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PubMed2000

Determination of the in vivo loading of the lumbar spine with a new approach directly at the workplace--first results for nurses.

OBJECTIVE: To determine the magnitude of workplace loading for nurses with and without a history of low back pain. DESIGN: A measurement system for the assessment of workplace loading as well as a model for the calculation of lumbo-sacral junction loading was designed and applied to a group of 12 nurses with and without a history of low back pain. BACKGROUND: Disagreement exists regarding the key factors in the aetiology of low back pain. Traditionally workplace loading is viewed as the dominant influence. Data for workplace loading in jobs with non-uniform tasks, however, do rarely exist. METHODS: A three-dimensional inverse-dynamic and force distribution model as well as the respective data acquisition system was used to assess the workplace loading of 12 nurses from surgical departments of two hospitals. The nurses were assigned to two groups based on their history of low back pain (with/without). Workplace loading was measured continuously for 4 h. RESULTS: No differences in workplace loading between nurses with/without a history of low back pain were found. Maximum values of the compressive force at the lumbo-sacral junction were high and well above suggested workplace load limits. High values occurred only during short-time periods (about 0.4% of total shift duration). CONCLUSIONS: A system for the assessment of overall workplace loading has been developed. First results for nurses suggest that critical loadings do exist at the workplace, even so they might not be the decisive factor for the development of low back pain. RELEVANCE: Preventative measures for low back pain in nursing have to include prevention of critical workplace loading. This approach by itself, however, is probably not sufficient.

Adult↗
PubMed2006

A randomized controlled trial of the therapeutic workplace for community methadone patients: a partial failure to engage.

The Therapeutic Workplace is an employment-based treatment for drug addiction that uses wages for work to reinforce drug abstinence. The Therapeutic Workplace has promoted abstinence from heroin and cocaine in treatment-resistant mothers in methadone treatment. This study attempted to replicate that effect in crack cocaine users recruited from community-based methadone programs. Participants were randomly assigned to a Therapeutic Workplace (n=22) or usual care control (n=25) group. Therapeutic Workplace participants were invited to work in the workplace and earn vouchers every weekday for 9 months contingent on documented opiate and cocaine abstinence. The two groups did not differ significantly on measures of cocaine or opiate use collected during study participation. Daily attendance and urinalysis results of the Therapeutic Workplace group were analyzed, and only 7 of the 22 participants initiated consistent periods of abstinence and workplace attendance. Two individuals gained access to the workplace on a few days, and 9 participants attempted to gain access to the workplace but never provided a drug-negative urine sample. Possible reasons for differences between the current study and the previous Therapeutic Workplace study are considered. Procedures that increase participant contact with the Therapeutic Workplace and its reinforcement contingencies might increase the likelihood of these individuals being successful in the treatment program.

Adolescent↗
PubMed1993

Lower levels of cigarette consumption found in smoke-free workplaces in California.

OBJECTIVE: We examined the relationship between workplace smoking policies and smoking prevalence and cigarette consumption. METHODS: California residents were questioned by telephone with the 1990 California Tobacco Survey. All respondents (11,704) above age 18 years who were employed indoors were used. Respondents were asked about smoking status, workplace smoking policy, desire to quit, and smoking history. Logistic regression was used to determine the relationship of workplace smoking policy to smoking status, accounting for demographic variables. RESULTS: Prevalence of regular smokers was significantly lower in smoke-free workplaces than in those with no restrictions (13.7% vs 20.6%, P < .001). Continuing regular smokers in smoke-free workplaces smoked fewer cigarettes than those in workplaces with no restrictions (296 vs 341 packs per year, P < .001). More comprehensive smoking policies were associated with smokers more likely to contemplate quitting (P = .014). CONCLUSIONS: Employees in smoke-free workplaces have a lower smoking prevalence and, among continuing smokers, lower cigarette consumption than individuals working where smoking is permitted. We estimate cigarette consumption among employees indoors is 21% below that if there were no smoking restrictions in California workplaces. Furthermore, if all California workplaces were smoke-free, cigarette consumption among employees would be 41% below that if there were no workplace smoking restrictions, approximately a $406 million annual loss in sales to the tobacco industry. This study supports the hypothesis that smoke-free workplace policies are an effective public health measure for decreasing smoking prevalence and cigarette consumption among continuing smokers.

Adolescent↗
PubMed2003

Workplace interventions for smoking cessation.

