Philip Harber

The University of Arizona, Tucson, Arizona, United States

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Publications (115)244.49 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: To identify factors affecting the likelihood of requiring medical services during international business trips.
    Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 11/2014; 56(11):1161-6. · 1.88 Impact Factor
  • Philip Harber, Jing Su, Gabriela Alongi
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    ABSTRACT: To assess the importance of occupational history for beryllium-exposed workers.
    Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 08/2014; 56(8):852-6. · 1.88 Impact Factor
  • Philip Harber, Jing Su
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    ABSTRACT: To optimize beryllium worker screening.
    Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 08/2014; 56(8):861-6. · 1.88 Impact Factor
  • Philip Harber, Jing Su, Gabriela Alongi
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    ABSTRACT: To incrementally improve the use of beryllium lymphocyte proliferation test (LPT) results.
    Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 08/2014; 56(8):857-60. · 1.88 Impact Factor
  • Philip Harber, Gabriela Alongi, Jing Su
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    ABSTRACT: Occupational health nurses have diverse backgrounds and their practices require the ability to perform unique professional tasks. This study empirically evaluated their activities and skills using a web-based log system to describe activities at 15 specific sampled times. A national sample of 128 occupational health nurses provided 1,893 activity logs revealing occupational health nurses use both clinical and management skills on a regular basis; indirect client care is as common as direct "hands-on" client care. Most occupational health nurses are directly paid by their employer and activities serve to benefit both individual workers and their employers. Occupational health nurses have specific knowledge and skills in addition to general nursing competencies. Understanding the actual work of occupational health nurses is necessary to align training, certification, and competency maintenance systems such as continuing education with the unique skills used in actual practice activities. [Workplace Health Saf 2014;62(6):233-242.].
    Workplace health & safety. 06/2014; 62(6):233-242.
  • Philip Harber, Jing Su, Cheng Cheng Hu
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    ABSTRACT: ABSTRACT Although retraining and repeat fit testing are needed for respirator users, the optimal frequency is uncertain. The persistence of proper respirator donning/doffing techniques and changes in quantitative fit factor over six months after initial training were measured in this study. Initial training was designed for rapid rollout situations in which direct contact with well-trained occupational health professionals may be infeasible.
    Journal of Occupational and Environmental Hygiene 05/2014; · 1.28 Impact Factor
  • Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 05/2014; 56(5):e21-40. · 1.88 Impact Factor
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    ABSTRACT: This study addresses methods for training respirator users, particularly when occupational health professionals are not immediately available. A randomized trial compared three training methods-printed brochure, video, and computer-based training-for two respirator types (filtering facepiece and a dual-cartridge half facemask). Quantitative fit testing (PortaCount) measured the effectiveness of training. The study included 226 subjects. For both respirator types, video was significantly superior to either print or computer-based training methods. Conclusions were consistent, whether determined by average fit factor (analysis of variance), log-transformed fit factors, or the number of users in the lowest quartile of achieved fit. Video training for proper respirator use can be effective when direct training from an occupational health professional is unavailable. These methods are particularly relevant to "rapid rollout" situations, such as natural disasters, epidemics, or bioterrorism concerns.
    Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 11/2013; · 1.88 Impact Factor
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    ABSTRACT: Rationale: Psychosocial characteristics likely play an important role in the severity of workplace disability for workers with a respiratory impairment. Objectives: We performed a systematic review of the available literature to examine the impact of psychosocial characteristics on workplace disability among workers with a respiratory impairment. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations, we searched Medline and other published and unpublished sources using the PubMed and Cochrane Central Register of Controlled Clinical Trials (CENTRAL) search engines from January 1, 1990 through March 8, 2013 for quantitative studies that examined the association of psychosocial characteristics with workplace disability among workers with a respiratory impairment. We also searched related citations and the bibliographies of selected studies and relevant review articles. One investigator abstracted data about study design and quality, psychosocial characteristics, and outcome measures. Measurements and Main Results: Of 5,746 potentially relevant studies, 20 met eligibility criteria and were included. Studies reported heterogeneous outcomes among heterogeneous samples of workers that precluded a quantitative synthesis. In general, mental illness was associated with increased workplace disability among workers with respiratory impairments. Few studies adjusted for disease severity, so the independent association of psychosocial characteristics and workplace disability is unclear. Most studies were cross-sectional, so the direction of the association could not be determined. We found only one trial of targeted therapy for the psychosocial condition, which was not effective at reducing disability. Conclusions: Psychosocial characteristics likely influence workplace disability in workers with respiratory impairments. The impact of targeted therapies is unclear and warrants further study.
