Journal of occupational and environmental medicine
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J. Occup. Environ. Med. · Sep 1999
Outcomes comparison of treatment for chronic disabling work-related upper-extremity disorders and spinal disorders.
Since 1986, the percentage of upper-extremity musculoskeletal disorders (UEMSDs) has increased from 1% to 4% of all occupational injury claims, while the average total medical and compensation cost is 80% higher than the average of all other claims. Because chronic disability leads to the highest cost, systematic evaluation of this growing occupational condition is needed. We performed a prospective case-series cohort study of patients (n = 163) with UEMSDs, compared with a matched group of spinal disorder (SD) patients (n = 163) treated with the same protocol. ⋯ The neuropathic UEMSD subgroup had the poorest outcomes, with significantly higher surgery rates, higher health care utilization rates, and lower work retention when compared with the SD group. Rehabilitation outcomes for UEMSDs are similar to those for SDs. However, neuropathic-diagnosis patients are at risk for high-cost injuries and/or poorer prognoses.
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J. Occup. Environ. Med. · Aug 1999
Distinctive emergency department usage for injury for workers' compensation cases in Utah in 1996.
To compare emergency department services paid by worker's compensation (WC) with services paid by other payers, a state database of 72,747 emergency department visits for injured adults (ages 21 to 54) in 1996 in Utah was analyzed. WC visits accounted for 21.6% (15,704) of all adult injury visits. ⋯ Differences were also found between these groups for Injury Severity Scores and diagnoses. In summary, WC emergency department usage was associated with less severe injuries than was emergency department usage for other payers in Utah in 1996.
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J. Occup. Environ. Med. · Jun 1999
Impact of a modern firefighting protective uniform on the incidence and severity of burn injuries in New York City firefighters.
The New York City Fire Department (FDNY) is the largest fire department in the United States, with over 11,000 firefighters. In 1994, FDNY changed to a modern firefighting protective uniform. The major difference between traditional and modern uniforms is that modern uniforms include both protective over-coat and over-pant, whereas traditional uniforms include only the over-coat. ⋯ Severity indicators (days lost to medical leave, hospital admissions, and skin grafts) for lower- and upper-extremity burn injuries were all substantially reduced. This occurred without significant change in the incidence or severity of trunk burns, heat exhaustion, inhalation injuries (actually decreased), or cardiac events. The reduction in the incidence and severity of burn injuries, the major occupational injury affecting this workforce, has been so dramatic and without untoward effects that the introduction of the modern uniform must be characterized as a sentinel event in the history of firefighter health and safety.
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J. Occup. Environ. Med. · Oct 1998
Comparative StudyA comparison of work-related injury visits and other injury visits to emergency departments in the United States, 1995-1996.
Estimates of nonfatal work-related injuries range from 6 to 13 million annually, and the most serious of these injuries are presented to hospital emergency departments (EDs). To describe work-related injury ED visits in the United States, we examined data from the 1995-1996 National Hospital Ambulatory Medical Care Survey, which is a national probability sample survey of visits to EDs of non-federal, short-stay, and general hospitals. In 1995-1996, an annual average of 4 million work-related injury ED visits were made by persons 16 years of age and over. ⋯ Males had higher work-related injury visit rates (4.3 per 100 FTEs) than females (2.4 per 100 FTEs). The leading cause of injury and diagnosis for work-related injury ED visits were "cuts" (16%) and "open wound" (22%), respectively. Determining appropriate preventive action will reduce the number of workers injured and may result in financial savings for industries and health care systems.
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J. Occup. Environ. Med. · Oct 1998
Somatic complaints disproportionately contribute to Beck Depression Inventory estimates of depression severity in individuals with multiple chemical sensitivity.
A number of individuals with multiple chemical sensitivity (MCS) are also diagnosed with depression. However, there is content overlap in MCS and symptoms of depression with respect to somatic complaints. The Beck Depression Inventory (BDI) was used to document severity of depressive symptomatology in 42 individuals with MCS. ⋯ An item analysis of the BDI revealed that individuals with MCS tended to endorse more somatic-performance items than did a sample of depressed outpatients. Two alternative interpretations are possible: (a) the BDI total score overestimated severity of depressive symptomatology in this sample, and/or (b) individuals with MCS tended to express depressive symptomatology in terms of somatic complaints. It was recommended that until the etiology of MCS is better understood, caution be used when estimating severity of depressive symptomatology in individuals with MCS when measures include somatic items.