Purpose: The aim of this study was to investigate whether rotating shift work increases occupational stress in nurses. Methods: This study measured shift work scheduling and occupational stress by using the Effort-Reward Imbalance model with self-reported questionnaires in a sample of 654 female nurses. Results: Overcommitment risk was higher in nurses who worked rotating shifts than in those who worked day/non-night shifts (OR, 2.16; 95% CI, 1.03–4.66). However, an effort/reward imbalance was not directly associated with work schedules (OR, 1.88; 95% CI, 0.87–4.35). Among nurses working rotation rotating shifts, those who had 2 days off after their most recent night shifts showed an alleviated risk of overcommitment (OR, 0.52; 95% CI, 0.32–0.82), but those who had worked for at least one series of 7 consecutive work days per month had an increased risk of effort/reward imbalance (OR, 2.75; 95% CI, 1.69–4.48). Additionally, those who had little or no participation in planning working hours and shift scheduling and worked overtime at least three times per week during the preceding 2 months tended to have high stress. Conclusions: The nurses who worked rotating shifts tended to experience work-related stress, but their stress levels improved if they had at least 2 days off after their most recent night shift and if they were not scheduled to work 7 consecutive days. These empirical data can be used to optimize work schedules for nurses to alleviate work stress.(J Occup Health 2015; 57: 307–315)
Objectives: We evaluated factors associated with increased radiation exposure dose in nursing staff who assisted patients with 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) examinations. Methods: The Barthel Index and Mini-Mental State Examination (MMSE) score were obtained before PET/CT examinations in 193 patients (mean age ± SD, 77.7 ± 8.0 yr). Three nurses self-measured their radiation exposure dose while assisting patients during each PET examination. Disturbance factors during PET examinations (use of a stretcher or wheelchair, use of lines or tubes connected to the patient, use of diapers or urethral catheterization, patient age), 18F-FDG injection dose, and previous PET/CT experience in the patients and outpatient or inpatient status were evaluated as factors possibly associated with increased radiation exposure. Principle component analysis, univariate analysis, and multivariate regression analysis were used for assessing associations between radiation exposure dose and factors. Results: The mean radiation exposure dose of the nursing staff was 6.07 ± 5.71 µSv per examination. Statistically significant factors associated with increased radiation exposure (<8 or ≥8 µSv/case) in the univariate analysis were the Barthel Index (<75 or ≥75), MMSE score (<22 or ≥22) of the patients, numbers of lines or tubes to the patient, use of a stretcher or wheelchair, and 18F-FDG injection dose. Multivariate logistic regression modeling showed that the Barthel Index (<75 or ≥75) and MMSE score (<22 or ≥22) of the patients were significant factors in the final model. Conclusions: Lower Barthel Indexes (lower ADL) and lower MMSE scores (lower cognitive function) were independent factors associated with increased radiation exposure dose in nursing staff assisting during 18F-FDG PET/CT.(J Occup Health 2015; 57: 316–323)
Objectives: Professional drivers are exposed to diesel engine exhaust and outdoor air pollution while driving. Diesel engine exhaust and outdoor air pollution are known carcinogens causing lung cancer. However, previous epidemiological studies examining lung cancer risk in professional drivers have not shown a consistent association. In the present study, we evaluated lung cancer risk among Korean professional drivers. Methods: Subjects consisted of male drivers aged 30–59 registered in the Korea Central Cancer Registry for lung cancer between 1999 and 2011. Proportionate cancer incidence ratios (PCIRs) for lung cancer were calculated and indirectly age standardized with the male general population. Additional PCIRs were calculated by indirectly adjusting for the effect of cigarette smoking. Results: The PCIR for lung cancer in professional drivers during the study period increased significantly (1.20, 95% CI: 1.13–1.26). The increased risk was generally consistent throughout study years and age categories. Adjusting for the effect of cigarette smoking did not change the significance of the associations (1.09, 95% CI: 1.03–1.15). Conclusions: Our findings support an association between lung cancer and driver jobs in the Korean male population. However, the association should be further evaluated in a study with a longitudinal design and a quantitative exposure assessment.(J Occup Health 2015; 57: 324–330)