BACKGROUND: The workplace has potential as a setting through which large groups of people can be reached to encourage smoking cessation. OBJECTIVES: To categorise workplace interventions for smoking cessation tested in controlled studies and to determine the extent to which they help workers to stop smoking or to reduce tobacco consumption. SEARCH STRATEGY: We searched the Tobacco Addiction Review Group trials register in November 2002, Medline (1966 - November 2002), EMBASE (1985 - November 2002) and PsycINFO (to November 2002). We searched abstracts from international conferences on tobacco and we checked the bibliographies of identified studies and reviews for additional references. SELECTION CRITERIA: We categorised interventions into two groups: a) Interventions aimed at the individual to promote smoking cessation and b) interventions aimed at the workplace as a whole. We applied different inclusion criteria for the different types of study. For interventions aimed at helping individuals to stop smoking, we included only randomised controlled trials allocating individuals, workplaces or companies to intervention or control conditions. For studies of smoking restrictions and bans in the workplace, we also included controlled trials with baseline and post-intervention outcomes and interrupted times series studies. DATA COLLECTION AND ANALYSIS: Information relating to the characteristics and content of all kinds of interventions, participants, outcomes and methods of the study was abstracted by one reviewer and checked by two others. Because of heterogeneity in the design and content of the included studies, we did not attempt formal meta-analysis, and evaluated the studies using qualitative narrative synthesis. MAIN RESULTS: Workplace interventions aimed at helping individuals to stop smoking included nine studies of group therapy, three studies of individual counselling, eight studies of self-help materials and four studies of nicotine replacement therapy. The results were consistent with those found in other settings. Group programmes, individual counselling and nicotine replacement therapy increased cessation rates in comparison to no treatment or minimal intervention controls. Self-help materials were less effective. Workplace interventions aimed at the workforce as a whole included 13 studies of tobacco bans, two studies of social support, four studies of environmental support, four studies of incentives, six studies of comprehensive (multi-component) programmes and two studies of competitions and recruitment. Tobacco bans decreased cigarette consumption during the working day but their effect on total consumption was less certain. We failed to detect an increase in quit rates from adding social and environmental support to these programmes. There was a lack of evidence that comprehensive programmes reduced the prevalence of smoking. Competitions and incentives increased attempts to stop smoking, though there was less evidence that they increased the rate of actual quitting. REVIEWER'S CONCLUSIONS: We found 1. Strong evidence that interventions directed towards individual smokers increase the likelihood of quitting smoking. These include advice from a health professional, individual and group counselling and pharmacological treatment to overcome nicotine addiction. Self-help interventions are less effective. All these interventions are effective whether offered in the workplace or elsewhere. Although people taking up these interventions are more likely to stop, the absolute numbers who quit are low. 2. Limited evidence that participation in programmes can be increased by competitions and incentives organised by the employer. 3. Consistent evidence that workplace tobacco policies and bans can decrease cigarette consumption during the working day by smokers and exposure of non-smoking employees to environmental tobacco smoke at work, but conflicting evidence about whether they decrease prevalence of smoking or overall consumption of tobacco by smokers. 4. A lack of evidence that comprehensive approaches reduce the prevalence of smoking, despite the strong theoretical rationale for their use. 5. A lack of evidence about the cost-effectiveness of workplace programmes.

Counseling↗
PubMed2006

Interference phenomena in temporal evolution of accident probability in workplaces.

The aim of this article is to investigate some implications of complexity in workplace risk assessment. Workplace is examined as a complex system, and some of its attributes and aspects of its behavior are investigated. Failure probability of various workplace elements is examined as a time variable and interference phenomena of these probabilities are presented. Potential inefficiencies of common perceptions in applying probabilistic risk assessment models are also discussed. This investigation is conducted through mathematical modeling and qualitative examples of workplace situations. A mathematical model for simulation of the evolution of workplace accident probability in time is developed. Its findings are then attempted to be translated in real-world terms and discussed through simple examples of workplace situations. The mathematical model indicates that workplace is more likely to exhibit an unpredictable behavior. Such a behavior raises issues about usual key assumptions for the workplace, such as aggregation. Chaotic phenomena (nonlinear feedback mechanisms) are also investigated for in simple workplace systems cases. The main conclusions are (1) that time is an important variable for risk assessment, since behavior patterns are complex and unpredictable in the long term and (2) that workplace risk identification should take place in a holistic view (not by work post).

Accidents↗
PubMed2006

[Study on the relationship between workplace violence and work ability among health care professionals in Shangqiu City].

