Analysis of the Full Economic Cost for Japanese Encephalitis Under Different Risk Scenarios for Business Travelers to Asia.

Objective: Methods for assessing the costs and benefits of administering vaccines to international business/occupational travelers, assignees, and expatriates have neglected the impact of health and treatment on work productivity. The research objective is to evaluate the benefit to cost ratio of the Japanese encephalitis (JE) vaccine for international business/occupational travelers to Asia and other endemic areas incorporating a health and productivity approach.

Methods: Costs and benefits were estimated using actuarial methods with data obtained from secondary sources describing prevalence of infection risk and health outcomes, and business traveler demographic and travel characteristics.

The changing epidemiology of Japanese encephalitis and New data: the implications for New recommendations for Japanese encephalitis vaccine.

The epidemiology of Japanese Encephalitis and risk to the traveler has changed and continues to evolve. The spread of Japanese Encephalitis virus into new environments, changes in agricultural practice and animal vectors, climate change, peri-urban growth, changes in international travel to Asia, personal risk factors, mosquito vector free transmission, interactions with other flaviviruses and better information on infections without encephalitis and other factors make Japanese Encephalitis an underappreciated risk. There has also been a change in the incidence of Japanese Encephalitis cases that questions the current travel duration and geographic based recommendations.

An Update on Travel Vaccines and Issues in Travel and International Medicine.

The fields of travel and international medicine are rapidly changing and growing. The role of occupational and travel health nurses is expanding and should be a focus for the future. At the American Association of Occupational Health Nurses Annual meeting on March 24, 2015, in Boston, five presentations were included in the session, An Update on Travel Vaccines and Issues in Travel and International Medicine.

The Changing Risk of Japanese Encephalitis for Business Travelers.

Japanese Encephalitis is an often fatal and vaccine preventable disease. New vaccine recommendations are needed due to changes in travel and disease patterns.

Integrating health and safety in the workplace: how closely aligning health and safety strategies can yield measurable benefits.

Objective: To better understand how integrating health and safety strategies in the workplace has evolved and establish a replicable, scalable framework for advancing the concept with a system of health and safety metrics, modeled after the Dow Jones Sustainability Index.

Methods: Seven leading national and international programs aimed at creating a culture of health and safety in the workplace were compared and contrasted.

Results: A list of forty variables was selected, making it clear there is a wide variety of approaches to integration of health and safety in the workplace.

Tracking low back problems in a major self-insured workforce: toward improvement in the patient's journey.

Objective: To assess the cost outcomes of treatment approaches to care for back problems in a major self-insured workforce, using published guidelines to focus on low back pain.

Methods: Longitudinally tracked episodes of three types of International Classification of Diseases, Ninth Revision diagnosis code-identified back problems (n=14,787) during 2001 to 2009. Identified five patterns of care on the basis of the first 6 weeks of claims and compared their total costs per episode with tests that included splits by episode type and duration, use of guidelines, and propensity-derived adjustments.

Managing the burden of chronic obstructive pulmonary disease on workforce health and productivity: upping a leading employer's game.

Objective: To develop new evidence for advancing a leading employer's capacity to manage the burden of chronic obstructive pulmonary disease (COPD).

Methods: Retrospective analyses of an integrated database tracking active employees (n = 19,989) from 2001-2009. Tests on 29 measures of direct/indirect costs and drivers examined unique disease burden and impact over time.

The self-reported health and productivity burden of autoimmune disorders at a major self-insured employer.

Objectives: Examine the self-reported health and productivity burden of three autoimmune disorders: rheumatoid arthritis, psoriasis, and inflammatory bowel disease.

Methods: A 2009 representative survey of a major employer's US workforce, with two approaches for disease identification: (1) self-report and (2) self-report replicated by claims-based International Classification of Diseases, 9th Revision (ICD-9), codes.

Results: Self-reported prevalence: rheumatoid arthritis, 4.

Reducing total health burden from 2001 to 2009: an employer counter-trend success story and its implications for health care reform.

Objectives: To examine total health burden for an employer whose health-related focus is direct and indirect costs. To explore implications for the Final Rule for Accountable Care Organizations recently issued by the Centers for Medicare and Medicaid Services, whose focus includes direct but not indirect costs.

