Background
The teaching profession is an occupation with a high prevalence of work‐related stress. This may lead to sustained physical and mental health problems in teachers. It can also negatively ...affect the health, wellbeing and educational attainment of children, and impose a financial burden on the public budget in terms of teacher turnover and sickness absence. Most evaluated interventions for the wellbeing of teachers are directed at the individual level, and so do not tackle the causes of stress in the workplace. Organisational‐level interventions are a potential avenue in this regard.
Objectives
To evaluate the effectiveness of organisational interventions for improving wellbeing and reducing work‐related stress in teachers.
Search methods
We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, PsycINFO, ASSIA, AEI, BEI, BiblioMap, DARE, DER, ERIC, IBSS, SSCI, Sociological s, a number of specialist occupational health databases, and a number of trial registers and grey literature sources from the inception of each database until January 2015.
Selection criteria
Randomised controlled trials (RCTs), cluster‐RCTs, and controlled before‐and‐after studies of organisational‐level interventions for the wellbeing of teachers.
Data collection and analysis
We used standard methodological procedures expected by Cochrane.
Main results
Four studies met the inclusion criteria. They were three cluster‐randomised controlled trials and one with a stepped‐wedge design.
Changing task characteristics
One study with 961 teachers in eight schools compared a task‐based organisational change intervention along with stress management training to no intervention. It found a small reduction at 12 months in 10 out of 14 of the subscales in the Occupational Stress Inventory, with a mean difference (MD) varying from ‐3.84 to 0.13, and a small increase in the Work Ability Index (MD 2.27; 95% confidence interval (CI) 1.64 to 2.90; 708 participants, low‐quality evidence).
Changing organisational characteristics
Two studies compared teacher training combined with school‐wide coaching support to no intervention. One study with 59 teachers in 43 schools found no significant effects on job‐related anxiety (MD ‐0.25 95% CI ‐0.61 to 0.11, very low‐quality evidence) or depression (MD ‐0.26 95% CI ‐0.57 to 0.05, very low‐quality evidence) after 24 months. The other study with 77 teachers in 18 schools found no significant effects on the Maslach Burnout Inventory subscales (e.g. emotional exhaustion subscale: MD ‐0.05 95% CI ‐0.52 to 0.42, low‐quality evidence) or the Teacher Perceived Emotional Ability subscales (e.g. regulating emotions subscale: MD 0.11 95% CI ‐0.11 to 0.33, low‐quality evidence) after six months.
Multi‐component intervention
One study with 1102 teachers in 34 schools compared a multi‐component intervention containing performance bonus, job promotion opportunities and mentoring support to a matched‐comparison group consisting of 300 schools. It found moderately higher teacher retention rates (MD 11.50 95% CI 3.25 to 19.75 at 36 months follow‐up, very low‐quality evidence). However, the authors reported results only from one cohort out of four (eight schools), demonstrating a high risk of reporting bias.
Authors' conclusions
We found low‐quality evidence that organisational interventions lead to improvements in teacher wellbeing and retention rates. We need further evaluation of the effects of organisational interventions for teacher wellbeing. These studies should follow a complex‐interventions framework, use a cluster‐randomised design and have large sample sizes.
Psychological suffering by health professionals may be associated with the uncertainty of a safe workplace. Front-line professionals exposed and involved in the diagnosis and treatment of COVID-19 ...patients are more susceptible.
This review was conducted based on papers that were published at MEDLINE, BMJ, PsycINFO, and LILACS, the according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA).
Health professionals had a higher level of anxiety (13.0 vs. 8.5%, p < 0.01, OR = 1.6152; 95%CI 1.3283 to 1.9641; p < 0.0001) and depression 12.2 vs. 9.5%; p = 0.04; OR = 1.3246; 95%CI 1.0930 to 1.6053; p = 0.0042), besides somatizations and insomnia compared to professionals from other areas.
Health professionals, regardless of their age, showed significant levels of mental disorders. We observed a prevalence of anxiety and depression. Insomnia was a risk factor for both.
•During the pandemic, the anxiety and depression scores are significantly higher in the healthcare teams.•The teams working closer to infected patients showed a higher prevalence of mental disorders.•Health professionals showed high prevalence of mental disorders.
