Assess the effect of non-pharmaceutical interventions at work on noise exposure or occupational hearing loss compared to no or alternative interventions. Pubmed, Embase, Web of Science, OSHupdate, Cochrane Central and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched. Randomized Controlled Trials (RCT), Controlled Before-After studies (CBA) and Interrupted Time-Series studies (ITS) evaluating engineering controls, administrative controls, personal hearing protection devices, and hearing surveillance were included. Case studies of engineering controls were collected. Cochrane methods for systematic reviews, including meta-analysis, were followed. 29 studies were included. Stricter legislation can reduce noise levels by 4.5 dB(A) (very low-quality evidence). Engineering controls can immediately reduce noise (107 cases). Eleven RCTs and CBA studies (3725 participants) were evaluated through Hearing Protection Devices (HPDs). Training of earplug insertion reduces noise exposure at short term follow-up (moderate quality evidence). Earmuffs might perform better than earplugs in high noise levels but worse in low noise levels (very low-quality evidence). HPDs might reduce hearing loss at very long-term follow-up (very low-quality evidence). Seventeen studies (84028 participants) evaluated hearing loss prevention programs. Better use of HPDs might reduce hearing loss but other components not (very low-quality evidence). Hearing loss prevention and interventions modestly reduce noise exposure and hearing loss. Better quality studies and better implementation of noise control measures and HPDs is needed.
Study Design A prospective experimental study. Objectives To investigate the potential of serum keratan sulfate (KS) as an indicator of biochemical changes in intervertebral discs induced by physical loading of the back. Background By providing objective information on exposure and effects at the tissue level, biomarkers may enable us to improve our understanding of the intermediate steps between exposure to physical loading and the occurrence of back disorders. Serum KS has been proposed as a potential biomarker of the molecular changes in intervertebral discs that occur because of physical loading and are a potential cause of back disorders. Methods and Measures Thirty-two nonimpaired men volunteers with a mean age of 22.5 ± 2.3 years participated in the experimental condition, a manual lifting task, as well as in the control condition, lying on the back. Serum KS levels were measured immediately before and after both conditions, as well as 24 hours and 1 week later. Results No significant changes in serum KS levels were found after exposure to physical loading (mean ± SD serum KS before, 287.4 ± 83.9 ng/mL; immediately after, 279.5 ± 65.5 ng/mL; 24 hours after, 266.6 ± 71.9 ng/mL; and 1 week after, 268.9 ± 79.3 ng/mL), and no significant changes were found after lying on the back for 8 hours (mean ± SD serum KS before, 273.0 ± 94.3 ng/mL; immediately after, 261.6 ± 68.9 ng/mL; 24 hours after, 277.3 ± 68.9 ng/mL; and 1 week after, 274.5 ± 68.5 ng/mL). Conclusions These results indicate that the serum KS level is not suitable as a biomarker of the effects of short-term physical loading of the back induced by a manual lifting task. J Orthop Sports Phys Ther 2001;31:472–480.
Changes in working conditions give rise to new occupational health risks and work-related diseases (WRDs). Monitoring these new WRDs is essential for their early recognition and prevention and requires a comprehensive approach, using several complementary methods. The aim of this review is to provide an overview and basic typology of different approaches to detect new/emerging WRDs.
Methods
We conducted an extensive scientific literature search combining terms for the following three concepts: surveillance/reporting systems; occupational/work–related diseases; and new or emerging risks. In addition, a grey literature search was performed of both grey literature databases and relevant EU and research institute websites for additional resources.
Results
We identified a total of 75 surveillance systems from 26 different countries. We set up a basic typology of these systems dividing them into four main groups. Compensation-based systems (n=22) were designed to gather data for compensation purposes and are insurance-driven. Non-compensation-related systems (n=34) were created with the aim of improving the collection and analysis of data to measure trends in occupational and work-related diseases. Sentinel systems (n=12) were specifically designed to provide a warning signal that will initiate health interventions and preventive actions. Finally, public health surveillance systems (n=7) aim to monitor the health of the general population, but can also be used for work-related surveillance. These four main types further differed in terms of disease coverage, means of data collection, evaluation of work-relatedness, follow-up of new/emerging risks, link with prevention etc.
Conclusion
Sentinel systems seem to have the most suitable approach to detect and alert to new/emerging WRDs. Nevertheless, systems identified in the other three groups can also contribute to identifying new/emerging WRDs, despite being primarily designed for other purposes.
