1,721,001 research outputs found
Respiratory illness in agricultural workers
No full textRespiratory diseases have long been recognized in association with work in farming. Overall, only a small proportion of the population is employed in agriculture, so respiratory disease in farmers is not a major public health issue. However, farmers are known to have high morbidity and mortality from certain respiratory diseases, as shown by routinely collected statistics. Despite this, knowledge of the frequency, nature and risk factors for some respiratory disorders in agricultural workers is incomplete. Multiple exposures are common and some exposures can give rise to more than one specific disease. Moreover, the most common respiratory symptoms reported by farm workers (wheeze, dyspnoea and cough) are relatively non-specific and can be associated with several occupational respiratory disorders. This review describes the main occupational respiratory illnesses in farming and summarizes the current literature about epidemiology and prevention. The most important diseases are rhinitis and asthma, which, although common, are not usually fatal. Some non-allergic conditions, e.g. asthma-like syndrome and organic toxic dust syndrome, are not yet fully understood, but appear to be common among farm workers. The most serious respiratory diseases are hypersensitivity pneumonitis and respiratory infections, but these are rare. Most importantly, respiratory diseases are preventable by controlling harmful exposures to organic dust, toxic gases and chemicals on farms through improvements in animal rearing techniques, ventilation of animal accommodation, careful drying and storage of animal feed-stuffs, crops and other products, and use of personal protective equipment
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/
Work activities and risk of prematurity, low birth weight and pre-eclampsia: an updated review with meta-analysis
No full textThe 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
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/
Population-based cohort study of incident and persistent arm pain: role of mental health, self-rated health and health beliefs
No full textTo investigate whether somatising tendency, low mood and poor self-rated health (SRH) predict incident arm pain, and whether these factors and beliefs about causation and prognosis predict symptom persistence, we conducted an 18-month postal follow-up in 1798 working-aged subjects, sampled from the registers of five British general practices. At baseline questions were asked about pain in the arm (lasting >or=1day in the prior 12months), mental health (Short-Form 36 (SF-36MH)), somatising tendency (the Brief Symptom Inventory (BSI)), SRH, and beliefs about causation and prognosis. At follow-up we asked about arm pain in the last four weeks, and whether it had been present on >or=14days. Associations with incidence and persistence were explored using logistic regression. The 1256 participants (70% response) comprised 613 free of, and 643 with, arm pain initially. Among the former, 21% reported new pain at follow-up, while 53% of the latter reported symptom persistence. The odds of both incident and persistent arm pain were significantly raised (1.7- to 4-fold) in the least vs. most favourable bands of SF-36MH, BSI and SRH. Even stronger associations were found for arm pain on >or=14days. Persistent pain was significantly more common among those who attributed their pain to work or stress, and in those who expected symptoms still to be a problem in 12months. Thus, SRH and mental health indices were strong predictors of incident and persistent arm pain in adults from the community, while persistence was also predicted by beliefs about causation and prognosis
Epilepsy, diabetes mellitus and accidental injury at work
No full textAims: to assess the contribution of epilepsy and diabetes to occupational injury.Methods: the Clinical Practice Research Datalink logs primary care data for 6% of the British population, coding all consultations and treatments. Using this, we conducted a population-based case–control study, identifying patients aged 16–64 years, who had consulted over two decades for workplace injury, plus matched controls. By conditional logistic regression, we assessed risks for diabetes and epilepsy overall, several diabetic complications and indices of poor control, occurrence of status epilepticus and treatment with hypoglycaemic and anti-epileptic agents.Results: we identified 1348 injury cases and 6652 matched controls. A total of 160 subjects (2%) had previous epilepsy, including 29 injury cases, whereas 199 (2.5%) had diabetes, including 77 with eye involvement and 52 with a record of poor control. Odds ratios (ORs) for occupational injury were close to unity, both in those with epilepsy (1.07) and diabetes (0.98) and in those prescribed anti-epileptic or hypoglycaemic treatments in the previous year (0.87–1.16). We found no evidence of any injury arising directly from a seizure and no one had consulted about their epilepsy within 100 days before their injury consultation. Two cases and six controls had suffered status epilepticus (OR versus never had epilepsy 1.61). Risks were somewhat higher for certain diabetic complications (OR 1.44), although lower among those with eye involvement (OR 0.70) or poor diabetic control (OR 0.50). No associations were statistically significant.Conclusions: no evidence was found that diabetes or epilepsy are important contributors to workplace injury in Britai
Optimal case definitions of upper extremity disorder for use in the clinical treatment and referral of patients
No full textObjective: Experts disagree about the optimal classification of upper extremity disorders. To explore whether differential response to treatments offers a basis for choosing between case definitions, we analyzed previously published research.Methods: We screened 183 randomized controlled trials (RCTs) of treatments for upper extremity disorders identified from the bibliographies of 10 Cochrane reviews and 4 other systematic reviews, and a search in Medline, Embase, and Google Scholar to June 2010. From these, we selected RCTs that allowed estimates of benefit (expressed as relative risks [RRs]) for >1 case definition to be compared when other variables (treatment, comparison group, followup time, outcome measure) were effectively held constant. Comparisons of RRs for paired case definitions were summarized by their ratios, with the RR for the simpler and broader definition as the denominator.Results: Two RCT reports allowed within-trial comparison of RRs and 13 others allowed between-trial comparisons. Together these provided 17 ratios of RRs (5 for shoulder treatments, 12 for elbow treatments, and none for wrist/hand treatments). The median ratio of RRs was 1.0 (range 0.3–1.7, interquartile range 0.6–1.3).Conclusion: Although the evidence base is limited, our findings suggest that for musculoskeletal disorders of the shoulder and elbow, clinicians in primary care will often do best to apply simpler and broader case definitions. Researchers should routinely publish secondary analyses for subgroups of patients by different diagnostic features at trial entry to expand the evidence base on optimal case definitions for patient management.<br/
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