MedWorm: Occupational Health

This issue: articles of interest for clinicians.

Journal of Occupational and Environmental Medicine — Sat, 11 Oct 2008 10:33:53 +0100

DOI: 10.1097/JOM.0b013e31818d3e27 (Source: Journal of Occupational and Environmental Medicine)

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Calendar of meetings/events.

Journal of Occupational and Environmental Medicine — Sat, 11 Oct 2008 10:33:53 +0100

Page: 1206DOI: 10.1097/01.jom.0000338423.14572.b5 (Source: Journal of Occupational and Environmental Medicine)

People and events.

Journal of Occupational and Environmental Medicine — Sat, 11 Oct 2008 10:33:53 +0100

Page: 1205DOI: 10.1097/JOM.0b013e31818c6fa7Authors: Dreger, Marianne (Source: Journal of Occupational and Environmental Medicine)

Handbook of chemical and biological warfare agents.

Journal of Occupational and Environmental Medicine — Sat, 11 Oct 2008 10:33:53 +0100

Page: 1203DOI: 10.1097/JOM.0b013e318188e245Authors: Borak, Jonathan MD (Source: Journal of Occupational and Environmental Medicine)

The prognosis of burnout and prolonged fatigue in the working population: a comparison.

Journal of Occupational and Environmental Medicine — Sat, 11 Oct 2008 10:33:53 +0100

Page: 1195DOI: 10.1097/JOM.0b013e31817e7c05Authors: Leone, Stephanie S. MA; Huibers, Marcus J. H. PhD; Knottnerus, J Andre MD, PhD; Kant, IJmert PhD (Source: Journal of Occupational and Environmental Medicine)

The effect of occupation and industry on the injury risks from demanding work schedules.

Journal of Occupational and Environmental Medicine — Sat, 11 Oct 2008 10:33:53 +0100

Page: 1185DOI: 10.1097/JOM.0b013e31817e7bf2Authors: Dembe, Allard E. ScD; Delbos, Rachel MS; Erickson, J Bianca MS (Source: Journal of Occupational and Environmental Medicine)

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The association between a tiered pharmacy benefit plan and medication usage, health status, and disability absence days-one employer's experience.

Journal of Occupational and Environmental Medicine — Sat, 11 Oct 2008 10:33:53 +0100

Page: 1176DOI: 10.1097/JOM.0b013e31817e7bc1Authors: Burton, Wayne N. MD; Chen, Chin-Yu PhD; Schultz, Alyssa B. MS; Edington, Dee W. PhD (Source: Journal of Occupational and Environmental Medicine)

Occupation, gender, race, and lung cancer.

Journal of Occupational and Environmental Medicine — Sat, 11 Oct 2008 10:33:53 +0100

Page: 1167DOI: 10.1097/JOM.0b013e31817d3639Authors: Amr, Sania MD, MS; Wolpert, Beverly MS; Loffredo, Christopher A. PhD; Zheng, Yun-Ling PhD; Shields, Peter G. MD; Jones, Raymond PhD; Harris, Curtis C. MD (Source: Journal of Occupational and Environmental Medicine)

Exposure of rome city tram drivers to airborne platinum, rhodium, and palladium.

Journal of Occupational and Environmental Medicine — Sat, 11 Oct 2008 10:33:53 +0100

Page: 1158DOI: 10.1097/JOM.0b013e31818226a1Authors: Iavicoli, Ivo MD, PhD; Bocca, Beatrice ScD; Caroli, Sergio ScD; Caimi, Stefano ScD; Alimonti, Alessandro ScD; Carelli, Giovanni ScD; Fontana, Luca MD (Source: Journal of Occupational and Environmental Medicine)

Impaired work performance among women with symptomatic uterine fibroids.

Journal of Occupational and Environmental Medicine — Sat, 11 Oct 2008 10:33:53 +0100

Page: 1149DOI: 10.1097/JOM.0b013e3181895e10Authors: Lerner, Debra MS, PhD; Mirza, Fadi MD; Chang, Hong PhD; Renzulli, Karen PsyD; Perch, Katherine BA; Chelmow, David MD (Source: Journal of Occupational and Environmental Medicine)

The prevalence of metabolic syndrome in an employed population and the impact on health and productivity.

Journal of Occupational and Environmental Medicine — Sat, 11 Oct 2008 10:33:53 +0100

Page: 1139DOI: 10.1097/JOM.0b013e318188b8ebAuthors: Burton, Wayne N. MD; Chen, Chin-Yu PhD; Schultz, Alyssa B. MS; Edington, Dee W. PhD (Source: Journal of Occupational and Environmental Medicine)

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Health care costs among individuals with chronic obstructive pulmonary disease within several large, multi-state employers.

Journal of Occupational and Environmental Medicine — Sat, 11 Oct 2008 10:33:53 +0100

Page: 1130DOI: 10.1097/JOM.0b013e31818837c8Authors: Darkow, Theodore PharmD; Chastek, Benjamin J. MS; Shah, Hemal PharmD; Phillips, Amy L. PharmD (Source: Journal of Occupational and Environmental Medicine)

Long-term health experience of jet engine manufacturing workers: ii. total and cause-specific mortality excluding central nervous system neoplasms.

Journal of Occupational and Environmental Medicine — Sat, 11 Oct 2008 10:33:53 +0100

Page: 1117DOI: 10.1097/JOM.0b013e31818bc327Authors: Marsh, Gary M. PhD; Buchanich, Jeanine M. PhD; Youk, Ada O. PhD; Cunningham, Michael A. MS; Lieberman, Frank S. MD; Kennedy, Kathleen J. MS; Lacey, Steven E. PhD; Hancock, Roger P. MCE; Esmen, Nurtan A. PhD (Source: Journal of Occupational and Environmental Medicine)

Long-term health experience of jet engine manufacturing workers: i. mortality from central nervous system neoplasms.

Journal of Occupational and Environmental Medicine — Sat, 11 Oct 2008 10:33:53 +0100

Page: 1099DOI: 10.1097/JOM.0b013e31818bc30eAuthors: Marsh, Gary M. PhD; Buchanich, Jeanine M. PhD; Youk, Ada O. PhD; Cunningham, Michael A. MS; Lieberman, Frank S. MD; Kennedy, Kathleen J. MS; Lacey, Steven E. PhD; Hancock, Roger P. MCE; Esmen, Nurtan A. PhD (Source: Journal of Occupational and Environmental Medicine)

Health assurance and the communitarian ethic.

