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[Evaluation of working conditions of municipal employees engaged in manual labor].

The working conditions of municipal employees of Botucatu (State of S. Paulo, Brazil) are described with a view to identifying the most frequent and serious occupational risks. Office workers (clerks) were not included in this study. The morbidities registered in the municipal outpatient service (from July 17 through December 4, 1987) and in the occupational accident register for the period 1984-1987 were evaluated. The activities of the majority of the employees were found to be carried out manually with no technological assistance, likely to generate "occupational accidents" (OA) and related to inadequate (antiergonomic) positions. The coefficient of severity of the OA has increased so rapidly that in 1987 it was 1.85 times higher than in 1984. The analysis of the external sources and the nature of the lesions caused by the OA were closely related to the description of the activities and the risk factors observed. The most frequent ailments registered in the outpatient service were: arterial hypertension, lumbago, the common cold, chronic alcoholism, acute gastroenterecolitis and "personal difficulties". An occupational health program for the municipal workers in Botucatu is proposed.

Accidents, Occupational↗

Work conditions as risk factors for varicose veins of the lower extremities in certain professions of the working population of Rijeka.

This research aims to establish the effect of working conditions on the appearance of varicose veins. The epidemiological study was carried out on 1,324 examinees, 530 males and 794 females, employed in 5 highly represented groups of professional activities in Rijeka (catering, trade, light industry, heavy industry and finances). The data were collected by survey and clinical examination. Varicose veins were more prevalent in the trade than in the office workers (odds ratio (OR) = 2.08; 95% confidence interval (CI) = 1.31-3.31), and more prevalent in catering industries than in the office workers (OR = 1.56; 95% CI = 1.001-2.43). chi 2-testing suggested that standing in the workplace (OR = 1.35; 95% CI = 0.95-1.92), weight handling while working (OR = 1.29; 95% CI = 1.01-1.64) and working indoors (OR = 1.61; 95% CI = 1.02-2.53) were risk factors for varicose veins. By multiple logistic regression, the following risk factors were isolated in the total population: female sex (OR = 1.92; 95% CI = 1.37-2.67), workplace (OR = 0.89; 95% CI = 0.78-0.99), age (OR = 1.05; 95% CI = 1.03-1.07), body mass index (OR = 1.04; 95% CI = 1.01-1.07) and family history of the disease (OR = 1.99; 95% CI = 1.55-2.57).

Adult↗

[Working conditions and health status of women employed in clay brick industry (in subtropical climate)].

The workers engaged into clay brick production in subtropic climate are exposed to dust and heating microclimate. Scientific and technologic progress has a great positive influence on the improvement of work conditions in the stated production. Respiratory diseases turned out to take the first place in the structure of morbidity with transitory disablement. The clinical studies established the correlation between the work conditions and gynecologic morbidity, occurrence of complicated pregnancy and delivery, impaired physical development and health status of newborns and children. The methodic documents and prophylactic recommendations are worked out.

Adaptation, Physiological↗

[Internal control of working conditions as a form of occupational health and safety management--experience of Western European countries and the situation in Poland].

Good occupational health and safety management not only protects workers from hazards and health impairment, but also contributes to the success of the enterprise as a whole. The internal control of working conditions in an enterprise, carried out by an employer, is one of the forms of occupational health and safety management implemented widely in many western countries, for example in Scandinavian countries and Ireland. This method may serve employers as an useful tool for stimulating and developing programmes aimed at improving working conditions and supporting workers' health protection against various hazards occurring in the work environment. The experience of the western countries in developing and implementing the internal control system, and the adaptation of the principles of this system to suit Polish conditions helped the authors to produce a set of general rules and guidelines addressed to employers who decide to use the method of internal control in their enterprises.

Employment↗

Use of analgesics in Sweden--the importance of sociodemographic factors, physical fitness, health and health-related factors, and working conditions.

In this study, factors related to analgesic use-independent of their association with pain-were studied in the general Swedish population. These included sociodemographics, health and health-related factors, physical fitness and working conditions. Data from the Swedish Survey of Living Conditions for the two-year period 1988/89 were used. In this survey a random sample (n = 13,295, response rate 79.4%) of the Swedish population aged 16 years and older was interviewed about health, medication use and related matters, among other things. In all, 35% of the population used analgesics at least once during a two-week period, and analgesic use was more than 50% higher among women than men. Analgesic use was less common among those aged 45-64 years and 65-74 years than those 18-44, after controlling for all other variables. The study showed that self-perceived poor health and pain explain much analgesic use. Analgesic use is further explained by lifestyle, sleeping problems, and health care utilization. Marital status, educational level, socioeconomic status, social network and working conditions were found to be of minor importance.

