Abstract: An apparent two to three times higher injury frequency rate for temporary employees compared to permanent workers was identified in one manufacturing setting. Data were collected using demographic surveys (N = 20) and three focus group interviews (n = 13), with a convenience sample of temporary employees as well as four structured interviews with temporary agency owners and managers to explore factors which increase the vulnerability of temporary employees to workplace injuries. Several physical and psychological stressors were identified as well as a perception by the temporary employees that the reporting of work injuries could lead to loss of a temporary work assignment or the opportunity for permanent employment. In contrast, the agency owners and managers were concerned that reported injuries were not always legitimate. All of them actively used strategies to control their injury experience but faced the challenge of lacking day to day control of both the work environment and employee work behaviors. This preliminary study cannot be generalized to manufacturing worksites. Additional research is needed to document the injury experience of temporary employees, identify training needs, and design interventions. Language: en

Abstract: Using a randomized, retrospective case control survey approach, this study compared emplyees immunized (cases) to a group of non immunized employees (controls) between the months of October and Dec...

Abstract: 1. The basic principles of envelope theory are explained. By not overexerting themselves, people with CFS can avoid the setbacks and relapses that commonly occur in response to overexertion while increasing their tolerance to activity. 2. By collecting time series data on fluctuations in energy levels, important clinical observations can be made in respect to a client's unique condition and experience with CFS.

Abstract: This pilot project employed a case study design consistent with that of Rice to describe the impact of violence on individuals who incurred a work related assault in 1992. Ten randomly selected subjects were interviewed from a population of 429 individuals reporting a work related assault that resulted in a wage loss claim. Half of the subjects had received permanency ratings, thought to be a measure of injury severity. The study hypothesis, stating the impact of the assault (e.g., pain and suffering, decrease in functioning) years after a work related assault was associated with the severity of the injury (i.e., permanency rating), was not supported by the data. However, individuals' health and quality of life 4 years after the assault were affected significantly and resulted in job changes, chronic pain, changes in functional status, and depression. The new hypothesis resulting from this study is employer support and mental health intervention immediately after an assault may prevent employee job changes and decrease mental health sequelae.

Abstract: Given the current high incidence of depression, occupational health nurses in all work settings are likely to encounter many employees who suffer from some form of depression. Depression has the highest medical benefit costs for all behavioral conditions and results in more days of disability than chronic medical conditions such as heart disease, hypertension, diabetes, and lower back pain. Advances in understanding the physiologic changes in the brain which cause depression have lead to development of effective psychopharmacologic agents for treatment. Depressed individuals have the most positive responses with a combination of medication and psychotherapy. Nurses need to assist affected employees to obtain optimal mental health care so they may remain as functional as possible, thereby diminishing the detrimental effects of the illness.

Abstract: A major goal of case management programs is the worker's timely return to work. Few studies have examined return to work from the perspective of the injured worker. This article describes the findings from the case management evaluation that describe the return to work experience of workers who sustained catastrophic injuries, or who had secondary conditions or complications following the injury occurrence. Among the factors determined to affect the return to work experience were structural factors (i.e., psychosocial variables including job satisfaction and relationship with employer and coworkers, financial pressures, and system issues such as securing benefits) and process factors (i.e., interaction with service providers and with the workers' compensation system). Outcomes are described in terms of satisfaction with services and return to work.

Abstract: 1. Occupational health nurses can advocate for fair and equitable policies for both workers and employers. Assisting workers to understand and negotiate through the workers compensation system can minimize suspicion among workers and service providers, and can increase the effectiveness and efficiency of service provision. 2. Occupational health nurses can work with the team of service providers and the injured worker to develop appropriate and realistic goals for service provision. Make sure there is clarity related to the roles and responsibilities of all persons on the team (including the injured worker) is essential. Consistency and continuity of services throughout the life of the case is crucial. 3. The injury and its sequelae have personal meaning to the worker that may profoundly affect the outcome of their case. The OHN/CM must be sensitive and responsive to the worker's issues and concerns, and respectful of their views. Workers must be assisted to identify and tap into their social support systems. 4. Occupational health nurse/case managers should take an active role in developing and advocating for strategies that will assure effective and meaningful communication among all parties involved in a case.

Abstract: The study purpose was to determine whether group intervention or an individual self help program proved to be more effective at lowering heart disease risk factors among employees in different worksites. Eight worksites and 502 employees in the Denver metropolitan area were selected for the project, with four randomized to Usual Care and four to the Special Intervention. Most worksites had < 200 employees. Employees were randomly assigned to either a control group receiving usual nutrition education or one of two special intervention groups in which employees selected to attend group nutrition education classes or complete an individual self paced nutrition education program. Results indicated that offering a choice of methods for the special nutrition education intervention was valuable, and both approaches modified behavior and certain physiological outcomes. Results suggested that enhanced nutrition education efforts in worksites may be effective and will realize greater benefits than a pamphlet or brief discussion following a worksite screening.

