Measurement equivalence and mean comparisons of a safety climate measure across construction trades.

The use of safety climate measures for needs assessment and interventions has become increasingly popular. However, no research to date has examined whether the meaning and level of safety climate may differ across different groups of interest. This study used multi-group confirmatory factor analyses to investigate the measurement equivalence of a multidimensional safety climate measure across ten construction trade groups (N=4725).

Comparison of frequency of atrial fibrillation after coronary artery bypass grafting in African Americans versus European Americans.

In the general population, African Americans experience atrial fibrillation (AF) less frequently than European Americans. This difference could also exist in the incidence of this arrhythmia after cardiac surgery, but this possibility has been insufficiently examined. To test the association of such an ethnic difference, we compared the incidence of postoperative AF in a consecutive series of 2,312 African Americans and 6,054 European Americans who underwent isolated coronary artery bypass grafting from July 2000 to June 2007.

Is vasoplegic syndrome more prevalent with open-heart procedures compared with isolated on-pump CABG surgery?

Postoperative vasoplegic syndrome (PVS) is a frequent complication and can affect the early postoperative course. Our study investigated the incidence and risk factors of PVS after on-pump isolated coronary artery grafting bypass (CABG) and on-pump open-heart surgery. A total of 629 patients underwent on-pump cardiac surgery from November 21, 2005, to June 9, 2006, at our institution.

[Case Study] CityCenter and Cosmopolitan Construction Projects, Las Vegas, Nevada: lessons learned from the use of multiple sources and mixed methods in a safety needs assessment.

Problem: The present study describes a response to eight tragic deaths over an eighteen month times span on a fast track construction project on the largest commercial development project in U.S. history.

Validity assessment of self-reported construction tasks.

This study assessed agreement between workers' and observers' daily estimates of exposure to construction work tasks. The ultimate aim was to develop a valid method and instrument for the collection of self-reported data on duration of exposure to a priori identified work tasks for use in characterizing exposure in settings with substantial task variability. Forty-nine shop workers and 52 construction site sheet metal workers were observed for up to 3 full workdays.

Impact of musculoskeletal and medical conditions on disability retirement-a longitudinal study among construction roofers.

Background: To assess the intersection of work demands, chronic medical and musculoskeletal conditions, aging, and disability, we initiated a longitudinal study of construction roofers who were current union members between the ages of 40 and 59.

Methods: Participants were asked about the presence of medical conditions and musculoskeletal disorders; the Work Limitations Questionnaire, the SF-12, and other validated assessments of social and economic impact of injury were included.

Results: Factors at baseline that predicted leaving for a health-related reason were older age, lower physical functioning, work limitations, and having missed work.

Current practice and outcomes of off-pump multivessel coronary artery bypass.

Outcomes of off-pump multivessel coronary artery bypass were compared with those of the on-pump procedure. From July 2001 to June 2006, 3,637 patients with multivessel coronary disease underwent off-pump coronary artery bypass, and 3,586 patients had on-pump coronary artery bypass in our center. The rates of operative mortality, permanent stroke, renal failure and perioperative myocardial infarction were significantly lower in the off-pump group, and these patients required fewer blood transfusions, shorter durations of ventilatory support, and shorter hospital stays.

Mortality among sheet metal workers participating in a medical screening program.

Background: The Sheet Metal Occupational Health Institute Trust (SMOHIT) was formed in 1985 to examine the health hazards of the sheet metal industry in the U.S. and Canada through an asbestos disease screening program.

Asbestos-related disease among sheet metal workers 1986-2004: radiographic changes over time.

Background: In 1985, the Sheet Metal Workers International Association and the Sheet Metal and Air Conditioning National Association formed The Sheet Metal Occupational Health Institute Trust (SMOHIT) to examine the health hazards of the sheet metal industry. Between 1986 and 2004 18,211 individuals were examined. At the time of the first examination 9.

Musculoskeletal disorders among construction roofers--physical function and disability.

Objectives: This study investigated the relationships between work demands, chronic medical and musculoskeletal conditions, aging, and the ability to remain on the job in a longitudinal study of 979 construction roofers between the ages of 40 and 59 years.

Methods: In a phone interview at baseline and 1 year later, the participants were asked about the presence of medical conditions and musculoskeletal disorders, work limitations and work accommodations, and social and economic functioning.

Results: Among the workers for whom a musculoskeletal disorder was their most serious condition at baseline, 8% left roofing due to a health condition during the first year of follow-up.

Is cardiac surgery safe in extremely obese patients (body mass index 50 or greater)?

Background: We investigated the impact of extreme obesity (body mass index [kg/m(2)] 50 or greater) on short-term clinical outcomes and report 1-year mortality.

Methods: Fifty-seven patients were found to have a body mass index of 50 or greater among 14,449 patients who underwent cardiac surgery between July 2000 and June 2007. Multivariable logistic regression analyses were used to assess the independent influence of extreme obesity on the major outcomes.

Off-pump coronary artery bypass grafting improves in-hospital mortality in patients with dialysis-dependent renal failure.

Objective: Patients with chronic dialysis-dependent end-stage renal disease are increasingly referred for coronary artery bypass grafting (CABG) and their early outcome is less favorable. Off-pump CABG (OPCAB) has achieved encouraging results in high-risk patients. Therefore, we designed this retrospective study to test the hypothesis that OPCAB reduced surgical risks in dialysis patients.

Age, work limitations and physical functioning among construction roofers.

Background: To investigate the intersection of aging with work limitations, chronic medical and musculoskeletal conditions, and physical functioning we undertook a cross-sectional study of U.S. construction roofers who were current union members between the ages of 40 and 59.