Adolescent↗

The personal doctor reform in Sweden: perceived changes in working conditions.

BACKGROUND: In primary care in Sweden, several organizational changes have been implemented during the last decades in order to facilitate a shift from a high proportion of hospital care to a more primary-health-based care. The personal doctor reform has been one of the most important during recent years, for both personnel and patients. OBJECTIVES: We aimed to compare perceived changes in psychosocial working conditions for GP and district nurses in regions with traditional primary care and regions that have implemented a personal doctor system. METHODS: A questionnaire was mailed to 566 GPs and 554 district nurses in four selected county councils, two with traditional primary care and two with a personal doctor system. The overall response rate was 83%. A factor analysis of data concerning the experience of the organizational change revealed the following factors: fellowship at work, demands on the individual, influence and control, competence development and stimulation at work. RESULTS AND CONCLUSIONS: In the group as a whole, there was a general experience of deterioration of working conditions in all aspects except stimulation at work. This tendency was mostly marked in the regions with a personal doctor system. In these regions, GPs and district nurses reported significantly more impairments concerning demands on the individual and competence development. In addition, the district nurses also found themselves less able to exercise influence and control. These changes are neither desirable nor necessary consequences of an organizational development. It is important to follow continuously the personnel's experience in a changing primary health care system.

Community Health Nursing↗

Job loss, human capital job feature, and work condition job feature as distinct job insecurity constructs.

The projected growth of new technologies, increasing use of automation, and continued consolidation of health-related services suggest that continued study of job insecurity is needed for health care professionals. Using a sample of 178 medical technologists over a 5-year period, this study's findings extend earlier work by Blau and Sharp (2000) and suggest that job loss insecurity, human capital job feature insecurity, and work condition job feature insecurity are related but distinct types of job insecurity. A seven-item measure of job loss insecurity, a four-item measure of human capital job feature insecurity, and a four-item measure of work condition job feature insecurity were analyzed. Confirmatory factor analysis using a more heterogeneous sample of 447 working adults supported this three-factor structure. Using correlation and path analysis, different significant relationships of antecedent variables and subsequent organizational withdrawal cognitions to these three types of job insecurity were found.

Adult↗

High demand, low control, and impaired general health: working conditions in a sample of Swedish general practitioners.

This cross-sectional survey of 1,004 Swedish general practitioners (GPs) aged 32 64 years analyses the extent to which low control, high work demand, and other work-related conditions are associated with self-rated impaired general health and impaired quality of life among Swedish GPs. The first part of the questionnaire contained "SF-36 Health Survey", from which we chose five psychosocial multi-item scales as dependent variables. The second part of the questionnaire had questions about working conditions from "The Swedish Survey of Living Conditions". Unconditional logistic regression was used. Female and male GPs with high job strain, i.e. low control and high work demand, exhibited a more than threefold increased risk of impaired general health compared with those with medium job strain. Low job strain among male GPs was associated with a low risk of impaired health. The finding of significant associations between psychosocial working conditions and impaired general health and impaired, quality of life in GPs in 1996 highlights the need to improve working conditions in Swedish primary healthcare, for example, by reducing number of inhabitants per full-time GP to 1,500.

Adult↗

[Types of employment and health: analysis of the Second European Survey on Working Conditions].

OBJECTIVES: To investigate the relationships among types of employment and several health self-perceived outcomes in a sample of active workers from the 15 state members of the European Union. METHODS: Cross-sectional study with data drawn from the Second European Survey on Working Conditions (n = 15,146 individuals). The predictive variable was the types of employment aggregated in: permanent workers, sole traders, small employers (less than 10 employees) and temporary workers (full-and part-time). Unconditional logistic regression models were adjusted by age, gender and several indications of working conditions. Permanent workers was used as the baseline category. RESULTS: Employees with permanent (69,3%) and temporary (12,5%) contracts notified the highest level of a job absenteeism while temporary employees reported the highest level of job dissatisfaction. On the other hand, sole traders (12,2%) and small employees (6.1%) notified the most frequent level of overall fatigue, backache and muscular pains. Having permanent workers as baseline category, temporary employees was associated with high dissatisfaction (OR = 1.68), and and overall fatigue (OR = 1.16), but with lower frequency of stress (OR = 0.74) and job absenteeism (OR = 0.87). Small employers showed a low frequency of absenteeism (OR = 0.68), but a high stress (OR = 1.77) and overall fatigue (OR = 1.27). Finally, sole traders reported more frequently overall fatigue (OR = 1.40), and stress (OR = 1.33), but less job absenteeism (OR = 0.58). CONCLUSIONS: These findings suggest that types of employment may have an independent effect on several health self-perceive outcomes. Further research is necessary to overcome various shortcoming of this study, and to assess the role either job security or level of income and social protection.

