Postoffer Pre-Placement Screening for Carpal Tunnel Syndrome in Newly Hired Manufacturing Workers

OBJECTIVE: We determined the predictive validity of a post-offer pre-placement (POPP) screen using nerve conduction velocity studies (NCV) to identify future cases of carpal tunnel syndrome (CTS). METHODS: A cohort of 1648 newly hired manufacturing production workers underwent baseline NCS, and were followed for 5 years. RESULTS: There was no association between abnormal POPP NCV results and incident CTS. Varying NCV diagnostic cut-offs did not improve predictive validity. Workers in jobs with high hand/wrist exposure showed greater risk of CTS than those in low exposed jobs (Relative Risk 2.82; 95% CI 1.52, 5.22). CONCLUSIONS: POPP screening seems ineffective as a preventive strategy for CTS

Functional Measures Developed for Clinical Populations Identified Impairment Among Active Workers with Upper Extremity Disorders

PURPOSE: Few studies have explored measures of function across a range of health outcomes in a general working population. Using four upper extremity (UE) case definitions from the scientific literature, we described the performance of functional measures of work, activities of daily living, and overall health. METHODS: A sample of 573 workers completed several functional measures: modified recall versions of the QuickDASH, Levine Functional Status Scale (FSS), DASH Work module (DASH-W), and standard SF-8 physical component score. We determined case status based on four UE case definitions: 1) UE symptoms, 2) UE musculoskeletal disorders (MSD), 3) carpal tunnel syndrome (CTS), and 4) work limitations due to UE symptoms. We calculated effect sizes for each case definition to show the magnitude of the differences that were detected between cases and non-cases for each case definition on each functional measure. Sensitivity and specificity analyses showed how well each measure identified functional impairments across the UE case definitions. RESULTS: All measures discriminated between cases and non-cases for each case definition with the largest effect sizes for CTS and work limitations, particularly for the modified FSS and DASH-W measures. Specificity was high and sensitivity was low for outcomes of UE symptoms and UE MSD in all measures. Sensitivity was high for CTS and work limitations. CONCLUSIONS: Functional measures developed specifically for use in clinical, treatment-seeking populations may identify mild levels of impairment in relatively healthy, active working populations, but measures performed better among workers with CTS or those reporting limitations at work

Worksite influences on obesogenic behaviors in low-wage workers in St Louis, Missouri, 2013-2014

INTRODUCTION: More than one-third of US adults are obese. Workplace programs to reduce obesity and improve overall health are not available or accessible to all workers, particularly low-wage workers among whom obesity is more prevalent. The goal of the study was to identify modifiable workplace factors and behaviors associated with diet and exercise to inform future workplace interventions to improve health. METHODS: We distributed paper and online surveys to 2 groups of low-wage workers, hospital workers and retail sales workers, at the worksites. The surveys assessed obesity, obesogenic behaviors, workplace factors, and worker participation in workplace health programs (WHPs). Descriptive and regression analyses were conducted to examine workplace factors associated with obesogenic behaviors. RESULTS: A total of 529 surveys were completed (219 hospital workers and 310 retail workers). More than 40% of workers were obese and 27% were overweight. In general, workers had poor diets (frequent consumption of sugary and high-fat foods) and engaged in little physical activity (only 30.9% met recommended physical activity guidelines). Access to and participation in workplace health programs varied greatly between hospital and retail sales workers. We identified several modifiable workplace factors, such as food source and work schedule, that were associated with diet, exercise, or participation in workplace health programs. CONCLUSION: This study illustrates the high prevalence of obesity and obesogenic behaviors workers in 2 low-wage groups. The differences between work groups indicated that each group had unique facilitators and barriers to healthy eating and exercise. An understanding of how socioeconomic, demographic, and work-related factors influence health will help to identify high-risk populations for intervention and to design interventions tailored and relevant to the target audiences

Reliability of hand diagrams for the epidemiologic case definition of carpal tunnel syndrome

