Publications (17)27.08 Total impact
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Article: Healthy Workplaces? A Survey of Massachusetts Employers.
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ABSTRACT: Abstract Purpose. This study examines worksite health promotion (WHP) and occupational health and safety (OHS) activities by Massachusetts employers, and the extent to which workplaces with programming in one domain were more likely to have the other as well. Design. In 2008, the Massachusetts Department of Public Health surveyed a stratified sample of Massachusetts worksites. Setting. A mailed questionnaire to be completed by workplace representatives. Subjects. Massachusetts worksites returning the questionnaire. Measures. Questionnaire items about worksite characteristics, WHP, and some OHS practices. Analysis. We scored levels of WHP and OHS activity; examined the relationship between activities in the two domains by employer characteristics; and assessed self-reported coordination between them. Results. The 890 responding worksites had higher scores for OHS (mean = 48% of practices, SD = 24%) than WHP (mean = 20%, SD = 12%). The difference between these scores varied by a factor of two across industry sectors and was smallest for workforces of 100+ employees (p = .001). Employers with no unionized workers reported fewer activities in both domains (p < .0001). Only 28% of respondents reported always/often coordinating OHS and WHP efforts; these organizations had more activities overall in both domains. Conclusion. Larger and unionized workplaces in Massachusetts were more likely to offer both WHP and OHS programming. Self-reported coordination was somewhat associated with more activity in both domains, although levels of WHP activity varied widely.American journal of health promotion: AJHP 03/2013; · 2.37 Impact Factor -
Article: Sharps injuries among employees of acute care hospitals in Massachusetts, 2002-2007.
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ABSTRACT: Sharps with engineered sharps injury protections (SESIPs) have been found to reduce risk of sharps injuries (SIs). We examined trends in SI rates among employees of acute care hospitals in Massachusetts, including the impact of SESIPs on SI trends during 2002-2007. Prospective surveillance. Seventy-six acute care hospitals licensed by the Massachusetts Department of Public Health. Employees of acute care hospitals who reported SIs to their employers. Data on SIs in acute care hospitals collected by the Massachusetts Sharps Injury Surveillance System were used to examine trends in SI rates over time by occupation, hospital size, and device. Negative binomial regression was used to assess trends. During 2002-2007, 16,158 SIs among employees of 76 acute care hospitals were reported to the surveillance system. The annual SI rate decreased by 22%, with an annual decline of 4.7% (P < .001). Rates declined significantly among nurses (-7.2% per year; P < .001) but not among physicians (-0.9% per year; P = .553). SI rates associated with winged steel needles and hypodermic needles and syringes also declined significantly as the proportion of injuries involving devices with sharps injury prevention features increased during the same time period. SI rates involving devices for which SESIPs are widely available and appear to be increasingly used have declined. The continued use of devices lacking SI protections for which SESIPs are available needs to be addressed. The extent to which injuries involving SESIPs are due to flaws in design or lack of experience and training must be examined.Infection Control and Hospital Epidemiology 06/2011; 32(6):538-44. · 3.67 Impact Factor -
Article: Prepackaged procedure trays and sharps safety standards.
Nursing management 03/2011; 42(3):50-2. -
Article: The Snowman: A model of injuries and near-misses for the prevention of sharps injuries.
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ABSTRACT: Sharps injuries (SI) and other blood/body fluid exposures (BBFE) present bloodborne pathogen risks for home healthcare (HHC) workers. While SI and BBFE are sufficiently frequent in HHC to be serious public health concerns, even moderately large surveys can still have insufficient power to identify risk factors. In this study, a new conceptual model for using near-misses for SI and BBFE was developed and its utility in statistical analyses of SI and BBFE risk factors was evaluated. A survey of HHC nurses (n = 787) and aides (n = 282) gathered data on the numbers of SI, BBFE, and near-misses in the past year. Questions focused on the circumstances leading up to the SI, BBFE, and near-misses. After evaluating the hypothesis that near-misses and events lie along the same causal pathway, we combined these outcomes to estimate their association with an important risk factor: employment status. There were similar frequencies of risk factors for the events SI, BBFE, and their near-misses, suggesting that they may share common causal pathways. Combined data on events and near-misses confirmed our hypothesis that part-time and temporary HHC aides were at higher risk than full-timers. Analyses combining injuries and near-misses may be useful in risk factor investigations.American Journal of Industrial Medicine 11/2010; 53(11):1119-27. · 1.63 Impact Factor -
Article: Do your procedure trays meet sharps safety standards?