OBJECTIVES: To assess if the implementation of guidelines for occupational rehabilitation of patients with low back pain by means of process variables--a set of objective criteria for technical performance and continuity of care--led to a better outcome in clinical and return to work variables. METHODS: The study group consisted of 59 patients with at least 10 days of sick leave because of low back pain. Univariate analyses as well as multiple logistic regression and Cox's regression analyses were performed to assess the relation between quality of care and outcome. RESULTS: Process indicators for technical competence, continuity of care, and total performance were all significantly related to satisfaction of employees. Continuity of care and total performance were significantly related to working status at 3 months, and time to return to work. None of the process indicators was related to pain or disability after 3 months follow up. Satisfaction was not related to any of the other outcome variables. This indicates that if guidelines for occupational rehabilitation are met, outcome is better. CONCLUSION: Quality of the process of care was related to outcome. Interventions of occupational physicians need improvement in the areas of continuity of care and communication with treating physicians. The effectiveness of an improved intervention should be studied in a subsequent randomised clinical trial.
In this issue: Global poverty reduction via expanding opportunities; by Timothy Besley, Robin Burgess, and David Donaldson. Interview with Alberto Alesina. Good_bye Lenin (or not)? The effect of communism on people's preferences for redistribution; by Alberto Alesina and Nicola Fuchs_Schuendeln. Economic growth, income distribution and poverty in Poland during transition; by Pierella Paci, Marcin J. Sasin, and Jos Verbeek. Latin America 1980_2005: institutions, growth and poverty; by Alvaro Garcia. Microlending to vulnerable groups: evidence from a recent UNDP survey; by Andrey Ivanov. Labor market distortions, rural_urban inequality and the opening of China's economy ; byThomas Hertel, Fan Zhai. Urban poverty in Russia and social assistance to the urban poor; by Anastasia Alexandrova and Elena Grishina. Adjustment costs of trade liberalization for the Russian labor market; by Irina Denisova. Poverty effects of Russia's WTO accession; by Thomas Rutherford, David Tarr, and Oleksandr Shepotylo. Assessing legal systems: a catalyst for reform ; byMichel Nussbaumer. Family background and schooling outcomes in the Baltic countries; by Mihails Hazans, Olga Rastrigina and Ija Trapeznikova. A troubled country? By Preston Smith
Objectives To determine whether advice and training on working techniques and lifting equipment prevent back pain in jobs that involve heavy lifting. Data sources Medline, Embase, CENTRAL, Cochrane Back Group’s specialised register, CINAHL, Nioshtic, CISdoc, Science Citation Index, and PsychLIT were searched up to September-November 2005. Review methods The primary search focused on randomised controlled trials and the secondary search on cohort studies with a concurrent control group. Interventions aimed to modify techniques for lifting and handling heavy objects or patients and including measurements for back pain, consequent disability, or sick leave as the main outcome were considered for the review. Two authors independently assessed eligibility of the studies and methodological quality of those included. For data synthesis, we summarised the results of studies comparing similar interventions. We used odds ratios and effect sizes to combine the results in a meta-analysis. Finally, we compared the conclusions of the primary and secondary analyses. Results Six randomised trials and five cohort studies met the inclusion criteria. Two randomised trials and all cohort studies were labelled as high quality. Eight studies looked at lifting and moving patients, and three studies were conducted among baggage handlers or postal workers. Those in control groups received no intervention or minimal training, physical exercise, or use of back belts. None of the comparisons in randomised trials (17 720 participants) yielded significant differences. In the secondary analysis, none of the cohort studies (772 participants) had significant results, which supports the results of the randomised trials. Conclusions There is no evidence to support use of advice or training in working techniques with or without lifting equipment for preventing back pain or consequent disability. The findings challenge current widespread practice of advising workers on correct lifting technique.
Abstract Background Evidence synthesis in the field of occupational safety and health (OSH) has been continuously growing over the last two decades. With over 100 systematic reviews now published, the Cochrane Work Review group has played an important role in this development and the Cochrane Thematic Group ‘Work & Health & Social Security’ was established recently to combine evidence from both the OSH and insurance medicine fields. Worldwide, many organizations produce and synthesize evidence in OSH that can complement and support each other. We believe that a global network including Cochrane and others can collaborate on methods development and in the production, synthesis, use and dissemination of different types of evidence even more effectively. Aims To determine if establishing a global network for evidence synthesis in OSH is feasible. Methods We conducted a survey of international and national institutions between November 2022 and January 2023 using LimeSurvey. Participants included representatives of affiliated and sustaining members of the International Commission on Occupational Health, national institutes for OSH, academia and other international organizations. Results From 151 invitations, we received responses from 57 representatives of 54 organizations. Representatives reported that their organization will contribute financially on an annual basis (n = 1) or provide in-kind support (n = 10), and will probably be able to provide financial or in-kind support (n = 25). Conclusions The feasibility criterion was met and an international network is being established.
