Journal of occupational and environmental medicine
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J. Occup. Environ. Med. · Mar 2015
Guidance to employers on integrating e-cigarettes/electronic nicotine delivery systems into tobacco worksite policy.
In recent years, new products have entered the marketplace that complicate decisions about tobacco control policies and prevention in the workplace. These products, called electronic cigarettes (e-cigarettes) or electronic nicotine delivery systems, most often deliver nicotine as an aerosol for inhalation, without combustion of tobacco. This new mode of nicotine delivery raises several questions about the safety of the product for the user, the effects of secondhand exposure, how the public use of these products should be handled within tobacco-free and smoke-free air policies, and how their use affects tobacco cessation programs, wellness incentives, and other initiatives to prevent and control tobacco use. In this article, we provide a background on e-cigarettes and then outline key policy recommendations for employers on how the use of these new devices should be managed within worksite tobacco prevention programs and control policies.
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J. Occup. Environ. Med. · Jan 2015
The reliability and validity of the Caregiver Work Limitations Questionnaire.
To test a new Caregiver Work Limitations Questionnaire (WLQ). On the basis of the original WLQ, this new survey instrument assesses the effect of caregiving for ill and/or disabled persons on the caregiver's work performance. ⋯ The Caregiver WLQ is a new tool for understanding the workplace effect of caregiving.
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J. Occup. Environ. Med. · Jan 2015
The health care and productivity costs of back and neck pain in a multi-employer sample of utility industry employees.
To determine the cost of back and/or neck (B/N) pain among predominantly rural employees insured through an employee benefits trust. ⋯ Many covered employees did not use formal care. The effect of care choices on productivity costs requires closer scrutiny.
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J. Occup. Environ. Med. · Dec 2014
The risk of lung cancer after cessation of asbestos exposure in construction workers using pleural malignant mesothelioma as a marker of exposure.
To study the risk of lung cancer in heavily asbestos-exposed workers after the exposure to asbestos has ended. ⋯ Workers with heavy exposure to asbestos have a similar risk of lung cancer as persons with low or no exposure 20 years after the exposure has ended.
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J. Occup. Environ. Med. · Dec 2014
Practice GuidelineACOEM practice guidelines: opioids for treatment of acute, subacute, chronic, and postoperative pain.
The American College of Occupational and Environmental Medicine's guidelines have been updated to develop more detailed guidance for treatment of acute, subacute, chronic, and postoperative pain with opioids. ⋯ No quality evidence directly supports histories, physical examinations, and opioid treatment agreements, although they are thought to be important. No quality trials were identified showing superiority of opioids, compared with nonsteroidal anti-inflammatory and other medications for treatment of chronic, noncancer pain. The use of opioid-sparing treatments associated with lower doses of postoperative opioids is also associated with better long-term functional outcomes. Selective use of opioids is recommended for patients with acute and postoperative pain. Consensus recommendations also include consideration of carefully conducted trials of chronic opioid treatment for highly select patients with subacute and chronic pain and to maintenance opioid prescriptions only if documented objective functional gain(s) results. A strong and reproducible dose-response relationship identifies a recommended morphine equivalent dose limit of no more than 50 mg/day. Higher doses should be prescribed only with documented commensurately greater functional benefit(s), comprehensive monitoring for adverse effects, informed consent, and careful consideration of risk versus benefit of such treatment. Chronic opioid use should be accompanied by informed consent, a treatment agreement, tracking of functional benefits, drug screening, and attempts at tapering.