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ABSTRACT: An abstract is unavailable. This article is available as HTML full text and PDF.OR Nurse 2012. 10/2010; 4(6):11–14. -
Article: Sharps injuries and other blood and body fluid exposures among home health care nurses and aides.
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ABSTRACT: We quantified risks of sharp medical device (sharps) injuries and other blood and body fluid exposures among home health care nurses and aides, identified risk factors, assessed the use of sharps with safety features, and evaluated underreporting in workplace-based surveillance. We conducted a questionnaire survey and workplace-based surveillance, collaborating with 9 home health care agencies and 2 labor unions from 2006 to 2007. Approximately 35% of nurses and 6.4% of aides had experienced at least 1 sharps injury during their home health care career; corresponding figures for other blood and body fluid exposures were 15.1% and 6.7%, respectively. Annual sharps injuries incidence rates were 5.1 per 100 full-time equivalent (FTE) nurses and 1.0 per 100 FTE aides. Medical procedures contributing to sharps injuries were injecting medications, administering fingersticks and heelsticks, and drawing blood. Other contributing factors were sharps disposal, contact with waste, and patient handling. Sharps with safety features frequently were not used. Underreporting of sharps injuries to the workplace-based surveillance system was estimated to be about 50%. Sharps injuries and other blood and body fluid exposures are serious hazards for home health care nurses and aides. Improvements in hazard intervention are needed.American Journal of Public Health 11/2009; 99 Suppl 3:S710-7. · 3.93 Impact Factor -
Article: Procedure trays: a call to action for sharps safety.
Nursing 02/2009; 39(1):13-5. -
Article: Work-related asthma in the educational services industry: California, Massachusetts, Michigan, and New Jersey, 1993-2000.
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ABSTRACT: To characterize work-related asthma (WRA) cases working in the educational services industry identified by state-based occupational disease surveillance systems. We examined 2,995 WRA cases reported from 1993 to 2000 to four states: California, Massachusetts, Michigan, and New Jersey. A total of 265 (9%) WRA cases were employed in the educational services industry; 69% of cases were classified as new-onset asthma and 31% as work-aggravated asthma. New-onset asthma cases were further classified as occupational asthma (61%) or as reactive airways dysfunction syndrome (8%). The most frequently reported occupation was teachers and teachers' aides (54%). The most frequently reported agents were indoor air pollutants (28%), unspecified mold (16%), dusts (14%), and cleaning products (7%). Asthma within the educational services industry is an occupational health problem. The health of school employees should also be considered when initiatives addressing asthma among schoolchildren are instituted. The identification, elimination, and/or control of respiratory hazards are important factors for the protection of staff and students alike.American Journal of Industrial Medicine 02/2008; 51(1):47-59. · 1.63 Impact Factor -
Article: Work‐related asthma in the Educational Services industry: California, Massachusetts, Michigan, and New Jersey, 1993–2000
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ABSTRACT: Objectives To characterize work-related asthma (WRA) cases working in the educational services industry identified by state-based occupational disease surveillance systems.Methods We examined 2,995 WRA cases reported from 1993 to 2000 to four states: California, Massachusetts, Michigan, and New Jersey.ResultsA total of 265 (9%) WRA cases were employed in the educational services industry; 69% of cases were classified as new-onset asthma and 31% as work-aggravated asthma. New-onset asthma cases were further classified as occupational asthma (61%) or as reactive airways dysfunction syndrome (8%). The most frequently reported occupation was teachers and teachers' aides (54%). The most frequently reported agents were indoor air pollutants (28%), unspecified mold (16%), dusts (14%), and cleaning products (7%).Conclusions Asthma within the educational services industry is an occupational health problem. The health of school employees should also be considered when initiatives addressing asthma among schoolchildren are instituted. The identification, elimination, and/or control of respiratory hazards are important factors for the protection of staff and students alike. Am. J. Ind. Med. 51:47–59, 2008. © 2007 Wiley-Liss, Inc.American Journal of Industrial Medicine 12/2007; 51(1):47 - 59. · 1.63 Impact Factor -
Article: There's no place like home: a qualitative study of the working conditions of home health care providers.
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ABSTRACT: Home health care (HHC) is one of the fastest growing US industries. Its working conditions have been challenging to evaluate, because the work environments are highly variable and geographically dispersed. This study aims to characterize qualitatively the work experience and hazards of HHC clinicians, with a focus on risk factors for bloodborne pathogen exposures. The researchers conducted five focus group discussions with HHC clinicians and ten in-depth interviews with HHC agency managers and trade union representatives in Massachusetts. HHC clinicians face serious occupational hazards, including violence in neighborhoods and homes, lack of workstations, heavy patient lifting, improper disposal of dressings or sharp medical devices, and high productivity demands. The social context of the home-work environment challenges the implementation of preventive interventions to reduce occupational hazards in HHC.Journal of Occupational and Environmental Medicine 04/2007; 49(3):327-37. · 2.06 Impact Factor -
Article: Indicators for occupational health surveillance.
