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Biomedical subjects

F J van Dijk

Publications and source records attributed to F J van Dijk.

At least 37 records · Page 2Linked to original sources
PubMed1996

Health complaints and working conditions experienced in relation to work and age.

OBJECTIVES: The main objective is to describe the potential health and work problems of the aging employees in the Dutch working population. In this way, we can identify groups at extra risk of specific health problems. METHODS: In The Netherlands, occupational health services gather questionnaire data about work and health as part of periodical occupational health surveys (POHSs). These data from the POHSs of complaints about health and working conditions, aggregated into occupational groups and age categories, are used to provide indications for groups at extra risk of specific health problems. These problems are assessed by overviews of the relation between age and complaints about health and working conditions. RESULTS: Almost all of the health questions show an increase in health complaints with increasing age. White collar workers, especially the high grade white collar workers, usually have lower complaint percentages on health questions than blue collar workers. Female employees have relatively high complaint percentages on the health questions. Differences between occupational groups in the complaints about work and working conditions reflect the differences in work demands and exposure. The relation between age and work complaints is generally inconsistent and weak. The complaint percentages on work questions of female employees tend to be equal to or lower than those of the male employees. CONCLUSIONS: The absence of a clear increase of work complaints with advancing age in the presence of a decrease in health and working capacity may be explained by a selective turnover in the working population, especially in demanding occupations. To enhance the work participation of older employees it may be necessary to reduce the work demands and to increase decision latitude.

Adult↗
PubMed1995

The Atlas of Health and Working Conditions by Occupation. 1. Occupational ranking lists and occupational profiles from periodical occupational health survey data.

In this article, we describe methods which have been applied in the compilation of the Atlas of Health and Working conditions by Occupation. First, we discuss the need for information systems to identify problems concerning working conditions and health. Such information systems have an exploratory purpose, being deployed to identify work risks in companies, groups of occupations and sectors of industry, and can also be a starting point for the generation of hypotheses on the causes of adverse health effects. In the Netherlands, occupational health services gather questionnaire data about work and health as part of periodical occupational health surveys. In the atlas, aggregated questionnaire data for 129 occupations with male employees and 19 occupations with female employees are presented. In this article, we explain the methodology used to compare occupations with regard to each item in the questionnaire. We then discuss applications of these occupational ranking lists. The cross-sectional nature of the data collection, various forms of selection and the limited size of some occupational populations have to be taken into account when interpreting the results. Occupational ranking lists can be applied in the allocation of resources and in the design of scientific research. The overviews for each occupation, presented in the second half of the atlas, provide an occupational profile of existing problems with respect to work and health. These profiles are used as basic information to develop a practical policy on working conditions and health.

Adult↗
PubMed1995

The Atlas of Health and Working Conditions by Occupation. 2. A comparison with the "Atlas of Health and Working Conditions in the Construction Industry".

The results of the general Atlas of Health and Working Conditions by Occupation were compared with the results of the Atlas of Health and Working Conditions in the Construction Industry. Both are based on questionnaire data from periodical occupational health surveys [POHSs]. The scores on most of the items showed considerable differences between the two atlases, partly due to differences in the regional origin of the data. Therefore, direct comparisons between the atlases are biased by regional differences. To study the reliability and the generalizability of the results of both atlases, similarities between the data files with respect to occupations in the construction industry were studied. Most of the items on working conditions, especially those with a widespread distribution, showed a close resemblance between the data files in terms of the relative position of an occupation compared to other occupations in the construction industry. The items on health showed less resemblance, except for the items on musculoskeletal complaints, which showed results similar to those of the work items. These results indicate the reliability and generalizability of the judgements based on both atlases outside the regions of origin, as far as items with a widespread distribution are concerned. Therefore, we recommend the aggregation of POHS data on a national scale, taking regional differences into account. In that way, a greater number of occupations will be described and the reliability of the results will be enhanced.

Adult↗
PubMed1995

Physical workload and the aging worker: a review of the literature.

