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Depression, women, and the workplace.

Depression is a highly prevalent disorder that causes much personal distress and difficulties in functioning at home and in the workplace. In the workplace, as elsewhere, depression can manifest as a variation in normal mood, as a symptom, as a disorder, or as a disease. Occupational health professionals are more concerned with clinical depression, a term used to signify any type of depression that causes significant personal distress and/or problems in functioning. Clinical depression is manifest in the workplace and adversely affects the employee's work satisfaction and performance. For most types of depression, women are at a higher risk than men. A number of events and variables related to women and depression were reviewed. Although the effects of some of these events, such as menopause, can be manifest in the workplace, they are not associated with an increased incidence of clinical depression. Other events, such as victimization (e.g., childhood sexual abuse or battering by an intimate partner), are associated with higher risks of depression in women. Women derive substantial satisfaction from interpersonal relationships but also are at greater risk for depression when strains and conflicts in these relationships occur. In the workplace women who have no difficulty in arranging for child care and whose spouses share in the care of children show lower rates of depression. When marriages are unhappy, women are three times as likely as men to be depressed. These findings speak to the importance of relationships to women. In the workplace, when women are depressed, problems with relationships are likely to be involved. Clinically depressed women are not difficult to identify in work settings. Dejected mood and loss of interest in usual activities are noticeable, along with numerous other symptoms that accompany depression. The effective treatment of depression depends on careful diagnosis and assessment. Both drug therapy and the more structured psychotherapies, such as cognitive-behavioral and interpersonal therapy, have demonstrated effectiveness in treating depression. For mild depression, pharmacotherapy is likely to be the treatment of choice. In cases in which the depressive symptomatology is moderate to severe, a combination of drug therapy and psychotherapy is likely to be the most effective treatment and to provide the best prophylaxis. Drug therapy seems particularly effective in promoting rapid reduction of vegetative and physical symptoms. Psychotherapy enhances coping skills at home and at work and also focuses on problem-solving, relationship difficulties, and dealing with stressors. In the area of prevention, occupational health practitioners currently can have the greatest impact in secondary prevention.(ABSTRACT TRUNCATED AT 400 WORDS)

Depression↗

PubMed1997

Violence in the workplace.

This integrative review of research on workplace violence in Canada and the United States showed that risk factors for homicide and nonfatal assault injuries differed significantly. In 1993, there were 1,063 work-related homicides in the United States (Bureau of Labor Statistics, 1994). Workplace homicide was the second leading cause of fatal occupational injuries overall, but the primary cause for women. The highest risk for workplace homicide was observed among males, the self-employed, and those employed in grocery stores, eating and drinking establishments, gas service stations, taxicab services, and government service, including law enforcement. The majority of workplace homicides occurred during robberies. Unlike workplace homicide, the majority of nonfatal assaults that involved lost work time occurred to women, primarily employed in health care or other service sector work. The assault rates for residential care and nursing and personal care workers were more than ten times that of private non-health care industries. Minimal intervention research has been reported. In recent years, some governmental agencies and professional organizations have begun to address policy issues related to workplace violence.

Adolescent↗

PubMed1997

Health science graduates: preparation for the workplace.

The research reported in this article was undertaken to assess the perceptions of health science graduates in the fields of health information management, occupational therapy, orthoptics, physiotherapy, and speech pathology regarding their perceptions of the adequacy of undergraduate preparation in meeting the demands of a changing health care environment. An instrument was devised for use by graduates on the basis of the skills and workplace behaviours specified by experienced practitioners in the above fields as necessary in newly recruited graduates. A total of 527 health science graduates completed the 52 item instrument. The statistical analyses indicated that 11 factors define the adequacy of graduates' preparation for the workplace. Health science graduates perceived themselves to have been more thoroughly prepared on certain workplace dimensions than on others. Specifically, graduates perceived themselves to be ill-equipped on dimensions concerned with workplace management, knowledge of the health industry, and coping in the workplace. Graduates also perceived themselves to be inadequately prepared in terms of communicating with clients, health professionals, and the general public. The strengths of their courses were perceived to be in completing essential tasks, having confidence in the clinical role, in ethical practice, in pursuit and application of knowledge, and having a realistic expectation of the workplace role. The results are discussed in terms of the need to address curriculum changes.

Adult↗

PubMed1994

Inconsistency between workplace and spousal studies of environmental tobacco smoke and lung cancer.

