Annals of Occupational and Environmental Medicine

Review

Environmentally induced, occupational diseases with emphasis on chronic kidney disease of multifactorial origin affecting tropical countries: Shehani A. Wimalawansa, Sunil J. Wimalawansa; Ann Occup Environ Med 2016;28:33. Published online August 5, 2016; DOI: https://doi.org/10.1186/s40557-016-0119-y

Background

Environmentally induced, occupational diseases are increasing worldwide, especially in rural agricultural communities. Poverty-associated malnutrition, environmental hazards and pollution, and lack of access to clean water, safe sanitation, and modern healthcare facilities are often associated with these chronic illnesses.

Method

The authors systematically reviewed occupational public health issues that have been related to the environment. General interpretations of results were included as per the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Pertinent publications from research databases were reviewed on (A) the risk–benefits, (B) the prevalence of risk factors for various diseases, (C) the benefits of not ignoring the risk factors (i.e., broader evidence), and (D) the risks, effects, and outcomes of different types of interventions. The authors used chronic kidney disease of multifactorial origin (CKDmfo) as an example to explore the theme. Emphasis was given to the regions with emerging economies and developing countries located in the vicinity of the equator.

Findings

Geographical, socio-economic and aetiological similarities exist for many chronic non-communicable diseases that are affecting tropical countries around the equator. The authors identified manufacturing, mining, and agriculture as the biggest polluters of the environment. In addition, deforestation and associated soil erosion, overuse of agrochemicals, and irresponsible factory discharge (e.g., chemicals and paint, from rubber and textile factories, etc.), all contribute to pollution. To decrease the escalating incidences of environmentally induced diseases, governments should work proactively to protect the environment, especially watersheds, and take steps to minimise harmful occupational exposures and strictly enforce environmental regulations.

Conclusion

Creating public awareness of environmental issues and their relationship to public health is essential. This includes regular monitoring and periodic publication of the quality of water, air and soil; preventing deforestation and man-made soil erosion, increasing forest and ground cover, preventing occupational injuries, judicious and safe use of agrochemicals, sustainable agriculture and development programs, and implementing legislation to protect and conserve water heriage and the environment. These actions are essential both for a healthier environment and for the health of the people who live in that environment. Such measures would also decrease public health threats from such, including global-warming-related erratic environmental changes and the occurrence and the spread of non-communicable diseases, such as CKDmfo.

Citations

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Rising of a global silent killer: critical analysis of chronic kidney disease of uncertain aetiology (CKDu) worldwide and mitigation steps
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Review

French good practice guidelines for medical and occupational surveillance of the low back pain risk among workers exposed to manual handling of loads: Audrey Petit, Jean-Baptiste Fassier, Sandrine Rousseau, Philippe Mairiaux, Yves Roquelaure; Ann Occup Environ Med 2015;27:18. Published online July 22, 2015; DOI: https://doi.org/10.1186/s40557-015-0069-9

Abstract PDF PubReader ePub

Several clinical practice guidelines related to the assessment and management of low back pain (LBP) have been published with varied scopes and methods. This paper summarises the first French occupational guidelines for management of work-related LBP (October 2013). There main originality is to treat all the three stages of primary, secondary and tertiary prevention of work-related LBP. The guidelines were written by a multidisciplinary working group of 24 experts, according to the Clinical Practice Guidelines method proposed by French National Health Authority, and reviewed by a multidisciplinary peer review committee of 50 experts. Recommendations were based on a large systematic review of the literature carried out from 1990 to 2012 and rated as strong (Level A), moderate (B), limited (C) or based on expert consensus (D) according to their level of evidence. It is recommended to deliver reassuring and consistent information concerning LBP prognosis (Level B); to perform a clinical examination looking for medical signs of severity related to LBP (Level A), encourage continuation or resumption of physical activity (Level A), identify any changes in working conditions and evaluate the occupational impact of LBP (Level D). In case of persistent/recurrent LBP, assess prognostic factors likely to influence progression to chronic LBP, prolonged disability and delayed return to work (Level A). In case of prolonged/repeated sick leave, evaluate the pain, functional disability and their impact and main risk factors for prolonged work disability (Level A), promote return to work measures and inter professional coordination (Level D). These good practice guidelines are primarily intended for professionals of occupational health but also for treating physicians and paramedical personnel participating in the management of LBP, workers and employers.

Citations

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Mapping the conceptual structure of ergonomics, musculoskeletal disorders, treatment and return to work in manual jobs: A systematic review
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Annals of Work Exposures and Health.2018; 62(5): 530. CrossRef

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Research Article

Psychosocial Risk Factors and Musculoskeletal Symptoms among White and Blue-collar Workers at Private and Public Sectors: Leticia B Januario, Mariana V Batistao, Helenice JCG Coury, Ana Beatriz Oliveira, Tatiana O Sato; Ann Occup Environ Med 2014;26:20-20. Published online July 25, 2014; DOI: https://doi.org/10.1186/s40557-014-0020-5

Abstract PDF PubReader ePub

Objectives

The aim of this study was to evaluate musculoskeletal and psychosocial perception and compare these conditions regarding the type of job (white or blue-collar) and the type of management model (private or public).

