Background This article provides an overview of the adverse health effects caused by exposure to ... more Background This article provides an overview of the adverse health effects caused by exposure to safety and health hazards at work and briefly outlines approaches to reducing hazards to promote workplace safety and health, all of which will be explored in greater depth in other articles. Although work has inherent hazards, working is fundamentally positive. It provides food, clothing, and shelter, creates cities and transportation systems, and forms the basis for human civilization. Work shapes society and profoundly affects the person conducting it. To the extent that workers gain income and other benefits, accomplishment, and social engagement, they share in the positive aspects of work. However, benefits to the individual and to society must include the systematic development of hazard identification and intervention to prevent the illnesses, injuries, and loss of life that unfortunately continue to characterize this important human activity.
New Solutions: A Journal Of Environmental And Occupational Health Policy, Sep 4, 2022
The Covid-19 pandemic has made clear the central role of the workplace in public health. Workers ... more The Covid-19 pandemic has made clear the central role of the workplace in public health. Workers and working families have been particularly impacted by a public health and economic crisis that has revealed both structural shortcomings and opportunities for future preparedness. In response to the pandemic, a group of scholars, labor and anti-poverty advocates, activists, union representatives, frontline workers, and public health professionals gathered to share observations and create a forum for information sharing and collaboration. Conversations evolved with the pandemic to include policy solutions aimed at addressing the pandemic's health and economic impacts. In this paper, we summarize key lessons from the “Covid-19 and Workers” calls and suggest that ongoing collaboration among labor activists and academic and public health advocates may help to prepare for new public health crises and protect the safety and health of workers and communities.
Journal of Occupational and Environmental Medicine, Apr 1, 2017
T he gig economy describes forms of contingent work arrangements that require digital platforms, ... more T he gig economy describes forms of contingent work arrangements that require digital platforms, representing an evolution in contingent work, both in moving up the educational scale and in increased visibility. It has engaged many workers who are highly educated and might previously have been in traditional employer-employee relationships, and appears to increase their vulnerability to wage theft, independent contractor misclassification, job insecurity, and lack of occupational health protections. As occupational health physicians, our need to develop, evaluate, and implement interventions to address the needs of workers in nontraditional employment relationships is growing. BACKGROUND Nonstandard working arrangements are those in which the traditional employer-employee relationship has been altered. Although there is no universally acknowledged taxonomy, such arrangements may include working less than full-time, through a second employer, on-call, on a temporary basis, outside the legal definition of employment, among others. 1,2 Proponents of such arrangements consider them ''flexible,'' while others have characterized them as ''precarious.'' 2 Contingent work is defined by the US Department of Labor Bureau of Labor Statistics (BLS) as ''any work arrangement which does not contain an explicit or implicit contract for long-term employment,'' 3 to include independent contractors, on call workers, and workers provided by contract firms; the Government Accountability Office has expanded that definition to include additional non-standard work arrangements. 4 In a series of surveys, contingent workers earned less, were more likely to live in poverty, received fewer benefits, and were younger and more often of Hispanic ethnicity when compared with workers in standard working arrangements. 5-7 Nonstandard work relationships raise questions about occupational safety and health and have been associated with adverse mortality outcomes. 2,6,7 ''Gig'' work, a unique subset of contingent work, has grown markedly since the most recent recession, although absolute numbers are still small and difficult to track. 3 The term was first coined by journalist Tina Brown to describe ''contingent'' work that is transacted on a digital ''marketplace.'' 8 Recently, the US Department of Commerce proposed a new definition for these companies, which it calls ''digital matching services.'' These services are defined as those that (1) facilitate peer-to-peer transactions using online platforms or mobile apps; (2) utilize user-based rating systems; (3) offer workers flexibility in determining their hours; and (4) place responsibility on workers to
New Solutions: A Journal Of Environmental And Occupational Health Policy, Nov 14, 2019
Enclosed cabs with filtration systems, an engineering control preferred in the hierarchy of contr... more Enclosed cabs with filtration systems, an engineering control preferred in the hierarchy of controls, may reduce heavy equipment operators' silica exposure during demolition, grading, and excavation. We surveyed operating engineer trainers about silica training, familiarity with the Occupational Safety and Health Administration (OSHA) silica standard, and cab filtration systems. A voluntary and anonymous online survey was e-mailed to 437 trainers in January 2018. The response rate was 22.9 percent (n ¼ 100). Most trainers (84 percent) covered health risks and silica exposure prevention in their courses. Of these, 59 percent discussed cab filtration as an engineering control. Trainers identified possible barriers to the use of cab filtration systems and a need for education to increase use, and raised concerns about other exposures associated with heavy equipment use. Education about selection, use, and maintenance of cab filtration systems to control silica exposure is needed. Engineering improvements to heavy equipment should address cab filtration, noise, heat, and vibration.