In a risk assessment released at the end of 1992, the U.S. Environmental Protection Agency (EPA) concluded that environmental tobacco smoke (ETS) is a known human lung carcinogen. The Agency reached that conclusion primarily on the basis of epidemiologic studies of self-reported never-smoking women, in which the exposure index was marriage to a smoker. However, the use of the spousal smoking exposure surrogate introduces many potential confounding factors. Such confounding and bias due to denial of active smoking are likely explanations for weak and inconsistent reported ETS-lung cancer associations. This contention is supported by the results of 14 worldwide studies of lung cancer and ETS exposure in the workplace, which in combination indicated no risk elevation. Workplace ETS-lung cancer studies are not subject to the bias and confounding introduced by the spousal smoking exposure surrogate. The EPA ignored the workplace studies in its risk assessment and extrapolated the results of spousal smoking studies to workplace and other sources of ETS exposure. In its estimate of ETS-attributable lung cancer deaths in the United States, the EPA ascribed over 70% of the deaths to nonspousal ETS exposure, primarily workplace exposure. Considered in their entirety, the ETS-lung cancer epidemiologic data do not support a causal inference or provide a scientific basis for government regulation of smoking in the workplace.

Bias↗

PubMed2007

[Workplace related anxiety and phobia].

Work is an important aspect of life. Problems at the workplace must therefore have negative consequences on the mental status and mental problems will interfere with the working place. The relation between anxiety and the workplace is especially important because the workplace causes anxiety due to its very nature. A common final pathway of mental disorders in general, and work related anxieties in particular, are workplace phobias, with panic when approaching or even thinking of the workplace. This is a serious complication with negative consequences for the further course of illness. It makes special therapeutic intervention necessary. This paper describes the phenomenon of workplace related anxieties and phobia and provides a conceptual framework for their understanding.

Anxiety↗

PubMed2004

Feedback of workplace data to individual workers, workgroups or supervisors as a way to stimulate working environment activity: a cluster randomized controlled study.

OBJECTIVE: To test whether feedback and discussion of ergonomic and psychosocial working-environment data during one short session with individual, groups or supervisors of white-collar computer workers had an effect on activity to modify workplace design, working technique and psychosocial aspects of work. METHODS: A total of 36 workgroups from nine organizations representing different trades was randomized (stratified for organization) to three feedback conditions or control with no feedback. Data were collected 1 month before and 6 months after feedback sessions. The effects studied were: (1) change in the proportion of workgroup members who reported any modification regarding workplace design or working technique; (2) change in the proportion of workgroup members who reported any modification regarding psychosocial aspects; (3) average number of modification types regarding workplace design or working technique per individual in a workgroup; (4) average number of modification types regarding psychosocial aspects per individual in a workgroup. RESULTS: All feedback conditions differed positively from controls regarding change in the proportion of workgroup members who reported any modification in workplace design or working technique. No such effect was found for psychosocial aspects. For change in average number of psychosocial modification types per individual in a workgroup an effect was observed for feedback to supervisors. No intervention effect was observed for the average number of modifications in workplace design or working technique per individual in a workgroup. CONCLUSION: Feedback and discussion of ergonomic and psychosocial working-environment data during one short session with individual, groups or supervisors of white-collar computer workers may have a positive effect on how many people in a workgroup modify (or have modifications done regarding) workplace design and working technique. Feedback to supervisors may have an effect on the average number of psychosocial modification types per individual in a workgroup. Feedback to group supervisors appeared to be the most cost-effective variant.

Adult↗

PubMed1997

Lost workdays and decreased work effectiveness associated with headache in the workplace.

Little is known about the impact of different types of headache on lost work time and work effectiveness in the United States. Estimation of the distribution and magnitude of the impact of headache in the workplace is necessary before workplace interventions can be developed. During 1993 and 1994 in Baltimore County, Maryland, study subjects were contacted by random-digit dialing and interviewed by telephone about their headaches. Headache diagnoses were assigned using International Headache Society criteria for migraine and episodic tension-type headache. Measures of workplace impact were derived based on self-reports of missing work because of headache and frequency and magnitude of reduced work level because of headache. Of the 13,343 respondents, 9.4% reported missing work more than rarely because of headache, 31% reported that their work level was reduced more than rarely by headache, and 9.2% reported that their work level was reduced more than 50% by headaches during work. In accounting for both actual lost workdays and reduced effectiveness at work, individuals lost the equivalent of 4.2 days per year because of headache. Of the 9922 annual estimated actual lost workdays because of headache, 57% were due to migraine and 43% were due to tension-type and other headache types. Of the 23,287 annual estimated reduced effectiveness workday equivalents, 64% were due to tension-type and other headache types, and 36% were due to migraine. Headache type, headache severity, and education level were each independent predictors of workplace impact of headache. Subjects with migraine headache were much more likely to report actual lost workdays because of headache, whereas tension-type and other headache types accounted for a large proportion of decreased work effectiveness because of headache. The results have implications regarding the control of indirect costs in the workplace because of headache, and on workplace-based treatment and prevention programs.

