Return-to-work similar for most injuries
No difference whether occupational or not
Return-to-work programs are very similar in content and results regardless of whether the worker was injured on the job or on personal time, according to a new survey.
The somewhat surprising results come from a survey conducted by the Integrated Benefits Institute, a research organization based in San Francisco.
The consultants surveyed 121 nationwide companies and found that 63% had return-to-work programs for both occupational and non-occupational injuries and illnesses. About 75% of those employers reported that their return-to-work programs were similar in design.
The employers reported that their return- to-work programs, regardless of whether the injury or illness was job-related, typically included modifying the employee's job, placing the worker in alternate work, communicating with the employer about return-to-work plans, and studying the essential functions of a job to aid in modifying the work assignment.
Most of the employers reported that the return-to-work programs, whether for occupational or non-occupational problems, were a fairly new development in their workplaces. About 85% of the employers said the programs had been established after 1988. n
Pereira MA, Kriska AM, Collins VR, et al. Occupational status and cardiovascular disease risk factors in the rapidly developing, high-risk population of Mauritius. Amer J Epidemiology 1998: 148;148-159.
The occupational status of workers may play a significant role in fine-tuning the advice given to patients who should try to reduce their risks for cardiovascular disease, according to these researchers.
They studied a group of workers from Mauritius, some from white-collar office jobs and some from blue-collar, labor-intensive jobs. The workers had sharply different lifestyles, and the researchers suggest taking that into account when offering advice on improving the patient's health.
Sports, leisure activities helpful
In particular, the white-collar workers should be encouraged to engage in leisure time physical activities, such as sports.
Mauritius is a rapidly developing island nation located east of Madagascar in the southwest Indian Ocean. Using a group of 2,795 people between the ages of 35 and 54, the researchers studied data on their occupational status, physical activity in the previous year, cigarette smoking, and alcohol consumption.
The researchers also were able to collect various physical measurements, including body mass index, cholesterol, and blood pressure.
Professional/skilled workers had significantly higher scores for insulin and glucose, lipoprotein cholesterol, triglycerides, and systolic and diastolic blood pressure. High density lipoprotein cholesterol, however, was significantly higher for those in the blue-collar group.
Unskilled workers reported significantly more physical activity, alcohol consumption, and cigarette smoking than the other groups. A statistical analysis revealed an independent association between occupational status and most cardiovascular disease risk factors.
"From this perspective, the results of this investigation indicate that promotion of leisure-time physical activity may be most worthwhile in the professional/skilled workers, partly skilled workers, and homemakers, for whom levels of leisure time and occupational physical activity appear to be low," the researchers conclude. t
Ferrie JE, Shipley MJ, Marmot MG, et al. An uncertain future: The health effects of threats to employment security in white-collar men and women. Amer J Public Health 1998; 1,030-1,035.
The fear of losing their job can have a direct effect on workers' health, according to this study from London.
Data were collected from 10,308 men and women, all working as office staff in 20 British civil service departments. Of that total, 530 were in a department that was known to be under threat of discontinuation.
Physiological measurements, self-reported behaviors, and health-related behaviors from that group were compared to the same data from 19 other departments in which the employees had no reason to fear losing their jobs.
The authors had been collecting health information on the workers for years when it became known that one department might be laid off. Information collected during that period of uncertainty for the one department was compared to data from five years earlier when none of the departments had reason to fear widespread job loss.
The information collected five years earlier showed no significant differences in self-reported morbidity and physiological risk factors among the departments.
Workers' health suffer in uncertain times
But during the period when some workers feared job loss, self-reported illness and physiological risk factors tended to increase for those workers.
They experienced significant weight gain and higher cholesterol levels during that period when compared to other workers. The threatened workers also tended to sleep longer, usually nine or more hours per night - a sleep pattern associated with increased morbidity and mortality, the authors note.
Blood pressure increased significantly for women threatened with job loss but not for men. For both sexes, those fearing job loss had an average 45% increase in cardiac ischemia during that period.
On the positive side, the authors note that fear of job loss did not cause an increase in drinking or smoking, nor did it reduce the amount of regular exercise. That suggests that the diminishing health status is related more to psychological stress or other factors than to changes in health-related behaviors, the researchers say. t
Wells AJ. Lung cancer from passive smoking at work. Am J Public Health 1998; 1,025-1,029.
Workplace exposure to secondhand tobacco smoke is about as dangerous as household exposure, according to this recent study.
The findings are in contrast to information publicized by the tobacco industry.
The recent research suggests that the presence of passive smoke in the workplace increases the risk of lung cancer, as does exposure in the home. Both studies used the same set of 14 previous studies for a meta-analysis, but in this one, a Pennsylvania researcher determined that only five of the 14 studies met all the proper criteria for inclusion in a meta-analysis studying the effects of workplace exposure.
When using only the five studies, the author's analysis determined that there was a relative risk of 1.39 for lung cancer after workplace exposure to tobacco smoke. That means there is a 39% higher risk for those exposed to tobacco smoke at work, compared to those who are not exposed, he says.
"When appropriate cognizance is taken of the quality of data inputs, the increase in lung cancer risk from workplace exposure to environmental tobacco smoke is about the same as that from household exposure," the researcher concludes. t
Waters AJ, Jarvis MJ. Nicotine withdrawal and accident rates. Nature 1998; 394:137.
Workplace accidents rise on national "no-smoking" days, say researchers in London.
The United Kingdom has a national No Smoking Day every year, similar to the United States' Great American Smokeout, in which smokers are encouraged to abstain all day in hopes that it can lead to a complete break from smoking.
Annual event garners large participation
Up to 2 million British smokers abstain on No Smoking Day, including a large number of workers, so the researchers looked at accident data from those days to determine if there was any increase or decrease.
Studies already have shown that regular smokers who abstain will soon suffer deteriorations in mood and cognitive performance. To look for the effect on accident rates, the researchers compared the average number of reported accidents during the week of No Smoking Day with the average for the two weeks before and the average for the two weeks after. They found that the number of reported accidents rose significantly on No Smoking Day.
Other factors, such as weather, may play a role in the increased rate of accidents, but the researchers say the data suggest that there is some effect from the nicotine withdrawal that smokers experience on No Smoking Day. That should be taken into consideration by occupational health professionals promoting smoking cessation, they say.
"We stress that the [No Smoking Day] effect, if real, should not be construed as indicating that cessation attempts on No Smoking Day are a bad idea, although it may suggest that wider use of nicotine replacement might be beneficial," they say.
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