is important that tobacco usage continues its decline in future years so that the dental profession may remain exemplars at the forefront of preventive oral care.

Australia↗

Hand dermatitis risk factors among clinical nurses in Japan.

The purpose of this study was to establish hand dermatitis (HD) risk factors among Japanese nurses. A questionnaire was administered to 1,162 clinical nurses, from whom 860 replies were received (response rate of 74.0%). Their overall HD prevalence was 53.3%. Several risk factors were identified: using latex gloves (odds ratio [OR] 1.9), allergies in adulthood (OR 2.7), urticaria as an adult (OR 1.5), atopic dermatitis as an adult (OR 2.7), any allergies to latex products (OR 5.2), skin irritation following contact with latex (OR 4.1), contact dermatitis following contact with latex (OR 3.5), family history of hay fever (OR 1.6), and family history of atopic dermatitis (OR 1.9). The use of hand cream was associated with a 50% reduction in HD risk (OR 0.5). In this study, we found that Japanese clinical nurses suffer a significant occupational burden from HD. As such, it is essential that hospital managers consider interventions to reduce this troublesome occupational disease among clinical nurses in Japan, as elsewhere.

Adult↗

24 years of pneumoconiosis mortality surveillance in Australia.

Asbestosis, silicosis and Coal Worker's Pneumoconiosis (CWP) represent three of the most important occupationally-related dust diseases in Australia. To gain a clear picture of pneumoconiosis trends over time, a 24-yr retrospective analysis of national mortality data was performed for the period 1979 to 2002. Over 1,000 pneumoconiosis-related fatalities occurred during this time, 56% of which were caused by asbestosis, 38% by silicosis and 6% by CWP. Between 1979 and 1981, silicosis accounted for 60% of all pneumoconiosis-related fatalities in Australia, followed by asbestosis (31%). By 2002 however, asbestosis was causing 78% of all fatalities, while silicosis accounted for only 19%. Asbestos-related mortality increased three-fold between 1979 and 2002, with a clear excess risk demonstrated among males. On the other hand, mortality rates for silicosis and CWP declined significantly during the same time period. Overall, this study suggests that pneumoconiosis, particularly asbestosis, continues to be an important occupational disease in Australia. Although progress has been made in reducing deaths due to occupational silicosis and CWP, asbestosis rates continue to rise, reflecting the long latency between dust exposure and clinical disease. Countries which continue to use asbestos products in the workplace should note the tragic legacy of this material within contemporary Australia.

Asbestos↗

Needlestick and Sharps Injuries among Australian medical students.

We investigated the prevalence and distribution of Needlestick and Sharps Injuries (NSI) among a group of Australian medical undergraduates from 4 consecutive grades. Data was obtained by means of an anonymous, self-reporting survey. A total of 254 questionnaires were obtained (response rate 97.3%). Among them, 35 students (13.8%) had suffered a total of 41 NSI incidents. By gender, 71.4% of the NSI reporters were female and 28.6% were male. NSI prevalence varied significantly with respect to students' year of study (P for Trend=0.0106), ranging from 7.3% in the 1st year to 26.8% in the 3rd year. Of the 41 NSI incidents, 29.2% were caused by a glass item, 24.4% by a hollow bore needle, 24.4% by another device and 22.0% by a surgical device. The distribution by causative device also varied from year to year. Overall, this study has shown that NSI represent an important hazard for Australian medical students. As such, the importance of intervention strategies to reduce NSI exposures must remain an essential facet of medical education, worldwide. Future preventive measures will also need to consider the unique situation of medical students in Australia, as elsewhere.

Australia↗

The historical development of occupational health in Australia Part 2: 1970-2000.

Australian occupational health was shaped by various social, political and economic forces during the latter half of the last century. An overall downturn in manufacturing and increased wage restraint during the early 1970s, encouraged trade unions to turn their attention to broader social issues, such as workplace health. Mainstream Australian society was also being influenced by wider community sentiment during this time, including anti-war protests, environmental lobby groups and the women's movement. Interest in occupational health subsequently flourished, with formalised education commencing in the 1970s, and the number of tertiary courses rapidly increasing throughout the 1980s. Occupational health and worker's compensation legislation similarly evolved throughout the latter stages of the twentieth century. Australian workplace health and safety is now based on a theory of self-regulation and managed in a tri-partite model, consisting of employers, trade unions and government departments. In Part 1 of our occupational health review, we outlined the historical development of Australian occupational health between 1788 and 1970. In the current paper, Part 2, we describe the historical development of Australian occupational health between 1970 and 2000.

