2015-02-01 12:00 - Messages

Enquêtes sur les accidents du travail et les maladies professionnelles

Le présent guide vise à fournir aux inspecteurs du travail les compétences nécessaires pour mener des enquêtes efficaces sur les accidents du travail, les maladies professionnelles et autres événements inattendus (tels les événements dangereux et les quasi-accidents/incidents), qui auraient pu causer des lésions corporelles aux travailleurs ou à la population. Il ne faut pas perdre de vue que les accidents du travail, les maladies professionnelles et autres événements inattendus sont évitables. Une enquête efficace permettra d'identifier non seulement les facteurs de causalité, mais aussi les mesures qui auraient pu empêcher l'événement de se produire.

Source: http://www.ilo.org/labadmin/info/pubs/WCMS_346715/lang--fr/index.htm

Primary selection into shift work and change of cardiovascular risk profile

Objectives A potential “healthy shift worker effect” may bias the studied effect of shift work on health. The observed differences among shift and day workers in health behavior and health outcomes can be caused by: (i) primary selection, (ii) the influence from the shift work-related environment, and (iii) the impact of shift work. We aimed to study these potential sources.
Methods A cohort of 4754 male trainees who had finished their professional training and started their career in production in a chemical company between 1995 and 2012 was identified. Among them, 1348 (28%) were involved in rotating shift work and 3406 (72%) in day work. Information on health behavior and risk factors for cardiovascular diseases was retrieved from the medical examinations. This information was then compared (i) at the beginning of training, (ii) at the end of training, and (iii) 3 years after the employment, in relation to the working time.
Results At the beginning of the training, the prevalence of smokers was higher among future shift workers (26% versus 21%), from 1995 to 2012. During the training and the first three years of employment, a marginal decline of systolic blood pressure and an elevation of triglyceride were related with shift work. No difference was found with respect to other risk factors for cardiovascular diseases.
Conclusions Our findings do not support a primary selection in favor of shift workers. An impact of shift work on the risk profile of cardiovascular diseases was not indicated in the observation period.

Source: Mei Yong M, Germann C, Lang S, Oberlinner C. Scand J Work Environ Health, 2015.  
http://dx.doi.org/10.5271/sjweh.3487

For What Illnesses Is a Disease Management Program Most Effective?

Objective: We examined the impact of a disease management (DM) program offered at the University of Minnesota for those with various chronic diseases.
Methods: Differences-in-differences regression equations were estimated to determine the effect of DM participation by chronic condition on expenditures, absenteeism, hospitalizations, and avoidable hospitalizations.
Results: Disease management reduced health care expenditures for individuals with asthma, cardiovascular disease, congestive heart failure, depression, musculoskeletal problems, low back pain, and migraines. Disease management reduced hospitalizations for those same conditions except for congestive heart failure and reduced avoidable hospitalizations for individuals with asthma, depression, and low back pain. Disease management did not have any effect for individuals with diabetes, arthritis, or osteoporosis, nor did DM have any effect on absenteeism.
Conclusions: Employers should focus on those conditions that generate savings when purchasing DM programs.

Source: Jutkowitz, Eric; Nyman, John A.; Michaud, Tzeyu L.; Abraham, Jean M.; Dowd, Bryan. Journal of Occupational & Environmental Medicine: February 2015, Volume 57, Issue 2, p. 117–123.
http://dx.doi.org/10.1097/JOM.0000000000000385