Most studies of the association between diesel exhaust exposure and lung cancer suggest a modest, but consistent, increased risk. However, to our knowledge, no study to date has had quantitative data ...on historical diesel exposure coupled with adequate sample size to evaluate the exposure-response relationship between diesel exhaust and lung cancer. Our purpose was to evaluate the relationship between quantitative estimates of exposure to diesel exhaust and lung cancer mortality after adjustment for smoking and other potential confounders.
We conducted a nested case-control study in a cohort of 12 315 workers in eight non-metal mining facilities, which included 198 lung cancer deaths and 562 incidence density-sampled control subjects. For each case subject, we selected up to four control subjects, individually matched on mining facility, sex, race/ethnicity, and birth year (within 5 years), from all workers who were alive before the day the case subject died. We estimated diesel exhaust exposure, represented by respirable elemental carbon (REC), by job and year, for each subject, based on an extensive retrospective exposure assessment at each mining facility. We conducted both categorical and continuous regression analyses adjusted for cigarette smoking and other potential confounding variables (eg, history of employment in high-risk occupations for lung cancer and a history of respiratory disease) to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Analyses were both unlagged and lagged to exclude recent exposure such as that occurring in the 15 years directly before the date of death (case subjects)/reference date (control subjects). All statistical tests were two-sided.
We observed statistically significant increasing trends in lung cancer risk with increasing cumulative REC and average REC intensity. Cumulative REC, lagged 15 years, yielded a statistically significant positive gradient in lung cancer risk overall (P (trend) = .001); among heavily exposed workers (ie, above the median of the top quartile REC ≥ 1005 μg/m(3)-y), risk was approximately three times greater (OR = 3.20, 95% CI = 1.33 to 7.69) than that among workers in the lowest quartile of exposure. Among never smokers, odd ratios were 1.0, 1.47 (95% CI = 0.29 to 7.50), and 7.30 (95% CI = 1.46 to 36.57) for workers with 15-year lagged cumulative REC tertiles of less than 8, 8 to less than 304, and 304 μg/m(3)-y or more, respectively. We also observed an interaction between smoking and 15-year lagged cumulative REC (P (interaction) = .086) such that the effect of each of these exposures was attenuated in the presence of high levels of the other.
Our findings provide further evidence that diesel exhaust exposure may cause lung cancer in humans and may represent a potential public health burden.
Background
Work‐related upper limb and neck musculoskeletal disorders (MSDs) are one of the most common occupational disorders worldwide. Studies have shown that the percentage of office workers that ...suffer from MSDs ranges from 20 to 60 per cent. The direct and indirect costs of work‐related upper limb MSDs have been reported to be high in Europe, Australia, and the United States. Although ergonomic interventions are likely to reduce the risk of office workers developing work‐related upper limb and neck MSDs, the evidence is unclear. This is an update of a Cochrane Review which was last published in 2012.
Objectives
To assess the effects of physical, cognitive and organisational ergonomic interventions, or combinations of those interventions for the prevention of work‐related upper limb and neck MSDs among office workers.
Search methods
We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, CINAHL, Web of Science (Science Citation Index), SPORTDiscus, Embase, the US Centers for Disease Control and Prevention, the National Institute for Occupational Safety and Health database, and the World Health Organization's International Clinical Trials Registry Platform, to 10 October 2018.
Selection criteria
We included randomised controlled trials (RCTs) of ergonomic interventions for preventing work‐related upper limb or neck MSDs (or both) among office workers. We only included studies where the baseline prevalence of MSDs of the upper limb or neck, or both, was less than 25%.
Data collection and analysis
Two review authors independently extracted data and assessed risk of bias. We included studies with relevant data that we judged to be sufficiently homogeneous regarding the interventions and outcomes in the meta‐analysis. We assessed the overall quality of the evidence for each comparison using the GRADE approach.
Main results
We included 15 RCTs (2165 workers). We judged one study to have a low risk of bias and the remaining 14 studies to have a high risk of bias due to small numbers of participants and the potential for selection bias.