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ABSTRACT: Each year, millions of the estimated 140 million U.S. workers are injured on the job or become ill from exposure to hazards at work. These work-related injuries and illnesses result in substantial human and economic costs for workers, employers, and society; estimated direct and indirect costs of work-related injuries and illnesses are approximately $170 billion annually. In 1998, the Council of State and Territorial Epidemiologists (CSTE) and CDC's National Institute for Occupational Safety and Health (NIOSH) convened a work group that identified priority occupational health conditions to be placed under surveillance, addressed cross-cutting surveillance concerns, and made recommendations regarding the role of states in a comprehensive nationwide surveillance system for work-related disease, injuries, and hazards. CSTE recommendations led to the generation of 19 occupational health indicators (OHIs) and one Employment Demographic Profile, which were developed during 2001-2003. The OHIs complement other guidelines for state-based occupational health surveillance to address overall state and national goals to improve public health. These OHIs are intended to help states build occupational health capacity by providing them with tools to collect and generate important, basic information concerning the occupational health status of the state population and to identify areas in which to focus prevention efforts. In 2005, CSTE released a report compiling OHI data from 13 states. NIOSH provides funding for the OHIs because they are now a required component of state-based cooperative agreements for occupational health surveillance. This report introduces the OHIs and describes CSTE's approach to developing this new occupational health surveillance tool.MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control 02/2007; 56(RR-1):1-7. -
Article: The proportion of self-reported asthma associated with work in three States: California, Massachusetts, and Michigan, 2001.
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ABSTRACT: To assess the proportion of adult asthma at the state level that may be related to work. Work-related asthma questions were added to the 2001 Behavioral Risk Factor Surveillance System (BRFSS) questionnaire in California, Massachusetts, and Michigan. Findings indicate 7.4-9.7% of those with current asthma reported that their asthma may be work related. These results estimate that approximately 137,000 adults in California, 39,000 in Massachusetts, and 63,000 in Michigan have asthma that may be work related. These findings are unique in providing population-based estimates at the state level that illustrate that a substantial portion of adult asthma morbidity is due to exposures in the work environment.Journal of Asthma 05/2006; 43(3):213-8. · 1.52 Impact Factor -
Article: A comparison of data sources for the surveillance of work-related carpal tunnel syndrome in Massachusetts.
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ABSTRACT: This study examined whether a state surveillance system for work-related carpal tunnel syndrome (WR-CTS) based on workers' compensation claims (Sentinel Event Notification System for Occupational Risks, SENSOR) and the Annual Survey of Occupational Injuries and Illnesses (SOII) identified the same industries, occupations, sources of injury, and populations for intervention. Trends in counts, rates, and female/male ratios of WR-CTS during 1994-1997, and age distributions were compared across three data sources: SENSOR, Massachusetts SOII, and National SOII. SENSOR and National SOII data on WR-CTS were compared by industry, occupation, and injury source. Due to small sample size and subsequent gaps in available information, state SOII data on WR-CTS were of little use in identifying specific industries and occupations for intervention. SENSOR and National SOII data on the frequency of WR-CTS cases identified many similar occupations and industries, and both surveillance systems pointed to computer use as a risk factor for WR-CTS. Some high rate industries identified by SENSOR were not identified using National SOII rates even when national findings were restricted to take into account the distribution of the Massachusetts workforce. Use of national SOII data on rates of WR-CTS for identifying state industry priorities for WR-CTS prevention should be undertaken with caution. Options for improving state SOII data and use of other state data systems should be pursued.American Journal of Industrial Medicine 10/2004; 46(3):284-96. · 1.63 Impact Factor -
Article: Work-related carpal tunnel syndrome (WR-CTS) in Massachusetts, 1992-1997: source of WR-CTS, outcomes, and employer intervention practices.