Impact of 12 h shift patterns in nursing

A scoping review
Objectives: To provide a comprehensive scoping review of evidence of the impact and effectiveness of 12 h shifts in the international nursing literature, supplemented by a review of evidence in other, non-nursing related industries.
Data sources: A search of the academic literature was undertaken in electronic databases (AMED, MEDLINE, CINAHL, PsychInfo, Scopus, HMIC, the Cochrane Library, Business Source Premier, Econ Lit, ASSIA and Social Policy and Practice).
Review methods: A total of 158 potentially relevant nursing research papers and reviews were published between 1973 and 2014. Two reviewers independently reviewed the articles, leaving 85 primary research studies and 10 review papers in the nursing field to be included in the scoping review. Thirty-one relevant primary research papers and reviews were also identified in the non-nursing related industries literature.
Results: Research into 12 h nursing shifts fell within five broad themes: ‘risks to patients', ‘patient experience', ‘risks to staff', ‘staff experience' and ‘impact on the organisation of work'. There was inconclusive evidence of the effects of 12 h shift patterns in all five themes, with some studies demonstrating positive impacts and others negative or no impacts. This also mirrors the evidence in other, non-nursing related industries. The quality of research reviewed is generally weak and most studies focus on the risks, experience and work/life balance for staff, with few addressing the impact on patient outcomes and experience of care or work productivity.
Conclusions: There is insufficient evidence to justify the widespread implementation or withdrawal of 12 h shifts in nursing. It is not clearly understood where there are real benefits and where there are real and unacceptable risks to patients and staff. More research focusing on the impact of 12 h nursing shifts on patient safety and experience of care and on the long term impact on staff and work organisation is required.

Source: Harris, Ruth, Sims, Sarah, Parr, Jenny, & Davies, Nigel. (2015). International Journal of Nursing Studies, 52(2), 605-634.
http://dx.doi.org/10.1016/j.ijnurstu.2014.10.014

Violence at work

The number and incidence rate of violent incidents at work has declined over the last decade.
Findings from the 2013/14 Crime Survey for England and Wales (CSEW) show that:
- the risk of being a victim of actual or threatened violence at work is similar to the last five years with an estimated 1.1% of working adults the victims of one or more violent incidents at work (CSEW)
- in 2013/14, the survey estimated 257 000 adults of working age in employment experienced work related violence including threats and physical assault
- there were an estimated 583 000 incidents of violence at work according to the 2013/14 CSEW, comprising 269 000 assaults and 314 000 threats. This was lower than the estimated 656 000 incidents in the 2012/13 survey but this change is not statistically significant.
- the 2013/14 CSEW estimated that 1.0% of women and 1.2% of men were victims of violence at work once or more during the year prior to their interview
- it is estimated that 56% of victims reported one incident of work related violence whilst 17% experienced two incidents of work related violence and 27% experienced three or more incidents
- strangers were the offenders in 56% of the reported incidents of workplace violence. Among the 44% of incidents where the offender was known, the offenders were most likely to be clients or a member of the public known through work.
- the survey found 72 % per cent of violence at work resulted in no physical injury. Of the remaining 28 % of cases, minor bruising or a black eye accounted for the majority of the injuries recorded.
- in 2013/14 there were 4 936 RIDDOR reports of injuries to employees involving acts of violence in Great Britain (one fatality, 866 major or specified injuries, and 4 069 over-7-day injuries). More information on over 7-day injuries is available.

Source: http://www.hse.gov.uk/Statistics/causinj/violence/index.htm

La santé psychologique et la performance au travail

Des liens longitudinaux bidirectionnels?
Bien que certains indicateurs d'attitude ou de vécu affectif aient été liés à la performance individuelle au travail, peu d'études se sont intéressées à ces liens au plan longitudinal. Les méthodes de recherches longitudinales sont pourtant pertinentes, considérant qu'ils permettent d'inférer la direction de la relation entre les variables. S'intéressant au concept bidimensionnel de santé psychologique au travail, composé de fort bien-être et de faible détresse, cette étude en panel a pour objectif de tester les relations entre la santé psychologique et la performance individuelle au travail. Un échantillon d'enseignants québécois (n = 153) est utilisé, avec deux mesures espacées d'un an. Les résultats des régressions hiérarchiques montrent que tant au sein du bien-être que de la détresse, c'est le volet ciblant la relation avec l'environnement social qui prédit la performance ultérieure. De plus, la performance prédit deux composantes du bien-être dans le temps : l'harmonie sociale et la sérénité. Cette étude suggère que la relation santé psychologique-performance est bidirectionnelle. Promouvoir de bonnes relations entre collègues peut être une bonne façon d'optimiser la performance future et bien performer pourrait favoriser le bien-être ressenti envers soi (sérénité) et les autres (harmonie sociale).