Medical surveillance of hazardous waste workers is essential for the health of these workers, who... more Medical surveillance of hazardous waste workers is essential for the health of these workers, who have unique, complex exposures. In order for this preventive tool to be effective, the supervising and/or examining physician must be educated about the specific health risks of hazardous waste workers and also must perform a comprehensive examination. Results of testing should be evaluated both for remarkable abnormalities as well as longitudinal subtle changes in individuals, and also for trends in workers with similar exposures. Fitness for duty determinations should be then made with appropriate communication of abnormalities and follow-up recommendations to both employers and employees. To date, clinical and research findings from clinical centers performing surveillance examinations on hazardous waste workers have not revealed remarkable abnormalities related to their potential exposures. The possible causes for these results include: (1) the workers have been well protected; (2) the current diagnostic methodologies are not sensitive enough to detect pathophysiologic changes; and (3) disease may not yet be manifest due to latency or cumulative effects of long-term low-dose exposure. In addition, one must keep in mind that previous clinical and research data were collected from test results of workers who were mainly involved in feasibility, as opposed to remediation, activities. With the prospective change of more clean-up involvement of hazardous waste workers, their potential for exposure may increase. Therefore, periodic collaborative evaluation of existing surveillance programs' results (e.g., every 5 years) is advised. This would allow determination of the efficacy of the current diagnostic methods in detecting disease, as well as the possible inclusion of more sensitive and/or specific newer technologies for use on a more routine basis.(ABSTRACT TRUNCATED AT 250 WORDS)
Journal of Health Care for the Poor and Underserved, 2020
Abstract:Introduction. Falls are the leading cause of fatal traumatic injury among people over 65... more Abstract:Introduction. Falls are the leading cause of fatal traumatic injury among people over 65 and the rate continues to increase. We evaluated a recently implemented municipal program providing no-cost baseline and follow-up home assessment and home modifications to reduce fall hazards among low-income elderly or disabled residents. Methods. Program participants received writ ten invitations to return informed consent for phone interviews that included process and outcome evaluation. Data analysis used repeat measures ANOVA and non parametric Wilcoxon signed rank tests. Results. During its first year, the program served 230 elderly or disabled low-income residents. Among 51 participants interviewed an average of 281 days after home modification, fear of falling was reduced, and annualized rate of falls decreased from an average of 0.92 (SD = 1.6) per person per year to 0.24 (SD = .74) (p<.001). Conclusion. Home assessments and modest infrastructure improvements significantly reduced falls in a non-research, municipal setting.
Journal of Health Care for the Poor and Underserved, 2019
Home care aides (HCAs) provide housekeeping and personal care services to help older clients rema... more Home care aides (HCAs) provide housekeeping and personal care services to help older clients remain in the community. However, little is known about the health of HCAs, who themselves constitute an underserved population. The goal of this study was to investigate how HCAs' work and life contexts manifest themselves in HCAs' health as perceived by HCAs. Six focus groups were conducted with HCAs (N=45). Analysis revealed how HCAs' work-and life-related stress accumulated over time and affected HCAs' health and interaction with their older clients. Home care aides were interested in personal health promotion and client well-being. Home care aides may constitute an underused resource for the care of older adults with disabilities. Information about intricately intertwined work and life contexts should inform policymakers and home care providers in their efforts to improve the quality of publicly funded home care services.