Physical ergonomic interventions
There is inconsistent evidence for arm supports and alternative computer mouse designs. There is moderate‐quality evidence that an arm support with an alternative computer mouse (two studies) reduced the incidence of neck or shoulder MSDs (risk ratio (RR) 0.52; 95% confidence interval (CI) 0.27 to 0.99), but not the incidence of right upper limb MSDs (RR 0.73; 95% CI 0.32 to 1.66); and low‐quality evidence that this intervention reduced neck or shoulder discomfort (standardised mean difference (SMD) −0.41; 95% CI −0.69 to −0.12) and right upper limb discomfort (SMD −0.34; 95% CI −0.63 to −0.06).
There is moderate‐quality evidence that the incidence of neck or shoulder and right upper limb disorders were not considerably reduced when comparing an alternative computer mouse and a conventional mouse (two studies; neck or shoulder: RR 0.62; 95% CI 0.19 to 2.00; right upper limb: RR 0.91; 95% CI 0.48 to 1.72), and also when comparing an arm support with a conventional mouse and a conventional mouse alone (two studies) (neck or shoulder: RR 0.91; 95% CI 0.12 to 6.98; right upper limb: RR 1.07; 95% CI 0.58 to 1.96).
Workstation adjustment (one study) and sit‐stand desks (one study) did not have an effect on upper limb pain or discomfort, compared to no intervention.
Organisational ergonomic interventions
There is very low‐quality evidence that supplementary breaks (two studies) reduce discomfort of the neck (MD −0.25; 95% CI −0.40 to −0.11), right shoulder or upper arm (MD −0.33; 95% CI −0.46 to −0.19), and right forearm or wrist or hand (MD ‐0.18; 95% CI ‐0.29 to ‐0.08) among data entry workers.
Training in ergonomic interventions
There is low to very low‐quality evidence in five studies that participatory and active training interventions may or may not prevent work‐related MSDs of the upper limb or neck or both.
Multifaceted ergonomic interventions
For multifaceted interventions there is one study (very low‐quality evidence) that showed no effect on any of the six upper limb pain outcomes measured in that study.
Authors' conclusions
We found inconsistent evidence that the use of an arm support or an alternative mouse may or may not reduce the incidence of neck or shoulder MSDs. For other physical ergonomic interventions there is no evidence of an effect. For organisational interventions, in the form of supplementary breaks, there is very low‐quality evidence of an effect on upper limb discomfort. For training and multifaceted interventions there is no evidence of an effect on upper limb pain or discomfort. Further high‐quality studies are needed to determine the effectiveness of these interventions among office workers.
The aim is to analyze the structure of occupational diseases in first-third year piano students studying.
A total sample of 300 individuals participating in the research process underwent a complete ...medical examination at the end of each academic year.
Among piano students, number of those distributed to special medical groups for health reasons grew from 14 to 38% (p ≤ 0.02). The incidence of diseases of the muscular system increased from 58 to 71% (p ≤ 0.05), with the sharpest rise during the transition from the second to the third year of study. Similar tendencies were obtained for the incidence of hand-related diseases-their overall frequency advanced from 17 to 23% (p ≤ 0.05). The surge of morbidity in the transition from the second to the third year of study can be attributed to the increased educational load experienced by students during this period, as they begin to practice music intensively after theoretical classes. Сorresponding measures directed at preventing occupational diseases, bettering physical education, expanding the rest intervals between piano lessons are to be taken.
The research results indicate that the main occupational diseases of piano students are those related to hands and muscular system.
The obtained data suggest that the range of diseases is likely to progress throughout the musical training. The main diseases of piano students are those related to hands and muscular system. The sharpest rise was during the transition from the 2nd to the 3rd year of study.
Current information points to an association between diesel exhaust exposure and lung cancer and other mortality outcomes, but uncertainties remain.
We undertook a cohort mortality study of 12 315 ...workers exposed to diesel exhaust at eight US non-metal mining facilities. Historical measurements and surrogate exposure data, along with study industrial hygiene measurements, were used to derive retrospective quantitative estimates of respirable elemental carbon (REC) exposure for each worker. Standardized mortality ratios and internally adjusted Cox proportional hazard models were used to evaluate REC exposure-associated risk. Analyses were both unlagged and lagged to exclude recent exposure such as that occurring in the 15 years directly before the date of death.