Adolescent↗

PubMed2004

Surveillance of noise exposure in the Danish workplace: a baseline survey.

AIMS: To evaluate an epidemiological approach to a national noise hazard surveillance strategy, and report current exposure levels in the Danish workplace. METHODS: A study base of 840 companies in 10 selected high risk industries in the largest county in Denmark was identified from a national register. Noise exposure was measured among manual workers recruited from a random sample of workplaces in each industry. For reference, financial companies and a sample of residents were investigated according to the same protocol. The A-weighted equivalent sound level (L(Aeq)) for a full shift was measured by portable dosimeters worn by 830 workers employed at 91 workplaces (67% of 136 eligible companies). RESULTS: The epidemiological design proved feasible and established a baseline for future noise surveillance. Substantial resources were needed to motivate workplaces to enlist and the final participation rate was less than optimal (66.9%). The L(Aeq (8)) values in the selected industries were highly elevated (mean 83.7 dB(A) (95% CI 83.3 to 84.1) in comparison with residents and office workers (mean 69.9 dB(A), 95% CI 68.8 to 71.0). Some 50% of the workers were exposed to more than 85 dB(A) and some 20% to more than 90 dB(A) in several industries. CONCLUSION: Noise levels in Danish high risk industries remain high. A substantial proportion of workers are exposed to noise levels above the current threshold limit of 85 dB(A). Ongoing surveillance of noise exposure using full shift dosimetry of workers in random samples of workplaces most at risk to high noise levels may help reinforce preventive measures. Such a programme would benefit from compulsory workplace participation.

Adult↗

PubMed2000

Job strain, social support in the workplace, and haemoglobin A1c in Japanese men.

OBJECTIVES: To examine the association between job strain (defined in the model of job demands and job control) and social support at the workplace with levels of glycosylated haemoglobin A1c (HbA1c) METHODS: All male employees aged 40-60 in a manufacturing firm, Japan, were invited to take part in the study. A blood sample was taken from the participants and HbA1c (%) was measured. Job strain and social support at the workplace were assessed with the job content questionnaire (JCQ). After excluding those who had a history of diabetes mellitus or other chronic diseases, data from 268 male day workers were analyzed. RESULTS: Age adjusted average concentrations of HbA1c were significantly higher in the highest quartile group of job strain or the lowest quartile group of social support at the workplace (p<0.05). Multiple linear regression analysis indicated that job strain was significantly and positively related to HbA1c (p<0.05), whereas social support at the workplace was significantly and negatively related to HbA1c (p<0.05), both after controlling for other covariates. CONCLUSIONS: Greater job strain and lower social support at the workplace may be associated with increased concentrations of HbA1c. Increased blood glucose may be a physiological mediator between job strain or social support at the workplace and coronary heart disease.

Adult↗

PubMed1987

Workplace homicides of Texas males.

A review of Texas death certificates for 1975-84 identified 779 civilian males whose deaths were homicides that occurred in the workplace. Injuries from firearms caused 81 per cent of the deaths. The overall rate of workplace homicide was 2.1/100,000 male workers/year. Males employed in taxicab service had the highest rate of workplace homicide. 78.2/100,000 male workers/year. Males employed in certain retail trade industries, law enforcement, and the private-security industry also had high rates of workplace homicide. Male workers greater than or equal to 65 years old were at especially high risk, with a workplace-homicide rate 3.5 times that of younger workers. A review of medical examiners' records in five urban counties indicated that 32 per cent of victims who had worked in eating-and-drinking places and 5 per cent of other workers had blood or cerebrospinal-fluid alcohol levels greater than or equal to 0.10 g/dl. These results provide a base for designing effective strategies to prevent workplace homicides.

Adolescent↗

PubMed2006

Relation of average and highest solvent vapor concentrations in workplaces in small to medium enterprises and large enterprises.

