Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine

Publications in this journal

• Article: Use of Propensity Scores in Occupational Health?

  Alexis Descatha, Annette Leclerc, Eleonore Herquelot
  Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 05/2013; 55(5):477-478.
• Article: Advancing Workplace Health Protection and Promotion for an Aging Workforce.

  Ronald R Loeppke, Anita L Schill, L Casey Chosewood, James W Grosch, Pamela Allweiss, Wayne N Burton, Janet L Barnes-Farrell, Ron Z Goetzel, Luann Heinen, T Warner Hudson, Pamela Hymel, James Merchant, Dee W Edington, Doris L Konicki, Paul W Larson
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  ABSTRACT: OBJECTIVE:: To explore issues related to the aging workforce, including barriers to integrating health protection and promotion programs, and provide recommendations for best practices to maximize contributions by aging workers. METHODS:: Workgroups reviewed literature and case studies to develop consensus statements and recommendations for a national approach to issues related to older workers. RESULTS:: Consensus statements and actions steps were identified for each of the Summit goals and call-to-action statements were developed. CONCLUSIONS:: A national dialogue to build awareness of integrated health protection and promotion for the aging workforce is needed. Workers will benefit from improved health and performance; employers will realize a more engaged and productive workforce; and the nation will gain a vital, competitive workforce.
  Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 05/2013; 55(5):500-506.
• Article: Screening for Occupational Asthma by Using a Self-Administered Questionnaire in a Clinical Setting.

  Jacques A Pralong, Gregory Moullec, Eva Suarthana, Michel Gérin, Denyse Gautrin, Jocelyne Lʼ Archevêque, Manon Labrecque
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  ABSTRACT: OBJECTIVE:: Because of its high prevalence, early screening for occupational asthma (OA) is crucial. We aimed to evaluate the screening performance of the Occupational Asthma Screening Questionnaire-11 items (OASQ-11) in a clinical setting. METHODS:: Between January 2009 and December 2011, 169 workers referred for potential OA to our hospital completed the OASQ-11 and underwent workups to determine the final diagnosis. The discriminative abilities of the OASQ-11 as a whole and in relation to demographic and exposure parameters were determined by the area under the receiving operator characteristic curve (AUC). RESULTS:: Model 1, consisting of the OASQ's items, showed fair discrimination (AUC, 0.69; 95% confidence interval, 0.58 to 0.80). Addition of age and exposure duration to model 1 improved discrimination (AUC, 0.80; confidence interval, 0.72 to 0.88). CONCLUSION:: A simple model consisting of the OASQ-11's items, age, and exposure duration could well discriminate subjects with OA in a clinical setting.
  Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 04/2013;
• Article: Low-Level Exposure to Air Pollution and Risk of Adverse Birth Outcomes in Hillsborough County, Florida.

  Maria B Mainolfi, Hamisu M Salihu, Roneé E Wilson, Alfred K Mbah
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  ABSTRACT: OBJECTIVE:: In this retrospective cohort (1998 to 2007), 145,445 singleton live births in Hillsborough, Florida, were analyzed to elucidate the relationship between fetal morbidity and prenatal exposure to six criteria air pollutants. METHODS:: This study was based on three linked databases: Florida Hospital Discharge, vital statistics records, and air pollution meteorological data from the Environmental Protection Agency. The primary outcomes of interest were low birth weight, preterm births, and small for gestational age. This study used structural equation modeling and trimester groupings to evaluate the relationship between air pollution and birth outcomes of pregnant residents. RESULTS:: The latent variables of structural equation modeling yielded a significant B value of 0.35, indicating that exposure to the criteria pollutants in pregnancy may have a significant relationship to fetal morbidity. CONCLUSION:: Exposure to criteria air pollutants in pregnancy is associated with fetal morbidity outcomes.
  Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 04/2013;
• Article: Value of Occupational Medicine Board Certification.