In the coming decades, demographic, economic and social changes will result in an increased proportion of elderly persons in the workforce in most industrialized countries. This trend is causing growing interest in the problems of the aging worker in current employment. The objective of this particular paper is to provide more insight into the impact of aging on the balance between physical work capacity and physical workload. To this end, the scientific literature in the field is reviewed and ordered by means of a specific conceptual model of "aging and physical workload". A progressive decline in physical work capacity, characterized by diminished aerobic capacity and muscular capacity, has consistently been reported. However, inter-individual differences appear to be considerable. The question of whether there are systematic differences in physical work demands between younger and older workers within occupations has been answered vaguely. Conflicting results in this matter bring into discussion the role of the actual working method as one of the determinants of the physical workload. An age-related imbalance between physical workload and physical work capacity is suggested to result in a chronic overload, increasing the risk of long-term health effects such as musculoskeletal complaints and disorders. For many aging workers in physically demanding occupations, extreme physical workloads, increasing the risk of disease or disablement, are still reported. The multiconceptual study of aging and physical workload in the present paper reveals several possibilities for preventive measures. However, as information is still lacking, additional research is needed, in particular on the onset and development of long-term effects on health in relation to age and work demands.

Adult↗
PubMed1995

Occupational health care and work incapacity: recent developments in The Netherlands.

Due to political priorities and benefit arrangements, prevention of work incapacity has played a minor role in employers' policies in the Netherlands. However, the comparatively high sickness absence rates and large numbers of disability benefit recipients in the Netherlands have fostered preventive policies and measures regarding unfavourable working conditions. Corresponding to recent changes in legislation, the role of occupational health and safety services will substantially increase in the coming years. Part of the new orientation will be a multi-disciplinary staff structure and more attention to tailor-made services and effectiveness. There is much debate about the precise role for occupational physicians in the control of sickness absenteeism in companies. This paper presents several instruments which are now being applied or which are still in a developmental stage. The issues of prevention of sickness absence and monitoring of long-term sick employees will remain a substantial part of the responsibilities of occupational health and safety services.

Absenteeism↗
PubMed1995

Developments in reproductive risk management.

Internationally, the debate on aims for occupational health policy is expanding its horizons. Included among the issues are not only concerns about safety for workers, but also for their progeny. Equality among the sexes is also assuming a prominent position. In several countries, existing and proposed legislation already considers these matters. In the course of this article it is argued that this legislation and its implementation are inadequate. There are several reasons for this. Firstly, what constitutes health risks for workers exposed to chemical substances is subject to different interpretations. This is further complicated when one includes risks to reproductive function and to the progeny: the reproductive risks of toxicity. The different interpretations of the concepts of safety and equality are also discussed. There are differences in regulations and in standards about whether or not safety factors should be used when knowledge is uncertain. The operation of reasonable measures with a generic or sex specific policy also differs. Secondly, the current occupational exposure limits are set too high. These aspects are considered and it is probable that the policy aims should be made more specific. An elaborated approach that includes the "precautionary principle" in safety standards is proposed. To advise employers in their role as managers of reproductive risks of toxicity, a recently developed system for occupational health and safety services is described. This system is based on two criteria: effectiveness and reasonableness of proposed measures. The effectiveness criterion includes the precautionary principle; the reasonableness criterion includes equal rights and opportunities for men and women. Finally, a supportive governmental policy that is consistent with the most recent international development is recommended.

Female↗
PubMed1994

Work load and musculoskeletal complaints during pregnancy.

OBJECTIVES: Many pregnant women have musculoskeletal complaints, the onset and aggravation of which are thought to be associated with their activity or work postures. The purpose of this paper was to obtain more insight into the influence of pregnancy on the load of the musculoskeletal system at work to provide a better basis for preventing complaints. METHODS: To this end, literature pertinent to a model called "work load of the musculoskeletal system" was reviewed. The model was developed to describe how work contributes to musculoskeletal complaints. RESULTS: It was found that pregnancy causes changes in a worker's characteristics. These changes can lead to changes in the work situation, activity pattern, and postural characteristics and possibly result in a change in work load. In addition, physical changes such as weight gain increase the work load in a given posture. The load-bearing capacity of the musculoskeletal system decreases due to pregnancy. CONCLUSIONS: The changes in load and the decrease in load-bearing capacity singly or simultaneously increase the risk of musculoskeletal complaints. The multifactorial cause of musculoskeletal complaints during pregnancy reveals various possibilities for prevention.