Standardized mortality ratios for lung cancer (1.26, 95% confidence interval CI = 1.09 to 1.44), esophageal cancer (1.83, 95% CI = 1.16 to 2.75), and pneumoconiosis (12.20, 95% CI = 6.82 to 20.12) were elevated in the complete cohort compared with state-based mortality rates, but all-cause, bladder cancer, heart disease, and chronic obstructive pulmonary disease mortality were not. Differences in risk by worker location (ever-underground vs surface only) initially obscured a positive diesel exhaust exposure-response relationship with lung cancer in the complete cohort, although it became apparent after adjustment for worker location. The hazard ratios (HRs) for lung cancer mortality increased with increasing 15-year lagged cumulative REC exposure for ever-underground workers with 5 or more years of tenure to a maximum in the 640 to less than 1280 μg/m(3)-y category compared with the reference category (0 to <20 μg/m(3)-y; 30 deaths compared with eight deaths of the total of 93; HR = 5.01, 95% CI = 1.97 to 12.76) but declined at higher exposures. Average REC intensity hazard ratios rose to a plateau around 32 μg/m(3). Elevated hazard ratios and evidence of exposure-response were also seen for surface workers. The association between diesel exhaust exposure and lung cancer risk remained after inclusion of other work-related potentially confounding exposures in the models and were robust to alternative approaches to exposure derivation.
The study findings provide further evidence that exposure to diesel exhaust increases risk of mortality from lung cancer and have important public health implications.
Pathophysiology of manganese-associated neurotoxicity Racette, Brad A.; Aschner, Michael; Guilarte, Tomas R. ...
Neurotoxicology (Park Forest South),
08/2012, Letnik:
33, Številka:
4
Journal Article, Conference Proceeding
Recenzirano
Odprti dostop
Manganese (Mn) is a well established neurotoxin associated with specific damage to the basal ganglia in humans. The phenotype associated with Mn neurotoxicity was first described in two workers with ...occupational exposure to Mn oxide (Couper, 1837). Although the description did not use modern clinical terminology, a parkinsonian illness characterized by slowness of movement (bradykinesia), masked facies, and gait impairment (postural instability) appears to have predominated. Nearly 100 years later an outbreak of an atypical parkinsonian illness in a Chilean Mn mine provided a phenotypic description of a fulminant neurologic disorder with parkinsonism, dystonia, and neuropsychiatric symptoms (Rodier, 1955). Exposures associated with this syndrome were massive and an order of magnitude greater than modern exposures (Rodier, 1955; Hobson et al., 2011). The clinical syndrome associated with Mn neurotoxicity has been called manganism.
Modern exposures to Mn occur primarily through occupations in the steel industry and welding. These exposures are often chronic and varied, occurring over decades in the healthy workforce. Although the severe neurologic disorder described by Rodier and Couper are no longer seen, several reports have suggested a possible increased risk of neurotoxicity in these workers (Racette et al., 2005b; Bowler et al., 2007; Harris et al., 2011). Based upon limited prior imaging and pathologic investigations into the pathophysiology of neurotoxicity in Mn exposed workers (Huang et al., 2003), many investigators have concluded that the syndrome spares the dopamine system distinguishing manganism from Parkinson disease (PD), the most common cause of parkinsonism in the general population, and a disease with characteristic degenerative changes in the dopaminergic system (Jankovic, 2005).
The purpose of this symposium was to highlight recent advances in the understanding of the pathophysiology of Mn associated neurotoxicity from Caenorhabditis elegans to humans. Dr. Aschner's presentation discussed mechanisms of dopaminergic neuronal toxicity in C. elegans and demonstrates a compelling potential role of Mn in dopaminergic degeneration. Dr. Guilarte's experimental, non-human primate model of Mn neurotoxicity suggests that Mn decreases dopamine release in the brain without loss of neuronal integrity markers, including dopamine. Dr. Racette's presentation demonstrates a unique pattern of dopaminergic dysfunction in active welders with chronic exposure to Mn containing welding fumes. Finally, Dr. Dydak presented novel magnetic resonance (MR) spectroscopy data in Mn exposed smelter workers and demonstrated abnormalities in the thalamus and frontal cortex for those workers. This symposium provided some converging evidence of the potential neurotoxic impact of Mn on the dopaminergic system and challenged existing paradigms on the pathophysiology of Mn in the central nervous system.