The present study was initiated to examine the relationship between the workplace concentrations and the estimated highest concentrations in solvent workplaces (SWPs), with special references to enterprise size and types of solvent work. Results of survey conducted in 1010 SWPs in 156 enterprises were taken as a database. Workplace air was sampled at > or = 5 crosses in each SWP following a grid sampling strategy. An additional air was grab-sampled at the site where the worker's exposure was estimated to be highest (estimated highest concentration or EHC). The samples were analyzed for 47 solvents designated by regulation, and solvent concentrations in each sample were summed up by use of additiveness formula. From the workplace concentrations at > or = 5 points, geometric mean and geometric standard deviations were calculated as the representative workplace concentration (RWC) and the indicator of variation in workplace concentration (VWC). Comparison between RWC and EHC in the total of 1010 SWPs showed that EHC was 1.2 (in large enterprises with>300 employees) to 1.7 times [in small to medium (SM) enterprises with < or = 300 employees] greater than RWC. When SWPs were classified into SM enterprises and large enterprises, both RWC and EHC were significantly higher in SM enterprises than in large enterprises. Further comparison by types of solvent work showed that the difference was more marked in printing, surface coating and degreasing/cleaning/wiping SWPs, whereas it was less remarkable in painting SWPs and essentially nil in testing/research laboratories. In conclusion, the present observation as discussed in reference to previous publications suggests that RWC, EHC and the ratio of EHC/WRC varies substantially among different types of solvent work as well as enterprise size, and are typically higher in printing SWPs in SM enterprises.

Air Pollutants, Occupational↗

PubMed1985

The workplace as a community: promoting employee satisfaction.

Because people's primary commitments lie elsewhere, the workplace will never be a true community. The workplace will be better, however, if employees show concern and respect for coworkers and if employers celebrate traditions, recognize achievement, and encourage creative thinking. Such workplace enhancement should encourage employees' participation in a shared enterprise but not substitute for workers' outside ties. To offset excessive competition, which can lead to suspicion and hostility, employers can (1) provide communication outlets, (2) faster loyalty to the job by providing attractive surroundings and benefits, (3) promote cooperation by allowing employees to participate in decision making. Family, neighborhood, and faith communities also benefit if employers acknowledge the family's importance, bring the workplace and the neighborhood together (for example, by investing in the area), and encourage church membership. Work in health care is potentially satisfying because it can meet people's need to serve others. Efforts to provide some semblance of community in the workplace will help to release the workplace's potential to provide personal satisfaction.

Job Satisfaction↗

PubMed2000

Assessing the implementation of workplace health programs outside of controlled environments.

The study explored the implementation of workplace health programmes in 14 NHS Trusts (hospitals). It sought to identify different approaches to implementation and measures that could be used to guide future development. The study comprised inter-related elements examining the process of implementing workplace health and the impact on staff. An innovative action research approach was applied to the evaluation. The aims of the evaluation were to generate activity and learning within the organisations which was sustainable (long term) and transferable outside the study organisations. The study is described in terms of the multiple methods and the ways in which these have been brought together in the analysis. The approach has been informed by a shift from an individualistic perspective towards one which sees the health of workers within the broader context of organisational development and management. The research identified a number of dilemmas for workplace health with its focus on the health of the individual. A typology was developed which describes different approaches to workplace health and their impact on sustaining such initiatives. It suggests that for workplace health to be successful it must address the organisational context as well as individual staff needs. Results from a survey of staff in the 14 trusts seems to demonstrate an association between the approaches, described in the typology, and an impact on staff. Workplace health programmes need to shift towards approaches where the individual's health is seen within the wider context of the organisation.

Health Promotion↗

PubMed2000

Violence in the workplace and ergonomic prevention.

There is a growing problem of violence in the workplace that should not be ignored. An estimated 6,359 deaths occur per year in the workplace [8] and an average one million each year are assaulted while at work [3]. Workplace violence is detrimental to both the employer and employee. It causes decreased worker productivity which results in monetary loss for businesses and the worker. Prevention programs can and should be implemented to address workplace violence. Prevention strategies that incorporate ergonomic and occupational therapy concepts can increase work productivity and job satisfaction. Certain occupations, such as health care and social service workers, are at a high risk for violence in the workplace. Violence in the workplace may never be eliminated, but steps can be taken to hinder the problem from growing.

Journal Article↗

PubMed1994

A multiyear workplace-monitoring program for refractory ceramic fibers.