Abstract: T he rapidly changing climate of health care, with advances in scientific and professional knowledge and technology, is characterized by growing expectations on the part of employers, consumers, and regulatory bodies for high quality, cost effective, and competent care. Occupational and environmental health nurses increasingly are held accountable for possessing the skills and abilities necessary to provide competent care and produce desired outcomes. As changes in the health care delivery system have been proposed and implemented to address these issues, many nursing and non-nursing groups and organizations have spearheaded initiatives related to competency development and verification for health care professionals. It is the responsibility of the American Association of Occupational Health

Abstract: An increasing number of employers and third party administrators are choosing case management as a strategy to coordinate services for workers who sustain an occupational injury or illness. The successful delivery of case management services requires the service provider possess special skills and knowledge. Occupational health nurses are uniquely qualified to provide case management services to injured and ill workers. The effectiveness of case management services is generally described in terms of costs and quality of services; thus, determining the effectiveness of a case management program requires an evaluation of costs and service quality. Language: en

Abstract: Excessive ambient noise levels in audiometric test booths may elevate and therefore invalidate hearing thresholds of employees included in a hearing conservation program. This study was conducted to determine if a sample of mobile test vans and trailers operating in the Midwest met the 1983 Occupational Safety and Health Administration (OSHA) maximum permissible ambient noise levels (MPANLs), the MPANLs in the American National Standards Institute (ANSI) S3.1-1991, and the suggested National Hearing Conservation Association (NHCA) values. Ambient noise levels were measured in 13 audiometric test booths contained in 12 different industrial mobile test vans and trailers operating in the Midwest. Results indicated that all 13 (100%) of the industrial mobile test vans and trailers evaluated complied with 1983 OSHA permissible levels and the NHCA 1996 recommended levels. With regard to the 1991 ANSI MPANLs, 5 (38%) of the 13 booths were in compliance at all frequencies. Those that failed did so at 125, 250, and 500 Hz. It appears that the NHCA levels need to be used for all hearing conservation programs with respect to compliance for noise levels in mobile audiometric test booths.

Abstract: Finding a measure that distinguishes well between the severity levels of less serious injuries such as those found in occupational settings has been problematic. In this study of 255 construction workers who sustained nonfatal falls at work, two measures of injury severity were used--the Injury Severity Score (ISS) and the disability index of the Stanford Health Assessment Questionnaire (HAQ), a functional limitation measure. The HAQ scores were more normally distributed than the ISS and provided useful information about the degree to which workers were disabled from falls during their first week of recovery. The mean HAQ score was 1.46 (SD = 0.75) on a scale of 0 to 3, with higher numbers representing more limited functioning. With regard to individual tasks, participants reported having the most difficulty performing heavy chores (mean = 1.89; SD = 1.02), dressing themselves (mean = 1.54; SD = 1.05), and bending to pick up clothing from the floor (mean = 1.40; SD = 1.02). The HAQ scores were significantly and moderately correlated with days lost from work (r = .52; p Language: en

Abstract: 1. The majority of ocular burns are related to accidents at work. Acute ocular chemical injuries require emergent recognition and management. 2. Copious irrigation of the eye, done immediately at the scene, is the most important factor in the long term prognosis of ocular chemical burns. 3. After irrigation has been completed and the eyes have been allowed to rest, visual acuity can be tested and referrals can be made to health care facilities and an ophthalmologist. 4. The nurse conducts health hazard assessments of the workplace, provides information about workplace chemicals and their risks, and ensures proper safety protective equipment and emergency supplies. Practicing emergency procedures such as irrigation is important. 5. The nurse monitors and analyzes injury exposure episodes and trends, along with coordinating referrals, treatments, and follow up care for workers with ocular chemical burns. Language: en

Abstract: This article describes the findings from a study of injured workers conducted as part of a multifaceted evaluation study of a case management program. The sample consisted of workers who filed a workers' compensation claim between January 1 and September 30, 1995. Data collection consisted of written surveys (n = 45), personal interviews (n = 27), and telephone interviews (n = 16). The findings from this study provided many insights into the injured workers' personal and work experiences, and, in particular, their perceptions of their experience with the nurse case management program. Workers satisfied with services described the nurse case manager (NCM) as having the ability to see the "big picture," to develop appropriate goals, and to anticipate client needs. Dissatisfied workers reported feeling unimportant in terms of service provision. They reported feeling that "the system" did not respond to their needs, and that the NCM was uninterested and disrespectful. This vivid portrayal of workers' experiences and perceptions of case management services provides valuable information about the world view of the injured worker. Language: en