This chapter describes various approaches to recognizing and preventing occupational and environm... more This chapter describes various approaches to recognizing and preventing occupational and environmental disease and injury from primarily a clinical perspective. It describes in detail the occupational and environmental health history, including what questions to ask and when to ask them. It also describes recognizing occupational or environmental disease clusters or outbreaks. The chapter describes in detail the options that health and safety professionals have for implementing and facilitating preventive measures, including substitution of hazardous substances, installation of engineering controls, changes in job design and work practices and organization, education and training, use of personal protective equipment, and screening surveillance. Prevention options are discussed both at the individual and organizational levels.
New Solutions: A Journal Of Environmental And Occupational Health Policy, May 8, 2021
Grocery store workers are essential workers, but often have not been provided with appropriate pr... more Grocery store workers are essential workers, but often have not been provided with appropriate protection during the current pandemic. This report describes efforts made by one union local to protect workers, including negotiated paid sick leave and specific safety practices. Union representatives from 319 stores completed 1612 in-store surveys to assess compliance between 23 April 2020 and 31 August 2020. Employers provided the union with lists of workers confirmed to have COVID-19 infection through 31 December 2020. Worker infection rates were calculated using store employees represented by the union as the denominator and compared to cumulative county infection rates; outcome was dichotomized as rates higher or lower than background rates. Restrictions on reusable bags and management enforcement of customer mask usage were most strongly associated with COVID-19 rates lower than rates in the surrounding county. Stores that responded positively to worker complaints also had better outcomes. The union is currently engaging to promote improved ventilation and vaccination uptake.
Journal of Occupational and Environmental Medicine, Jul 8, 2021
Climate change is an urgent challenge amplified by socioeconomic factors that demands thoughtful ... more Climate change is an urgent challenge amplified by socioeconomic factors that demands thoughtful public health responses from OEM professionals. This guidance statement from the American College of Occupational and Environmental Medicine focuses on the different strategies that these health professionals can implement to protect workers from health impacts associated with climate change hazards, foster workplace resilience in the face of rapidly changing environments, and take the necessary steps to mitigate the effects of global climate change.
Journal of Occupational and Environmental Medicine, Sep 1, 2018
Objective: To address the gap of knowledge about slips, trips, and falls (STFs) among home care a... more Objective: To address the gap of knowledge about slips, trips, and falls (STFs) among home care aides (HCAs) who work in clients' homes. Methods: This mixed method study used survey and focus group data of HCAs in a Medicaid-funded homecare program. Results: STFs were common with over 12% of HCAs reporting occurrence in the previous 12 months, of whom 58% fell to the ground. Both survey and focus group data identified ice, clutter, workload, rushing and other hazards. Focus group data explained the reasons for not reporting STFs, even among those who sustained injury, and added HCAs' voices to the understanding of causes, consequences and prevention strategies for STFs. Conclusions: Empowering HCAs with knowledge, training, and involvement may transform ''near miss'' STFs into opportunities to prevent STFs among care workers and their clients.
Occupational safety and health has a profound impact on individuals, families, communities, and s... more Occupational safety and health has a profound impact on individuals, families, communities, and societies. This article briefly outlines types of hazards and the resulting burden of fatal and nonfatal illness and injury in the context of vulnerable working populations and the changing context of work, including the globalization of work and migration of labor, growth in precarious working arrangements, and specific problems faced by workers at both age extremes. It describes a public health approach anchored in comprehensive programs driven by data and based in management leadership and employee participation. The role of government to provide services and enforce responsibilities is described using examples drawn primarily from the United States, as is the past and potentially future positive role played by labor unions.
Journal of Occupational and Environmental Medicine, Jun 1, 2004
Page 1. Terrorism and Public Health: A Balanced Approach to Strengthening Systems and Protecting ... more Page 1. Terrorism and Public Health: A Balanced Approach to Strengthening Systems and Protecting People BARRY S. LEVY VICTOR W. SIDEL, Editors OXFORD UNIVERSITY PRESS Page 2. Terrorism and Public Health Page 3. This page intentionally left blank Page 4. ...