Journal of Occupational and Environmental Medicine — Sat, 11 Oct 2008 10:33:53 +0100

Page: 1096DOI: 10.1097/JOM.0b013e318188b91eAuthors: Hadler, Nortin M. MD, FACP, FACR, FACOEM (Source: Journal of Occupational and Environmental Medicine)

Authors' response.

Journal of Occupational and Environmental Medicine — Sat, 11 Oct 2008 10:33:53 +0100

Page: 1094DOI: 10.1097/JOM.0b013e31818bc43dAuthors: Cawley, John PhD; Rizzo, John A. PhD; Haas, Kara (Source: Journal of Occupational and Environmental Medicine)

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The association of diabetes with job absenteeism costs among obese and morbidly obese workers.

Journal of Occupational and Environmental Medicine — Sat, 11 Oct 2008 10:33:53 +0100

Page: 1094DOI: 10.1097/JOM.0b013e31818837e0Authors: Brautbar, Nachman MD (Source: Journal of Occupational and Environmental Medicine)

Author's response.

Journal of Occupational and Environmental Medicine — Sat, 11 Oct 2008 10:33:53 +0100

Page: 1093DOI: 10.1097/JOM.0b013e31818bc454Authors: Brink, LuAnn L. PhD (Source: Journal of Occupational and Environmental Medicine)

Re: who cares about paperwork?

Journal of Occupational and Environmental Medicine — Fri, 10 Oct 2008 23:31:48 +0100

Page: 1093DOI: 10.1097/JOM.0b013e3181883d72Authors: Clarke, William R. MD, JD, MTMH, MA (Source: Journal of Occupational and Environmental Medicine)

Governing the majority world? critical reflections on the role of occupation technology in international contexts

Australian Occupational Therapy Journal — Fri, 10 Oct 2008 04:00:00 +0100

Background: Within occupational therapy, increasing attention has been focussed on international development work. However, many have critiqued the focus of knowledge development within occupational therapy and occupational science, arguing that it is focussed on Western values. Questions arise about how occupational therapy and occupational science, and the knowledge and therapeutic technologies that are associated with these communities, will affect the 'developing' world, which, recently, some have described as the Majority World.Aim and method: Using Foucauldian analytical tools, this paper reflects on specific discourses that are foundational for development work. Specifically, this paper attempts to better understand how concepts like 'occupational justice' and the 'occupational being' are presented in the literature and relate to practices in international contexts. Within this analysis, attention is focussed on how practices associated with occupational development work might also be enmeshed in power dynamics.Results: This paper outlines how occupational discourses may shape and order life in particular ways and challenges researchers and practitioners to develop a better understanding of how power can operate through occupational discourses and occupational therapy practices. This paper also adds to the literature through the interpretation and explication of various theories that may underpin work in international contexts.Conclusions/future directions: Suggestions for future directions that will enable the development of more politically and culturally sensitive knowledge and practices are also explored. It is crucial that as a community we become more aware of how our theoretical frameworks may impact and shape practice. (Source: Australian Occupational Therapy Journal)

Factors affecting the number and type of impairments of visual perception and praxis following stroke

Australian Occupational Therapy Journal — Fri, 10 Oct 2008 04:00:00 +0100

Aim: This study aimed to examine the effect of clinical factors including side of stroke, region of affected cerebral circulation, type of stroke and time since stroke, as well as age on the number and type of impairments of visual perception and praxis in patients following stroke.Methods: Two hundred and eight participants with stroke were conveniently sampled from 12 hospitals in Brisbane and the Gold Coast. Background information was collected and each participant was assessed for impairments of visual perception and praxis using the Occupational Therapy Adult Perceptual Screening Test.Results: Participants with left-hemisphere stroke were more likely to have impaired body scheme than participants with right-hemisphere stroke. Additionally, participants with right-hemisphere stroke were more likely to have unilateral neglect and impaired constructional skills than those with left-hemisphere stroke. There was a significant relationship between region of affected cerebral circulation and the occurrence of agnosia, unilateral neglect and constructional skill impairment. Moreover, the number of visual perceptual impairments experienced by participants was associated with the region of affected cerebral circulation. Increasing age was significantly related to the occurrence of constructional skill impairment and acalculia.Conclusions: Side of stroke, region of affected cerebral circulation and age affected the type of impairments of visual perception and praxis experienced by patients following stroke. Furthermore, region of affected cerebral circulation also influenced the number of impairments of visual perception and praxis in patients after stroke. The results have implications for more specific targeting of assessment and treatment practices following stroke. (Source: Australian Occupational Therapy Journal)

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Questioning: a critical skill in postmodern health-care service delivery

Australian Occupational Therapy Journal — Fri, 10 Oct 2008 04:00:00 +0100

Occupational therapists can no longer rely exclusively on biomedical frameworks to guide their practice and facilitate clinical problem-solving. A postmodernist perspective of health and well-being underlines that the illness experience is not a linear, cause-and-effect equation. Rather, life experiences are constructed through a myriad of social, cultural, physical and economic contexts that are highly unique to each individual. In other words, the assumption that 'one-size-fits-all' is as flawed in health care as it is in clothing design. This paper contributes to the growing discussion of health care within the postmodern context of the twenty-first century through first presenting a brief discussion of emerging postmodern thinking and application within the profession, followed by a rationale for the need to scrutinise prevalent modernist assumptions that guide decision-making. Finally, the paper introduces the method of Socratic questioning as a critical tool in successfully carrying out this scrutiny in an empowering and respectful manner for all stakeholders. (Source: Australian Occupational Therapy Journal)

Are we applying interventions with research evidence when targeting secondary complications of the stroke-affected upper limb

Australian Occupational Therapy Journal — Fri, 10 Oct 2008 04:00:00 +0100

Background/aim: This study aimed to survey occupational therapy practice with reference to the current evidence for management of secondary complications of the stroke-affected upper limb.Methods: A questionnaire was developed to identify the clinical practice of occupational therapists in managing the client's stroke-affected upper limb. Participants were recruited via an email to the national occupational therapy neurology listserve. Occupational therapists working in stroke rehabilitation were invited to complete the questionnaire online or to print off and return.Results: Fifty-five occupational therapists completed the questionnaire. Results revealed that treatment techniques with little to no evidence were used frequently, including pillow cushion supports (98%), positional stretch (94%) and slings (61%). Alternatively, treatment techniques with significant supporting evidence were used at a lower frequency, such as electrical stimulation (39%).Conclusions: The results of the questionnaire highlight an inconsistent application of evidence within clinical practice and the consistent application of treatment techniques with poor supporting evidence. This result does not represent poor clinical practice. Rather, it highlights the need for the research literature to articulate the clinical reasoning underpinning clinicians' selection of treatment techniques and to determine the effectiveness of frequently used, but poorly supported treatment techniques. (Source: Australian Occupational Therapy Journal)

