Journal of occupational medicine. : official publication of the Industrial Medical Association
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Industrial workers on rotating shifts were evaluated for the effects of rotating shift work. Twenty-five (86%) of 29 workers in the study area who work 12-hour shifts in a scheduled 16-day rotation participated. The mean number of hours of sleep at home after working day shifts (5.6 hours) was less than after the first three night shifts (6.0, 6.4, and 6.6 hours, respectively). ⋯ We demonstrate that workers on rotating shift work exhibit low alertness-related outcomes on both shifts. These workers have early shift work starting times that appear to disrupt sleep patterns on both day and night shifts. At this work site, a number of interventions to lessen the effects of rotating shift work are being evaluated.
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Case Reports
Toxicity associated with severe inhalational and dermal exposure to dimethylacetamide and 1,2-ethanediamine.
We present the case of a worker who was accidentally exposed (inhalational and dermal routes) to the chemicals dimethylacetamide and ethylenediamine for 90 minutes in a confined space. Clinical effects included delirium, hallucinations, skin burns, cellulitis, bilateral conjunctivitis, hepatitis, secondary coagulopathy, rhabdomyolysis, and a grade 2 esophagitis. Urinary monomethylacetamide levels 6 days after the exposure were 61 ppm.
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To learn more about the causes of nonfatal construction worker injuries, and to identify injury cases for further work-site investigations or prevention programs, an emergency department-based surveillance program was established. Construction workers with work-related injuries or illnesses were identified by reviewing the medical records of all patients treated at the George Washington University Emergency Department between November 1, 1990 and November 31, 1992. Information regarding the worker, the injury, and the injury circumstances were abstracted from medical records. ⋯ Laborers and Hispanic workers were overrepresented among these severe cases. Emergency Department records were a useful surveillance tool for the initial identification and description of work-related injuries. Although E codes were not that useful for formulating prevention strategies, detailed review of injury circumstances from Emergency Department records was valuable and has helped to establish priorities for prevention activities.
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There is a current trend for corporations to switch from in-house medical departments to outside contract organizations for provision of occupational health services. Although this may be driven by a desire to reduce expenses, there is little objective data on which to base this decision. This study compares the costs to a corporation of an in-house medical department with the costs for the same services if rendered by outside providers. ⋯ We found that the cost for the in-house medical department was 42% less than that of the outside providers at the prevailing rates. Thus, the in-house medical department is more cost-effective than the outside providers. We also discuss other advantages of an in-house department that are more difficult to quantify.
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Comparative Study
A prospective, nonrandomized study of iontophoresis, wrist splinting, and antiinflammatory medication in the treatment of early-mild carpal tunnel syndrome.
Carpal tunnel syndrome (CTS) has become the industrial epidemic syndrome of the decade and its incidence is continuing to rise. Because of public awareness. CTS is being diagnosed much earlier in the course of the disease. ⋯ Iontophoresis may become an alternative to steroid injections to the carpal tunnel region if further studies substantiate these findings. It provides an excellent complication and side-effect profile compared with other methods of delivering dexamethasone. No complications occurred (including no significant elevation of serum glucose in insulin-dependent diabetics.)