  Philip Harber, Samantha Wu, Johnny Bontemps, Sasha Rose, Kaochoy Saechao, Yihang Liu
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  ABSTRACT: OBJECTIVE:: To assess the impact of occupational medicine board certification and career stage on practice characteristics. METHODS:: Two hundred sixty occupational medicine physicians completed a questionnaire and 25 activity log descriptions about 72 items in 9 major domains. For each item, the percentage of activities involving the item and the percentage of physicians conducting the item at least once were calculated. Results were analyzed by board certification status and career stage. RESULTS:: Board-certified physicians had more-diverse practice activities and skills. They were more involved in management and public health-oriented activities, with greater emphasis on toxicology and less on musculoskeletal disorders. The noncertified physicians received more payment from workers' compensation. Early-career physicians spent more time in direct injury/illness treatment, being paid by workers' compensation, and addressing musculoskeletal problems. CONCLUSIONS:: Formal training confers advantages in practice diversity and population medicine orientation.
  Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 04/2013;
• Article: Upper and Lower Airways Obstruction Following an Inhalation Injury.

  Stuart M Brooks
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  ABSTRACT: The Occupational Medicine Forum is prepared by the ACOEM Occupational and Environmental Medical Practice Committee and does not necessarily represent an official ACOEM position. The Forum is intended for health professionals and is not intended to provide medical or legal advice, including illness prevention, diagnosis or treatment, or regulatory compliance. Such advice should be obtained directly from a physician and/or attorney.
  Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 04/2013;
• Article: Prospective Outcome Assessment of Occupational Rhinitis After Removal From Exposure.

  Roberto Castano, Carole Trudeau, Lucero Castellanos, Jean-Luc Malo
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  ABSTRACT: OBJECTIVE:: To conduct a prospective evaluation of clinical and quality of life (QOL) outcomes of occupational rhinitis (OR) after cessation of exposure. METHODS:: We assessed changes in nasal symptoms, disease-specific QOL, nasal patency, and nasal inflammation in 20 subjects with confirmed OR. Olfactory function was assessed cross-sectionally at follow-up. RESULTS:: At follow-up, a significant decrease in the number of nasal symptoms and a significant improvement in QOL were observed. There were no significant differences in nasal patency outcomes. A not significant decrease in neutrophils number in nasal fluid and a significant decrease in macrophages were observed. As a group, study subjects showed a mild olfactory dysfunction at follow-up. CONCLUSIONS:: We showed that cessation of exposure to causal agent improved QOL in patients with OR, leading to relief of rhinitis-associated symptoms and improvement in well-being.
  Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 04/2013;
• Article: Improving Patient-Centered Care: Agenda-Setting in Occupational Medicine.

  Carol S Kuhle, Frances Truitt, Mark Steffen, Chaitanya Undavalli, Zhen Wang, Victor M Montori, Mohammad Hassan Murad
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  ABSTRACT: OBJECTIVE:: To improve patient satisfaction with care at an occupational medicine clinic by promoting agenda-setting before the visit. METHODS:: We distributed agenda-setting form to 77 randomly selected patients attending an occupational health clinic and used another randomly selected sample of 36 patients as control group. Patients completed a survey regarding the acceptability of this procedure and whether they felt clinicians addressed their important concerns. RESULTS:: Most patients found the form helpful (73%) and wanted it offered in future visits (74%). There was no statistically significant difference in terms of the proportion of patients expressing greatest satisfaction by answering, "strongly agree" (intervention [86%], control [97%]; odds ratio, 0.17; 95% confidence interval, 0.02 to 1.38; P = 0.06). CONCLUSION:: Agenda-setting can improve patient experience before occupational visits but does not improve postvisit satisfaction.
  Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 04/2013;
• Article: Temporal Relationship Between Lumbar Spine Surgeries, Return to Work, and Workers' Compensation Costs in a Cohort of Injured Workers.