Pretend play, social competence and involvement in children aged 5–7 years: the concurrent validity of the child-initiated pretend play assessment

Australian Occupational Therapy Journal — Fri, 10 Oct 2008 04:00:00 +0100

Background and aims: The aims of this study were to investigate the relationship between pretend play, social competence and involvement in school-based activities in children aged 5[ndash]7 years and to determine whether children's social competence and level of involvement could be inferred from their scores on the Child-Initiated Pretend Play Assessment.Procedure: The pretend play skills of 41 primary school-aged children aged 5[ndash]7 years were assessed on a one-on-one basis. Classroom teachers of the children assessed the children's social competence using the Penn Interactive Peer Play Scale and their involvement in school based activities using the Leuven Involvement Scale for Young Children.Main findings: Significant positive relationships were found between elaborate pretend play and object substitution scores, involvement scores and peer play interaction scores (P < 0.05, P < 0.01). A significant negative relationship was found between elaborate pretend play scores, and social disconnection and social disruption scores (P < 0.05). Play deficit indicators were significantly negatively related to involvement scores (P < 0.01). This suggests that children with proficient pretend play skills are socially competent with peers and are able to engage in classroom activity. Children who scored poorly on the play assessment were more likely to have difficulty interacting with their peers and engaging in school activities.Conclusion: Social competence and involvement skills are related to a child's ability to engage in pretend play. A child's social skills and ability to engage in school activities as assessed by teachers can be inferred from their scores on the Child-Initiated Pretend Play Assessment. (Source: Australian Occupational Therapy Journal)

Profile of cognitive problems in schizophrenia and implications for vocational functioning

Australian Occupational Therapy Journal — Fri, 10 Oct 2008 04:00:00 +0100

Aim: This literature review attempts to profile specific areas of cognition that have shown unique and consistent evidence of dysfunction among people with schizophrenia. In addition, their impact on vocational functioning is illustrated, so as to highlight the importance of managing these cognitive difficulties in vocational rehabilitation.Methods: Literature search was carried out on seven key cognitive domains identified by the National Institute of Mental Health in the USA. Their impact on vocational function was also reviewed.Results: It is found that attention, declarative and working memory, reasoning, problem-solving and social cognition are areas of impairment that have great impact on vocational functioning. Attention and memory problems affect learning of new work tasks. Executive function is particularly crucial in determining supported and open employment outcomes, as executive dysfunction cannot be easily compensated. Lastly, social cognition plays a major role in determining the success of workplace social exchanges.Conclusion: Occupational therapists need to have a good understanding of the profile of cognitive problems among people with schizophrenia, in order to tailor our intervention according to their cognitive strengths and difficulties. Several cognitive remediation strategies and programs have been designed specifically for people with mental illness. Equipping ourselves with skills in conducting such programs will augment our expertise in vocational rehabilitation. (Source: Australian Occupational Therapy Journal)

Movement skills proficiency and physical activity: a case for engaging and coaching for health (each)–child

Australian Occupational Therapy Journal — Fri, 10 Oct 2008 04:00:00 +0100

Background/aim: Supporting children's participation in health-enhancing physical activities is an important occupational goal for therapists. Fundamental movement skills (FMS) are thought to underpin and enable many activity options. This study had two goals: first, to examine the relationship between fundamental movement skills (FMS) and physical activity, and second, to use this and existing evidence to inform strategies whereby children's motivation for and engagement in physical activity can be supported.Methods: A cross-sectional investigation of 124 children, aged 6[ndash]12 years, was undertaken. FMS were assessed using the Movement Assessment Battery for Children (M-ABC) and physical activity by pedometer step counts.Results: A weak but significant association was found between weekend physical activity and balance skills for girls. Correlations between physical activity and ball skills or manual dexterity were not significant for either gender, however, having age appropriate ball skills did result in greater but not significant levels of physical activity for all children when grouped together.Conclusions: Findings from this study question the magnitude of the relationship between children's FMS and physical activity as measured by pedometers. If the goal of health enhancement through physical activity engagement is to be realised, it is proposed that community, occupation-based approaches may offer more potential than skills-based interventions at increasing activity participation. The concept of Engaging and Coaching for Health (EACH)-Child is introduced to this end. Occupational therapists are encouraged to work collaboratively with school and community organisations to assist children to find the physical activities that best accommodate their interests, abilities and offer opportunities for lifelong engagement. (Source: Australian Occupational Therapy Journal)

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Complementary value of functional capacity evaluation for physicians in assessing the physical work ability of workers with musculoskeletal disorders

International Archives of Occupational and Environmental Health — Thu, 09 Oct 2008 09:09:31 +0100

Abstract Objective To study the complementary value of information from functional capacity evaluation (FCE) for insurance physicians (IPs) who assess the physical work ability of claimants with long-term musculoskeletal disorders (MSD). Method A post-test only design was used in the context of disability claims. Twenty-eight IPs participated in the study. Claimants with MSD formed the patient population. For each IP, the first claimant who agreed to participate was included in the study, and underwent FCE in addition to the regular disability claim assessment. Firstly, the IP performed the statutory disability claim assessment. Secondly, the FCE assessment took place. Finally, a self-formulated questionnaire was presented to the IPs after they viewed the FCE report. IPs were asked whether they perceived FCE information to be of complementary value to their judgment of the claimant’s physical work ability investigated. We considered FCE information to be of complementary value if more than 66% of the IPs indicated as such. IPs were also asked whether FCE information led them to change their initial judgment about the claimant’s physical work ability, and whether they felt this information made them more confident about their ultimate judgement. Finally, they were asked whether they planned to include FCE information in future disability claims and for what type of claimants. Differences between IPs who did or did not experience complementary value were explored. Results Of the 28, 19 (nearly 68%) IPs considered FCE information to be of complementary value for their assessment of claimants with MSD. Half of the IPs stated that FCE information reinforced their judgment. All but four IPs changed their assessment after reading the FCE report. Sixteen IPs intended to involve FCE information in future disability claim assessments. There were no observed differences between the IPs who did or did not consider the FCE information to be of complementary value. Conclusion FCE information was found to have complementary value at present and in the future according to most IPs in the assessment of the physical work ability of claimants with MSD. Half of the IPs felt that this information reinforces their judgment in this context. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00420-008-0361-xAuthors Haije Wind, Academic Medical Center, University of Amsterdam Coronel Institute of Occupational Health P.O. Box 22700 1100 DE Amsterdam The NetherlandsVincent Gouttebarge, Academic Medical Center, University of Amsterdam Coronel Institute of Occupational Health P.O. Box 22700 1100 DE Amsterdam The NetherlandsP. Paul F. M. Kuijer, Academic Medical Center, University of Amsterdam Coronel Institute of Occupational Health P.O. Box 22700 1100 DE Amsterdam The NetherlandsJudith K. Sluiter, Academic Medical Center, University of Amsterdam Coronel Institute of Occupational Health P.O. Box 22700 1100 DE Amsterdam The NetherlandsMonique H. W. Frings-Dresen, Academic Medical Center, University of Amsterdam Coronel Institute of Occupational Health P.O. Box 22700 1100 DE Amsterdam The Netherlands Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131 (Source: International Archives of Occupational and Environmental Health)