Source: Jean-Simon Leclerc, Jean-Sébastien Boudrias, André Savoie. Le travail humain, 2014/4.
http://dx.doi.org/10.3917/th.774.0351

An exploration of the current effectiveness of worker engagement practices in the quarry industry

This study was instigated by the Quarries National Joint Advisory Committee (QNJAC) on the basis that worker engagement practices were not perceived as widespread within the quarry industry. Thus, the present qualitative study explored how worker engagement in quarries is achieved and what makes it more challenging. Worker engagement is about going beyond workers' consultation. Workers and their representatives need to be involved in decisions in order for them to be committed to health and safety (H&S).
Findings suggest that a great deal of effort is made to engage quarries' workers in H&S. Management commitment to H&S plays a key role in workers' engagement. However, management visibility on site needs to occur more often to create or sustain workers' engagement. A variety of communication methods proved to be essential to engage workers in multiple ways and on a continuous basis but H&S messages need to be relevant to their audiences, and proportionate in quantity. Worker attitude to H&S has improved although resistance from some groups still persists. Safety representatives play an important role in increasing attention to H&S although their role could be better exploited in some workplaces and their training courses being better implemented.

Source: http://www.hse.gov.uk/research/rrhtm/rr1031.htm

Households as employers

Working conditions and job quality
This report gives an overview of working conditions, job quality, workers' health and job sustainability in the activities of households as employers of domestic personnel sector (NACE 97), referred to here as the households as employers sector. It is based mostly on the fifth European Working Conditions Survey (EWCS), which gathers data on working conditions and the quality of work across 34 European countries. Additional information on the structural characteristics of the sector is derived from Eurostat data. The fifth EWCS contains responses from 541 workers in this sector.

Source: http://eurofound.europa.eu/publications/information-sheet/2015/working-conditions/households-as-employers-working-conditions-and-job-quality

Total and Cause-Specific Mortality of U.S. Nurses Working Rotating Night Shifts

Background : Rotating night shift work imposes circadian strain and is linked to the risk of several chronic diseases.
Purpose : To examine associations between rotating night shift work and all-cause; cardiovascular disease (CVD); and cancer mortality in a prospective cohort study of 74,862 registered U.S. nurses from the Nurses' Health Study.
Methods : Lifetime rotating night shift work (defined as ≥3 nights/month) information was collected in 1988. During 22 years (1988–2010) of follow-up, 14,181 deaths were documented, including 3,062 CVD and 5,413 cancer deaths. Cox proportional hazards models estimated multivariable-adjusted hazard ratios (HRs) and 95% CIs.
Results : All-cause and CVD mortality were significantly increased among women with ≥5 years of rotating night shift work, compared to women who never worked night shifts. Specifically, for women with 6–14 and ≥15 years of rotating night shift work, the HRs were 1.11 (95% CI=1.06, 1.17) and 1.11 (95% CI=1.05, 1.18) for all-cause mortality and 1.19 (95% CI=1.07, 1.33) and 1.23 (95% CI=1.09, 1.38) for CVD mortality. There was no significant association between rotating night shift work and all-cancer mortality (HR≥15years=1.08, 95% CI=0.98, 1.19) or mortality of any individual cancer, with the exception of lung cancer (HR≥15years=1.25, 95% CI=1.04, 1.51).
Conclusions : Women working rotating night shifts for ≥5 years have a modest increase in all-cause and CVD mortality; those working ≥15 years of rotating night shift work have a modest increase in lung cancer mortality. These results add to prior evidence of a potentially detrimental effect of rotating night shift work on health and longevity.

Source: Fangyi Gu; Jiali Han; Francine Laden; An Pan; Neil E. Caporaso; Meir J. Stampfer; Ichiro Kawachi; Kathryn M. Rexrode; Walter C. Willett; Susan E. Hankinson; Frank E. Speizer; Eva S. Schernhammer. American journal of préventive medecine, 2015.
http://dx.doi.org/10.1016/j.amepre.2014.10.018

Prévenir l’usure professionnelle

Guide pour l'action
Dans un contexte d'allongement de la vie professionnelle et d'accélération des mutations, la prévention de l'usure devient une question centrale pour tous les acteurs de l'entreprise. Avec le guide « Prév'Up », l'Agence Rhône-Alpes pour la valorisation de l'innovation sociale et l'amélioration des conditions de travail propose aux directions des ressources humaines, employeurs et représentants des salariés des dizaines de pistes d'action concrètes pour lutter contre l'usure au travail. Testée en entreprise, l'approche proposée dans le guide repose sur la combinaison de deux leviers d'action : la gestion des parcours et la prévention des risques professionnels.