Methods

Forty-seven public white-collar (PuWC), 84 private white-collar (PrWC) and 83 blue-collar workers (PrBC) were evaluated. Job Content Questionnaire (JCQ) and Utrecht Work Engagement Scale (UWES) were applied to evaluate psychosocial factors. Nordic Musculoskeletal Questionnaire (NMQ) was used to assess musculoskeletal symptoms. Pressure Pain Threshold (PPT) was measured to evaluate sensory responses.

Results

According to JCQ, all groups were classified as active profile. There was a significant association between work engagement and workers’ categories (p < 0.05). PrWC workers had the highest scores for all the UWES domains, while PrBC had the lowest ones. PPT showed that PrBC workers had an increased sensitivity for left deltoid (p < 0.01), and for both epicondyles (p < 0.01), when compared to the other groups. PrWC workers had an increased sensitivity for both epicondyles than PuWC (right p < 0.01; left, p = 0.05). There was no significant association in the report of symptoms across the groups (p > 0.05).

Conclusion

This study showed differences in psychosocial risk factors and musculoskeletal symptoms in workers engaged in different types of jobs and work organization. Personal and work-related characteristics, psychosocial factors and PPT responses were different across workers’ group. Despite all, there was no significant difference in reported symptoms across the groups, possibly indicating that the physical load is similar among the sectors.

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Review

An Evidence-Based Multidisciplinary Practice Guideline to Reduce the Workload due to Lifting for Preventing Work-Related Low Back Pain: P Paul FM Kuijer, Jos HAM Verbeek, Bart Visser, Leo AM Elders, Nico Van Roden, Marion ER Van den Wittenboer, Marian Lebbink, Alex Burdorf, Carel TJ Hulshof; Ann Occup Environ Med 2014;26:16-16. Published online June 24, 2014; DOI: https://doi.org/10.1186/2052-4374-26-16

Abstract PDF PubReader ePub

We developed an evidence-based practice guideline to support occupational safety and health (OSH) professionals in assessing the risk due to lifting and in selecting effective preventive measures for low back pain (LBP) in the Netherlands. The guideline was developed at the request of the Dutch government by a project team of experts and OSH professionals in lifting and work-related LBP. The recommendations for risk assessment were based on the quality of instruments to assess the risk on LBP due to lifting. Recommendations for interventions were based on a systematic review of the effects of worker- and work directed interventions to reduce back load due to lifting. The quality of the evidence was rated as strong (A), moderate (B), limited (C) or based on consensus (D). Finally, eight experts and twenty-four OSH professionals commented on and evaluated the content and the feasibility of the preliminary guideline. For risk assessment we recommend loads heavier than 25 kg always to be considered a risk for LBP while loads less than 3 kg do not pose a risk. For loads between 3–25 kg, risk assessment shall be performed using the Manual handling Assessment Charts (MAC)-Tool or National Institute for Occupational Safety and Health (NIOSH) lifting equation. Effective work oriented interventions are patient lifting devices (Level A) and lifting devices for goods (Level C), optimizing working height (Level A) and reducing load mass (Level C). Ineffective work oriented preventive measures are regulations to ban lifting without proper alternatives (Level D). We do not recommend worker-oriented interventions but consider personal lift assist devices as promising (Level C). Ineffective worker-oriented preventive measures are training in lifting technique (Level A), use of back-belts (Level A) and pre-employment medical examinations (Level A). This multidisciplinary evidence-based practice guideline gives clear criteria whether an employee is at risk for LBP while lifting and provides an easy-reference for (in)effective risk reduction measures based on scientific evidence, experience, and consensus among OSH experts and practitioners.

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Research Article

Automation of Workplace Lifting Hazard Assessment for Musculoskeletal Injury Prevention: June T Spector, Max Lieblich, Stephen Bao, Kevin McQuade, Margaret Hughes; Ann Occup Environ Med 2014;26:15-15. Published online June 24, 2014; DOI: https://doi.org/10.1186/2052-4374-26-15

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Objectives

Existing methods for practically evaluating musculoskeletal exposures such as posture and repetition in workplace settings have limitations. We aimed to automate the estimation of parameters in the revised United States National Institute for Occupational Safety and Health (NIOSH) lifting equation, a standard manual observational tool used to evaluate back injury risk related to lifting in workplace settings, using depth camera (Microsoft Kinect) and skeleton algorithm technology.

Methods

A large dataset (approximately 22,000 frames, derived from six subjects) of simultaneous lifting and other motions recorded in a laboratory setting using the Kinect (Microsoft Corporation, Redmond, Washington, United States) and a standard optical motion capture system (Qualysis, Qualysis Motion Capture Systems, Qualysis AB, Sweden) was assembled. Error-correction regression models were developed to improve the accuracy of NIOSH lifting equation parameters estimated from the Kinect skeleton. Kinect-Qualysis errors were modelled using gradient boosted regression trees with a Huber loss function. Models were trained on data from all but one subject and tested on the excluded subject. Finally, models were tested on three lifting trials performed by subjects not involved in the generation of the model-building dataset.