Effectiveness of a peer-support community in addiction recovery: participation as intervention

Occupational Therapy International — Thu, 09 Oct 2008 04:00:00 +0100

The main purpose of the study was to determine whether a peer-support community programme would reduce relapse rates among clients recovering from substance addictions and homelessness and result in increased perceived community affiliation, supportive behaviours, self-determination and quality of life.Mixed methods were utilized including semi-structured interviews, participant observation and a pretest/post-test to evaluate changes on the quality of life rating, the Medical Outcomes Study-Social Support Survey, and the Volitional Questionnaire. Data from the prior year's permanent supportive housing programme were used for comparison of relapse rates.Significant reduction of risk of relapse was found in clients who participated in the programme. Significant differences were found on three subscales of the Medical Outcomes Study-Social Support Survey. Improvement that did not reach statistical significance was seen on the quality of life rating. Qualitative evidence supported improvements in perceived community affiliation and supportive behaviours.Evidence suggests that a peer-supported community programme focused on self-determination can have a significant positive impact on recovery from substance addictions and homelessness. Limitations include a small sample size and lack of a randomized control group. Copyright © 2008 John Wiley & Sons, Ltd. (Source: Occupational Therapy International)

Particle dose estimation from frying in residential settings

Indoor Air — Thu, 09 Oct 2008 04:00:00 +0100

Abstract Fumes produced during frying have been implicated as a potential cause for the increased incidence of adenocarcinoma. Particulate matter exposure has also been linked with other pulmonary and coronary disease. This study investigated the contribution of frying in residential settings to ultrafine and fine particulate matter (UFP, PM2.5, respectively) exposure in homes. Production rates of 44 ± 26 particles (pt)/cm3 s (mean ± standard deviation) and 0.13 ± 0.12 [mu]g/m3 s were found for UFP and PM2.5, respectively, from frying a variety of foods at medium heat in a loft-style apartment. Rates of 290 ± 150 pt/cm3 s and 3.5 ± 4.9 [mu]g/m3 s were found for UFP and PM2.5, respectively, from frying with vegetable oil alone in five homes; the higher rates were ascribed to differences between the homes rather than the absence of food. The elimination of UFP and PM2.5 was found to be primarily through exhaust fans in these homes, and it was found to follow a first-order process with an elimination rate constant of 6.1 × 10[minus]4 ± 2.5 × 10[minus]4 s[minus]1. The dose to an individual from frying was estimated based on the measured production and elimination rates and found to be significant when compared with the typical daily dose incurred within a home because of outside sources. The contribution of indoor sources to particulate matter exposure in homes remains poorly understood. Yet common household activities such as frying may produce substantial concentrations of potentially toxic particles. Because of the potential adverse health impacts associated with exposure to air pollution, potentially vulnerable individuals may be advised to remain indoors at certain times so as to reduce their overall exposure. Such interventions can be negated without proper guidance regarding the exposure involved in various indoor activities such as cooking. This paper outlines a methodology to estimate the dose to particulate matter incurred during frying and shows that this can represent a significant source of daily exposure. (Source: Indoor Air)

Indoor air quality assessment in and around urban slums of delhi city, india

Indoor Air — Wed, 08 Oct 2008 04:00:00 +0100

Abstract The present study aims at investigating the indoor air quality (IAQ) in selected households in one of the urban slums i.e. the Nizamuddin slums in Delhi, the capital city of India. The study includes investigations and assessments on associated health effects on the occupants living in inefficiently designed houses having poor ventilation. The monitoring of indoor air pollutants e.g. the respirable suspended particulate matter (RSPM), the carbon dioxide (CO2), the carbon monoxide (CO), the sulphur dioxide (SO2) and the nitrogen dioxide (NO2) for all three seasons i.e. summer (April[ndash]June 2004), rainy (July[ndash]September 2004) and winter (December 2004[ndash]February 2005) have been conducted. In addition, the spirometry tests on the occupants, particularly the womenfolk and children have been performed to determine the incidence of acute respiratory infections (ARI). Questionnaire survey has also been conducted in the households during the study period to investigate the sick building syndrome (SBS). The study reveals maximum concentration of indoor air pollutants in households during winters (December 2004[ndash]February 2005) associated with aggravated respiratory problems like cough, phlegm, wheezing, and breathlessness among occupants particularly the women occupants. Besides, decrement in lung function indices (i.e. FVC and/or FEV1) due to increased concentrations of RSPM and CO2 indoors during winter period has also been observed in the women respondents. The study concludes that women and children indoors are most vulnerable to respiratory problems compared to other sexes. A high SBS score is observed in these 'urban poor' households because of inadequate ventilation. 'High indoor airborne pollutants during winter are associated with respiratory problems for women and children in houses in urban slum in Delhi. The work demonstrated the need of further studies of indoor air quality for the 'urban poor' in developing countries.' (Source: Indoor Air)

