Hand dermatitis among a complete cross-section of Chinese physicians.
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Allergens↗
Biomedical subjects
Derek R Smith
Publications and source records attributed to Derek R Smith.
Needlestick and sharps injuries among nursing students.
AIMS: This paper reports the first investigation of the prevalence and nature of needlestick injuries among Australian nursing students. BACKGROUND: Needlestick and sharps injuries are the most efficient method of transmitting blood-borne pathogens between patients and healthcare staff. Although nurses are known to be a high-risk subgroup for these events, nursing students may be at even greater risk due to their limited clinical experience. Despite this fact, the epidemiology of needlestick and sharps injuries among nursing students has not been clearly elucidated in Australia. METHODS: A questionnaire-based methodology adapted from other international investigations was conducted among nursing students. We recruited a complete cross-section of students from a large university nursing school in North Queensland, Australia, in March 2004, and analysed needlestick and sharps events as a percentage of all students and also as a proportion of all cases. Risk factors were evaluated using logistic regression. RESULTS: From a group of 319 students, 274 successfully completed questionnaires were obtained (overall response rate 85.9%). A total of 38 students (13.9%) reported a needlestick or sharps injury during the previous 12 months. By causative item, 6.2% of students had been injured by a normal hollow-bore syringe needle, 3.6% by a glass item and 3.3% by an insulin syringe needle. Regarding prior usage, 81.6% of all injuring items were unused, 15.8% had been used on a patient and the status of 2.6% was unknown. Most needlestick injuries occurred either in the nursing laboratory (45%) or the teaching hospital (37%). Opening the needle cap was the most common causative event (28% of all cases). A total of 39.5% of needlestick injuries were not reported. The main reason for non-reporting was that the item was unused (42%). Logistic regression analysis revealed that students in the third year were 14.8 times more likely to have experienced a needlestick injury than their counterparts in other years (odds ratio 14.8, 95% confidence interval 5.2-50.3, P < 0.01). These injury rates were higher among Australian nursing students than in other international studies. CONCLUSIONS: Although hepatitis B vaccination coverage among the students was excellent, it is important that the principles of infection-control training and reporting of all needlestick and sharps continue to be emphasized throughout undergraduate nursing education.
Adult↗
Tobacco use among public health professionals in Beijing: the relationship between smoking and education level.
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China↗
Pioneering figures in medicine: Albert Bruce Sabin--inventor of the oral polio vaccine.
Over ten years after his death, the Sabin oral vaccine continues its profound influence on public health throughout the world. The annual incidence of polio has fallen dramatically since its introduction, with more than 300,000 lives being spared each year and an annual global saving in excess of 1 billion US dollars. In many ways, the development of an effective oral vaccine and its subsequent regulation by the World Health Organization can serve as a model for medical researchers. Our review describes the contribution of Albert Sabin as a medical researcher, and how his vaccine had a profound impact on the global reduction of polio infections. As many different factors influenced health-care last century, we describe Sabin's involvement with respect to prevailing scientific paradigms and public health issues of the time. Our paper also outlines the basic epidemiology of poliovirus and the historical development of an effective vaccine, both with and without Albert Sabin.
History, 20th Century↗
Musculoskeletal disorders among Chinese medical students.
We investigated the prevalence and distribution of Musculoskeletal Disorders (MSD) among Chinese medical students, by means of a questionnaire survey. A total of 207 questionnaires were successfully returned, giving a high response rate of 92.4%. The MSD period-prevalence at any body site was 67.6% in the previous year and 46.9% in the previous week. Almost one-third of them (31.9%), reported an ongoing MSD. By individual body site, the most commonly affected region was the lower back (40.1% in the last year), followed by the neck (33.8%) and shoulders (21.7%). The 7 day period-prevalence also followed a similar descending pattern, being reported by 20.8% at the lower back and 12.1% at both the neck and knees. MSD affected the daily life of students for an average period of 53.8 days, with an average of 6.6 sick days taken from school. Students reporting high mental pressure were 2.9 times more likely to suffer low back pain in the previous 12 months (OR 2.9, 95%CI 1.4-5.9, P=0.0030). Overall, our study suggests that Chinese medical students are at reasonable MSD risk, although it is probably lower than for working physicians. Further investigations are now recommended to elucidate the MSD mechanisms and contributory factors among medical students in China, as elsewhere. A longitudinal study of MSD among a complete group of medical students would be very useful in this regard.
Adult↗
Tobacco smoking prevalence among a cross-section of dentists in Queensland, Australia.
