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Biomedical subjects

Donald C Cole

Publications and source records attributed to Donald C Cole.

At least 19 recordsLinked to original sources
PubMed2006

Reducing musculoskeletal burden through ergonomic program implementation in a large newspaper.

OBJECTIVES: To assess the impact of a workplace ergonomic program to reduce musculoskeletal burden among newspaper employees and to understand relationships among participation, risk factor changes and health status within an employee cohort. METHODS: We conducted repeat cross-sectional surveys, with 1,003 employees from all major departments in 1996 and 813 in 2001, generating a cohort of 433 participants in both surveys. Elements of the ergonomic program included employee RSI (repetitive strain injury) training, pro-active assessment of workstations and workstation modifications, and encouragement of early treatment through on-site physiotherapy. Potential risk factors included biomechanical and work organizational aspects of office work. Health status measures included pain intensity and the Work-Disability of the Arm, Shoulder, and Hand (DASH). Repeat cross-sectional analyses incorporated modifications for shared variance. For the cohort, a theory of change informed path analyses using MPLUS. RESULTS: Among respondents in 2001, 69% reported participation in RSI training and 56% had workstation assessments. Among those with pain, 57% had consulted a health practitioner, including the on-site physiotherapist. In repeat cross-sectional analyses, the proportion reporting moderate pain or worse, at least once per month or for longer than 1 week, declined from 20 to 16% (p=0.01). Among the cohort, pain intensity and work disability in 1996 were the strongest predictors of 2001 health status (both p<0.001). Stable or increased supervisor awareness and concern about RSI was associated with decreased pain in 2001(p<0.01). Participation in RSI training was associated with increases in decision latitude (p<0.05), which themselves were associated with decreased work disability in 2001 (p<0.05). Increased time mousing was associated with increases in work disability (p<0.05). CONCLUSIONS: Implementation of a worksite ergonomics program was associated with a reduction in frequent and severe pain in the workforce. Changes in work disability were affected by multiple factors.

Adult↗
PubMed2006

Environmental contaminant levels and fecundability among non-smoking couples.

OBJECTIVE: To investigate the effects of low level maternal and paternal persistent contaminant exposures on fecundability among couples from the general population. METHODS: About 41 couples having their first pregnancy completed questionnaires and provided blood samples for analysis of metals, organochlorine pesticides, and polychorinated biphenyls. Associations of personal consumption and contaminant measures for mothers, fathers, and couples overall were analyzed through fecundability odds ratios (fOR, probability of pregnancy per month in more versus less exposed) in multivariable analyses. FINDINGS: Couples with higher reported caffeine consumption (couple consumption > or =111 drinks/month, fOR 0.25, 95% CI, 0.10, 0.63) and higher mercury concentrations in maternal blood (>1.2 microg/L or 0.24 ppm in hair, fOR 0.22, 95% CI, 0.07, 0.72) had lower fecundability, after adjustment for intercourse frequency. CONCLUSION: Reduced fecundability at levels below the mercury reference dose warrants further research and prudent reduction in persistent toxic substances exposure among women and men of reproductive age.

Adult↗
PubMed2006

Evaluation of a participatory ergonomic intervention aimed at improving musculoskeletal health.

BACKGROUND: Participatory ergonomic (PE) interventions have been increasingly utilized to deal with work-related musculoskeletal disorders (WMSD). METHODS: Using a longitudinal quasi-experimental design, a PE process was launched at one depot of a large courier company, with a nearby depot serving as a control. Evaluations focused on 122 employees across the two depots who participated in both pre- and post-questionnaires. An evaluation framework assessed the process of implementation, changes in risk factors, and changes in musculoskeletal health outcomes. Partial and multiple regressions explored the relationships in the evaluation framework. RESULTS: Changes in work organizational factors had a consistent impact upon changes in health outcomes. Greater participation in the process was associated with increased levels of job influence and communication (P = 0.0059 and P = 0.0940 respectively). Improvements in communication levels were associated with reduced pain intensity and improved work role function (WRF) (P = 0.0077 and P = 0.0248 respectively). Lower levels of pain post-intervention were related to greater WRF (P = 0.0493). CONCLUSIONS: A PE approach can improve risk factors related to WMSD, and meaningful worker participation in the process is an important aspect for the success of such interventions.