Abstract: 1. Hospital employees often do not recognize the chemical hazards that exist in their work environment. 2. Formaldehyde and xylene are common hazards in histology and pathology laboratories. Occupational and environmental health nurses need to be familiar with the health effects that may result from exposure to these chemicals. 3. Although xylene does not have medical/health surveillance requirements set by OSHA, medical evaluation of employees exposed to xylene above the action level is effective occupational and environmental health practice. 4. Formaldehyde exposed employees require medical/health surveillance. Occupational and environmental health nurses need to be familiar with how to implement and manage a formaldehyde surveillance program.

Abstract: The perceptions of service providers involved in case management services are described here. The service providers included claims managers, occupational nurse consultants, attending physicians, and nurse case managers. The purposes of this phase of the study were to describe these providers' perceptions about the case management program; to organize findings according to the quality assessment model that guided this study (including structure, function, and outcomes); and to identify barriers and facilitators to satisfaction with case management services. Structural factors that affected services included the workers' compensation system, construction of the service team, roles within the program, and individual attributes of service providers. Process factors were conflicts among parties, role of communication, and interaction with workers. Outcomes were described in terms of program efficiency and effectiveness. Data are used to illustrate and explain each of these themes.

Abstract: The purpose of this study was to develop a valid methodology for comparing measured torque repetition data along a ham boning line to symptoms reported in an established clinical database, which in...

Abstract: A record review was used to examine case management services provided to 36 workers who sustained a catastrophic or medically complex injury, and who were referred to a case management program. The aims of this phase of the evaluation were to identify and describe: Workers' demographics and personal attributes, The structures and processes that affected the course of these cases, and The role of the nurse case manager (NCM). A data collection instrument was developed to collect quantitative and qualitative information. Structural factors that emerged as most consequential included the quality and quantity of the injured worker's social support and the employment situation, including the availability of a job post-injury, employer support, and worker motivation. Process variables identified included the interactions of service providers including communication, and collaboration. The NCM was described as a monitor, coordinator, supporter, and advocate for the worker. Additionally, the NCM served as a consultant to other service providers and played a key role in the implementation of cost containment strategies. Language: en

Abstract: 1. Intuition is an internal experience. It is a way of knowing something directly without an intervening analytic thought. It functions more subjectively than objectively. 2. The subjective nature of intuition makes it challenging to use in the business world yet the value it adds makes it worth the effort. Intuition adds value when making judgment calls, managing unforeseeables, when creativity and innovation are necessary. Intuition is the skill of responding appropriately, in the moment, to specific situations. Intuition "opens the doors" to new possibilities which can then be applied and evaluated analytically. 3. Intuition can be enhanced in the workplace by becoming familiar with some of the ways it is experienced, and facilitate co-workers to express their intuitions more openly. Another way to enhance intuition at work is to ask questions which collect non-analytic data. 4. Making intuitive thinking a regular part of team meetings will improve the productivity of the team and encourage individual use of intuitive skill. Individual intuitive skill can be increased with paying regular attention to physical responses, images, feelings, and synchronicities.

Abstract: This report presents data exploring the relationship between perceived psychological stress and several variables implicated in the etiology of upper extremity cumulative trauma disorders (UECTDs). The sample was 354 workers from three different manufacturing companies. The primary job exposure for the subjects was that they were engaged in jobs that involved repetitious movements of the upper extremities, primarily of the hands and arms. Data collection included a detailed health history, a comprehensive physical examination of the upper extremities, limited electrodiagnostic testing, Cohen's Perceived Stress Scale, Karasek's Job Content Questionnaire, demographic information, and a measurement of repetition. Descriptive analyses, analysis of variance, correlational analyses, and multiple linear regression were used to examine the data. Perceived stress, as measured in this study, was only weakly associated with repetition, job dissatisfaction, and subjective complaints related to UECTDs. In addition, factors generally accepted as related to UECTDs (e.g., repetition, female gender, hormonal influences, and existing medical conditions) were not robust predictors of perceived stress. The major limitation is related to the measurement of perceived psychological stress. Like most psychosocial phenomena, perceived stress is a complex construct, one that is difficult to measure and correlate with health outcomes. Further research is necessary to examine what role, if any, perceived stress may have in the etiology of UECTDs.

