1,721,001 research outputs found
HIP osteoarthritis and work
No full textEpidemiological evidence points strongly to a hazard of hip osteoarthritis from heavy manual work. Harmful exposures may be reduced by the elimination or redesign of processes and the use of mechanical aids. Reducing obesity might help to protect workers whose need to perform heavy lifting cannot be eliminated. Particularly high relative risks have been reported in farmers, and hip osteoarthritis is a prescribed occupational disease in the UK for long-term employees in agriculture. Even where it is not attributable to employment, hip osteoarthritis impacts importantly on the capacity to work. Factors that may influence work participation include the severity of disease, the physical demands of the job, age and the size of the employer. Published research does not provide a strong guide to the timing of return to work following hip arthroplasty for osteoarthritis, and it is unclear whether patients should avoid heavy manual tasks in their future employment
Sensory impairments, problems of balance and accidental injury at work: a case-control study
No full textObjectives Sensory impairments are becoming increasingly common in the workforces of Western countries. To assess their role in occupational injury, and that of disorders of balance, we undertook a case–control study. Methods Using the Clinical Practice Research Datalink, which documents all medical consultations, referrals and diagnoses in primary care for 6% of the British population, we identified 1348 working-aged patients who had consulted medical services over a 22-year period for workplace injury (cases) and 6652 age-matched, sex-matched and practice-matched controls. Risks were assessed by conditional logistic regression, for earlier recorded diagnoses of visual impairment, common eye diseases, hearing loss, perforated ear drum, non-acute otitis media and disorders of balance. Results In all, 173 (2.2%) participants had an earlier eye problem, 792 (9.9%) an ear problem (including 336 with impaired hearing and 482 with non-acute otitis media) and 266 (3.3%) a disorder of balance. No associations were found with glaucoma, cataract, retinal disorders or perforation of the ear drum specifically, but adjusted ORs were moderately elevated for eye and ear problems more generally, and higher where there was a record of blindness or partial sight (OR 1.90, 95% CI 1.05 to 3.44) or non-acute otitis media (OR 2.04, 95% CI 1.64 to 2.54). Risks for non-acute otitis media and for disorders of balance were particularly elevated for consultations in the 12?months preceding injury consultation (OR 2.70, 95% CI 1.58 to 4.62 and 1.77, 95% CI 1.01 to 3.11, respectively). Conclusions Problems of vision, impairments of hearing and disorders of balance all may carry moderately increased risks of occupational injury. <br/
The role of mental health problems and common psychotropic drug treatments in accidental injury at work: a case-control study
No full textObjectives Mental illness and psychotropic drugs have been linked with workplace injury, but few studies have measured exposures and outcomes independently or established their relative timings. To address this shortcoming, we conducted a case–control study nested within a database prospectively recording injury consultations, diagnoses and drug prescriptions. Methods The Clinical Practice Research Datalink logs primary care data for 6% of the British population, coding all consultations (by the Read system) and drug prescriptions. We identified 1348 patients aged 16–64?years from this database who had consulted a family doctor or hospital over a 20-year period for workplace injury (cases, 479 diagnostic codes) and 6652 age, sex and practice-matched controls with no such consultation. Groups were compared in terms of consultations for mental health problems (1328 codes) and prescription of psychotropic drugs prior to the case's injury consultation using conditional logistic regression. Results In total, 1846 (23%) subjects had at least one psychiatric consultation before the index date and 1682 (21%) had been prescribed a psychotropic drug. The OR for prior mental health consultation was 1.44 (p<0.001) and that for psychotropic drug treatment was 1.57 (p<0.001). Risks were significantly elevated for several subclasses of mental health diagnosis (eg, psychosis, neurosis) and for each of the drug classes analysed. Assuming causal relationships, about 9–10% of all workplace injuries leading to medical consultation were attributable to mental illness or psychotropic medication. Conclusions Mental health problems and psychotropic treatments may account for an important minority of workplace injuries. <br/
Differences in sickness absence by country and occupation: findings from the CUPID study
No full textOBJECTIVES: To assess the relative importance of occupational physical activities, conditions of employment and culturally determined health behaviour as determinants of sickness absence for musculoskeletal disorders, we compared patterns of absence in three categories of worker (nurses, office workers and manual workers) from culturally diverse countries. METHODS: The standardised CUPID questionnaire was used to collect data on sickness absence in the past year from 9347 workers in 31 occupational groups from 13 countries. RESULTS: The 1-year prevalence of sickness absence for musculoskeletal illness ranged from 3% in Japanese nurses and 6% in Japanese manual workers to 49% in Italian manual workers (in a toy factory). Rates for non-musculoskeletal disorders varied from 3% in Brazilian cane cutters to 70% in UK nurses and 73% in New Zealand postal workers. The ratio of the prevalence of absence attributed to musculoskeletal illness to that for non-musculoskeletal disorders varied more than 35-fold from 0.15 in Japanese nurses to 5.33 in Brazilian cane cutters. In general it was higher in nurses than in office workers from the same country, and more variable in manual workers than in the other occupational groups. CONCLUSIONS: The large differences between occupational groups in the attribution of sickness absence to musculoskeletal as compared with other disorders are unlikely to be explained entirely by differences in the physical demands of work and in employment conditions. They may also be importantly influenced by culturally determined differences in health behaviours