Adult↗
PubMed2006

Taking environmental action: the role of local composition, context, and collective.

This article explores individual and community action taken in response to perceived environmental risks by investigating the determinants of environmental action across a range of action types. A conceptual framework is first presented, which provides a foundation for investigating the role of local compositional (i.e., individual characteristics), contextual (i.e., neighborhood environment), and collective (i.e., social networks) factors in environmental action. To test the utility of the conceptual framework, a quantitative survey was administered to a random sample of households (n = 512) in Hamilton, Canada. The results suggest that the predictors of environmental action vary by action type (i.e., personal change, individual civic action, and cooperative civic action), and that factors related to perceived environmental exposure and social capital generally play a stronger, more consistent role in civic environmental action than sociodemographic or neighborhood factors. The results underscore the role of social connection in responses to perceived environmental risks.

Attitude↗
PubMed2006

Health care use associated with work-related musculoskeletal disorders among hospital workers.

INTRODUCTION: The purpose of this study was to investigate if work-related musculoskeletal disorders (WMSDs) are associated with increased health care use, over and above workers' compensation health care benefits, in the period prior to and following a workers' compensation claim indicating gradual progression and declining function associated with musculoskeletal morbidity. METHODS: This study employed secondary analysis of employment data, workers' compensation claim data and provincial (universal) medical services data for a cohort of health care workers; and investigated rates of medical care contacts among injured workers with a WMSD claim (n=549) compared to a matched group of non-claim workers. Predictors of health care contacts were estimated using general linear regression. RESULTS: WMSD injured workers had significantly higher rates of health care contacts associated with a claim compared to non-injured workers, over and above workers compensation health care benefits. In the final multi-variable model, a WMSD claim among injured workers was associated with an estimated 69% (95% CI, 1.50, 1.91) increase in health care use for the 12-month period immediately after the injury date compared to non injured workers. CONCLUSION: The pattern of visits for WMSDs suggests that workers visit general practitioners as part of an ongoing pattern of symptoms, resulting in frequent utilization of health services prior to work disability that is also reflected in health care contacts after return-to-work.

Adult↗
PubMed2006

Integrative interventions for MSDs: nature, evidence, challenges & directions.

BACKGROUND: When applied to workplace interventions, integrative may be seen in various ways, requiring elucidation. METHODS: Identification of primary studies through systematic reviews, limited bibliographic literature searches, the Cochrane Occupational Health Field database on intervention studies, and authors' files. Focus was 2000 on. Categorization according to the Cochrane classes and lenses on integrative. Synthesis as narrative review. RESULTS: Examples of each lens on integrative were uncovered: biomechanical and psychosocial, multiple component, primary and secondary prevention, organizational, and system. Each contributed different understanding to the potential impacts on different knowledge, exposure, behavior, health and administrative outcomes. CONCLUSIONS: Considerable opportunities exist to expand the range of integrative interventions, particularly at the organizational and system levels, and incorporate a combination of knowledge transfer and exchange with intervention evaluation.

Cumulative Trauma Disorders↗
PubMed2005

Predictors of work-related repetitive strain injuries in a population cohort.

