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PubMed2004

Costs of occupational injury and illness across industries.

OBJECTIVES: This study has ranked industries using estimated total costs and costs per worker. METHODS: This incidence study of nationwide data was carried out in 1993. The main outcome measure was total cost for medical care, lost productivity, and pain and suffering for the entire United States (US). The analysis was conducted using fatal and nonfatal injury and illness data recorded in large data sets from the US Bureau of Labor Statistics. Cost data were derived from workers' compensation records, estimates of lost wages, and jury awards. Current-value calculations were used to express all costs in 1993 in US dollars. RESULTS: The following industries were at the top of the list for average cost (cost per worker): taxicabs, bituminous coal and lignite mining, logging, crushed stone, oil field services, water transportation services, sand and gravel, and trucking. Industries high on the total-cost list were trucking, eating and drinking places, hospitals, grocery stores, nursing homes, motor vehicles, and department stores. Industries at the bottom of the cost-per-worker list included legal services, security brokers, mortgage bankers, security exchanges, and labor union offices. CONCLUSIONS: Detailed methodology was developed for ranking industries by total cost and cost per worker. Ranking by total costs provided information on total burden of hazards, and ranking by cost per worker provided information on risk. Industries that ranked high on both lists deserve increased research and regulatory attention.

Absenteeism↗
PubMedDate not supplied

Health care futures. What lies ahead? Where are we going? Panel discussion.

Who would have guessed that managed care would dominate the health care industry in the final two decades of the millennium? That physicians would be joining labor unions? Or that they would be going back to school to become Fellows of the American College of Physician Executives? To find out what may be in store for health care in America five to 10 years hence, The Physician Executive asked nine health care experts to participate in a two-part panel discussion. Here's what they see ahead in managed care, information technology, and biotechnology. Part 2 will appear in the July/August Issue of The Physician Executive.

Biotechnology↗
PubMed1979

Health care costs: saving in the private sector.

Robeson offers a number of options to employers to help reduce the impact of increasing health care costs. He points out that large organizations which employ hundreds of people have considerable market power which can be exerted to contain costs. It is suggested that the risk management departments assume the responsibility for managing the effort to reduce the costs of medical care and of the health insurance programs of these organizations since that staff is experienced at evaluating premiums and negotiating with third-party payors. The article examines a number of short-run strategies for firms to pursue to contain health care costs: (1) use alternative delivery systems such as health maintenance organizations (HMOs) which have cost-cutting potential but require marketing efforts to persuade employees of their desirability; (2) contracts with third-party payors which require a second opinion (peer review), a practice which saved one labor union over $2 million from 1972 to 1976; (3) implementation of insurance coverage for less expensive outpatient care; and (4) the use of claims review. These strategies are compared in terms of four criteria: supply of demand for health services; management effort; cost; and time necessary for realized savings. Robeson concludes that development of a management plan for containing health care costs requires an extensive analysis of alternatives, organizational objectives, existing policies, and resources, and offers a table summarizing the cost-containment strategies that a firm should consider.

Ambulatory Care↗
PubMedDate not supplied

Can we control health care costs?

The health care system will never go bankrupt, the author of this article asserts. But the expense of maintaining it is putting such a strain on our resources that bankruptcy sometimes seems not so far off. The controls and devices we use, like certificate-of-need requirements and health management organizations, obviously have not slowed the rise in costs. We need to focus our attention on three elements in the picture that can do the most about curbing expenditures: the health care administrator, the physician, and the business organization (the labor union as well as the corporation). The author offers suggestions for action from these quarters.

Certificate of Need↗
PubMed1997

[New labor relations and workers' health in Argentina: challenges and perspectives for epidemiology]

This paper analyzes changes in labor relations, legislation pertaining to work-related diseases and accidents, and the impact on workers' health in Argentina (1989-1995). The data indicate an increase in unemployment, underemployment, self-employment, and new hiring practices. The study shows the mechanisms by which the state has delegated responsibility for prevention of work-related risks to the private insurance sector. The theoretical discussion of causality thus acquires a political/practical dimension. The data show an increase in work-related accidents following labor reform. Research by universities, NGOs, and labor unions reveal changes in health profiles for salaried, self-employed, and underemployed workers. The three National Meetings on Employment and Health (1992-1994) established an area of exchange between academic and workers' knowledge, with some 128 presentations, research projects, and studies, pointing to an enhanced field for epidemiological surveillance and intervention. The paper reviews the surveys performed by the National Confederation of Workers in Education and the Public Employees' Association.

Journal Article↗
PubMed2002

Impact of September 11 attacks on workers in the vicinity of the World Trade Center--New York City.