    American Journal of Respiratory and Critical Care Medicine 11/2013; 188(9):1147-60. · 11.04 Impact Factor
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    ABSTRACT: Respirators must be properly used to be effective. In an experimental protocol, 145 subjects were trained and then observed donning and doffing respirators. Filtering facepiece and dual cartridge half face mask types were studied. Subjects were then tested for knowledge and for proper performance using video recording analysis. Knowledge tests showed adequate learning, but performance was often poor. Inspection, strap tension (half mask), seal checking, and avoiding mask contact during doffing were particularly problematic. Mask positioning was generally well done. Correlation between knowledge and performance for specific items was generally poor, although there was a weak correlation between overall knowledge and overall performance (rho = 0.32) for the half mask users. Actual unprompted performance as well as knowledge and fit-testing should be assessed for user certification. Respirator design approval should consider users' ability to learn proper technique.
    Journal of Occupational and Environmental Hygiene 10/2013; 10(10):556-63. · 1.28 Impact Factor
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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; · 1.88 Impact Factor
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    ABSTRACT: OBJECTIVE:: To describe career path patterns for occupational medicine (OM) physicians. METHODS:: A convenience sample of 129 occupational physicians described work activities and locations at several career points up to 20 years ago, first OM position, and 10 years after expectations. RESULTS:: Clinical activities were important throughout (eg, 41% and 46% of occupational physicians reported frequently treating patients 20 years ago and currently). Practice locations changed more markedly, with increased multisite clinics and hospital/medical center-based practices. Performing mainly clinical activities in a first job increased from 82% to 97% over the past 20 years. Career transitions between clinical and nonclinical roles were common (40% of participants). Many anticipate transition to nonclinical work over 10 years. CONCLUSIONS:: Activities have not fundamentally changed, but practice locations have evolved. Both clinical and management activities remain important, and path to managerial positions increasingly begins in clinical practice.
    Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 10/2012; · 1.88 Impact Factor
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    ABSTRACT: : To assess country factors associated with the risk of requiring aeromedical evacuation and hospitalization among expatriate workers and their dependents. : The 2009-2010 data including 5725 aeromedical evacuations and 17,828 hospitalizations, and 2009 data of hospitalizations and aeromedical evacuations among 94,651 at-risk expatriates, were analyzed to assess 2 country risk rating tools. Each tool utilized four risk categories and reflected level of development and medical capabilities. : Country risk category was strongly associated with risk of evacuation and/or hospitalization for each risk rating tool (eg, 46-fold increase from lowest to highest country risk category). : Country risk tools strongly associate hospitalization and aeromedical evacuation with country risk category, and thus can be important indicators of relative medical risk. Employers may use these results to implement targeted prevention programs to support expatriate workers and their families.
    Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 08/2012; 54(9):1118-25. · 1.88 Impact Factor
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    ABSTRACT: 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.
    American Journal of Respiratory and Critical Care Medicine 08/2011; 184(3):368-78. · 11.04 Impact Factor
  • American Thoracic Society 2011 International Conference, May 13-18, 2011 • Denver Colorado; 05/2011
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    ABSTRACT: Providing higher quality medical care to workers with occupationally associated carpal tunnel syndrome (CTS) may reduce disability, facilitate return to work, and lower the associated costs. Although many workers' compensation systems have adopted treatment guidelines to reduce the overuse of unnecessary care, limited attention has been paid to ensuring that the care workers do receive is high quality. Further, guidelines are not designed to enable objective assessments of quality of care. This study sought to develop quality measures for the diagnostic evaluation and non-operative management of CTS, including managing occupational activities and functional limitations. Using a variation of the well-established RAND/UCLA Appropriateness Method, we developed draft quality measures using guidelines and literature reviews. Next, in a two-round modified-Delphi process, a multidisciplinary panel of 11 U.S. experts in CTS rated the measures on validity and feasibility. Of 40 draft measures, experts rated 31 (78%) valid and feasible. Nine measures pertained to diagnostic evaluation, such as assessing symptoms, signs, and risk factors. Eleven pertain to non-operative treatments, such as the use of splints, steroid injections, and medications. Eleven others address assessing the association between symptoms and work, managing occupational activities, and accommodating functional limitations. These measures will complement existing treatment guidelines by enabling providers, payers, policymakers, and researchers to assess quality of care for CTS in an objective, structured manner. Given the characteristics of previous measures developed with these methods, greater adherence to these measures will probably lead to improved patient outcomes at a population level.