American Journal of Industrial Medicine, Jun 5, 2019
In 1985, the Sheet Metal Workers International Association and the Sheet Metal and Air Conditioni... more In 1985, the Sheet Metal Workers International Association and the Sheet Metal and Air Conditioning National Association formed The Sheet Metal Occupational Health Institute Trust to examine the health hazards of the sheet metal industry in the United States and Canada. Between 1986 and 2004, 18,211 individuals were examined. The mean age of this cohort was 57.9 years, and the participants had worked for a mean (؎ SD) duration of 32.9 ؎ 6 years in the sheet metal trade. Twenty-three percent of participants were current smokers, 49% were former smokers, and 28% were never-smokers. A total of 9.6% of participants (1,745 participants) had findings that were consistent with parenchymal disease (International Labor Organization [ILO] score, > 1/0); 60% of those with an ILO score > 1/0 were classified as 1/0, 34% as 1/1 to 1/2, and 6% as > 2/1. A total of 21% of participants (3,827 participants) had pleural scarring. There was a lower prevalence of nonmalignant asbestos-related disease among those who began to work after 1970, when compared to workers who began to work before 1949; those who began to work between 1950 and 1969 had a prevalence between the other two groups. The strongest predictor of both parenchymal and pleural disease on a chest radiograph was the calendar year in which the worker began sheet metal work; work in a shipyard was also an important risk. The results of this study suggest that the efforts to reduce asbestos exposure in the 1980s through strengthened Occupational Safety and Health Administration regulation have had a positive public health impact.
Occupational and environmental health covers a wide spectrum and presents many challenges and opp... more Occupational and environmental health covers a wide spectrum and presents many challenges and opportunities. This chapter describes categories of occupational and environmental hazards, the nature and magnitude of problems, the contexts in which occupational and environmental health problems occur, and the prevention of occupational and environmental disease and injury. In addition, the chapter covers the changing nature of work and the workforce, evolving roles of government, liability, climate change, new directions for research, and economic globalization. It also discusses additional challenges for low- and middle-income countries. A final section of the chapter describes disciplines and careers in occupational and environmental health sciences and basic sources of information.
Background This article provides an overview of the adverse health effects caused by exposure to ... more Background This article provides an overview of the adverse health effects caused by exposure to safety and health hazards at work and briefly outlines approaches to reducing hazards to promote workplace safety and health, all of which will be explored in greater depth in other articles. Although work has inherent hazards, working is fundamentally positive. It provides food, clothing, and shelter, creates cities and transportation systems, and forms the basis for human civilization. Work shapes society and profoundly affects the person conducting it. To the extent that workers gain income and other benefits, accomplishment, and social engagement, they share in the positive aspects of work. However, benefits to the individual and to society must include the systematic development of hazard identification and intervention to prevent the illnesses, injuries, and loss of life that unfortunately continue to characterize this important human activity.
New Solutions: A Journal Of Environmental And Occupational Health Policy, Sep 4, 2022
The Covid-19 pandemic has made clear the central role of the workplace in public health. Workers ... more The Covid-19 pandemic has made clear the central role of the workplace in public health. Workers and working families have been particularly impacted by a public health and economic crisis that has revealed both structural shortcomings and opportunities for future preparedness. In response to the pandemic, a group of scholars, labor and anti-poverty advocates, activists, union representatives, frontline workers, and public health professionals gathered to share observations and create a forum for information sharing and collaboration. Conversations evolved with the pandemic to include policy solutions aimed at addressing the pandemic's health and economic impacts. In this paper, we summarize key lessons from the “Covid-19 and Workers” calls and suggest that ongoing collaboration among labor activists and academic and public health advocates may help to prepare for new public health crises and protect the safety and health of workers and communities.
