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[Work conditions and physicians health in the city of Salvador, Brasil].

BACKGROUND: The conditions of work and health of physicians in the city of Salvador, State of Bahia, Brasil were described. METHODS: A cross sectional study investigated a random sample of 350 physicians. Information about the physical and mental health, living habits and working conditions of these physicians was collected by self-reported, individual questionnaires forwarded by mail. RESULTS: The physicians reported excessive work loads, more than one job, low income, and precarious contracting with payment for each procedure performed. A private practice was also reported by 45.2% of the physicians however only 1.5% exercised it exclusively. The most frequent health complaints were related to body posture and mental health. CONCLUSION: The prevalence of minor psychological disorders was of 26.0%. The observed conditions of work and health point to a need for major changes in the organization of medical work.

Adult↗

Working status among Dutch patients with rheumatoid arthritis: work disability and working conditions.

OBJECTIVES: To assess work disability and variables associated with work disability among Dutch patients with rheumatoid arthritis (RA). METHODS: A questionnaire on working status was filled out by 296 patients of working age. Employment and work disability rates adjusted for age and sex from the Dutch population were determined using indirect standardization. Cox proportional hazard analysis was used to assess baseline predictors of work disability in a subgroup of patients (n = 195). RESULTS: After a mean disease duration of 4.3 yr, patients had a 0.78 (95% CI 0.67-0.88) chance of being employed and a 2.14 (95% CI 1.75-2.54) risk of being work disabled when compared with the Dutch population. Functional disability and job type at the start of the disease were predictors of future work disability. In total, 48 (37%) currently employed patients had changed their working conditions, of which reduced working hours (46%), reduced pacing of work (42%) and help from colleagues (49%) were the most important alterations. Of the 60 work disabled patients without a paid job, only 11 patients (18%) would be willing to work again. CONCLUSION: This study shows that the adjusted employment rates were lower and that work disability rates were higher in patients with RA when compared with the general Dutch population. In addition, a substantial number of employed patients had to change their working conditions due to RA. Only a minority of work disabled RA patients was willing to return to the paid labour force.

Arthritis, Rheumatoid↗

Conformity of Workers' and Occupational Health Physicians' Descriptions of Working Conditions.

To determine whether workers, describing their own work, and occupational physicians, describing typical workstations, would report the same working conditions, and whether the relationships between health status and working conditions described by these two sources would be similar. An epidemiologic survey was carried out in 1987-88 in 17 poultry slaughterhouses and six canneries in France. The data were collected in two ways: workers described their own working conditions, and occupational physicians described the working conditions at workstations in the same factories. The study included 507 workers who worked at fixed workstations that had been described by the 24 occupational physicians. Health data were obtained from the workers by the physicians during their annual visits. The agreement between workers and physicians in the descriptions of seven working conditions was analyzed. On the whole, the prevalences of exposures to the seven selected working conditions estimated by the two sources were similar. Nevertheless, the observed agreement was not necessarily high. When agreement existed about specific working conditions, the relationships observed between those conditions and workers' health were generally similar for the two sources. This result was stronger for physical health problems than for mental health problems. When both sources agreed that the worker was being exposed to a risk factor, the risk estimation was higher compared with the cases of discordant judgment. This study confirms the usefulness of information provided by experts but also the necessity to interview workers themselves about their working conditions.

Journal Article↗

Work conditions and health of locomotive engineers. II. Questionnaire study, mortality and disability.

A questionnaire study on work conditions, work organization, leisure time, social problems, and health was directed toward active and retired locomotive engineers. This article mainly presents responses of the active engineers. The active locomotive engineers quoted the irregular work hours as the worst occupational problem. They judged noise and vibration in the locomotive cabs as disturbing. The majority of the desired changes in the work and work conditions concerned work time. The most common complaints given on the questionnaire were back trouble, hypertension and dermatitis. Tiredness and exhaustion were the most prevalent neuropsychological symptoms. A retrospective follow-up survey on invalidity and mortality was made. Trainmen and railroad clerks were used as reference cohorts.The engineers had relatively high invalidity and mortality rates in comparison to the reference groups, especially with respect to cardiovascular diseases and malignant tumors. Higher rates for disease of the digestive system and hearing loss were also suggested by the results.

Adult↗

Hygienic characteristics of work conditions in the manufacture of planer shavings (veneers) from exotic species of wood.

Results of investigation of the hygienic conditions of work in the manufacture of planer shavings (veneers) from exotic species of wood are reported. The manufacture is characterized by an unfavourable complex of environmental factors; noise exceeding the maximum admissible levels, high levels of relative humidity and temperature of the air and a complex of chemical compounds whose concentrations sometimes exceed MAC. A list of sanitary-hygienic and technological measures promoting and improvement of the working conditions in the manufacture of planer shavings (veneers) from exotic species of wood is presented.

Air Pollutants, Occupational↗

Pregnancy and its outcome among hospital personnel according to occupation and working conditions.