OBJECTIVES: We assessed predictors of work-related repetitive strain injuries using data from 4 waves of the Canadian National Population Health Survey. METHODS: Participants were 2806 working adults who completed an abbreviated version of the Job Content Questionnaire in 1994-1995 and did not experience repetitive strain injuries prior to 2000-2001. Potential previous wave predictors of work-related repetitive strain injuries were modeled via multivariate logistic regression. RESULTS: Female gender (odds ratio [OR] = 1.98; 95% confidence interval [CI]=1.24, 3.18), some college or university education (OR=1.98; 95% CI=1.06, 3.70), job insecurity (OR=1.76; 95% CI=1.07, 2.91), high physical exertion levels (OR = 2.00; 95% CI = 1.29, 3.12), and high levels of psychological demands (OR = 1.61; 95% CI = 1.02, 2.52) were all positively associated with work-related repetitive strain injuries, whereas working less than 30 hours per week exhibited a negative association with such injuries (OR=0.2; 95% CI=0.1, 0.7). CONCLUSIONS: Modifiable job characteristics are important predictors of work-related repetitive strain injuries.

Adult↗
PubMed2005

Paddling upstream: a contextual analysis of implementation of a workplace ergonomic policy at a large newspaper.

Efforts to implement workplace ergonomic programs aimed at reducing the burden of work-related musculoskeletal disorders (WMSD) have to address multiple physical and psychosocial aspects of work environments yet often contextual factors limit their success. We describe the processes involved in an ergonomic program to reduce neck and upper limb WMSDs at a large Canadian newspaper. Using qualitative data collection and analysis methods, we illustrate the impact of key contextual characteristics of: (1) the program (management commitment, union involvement, experience and skill of program leaders, and researcher involvement); (2) the organization (drive for productivity, management control, organizational culture); and (3) the broader social context (economic climate, nature of newspaper work, technology and nature of WMSD). We argue for increased attention to identification and response to the contextual factors affecting program implementation in order to more successfully address upstream determinants of WMSD.

Canada↗
PubMed2005

Study of the effectiveness of a participatory ergonomics intervention in reducing worker pain severity through physical exposure pathways.

A participatory ergonomics programme was implemented in an automotive parts manufacturing factory. An ergonomics change team was formed composed of members from management and the organized labour union. It was hypothesized that the physical change projects implemented as part of this process would result in decreased worker exposures to peak and cumulative physical demands and reduced worker perceptions of physical effort and pain severity. A quasi-experimental design was employed, utilizing a sister plant in the corporation as a referent group. A longitudinal questionnaire approach was used to document pre-post changes in worker perceptions. In general, the physical change projects were rated as improvements by workers and were successful at reducing peak and/or cumulative mechanical exposures. However, there were few systematic changes in perceived effort or pain severity levels. Explanations include the confounding effects of differential production rate and staffing changes at the intervention and referent plants and/or insufficient overall intervention intensity due to a relatively short intervention period, plant and team ambivalence towards the process and the low overall impact on exposure of the particular changes implemented.

Ergonomics↗
PubMed2005

Quality of working life indicators in Canadian health care organizations: a tool for healthy, health care workplaces?

BACKGROUND: Quality-of-work-life (QWL) includes broad aspects of the work environment that affect employee learning and health. Canadian health care organizations (HCOs) are being encouraged to monitor QWL, expanding existing occupational health surveillance capacities. AIM: To investigate the understanding, collection, diffusion and use of QWL indicators in Canadian HCOs. METHODS: We obtained cooperation from six diverse public HCOs managing 41 sites. We reviewed documentation relevant to QWL and conducted 58 focus groups/team interviews with strategic, support and programme teams. Group interviews were taped, reviewed and analysed for themes using qualitative data techniques. Indicators were classified by purpose and HCO level. RESULTS: QWL indicators, as such, were relatively new to most HCOs yet the data managed by human resource and occupational health and safety support teams were highly relevant to monitoring of employee well-being (119 of 209 mentioned indicators), e.g. sickness absence. Monitoring of working conditions (62/209) was also important, e.g. indicators of employee workload. Uncommon were indicators of biomechanical and psychosocial hazards at work, despite their being important causes of morbidity among HCO employees. Although imprecision in the definition of QWL indicators, limited links with other HCO performance measures and inadequate HCO resources for implementation were common, most HCOs cited ways in which QWL indicators had influenced planning and evaluation of prevention efforts. CONCLUSIONS: Increase in targeted HCO resources, inclusion of other QWL indicators and greater integration with HCO management systems could all improve HCO decision-makers' access to information relevant to employee health.