  Robert A Lavin, Xuguang Tao, Larry Yuspeh, Edward J Bernacki
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  ABSTRACT: OBJECTIVE:: Determine the relationship between time to surgery, lost time, and insurance costs. METHOD:: A cohort of 582 claimants undergoing lumbar spine surgery (1999 to 2002) in the state of Louisiana was observed for 7 years. RESULTS:: The shorter the time interval between injury and first lumbar surgery, the lower the cost and time lost from work. Average days lost from work and claim costs for 42% of those undergoing early lumbar surgery did not differ from injured workers who lost time from work for claims not involving lumbar surgery. Claim cost for the remaining 58% who had delayed surgery was 5.7 times greater than that for the early surgery cohort. CONCLUSION:: The decision to perform lumbar surgery is not necessarily associated with high claim costs or longer time out from work, provided that the determination to operate is early.
  Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 04/2013;
• Article: Tibial Bone Lead, but Not Serum Polychlorinated Biphenyl, Concentrations Are Associated With Neurocognitive Deficits in Former Capacitor Workers.

  Richard F Seegal, Edward F Fitzgerald, Robert J McCaffrey, Srishti Shrestha, Elaine A Hills, Mary S Wolff, Richard F Haase, Andrew C Todd, Patrick J Parsons, Eric S Molho, Donald S Higgins, Stewart A Factor, John P Seibyl
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  ABSTRACT: OBJECTIVE:: To determine the relationships between tibial bone lead and serum polychlorinated biphenyl (PCB) concentrations and neurocognitive function. METHODS:: The study population consisted of men and women former capacitor workers had been employed by the General Electric Corporation between 1946 and 1977. Regression analyses evaluated the association between neurocognitive function and lipid-adjusted serum PCB and tibia lead concentrations. RESULTS:: Tibia lead, but not serum PCBs, was significantly correlated with deficits in neurocognitive function. Women showed more associations between tibia lead and neurocognitive function than men, especially regarding executive function. CONCLUSIONS:: These results demonstrate that low levels of tibia lead, but not serum PCBs, are associated with neurocognitive deficits and that postmenopausal women show a greater number of deficits in executive function than men.
  Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 04/2013;
• Article: Reliability and Validity Testing of the CDC Worksite Health ScoreCard: An Assessment Tool to Help Employers Prevent Heart Disease, Stroke, and Related Health Conditions.

  Enid Chung Roemer, Karen B Kent, Daniel K Samoly, Laura M Gaydos, Kristyn J Smith, Amol Agarwal, Dyann M Matson-Koffman, Ron Z Goetzel
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  ABSTRACT: OBJECTIVE:: To develop, evaluate, and improve the reliability and validity of the CDC Worksite Health ScoreCard (HSC). METHODS:: We tested interrater reliability by piloting the HSC at 93 worksites, examining question response concurrence between two representatives from each worksite. We conducted cognitive interviews and site visits to evaluate face validity of items and refined the instrument for general distribution. RESULTS:: The mean question concurrence rate was 77%. Respondents reported the tool to be useful, and on average 49% of all possible interventions were in place at the surveyed worksites. The interviews highlighted issues undermining reliability and validity, which were addressed in the final version of the instrument. CONCLUSIONS:: The revised HSC is a reasonably valid and reliable tool for assessing worksite health promotion programs, policies, and environmental supports directed at preventing cardiovascular disease.
  Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 04/2013;
• Article: Relationship Between Physical Inactivity and Health Characteristics Among Participants in an Employee-Wellness Program.