Australia↗

Gas-phase ion-molecule reactions of metal-carbide cations MCn+ (M=Y and La; n=2, 4, and 6) with benzene and cyclohexane investigated by FTICR mass spectrometry and DFT calculations.

Yttrium- and lanthanum-carbide cluster cations YC(n)(+) and LaC(n)(+) (n = 2, 4, and 6) are generated by laser ablation of carbonaceous material containing Y(2)O(3) or La(2)O(3). YC(2)(+), YC(4)(+), LaC(2)(+), LaC(4)(+), and LaC(6)(+) are selected to undergo gas-phase ion-molecule reactions with benzene and cyclohexane. The FTICR mass spectrometry study shows that the reactions of YC(2)(+) and LaC(2)(+) with benzene produce three main series of cluster ions. They are in the form of M(C(6)H(4))(C(6)H(6))(n)(+), M(C(8)H(4))(C(6)H(6))(n)(+), and M(C(8)H(6))(C(6)H(6))(m)(+) (M = Y and La; n = 0-3; m = 0-2). For YC(4)(+), LaC(4)(+), and LaC(6)(+), benzene addition products in the form of MC(n)(C(6)H(6))(m)(+) (M = Y and La; n = 4, 6; m = 1, 2) are observed. In the reaction with cyclohexane, all the metal-carbide cluster ions are observed to form metal-benzene complexes M(C(6)H(6))(n)(+) (M = Y and La; n= 1-3). Collision-induced-dissociation experiments were performed on the major reaction product ions, and the different levels of energy required for the fragmentation suggest that both covalent bonding and weak electrostatic interaction exist in these organometallic complexes. Several major product ions were calculated using DFT theory, and their ground-state geometries and energies were obtained.

Journal Article↗

Hand dermatitis among nurses in a newly developing region of Mainland China.

Although hand dermatitis (HD) is a common occupational problem for nurses worldwide; few, if any, epidemiological studies of this disease have been conducted in Mainland China. Therefore, we administered a previously validated questionnaire to 306 nurses from a large teaching hospital in Shijiazhuang city, Hebei province. A total of 282 replies were received (92.2%). The 12-month period-prevalence of HD across hospital departments ranged from 14.3% to 23.8%, with an overall rate of 17.7%. Nurses with pre-existing atopic dermatitis were 5.3 times more likely to suffer from HD when compared to nurses without this condition (OR 5.3, 95% CI 2.0-14.2, P = 0.0009). Overall, our study suggests that HD is less common among Chinese hospital nurses when compared to their counterparts around the world. The identification of atopic dermatitis as a significant HD risk factor was, however, consistent with previous research.

Adult↗

Percutaneous exposure incidents among Australian hospital staff.

We investigated all reported Percutaneous exposure incidents (PEI) among staff from a large Australian hospital in the 3-year period, 2001-2003. There were a total of 373 PEI, of which 38.9% were needlestick injuries, 32.7% were cutaneous exposures and 28.4% sharps-related injuries. Nurses were the most commonly affected staff members, accounting for 63.5% of the total, followed by doctors (18.8%) and other staff (17.7%). Needlestick injuries were responsible for the majority of nurses' PEI (44.7%). Sharps injuries constituted the major category for doctors (44.3%). Most needlestick injuries (67.6%) were caused by hollow-bore needles, while the majority of cutaneous exposures involved blood or serum (55.8%). Most sharps injures were caused by unknown devices (35.9%) or suture needles (34.9%). Overall, our investigation suggests that PEI is a considerable burden for health care workers in Australia. Further research is now required to determine the relationships, if any, between workers who suffer PEI and those who do not.

Australia↗

Epidemiology of musculoskeletal symptoms among Korean hospital nurses.

We investigated the epidemiology of musculoskeletal symptoms (MSS) among a complete cross-section of 330 nurses from a large Korean hospital, by means of a questionnaire survey (response rate: 97.9%). The prevalence of MSS at any body site was 93.6%, with symptoms most commonly reported at the shoulder (74.5%), lower back (72.4%), neck (62.7%), lower legs (52.1%) and hand/wrist (46.7%). Logistic regression indicated that nurses who undertook manual handling of patients were 7.2 times as likely to report MSS (OR 7.2, 95%CI 1.2-42.3, P = .0275), while nurses suffering from periodic depression experienced a 3.3-fold MSS risk (OR 3.3, 95%CI 1.3-8.3, P = .0104). Overall, our study suggests that Korean nurses incur a very high MSS burden when compared internationally. A greater commitment is needed to improve physical conditions, occupational tasks and psychosocial work issues among nurses in this country.

Adult↗