Canada↗
PubMed2005

Biomonitoring of herbicides in Ontario farm applicators.

OBJECTIVES: Biomonitoring of pesticide residues in urine offers the advantages of integrating exposure due to all routes of entry and accounting for individual differences in several factors such as pharmacokinetics. The study was designed to measure the body burden of 2,4-dichlorophenoxyacetic acid (2,4-D) and 4-chloro-2-methylphenoxyacetic acid (MCPA) in farm applicators and to measure compliance with label recommendations regarding the use of personal protective gear and the impact of such use on exposure. METHODS: Farmers (N=126) from Ontario, Canada, collected a preexposure spot sample of urine and then two consecutive 24-hour urine samples immediately following the farmers' first use of these herbicides during 1996. Details on the pesticides used and handling practices were collected by questionnaire. RESULTS: For the farmers who reported using 2,4-D, the mean urinary concentration was 27.6 microg/l in the day-1 sample and 40.8 microg/l in the day-2 sample. The comparable figures for MCPA were 44.4 microg/l and 58.0 microg/l, respectively. Adherence to all of the recommended personal protective gear was rare (3%). Wearing goggles or a face shield during mixing and loading was associated with the lowest exposures. CONCLUSIONS: The urinary concentrations of 2,4-D and MCPA of these farm applicators were of the same order of magnitude as those published in the past decade, but lower than earlier studies, indicating that improvements in education, equipment, and labeling have likely had an impact on the degree of exposure in occupational settings.

Environmental Monitoring↗
PubMed2005

[Evaluation of time-to-pregnancy as a measure in environmental epidemiology].

Since the late 80's, time to pregnancy has been used in environmental epidemiology to explore adverse effects of different exposures. The advantages of this measure and additional elements to be considered in the performance of this type of studies are reviewed. Study design includes the following steps: population selection, sample size, outcome measurement, statistical analyses and sources of bias. Guidelines were suggested for the properly development of this type of study.

Birth Intervals↗
PubMed2004

Blood mercury levels among Ontario anglers and sport-fish eaters.

We conducted two surveys of Ontario (Canada) fishers: a stratified sample of licensed anglers in two Lake Ontario communities (anglers, n=232) and a shore and community-based sample in five Great Lakes' Areas of Concern (AOC eaters, n=86). Among the 176 anglers consuming their catch, the median number of sport-fish meals/year was 34.2 meals and 10.9, respectively, in two communities, with a mean blood total mercury level among these sport-fish consumers of 2.8 microg/L. The vast majority of fish eaten by AOC eaters was from Ontario waters (74%). For AOC eaters, two broad country-of-origin groups were assembled: Euro-Canadians (EC) and Asian-Canadians (AC). EC consumed a median of 174 total fish meals/year and had a geometric mean total mercury level of 2.0 microg/L. Corresponding AC figures were 325 total fish meals/year and 7.9 microg/L. Overall, mercury levels among AOC eaters were higher than in many other Great Lakes populations but lower than in populations frequently consuming seafood. In multivariate models, mercury levels were significantly associated with levels of fish consumption among both anglers and EC AOC eaters. Given the nutritional and social benefits of fish consumption, prudent species and location choices should continue.

Adult↗
PubMed2004

Individual factors and musculoskeletal disorders: a framework for their consideration.

Individual factors have been variously defined as non-work, demographic, physiological or psychological factors. They may represent a variety of important constructs at different relevant levels that may not be initially evident in their measurement. These include: work-related factors e.g., job assignment, duration of exposure, work style, anthropometric mismatches, and differential responses to job demands; concomitant external or internal exposures e.g., sports, smoking, and endogenous hormones; and physical, psychological and social vulnerabilities e.g., prior injury, depression, socio-economic status. Such factors operate in different ways in the development, course and response to interventions of musculoskeletal disorders. Newer framings of their contribution to musculoskeletal disorders are providing new insights into the role of such factors as some among many which contribute to the burden of MSK disorders in working age populations. As researchers, practitioners and policy makers, we need to consider them in order to reduce burden, to protect the vulnerable and to match interventions to different groups of people most appropriately.