Workers' interpretation of self-assessment of exposure

Annals of Occupational Hygiene — Tue, 07 Oct 2008 04:00:00 +0100

Objectives: The aim was to investigate how workers interpret and act upon results from self-assessment of exposure (SAE). Methods: Workers in four sawmills in Sweden were supplied with diffusive samplers for measurement of terpenes. Workers received both oral and written instructions about terpenes, their medical effects and how to handle the samplers. Responsibility for sampling was left to the individual worker; written feedback about terpene levels was provided after each measurement. The number of measurements was registered. The workers and supervisors were interviewed about their attitudes, perceived control of their work environment, need for preventive actions and future surveillance of the workplace. Results: In total, 28 workers performed 100 terpene measurements. At one sawmill, there was a significant association between exposure levels and the number of measurements performed by each worker ( = 0.79, P = 0.03). Contrary to instructions, supervisors played an important role in spontaneous organization of the measurements at each mill. Four measurements revealed terpene concentrations that exceeded the occupational exposure limits, and one preventive action was taken as a consequence of high levels. Seventy percent of the workers could not identify any reason for more measurements. Only 15% considered the measurements as their ‘own’ project, and the rest stated that they participated in order to satisfy the researchers. Conclusions: Previous studies have shown that workers can perform valid measurements, both select a day and technically perform measurements. This study indicates that this ability is not sufficient to ensure that measurements will be done or that implementing measurements will result in preventive actions. Workers need additional support to take preventive actions and use SAE for ongoing surveillance. (Source: Annals of Occupational Hygiene)

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Dna damage and repair detected by the comet assay in lymphocytes of african petrol attendants: a pilot study

Annals of Occupational Hygiene — Tue, 07 Oct 2008 04:00:00 +0100

Petrol attendants are exposed to petrol volatile organic compounds (VOCs) which may have genotoxic and carcinogenic effects. The single-cell gel electrophoresis assay (comet assay) is a method highly sensitive to DNA damage induced by environmental and occupational exposure to carcinogenic and mutagenic agents. The aim of this study was to evaluate the level of exposure of petrol attendants to petrol VOCs and also to determine their effect on DNA damage and repair in lymphocytes of African petrol attendants. The exposed group consisted of 20 subjects, randomly selected from three petrol stations. A control group of 20 unexposed subjects was also chosen and matched for age and smoking habits with the exposed group. Sorbent tubes were used to assess personal exposure of petrol attendants. The comet assay was used to investigate the basal DNA damage and repair capacity in isolated lymphocytes of petrol attendants and unexposed subjects. Blood samples were taken from the petrol attendants at the end of their 8-h working shift and also from the unexposed subjects. The petrol attendants were found to be exposed to levels of petrol VOCs lower than the South African occupational exposure limit for constituent chemicals. A significant relationship was found between the volume of petrol sold during the shift and the average concentrations of benzene, toluene and the total VOCs measured. However, relative humidity had a negative correlation with the average concentrations of benzene, toluene, xylene and the total VOCs. Significantly higher basal DNA damage was observed with the exposed group compared to the unexposed group. The period of exposure influenced the level of DNA damage and the calculated repair capacity. Smoking and age had a significant influence on the level of DNA damage. DNA repair capacity was delayed in smokers of both exposed and unexposed group. (Source: Annals of Occupational Hygiene)

Assessment of occupational genotoxic risk among brazilian hairdressers

Annals of Occupational Hygiene — Tue, 07 Oct 2008 04:00:00 +0100

Objectives: To evaluate the genotoxic risk to hairdressers exposed daily to chemical substances such as hair dyes, waving and straightening preparations and manicurists' products by the Comet assay test (single-cell gel electrophoresis). Methods: The Comet assay was performed on blood samples from 69 female hairdressers (36.4 ± 10.7 years old) currently employed in 21 different beauty institutes in São Paulo, Brazil, and on 55 female control blood donors (32.6 ± 10.0 years old) from the São Paulo University Clinical Hospital blood bank. All the control subjects had occupations other than hairdresser. Comet assays were performed by evaluating 100 blood lymphocytes per individual and graded by visual score according to comet tail length. Results: The hairdressers showed a higher frequency of DNA damage revealed by Comet Score (159.8 ± 71) when compared to the control group (125.4 ± 64.1), and the difference was statistically significant by the Student's t-test (P = 0.005). Multiple regression analysis showed that in addition to the hairdressers' profession, tobacco use contributed to the higher frequency of cells with comets (P < 0.05). Conclusions: The observed DNA damage could be associated with the hairdressers' occupational environment, where different chemicals are chronically manipulated and inhaled. Considering that this profession in many countries, including Brazil, is not officially regulated, more attention should focus on these professionals not only by legislative bodies but also by multidisciplinary teams able to develop and implement risk prevention and control strategies for chemical, physical and biological agents to which hairdressers are exposed. (Source: Annals of Occupational Hygiene)

Effects of doorsill jet injection on fume cupboard containment

Annals of Occupational Hygiene — Tue, 07 Oct 2008 04:00:00 +0100

The flow separation and its accompanied recirculation induced when the airflow passes over the inappropriately designed doorsill of a chemical fume cupboard are the key factors which would lead to deterioration of the cupboard performance. In order to alleviate the contaminant leakage of the fume cupboard induced by inherent aerodynamic deficiency, a technique using doorsill jet injection is developed and validated. A planar jet is ejected upward through a slot located across the inner surface of the doorsill of a full-scale, transparent fume cupboard and is ejected upward. The laser-light-sheet-assisted smoke flow visualization is performed to explore the physical mechanism of changing and controlling the flow structure. It is found that the upward injected jet is curved by the airflow drawn into the sash opening and forms a layer of clean air which can isolate the contaminant and alleviate the diffusion through the recirculating vortex on the doorsill, if the jet velocity is properly adjusted. The tracer gas concentration measurements present extraordinarily satisfactory results—the order of magnitude of the leakage of tracer gas near the doorsill may be reduced from original levels of ~102 to ~10–2 p.p.m. Except for the experimental fume cupboard used for development of technique, two commercial fume cupboards are employed for verifications and comparisons on the proposed method. Tests about the two modified commercial fume cupboards demonstrate good agreement to those of the model fume cupboard. (Source: Annals of Occupational Hygiene)

Quantitative and qualitative assessment of exposure among employees in norwegian smelters