Objectives: The aim of this study was to reveal factors related to heat illness in radiation decontamination workers and determine effective preventive measures. Methods: A self-administered questionnaire was sent to 1,505 radiation decontamination workers. The questionnaire included age, sex, duration of decontamination work, previous occupation, education provided by employers regarding heat illness, preventive action against heat illness, and subjective symptoms of heat illness during work. We included 528 men, who replied and answered all questions, in the statistical analysis. Subjective symptoms of heat illness were categorized as “no symptoms”, “Grade I” and “Grade II” according to severity. A multiple linear regression model was used to determine the factors associated with the severity of heat illness. Results: The mean age of the subjects was 47.6 years old (standard deviation: 13.4). Of the 528 workers, 316 (59.8%) experienced heat illness symptoms (213 at Grade I and 103 at Grade II). The results of the stepwise selection revealed that age, outdoor manual labor, adequate sleep, use of a cool vest, and salt intake were selected as preventive factors, whereas living in a company dormitory or temporary housing, wearing light clothing, and consuming breakfast were selected as risk factors for heat illness. Conclusions: Both working conditions and living environment are associated with heat illness in radiation decontamination workers. Type of housing and sleep are also strongly related to heat illness during work. Employers should consider not only the working conditions of the employee but also the employee's daily living conditions, in order to prevent heat illness.(J Occup Health 2015; 57: 331–338)
Objectives: The objective of this study was to compare Control of Substances Hazard to Health (COSHH) Essentials (a chemical risk assessment method in the UK) with Chemical Hazard Risk Management (CHARM) (a chemical risk assessment method in South Korea). The differences between the two processes were explored with a particular focus on their features and distinctions. Methods: The results obtained from applying COSHH Essentials and CHARM to 59 carcinogenic, mutagenic, and reprotoxic (CMR) substances were analyzed. The outcomes of the working environment assessments and the collated information about the usage of CMR chemicals were used for the analysis. Results: Among the 59 substances tested, 56 substances were rated at a risk level lower than 2, when evaluated with CHARM. However, with COSHH, all 59 substances were rated at risk level 3 or higher. With COSHH Essentials, the highest hazard group of 4 was automatically assigned to category E substances, regardless of the exposure level assessment. However, for CHARM, the risk could be adjusted according to the exposure level assessment, even for hazard group of 4. Conclusions: CHARM allocated lower risk levels to hazardous substances than COSHH Essentials. Ultimately, COSHH Essentials assesses exposure level through the physical properties and overall handling, and considers hazard with H-statements and R-phrases. COSHH Essentials was deemed more conservative than CHARM. CHARM may have underestimated the risk according to exposure level, even though the chemicals were highly hazardous. Therefore, CHARM can be used for the localized risk assessment of chemicals used in individual workplaces.(J Occup Health 2015; 57: 339–345)
Objectives: Indium was added to the list of substances regulated by the Ordinance on Prevention of Hazards due to Specified Chemical Substances (OPHSCS) in 2013. Indium metal (IM), however, is not regulated by the OPHSCS due to insufficient information on pulmonary effects following exposure. Methods: From 2011 to 2013, a cross-sectional study was conducted on 141 IM-exposed workers at 11 factories. Subjective symptoms were assessed, including levels of serum biomarkers, spirometry readings and total and diffuse lung capacity. Krebs von den Lungen-6 (KL-6) and surfactant protein D (SP-D) were selected as biomarkers of interstitial pneumonia. Indium serum concentration (In-S) and personal air sampling data were used to estimate exposure. Subjects were categorized into 5 groups based on occupation and type of exposure: smelting, soldering, dental technician, bonding and other. Results: The highest level of In-S was 25.4 µg/l, and the mean In-S level was significantly higher in the smelting group than in other groups. In the smelting group, the prevalence of increased In-S levels was 9.1%, while that of abnormal KL-6 was 15.2%. A significant dose-effect relationship was observed between the In-S and KL-6 levels. No marked differences were observed between any of the groups in SP-D values, pulmonary symptoms, or pulmonary function test results. A total of 31% of the subjects worked in an environment with IM levels exceeding 0.3 µg/m3, which requires a protective mask to be worn. Conclusions: For workers exposed to IM, work environments should be monitored, appropriate protective masks should be worn, and medical monitoring should be conducted according to the OPHSCS.(J Occup Health 2015; 57: 346–352)