Relationships between occupation, working conditions, and the development and outcome of pregnancy were analysed on a sample of women employed in hospital during their pregnancy. Ancillary staff members experienced more uterine contractions during pregnancy, more preterm deliveries, and more low birthweight infants than those performing other duties; this remained true after adjusting for social characteristics. The rate of preterm delivery was significantly higher in the presence of at least two of the following arduous working conditions: stand-up work, carrying heavy loads (exclusive of patients), and heavy cleaning tasks; this was so, whatever the occupation.

Female↗

Allostatic load and work conditions.

Adverse work characteristics and poor social support have been associated with an increased risk for cardiovascular disease and other adverse health outcomes in otherwise apparently healthy adults. We undertook a cross-sectional study to evaluate the relationship between objective health status and work characteristics in industrial workers in Germany. Volunteers (n=324) were recruited from a representative random sample (n=537) of employees of an airplane manufacturing plant. Psychosocial work characteristics were assessed by the 52-item, 13-subscale salutogenetic subjective work analysis (SALSA) questionnaire, which assesses potentially salutogenic and pathogenic conditions. Factor analysis revealed three factors: decision latitude, job demands and social support. Biological health status was determined by the revised allostatic load score with 14 components: body-mass index, waist-to-hip ratio; systolic and diastolic blood pressure; plasma levels of C-reactive protein (CRP), tumor-necrosis factor-alpha, HDL, cholesterol, dehydroepiandrosterone sulfate; glycosylated hemoglobin; urinary cortisol, epinephrine, norepinephrine, and albumin. Score points were given for values in the high-risk quartile (maximum=14). General linear models revealed that older individuals and men had significantly higher allostatic load scores than younger participants or women. Of the SALSA factors, only job demands related significantly to allostatic load. The effect of demands was stronger in older individuals. Post-hoc analysis showed possible positive associations between high job demands and blood pressure or CRP, and between low social support and nocturnal excretion of cortisol or plasma levels of CRP. We conclude that this cross-sectional study on industrial employees found a weak association between a health summary score based on objective medical data and self-reported adverse work characteristics.

Adult↗

Socioeconomic inequalities in health in the working population: the contribution of working conditions.

BACKGROUND: The aim was to study the impact of different categories of working conditions on the association between occupational class and self-reported health in the working population. METHODS: Data were collected through a postal survey conducted in 1991 among inhabitants of 18 municipalities in the southeastern Netherlands. Data concerned 4521 working men and 2411 working women and included current occupational class (seven classes), working conditions (physical working conditions, job control, job demands, social support at work), perceived general health (very good or good versus less than good) and demographic confounders. Data were analysed with logistic regression techniques. RESULTS: For both men and women we observed a higher odds ratio for a less than good perceived general health in the lower occupational classes (adjusted for confounders). The odds of a less than good perceived general health was larger among people reporting more hazardous physical working conditions, lower job control, lower social support at work and among those in the highest category of job demands. Results were similar for men and women. Men and women in the lower occupational classes reported more hazardous physical working conditions and lower job control as compared to those in higher occupational classes. High job demands were more often reported in the higher occupational classes, while social support at work was not clearly related to occupational class. When physical working conditions and job control were added simultaneously to a model with occupational class and confounders, the odds ratios for occupational classes were reduced substantially. For men, the per cent change in the odds ratios for the occupational classes ranged between 35% and 83%, and for women between 35% and 46%. CONCLUSIONS: A substantial part of the association between occupational class and a less than good perceived general health in the working population could be attributed to a differential distribution of hazardous physical working conditions and a low job control across occupational classes. This suggests that interventions aimed at improving these working conditions might result in a reduction of socioeconomic inequalities in health in the working population.

Adolescent↗

Use of physiological criteria for improving physical work conditions.

Physical work is still present in many countries, specially in developing ones. The physiological analysis of the work load could be conducted through two different ways, referring to his energetic cost and/or to the mechanical power of the human motor. The purpose of ergonomics is to organize any physical professional task in order to maintain the workers as much as possible inside the limits of a fatiguing activity. The process of fatigue affects differently a "general activity" and a "local work." If a worker is engaged in a general hard activity, like carrying a load or pushing a trolley, an increase of oxygen consumption or/and an acceleration of the heart rate could be observed. This latter, allowing to estimate the oxygen cost of the work, is more affected if the work is performed in a hot environment. In order to establish the ratio between the data observed at the work place and the maximal working capacity of the organism, it is possible to experiment with the physiological effects of transitory increases of the work stress, by increasing the load or/and the frequency of the repetition of the "unit" of work done. When the task could be described in terms of local work, the correct methodology is based upon the general rules established respectively for the static and the dynamic work. In both the cases, it is possible to determine the critical rate of the muscular activity, the part of the muscular capacity engaged at the work place and the probable time for local exhaustion, in order to limit the duration of each period of work. It should be remembered that 50 years ago, Lucien Brouha proposed that heart rate determinations at work be used as a criteria for a better organization of human work by a non-sophisticated method.

Biomechanical Phenomena↗