Annals of Occupational Hygiene — Tue, 07 Oct 2008 04:00:00 +0100

Objectives: To generate a job exposure matrix (JEM) for dust exposure in Norwegian smelters to be used in an epidemiologic study of respiratory diseases and to identify determinants of exposure. Methods: The arithmetic mean and geometric mean (GM) of 2619 personal dust exposure measurements were applied in constructing the JEM, which was assigned to 2620 employees participating in a respiratory survey including yearly spirometry and a respiratory questionnaire. A qualitative exposure classification was constructed: (i) line operators were those employed full time in the production line, (ii) non-exposed employees were those who did not work in production and (iii) the remainder were classified as non-line operators. Results: In the ferrosilicon alloy and silicon metal production group (FeSi/Si-metal), the median GM of dust exposure was 2.3 mg m–3 (0.04–5.6) (10–90% percentiles) compared with 1.6 mg m–3 (0.02–2.3) in the silicomanganese, ferromanganese and ferrochromium production group (SiMn/FeMn/FeCr). Multivariate analyses showed that dust exposure concentration levels decreased significantly with increasing age (FeSi/Si-metal), was significantly lower in females than in males and was significantly higher in current smokers than in never-smokers. Dust exposure concentration levels were also higher in employees reporting previous exposure to dust, fumes and gases than in employees without such previous exposure, though, significant only in the FeSi/Si-metal production group. Conclusion: The dust exposure levels of the employees were higher in the FeSi/Si-metal production group than in the SiMn/FeMn/FeCr production group. Age, gender, smoking status and previous exposure were significant determinants of dust exposure and should be evaluated in future analyses of the relationship between health outcomes and dust exposure in this industry. (Source: Annals of Occupational Hygiene)

Determination of risk of infection with blood-borne pathogens following a needlestick injury in hospital workers

Annals of Occupational Hygiene — Tue, 07 Oct 2008 04:00:00 +0100

Objectives: Our paper measures the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) in patients at the University Hospital of Frankfurt/Main, and correlates the prevalence with risk factors for exposure to and infection of healthcare workers (HCWs). Individual risk assessments were calculated for exposed HCWs. Methods: Survey of patients admitted to a German University Hospital. Markers for HBV, HCV and HIV were studied and evaluated statistically. Data on needlestick injuries (NSIs) among HCWs were correlated with the prevalence of infectious patients. Results: The HBV, HCV and HIV prevalence among patients at the University Hospital were 5.3% (n = 709/13 358), 5.8% (n = 1167/20 163) and 4.1% (n = 552/13 381), respectively. Our results indicate that the prevalence of blood-borne infections in patients was about nine times higher for HBV, ~15 times higher for HCV and ~82 times higher for HIV than in the overall German population. The highest risk of acquiring a blood-borne infection via NSI was found in the department of internal medicine due to increased prevalence of blood-borne pathogens in patients under treatment. Conclusions: While accidental NSIs were most frequent in surgery, the nominal risk of blood-borne virus infection was greatest in the field of internal medicine. The study underlines the importance of HBV vaccinations and access to HIV-post-exposure prophylaxis for HCWs as well as the use of anti-needlestick devices. (Source: Annals of Occupational Hygiene)

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Respiratory exposure to components of water-miscible metalworking fluids

Annals of Occupational Hygiene — Tue, 07 Oct 2008 04:00:00 +0100

Water-miscible metalworking fluids (MWFs) are capable of causing respiratory symptoms and diseases. Recently, much emphasis has been put on developing new methods for assessing respiratory exposure to MWF emulsions. The air concentrations of ingredients and contaminants of MWF and inhalable dust were measured in 10 metal workshops in southern Finland. Oil mist was determined by infra red spectroscopy analysis after tetrachloroethylene extraction from the filter. Aldehydes were collected on Sep-Pak chemosorbents and analysed by liquid chromatography. Volatile organic compounds (VOCs) were collected on Tenax adsorbents and analysed by gas chromatography with mass spectrometric detection after thermal desorption. Endotoxins were collected on glass fibre filter and analysed by enzyme-based spectrophotometry, and viable microbes were collected on polycarbonate filter and cultured. Inhalable dust was collected on cellulose acetate filter and quantified gravimetrically. Associations between the different exposures were calculated with Spearman’s correlations. The mean concentration of oil mist was 0.14 (range <0.010–0.60) mg m–3. The mean total concentration of aldehydes was 0.095 (0.026–0.38) mg m–3, with formaldehyde as the main aldehyde. The average total concentration of VOC was 1.9 (0.34–4.5) mg m–3 consisting mainly of high-boiling aliphatic hydrocarbons. Several potential sensitizing chemicals such as terpenes were found in small quantities. The concentration of microbial contaminants was low. All the measured air concentrations were below the Finnish occupational exposure limits. The exposure in machine shops was quantitatively dominated by volatile compounds. Additional measurements of MWF components such as aldehydes, alkanolamines and VOCs are needed to get more information on the chemical composition of workshops’ air. New air cleaning methods should be introduced, as oil mist separators are insufficient to clean the air of small molecular impurities. (Source: Annals of Occupational Hygiene)

Exposure to metalworking fluid aerosols and determinants of exposure

Annals of Occupational Hygiene — Tue, 07 Oct 2008 04:00:00 +0100

Metalworking fluid (MWF) aerosols are associated with respiratory disorders including asthma and hypersensitivity pneumonitis. The aims of this study were to describe exposure to inhalable MWF aerosols and volatile compounds in machine shops, to estimate the influence of important determinants of exposure and to compare different sampling techniques for MWF aerosols. Personal full-shift air samples of inhalable aerosol (PAS-6 sampler) and total aerosol (open-faced sampler) were collected on operators in five medium to big-sized machine shops in three companies. The filters were analysed gravimetrically and extracted by supercritical fluid extraction for MWF aerosol and triethanolamine content. In addition, personal measurements were taken for formaldehyde and volatile compounds on adsorbent samplers. Continuous dust measurements were performed with a real-time instrument (DataRAM) during 2 h periods, using 1-min average values. In total, 95 measurements of inhalable aerosol and extracted MWF aerosols on 51 operators were conducted. Within the companies, the average exposure to inhalable aerosol ranged from 0.19 to 0.25 mg m–3 with geometric standard deviations from 1.56 to 1.79. On average, the extracted fraction of MWF aerosol was 67% of the inhalable aerosol concentration. The exposure levels of triethanolamine, formaldehyde and volatile compounds were generally low. About 45% of the between-worker variance could be explained by use of compressed air, lack of complete enclosure of machines or grinding as cutting task. In 21 workers with continuous aerosol measurements, short-term peak exposures during 6% of the work time contributed to ~25% of the average concentration of inhalable MWF aerosol. Inhalable MWF aerosol concentration measured with the PAS-6 sampler was a factor 2 higher than the concentrations derived from the open-faced sampler. These findings suggest that control measures, such as full enclosure of machines and the elimination of the use of compressed air as cleaning technique, are required to reduce the exposure to MWF aerosols to levels below the expected threshold for adverse respiratory health effects. (Source: Annals of Occupational Hygiene)