In January 2002, CDC's National Institute for Occupational Safety and Health received requests for Health Hazard Evaluations from labor unions representing workers employed in buildings in the vicinity of the World Trade Center (WTC). Workers reported persistent physical and mental health symptoms that they associated with exposures from the WTC collapse and ensuing fires. To address these concerns, CDC conducted surveys of workers at four workplaces in New York City (NYC), a high school (high school A) and college (college A) near the WTC site, and a high school (comparison high school B) and college (comparison college B) > or = 5 miles from the WTC site to determine rates of physical and mental health symptoms. This report summarizes the preliminary results of the employee surveys, which indicated that workers employed near the WTC site had significantly higher rates of physical and mental health symptoms than workers employed > or = 5 miles from the site. Intervention programs should be tailored to address the needs of these workers, and the effectiveness of these programs should be evaluated. Further assessment is warranted to describe the nature and extent of illness in specific working groups and individual medical follow-up in those with persistent symptoms.

Aircraft↗
PubMed2001

Shiftworkers in developing countries: health and well-being and supporting measures.

Developing countries currently represent approximately 79% of the world population. Living and working conditions in middle and low income countries are harder and worse than for workers in industrialized countries. In developing countries, workers usually face more dangerous workplaces and unhealthy environmental and occupational conditions than those of industrial countries. Shiftworkers can face even more difficulties, due to constraints caused by their working time and consequences on health. Occupational health actions oriented by health policies were implemented during the 1990s in several Asian countries and in Brazil. these actions are important to promote workers' health. The general aims of this report are: a) to discuss topics related to equity and health; b) to present the main items of international and Brazilian legislation for shiftworkers; and c) to review general and specific measures of occupational health for shiftworkers in developing countries. In order to have equity on health and well-being, supporting measures should encompass micro and macro improvements at local, regional and national levels. Governmental and non-governmental organizations, professional bodies, labor unions, research institutes, universities, technical schools and syndicates, would play important roles to achieve these goals.

Cross-Cultural Comparison↗
PubMed2006

[The effect of perceived work and organizational chracteristics on psychological distress and intention to quit of information technology professionals].

PURPOSE: The information technology (IT) and service industry in Japan is known to have many work-related stressors, and requires more effective stress reduction to control an elevated turnover rate and adverse health effects. However, little research has been performed using either individual or organizational outcomes (e.g., psychological distress and intention to quit) to determine micro and macro-level stressors on information technology (IT) professionals. This study aimed to examine the effect of perceived work and organizational characteristics (PWOC) as micro and macro-level stressors on psychological distress and intention to quit, controlling for profitability of the organization and individual characteristics on IT professionals in Japan. METHODS: We conducted a web-based questionnaire at fifty-three Japanese IT-related companies. From May to June of 2003, ten to thirty people from each company, who were chosen according to quota method indicators through the labor unions, voluntarily participated in this study. Participants accessed our webpage, which was designed with a self-administrated questionnaire and was accessible by password. The data they entered were sent to our database automatically. The questionnaire consisted of items concerning socio-demographic status; office size; employment characteristics; work hour characteristics; profitability of the organization; a novel 29-item scale (PWOC); as well as individual characteristics. The response rate was 66% (n = 1049). For the purpose of this study, we analyzed data on an IT engineers' group separately (n = 871). RESULTS: Hierarchical multiple regression analysis showed that each model explained 23% and 26% of the variance in psychological distress and intention to quit, respectively. PWOC sub-scales, which are related to macro-level stressors (e.g., undeveloped management systems and career and future ambiguity), affect not only psychological distress but also intention to quit. Objective data of macro-level stressors such as increased profitability determine intention to quit, independently controlling for their PWOC. Also, growth need strength was an important personal characteristic for psychological distress. The results allow us to speculate on macro as well as micro-level stressors for ways that organizations might reduce IT professionals' stress and increase their productivity. CONCLUSIONS: This study suggests that macro-level stressors are important factors for psychological distress and intention to quit for IT professionals, as well as micro-level stressors. Since occupational stress is costly in terms of organizational outcomes, further research on occupational stress measuring individual and organizational outcomes both within and beyond the Japanese IT industry should prove useful.

Computers↗
PubMedDate not supplied

MR findings in the brains of compressed-air tunnel workers: relationship to psychometric results.

