In 1985, the Sheet Metal Workers International Association and the Sheet Metal and Air Conditioning National Association formed The Sheet Metal Occupational Health Institute Trust to examine the ...health hazards of the sheet metal industry in the United States and Canada. Between 1986 and 2004, 18,211 individuals were examined. The mean age of this cohort was 57.9 years, and the participants had worked for a mean (± SD) duration of 32.9 ± 6 years in the sheet metal trade. Twenty-three percent of participants were current smokers, 49% were former smokers, and 28% were never-smokers. A total of 9.6% of participants (1,745 participants) had findings that were consistent with parenchymal disease (International Labor Organization ILO score, ≥ 1/0); 60% of those with an ILO score ≥ 1/0 were classified as 1/0, 34% as 1/1 to 1/2, and 6% as ≥ 2/1. A total of 21% of participants (3,827 participants) had pleural scarring. There was a lower prevalence of nonmalignant asbestos-related disease among those who began to work after 1970, when compared to workers who began to work before 1949; those who began to work between 1950 and 1969 had a prevalence between the other two groups. The strongest predictor of both parenchymal and pleural disease on a chest radiograph was the calendar year in which the worker began sheet metal work; work in a shipyard was also an important risk. The results of this study suggest that the efforts to reduce asbestos exposure in the 1980s through strengthened Occupational Safety and Health Administration regulation have had a positive public health impact.
Intravenous therapy is a common practice among many specialties. Intravenous therapy extravasation is a potential complication to such therapy. Hospitals without a dedicated wound care team trained ...in these interventions will often default to plastic surgical consultation, making an understanding of available interventions essential to the initial evaluation and management of these injuries. The goal of this article was to provide plastic surgeons and health care providers with a general overview of the acute management of intravenous infiltration and extravasation injuries. Though the decision for surgical versus nonsurgical management is often a clear one for plastic surgeons, local interventions, and therapies are often indicated and under-utilized in the immediate postinfiltration period. Thorough knowledge of these interventions should be a basic requirement in the armamentarium of plastic surgery consultants.
Objectives This study investigated the relationships between work demands, chronic medical and musculoskeletal conditions, aging, and the ability to remain on the job in a longitudinal study of 979 ...construction roofers between the ages of 40 and 59 years. Methods In a phone interview at baseline and 1 year later, the participants were asked about the presence of medical conditions and musculoskeletal disorders, work limitations and work accommodations, and social and economic functioning. Results Among the workers for whom a musculoskeletal disorder was their most serious condition at baseline, 8% left roofing due to a health condition during the first year of follow-up. A comparison between those who left and those who stayed identified older age and lower physical functioning as statistically significant predictors of leaving the trade. Workers with a musculoskeletal disorder and who, in the baseline interview, reported receiving some type of job accommodation for their musculoskeletal disorder had an odds ratio of 0.24 (P=0.07) for leaving work by the time of the 1-year follow-up when compared with workers with a musculoskeletal disorder and no job accommodation. The workers with three or more work limitations were also more likely to leave roofing, but this association disappeared after adjustment for other factors. Conclusions Musculoskeletal conditions among roofers are strongly associated with work limitation, missed work, and reduced physical functioning, factors that are predictive of premature departure from the workforce. Job accommodation was provided for 31% of the roofers with a musculoskeletal disorder, and it was associated with a reduced likelihood of subsequently leaving roofing for health-related reasons.
Construction workers have always had a high risk of occupational illnesses. We used 25 years of data from a medical screening program serving older construction workers to determine how much health ...outcomes have improved over the past 60 years.
We investigated changes in relative risk for chest radiographs consistent with pneumoconiosis, COPD by spirometry, lung cancer mortality, and audiometry-assessed hearing impairment among workers participating in a medical screening program. Results were stratified by decade of first construction employment: before 1960, 1960-1969, 1970-1979, 1980-1989, and after 1990. Poisson and Cox regression analyses assessed relative risk by decade adjusted for age, sex, smoking, and years of construction trade work.
Subjects were 94% male and, on average, 60 years old with 25 years of construction work. When compared to workers employed before 1960, those first employed after 1990 experienced the following reductions in model-adjusted relative risks: chronic obstructive pulmonary disease, 32%; all pneumoconiosis, 68%; parenchymal abnormalities, 35%; pleural abnormalities, 71%; hearing impairment, 20%; and lung cancer mortality, 48%. Risks started to decline in the 1960s with greatest reductions among workers first employed after 1970.
This study demonstrates the positive impact that adoption of occupational health protections have had over the past 60 years. The greatest risk reductions were observed for outcomes with strong regulatory and legal incentives to reduce exposures and associated risks, such as those associated with inhalation hazards (asbestos and silica), while lowest improvement was for hearing impairment, for which little regulatory enforcement and few prevention incentives have been adopted.
Virtual reality environments (VREs) are an emerging modality consisting of computer-generated worlds. Players in VREs can choose to create representative avatars. Such choices may reflect beliefs ...related to identity and psychological functioning. The aim of the present study was to examine associations between psychological distress, exposure to adverse childhood experiences, and choice of avatar in an immersive virtual environment.
We recruited 436 participants in a VRE. Participants completed the Early Traumatic Inventory Self Report-Short Form and the Brief Symptom Inventory. We evaluated between-group differences (selection of child avatar, parent avatar, or “other” avatar, the control group) in psychological distress and traumatic childhood experiences.
Individuals who selected child avatars experienced a higher degree of psychological distress and childhood trauma, especially sexual abuse, as compared to individuals who selected other avatars. Individuals who selected parent avatars were more likely to have experienced psychological distress as compared to controls.
Avatar choice may reflect users’ identities and psychological functioning. VREs may provide safe environments for a “do over” of adverse childhood experiences. Future research should explore VREs as venues to treat trauma and psychological distress.
•Individuals who experienced childhood trauma, especially sexual abuse, were more likely to select child avatars in a virtual reality environment•Individuals who experience greater degrees of psychological distress were more likely to select child avatars in a virtual reality environment•Results suggest that avatar choice may reflect elements of psychological functioning and the influence of childhood trauma and be meaningful for the individual•Future directions could involve the development of psychological interventions to be implemented in a virtual reality environment
This study assessed agreement between workers' and observers' daily estimates of exposure to construction work tasks. The ultimate aimwas to develop a valid method and instrument for the collection ...of self-reported data on duration of exposure to a priori identified work tasks for use in characterizing exposure in settings with substantial task variability. Forty-nine shop workers and 52 construction site sheet metal workers were observed for up to 3 full workdays. Observers sampled approximately 25% of each worker's day, recording the work performed from a prespecified list of tasks. Each participant completed a daily questionnaire, indicating the tasks he or she performed that day and time spent on each task. Shopworkers tended to specialize in particular tasks, while at the construction site, the workers' tasks reflected substantial day-to-day variability. Agreement between worker and observer estimates was generally better for major shop tasks (with intraclass correlation coefficients ICCs ranging from 0.52 to 0.85), than for major construction site tasks (with ICCs ranging from 0.36 to 0.64). Workers tended to overestimate the amount of time spent at tasks of longer duration and to underestimate time spent at short-duration tasks. Rank order analysis of time spent on task revealed fairly high agreement. Agreement was acceptable for shop-based work, which has less day-to-day variability than construction site work. Overall, however, the data suggest that, for highly variable work, the use of task as the unit of exposure does not improve recall over assessment approaches focusing on questions about posture and material handling.
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