OBJECTIVE: To study the relationship between workplace violence and work ability and to provide evidence for preventing workplace violence and improving work ability among health care professionals. METHODS: A test of the workplace violence and work ability was carried out with workplace violence scale and work ability index, and Other information was investigated with questionnaire among 507 health care professionals in Shangqiu City of China. RESULTS: (1) The mean score of workplace violence was significantly higher in the group aged 30 - 44 than that of the group aged 45 - 59 (P < 0.05). (2) Among nurse group the mean score of workplace violence was higher than that of the doctor group and medical technician group (P < 0.05). (3) The mean score of WAI was lower in the group with primary educational level than that of other group (P < 0.05). (4) The workplace violence score correlated negatively to the WAI score (r = - 0.250, P < 0.01). (5) Logistic regression analysis showed that after controlling the other risk factors, workplace violence was an important risk factor of work ability ( OR = 8.44). CONCLUSION: Workplace violence has impact on work ability among health care professionals. Intervention measures should be taken to prevent workplace violence among health care professionals.

Adult↗
PubMed2005

Workplace interventions for smoking cessation.

BACKGROUND: The workplace has potential as a setting through which large groups of people can be reached to encourage smoking cessation. OBJECTIVES: To categorize workplace interventions for smoking cessation tested in controlled studies and to determine the extent to which they help workers to stop smoking or to reduce tobacco consumption. SEARCH STRATEGY: We searched the Cochrane Tobacco Addiction Group Specialized Register in October 2004, MEDLINE (1966 - October 2004), EMBASE (1985 - October 2004) and PsycINFO (to October 2004). We searched abstracts from international conferences on tobacco and we checked the bibliographies of identified studies and reviews for additional references. SELECTION CRITERIA: We categorized interventions into two groups: a) Interventions aimed at the individual to promote smoking cessation and b) interventions aimed at the workplace as a whole. We applied different inclusion criteria for the different types of study. For interventions aimed at helping individuals to stop smoking, we included only randomized controlled trials allocating individuals, workplaces or companies to intervention or control conditions. For studies of smoking restrictions and bans in the workplace, we also included controlled trials with baseline and post-intervention outcomes and interrupted times series studies. DATA COLLECTION AND ANALYSIS: Information relating to the characteristics and content of all kinds of interventions, participants, outcomes and methods of the study was abstracted by one author and checked by two others. Because of heterogeneity in the design and content of the included studies, we did not attempt formal meta-analysis, and evaluated the studies using qualitative narrative synthesis. MAIN RESULTS: Workplace interventions aimed at helping individuals to stop smoking included ten studies of group therapy, seven studies of individual counselling, nine studies of self-help materials and five studies of nicotine replacement therapy. The results were consistent with those found in other settings. Group programmes, individual counselling and nicotine replacement therapy increased cessation rates in comparison to no treatment or minimal intervention controls. Self-help materials were less effective.Workplace interventions aimed at the workforce as a whole included 14 studies of tobacco bans, two studies of social support, four studies of environmental support, five studies of incentives, and eight studies of comprehensive (multi-component) programmes. Tobacco bans decreased cigarette consumption during the working day but their effect on total consumption was less certain. We failed to detect an increase in quit rates from adding social and environmental support to these programmes. There was a lack of evidence that comprehensive programmes reduced the prevalence of smoking. Competitions and incentives increased attempts to stop smoking, though there was less evidence that they increased the rate of actual quitting. AUTHORS' CONCLUSIONS: We found: 1. Strong evidence that interventions directed towards individual smokers increase the likelihood of quitting smoking. These include advice from a health professional, individual and group counselling and pharmacological treatment to overcome nicotine addiction. Self-help interventions are less effective. All these interventions are effective whether offered in the workplace or elsewhere. Although people taking up these interventions are more likely to stop, the absolute numbers who quit are low. 2. Limited evidence that participation in programmes can be increased by competitions and incentives organized by the employer. 3. Consistent evidence that workplace tobacco policies and bans can decrease cigarette consumption during the working day by smokers and exposure of non-smoking employees to environmental tobacco smoke at work, but conflicting evidence about whether they decrease prevalence of smoking or overall consumption of tobacco by smokers. 4. A lack of evidence that comprehensive approaches reduce the prevalence of smoking, despite the strong theoretical rationale for their use. 5. A lack of evidence about the cost-effectiveness of workplace programmes.

Counseling↗
PubMed2004

Sickness absence in female- and male-dominated occupations and workplaces.