Cranial MR imaging was performed in 30 subjects who had been involved in compressed-air tunnel projects in and around Milwaukee, WI. Nineteen of these subjects had been exposed to various degrees of hyperbaric air as calculated by an exposure index (average PSI pressure gauge multiplied by the number of years exposed), while 11 of the subjects were age-matched controls who belonged to the same labor union but had not been exposed to hyperbaric air. All MR scanning was done on a 1.5-T unit, and axial, sagittal, and coronal T1, proton density, and T2-weighted images were obtained. Ventricular size was measured objectively. Foci of increased T2 intensity within deep white matter tracts were evaluated as to number and location, and psychometric testing was performed on both groups to exclude preexisting organic brain disease. The 19 subjects in the experimental group had a statistically higher number (p = .05) of white matter lesions (more than 152) than the control group (22 lesions), and 37% of the experimental group had more than 20 white matter lesions each (seven of 19 subjects) while only 18% of the control group had 10 or 11 lesions each. The experimental group had a five times higher risk than the control group of having high-grade lesions, and a high statistical correlation (p = .02) was found between the number and severity of lesions in the experimental group as compared with the control group when linear trend analysis was performed. No correlation was found between exposure index, MR grade or number, or aseptic necrosis. Ventricular size was normal in all subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Progress in establishing safety protocols based on CDC and OSHA recommendations.

In 1987, following the first documented reports of occupationally acquired human immunodeficiency virus (HIV) in healthcare employees, the American Nurses Association and some labor unions petitioned the Occupational Safety and Health Administration (OSHA) to issue an emergency infection control standard. OSHA responded by enforcing a series of voluntary guidelines developed by the Centers for Disease Control (CDC) four years earlier. A draft of regulations proposed by OSHA was published in the Federal Register, and the final set of these regulations is expected in early 1991. In the proposed guidelines, hepatitis B is cited as a major health risk to healthcare personnel--a more significant risk than HIV. The degree of risk varies between units in the hospital and between hospitals and other facilities. Standards are set for types of protective clothing and equipment, and for housekeeping and laundry areas. The report sets rules governing infectious waste disposal. It establishes guidelines for tracking employees, pre- and post-exposure. In enforcing these rules and guidelines, hospitals should stress continued education and training in order to increase compliance. A recent study revealed that, after a two-year training/evaluation period, physician compliance with infection control procedures increased from 20% to 80%, and nurse compliance rose from 50% to 86%.

Centers for Disease Control and Prevention, U.S.↗
PubMed1987

Retrospective cohort mortality study of dry cleaner workers using perchloroethylene.

To evaluate the carcinogenic potential from occupational exposure to perchloroethylene (PCE), a retrospective cohort mortality study of workers employed in the dry cleaning industry was conducted among 1,690 workers from four labor unions. The majority of the cohort had potential exposure to petroleum solvents as well as to PCE while working in the dry cleaning industry. Mortality from primary cancer of the liver was of particular interest, due to the findings of excess liver cancer in mice exposed to PCE. Other sites of cancer were also of interest. A total of 493 deaths were observed, whereas 575.5 were expected based on US mortality rates. Mortality from all cancers combined was greater than expected (142 observed v 122.9 expected). No deaths due to liver cancer were observed. Urinary tract cancer was the only specific site where there was a statistically significant excess in observed deaths (12 observed v 4.7 expected). There was some consistency in these findings across the four individual unions and across race/sex groups. A subcohort of workers who were employed only in dry cleaning shops that used PCE as their primary solvent was identified from the union records. There was only one death from urinary tract cancer, whereas 1.3 deaths were expected in this subcohort.

Actuarial Analysis↗
PubMedDate not supplied

Port Allegany Asbestos Health Program: a community response to a public health problem.

The Port Allegany Asbestos Health Program (PAAHP) is a unique, community-run program that resulted from the successful cooperative efforts of a labor union, a corporation, community health care providers, and a medical school. PAAHP's goal is to develop a permanent community health organization that will use the most advanced existing knowledge to mitigate the adverse health effects anticipated as a result of the use of amosite asbestos in a Port Allegany, Pa. factory. All 1,188 persons employed by the factory during the years 1964-72 and the 3,000-4,000 persons in household contact with them are eligible for the program. PAAHP's major services are intensive medical surveillance, smoking cessation assistance, health education for participants, and continuing education for area physicians about asbestos-related diseases. One of the program's policies is not to disturb the usual patterns of medical care. If further testing or treatment is needed, patients are referred to their usual personal physicians. PAAHP does not provide ordinary medical care or medical insurance. Across the nation, the number of workers estimated to have been exposed to asbestos is more than 20 million, and their household contacts are estimated to be about three to four times that number. Adverse health effects resulting from asbestos exposure include elevated risk of lung cancer, mesothelioma, gastrointestinal tumors, and asbestosis. The problem requires the development of public health solutions. PAAHP has demonstrated the feasibility of a community-based model as one useful approach.

Asbestos↗