Objectives: The aim of this study was to reexamine the dimensionality of the widely used 9-item Utrecht Work Engagement Scale using the maximum likelihood (ML) approach and Bayesian structural equation modeling (BSEM) approach. Methods: Three measurement models (1-factor, 3-factor, and bi-factor models) were evaluated in two split samples of 1,112 health-care workers using confirmatory factor analysis and BSEM, which specified small-variance informative priors for cross-loadings and residual covariances. Model fit and comparisons were evaluated by posterior predictive p-value (PPP), deviance information criterion, and Bayesian information criterion (BIC). Results: None of the three ML-based models showed an adequate fit to the data. The use of informative priors for cross-loadings did not improve the PPP for the models. The 1-factor BSEM model with approximately zero residual covariances displayed a good fit (PPP>0.10) to both samples and a substantially lower BIC than its 3-factor and bi-factor counterparts. Conclusions: The BSEM results demonstrate empirical support for the 1-factor model as a parsimonious and reasonable representation of work engagement.(J Occup Health 2015; 57: 353–358)
Objectives: For several organic solvents (solvents in short), biological occupational exposure limits (BOELs) have been established for un-metabolized solvents in urine, based on the solvent exposure-urinary excretion relationship. This study was initiated to investigate the possibiliy of estimating a BOEL from the Pow (the partition coefficient between n-octyl alcohol and water), a physico-chemical parameter. Methods: Data were available in the literatures for exposure-excretion relationship with regard to 10 solvents for men and 7 solvents for women. Results: Statistical analysis revealed that the slopes (after correction for molecular weights and logarithmic conversion) of the exposure-excretion regression lines linearly correlated (p<0.01) with the log Pow values the respective solvents. No significant difference (p>0.05) was observed between men and women, and it was acceptable to combine the data for the two sexes. Thus the log Pow-log slope relation was represented by a single equation for both sexes. Based on the observations, procedures were established to estimate BOEL values from Pow. Successful estimations of BOELs for styrene, tetrahydrofuran and m-xylene (a representative of xylene isomers) were calculated as examples. Conclusions: The present study proposed promising procedures for estimation of a BOEL from the Pow.(J Occup Health 2015; 57: 359–364)
Objectives: The aim of the present study was to comparatively evaluate the usefulness of urinary cyclohexanediols (CHdiols-U) and cyclohexanol (CHol-U) as biomarkers of occupational exposure to cyclohexane (CH). Methods: Sixteen subjects (14 men and 2 women) were exposed to CH during proof-printing work. Personal exposure monitoring was conducted during the whole shift on the last working day of the week. The time-weighted average level of exposure to CH (CH-A) was measured using a diffusive sampler. Two urine samples were collected from each worker at different times during the same week: a baseline urine sample (before the first shift of the working week, after a 5-day holiday with no CH exposure) and an end-of-shift urine sample (after the last shift of the same working week, the same day personal exposure monitoring was conducted). CH-A, CHdiols-U and CHol-U were determined using a gas chromatograph-flame ionization detector. Results: The CH-A concentrations ranged from 4.5 to 60.3 ppm, with a geometric mean (GM) of 18.1 ppm. The GMs and ranges (in parenthesis) of the creatinine (cr)-corrected end-of-shift 1,2-CHdiol-U, 1,4-CHdiol-U and CHol-U concentrations were 12.1 (4.1–36.6), 7.5 (2.4–20.1) and 0.4 (0.2–1.0) mg/g cr, respectively. Both CHdiols-U at the end of the shift were significantly correlated with CH-A (correlation coefficients for 1,2-CHdiol-U and 1,4-CHdiol-U of 0.852 and 0.847, respectively). No correlation was observed between CH-A and CHol-U. Conclusions: CHdiols-U at the end of the last shift of the working week are suitable biomarkers of occupational exposure to CH, but CHol-U is not suitable.(J Occup Health 2015; 57: 365–370)