Absenteeism↗

[Complex assessment of working conditions of painters in industrial plants and their improvement].

The working conditions of the female workers engaged in industrial painting do not correspond to the optimal criteria and exceeds the permissible levels in some respects. Considerable muscle loads which cause the workers' fatigue and corporal pain lead to the overstain of the locomotor system. A complex of health improving measures is proposed to create more favorable labour conditions, lower fatiguability and promote prevention of locomotor system disorders.

Adult↗

[Improved work conditions in present-day porcelain production].

The authors studied work conditions at Doulev porcelain production after its reconstruction. The dust levels appeared to decrease, therefore possible occurrence of occupational diseases caused by dust became lower. A problem of manual tasks liquidation still remains topical.

Ceramics↗

Synchronously counterpulsating extracorporeal life support enhances myocardial working conditions regardless of systemic perfusion pressure.

OBJECTIVE: A new pulsatile extracorporeal life support (pECLS) system has entered the market. We wanted to investigate what potential advantages pECLS may have over current non-pulsatile systems (NPS). Our research was focused on the pump's functional interaction with the left ventricle and the coronary circulation. METHODS: Extensive hemodynamic measurements were performed during asynchronous and synchronous pECLS in 10 calves. The two extremes regarding LV afterload, namely systolic arrival (SA) and diastolic arrival (DA) of the pump pulse were studied. RESULTS: SA was associated with increased oxygen consumption (+57%) and decreased diastolic coronary perfusion (-43%). DA increased left ventricular output (DA: 4.5+/-2.4 l/min vs SA: 3.5+/-2.2 l/min), LV ejection fraction (+10%), and ventricular efficiency (+17%). Mean aortic pressure and mean coronary flow were only marginally affected by pulse incidence. Systolic impairment was more pronounced with higher bypass flows. These results indicate that myocardial working conditions can be optimized by phasing pECLS ejection into cardiac diastole. CONCLUSION: We conclude that during pECLS, myocardial working conditions can be improved by avoidance of systolic impairment. Synchronously counterpulsating pECLS could be a more economic and versatile alternative to NPS or NPS combined with intra-aortic balloon pumping. The potential benefits of synchronously counterpulsating pECLS over the current alternatives remain to be investigated.

Animals↗

Common symptoms in middle aged women: their relation to employment status, psychosocial work conditions and social support in a Swedish setting.

STUDY OBJECTIVE: Over the past few decades there has been a growing interest among researchers, in women's overall life circumstances and their relation to women's health status. For example, paid employment has been considered an important part of women's living conditions in Western societies as the number of women entering the labour market has grown constantly over the past decades. When comparing men's and women's health, one of the most consistent findings is a higher rate of symptoms among women. The most commonly reported symptoms in women are depressive symptoms, symptoms of bodily tension and chronic pain from muscles and joints. The aim of this study was to investigate whether socioeconomic factors, employment status, psychosocial work conditions and social network/support are associated with middle aged women's health status in terms of common symptoms. DESIGN: A mailed questionnaire was used in a cross sectional design assessing socioeconomic factors, employment status, psychosocial work conditions according to the demand/control model, social network/support and an index based on the 15 most frequent symptoms presented by middle aged women when seeking health care. SETTING: A rural community with 13,200 inhabitants in the western part of Sweden. PARTICIPANTS: Women were randomly selected from the general population in the study area, 40 to 50 years of age. The response rate was 81.7 per cent. MAIN RESULTS: Women who were non-employed had a significantly increased odds of a high level of common symptoms (OR = 2.82; 95% confidence intervals 1.69, 4.70), as well as women exposed to job strain (OR = 3.27; 1.92, 5.57), independently of the level of social network/support. Furthermore, exposure to low social support, low social anchorage or low social participation independently showed significantly increased odds of a high level of common symptoms (OR = 2.75; 1.71, 4.42; OR = 2.91; 1.81, 4.69 and OR = 1.69; 1.10, 2.61, respectively). CONCLUSIONS: Work related factors, such as non-employment and job strain, and circumstances within the private sphere, such as social network/support, seem equally important for middle aged women's health status. These findings ought to have important policy implications and also to be of major importance in a primary health care setting when meeting women who seek health care because of common symptoms.