Biomechanical Phenomena↗
PubMed1993

Quality assessment of occupational health services instruments.

Interest in the quality of instruments for occupational health services is growing as a result of European legislation on preventive services stressing, for example, risk identification and assessment. The quality of the services can be enhanced when the quality of the applied instruments can be judged and improved. To judge quality aspects of instruments, a basic draft scheme and criteria are presented. A first category of criteria covers measurement objective and study design and comprises for example sample strategy and data aggregation level. Technical quality aspects are validity, reliability, standardization and precision. Acceptability of an instrument by employees, employers and professionals belongs to the process quality. At last, strategic quality or presumed utility has to be assessed. As an illustration four instruments have been judged: periodic occupational health surveys, pre-employment medicals, the company audit on work and health, and specific working conditions assessment instruments. Finally the presented basic scheme and criteria are brought into discussion.

Europe↗
PubMed1993

Evaluation of an occupational health care programme: negative results, positive results or a failure?

Among personnel of the city of Amsterdam the incidence of disability as a result of musculoskeletal problems amounts to 15 per 1000 person-years in the refuse collecting department. A disability prevention programme in accordance with literature was started to decrease this high incidence of disability. In the process-evaluation after 2 years from the start of the project it turned out that only three of the ten preventive measures advocated were realized. These meagre results were explained by strategic factors such as lack of motivation among management and the fact that policy on worker health protection was isolated from the overall company policy. Recommendations for future evaluation research are given.

Humans↗
PubMed1993

Development and evaluation of an occupational health services programme on the prevention and control of effects of vibration.

The outline of a study in occupational health services (OHS) on the prevention and control of effects of whole-body vibration is described and preliminary results are presented here. The study comprises an inventory of current activities of occupational health services in vibration-related issues, the development of a specific OHS-programme and evaluation of this programme, mainly on process level. Results of the inventory, a questionnaire survey in occupational health services (n = 112, response 67%), show that the impact of OHS in prevention and control of adverse health effects is small. The development and evaluation of a specific OHS-programme may be useful in setting up a preventive approach. Some methodologic problems are discussed also.

Health Surveys↗
PubMed1992

Agreement on medical fitness for a job.

Five experienced occupational physicians independently reviewed the uniformly structured, concise records of 180 applicants who had applied for a job in one of three categories. All had undergone a preemployment medical examination by the Governmental Occupational Health and Safety Service. Agreement was assessed by calculating the percentage of disagreement and Cohen's kappa. Agreement between the five panel physicians and between the panel physicians and the Service appeared to be poor, with overall percentages of disagreement of 31 and 37%, respectively, and kappa values of 0.38 and 0.37, respectively. On the average 31% of the applicants judged as unfit by one physician had been assessed as fit by the others, whereas agreement was only marginally better when detailed medical criteria for fitness were available. Lack of consensus on the medical fitness of an applicant, as evidenced by this study, suggests that the validity of such a judgment may be questionable even when detailed fitness criteria are available.

Adult↗
PubMed1991

Preemployment medical examinations in a large occupational health service.

Several hundreds of thousands of preemployment medical examinations are performed in The Netherlands each year, with the objective of screening for obvious risks for the applicants or others. Neither the efficacy of these examinations nor determinants for rejection are known. Altogether 101,754 preemployment medical examinations of applicants for governmental functions were analyzed. For one-fifth of the applicants some medical diagnosis was recorded. The overall rejection percentage was 0.6%, being highest for job categories involving public safety and high physical demands, but never exceeding 4%. Age was positively correlated with rejection percentage. Except for the diagnostic category "disorders of the musculoskeletal system" no relation between diagnostic category and job demands was apparent. Medical diagnoses frequently encountered among rejected applicants were also common among successful applicants. If selection aiming at reducing absenteeism or work disablement is considered to be the only goal of preemployment medical examinations, then their efficacy appears to be low for many job categories.

Absenteeism↗
PubMed1990

The quest for interaction: studies on combined exposure.