Objective: The purpose of this research was to develop and test the psychometric properties of the Thai version of the Work Ability Index (WAI). Methods: Forward translation and back-translation of the WAI were performed by seven bilingual professionals to ensure that the Thai WAI was culturally relevant and conceptually accurate. To ensure generalizability of the Thai WAI, a sample of 2,744 Thai workers from 19 different enterprises in five regions of Thailand completed the Thai version of the WAI along with the General Health Questionnaire. The 19 enterprises were from the following industries: canned food, snack food, cooking oil, footwear, pharmaceutical, ceramics, toy, steel, petrochemical, and auto parts. Results: The results from exploratory factor analysis supported a 3-factor model, accounting for 53.49% of the total variance. The results also provided evidence for adequate test-retest reliability and internal consistency of the Thai WAI. The internal consistency of the Thai WAI was found to be slightly low due to the newness of the concept of work ability, which is not a common term used in the Thai language; therefore, explanation of the meaning of work ability is needed to increase understanding of workers. Conclusions: By providing early recognition of workers' health risks as well as risks of early termination, the WAI can help Thai human resources managers respond better to the needs of workers and be proactive in their efforts to retain workers in their organizations. Occupational health professionals could also utilize the WAI to evaluate the work ability of Thai workers in order to help organizations recognize early signs of their workers' health risks and possible early terminations and respond appropriately.(J Occup Health 2015; 57: 371–377)
Objectives: The aims of this study were to clarify in detail the levels of whole-body vibration (WBV) exposure from a variety of agricultural machines in a rice farmer over one year, and to evaluate the daily level of exposure compared with European and Japanese threshold limits. Methods: The subject was a full-time, male rice farmer. We measured vibration accelerations on the seat pan and at the seat base of four tractors with various implements attached, one rice-planting machine, two combine harvesters, produced by the same manufacturer, and one truck used for transportation of agricultural machines. The position and velocity of the machines were recorded in parallel with WBV measurements. In addition, during the year starting in April 2010, the subject completed a questionnaire regarding his work (date, place, content, hours worked, machines used). We calculated the daily exposure to WBV, A(8), on all the days on which the subject used the agricultural machines. Results: The WBV magnitude in farm fields was relatively high during tasks with high velocity and heavy mechanical load on the machine, and had no dominant axis. The subject worked for 159 days using the agricultural machines during the year, and the proportion of days on which A(8) values exceeded the thresholds was 90% for the Japan occupational exposure limit and 24% for the EU exposure action value. Conclusions: Our findings emphasize the need for rice farmers to have health management strategies suited to the farming seasons and measures to reduce WBV exposure during each farm task.(J Occup Health 2015; 57: 378–387)
Objective: The aim of the present study was to investigate the association of one-year change in organizational justice (i.e., procedural justice and interactional justice) with job performance in Japanese employees. Methods: This study surveyed 425 men and 683 women from a manufacturing company in Japan. Self-administered questionnaires, including the Organizational Justice Questionnaire (OJQ), the World Health Organization Health and Work Performance Questionnaire (WHO-HPQ) and the scales on demographic characteristics, were administered at baseline (August 2009). At one-year follow-up (August 2010), the OJQ and WHO-HPQ were used again to assess organizational justice and job performance. The change in organizational justice was measured by dichotomizing each OJQ subscale score by median at baseline and follow-up, and the participants were classified into four groups (i.e., stable low, adverse change, favorable change and stable high). Analysis of covariance (ANCOVA) was employed. Results: After adjusting for demographic and occupational characteristics and job performance at baseline, the groups classified based on the change in procedural justice differed significantly in job performance at follow-up (ANCOVA: F [3, 1097]=4.35, p<0.01). Multiple comparisons revealed that the stable high procedural justice group had significantly higher job performance at follow-up compared with the stable low procedural justice group. The groups classified based on change in interactional justice did not differ significantly in job performance at follow-up (p>0.05). Conclusions: The present findings suggest that keeping the level of procedural justice high predicts higher levels of job performance, whereas the psychosocial factor of interactional justice is not so important for predicting job performance.(J Occup Health 2015; 57: 388–393)
Recommendation of Occupational Exposure Limits (2015-2016)
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