    Journal of Occupational Rehabilitation 03/2011; 21(1):100-19. · 2.80 Impact Factor
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    ABSTRACT: Anxiety may interfere with proper respirator use. This study directly compares the effect of two types of respirators--elastomeric half-face mask with dual-cartridges (HFM) and N95 filtering facepiece--on anxiety levels. Twelve volunteers with normal or mildly impaired respiratory conditions performed a series of simulated work tasks using the HFM and N95 on different days. The State-Trait Anxiety Inventory (STAI) measured state anxiety (SA) before and during respirator use. STAI also measured trait anxiety (TA), a stable personal characteristic. The effect of the respirator was measured as the difference between SA pre-use and during use. Work with HFM was associated with an increase in SA (2.92 units, p < .01), whereas work with the N95 had no observed effect. Anxiety should be considered in the selection of the best respirator for a user. Impact on anxiety should be considered for respirator design and certification purposes, particularly if the device is to be widely used in workplace and community settings.
    Journal of Occupational and Environmental Hygiene 03/2011; 8(3):123-8. · 1.28 Impact Factor
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    ABSTRACT: Respirators are used to maintain work performance and protect against inhaled toxins. The study compared the effects of two commonly used respirator classes--dual cartridge half face mask (HFM) and filtering face piece (N95)--upon work productivity. 107 volunteers performed eight simulated work tasks when using the HFM and N95 respirators. Tasks included several body positions, exertion levels, and concentration requirements. Objective measures of accuracy and speed were developed for each task. Scores for each task were based on the subject's rank among all subjects. All subjects were capable of performing the tasks. There were no statistically significant differences between respirator types in either task performance metric. Productivity impact can be measured effectively and should be considered as part of respirator design testing and when selecting the optimal respirator for a worker.
    Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 01/2011; 53(1):22-6. · 1.88 Impact Factor
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    ABSTRACT: To characterize activities and skills of occupational physicians using work diaries. A total of 260 occupational physicians from a national sample provided task/skill descriptions at approximately 25 specific times. The average percentage of activity samples using a skill and the interquartile range expressed results. Clinical activities, particularly musculoskeletal, were most frequent, followed by industry and health system management. Traditional public health approaches were infrequent. Injured patients, employers, and healthy workers were the most common beneficiaries. Communication about prevention and work restrictions was frequent. Interphysician variability was high for most measures. Results demonstrated a dichotomy-many frequent activities/skills are associated with other specialties as well (eg, treating injury); others, albeit less frequently used, demarcate the uniqueness of occupational medicine (eg, preventive examinations, toxicology, benefiting employers or worker groups, assessing work ability, payment by employers).
    Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 12/2010; 52(12):1147-53. · 1.88 Impact Factor
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    ABSTRACT: To characterize education, practice, and skills of occupational physicians and to evaluate subgroups within the profession. The data for the baseline surveys of the occupational medicine practice research project were collected for a national sample of occupational physicians using paper or on-line instruments. Three subgroups were defined a priori-injury care, clinical specialist, and management/population. Occupational medicine seems to include three distinct subgroups, which differ in characteristics such as patient volume, relevant clinical skills, and income source. Nevertheless, many commonalities were present across all three groups, such as emphasis on communication, OSHA, and workers compensation. Musculoskeletal and workers compensation care were most important, although there were highly significant differences among the three subgroups. Planning for education, certification, and organization of services should acknowledge the distinctions among the three subgroups.
    Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 07/2010; 52(7):672-9. · 1.88 Impact Factor

Publication Stats

795 Citations
244.49 Total Impact Points

Institutions

  • 2014
    • The University of Arizona
      • Division of Community, Environment and Policy
      Tucson, Arizona, United States
  • 1987–2010
    • University of California, Los Angeles
      • • Department of Family Medicine
      • • Department of Medicine
      Los Angeles, CA, United States
  • 2006
    • Children's Hospital Los Angeles
      Los Angeles, California, United States
  • 1989
    • University of Southern California
      • Division of Pulmonary and Critical Care Medicine
      Los Angeles, California, United States