Journal of Occupational and Environmental Medicine, Apr 1, 2017
T he gig economy describes forms of contingent work arrangements that require digital platforms, ... more T he gig economy describes forms of contingent work arrangements that require digital platforms, representing an evolution in contingent work, both in moving up the educational scale and in increased visibility. It has engaged many workers who are highly educated and might previously have been in traditional employer-employee relationships, and appears to increase their vulnerability to wage theft, independent contractor misclassification, job insecurity, and lack of occupational health protections. As occupational health physicians, our need to develop, evaluate, and implement interventions to address the needs of workers in nontraditional employment relationships is growing. BACKGROUND Nonstandard working arrangements are those in which the traditional employer-employee relationship has been altered. Although there is no universally acknowledged taxonomy, such arrangements may include working less than full-time, through a second employer, on-call, on a temporary basis, outside the legal definition of employment, among others. 1,2 Proponents of such arrangements consider them ''flexible,'' while others have characterized them as ''precarious.'' 2 Contingent work is defined by the US Department of Labor Bureau of Labor Statistics (BLS) as ''any work arrangement which does not contain an explicit or implicit contract for long-term employment,'' 3 to include independent contractors, on call workers, and workers provided by contract firms; the Government Accountability Office has expanded that definition to include additional non-standard work arrangements. 4 In a series of surveys, contingent workers earned less, were more likely to live in poverty, received fewer benefits, and were younger and more often of Hispanic ethnicity when compared with workers in standard working arrangements. 5-7 Nonstandard work relationships raise questions about occupational safety and health and have been associated with adverse mortality outcomes. 2,6,7 ''Gig'' work, a unique subset of contingent work, has grown markedly since the most recent recession, although absolute numbers are still small and difficult to track. 3 The term was first coined by journalist Tina Brown to describe ''contingent'' work that is transacted on a digital ''marketplace.'' 8 Recently, the US Department of Commerce proposed a new definition for these companies, which it calls ''digital matching services.'' These services are defined as those that (1) facilitate peer-to-peer transactions using online platforms or mobile apps; (2) utilize user-based rating systems; (3) offer workers flexibility in determining their hours; and (4) place responsibility on workers to
New Solutions: A Journal Of Environmental And Occupational Health Policy, Nov 14, 2019
Enclosed cabs with filtration systems, an engineering control preferred in the hierarchy of contr... more Enclosed cabs with filtration systems, an engineering control preferred in the hierarchy of controls, may reduce heavy equipment operators' silica exposure during demolition, grading, and excavation. We surveyed operating engineer trainers about silica training, familiarity with the Occupational Safety and Health Administration (OSHA) silica standard, and cab filtration systems. A voluntary and anonymous online survey was e-mailed to 437 trainers in January 2018. The response rate was 22.9 percent (n ¼ 100). Most trainers (84 percent) covered health risks and silica exposure prevention in their courses. Of these, 59 percent discussed cab filtration as an engineering control. Trainers identified possible barriers to the use of cab filtration systems and a need for education to increase use, and raised concerns about other exposures associated with heavy equipment use. Education about selection, use, and maintenance of cab filtration systems to control silica exposure is needed. Engineering improvements to heavy equipment should address cab filtration, noise, heat, and vibration.
Medical surveillance of hazardous waste workers is essential for the health of these workers, who... more Medical surveillance of hazardous waste workers is essential for the health of these workers, who have unique, complex exposures. In order for this preventive tool to be effective, the supervising and/or examining physician must be educated about the specific health risks of hazardous waste workers and also must perform a comprehensive examination. Results of testing should be evaluated both for remarkable abnormalities as well as longitudinal subtle changes in individuals, and also for trends in workers with similar exposures. Fitness for duty determinations should be then made with appropriate communication of abnormalities and follow-up recommendations to both employers and employees. To date, clinical and research findings from clinical centers performing surveillance examinations on hazardous waste workers have not revealed remarkable abnormalities related to their potential exposures. The possible causes for these results include: (1) the workers have been well protected; (2) the current diagnostic methodologies are not sensitive enough to detect pathophysiologic changes; and (3) disease may not yet be manifest due to latency or cumulative effects of long-term low-dose exposure. In addition, one must keep in mind that previous clinical and research data were collected from test results of workers who were mainly involved in feasibility, as opposed to remediation, activities. With the prospective change of more clean-up involvement of hazardous waste workers, their potential for exposure may increase. Therefore, periodic collaborative evaluation of existing surveillance programs' results (e.g., every 5 years) is advised. This would allow determination of the efficacy of the current diagnostic methods in detecting disease, as well as the possible inclusion of more sensitive and/or specific newer technologies for use on a more routine basis.(ABSTRACT TRUNCATED AT 250 WORDS)
Journal of Health Care for the Poor and Underserved, 2020
Abstract:Introduction. Falls are the leading cause of fatal traumatic injury among people over 65... more Abstract:Introduction. Falls are the leading cause of fatal traumatic injury among people over 65 and the rate continues to increase. We evaluated a recently implemented municipal program providing no-cost baseline and follow-up home assessment and home modifications to reduce fall hazards among low-income elderly or disabled residents. Methods. Program participants received writ ten invitations to return informed consent for phone interviews that included process and outcome evaluation. Data analysis used repeat measures ANOVA and non parametric Wilcoxon signed rank tests. Results. During its first year, the program served 230 elderly or disabled low-income residents. Among 51 participants interviewed an average of 281 days after home modification, fear of falling was reduced, and annualized rate of falls decreased from an average of 0.92 (SD = 1.6) per person per year to 0.24 (SD = .74) (p<.001). Conclusion. Home assessments and modest infrastructure improvements significantly reduced falls in a non-research, municipal setting.