Abstract: Occupational and environmental health nurses can identify the causes of injuries and use analytical skills to show how the prevention of a problem can save the company money and demonstrate a caring attitude from management Nurses can expand their traditional roles to position themselves as both advocates for the employees and profit enhancers to management as demonstrated by this program evaluation project Initial outcomes included improved employee morale and reduced soft tissue injuries in hotel housekeeping employees Changes in the workplace made by a proactive occupational and environmental health nurse and a committed management can reap rewards beneficial for both the employer and the work force

Abstract: Evaluation of the impact of preplacement assessments is important given the resources companies and occupational health nurses allocate to screening and the ambiguity of the literature about the effectiveness of such assessments. This study examined the effects of preplacement assessments on employee injuries. All individuals screened by an occupational health clinic in the upper Midwest and given work restrictions during a 3 year period were identified as cases (n = 67). Cases were matched with controls without work restrictions (n = 264) on the basis of employer, gender, and job. Age was controlled for statistically. Chi-square analysis, used to test differences in percent distribution of injuries between cases and controls, found no statistically significant differences in musculoskeletal injuries between the groups. Work restrictions recommended as a result of preplacement assessments appear to protect vulnerable workers.

Abstract: Individuals with a history of atopy are at increased risk of becoming latex allergic. Specific food allergies also cross react with latex. It is important to choose products low in allergen content and powder free to minimize exposure when use of latex products is essential. Using nonlatex products whenever possible is essential. Education of health care workers, clients, and their families about latex products, latex allergy, and substitutions for latex products needs to be current and ongoing. Development of clear guidelines related to working with health care workers with latex allergies encourages management to consider the seriousness of latex allergy and ways to avoid it.

Abstract: 1. As more people live longer and more active lives the likelihood of experiencing a disability during one's career increases. Although the unemployment rate among people with disabilities is high, workers with disabilities are becoming more common. 2. Effective job accommodation costs only a small fraction of the hundreds of thousands of dollars that would otherwise be paid out in disability benefits and insurance premiums, or wasted in litigation. 3. Job accommodation planning should begin as early as possible in the disability process and include the active involvement of the individual with the disability and appropriate clinicians, as well as the supervisor and coworkers. 4. Successful accommodation is the result of teamwork, The occupational health professional is often the coordinator of a number of internal and external resources in the job accommodation process. Tools are available for sharing information among all those involved in the accommodation process, without compromise of confidential medical or business information.

Abstract: The planning, implementation, and evaluation of worksite health promotion programs can benefit from adapting and using the steps in each phase of the PRECEDE-PROCEED model. The model provides a framework to build and sustain support from employers and employees, and a valuable tool to increase program efficiency, effectiveness, and accountability. During the PRECEDE phases of planning, the model provides opportunities for continuous communication and feedback to all levels of management. The evaluation phases in PROCEED provide occupational health nurses with valuable information to share with corporate planners, influence management behavior, and contribute to evidence based decisions for future programming.

Abstract: The occupational health nurse for the South Carolina Department of Transportation (SCDOT) collaborated with the Schools of Nursing within the state universities of South Carolina to coordinate individual health screenings for the employees of SCDOT. Personal Wellness Profiles (PWP) by Wellsource, Inc., were used to perform the health screenings and included family and personal histories, and assessment of blood pressure, vision, height, weight, total and high density lipoprotein cholesterol, and blood glucose levels. In addition, hepatitis and tetanus/diphtheria immunizations and influenza vaccines were provided. Each of the 48 county sites was visited twice during the semester by nursing faculty and nursing and public health students. The first visit was to collect assessment data for screening and provide immunizations. The second visit was to provide individualized analyzed data and health counseling. Of the 5,118 SCDOT employees, 3,141 were screened the first year and 2,315 were screened the second year. Of the original 3,141, only 1,549 elected to participate in the rescreening. Although the average population age was 41, 78.3% were rated at high coronary risk because of high blood pressure, high cholesterol and blood sugar levels, excessive weight and stress levels, and sedentary lifestyles.

Abstract: Health promotion and disease prevention activities should be carried out by all health care professionals. These activities are especially important in the Newly Independent States (NIS) of the for...

Abstract: 1. Occupational health nurses have the responsibility to educate their clients about hepatitis C as a growing public health threat. 2. Occupational health nurses have the responsibility to keep their clients up to date on the latest treatment modalities. 3. Occupational health nurses practice in a framework from which to establish policies and procedures to treat blood and body fluid exposures.

Abstract: The purpose of the study was to determine what effect modifications to American Heart Association (AHA) guidelines produce when taking blood pressures with an automatic device. Eight blood pressure measurements were taken at least 2 minutes apart; two with standard AHA guidelines and six with modifications. Findings of this study suggest that elevation of the arm can have a significant effect on both the systolic and diastolic blood pressure. Two modifications, talking and placing the arm beside the trunk, raised the diastolic pressure. However, some modifications did not have a statistically significant effect. Techniques used to take blood pressures with an automatic device can have a significant effect on the readings.