Source: http://www.aravis.aract.fr/wp-content/uploads/2014/11/Aravis_guideUsure_web.pdf

Psychological distress and dyslipidemia in Chinese police officers

A 4-year follow-up study in Tianjin, China
OBJECTIVE: This study aimed at investigating whether psychological distress in police officers was associated with dyslipidemia.
METHODS: A survey was conducted to examine the psychological distress among 5867 police officers in Tianjin, China, from 2007 to 2011. Psychological distress was measured using the Symptom Check List-90-Revised. Cox proportional hazard regression was used to calculate the hazard ratios (HR) of the incidence of dyslipidemia predicted by psychological distress.
RESULTS: Among the 3300 participants without dyslipidemia at baseline (2567 with dyslipidemia), 60.5% (n = 1829) developed incident dyslipidemia 2.61 years (median) later. The adjusted HR was 1.15 (95% confidence interval, 1.05 to 1.26) after the adjustment of police classifications and other variables. The adjusted HR for police officers in charge of traffic control was 1.30 (95% confidence interval, 1.09 to 1.56).
CONCLUSIONS: Further investigations for associations of psychological factors with dyslipidemia and cardiovascular diseases are needed.

Source: Chen X, Leng L, Yu H, Yang XL, Dong GH, Yue S, Chen JS, Tang NJ. J. Occup. Environ. Med. 2015.
http://dx.doi.org/10.1097/JOM.0000000000000372

Work schedule and physically demanding work in relation to menstrual function

The Nurses' Health Study 3
Objectives : This study aimed to evaluate occupational exposures and menstrual cycle characteristics among nurses.
Methods : Using cross-sectional data collected in 2010–2012 from 6309 nurses aged 21–45 years, we investigated nurses' menstrual function in the Nurses' Health Study 3. We used multivariable regression modeling to analyze the associations between occupational exposures and prevalence of irregular cycles and long and short cycle lengths.
Results : The cohort reported cycle length as <21 (1.5%), 21–25 (15.6%), 26–31 (69.7%), and 32–50 (13.2%) days. In addition, 19% of participants reported irregular cycles. Working ≥41 hours/week was associated with a 16% [95% confidence interval (95% CI): 4–29%] higher prevalence of irregular cycles and a higher prevalence of very short (<21-day) cycles [prevalence odds ratio (OR) 1.93, 95% CI 1.24–3.01] in adjusted models. Irregular menstrual cycles were more prevalent among women working nights only (32% higher; 95% CI 15–51%) or rotating nights (27% higher, 95% CI 10–47%), and was associated with the number of night shifts per month (P for trend <0.0001). Rotating night schedule was associated with long (32–50 day) cycles (OR 1.28, 95% CI 1.03–1.61). Heavy lifting was associated with a higher prevalence of irregular cycles (34% higher), and the prevalence of cycles <21 days and 21–25 day cycles increased with increasing heavy lifting at work (P for trend <0.02 for each endpoint).
Conclusion : Night work, long hours, and physically demanding work might relate to menstrual disturbances.

Source: Lawson CC, Johnson CY, Chavarro JE, Lividoti Hibert EN, Whelan EA, Rocheleau CM, Grajewski B, Schernhammer ES, Rich-Edwards JW. Scand J Work Environ Health, 2015.
http://dx.doi.org/10.5271/sjweh.3482