Mortality of workers exposed to ethylene oxide: extended follow up of a British cohort
No full textAims: To obtain further information about the risks of cancer associated with occupational exposure to ethylene oxide Methods: Follow up was extended by 13 years for a cohort of 2876 men and women with definite or potential exposure to ethylene oxide in the chemical industry or in hospital sterilising units. Subjects were traced through National Health Service and social security records, and their mortality was compared with that expected from rates in the national population by the person-years method. Results: Analysis was based on 565 deaths, of which 339 had occurred during the additional period of follow up. Mortality was close to or below expectation for all causes (565 deaths v 607.6 expected), all cancers (188 v 184.2), and for all specific categories of malignancy including stomach cancer (10 v 11.6), breast cancer (11 v 13.2), non-Hodgkin’s lymphoma (7 v 4.8), and leukaemia (5 v 4.6). All five deaths from leukaemia occurred in the subset of subjects with greatest potential for exposure to ethylene oxide, but even in this group the excess of deaths was small (2.6 expected). Conclusions: The balance of evidence from this and other epidemiological investigations indicates that any risk of human cancer from ethylene oxide is low, particularly at the levels of occupational exposure that have occurred in Britain over recent decades. This may reflect the capacity of human cells to repair DNA damage caused by the chemical, which is a potent genotoxin and animal carcinogen
Upper airways cancer, myeloid leukaemia and other cancers in chemical workers exposed to formaldehyde
No full textThe International Agency for Research on Cancer controversially has classified formaldehyde as causing nasopharyngeal carcinoma and myeloid leukemia. To provide further information on this question, we extended follow-up of a cohort of 14,008 chemical workers at 6 factories in England and Wales, covering the period 1941–2012. Mortality was compared with national death rates for England and Wales, and associations with incident upper airway cancer and leukemia were explored in nested case-control analyses. We observed excess deaths from cancers of the esophagus (100 observed vs. 93.1 expected), stomach (182 vs. 141.4), rectum (107 vs. 86.8), liver (35 vs. 26.9), and lung (813 vs. 645.8), but none of these tumors exhibited a clear exposure-response relationship. Nested case-control analyses of 115 men with upper airway cancer (including 1 nasopharyngeal cancer), 92 men with leukemia, and 45 men with myeloid leukemia indicated no elevations of risk in the highest exposure category (high exposure for ?1 year). When the 2 highest exposure categories were combined, the odds ratio for myeloid leukemia was 1.26 (95% confidence interval: 0.39, 4.08). Our results provide no support for an increased hazard of myeloid leukemia, nasopharyngeal carcinoma, or other upper airway tumors from formaldehyde exposure. These results indicate that any excess risk of these cancers, even from relatively high exposures, is at most small
The role of mental health problems and psychotropic drug treatments in accidental injury at work
No full textOBJECTIVES: Some evidence exists that mental health problems and drugs with psychotropic effects may raise risks of accidental injury at work. To confirm this and to quantify risks we undertook a case-control analysis nested within the UK General Practice Research Database (GPRD).METHODS: The GPRD logs all primary care information for some 6% of the British population. Medical consultations and referrals are classified by the Read system and drug prescriptions according to the British National Formulary. Using the GPRD, we identified 1,348 patients aged 16-64 years consulting a general practitioner between 1/1/89 and 31/12/09 for a workplace injury (cases - 479 diagnostic codes) and 6,652 age, sex, and practice-matched controls (subjects with no such consultation). Cases and controls were compared in terms of consultations for mental health problems (1,328 diagnostic codes) and prescription of hypnotics, anxiolytics and antidepressants before the index date of injury. Associations were explored using conditional logistic regression with adjustment for recorded alcohol misuse.RESULTS: In all, 1,846 (23%) of the 8,000 subjects had had at least one consultation in one/more of the coded psychiatric categories prior to the index date; 1,682 (21%) had been prescribed one/more drugs of inquiry. Odds of injury consultation were raised 46% (P<0.00) in those with prior mental health consultations, significant associations existing by subclass of diagnosis (psychosis, neurosis, certain other mental health conditions). Additionally, the Odds Ratio in relation to drug treatment was 1.59 (95%CI 1.38-1.83, P<0.001) and significantly increased for each of the drug classes considered.CONCLUSIONS: Mental health problems and psychotropic treatments account for an important and potentially preventable minority of workplace injury events
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