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ABSTRACT: The Massachusetts Sentinel Event Notification System for Occupational Risks (MASS SENSOR) receives reports of work-related carpal tunnel syndrome (WR-CTS) cases from (1) workers' compensation (WC) disability claims for 5 or more lost work days; and (2) physician reports (PR). From 1992 through 1997, 1,330 WC cases and 571 PR cases completed follow-back surveys to provide information on industry, occupation, attributed source of WR-CTS, outcomes, and employer intervention practices. Sixty-four percent of the respondents had bilateral CTS and 61% had surgery, both of which were proportionally more frequent among WC cases. Office and business machinery was the leading source of WR-CTS (42% of classifiable sources) in every economic sector except construction, followed by hand tools (20%). Managers and professional specialty workers were the most likely to report employers' interventions and were up to four times more likely to report equipment or work environment changes than higher risk groups. State-based surveillance data on the source of WR-CTS provided valuable information on how and where to implement interventions. New occurrences of WR-CTS are likely, especially in the highest risk industries where very few cases reported primary prevention measures (e.g., changes to equipment or work environment) implemented by their employers.American Journal of Industrial Medicine 03/2004; 45(2):139-52. · 1.63 Impact Factor -
Article: Cleaning products and work-related asthma.
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ABSTRACT: To describe the characteristics of individuals with work-related asthma associated with exposure to cleaning products, data from the California-, Massachusetts-, Michigan-, and New Jersey state-based surveillance systems of work-related asthma were used to identify cases of asthma associated with exposure to cleaning products at work. From 1993 to 1997, 236 (12%) of the 1915 confirmed cases of work-related asthma identified by the four states were associated with exposure to cleaning products. Eighty percent of the reports were of new-onset asthma and 20% were work-aggravated asthma. Among the new-onset cases, 22% were consistent with reactive airways dysfunction syndrome. Individuals identified were generally women (75%), white non-Hispanic (68%), and 45 years or older (64%). Their most likely exposure had been in medical settings (39%), schools (13%), or hotels (6%), and they were most likely to work as janitor/cleaners (22%), nurse/nurses' aides (20%), or clerical staff (13%). However, cases were reported with exposure to cleaning products across a wide range of job titles. Cleaning products contain a diverse group of chemicals that are used in a wide range of industries and occupations as well as in the home. Their potential to cause or aggravate asthma has recently been recognized. Further work to characterize the specific agents and the circumstances of their use associated with asthma is needed. Additional research to investigate the frequency of adverse respiratory effects among regular users, such as housekeeping staff, is also needed. In the interim, we recommend attention to adequate ventilation, improved warning labels and Material Safety Data Sheets, and workplace training and education.Journal of Occupational and Environmental Medicine 06/2003; 45(5):556-63. · 2.06 Impact Factor -
Article: Work-related reactive airways dysfunction syndrome cases from surveillance in selected US states.
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ABSTRACT: The objective was to elaborate the descriptive epidemiology of work-related cases of reactive airways dysfunction syndrome (RADS). Cases of work-related asthma (WRA) were identified in four states in the United States during 1993-1995 as part of the Sentinel Event Notification Systems for Occupational Risks (SENSOR). Information gathered by follow-back interview was used to describe 123 work-related RADS cases and to compare them to 301 other WRA cases whose onset of disease was associated with a known asthma inducer. RADS represented 14% of all new-onset WRA cases identified by the state SENSOR surveillance systems. RADS cases had significant adverse medical and occupational outcomes identified by follow-back interview. In particular, 89% still had breathing problems, 78% had ever sought emergency care and 39% had ever been hospitalized for work-related breathing problems, 54% had applied for worker compensation benefits, and 41% had left the company where they experienced onset of asthma. These values equaled or exceeded the comparable figures for those WRA cases whose onset was attributed to a known inducer. Work-related RADS represents a minority of all WRA cases, but the adverse impact of this condition appears to equal that of other WRA cases.Journal of Occupational and Environmental Medicine 05/2003; 45(4):360-8. · 2.06 Impact Factor -
Article: Integrating occupational health with mainstream public health in Massachusetts: an approach to intervention.
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ABSTRACT: In the late 19th century, workers' health was among the central concerns of the social reform movement to improve public health. Today, few state health agencies have comprehensive occupational health programs. Yet, state public health agencies have critical roles to play in occupational health and may be particularly instrumental in addressing the occupational health needs of underserved worker populations. Since the mid-1980s, with support from the National Institute for Occupational Safety and Health, the Massachusetts Department of Public Health has been working to build an occupational health program and promote the integration of occupational health concerns with ongoing public health activities in the state. This article provides a framework for considering the range of integration activities and presents examples of successful occupational health integration efforts in Massachusetts.Public Health Reports 124 Suppl 1:5-14. · 1.27 Impact Factor
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2009–2011
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University of Massachusetts Lowell
- Department of Work Environment
Lowell, MA, USA
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