The purpose of this study was to investigate the epidemiology of tobacco smoking among dentists in Queensland, Australia. We utilized an anonymous, self-reporting questionnaire which was posted to 400 dentists during 2004. The overall response rate was 72.1%, among whom the prevalence of current smoking was estimated to be 3.9% (95%CI: 2.2-6.9), with a further 11.0% being ex-smokers (95%CI: 7.9-15.2). Smoking rates varied by age, with 6.1% of dentists aged younger than 30 years who were smokers. The lowest smoking prevalence was seen among dentists aged between 30 and 40 years (1.4%), and the highest among those aged over 60 years (7.1%). Regarding weekly work hours, the highest smoking prevalence was seen among dentists who worked between 25 and 35 hrs per week (6.8%). Ex-smokers were more likely to work less than 25 hrs per week (21.7%). Smoking rates also varied by career length, with the lowest prevalence among dentists who had worked 10 to 20 years (1.3%) and the highest rate among those who had worked over 40 years (6.7%). A similar trend was revealed for ex-smokers, with prevalence rates of 1.7% and 33.3%, respectively. Overall, our study suggests that the prevalence of smoking is rather low among Queensland dentists. As the distribution of smoking was not uniform however, future preventive measures will need to consider the individual situation of dentists who smoke, particularly those in the older age groups.
Adult↗
Alcohol and tobacco consumption among police officers.
Police occupy an important position within the community as both enforcers of the law and as role models for appropriate behavior. Despite this interesting juxtaposition, research has shown that they may consume alcohol and tobacco at rates higher than the general population. A significant causal factor is occupational stress, and the fact that police are regularly exposed to stressors beyond the range of normal human experiences. Given this ongoing and unavoidable relationship, the recognition and control of stress is paramount within law enforcement. Because police stressors are usually multi-faceted, health promotion interventions should focus on stress-reduction at both the institutional and individual level. Examples of health promotion strategies may include reducing overtime, carefully organizing shift rosters, streamlining administrative processes and allowing rest breaks for those on the night-shift. Interventions which focus on the individual are also important, because excess alcohol and tobacco consumption levels often relate to individual stress-coping mechanisms. Programs to help recognize and prevent excess alcohol and tobacco consumption may be worthwhile, as too, counseling, interpersonal support and critical incident debriefing. Promoting non-drinking and non-smoking stress-reduction activities where police can socialize and de-brief with their colleagues may be beneficial. Encouraging social events at sports clubs and gymnasiums has also been suggested. In order to achieve these goals however, governments will need to place a greater emphasis on the occupational health of police officers and the law enforcement agencies in which they work.
Alcohol Drinking↗
Contemporary smoking habits among nurses in Mainland China.
Although China is the world's largest consumer of tobacco and tobacco-related products, the epidemiology of smoking has not been well studied among nurses. Given this serious gap in the literature, we considered it necessary to investigate tobacco smoking habits among a large cross-section of contemporary Chinese nurses, by means of a questionnaire survey. A total of 509 replies were obtained from 520 nurses (response rate: 97.9%). The overall prevalence of smoking was 2.6% (95%CI 1.5 - 4.3). When stratified by gender, the prevalence rate among male nurses was 52.2% (33.0 - 70.8). Of those who smoked, the median number was 11 smokes per day for a period of 25.0 years. When categorized by severity, 15.4% were light smokers, 69.2% moderate smokers and 15.4% heavy smokers. When stratified by age there were no smokers under 25 years, with the prevalence between 25 and 34 years similarly low, at 1.1%. The highest smoking rate was seen among nurses aged 45 to 50 years (10.1%), even though they only comprised 9.8% of the total workforce. Although our study suggests that tobacco usage is relatively uncommon among Chinese nurses overall, the rate among male nurses was alarmingly high. The distribution of smoking by age was not uniform however, with a high proportion being concentrated in the older age ranges. As such, future preventive measures will need to consider the individual situation of Chinese nurses who smoke, particularly those who occupy the older age groups.
Adult↗
The historical development of occupational health in Australia: Part I 1788-1970.
In 1788 the British Empire established a penal colony in Sydney Cove. By virtue of their unique demographic, the earliest occupations consisted predominately of convict or prison guard. Initial health hazards included disease, traumatic injury and punishment. Free settlement gradually developed throughout the early to mid 1800s, thus offering new forms of employment with their associated risks. The discovery of commercial gold deposits in 1851, led to a large increase in mining as the predominately dangerous occupation of the late 19th century. Early mining hazards included windlass accidents and flooding, and this was later enhanced by toxic chemicals such as arsenic and mercury. Industrial development occurred throughout the 1900s in Australia. This period was accompanied by increasing interest in worker's health, which later resulted in some pioneering epidemiological research. Overall, history has shown that significant lessons can be learned from the development of occupational health in Australia, many of which may help guide policy formation for the new millennium.