Evaluation of peak exposures in the dutch flour processing industry: implications for intervention strategies

Annals of Occupational Hygiene — Tue, 07 Oct 2008 04:00:00 +0100

Objectives: To effectively decrease occupational exposure to flour dust and related allergens, detailed information on exposure determinants and effectiveness of control measures is essential. In this paper, we use personal real-time exposure measurements to get more insight into the relationship between specific work characteristics, including the use of control measures, and (peak) exposure to flour dust. The study has three objectives: (i) identify tasks and activities related to peak exposure, (ii) identify control measures and other important exposure determinants and (iii) assess the potential impact of these control measures on the (peak) exposure to flour dust. Methods: A data set containing 82 real-time exposure measurements in combination with information from detailed observations was used to study the association between peak exposures and different tasks, activities and other determinants such as control measures. Descriptive statistics of peak exposure on job level were generated as well as information on contribution of task-specific peak exposures to time-weighted average (TWA) exposure levels. Finally, we evaluated the efficacy of a variety of control measures on task exposure by comparing exposure levels of groups of workers with and without controls. Results: In workers included in this study, >75% of TWA exposure is directly associated with peak exposures during a limited set of well-defined tasks/activities. The impact of a single task on population TWA exposure is generally limited (<40%). Worker behavior seems an important determinant in effective exposure control for many tasks. Conclusions: Data from real-time measurements provide important detailed information with respect to exposure determinants and control measures, not obtainable from conventional measurement studies focusing at TWA exposure. This information is essential to perform prospective impact assessments of intervention strategies on the populations’ exposure distribution. (Source: Annals of Occupational Hygiene)

Conceptual model for assessment of inhalation exposure: defining modifying factors

Annals of Occupational Hygiene — Tue, 07 Oct 2008 04:00:00 +0100

The present paper proposes a source–receptor model to schematically describe inhalation exposure to help understand the complex processes leading to inhalation of hazardous substances. The model considers a stepwise transfer of a contaminant from the source to the receptor. The conceptual model is constructed using three components, i.e. (i) the source, (ii) various transmission compartments and (iii) the receptor, and describes the contaminant's emission and its pattern of transport. Based on this conceptual model, a list of nine mutually independent principal modifying factors (MFs) is proposed: activity emission potential, substance emission potential, localized control, separation, segregation, dilution, worker behavior, surface contamination and respiratory protection. These MFs describe the exposure process at a high level of abstraction so that the model can be generically applicable. A list of exposure determinants underlying each of these principal MFs is proposed to describe the exposure process at a more detailed level. The presented conceptual model is developed in conjunction with an activity taxonomy as described in a separate paper. The proposed conceptual model and MFs should be seen as ‘building blocks’ for development of higher tier exposure models. (Source: Annals of Occupational Hygiene)

Development and evaluation of an exposure control efficacy library (ecel)

Annals of Occupational Hygiene — Tue, 07 Oct 2008 04:00:00 +0100

Objectives: This paper describes the development and evaluation of an evidence database on the effectiveness of risk management measures (RMMs) to control inhalation exposure. This database is referred to as Exposure Control Efficacy Library (ECEL). Methods: A comprehensive review of scientific journals in the occupational hygiene field was undertaken. Efficacy values for RMMs in conjunction with contextual information on study design, sampling strategy and measurement type (among other parameters) were stored in an MS Access database. In total, 433 efficacy values for six RMM groups (i.e. enclosure, local exhaust ventilation, specialized ventilation, general ventilation, suppression techniques and separation of the worker) were collected from 90 peer-reviewed publications. These RMM categories were subdivided into more specific categories. Results: Estimated average efficacy values ranged from 87% for specialized ventilation to 43% for general ventilation. Substantial variation in efficacy values was observed within RMM categories based on differences in selected covariables within each study (i.e. study design, sampling strategy, measurement type and others). More contrast in efficacy values was observed when evaluating more detailed subcategories. Conclusions: It is envisaged that ECEL will contribute to exposure modelling, but should be supplemented with expert opinion, preferably in a formal expert elicitation procedure. The work presented here should be considered as a first attempt to collate and analyse RMM efficacy values and inclusion of additional (unpublished) exposure data is highly warranted. (Source: Annals of Occupational Hygiene)

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A framework for the concurrent consideration of occupational hazards and obesity

Annals of Occupational Hygiene — Tue, 07 Oct 2008 04:00:00 +0100

Occupational hazards and obesity can lead to extensive morbidity and mortality and put great financial burden on society. Historically, occupational hazards and obesity have been addressed as separate unrelated issues, but both are public health problems and there may be public health benefits from considering them together. This paper provides a framework for the concurrent consideration of occupational hazards and obesity. The framework consists of the following elements: (i) investigate the relationship between occupational hazards and obesity, (ii) explore the impact of occupational morbidity and mortality and obesity on workplace absence, disability, productivity and healthcare costs, (iii) assess the utility of the workplace as a venue for obesity prevention programs, (iv) promote a comprehensive approach to worker health and (v) identify and address the ethical, legal and social issues. Utilizing this framework may advance the efforts to address the major societal health problems of occupational hazards and obesity. (Source: Annals of Occupational Hygiene)

Sources of nitrogen dioxide (no2) in new zealand homes: findings from a community randomized controlled trial of heater substitutions

Indoor Air — Tue, 07 Oct 2008 04:00:00 +0100

Abstract Houses in New Zealand have inadequate space heating and a third of households use unflued gas heaters. As part of a large community intervention trial to improve space heating, we replaced ineffective heaters with more effective, non-polluting heaters. This paper assesses the contribution of heating and household factors to indoor NO2 in almost 350 homes and reports on the reduction in NO2 levels due to heater replacement. Homes using unflued gas heaters had more than three times the level of NO2 in living rooms [geometric mean ratio (GMR) = 3.35, 95% CI: 2.83[ndash]3.96, P < 0.001] than homes without unflued gas heaters, whereas homes using gas stove-tops had significantly elevated living room NO2 levels (GMR = 1.42, 95% CI: 1.05[ndash]1.93, P = 0.02). Homes with heat pumps, flued gas heating, or enclosed wood burners had significantly lower levels of NO2 in living areas and bedrooms. In homes that used unflued gas heaters as their main form of heating at baseline, the intervention was associated with a two-third (67%) reduction in NO2 levels in living rooms, when compared with homes that continued to use unflued gas heaters. Reducing the use of unflued gas heating would substantially lower NO2 exposure in New Zealand homes. Understanding the factors influencing indoor NO2 levels is critical for the assessment and control of indoor air pollution. This study found that homes that used unflued gas combustion appliances for heating and cooking had higher NO2 levels compared with homes where other fuels were used. These findings require institutional incentives to increase the use of more effective, less polluting fuels, particularly in the home environment. (Source: Indoor Air)