  Gurjeet S Birdee, Daniel W Byrne, Paula W McGown, Russell L Rothman, Lori A Rolando, Marilyn C Holmes, Mary I Yarbrough
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  ABSTRACT: OBJECTIVE:: To characterize factors associated with physical inactivity among employees with access to workplace wellness program. METHODS:: We examined data on physical inactivity, defined as exercise less than once a week, from the 2010 health risk assessment completed by employees at a major academic institution (N = 16,976). RESULTS:: Among employees, 18% of individuals reported physical activity less than once a week. Individuals who were physically inactive as compared with physically active reported higher prevalence of cardiovascular diseases (adjusted odds ratio [AOR], 1.36 [1.23 to 1.51]), fair or poor health status (AOR, 3.52 [2.97 to 4.17]), and absenteeism from work (AOR, 1.59 [1.41 to 1.79]). Overall, physically inactive employees as compared with physically active employees reported more interest in health education programs. CONCLUSION:: Future research is needed to address barriers to physical inactivity to improve employee wellness and potentially lower health utility costs.
  Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 04/2013;
• Article: Case Identification of Work-Related Traumatic Brain Injury Using the Occupational Injury and Illness Classification System.

  Jeanne M Sears, Janessa M Graves, Laura Blanar, Stephen M Bowman
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  ABSTRACT: OBJECTIVES:: Traumatic brain injury (TBI) is one of the most common, costly, and disabling occupational injuries. Objectives included determining whether work-related TBI could be reliably identified using the Occupational Injury and Illness Classification System (OIICS) and describing challenges in developing an OIICS-based TBI case definition. METHODS:: Washington State trauma registry reports and workers' compensation claims were linked (1998 to 2008). Trauma registry diagnoses were used as the gold standard for six OIICS-based TBI case definitions. RESULTS:: The OIICS-based case definitions were highly specific but had low sensitivity, capturing less than a third of fatal and nonfatal TBI. CONCLUSION:: The use of OIICS versus International Classification of Diseases-Ninth Revision-Clinical Modification codes underestimated TBI and changed the attributable cause distribution, with potential implications for prevention efforts. Surveillance methods that can more fully and accurately capture the impact of work-related TBI across the United States are needed.
  Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 04/2013;
• Article: Six-Year Cost Trends at PPG Industries Paralleling the Introduction of Health Promotion Programs Directed at Cardiovascular Disease Prevention.

  Ron Z Goetzel, Niranjana M Kowlessar, Rachel Henke, Richele Benevent, Maryam Tabrizi, Alberto M Colombi
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  ABSTRACT: OBJECTIVE:: Over the past several years, PPG Industries (PPG) implemented worksite health promotion programs aimed at improving employees' health and reducing overall medical costs as well as those specific to cardiovascular disease. METHODS:: Using medical claims data, we examined trends in these costs among PPG employees for a 6-year period, from 2005 to 2010. RESULTS:: Overall medical costs remained relatively flat, increasing by 1.2% compounded annually, unadjusted for inflation, while inflation-adjusted costs declined by 2.9%. Comparing worksites rated "high-high" on both program implementation and leadership support with worksites scoring highly on one or none of those dimensions, the "high-high" group experienced a decreasing cost trend, whereas the "other" group showed an increase. CONCLUSIONS:: The analysis suggests that PPG's efforts to reconfigure and intensify its wellness program offerings may have resulted lower health care cost trends.
  Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 04/2013;
• Article: We're Working Hard, but Is It Hardly Working? Why Process Is Critical in the Delivery of Worksite Health Promotion Programs.

  Elizabeth M Felter, Beth A D Nolan, Alberto Colombi, Steven M Albert, Jan L Pringle
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  ABSTRACT: OBJECTIVE:: To evaluate the relationship between the process and outcomes of worksite wellness committees (WWCs) implementing worksite health promotion programs at PPG Industries, Inc. METHODS:: We developed two unique tools to understand how WWCs function and to assess their program implementation. We then analyzed survey data from 65 PPG worksites, measuring process and program implementation. RESULTS:: Worksites that scored higher on the process indicator had more robust program implementation. CONCLUSIONS:: The WWCs need increased attention from researchers and evaluators. Employers should consider administering worksite health promotion structural assessments to identify gaps in management support and program implementation that may influence program effectiveness.
  Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 04/2013;
• Article: Aging, Sex, and Cost of Medical Treatment.