Negotiating safety practice in small construction companies

Small construction companies have high rates of work related injuries and pervasive challenges in preventing them. This article examines safety practice from the employee perspective, taking into account the role of the owner–manager and interactions with customers in everyday work settings. Data were derived from a qualitative multi-case study of ten small construction companies (carpentry/plumbing/masonry) involving one or two-man work crews. The analytic approach is phenomenological, based on thematic content analysis of interviews and participant-observations. The employees' general approach to safety was “to take care of oneself”, which, in addition to standardized rule-based knowledge, drew on individual feelings, personal experience and the balancing of various concerns in different work settings, e.g. workflow, customer satisfaction, good work relations and safety issues. In the context of small companies, safety practice was negotiated in the tension between owner–manager decisions and employees' self-administration, which also was reflected in the way safety was communicated and learned within the companies as a matter of professionalism and individual mastering. Safety was rarely in explicit focus among employees in the small construction companies. It was an intrinsic part of their craftsmanship, established and negotiated in work situations and in interactions, in particular with customers. Safety issues were rarely shared or communicated as a common issue within the company. Consequently owner–managers had limited impact on the employees' daily safety practices. Injury prevention approaches should take into account the limited impact that owner–managers had on the day-to-day safety practices, as well as the importance of the employees' relationships with the customers.

Source: Ozmec MN, Karlsen IL, Kines P, et al. Negotiating safety practice in small construction companies. Safety Science, 2015; 71 (Part C) : 275-81.
http://dx.doi.org/10.1016/j.ssci.2014.03.016

A multi-case study of the implementation of an integrated approach to safety in small enterprises

An integrative approach to managing safety has been proposed which is based on a combination of the behavior change and culture change approach to safety. The key features are a data-based and participatory problem-solving process and an explicit culture change process.
Objective: The aim of the current study was to operationalize and test the implementation of an integrative approach to safety in small (20–49 employees) enterprises within the metal and wood processing industries using a quasi-experimental, multi-case design with two intervention (Int1 and Int2) and two control enterprises
Methods: Baseline measures included safety observations, questionnaires, interviews and inspection of machine safety. The intervention consisted of workshops where the safety organization, workers and supervisors discussed safety issues identified at baseline (the problem solving process), and a workshop on safety management and leadership, followed by several individual safety coaching sessions with supervisors (the culture change process).
Results: The results differed between the two intervention enterprises. In Int1 supervisors performed 80% of the activities planned in the coaching sessions, and 74% of the activities from the worker workshops, and 82% of the activities from the safety organization workshop were resolved, compared to only 48%, 59% and 20% respectively in Int2. Interviews with management and workers indicated a difference in management commitment to the process in the enterprises, and a lack of trust and perceived reciprocity between workers and supervisors in Int2. The effect measures showed improved safety leadership, safety knowledge, safety involvement and machine safety in Int1 at follow-up, and no improvements in Int2, as was also the case for the two control enterprises.
The results show that it is possible to implement the approach successfully in small enterprises, although further and lengthier studies are needed to link the approach to culture change. It is crucial to ensure management commitment throughout the implementation.

Source: Nielsen KJ, Kines P, Pedersen LM, et al. A multi-case study of the implementation of an integrated approach to safety in small enterprises. Safety Science, 2015; 71 (Part B) : 142-50.
http://dx.doi.org/10.1016/j.ssci.2013.11.015

Measuring operational performance of OSH management system

A demonstration of AHP-based selection of leading key performance indicators
Occupational safety and health management systems (OSH MSs) have been implemented in numerous enterprises worldwide since the mid-1980s. While stakeholders still have expectations on better prevention of occupational injuries and diseases, and on improving the working conditions, it suggest that new approaches are now needed to ensure OSH MS effectiveness, including development of new methods that would facilitate measurement of OHS MS operational status aimed at the genuine improvement of OSH management practices. A review of literature on leading pro-active safety performance indicators (PPIs) provided a rationale for a concept to elaborate a relatively small number of key performance indicators (KPIs) for measuring OSH MS operational performance. As a basis for this process an initial set of 109 PPIs was developed, composed of 20 sub-sets assigned respectively to individual OSH MS components. Next, for the selection of KPIs the method of the Analytic Hierarchy Process (AHP) was employed. The ranking and prioritization of leading performance indicators was made in relation to a set of SMART (Specific, Measurable, Achievable, Relevant and Time-bound) criteria.
The objective of this paper is to demonstrate the application of the AHP method for the selection of leading KPIs for measuring OSH MS operational performance. The proposed set of KPIs should be tailored to specific conditions of an enterprise, such as the size, industry sector, types of occurring hazards, or the maturity of OSH management processes.

Source: Daniel Podgórski. Safety Science, Volume 73, March 2015, Pages 146–166.
http://dx.doi.org/10.1016/j.ssci.2014.11.018

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