This paper summarizes interim results of a 5-year workplace monitoring program conducted by firms belonging to the Refractory Ceramic Fibers Coalition (RCFC) pursuant to a Consent Agreement with the U.S. EPA. The exposure monitoring program is part of a model Product Stewardship Program (PSP) developed by RCFC. This paper reviews the refractory ceramic fiber (RCF) industry, findings of animal bioassay and epidemiological investigations, and the regulatory approach used by EPA. The scope, protocols, sample collection budgets, and experimental design of the monitoring program are summarized. In brief, the program will gather 720 time-weighted average (TWA) workplace concentration measurements annually, partitioned among 8 functional job classifications, both from plants that manufacture and from those that process or use RCF. Statistical analyses reveal that: workplace airborne RCF concentration data are approximately log-normally distributed, 93% of workplace TWAs are beneath the industry's recommended exposure guideline of 1 fiber per cubic centimeter (f/cc), there are significant differences in average workplace RCF concentrations among job types, and PSP activities are effective in lowering workplace exposure. Results of this effort provide an interesting illustration of a successful cooperative effort between a responsible industry and regulatory agencies.

Animals↗

PubMed1996

Occupational health monitoring practices of registered mercury-using workplaces within Gauteng.

OBJECTIVES: To assess monitoring practices of workplaces registered as mercury users within the then PWV South region of the Department of Manpower (now Gauteng region of the Department of Labour); to identify the main industrial sectors that use mercury and to estimate the number of workers potentially exposed. DESIGN: A descriptive study design was used. SETTING: Workplaces situated in the former PWV South region, as defined by the Department of Manpower. SUBJECTS: Fifty-eight workplaces were registered as mercury users in this region. Postal questionnaires were sent to 34 workplaces on the Department of Manpower's list of mercury users-24 were excluded because they had closed, moved or claimed, on telephonic contact, no longer to use mercury. MAIN OUTCOME MEASURES: Industry type and form of mercury used, monitoring practices and attitudes to legislation. RESULTS: The response rate to the questionnaire was 73.5% (25). Despite being registered as users, 52% (13) of the respondents claimed not to use mercury. Of the 10 mercury-using workplaces, 5 conducted biological monitoring, while only 2 performed environmental measurements. Six of the 10 workplaces used an inorganic form of mercury, 3 used a combination of inorganic and organic mercury, while 1 used organic mercury only. Sixty per cent of all respondents would support legislation that regulated monitoring of mercury in industry. CONCLUSIONS: The study suggests that biological monitoring of mercury is conducted by a limited number of users in Gauteng, while environmental monitoring appears to be neglected. Recently enacted legislation for industrial mercury monitoring needs to be implemented rigorously. Since more than half of the respondents claimed not to use mercury, even though they were registered as users with the Department of Manpower, the study further demonstrates a need to review the system of registration and record-keeping.

Environmental Monitoring↗

PubMed2000

Killed on the clock: a population-based study of workplace homicide, 1977-1991.

BACKGROUND: This paper describes the epidemiology of workplace homicides in North Carolina, with emphasis on the circumstances. METHODS: Workplace homicide victims were identified by and data were abstracted from the North Carolina medical examiner system. RESULTS: Workplace homicide rates are highest for men, older and self-employed workers, minorities and specific occupations, especially taxi drivers. Robberies, mostly in retail settings, accounted for half of the cases, while 20% were known to involve disputes, the contexts of which differed by sex. Women were most likely to be killed by estranged partners. CONCLUSIONS: Preventive strategies need to address the specific contexts in which workplace homicide occurs, such as retail and taxi robberies, and law enforcement officers interacting with suspects. A workplace response to domestic violence is also needed. Other areas for future research and intervention include environmental modifications, employee screening and training, and identifying more inclusive occupational data sources.

Adolescent↗

PubMed2000

Empowerment-based health and safety training: evidence of workplace change from four industrial sectors.

BACKGROUND: Empowerment-based health and safety training programs posit that training workers to take action on health and safety issues is key to improving work environments. This article assesses how two union-led, empowerment-based hazardous materials training programs impacted health and safety workplace conditions across four industrial sectors. METHODS: A cross-sectional telephone interview survey was conducted with 362 workers and managers, six to twelve months following training. RESULTS: Participants reported increased attempts and successes in advocating for workplace health and safety changes, as well as individual changes in awareness and work practices. The training also appeared to influence two organizational factors key to worker-initiated changes in the workplace: manager support and union involvement. CONCLUSIONS: Empowerment-based training approaches appear to be effective in fostering workers' ability to initiate change in the workplace. Future evaluations should further refine training evaluation measures of workplace change processes, and consider them in the unique contexts in which they operate.

Accidents, Occupational↗