Accidents, Occupational↗
Musculoskeletal complaints and psychosocial risk factors among Chinese hospital nurses.
BACKGROUND: Musculoskeletal complaints represent a common occupational problem for health care workers throughout the world. Despite their sizeable numbers, however, few epidemiological studies have investigated musculoskeletal complaints among Chinese hospital nurses. Objective To assess the prevalence of, and risk factors for, musculoskeletal complaints among hospital nurses in mainland China. METHODS: A total of 282 female, registered nurses were surveyed (92% response rate) using a modified Chinese-language version of the Standardized Nordic Questionnaire. Body sites were divided into the neck, shoulder, upper back and lower back regions. RESULTS: The 12 month period-prevalence of musculoskeletal complaints at any of the four regions was 70%. The lower back was the most commonly reported body site (56%), followed by the neck (45%), shoulder (40%) and upper back (37%). High mental pressure, boring or tedious tasks and limited work support were identified as significant risk factors (adjusted odds ratios: 1.79-2.52). No correlations were found between manual handling or perceived physical exertion and increased reporting of musculoskeletal complaints. CONCLUSION: This study has shown that musculoskeletal complaints are prevalent among Chinese hospital nurses. The correlation with various psychosocial factors is also consistent with evidence from other countries.
Adult↗
Musculoskeletal disorders among rural Australian nursing students.
AIM: To investigate the prevalence of musculoskeletal disorders (MSD) among rural Australian nursing students and compare the results with other international studies. METHOD AND ANALYSIS: A self-reporting questionnaire adapted from previous research, was administered to 260 students from all three grades of a major nursing school in regional north Queensland, Australia. RESULTS: A high proportion of students reported an MSD at some body site (80.0%), with low back pain being the most common condition (59.2%). This was followed by MSD of the neck (34.6%), knee (25.0%), shoulder (23.8%), feet (16.5%), wrist (12.7%) and legs (11.9%). MSD of the shoulder was slightly more common among males when compared to females (39.3% vs 22.0%, P = 0.0424). Previous paid employment as a nurse or nursing assistant was found to increase the risk of upper arm MSD by a factor of 10.8 (odds ratio 10.8, 95% confidence interval 1.9-205.8, P = 0.0276). CONCLUSION: Overall, this investigation suggests that MSD is more frequent among rural Australian nursing students, when compared to their counterparts around the world. Their high rate of MSD is also comparable to that reported by hospital nurses in other countries.
Adult↗
Hand dermatitis among female nursing students in tropical Australia.
Although hand dermatitis is known to affect nursing students worldwide, the prevalence among their Australian counterparts has not been elucidated and the relative contribution of tropical environments is unclear. Therefore, we conducted the first investigation of hand dermatitis among 232 female, undergraduate nurses in tropical Australia using a previously validated methodology. Hand dermatitis prevalence rose from 10.8% in the first year to 27.4% by the third year and averaged 18.5% across all three grades. Pre-existing atopic dermatitis caused a 7.8-fold risk increase during logistic regression analysis (odds ratio [OR] 7.8, 95% confidence interval [CI] 3.0-21.1, P < 0.0001). Overall, this study suggests that hand dermatitis is less common among tropical Australian nursing students than their counterparts around the world. The identification of atopic dermatitis as a hand dermatitis risk factor was, however, consistent with previous research conducted in non-tropical areas.
Adult↗
Musculoskeletal disorders among professional nurses in mainland China.
Although musculoskeletal disorders represent a significant occupational issue for professional nurses worldwide, few epidemiological studies have been conducted in mainland China. Therefore, we investigated 180 nurses (84.1 percent response rate) from a teaching hospital in Shijiazhuang, Hebei Province, using a previously validated, self-reporting musculoskeletal disorder survey. The overall prevalence of musculoskeletal disorders was 70.0 percent, with individual categories reported as follows: lower back (56.7 percent), neck (42.8 percent), shoulders (38.9 percent) and upper back (38.9 percent). Period pain was shown to increase the risk of musculoskeletal disorders 23.8 times (odds ratio [OR] 23.8; 95 percent confidence interval [CI], 4.3-189.1; P = .0008). Excessive mental pressure incurred a 10.5-fold risk increase (OR 10.5; 95 percent CI, 2.2-67.5; P = .0058). Interestingly, occasional consumption of alcoholic drinks reduced the risk of musculoskeletal disorders 10-fold (OR 0.1; 95 percent CI, 0.01-0.4; P = .0046), as did working in the gynecology department (OR 0.1; 95 percent CI, 0.01-0.7, P = .0240). Overall, our study showed that musculoskeletal disorders are common among nursing professionals in mainland China and represent an important occupational issue for this Asian demographic.