INTRODUCTION: The purpose of this study was to evaluate the inter-rater reliability of hand diagrams, which are commonly used in research case definitions of carpal tunnel syndrome (CTS). To evaluate the potential of non-random misclassification of cases, we also studied predictors of rater disagreement as a function of personal and work factors, and of hand symptoms not classic for CTS. METHODS: Participants in a longitudinal study investigating the development of CTS completed repeated self-administered questionnaires. Three experienced clinicians, blind to subjects’ work or personal history, independently rated all hand diagrams on an ordinal scale from 0 to 3. Disagreements between ratings were resolved by consensus. Reliability was measured by the weighted kappa statistic. Logistic regression models evaluated predictors of disagreement. RESULTS: Three hundred and thirty-three subjects completed 494 hand diagrams. Eighty-five percent were completed by self-administered questionnaire and 15% by telephone interview. Weighted kappa values representing agreement among the three raters, were 0.83 (95% CI: 0.78, 0.87) for right hand diagrams and 0.88 (95% CI: 0.83, 0.91) for left hand diagrams. Ratings from hand diagrams obtained by telephone interview produced better agreement. Agreement among raters was not affected by subjects’ personal or work factors. Disagreement among raters was associated with the presence of hand/wrist symptoms other than classic CTS symptoms. CONCLUSIONS: Overall, high levels of agreement were attained by independent raters of hand diagrams. Personal factors did not affect agreement among raters, but presence of non-CTS symptoms seemed to affect results and should be considered in studies focused on diverse populations with heterogeneity of upper extremity symptoms

Assessing agreement of self-reported and observed physical exposures of the upper extremity

Assessment of workplace physical exposures by self-reported questionnaires has logistical advantages in population studies but is subject to exposure misclassification. This study measured agreement between eight self-reported and observer-rated physical exposures to the hands and wrists, and evaluated predictors of inter-method agreement. Workers (n=341) from three occupational categories (clerical/technical, construction, and service) completed self-administered questionnaires and worksite assessments. Analyses compared self-reported and observed ratings using a weighted kappa coefficient. Personal and psychosocial factors, presence of upper extremity symptoms and job type were evaluated as predictors of agreement. Weighted kappa values were substantial for lifting (0.67) and holding vibrating tools (0.61), moderate for forceful grip (0.58) and fair to poor for all other exposures. Upper extremity symptoms did not predict greater disagreement between self-reported and observed exposures. Occupational category was the only significant predictor of inter-method agreement. Self-reported exposures may provide a useful estimate of some work exposures for population studies

Enhancing workplace wellness efforts to reduce obesity: A qualitative study of low-wage workers in St Louis, Missouri, 2013-2014

INTRODUCTION: The objective of this study was to examine workplace determinants of obesity and participation in employer-sponsored wellness programs among low-wage workers. METHODS: We conducted key informant interviews and focus groups with 2 partner organizations: a health care employer and a union representing retail workers. Interviews and focus groups discussed worksite factors that support or constrain healthy eating and physical activity and barriers that reduce participation in workplace wellness programs. Focus group discussions were transcribed and coded to identify main themes related to healthy eating, physical activity, and workplace factors that affect health. RESULTS: Although the union informants recognized the need for workplace wellness programs, very few programs were offered because informants did not know how to reach their widespread and diverse membership. Informants from the health care organization described various programs available to employees but noted several barriers to effective implementation. Workers discussed how their job characteristics contributed to their weight; irregular schedules, shift work, short breaks, physical job demands, and food options at work were among the most commonly discussed contributors to poor eating and exercise behaviors. Workers also described several general factors such as motivation, time, money, and conflicting responsibilities. CONCLUSION: The workplace offers unique opportunities for obesity interventions that go beyond traditional approaches. Our results suggest that modifying the physical and social work environment by using participatory or integrated health and safety approaches may improve eating and physical activity behaviors. However, more research is needed about the methods best suited to the needs of low-wage workers

Exposure to COVID-19 patients increases physician trainee stress and burnout

The coronavirus disease 2019 (COVID-19) pandemic has put considerable physical and emotional strain on frontline healthcare workers. Among frontline healthcare workers, physician trainees represent a unique group-functioning simultaneously as both learners and caregivers and experiencing considerable challenges during the pandemic. However, we have a limited understanding regarding the emotional effects and vulnerability experienced by trainees during the pandemic. We investigated the effects of trainee exposure to patients being tested for COVID-19 on their depression, anxiety, stress, burnout and professional fulfillment. All physician trainees at an academic medical center (n = 1375) were invited to participate in an online survey. We compared the measures of depression, anxiety, stress, burnout and professional fulfillment among trainees who were exposed to patients being tested for COVID-19 and those that were not, using univariable and multivariable models. We also evaluated perceived life stressors such as childcare, home schooling, personal finances and work-family balance among both groups. 393 trainees completed the survey (29% response rate). Compared to the non-exposed group, the exposed group had a higher prevalence of stress (29.4% vs. 18.9%), and burnout (46.3% vs. 33.7%). The exposed group also experienced moderate to extremely high perceived stress regarding childcare and had a lower work-family balance. Multivariable models indicated that trainees who were exposed to COVID-19 patients reported significantly higher stress (10.96 [95% CI, 9.65 to 12.46] vs 8.44 [95% CI, 7.3 to 9.76]; P = 0.043) and were more likely to be burned out (1.31 [95% CI, 1.21 to1.41] vs 1.07 [95% CI, 0.96 to 1.19]; P = 0.002]. We also found that female trainees were more likely to be stressed (P = 0.043); while unmarried trainees were more likely to be depressed (P = 0.009), and marginally more likely to have anxiety (P = 0.051). To address these challenges, wellness programs should focus on sustaining current programs, develop new and targeted mental health resources that are widely accessible and devise strategies for creating awareness regarding these resources