Disease Susceptibility↗
PubMed2004

Farm children's exposure to herbicides: comparison of biomonitoring and questionnaire data.

BACKGROUND: Pesticide exposure has been associated with various childhood cancers. However, most studies rely on questionnaires, with few using biologic measures of dose. This study was designed to measure herbicide exposure directly in children of farm applicators, and to compare these results with exposure imputed from questionnaire information. METHODS: Two consecutive 24-hour urine samples were collected from 92 children of Ontario farm applicators who used the herbicides 2,4-D (2,4-dichlorophenoxyacetic acid) or MCPA (4-chloro-2-methylphenoxyacetic acid) for the first time during 1996. The farm applicator completed questionnaires describing his pesticide-handling practices as well as the child's location during the various stages of handling these pesticides. RESULTS: Approximately 30% of the children on farms using these herbicides had detectable concentrations in their urine, with maximum values of 100 microg/L for 2,4-D and 45 microg/L for MCPA. Children with higher levels were more likely to be boys and to have parents who also had higher mean urinary concentrations. The sensitivity and specificity of a simple indicator of use were 47% and 72%, respectively, for 2,4-D, and 91% and 30%, respectively, for MCPA, using the biomonitoring data as the gold standard. CONCLUSIONS: Information on living on a farm, or on living on a farm where a specific pesticide is used, is not enough to classify children's exposures. Given this potential for misclassification, we urge incorporation of biomonitoring studies in subsets of children at least to estimate the extent of misclassification.

2,4-Dichlorophenoxyacetic Acid↗
PubMed2003

Reducing acute poisoning in developing countries--options for restricting the availability of pesticides.

Hundreds of thousands of people are dying around the world each year from the effects of the use, or misuse, of pesticides. This paper reviews the different options to reduce availability of the most hazardous chemicals, focusing on issues in developing countries. Emphasis is placed on the fatal poisoning cases and hence the focus on self-harm cases. Overall, it is argued here that restricting access to the most hazardous pesticides would be of paramount importance to reduce the number of severe acute poisoning cases and case-fatalities and would provide greater opportunities for preventive programmes to act effectively. The aim should be to achieve an almost immediate phasing out of the WHO Classes I and II pesticides through national policies and enforcement. These short-term aims will have to be supported by medium- and long-term objectives focusing on the substitution of pesticides with safe and cost-effective alternatives, possibly guided by the establishment of a Minimum Pesticide List, and the development of future agricultural practices where pesticide usage is reduced to an absolute minimum. Underlying factors that make individuals at risk for self-harm include domestic problems, alcohol or drug addiction, emotional distress, depression, physical illness, social isolation or financial hardship. These should be addressed through preventive health programmes and community development efforts.

Acute Disease↗
PubMed2003

Methodological issues in evaluating workplace interventions to reduce work-related musculoskeletal disorders through mechanical exposure reduction.

Researchers of work-related musculoskeletal disorders are increasingly asked about the evidentiary base for mechanical exposure reductions. Mixed messages can arise from the different disciplinary cultures of evidence, and these mixed messages make different sets of findings incommensurate. Interventions also operate at different levels within workplaces and result in different intensities of mechanical exposure reduction. Heterogeneity in reporting intervention processes and in measuring relevant outcomes makes the synthesis of research reports difficult. As a means of synthesizing the current understanding of measures, this paper describes a set of intervention and observation nodes for which relevant workplace indicators prior to, during, and after mechanical exposure reduction can provide useful information. On the basis of this path of impacts from exposure reduction, an approach to the evaluation of multilevel ergonomic interventions is described that can assist fellow researchers in producing evidence relevant to the challenges faced by workplace parties and policy makers.

Biomechanical Phenomena↗