PubMed · 9288491
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D Holzman. 1997. A driving force.. https://doi.org/10.1289/ehp.97105582
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BACKGROUND: The Next Step Trial was a randomized trial of worksite colorectal cancer screening promotion and nutrition interventions for automobile industry employees at increased risk of colorectal cancer. Interventions were tested at 28 worksites with 5,042 employees. This report describes results of the screening promotion intervention. METHODS: Worksites randomized to the control group received a standard program including rectal examination, fecal occult blood testing, and flexible sigmoidoscopy. Intervention worksites received an enhanced program (i.e., standard program plus an educational booklet/telephone call). Compliance (i.e., completion of all recommended screening examinations) and coverage (i.e., completion of at least one screening examination), the primary and secondary outcomes, were measured over 2 years. RESULTS: In the 2 years prior to baseline, 61% of employees had been screened. After random assignment, baseline differences in several employee characteristics and worksite screening procedures were detected, including more past history of screening in control worksites. After adjusting for differences, we found modest, but higher, compliance and coverage in intervention compared with control worksites (odds ratio [95% confidence limits] = 1.46 [1.1-2.0] and 1.33 [1.1, 1.6], respectively). CONCLUSIONS: Adding a personally tailored behavioral intervention to a standard colorectal cancer screening program can promote continued employee participation in screening as measured by compliance. Further research is needed to assess intervention effects in other populations.
New systems of work organization, such as lean production and total quality management, have been introduced by employers throughout the industrialized world to improve productivity, quality, and profitability. However, few studies have examined the impact of such systems on occupational injuries or illnesses or on job characteristics related to job strain, which has been linked to hypertension and cardiovascular disease. The studies reviewed provide little evidence to support the hypothesis that lean production "empowers" auto workers. In fact, auto industry studies suggest that lean production creates intensified work pace and demands. Increases in decision authority and skill levels are modest or temporary, whereas decision latitude typically remains low. Thus, such work can be considered to have job strain. In jobs with ergonomic stressors, intensification of labor appears to lead to increases in musculoskeletal disorders. The evidence for adverse health effects remains inconclusive for related new work systems in other industries, such as modular manufacturing or patient-focused care.