Occupational exposures can contribute to the exacerbation as well as the onset of asthma. However, work-exacerbated asthma (WEA) has received less attention than occupational asthma (OA) that is ...caused by work.
The purpose of this Statement is to summarize current knowledge about the descriptive epidemiology, clinical characteristics, and management and treatment of WEA; propose a case definition for WEA; and discuss needs for prevention and research.
Information about WEA was identified primarily by systematic searches of the medical literature. Statements about prevention and research needs were reached by consensus.
WEA is defined as the worsening of asthma due to conditions at work. WEA is common, with a median prevalence of 21.5% among adults with asthma. Different types of agents or conditions at work may exacerbate asthma. WEA cases with persistent work-related symptoms can have clinical characteristics (level of severity, medication needs) and adverse socioeconomic outcomes (unemployment, reduction in income) similar to those of OA cases. Compared with adults with asthma unrelated to work, WEA cases report more days with symptoms, seek more medical care, and have a lower quality of life. WEA should be considered in any patient with asthma that is getting worse or who has work-related symptoms. Management of WEA should focus on reducing work exposures and optimizing standard medical management, with a change in jobs only if these measures are not successful.
WEA is a common and underrecognized adverse outcome resulting from conditions at work. Additional research is needed to improve the understanding of the risk factors for, and mechanisms and outcomes of, WEA, and to inform and evaluate preventive interventions.
Every person on the planet is entangled in a web of ecological relationships that link farms and factories with human consumers. Our lives depend on these relationships -- and are imperiled by them ...as well. Nowhere is this truer than on the Japanese archipelago.
During the nineteenth century, Japan saw the rise of Homo sapiens industrialis, a new breed of human transformed by an engineered, industrialized, and poisonous environment. Toxins moved freely from mines, factory sites, and rice paddies into human bodies.
Toxic Archipelagoexplores how toxic pollution works its way into porous human bodies and brings unimaginable pain to some of them. Brett Walker examines startling case studies of industrial toxins that know no boundaries: deaths from insecticide contaminations; poisonings from copper, zinc, and lead mining; congenital deformities from methylmercury factory effluents; and lung diseases from sulfur dioxide and asbestos.
This powerful, probing book demonstrates how the Japanese archipelago has become industrialized over the last two hundred years -- and how people and the environment have suffered as a consequence.
ObjectiveThe objective was to conduct an update of a previously published review and meta-analysis on the association between work-related psychosocial risk factors and stress-related mental ...disorders (SRD).DesignSystematic review and meta-analysis.Data sourcesMedline, Embase and PsycINFO were searched for articles published between 2008 and 12 August 2019 and references of a systematic review performed for the period before 2008 were included. Primary prospective studies were included when outcome data were described in terms of SRD assessment or a dichotomous outcome, based on a validated questionnaire, and at least two levels of work-related exposure were reported (exposed vs less or non-exposed). We used GRADE to assess the evidence for the associations between risk factors and the onset of SRD.ResultsSeventeen studies met the inclusion criteria. In total, a population of 73 874 workers from Belgium, Denmark, England, Finland, Japan, the Netherlands and Sweden were included in the meta-analysis of 14 prospective cohort studies. This meta-analysis revealed moderate evidence for associations between SRD and effort reward imbalance (OR=1.9, 95% CI 1.70 to 2.15), high job demands (OR=1.6, 95% CI 1.41 to 1.72), organisational justice (ORs=1.6 to 1.7, CIs 1.44 to 1.86), social support (ORs=1.3 to 1.4, CIs 1.16 to 1.69), high emotional demands (OR=1.6, 95% CI 1.35 to 1.84) and decision authority (OR=1.3, CI 1.20 to 1.49). No significant or inconsistent associations were found for job insecurity, decision latitude, skill discretion and bullying.ConclusionModerate evidence was found that work-related psychosocial risk factors are associated with a higher risk of SRD. Effort-reward imbalance, low organisational justice and high job demands exhibited the largest increased risk of SRD, varying from 60% to 90%.
PDF