Occupation and workplace policies predict smoking behaviors: Analysis of national data from the current population survey

OBJECTIVE: Describe differences in smoking behaviors associated with occupation, workplace rules against smoking, and workplace smoking cessation programs. METHODS: We analyzed data from the Current Population Survey- Tobacco Use Supplement surveys from 1992 through 2007. RESULTS: After adjusting for demographic factors, blue-collar workers were at higher risk than white-collar workers for ever smoking, current smoking, and persistent smoking (current smoking among ever smokers). Construction workers were more likely to be current daily smokers than other blue-collar workers. Among ever smokers, current daily smoking was more common in the absence of both workplace rules against smoking and workplace smoking cessation programs. CONCLUSIONS: Social or cultural effects related to occupation are important determinants of smoking. More aggressive promotion of smoking cessation programs and workplace rules prohibiting smoking could have a significant public health impact

Vivências e envolvimento acadêmico de estudantes universitários : adaptação e validação de escalas para a sua avaliação

Este artículo describe los procesos preliminares de adaptación y validación de dos instrumentos diseñados para describir Vivencias Académicas (centradas en la satisfacción) y la Implicación Académica (centrada en el compromiso) en estudiantes universitarios. De acuerdo con la literatura científica en el área, las vivencias y la implicación académica se encuentran asociadas con las dificultades relacionadas al abandono de los alumnos. Para este estudio se aplicaron dos cuestionarios a 261 estudiantes pertenecientes a la Universidad de Concepción, Campus Los Ángeles, Chile. Ambos instrumentos mostraron niveles adecuados de homogeneidad o consistencia interna en los ítems repartidos para las subescalas de cada cuestionario. Paralelamente, se calcularon las correlaciones entre las dimensiones de ambos cuestionarios, siendo los coeficientes obtenidos adecuados para los constructos evaluados. Estos antecedentes permiten el comienzo de la validación de los cuestionarios en estudio.This paper presents preliminary findings regarding the adaptation and validation of two instruments designed to measure Academic Experiences (centred on satisfaction) and Academic Involvement in university students. Previous research has shown that academic experience and involvement are strongly correlated with student drop-out rates. For the present study, the two surveys were administered to 261 students at the University of Concepción, Chile, on the Los Ángeles campus. Both instruments showed suitable levels of reliability and internal consistency on the subscales. Furthermore, the correlation coefficients obtained when comparing dimensions on each survey were acceptable for the constructs being evaluated. These findings allow for a preliminary validation of the two questionnaires included in the study.Descrevem-se os processos preliminares de adaptação e validação de dois instrumentos voltados para a avaliação das Vivências Acadêmicas (centradas na satisfação) e da Implicação Acadêmica (centrada no compromisso) de estudantes universitários. Conforme a literatura científica na área, vivências e implicação acadêmica encontram-se associadas às dificuldades relacionadas ao abandono dos alunos. Este estudo envolveu a aplicação dos dois questionários a 261 estudantes da Universidade de Concepción, campos Los Angeles, Chile. Ambos os instrumentos mostram níveis adequados de homogeneidade ou consistência interna dos itens divididos em subescalas, em cada questionário. Paralelamente, calculam-se as correlações entre as dimensões dos questionários, sendo os coeficientes obtidos adequados aos constructos avaliados. Estes antecedentes permitem o início da validação dos questionários em estudo.Red de Revistas Científicas de América Latina, el Caribe, España y Portugal Sistema de Información CientíficaUniversidad Austral de Chile Valdivia, Chil