Adult↗

Working conditions, compensation and absenteeism.

This paper examines absence behaviour in relation to the working environment. A theoretical model is built in order to separate the effects of voluntary absences and absences related to ill health, where health effects are assumed to be tied to working conditions. This model is based on the Shapiro and Stiglitz efficiency wage model. In addition, work environment is introduced as a part of the compensation package. The model gives a testable hypothesis of compensating wage differentials. A panel of quarterly firm level data from 1990 to 1998 are used and the theoretical model is supported by the empirical findings. The result indicates that the workers may not be fully compensated when experiencing high levels of noise in the work area, or when the job involves a high degree of monotonous work, heavy or frequent lifting or poor work postures. Ill health, and thus increased long-term absence, is not highly related to economic variables. However, long-term absence is relatively higher if the firm is troubled with many accidents or near misses. In addition, disamenities for which workers are not fully compensated cause ill health and increased long-term absence.

Absenteeism↗

Long-term sickness absence due to musculoskeletal disorders: the necessary intervention of work conditions.

To make rehabilitation of musculoskeletal disorders effective it is crucial to identify circumstances that tend to support the persistence of sickness absence. A total of 93 patients with recently developed disorders in the neck and shoulders were followed for one year after rehabilitation, in order to identify factors associated with recovery and chronicity, respectively. Health status was evaluated before rehabilitation and after 12 months in terms of sickness absence, pain ratings and self-rated quality of life, the Sickness Impact Profile. The study group was divided into tertiles based on their number of days of sickness absence during the follow-up period (short: < 25 days, medium: 25-101 days, long: > 101 days). Those with long-term sickness absence perceived higher physical and mental load in their jobs. There was also a higher proportion of persons who were not born in Sweden in this group and on average they had more sick-leave days the preceding year. Other background characteristics and personality ratings were similar between the groups. Long-term sickness absence was associated with worse ratings in quality of life after one year, and pain did not diminish during the follow-up year. Multiple regression analysis indicated that long-term sickness absence was largely associated with work conditions rather than with individual characteristics. Therefore, the results underscore the importance not only of treating the individual with musculoskeletal disorders, but in particular of improving his or her work conditions.

Adult↗

The health effects of jobs: status, working conditions, or both?

BACKGROUND: This study investigates whether the association of job strain and insecurity with health differs by status. METHODS: A cross-sectional study of 2,249 employed workers aged 40-44 years conducted in two regions in south-east Australia in 2000 used a self-completed questionnaire to collect data. Multivariate analyses were used to compare depression, anxiety, physical health and general practitioner (GP) visits over 12 months across categories of job strain and insecurity for three status groups (high, middle and low). RESULTS: High job strain and job insecurity were independently associated with poor mental health, poor physical health and visits to the GP for all status groups when adjusted for confounders. High job strain was associated with depression (OR = 2.46, 95% CI 1.96-3.07), anxiety (OR = 2.56, 95% Cl 2.05-3.20), lower mean physical health scores (-1.11, 95% CI -1.98 - -0.23), and more visits to the GP (IRR = 1.20, 95% CI 1.05-1.37). High job insecurity also showed significant associations with depression (OR = 3.03, 95% Cl 2.03-4.53), anxiety (OR = 2.66, 95% CI 1.81-3.91), and GP visits (IRR = 1.27, 95% CI 1.01-1.60). There were no significant differences by status in the associations of job strain and insecurity with outcomes. CONCLUSION: High-status workers were just as likely as low-status workers to be exposed to adverse work conditions and both status groups showed similar health effects. IMPLICATIONS: Exposure to insecure and high-strain jobs is likely to rise as economies and labour markets respond to globalisation and political change. High status may not protect employees from either exposure or impact, thus widening the population health consequences of adverse work conditions.

Adult↗

The impact of participatory ergonomics on working conditions, quality, and productivity.

A participatory ergonomics model was designed for improving working conditions, quality, and productivity in a medium-sized manufacturing enterprise by making use of a Supportive Expert Team (SET). In order to implement the model, a team-based structure consisting of a Steering Committee (SC) and 2 Action Groups (AGs) was designed and a 5-phase methodology followed. To validate the model, a similar factory was selected as control. Performance of the model was successful throughout the project. AGs under the supervision of the SC and the support of the SET designed and implemented several ergonomics solutions using local resources. Our findings showed that, in comparison with the control factory, application of such a model could be considered as a provider of a more humanized work environment as well as a more efficient and cost-effective approach.

Efficiency↗