Previous research suggests that both men's and women's level of sickness absence may be systematically related to the gender composition of their workplace as well as of their occupational category. The number of studies is, however, low and the composition of the occupational category has often been used as a proxy for the composition of the workplace. This paper employs a large data set broadly representative of the employed population of Norway. The data make it possible to take workplace and occupation simultaneously into account. Thus, the relationship between the gender composition of the workplace and sickness absence is estimated with detailed control for differences between occupational categories. Likewise, the importance of the gender composition of the occupation is assessed with control for between workplace variation. Men's sickness absence turns out to be largely unrelated to the gender composition of the workplace. For women the level of sickness absence tends to be higher in female-dominated workplaces, but the relationship is weak. These findings provide evidence against theories suggesting that the minority sex in the workplace faces special problems and is therefore more absent. They are to some extent consistent with the idea that female-dominated workplaces develop norms that are more tolerant towards sickness absence. The relationship of sickness absence to the gender composition of the occupational category is similar to the U-shaped pattern found in several previous studies (highest sickness absence both in strongly male-dominated and strongly female-dominated occupations), but again the relationship is weak.

Absenteeism↗
PubMed1999

Exposure to environmental tobacco smoke in the workplace and the impact of away-from-work exposure.

Concentrating on exposure in workplaces where smoking occurs, we examined environmental tobacco smoke (ETS)-related concentration data from the 16-City Study. This study involved a large population of nonsmokers, used personal monitors, and encompassed a wide selection of ETS-related constituents. This first article in a series of three describes the 16-City Study, considers the impact of demographic variables, and concludes that these variables did not explain differences in exposure to ETS. We compared 16-City Study concentrations obtained in the workplace to previously reported workplace concentrations and determined that data from this study were representative of current ETS exposure in nonmanufacturing workplaces where smoking occurs. Considering factors other than demographic factors, we found that, not surprisingly, the number of cigarettes observed in the workplace had an impact on exposure concentrations. Finally, we compared people from homes where smoking occurs with people from nonsmoking homes and found that people from smoking homes observed more smoking in the workplace and experienced higher concentrations of ETS-related compounds in the workplace, even when they observed the same number of cigarettes being smoked in the workplace. In two subsequent articles in this series, we discuss relationships between various ETS markers and provide estimates of distributions of doses to nonsmoking workers employed in workplaces where smoking occurs.

Adult↗
PubMed2003

Workplace violence in nursing in Queensland, Australia: a self-reported study.

This paper reports on workplace violence, self-reported as part of a survey among members of the Queensland Nurses' Union (QNU) in October 2001. The aim of the overall study was to ascertain how nurses perceived their work and their working conditions and to use the results of the study to inform strategic planning of the QNU. The participants of this study were drawn from a stratified random sample of 2800 QNU members employed in the public, the private acute and the aged care sectors. The total number of completed surveys analysed was 1436: 441 aged care, 497 public and 498 private acute sector surveys. The results suggest that the rate of workplace violence differs significantly across sectors. In the three months immediately prior to the survey, 50% of aged care sector nurses experienced some form of workplace violence compared to 47% of public sector nurses and 29% of acute private sector nurses. The major source of workplace violence was from patients. The second most common source of violence varied. Nurses in the public sector signified visitors and relatives while nurses in the aged care and acute private sectors indicated other nurses. The study found that inexperienced nurses are more likely to report workplace violence than experienced nurses. Additionally, the more experienced the nurse, the less likely they are to perceive workplace policies and procedures for workplace violence as effective. Additional findings include an apparent lack of policies and procedures for workplace violence in rural and remote areas, and an association between the designation of a nurse and the reported level of workplace violence.

Female↗
PubMed2004

Assessing the relationship of learning approaches to workplace climate in clerkship and residency.

PURPOSE: To determine what approaches to learning are adopted by clinical clerks and residents and whether these approaches are associated with demographic factors, specialty, level of training, and perceptions of the workplace climate. METHOD: In 2001-02, medical clerks (n = 532) and residents (n = 2,939) at five medical schools in Ontario, Canada, were mailed the Workplace Learning Questionnaire. The correlation between the approaches to learning at work and perceived workplace climate and the influence of gender, age, location, residency program and level of training on outcomes were measured. RESULTS: A total of 1,642 clerks and residents responded (47%). The factor structure and reliability of the Workplace Learning Questionnaire were confirmed for these respondents. A surface-disorganized approach to learning was correlated with perception of heavy workload (r = .401, p < .001). The deep approach to learning was correlated with perception of choice-independence in the workplace and a supportive-receptive workplace (r = .32, p < .001; r = .23, p < .001). The climate factors, perception of choice-independence and supportive-receptive workplace, were correlated (r = .60, p < .001). There were significant differences among the mean scores for scales based on residency, year of training, and location of training. CONCLUSIONS: Perception of the workplace climate was associated with the approach to learning in the workplace of clerks and residents. Perception of heavy workload was associated with less effective approaches to learning. These associations varied with the residency program and the level of training.

Adult↗