Journal of Health Care for the Poor and Underserved, 2019
Home care aides (HCAs) provide housekeeping and personal care services to help older clients rema... more Home care aides (HCAs) provide housekeeping and personal care services to help older clients remain in the community. However, little is known about the health of HCAs, who themselves constitute an underserved population. The goal of this study was to investigate how HCAs' work and life contexts manifest themselves in HCAs' health as perceived by HCAs. Six focus groups were conducted with HCAs (N=45). Analysis revealed how HCAs' work-and life-related stress accumulated over time and affected HCAs' health and interaction with their older clients. Home care aides were interested in personal health promotion and client well-being. Home care aides may constitute an underused resource for the care of older adults with disabilities. Information about intricately intertwined work and life contexts should inform policymakers and home care providers in their efforts to improve the quality of publicly funded home care services.
This chapter describes various approaches to recognizing and preventing occupational and environm... more This chapter describes various approaches to recognizing and preventing occupational and environmental disease and injury from primarily a clinical perspective. It describes in detail the occupational and environmental health history, including what questions to ask and when to ask them. It also describes recognizing occupational or environmental disease clusters or outbreaks. The chapter describes in detail the options that health and safety professionals have for implementing and facilitating preventive measures, including substitution of hazardous substances, installation of engineering controls, changes in job design and work practices and organization, education and training, use of personal protective equipment, and screening surveillance. Prevention options are discussed both at the individual and organizational levels.
New Solutions: A Journal Of Environmental And Occupational Health Policy, May 8, 2021
Grocery store workers are essential workers, but often have not been provided with appropriate pr... more Grocery store workers are essential workers, but often have not been provided with appropriate protection during the current pandemic. This report describes efforts made by one union local to protect workers, including negotiated paid sick leave and specific safety practices. Union representatives from 319 stores completed 1612 in-store surveys to assess compliance between 23 April 2020 and 31 August 2020. Employers provided the union with lists of workers confirmed to have COVID-19 infection through 31 December 2020. Worker infection rates were calculated using store employees represented by the union as the denominator and compared to cumulative county infection rates; outcome was dichotomized as rates higher or lower than background rates. Restrictions on reusable bags and management enforcement of customer mask usage were most strongly associated with COVID-19 rates lower than rates in the surrounding county. Stores that responded positively to worker complaints also had better outcomes. The union is currently engaging to promote improved ventilation and vaccination uptake.
Journal of Occupational and Environmental Medicine, Jul 8, 2021
Climate change is an urgent challenge amplified by socioeconomic factors that demands thoughtful ... more Climate change is an urgent challenge amplified by socioeconomic factors that demands thoughtful public health responses from OEM professionals. This guidance statement from the American College of Occupational and Environmental Medicine focuses on the different strategies that these health professionals can implement to protect workers from health impacts associated with climate change hazards, foster workplace resilience in the face of rapidly changing environments, and take the necessary steps to mitigate the effects of global climate change.