Results

Error-correction appears to produce estimates for NIOSH lifting equation parameters that are more accurate than those derived from the Microsoft Kinect algorithm alone. Our error-correction models substantially decreased the variance of parameter errors. In general, the Kinect underestimated parameters, and modelling reduced this bias, particularly for more biased estimates. Use of the raw Kinect skeleton model tended to result in falsely high safe recommended weight limits of loads, whereas error-corrected models gave more conservative, protective estimates.

Conclusions

Our results suggest that it may be possible to produce reasonable estimates of posture and temporal elements of tasks such as task frequency in an automated fashion, although these findings should be confirmed in a larger study. Further work is needed to incorporate force assessments and address workplace feasibility challenges. We anticipate that this approach could ultimately be used to perform large-scale musculoskeletal exposure assessment not only for research but also to provide real-time feedback to workers and employers during work method improvement activities and employee training.

Citations

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Research Article

Effects of health and safety problem recognition on small business facility investment: Jisu Park, Harin Jeong, Sujin Hong, Jong-Tae Park, Dae-Sung Kim, Jongseo Kim, Hae-Joon Kim; Ann Occup Environ Med 2013;25:26-26. Published online October 23, 2013; DOI: https://doi.org/10.1186/2052-4374-25-26

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Objectives

This study involved a survey of the facility investment experiences, which was designed to recognize the importance of health and safety problems, and industrial accident prevention. Ultimately, we hope that small scale industries will create effective industrial accident prevention programs and facility investments.

Methods

An individual survey of businesses’ present physical conditions, recognition of the importance of the health and safety problems, and facility investment experiences for preventing industrial accidents was conducted. The survey involved 1,145 business operators or management workers in small business places with fewer than 50 workers in six industrial complexes.

Results

Regarding the importance of occupational health and safety problems (OHS), 54.1% said it was “very important”. Received technical and financial support, and industrial accidents that occurred during the past three years were recognized as highly important for OHS. In an investigation regarding facility investment experiences for industrial accident prevention, the largest factors were business size, greater numbers of industrial accidents, greater technical and financial support received, and greater recognition of the importance of the OHS. The related variables that decided facility investment for industry accident prevention in a logistic regression analysis were the experiences of business facilities where industrial accidents occurred during the past three years, received technical and financial support, and recognition of the OHS. Those considered very important were shown to be highly significant.

Conclusions

Recognition of health and safety issues was higher when small businesses had experienced industrial accidents or received financial support. The investment in industrial accidents was greater when health and safety issues were recognized as important. Therefore, the goal of small business health and safety projects is to prioritize health and safety issues in terms of business management and recognition of importance. Therefore, currently various support projects are being conducted. However, there are issues regarding the limitations of the target businesses and inadequacies in maintenance and follow-up. Overall, it is necessary to provide various incentives for onsite participation that can lead to increased recognition of health and safety issues and practical investments, while perfecting maintenance and follow up measures by thoroughly revising existing operating systems.

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Original Article

Relating Factors of Industrial Accident: Dae Suk Ko, Soon Suk Choi, Soo Jin Jung, Jun Han Park, Hun Lee, Byung Chul Son, Sang Hwa Urm, Chae Un Lee, Ki Taek Bae, Jin Ho Chun; Korean Journal of Occupational and Environmental Medicine 1997;9(1):99-108. Published online February 28, 1997; DOI: https://doi.org/10.35371/kjoem.1997.9.1.99

Abstract PDF

This study was conducted to estimate the causing factors of industrial accident, and to prepare the fittable control program for accident through the evaluation of views of the patients who suffered from accidents. From January 5 to February 6 1993, questionnaire survey was executed on 166 persons who were injured and covered by the insurance under industrial accident compensation law at four university hospitals in Pusan. The results were as follows : 1. Most of subjects worked in the manufacturing (56.6%) and construction(29.5%), and in the small factory less than 49 workers(56.0%). They were thirties and forties(63.8%), less than 3 years tenure(53.6%), habitual drinker(69.2%). And, 72.3% worked for above 9 hours per day, 53.6% worked as near clerks, 89.2% thought that work is rather suitable to his own personality. 2. Self-recognition for the causing factor of industrial accident was the other's malfunction(19.3%), carelessness(15.1%), lack of education for safety(15.1%), and they thought the accident occurred by mainly some defect of establishment and working environment(34.9%), unskillfulness(22.9%), self-carelessness(22.3%). 3. The interests and recognition on safety was insufficient, 88.6% require job education, but 53% pointed out the necessity for strengthening of present status-rather incomplete with relying on self-education (40.9%), no previous participation in safety education (29.5%), etc. 4. For the kind of accident, fall-down(16.3%), crash(13.3%), falling(12.7%) was frequent, head(24.7%) and fracture(41.0%) was frequent for the part and type of injury, respectively. And, they had more injured by cooperative work (82.5%) than single work. As results, improvement of working environment and strengthening education program would be emphasized for the effective control of industrial accident. And, there should be prepared the specific prevention program for the small scale industries.

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