Early readmission of low-risk patients after coronary surgery.

Background: Early readmission after coronary artery bypass grafting (CABG) is an expensive adverse outcome. Although the perioperative experience of high-risk CABG patients has been studied extensively, little attention has been paid to low-risk CABG patients. The primary goal of this study was to identify the preoperative characteristics and to define risk predictors of readmission and preventive factors for readmission in low-risk isolated-CABG patients.

Von Willebrand factor, red cell fragmentation, and disease activity in systemic lupus erythematosus.

This study sought to determine whether the plasma levels of Von Willebrand factor (vWf) and the degree of red blood cell (RBC) fragmentation on peripheral smear correlate with disease activity in systemic lupus erythematosus (SLE). Forty consecutive patients who fulfilled the criteria for SLE were studied prospectively for 1 year. Patients were categorized according to the SLE Disease Activity Index (SLEDAI) as either active (>2) or inactive disease and followed up monthly (active) or quarterly (inactive).

Occupational injury costs and alternative employment in construction trades.

Objective: To present the costs of fatal and non-fatal days-away-from-work injuries in 50 construction occupations. Our results also provide indirect evidence on the cost exposure of alternative construction workers such as independent contractors, on-call or day labor, contract workers, and temporary workers.

Methods: We combine data from the Bureau of Labor Statistics on average annual incidence from 2000 to 2002 with updated per-case costs from an existing cost model for occupational injuries.

Costs of occupational injuries in construction in the United States.

This paper presents costs of fatal and nonfatal injuries for the construction industry using 2002 national incidence data from the Bureau of Labor Statistics and a comprehensive cost model that includes direct medical costs, indirect losses in wage and household productivity, as well as an estimate of the quality of life costs due to injury. Costs are presented at the three-digit industry level, by worker characteristics, and by detailed source and event of injury. The total costs of fatal and nonfatal injuries in the construction industry were estimated at $11.

Change in prevalence of asbestos-related disease among sheet metal workers 1986 to 2004.

In 1985, the Sheet Metal Workers International Association and the Sheet Metal and Air Conditioning National Association formed The Sheet Metal Occupational Health Institute Trust to examine the health hazards of the sheet metal industry in the United States and Canada. Between 1986 and 2004, 18,211 individuals were examined. The mean age of this cohort was 57.

Clinical outcomes of low-risk patients undergoing beating-heart surgery with or without pulmonary artery catheterization.

Objective: For patients who undergo off-pump coronary artery bypass (OPCAB) surgery, pulmonary artery catheterization (PAC) has been proposed as a useful intraoperative monitoring tool. This study was designed to determine if the choice of PAC versus central venous pressure monitoring (CVP) had any effect on outcome after OPCAB. This study compared these 2 methods of hemodynamic monitoring in low-risk patients undergoing beating-heart surgery via a median sternotomy and evaluated their effect on morbidity and in-hospital mortality.

Effect of clopidogrel premedication in off-pump cardiac surgery: are we forfeiting the benefits of reduced hemorrhagic sequelae?

Background: Premedication with clopidogrel has reduced thrombotic complications after percutaneous coronary revascularization procedures. However, because of the enhanced and irreversible platelet inhibition by clopidogrel, patients requiring surgical revascularization have a higher risk of bleeding complications and transfusion requirements. A principal benefit of surgical coronary revascularization without cardiopulmonary bypass is its lower hemorrhagic sequelae.

Cardiac surgery in renal transplant recipients: experience from Washington Hospital Center.

Background: The number of renal transplant survivors requiring surgical treatment for cardiovascular diseases is increasing. A retrospective study was conducted to determine the outcomes of renal transplant recipients undergoing cardiac surgery.

Methods: Fifty-seven renal transplant recipients whose cardiac surgery was performed between 1987 and 2004, and whose allograft was functioning at the time of cardiac surgery, were identified.

Clinical outcomes of nonelective coronary revascularization with and without cardiopulmonary bypass.

Background: Patients who undergo emergent coronary artery bypass grafting pose a greater challenge in terms of intraoperative and postoperative mortality and morbidity compared to elective coronary artery bypass. Coronary artery bypass without cardiopulmonary bypass (off-pump coronary artery bypass) might benefit these high-risk patients by eliminating the cardiopulmonary bypass and therefore decreasing the systemic inflammatory response associated with it. The aim of this study was to compare the early clinical outcome after nonelective off-pump coronary artery bypass with a matched set of patients undergoing coronary artery bypass with cardiopulmonary bypass (on pump).

Asbestos and peritoneal mesothelioma among college-educated men.

The proportion of peritoneal mesotheliomas among all mesotheliomas has been decreasing, leading some to suggest that peritoneal mesothelioma occurs only after high levels of exposure to asbestos. To investigate the relationship between asbestos exposure and the development of peritoneal mesothelioma, a case-control study examined 40 cases of primary peritoneal mesothelioma from a single institution. This series differed from previous reports in that 75% of the cases and controls had attended college.

Risk factors for hemorrhage-related reexploration and blood transfusion after conventional versus coronary revascularization without cardiopulmonary bypass.

Objective: The premise of coronary revascularization without cardiopulmonary bypass (off-pump CABG) proposes that patient morbidity and, potentially, mortality can be reduced without compromising the excellent results of conventional revascularization techniques (on-pump CABG). It is unknown, however, whether coronary artery bypass without cardiopulmonary bypass (off-pump CABG) is associated with similar hemorrhage related reexploration rates and blood transfusion requirements compared to the on-pump approach.

Methods: Between January 1998 and June 2002, 3646 patients underwent off-pump CABG and were compared with a contemporaneous control group of 5197 on-pump CABG patients.