Methods: Used 42 claims and survey-based measures to track this employer's continental US workforce burden in the aggregate and by healthy and selected disease designations from 2001-2002 to 2008-2009.

Health effects research and regulation of diesel exhaust: an historical overview focused on lung cancer risk.

The mutagenicity of organic solvent extracts from diesel exhaust particulate (DEP), first noted more than 55 years ago, initiated an avalanche of diesel exhaust (DE) health effects research that now totals more than 6000 published studies. Despite an extensive body of results, scientific debate continues regarding the nature of the lung cancer risk posed by inhalation of occupational and environmental DE, with much of the debate focused on DEP. Decades of scientific scrutiny and increasingly stringent regulation have resulted in major advances in diesel engine technologies.

Product stewardship and science: safe manufacture and use of fiber glass.

This paper describes a proactive product stewardship program for glass fibers. That effort included epidemiological studies of workers, establishment of stringent workplace exposure limits, liaison with customers on safe use of products and, most importantly, a research program to evaluate the safety of existing glass fiber products and guide development of new even safer products. Chronic inhalation exposure bioassays were conducted with rodents and hamsters.

Particulate matter in new technology diesel exhaust (NTDE) is quantitatively and qualitatively very different from that found in traditional diesel exhaust (TDE).

Diesel exhaust (DE) characteristic of pre-1988 engines is classified as a "probable" human carcinogen (Group 2A) by the International Agency for Research on Cancer (IARC), and the U.S. Environmental Protection Agency has classified DE as "likely to be carcinogenic to humans.

Evidence-based benefit design: toward a sustainable health care future for employers.

Health care costs for employers are rising much faster than inflation. The common approach to health benefit design of increasing cost sharing has failed to contain costs. Some employers, however, have been successful at mitigating the cost trend or actually reducing health care costs.

How to align evidence-based benefit design with the employer bottom-line: a case study.

Objective: To illustrate how to use evidence-based benefit design (EBD) by presenting the case study of a major manufacturer.

Method: Key components of the company's measurement and management approach to EBD are introduced. Descriptive results on the direct and indirect cost and utilization trends of the company's US active workforce during 2002 to 2008 are presented.

Indirect costs associated with nonadherence to treatment for bipolar disorder.

Objective: To examine the association between treatment adherence and indirect productivity costs within a cohort of commercially insured employees with bipolar disorder in the United States.

Methods: Adults diagnosed with bipolar disorder who had at least one prescription claim for a mood stabilizer or atypical antipsychotic, with 6 months prior and 12 months subsequent continuous medical and prescription coverage, were identified in the MarketScan research databases (2000-2005). Two-part multiple regression models estimated the association between adherence (medication possession ratio > or =0.

Critical review of the human data on short-term nitrogen dioxide (NO2) exposures: evidence for NO2 no-effect levels.

Nitrogen dioxide (NO2) is a ubiquitous atmospheric pollutant due to the widespread prevalence of both natural and anthropogenic sources, and it can be a respiratory irritant when inhaled at elevated concentrations. Evidence for health effects of ambient NO2 derives from three types of studies: observational epidemiology, human clinical exposures, and animal toxicology. Our review focuses on the human clinical studies of adverse health effects of short-term NO2 exposures, given the substantial uncertainties and limitations in interpretation of the other lines of evidence.

Best practices in the care of type 2 diabetes: integrating clinical needs with medical policy and practice.

An estimated 1 in 4 Americans either has diabetes or is at increased risk of developing it in their lifetime. Diabetes is the sixth leading cause of death in America and can often lead to other major medical issues, including heart disease and blindness. Furthering the diabetes dilemma is that almost half of all diabetes patients' glycosylated hemoglobin levels are not controlled properly.

Non-cancer health effects of diesel exhaust: a critical assessment of recent human and animal toxicological literature.

We reviewed laboratory and clinical studies bearing on the non-cancer health effects of diesel exhaust (DE) published since the 2002 release of the US EPA Health Assessment Document for Diesel Engine Exhaust. We critically evaluated over 100 published articles on experimental research, focusing on their value for predicting the risk of non-cancer health effects in humans exposed to DE. Human controlled-exposure studies provide new evidence of lung inflammatory effects and thrombogenic and ischemic effects of inhaled DE, albeit for older-model diesel engines and concentrations that are much higher (approximately 300 microg/m(3)) than typical ambient or even occupational levels.