Adult↗
Epidemiology of needlestick and sharps injuries among professional Korean nurses.
Although needlestick and sharps injuries (NSI) are known to affect professional nurses at high rates, most studies depend on officially reported data and few have been undertaken in Korea. Thus, we surveyed a large cross-section of nurses from a hospital in Gangneung (response rate, 97.9%). Four hundred thirty-two incidents of NSI were reported by 263 nurses (79.7%) in the previous 12-month period (average, 1.31 events/nurse/year). Syringe needles were the most common devices, affecting 67.3% and comprising 52% of all NSI events. Sixty percent of all NSI events involved contaminated devices. Opening an ampoule or vial was the most common cause (affecting 35.2% of all nurses and accounting for 15.9% of all NSI events). Logistic regression indicated that nurses working in "other" departments were 5.4 times more likely to suffer any NSI (odds ratio [OR] = 5.4; 95% confidence interval [95% CI] = 2.0-15.2; P < .05) and 4.7 times more likely to incur a syringe-needle injury than nurses in intensive care units or inpatient departments (OR = 4.7; 95% CI = 2.0-11.6; P < .05). Younger-than-average nurses (< 27 years) were 4.5 times more likely to suffer NSI (OR = 4.5; 95% CI = 1.7-12.6; P < .05) and 3.1 times more likely to incur a syringe-needle injury (OR = 3.1; 95% CI = 1.4-7.0; P < .05). Working mixed shifts also increased the risk of any NSI (OR = 4.0; 95% CI = 1.7-10.4; P < .05) or syringe-needle NSI (OR = 4.4; 95% CI = 2.0-10.1; P < .05). Overall, our study suggests that NSI are common among Korean hospital nurses and represent a significant occupational burden for this large Asian demographic. Intervention and preventive strategies to help reduce their NSI exposures are urgently required in this country.
Accidents, Occupational↗
Musculoskeletal symptoms among Korean nursing students.
We investigated the epidemiology of Musculoskeletal Symptoms (MSS) among Korean nursing students using a validated, questionnaire survey. Among 202 students, the prevalence of MSS at any body site ranged from 69.0% to 77.1% (overall rate: 73.3%). MSS was most commonly reported at the shoulder (46.0%), followed by the lower back (39.1%), neck (35.6%), feet (25.2%) and lower legs (23.8%). Logistic regression analysis indicated that students who undertook regular exercise were only half as likely to report an MSS at any body site (OR 0.5, 95% CI 0.2 - 0.9, P = 0.0350). Increasing body weight was also correlated with a decreased likelihood of MSS (OR 0.04, 95% CI 0.002 - 0.9, P = 0.0460). Overall, our study has shown that Korean nursing students report a high prevalence of MSS, when compared to their international counterparts. Their MSS burden is roughly comparable with Korean workers, in a variety of occupations. Further investigations will now be required to elucidate the contributory factors for nursing students' MSS in Korea, as elsewhere.
Adult↗
Prevalence of hand dermatitis among hospital nurses working in a tropical environment.
BACKGROUND: Although hand dermatitis (HD) is a common occupational problem among hospital nurses, few epidemiological studies of this disease have been conducted in regional areas or tropical environments. AIM: The aim of our investigation was, therefore, to investigate HD prevalence and correlates among nurses within a unique Australian setting. DESIGN: We recruited a cohort of 148 female nurses from a large tertiary hospital in north Queensland, Australia, and administered a previously validated, self-reporting HD questionnaire. RESULTS: The 12-month period prevalence ranged from 43.2% to 59.3%, with an overall group mean of 50.0%. There were no statistically significant differences in HD prevalence between the different hospital wards (p=0.4238). During multiple logistic regression, a history of allergic rash was shown to increase the HD risk 5.5-fold (odds ratio: 5.5, 95% CI: 1.9-19.2, p=0.0038). The risk of HD was also related to increased hand washing frequency (OR 5.8, 95% CI: 1.1-33.4, p=0.0402). CONCLUSIONS: Overall, the occurrence of HD among Australian nurses was relatively consistent across the various hospital wards. Their 12-month period-prevalence of HD was, however, generally higher than previous reports from other countries.
Adult↗