  Hyun Kim, Jacqueline Moline, Jonathan Dropkin
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  ABSTRACT: OBJECTIVE:: Association between medical cost from workplace injuries and aging and its effect modification by sex were examined. METHODS:: Medical costs reimbursed from workers' compensation between 2003 and 2009 were used. A multiple zero-truncated negative binomial regression predicted percent changes in medical cost. Cubic regression spline smoothers tested effect modification. RESULTS:: Reimbursed medical costs comprised 3452 claims. Medical costs increased with aging; however, the trends differ by sex. Medical cost increase after 10 years of age increase was 27% among men (95% CI = 17% to 38%) and was 15% among women (12% to 22%). Medical cost spent among the youngest women was higher than that for the oldest men. The ratio of cost between the oldest women and oldest men was double. CONCLUSIONS:: Prioritizing controls for injuries in hospitals should focus on women and aging workers.
  Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 04/2013;
• Article: Respiratory Symptoms, Exhaled Nitric Oxide, and Lung Function Among Workers in Tanzanian Coffee Factories.

  Gloria Sakwari, Simon H D Mamuya, Magne Bråtveit, Bente E Moen
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  ABSTRACT: OBJECTIVE:: To compare chronic respiratory symptoms, fractional exhaled nitric oxide (FENO), and lung function between Robusta and Arabica coffee workers and a control group. METHODS:: Chronic respiratory symptoms were assessed by a questionnaire (n = 138 coffee workers and n = 120 controls). The FENO was measured by NIOX MINO device (Aerocrine AB, Solna, Sweden). Lung function was examined by a portable spirometer. RESULTS:: Coffee workers had higher prevalence of chronic respiratory and asthma symptoms than controls. Robusta coffee workers were exposed to higher levels of endotoxin and had more asthma symptoms than Arabica coffee workers (38% vs 18%). Coffee workers had reduced lung function associated with cumulative exposure to total dust and endotoxin. CONCLUSION:: Work in coffee factories is associated with small but significant lung function impairment. These changes were not associated with the level of FENO.
  Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 04/2013;
• Article: The Need for Industry and Occupation Standards in Hospital Discharge Data.

  Jennifer A Taylor, Leslie T Frey
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  ABSTRACT: Occupational injuries and illnesses affect the productivity of the US workforce, yet public health surveillance in the United States does not adequately track and report these incidents. Adding industry and occupation standards to US hospital data collection would enable physicians, researchers, and payors to accurately account for occupational injuries and illnesses as well as support prevention initiatives. The authors petitioned for the inclusion of standards for industry and occupation within hospital data; however, additional support from the occupational and environmental health community is needed to move the petition to adoption. This article discusses the policy implications and benefits to occupational medicine and public health provided by collecting industry and occupation in hospital discharge data, as well as the process of initiating a data change request with the National Uniform Billing Committee.
  Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 04/2013;
• Article: The association between modifiable well-being risks and productivity: a longitudinal study in pooled employer sample.

  Yuyan Shi, Lindsay E Sears, Carter R Coberley, James E Pope
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  ABSTRACT: : To examine the longitudinal relationship between modifiable well-being risks and productivity. : A total of 19,121 employees from five employers participated in baseline and follow-up well-being assessment surveys. Multivariate regressions assessed whether changes in absenteeism, presenteeism, and job performance were associated with changes in 19 modifiable well-being risks. : Over time, a 5% reduction in total count of well-being risks was significantly associated with 0.74% decrease in absenteeism, 2.38% decrease in presenteeism, and 0.24% increase in performance. High blood pressure, recurring pain, unhealthy diet, inadequate exercise, poor emotional health, poor supervisor relationship, not utilizing strengths doing job, and organization unsupportive of well-being had greater independent contributions in explaining productivity impairment. : The often-ignored well-being risks such as work-related and financial health risks provided incremental explanation of longitudinal productivity variations beyond traditional measures of health-related risks.
  Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 04/2013; 55(4):353-64.