Journal of Occupational and Environmental Medicine, Sep 1, 2018
Objective: To address the gap of knowledge about slips, trips, and falls (STFs) among home care a... more Objective: To address the gap of knowledge about slips, trips, and falls (STFs) among home care aides (HCAs) who work in clients' homes. Methods: This mixed method study used survey and focus group data of HCAs in a Medicaid-funded homecare program. Results: STFs were common with over 12% of HCAs reporting occurrence in the previous 12 months, of whom 58% fell to the ground. Both survey and focus group data identified ice, clutter, workload, rushing and other hazards. Focus group data explained the reasons for not reporting STFs, even among those who sustained injury, and added HCAs' voices to the understanding of causes, consequences and prevention strategies for STFs. Conclusions: Empowering HCAs with knowledge, training, and involvement may transform ''near miss'' STFs into opportunities to prevent STFs among care workers and their clients.
Occupational safety and health has a profound impact on individuals, families, communities, and s... more Occupational safety and health has a profound impact on individuals, families, communities, and societies. This article briefly outlines types of hazards and the resulting burden of fatal and nonfatal illness and injury in the context of vulnerable working populations and the changing context of work, including the globalization of work and migration of labor, growth in precarious working arrangements, and specific problems faced by workers at both age extremes. It describes a public health approach anchored in comprehensive programs driven by data and based in management leadership and employee participation. The role of government to provide services and enforce responsibilities is described using examples drawn primarily from the United States, as is the past and potentially future positive role played by labor unions.
Journal of Occupational and Environmental Medicine, Jun 1, 2004
Page 1. Terrorism and Public Health: A Balanced Approach to Strengthening Systems and Protecting ... more Page 1. Terrorism and Public Health: A Balanced Approach to Strengthening Systems and Protecting People BARRY S. LEVY VICTOR W. SIDEL, Editors OXFORD UNIVERSITY PRESS Page 2. Terrorism and Public Health Page 3. This page intentionally left blank Page 4. ...
American Journal of Industrial Medicine, Jun 5, 2019
In 1985, the Sheet Metal Workers International Association and the Sheet Metal and Air Conditioni... more In 1985, the Sheet Metal Workers International Association and the Sheet Metal and Air Conditioning National Association formed The Sheet Metal Occupational Health Institute Trust to examine the health hazards of the sheet metal industry in the United States and Canada. Between 1986 and 2004, 18,211 individuals were examined. The mean age of this cohort was 57.9 years, and the participants had worked for a mean (؎ SD) duration of 32.9 ؎ 6 years in the sheet metal trade. Twenty-three percent of participants were current smokers, 49% were former smokers, and 28% were never-smokers. A total of 9.6% of participants (1,745 participants) had findings that were consistent with parenchymal disease (International Labor Organization [ILO] score, > 1/0); 60% of those with an ILO score > 1/0 were classified as 1/0, 34% as 1/1 to 1/2, and 6% as > 2/1. A total of 21% of participants (3,827 participants) had pleural scarring. There was a lower prevalence of nonmalignant asbestos-related disease among those who began to work after 1970, when compared to workers who began to work before 1949; those who began to work between 1950 and 1969 had a prevalence between the other two groups. The strongest predictor of both parenchymal and pleural disease on a chest radiograph was the calendar year in which the worker began sheet metal work; work in a shipyard was also an important risk. The results of this study suggest that the efforts to reduce asbestos exposure in the 1980s through strengthened Occupational Safety and Health Administration regulation have had a positive public health impact.
Occupational and environmental health covers a wide spectrum and presents many challenges and opp... more Occupational and environmental health covers a wide spectrum and presents many challenges and opportunities. This chapter describes categories of occupational and environmental hazards, the nature and magnitude of problems, the contexts in which occupational and environmental health problems occur, and the prevention of occupational and environmental disease and injury. In addition, the chapter covers the changing nature of work and the workforce, evolving roles of government, liability, climate change, new directions for research, and economic globalization. It also discusses additional challenges for low- and middle-income countries. A final section of the chapter describes disciplines and careers in occupational and environmental health sciences and basic sources of information.
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Papers by Rosemary Sokas