A literature review was performed on the subject of combined exposure to stressors in the working situation. A general, dynamic model of workload served as the theoretical framework for the study. In this model, every factor that triggers a physiological or psychological response in the worker is regarded as a stressor. Decision latitude plays an important role in the model. A quantitative and qualitative analysis was performed on the available literature. It was concluded that the stressors that appear in studies on combined exposure stem mostly from the physical, chemical and biological environment. The task contents, the labor conditions, social relationships at work and the decision latitude are considerably less often studied in relation to combined exposure. It is concluded that important concepts in the study of combined exposure (e.g. interaction, independence, synergism, antagonism) are often quite carelessly mentioned in the literature. Explicit definition of these concepts is lacking in many publications. Establishment of maximum exposure levels is not yet possible for most stressor combinations. Examples are given of combinations that do allow more or less definite conclusions. It is recommended that more studies should be interdisciplinary organized. More studies are necessary in the field, studying effects of long exposure periods in the working population instead of studying students in laboratory situations. Exposure of susceptible groups, such as older workers and partially disabled workers, deserves special attention.

Environmental Pollutants↗
PubMed1987

Non-auditory effects of noise in industry. IV. A field study on industrial noise and blood pressure.

Audiometry and casual blood pressure measurements were carried out among industrial workers exposed to noise levels exceeding 80 dB(A). Workers with long-term noise exposure had increased blood pressure, after correction for age. Only a weak correlation was observed between noise-induced hearing loss and the corrected blood pressure. The influence of other working conditions and of the relative body weight could not be evaluated.

Blood Pressure↗
PubMed1987

Non-auditory effects of noise in industry. V. A field study in a shipyard.

Workers of a shipbuilding and a machine shop department of a shipyard, with average noise levels of 98 dB(A) and 85.5 dB(A) respectively, were compared with respect to auditory and non-auditory effects. The distribution of years of noise exposure and of age was similar in both departments. No difference in blood pressure was observed after correction for age and relative body weight, however, the cross-sectional study design may have obscured a relationship. Analysis of other adverse working conditions could not explain the absence of a relationship between noise exposure and blood pressure. Noise-induced hearing loss and noise annoyance were observed far more frequently in the shipbuilding department in comparison with the machine shop. There were no differences in the consumption of pharmaceutical drugs, alcohol and tobacco.

Adult↗
PubMed1987

Non-auditory effects of noise in industry. VI. A final field study in industry.

Non-auditory effects of noise were studied among 539 male workers from seven industries. The LAeq, assessed by personal noise dosimetry, has been used to study acute effects. Various indices of total noise exposure, involving level and duration, were developed for long-term effect studies. In the analysis close attention was paid to prevent confounding, e.g. by other adverse working conditions. As expected, hearing loss increased with total noise exposure. Tinnitus was related particularly to hearing loss. Dizziness and hoarseness, however, were not related with noise exposure in this study. Also no correlation could be demonstrated between blood pressure and total noise exposure after correction for age, relative weight and various confounding variables. Use of hearing protection, selection processes and incomplete analysis of interactions between independent variables are suggested for possible explanation. About two-thirds of the workers reported noise annoyance. Various aspects were mentioned, such as irritation, surprise and impairment of communication and perception. Mentally stressful tasks appeared to be the most noise-sensitive. Particularly annoying noise sources, mental work load and time pressure had a relatively large impact on noise annoyance in comparison with the influence of noise level (LAeq) itself. Stress responses were not simply related to the noise exposure level, although consistent positive relations could be demonstrated between symptoms of stress and noise annoyance. Various findings led to the conclusion that noise exposure together with stressful mental activities may lead to disturbed concentration, irritation and annoyance. Experienced stress in turn may render workers more susceptible to noise. To overcome some limitations of this study, cohort studies and studies designed to assess interaction-effects are recommended.

Adult↗
PubMed1987

Non-auditory effects of noise in industry. VII. Evaluation, conclusions and recommendations.

The results of epidemiological studies on non-auditory effects of noise in industry are commented upon. The present state of the art does not permit any definite conclusion to be drawn about the risk of hypertension. Annoyance by noise is widespread; it has many different aspects and it has been studied in detail in this project. Combinations of working conditions should be studied that produce interaction effects overloading psychological or physiological systems. Some examples are given. Standards and guidelines for industrial exposure to noise should also prevent wellknown, non-auditory effects, such as communication problems, which result in social isolation.

Epidemiologic Methods↗