Magnitude of indoor no2 from biomass fuels in rural settings of ethiopia

Indoor Air — Mon, 06 Oct 2008 04:00:00 +0100

Abstract Half of the world's population and about 80% of households in Sub-Saharan Africa depend on biomass fuels. Indoor air pollution due to biomass fuel combustion may constitute a major public health threat affecting children and women. The purpose of this study was to measure levels of indoor NO2 concentration in homes with under-five children in rural Ethiopia. The study was undertaken in the Butajira area in Ethiopia from March 2000 to April 2002. 24-h samples were taken regularly at about three month intervals in approximately 3300 homes. Indoor air sampling was done using a modified Willems badge. For each sample taken, an interview with the mother of the child was performed. A Saltzman colorimetric method using a spectrometer calibrated at 540 nm was employed to analyze the mass of NO2 in field samples. Wood, crop residues and animal dung were the main household fuels. The mean (s.d.) 24-h concentration of NO2 was 97 [mu]g/m3 (91.4). This is more than double the currently proposed annual mean of WHO air quality guideline. Highland households had significantly higher indoor NO2 concentration. This study demonstrates high levels of indoor NO2 in rural homes of Ethiopia. Respiratory infection is a major cause of morbidity and mortality, globally. Acute respiratory symptoms are also related to high levels of air pollution. Interventions aimed at reducing exposure to indoor air pollution should focus on cooking and heating practices in developing countries. This study is not undermining the role of other biomass smoke constituents in determining respiratory infections. (Source: Indoor Air)

Global initiatives to prevent climate change

Indian Journal of Occupational and Environmental Medicine — Sun, 05 Oct 2008 07:44:04 +0100

Pandve Harshal TIndian Journal of Occupational and Environmental Medicine 2008 12(2):96-97 (Source: Indian Journal of Occupational and Environmental Medicine)

The asian brown cloud

Indian Journal of Occupational and Environmental Medicine — Sun, 05 Oct 2008 07:44:04 +0100

Pandve Harshal TIndian Journal of Occupational and Environmental Medicine 2008 12(2):93-95 (Source: Indian Journal of Occupational and Environmental Medicine)

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Indian association of occupational health denies industry influence

Indian Journal of Occupational and Environmental Medicine — Sun, 05 Oct 2008 07:44:04 +0100

Shanbhag S MIndian Journal of Occupational and Environmental Medicine 2008 12(2):91-92 (Source: Indian Journal of Occupational and Environmental Medicine)

Morbidity profile of steel pipe production workers

Indian Journal of Occupational and Environmental Medicine — Sun, 05 Oct 2008 07:44:04 +0100

Pandit Kirti, Tiwari Rajnarayan RIndian Journal of Occupational and Environmental Medicine 2008 12(2):88-90Objective: To study the different morbid conditions among steel pipe producing workers. Methods: The present cross-sectional study has been carried out among the workers of one of the steel pipes and tubes manufacturing factory of Gujarat. Hundred workers from the four major departments of the steel pipe production plant, namely welding, pressing machine, X-ray welding and loading/transportation department were covered. The information regarding demographic, occupational, clinical characteristics and diagnosis were recorded on a pre-designed proforma. Statistical analysis included calculation of percentages and proportions and was carried out using the statistical software Epi Info Version 3.3.2. Results: The mean age of the study subjects was found to be 38.7±7.1 years. The mean duration of exposure was found to be 9.0±3.4 years. Forty-four percent of the subjects had an upper respiratory tract infection, as evidenced by symptoms like dry cough, cough with rhinitis and cough with fever. Symptoms suggestive of allergic bronchitis were observed in 12% of the subjects while symptoms suggestive of heat stress such as prickly heat, dehydration, perspiration and pyrexia were observed in 13% of the subjects. (Source: Indian Journal of Occupational and Environmental Medicine)

The role of exhaust ventilation systems in reducing occupational exposure to organic solvents in a paint manufacturing factory

Indian Journal of Occupational and Environmental Medicine — Sun, 05 Oct 2008 07:44:04 +0100

Jafari Mohammad Javad, Karimi Ali, Azari Mansoor RezazadehIndian Journal of Occupational and Environmental Medicine 2008 12(2):82-87This paper presents the successful design and implementation of several exhaust ventilation systems in a paint manufacturing factory. The ventilation systems were designed based on American Conference of Governmental Industrial Hygienists recommendations. The duct works, fans, and other parts were made and mounted by local manufacturers. The concentrations of toluene and xylene as the common solvents used in paint mixing factories were measured to evaluate the role of ventilation systems in controlling the organic solvents. Occupational exposure to toluene and xylene as the major pollutants was assessed with and without applying ventilation systems. For this purpose, samples were taken from breathing zone of exposed workers using personal samples. The samples were analyzed using Occupational Safety and Health Administration analytical method No.12. The samples were quantified using gas chromatography. The results showed that the ventilation systems successfully controlled toluene and xylene vapors in workplace, air well below the recommended threshold limit value of Iran (44.49 and 97.73 ppm, respectively). It was also discovered that benzene concentration in workplace air was higher than its allowable concentrations. This could be from solvents impurities that require more investigations. (Source: Indian Journal of Occupational and Environmental Medicine)

Solid-waste management in jalandhar city and its impact on community health

Indian Journal of Occupational and Environmental Medicine — Sun, 05 Oct 2008 07:44:04 +0100

Puri Avinash, Kumar Manoj, Johal EonkarIndian Journal of Occupational and Environmental Medicine 2008 12(2):76-81In this study, solid-waste management practices were evaluated in order to find out its link with occurrence of vector-borne disease. Strategies for solid-waste management were employed as practical model to solve the problems regarding pollution which is originated by solid-waste. (Source: Indian Journal of Occupational and Environmental Medicine)