Harness suspension and first aid management: development of an evidence-based guideline.

The possibility of a fall into rope protection and subsequent suspension exists in some industrial situations. The action to take for the first aid management of rescued victims has not been clear, with some authors advising against standard first aid practices. To clarify the medical evidence relating to harness suspension the UK Health and Safety Executive commissioned an evidence-based review and guideline.

Impact of a direct access occupational physiotherapy treatment service.

Background: Musculoskeletal disorders (MSDs) cause significant morbidity and absence from work for both manual and sedentary occupations.

Aims: To examine the impact of a direct access physiotherapy treatment service in an occupational setting.

Methods: This was a pilot study carried out as a service audit.

Shift work and metabolic syndrome, diabetes mellitus and ischaemic heart disease.

Shift work is affecting 20% to 25% employees and is becoming increasingly prevalent in contemporary life all over Europe and USA. It is associated with several health problems, such as e.g.

Comparison of various airflow measurements in symptomatic textile workers.

Aims: To investigate the poorly understood relationship between work-related respiratory symptoms, airway reactivity, across working shift change in forced expiratory volume in 1 s (FEV(1)) and work-related changes in serial peak expiratory flow (sPEF) measures in a group of textile workers.

Methods: Fifty-three workers, 34 exposed to cotton dust and 19 to man-made fibre (MMF), were investigated using a standard respiratory questionnaire, sPEF, across-shift FEV(1) measurement and airway responsiveness.

Results: Thirty-four workers (64%) were male, and 9 workers (17%) had a >5% across-shift fall in FEV(1), and these falls were associated with the presence of work-related symptoms.

Knowledge and utilisation of occupational asthma guidelines in primary care.

Aims: To develop an occupational asthma learning module, which could be used both as an educational tool and to evaluate awareness and usage of clinical guidelines in primary care.

Methods: Healthcare professionals were invited to undertake an interactive BMJ Learning module, developed from existing national occupational asthma guidelines. Participants were invited to record immediate post-module feedback, and were also sent an e-mail questionnaire six weeks later to assess the impact of the module.

Chronic Obstructive Pulmonary Disease and the workplace.

Chronic Obstructive Pulmonary Disease (COPD) is a progressive respiratory disease associated with increasing morbidity and mortality worldwide. Whilst tobacco smoking is the important cause, other causes are recognized. This article discusses the contribution that harmful inhaled occupational exposures make to the overall burden of COPD, and goes on to discuss other aspects of the COPD workplace interface.

Chronic cough - occupational considerations.

Chronic cough is a common symptom in a wide range of respiratory conditions, and may also occur as a result of upper airway or gastro-esophageal problems. Whilst chronic cough of any cause may be exacerbated by work, in some cases it has a direct occupational cause, resulting from a harmful acute or chronic workplace exposure. Such occupational conditions may only be suspected by taking a detailed occupational history, and directly asking employed patients whether their cough improves away from work.

Sensitization to wheat flour and enzymes and associated respiratory symptoms in British bakers.

Rationale: Current literature suggests that flour exposed workers continue to be at risk of allergic sensitization to flour dust and respiratory ill health.

Objectives: A cross-sectional study of 225 workers currently potentially exposed to flour dust in British bakeries was performed to identify predictors of sensitization to wheat flour and enzymes.

Results: Work-related nasal irritation was the most commonly reported symptom (28.

Variability in the diagnosis of occupational asthma and implications for clinical practice.

Purpose Of Review: The purpose of this review is to provide a summary of recent evidence relating to occupational asthma diagnosis.

Recent Findings: Recent evidence suggests that whilst prolonged asthmagen exposure worsens the prognosis, many steps in the diagnostic process are problematic for workers with possible occupational asthma. Certain workers suffer delay prior to specialist assessment, and assessment itself may be of variable quality.

Facilities for investigating occupational asthma in UK non-specialist respiratory departments.

Background: The facilities which should be available to physicians offering specialist occupational asthma services have recently been agreed upon by a UK panel of experts.

Aims: This study aimed to investigate whether these facilities are available in UK non-specialist secondary care respiratory departments and to document tertiary care referral patterns.

Methods: A random sample of 100 UK respiratory units was selected, and the lead consultant invited to participate.

Approaches to the diagnosis and management of occupational asthma amongst UK respiratory physicians.

This study aimed to assess the approach to the diagnosis and management of occupational asthma amongst general (non-specialist) respiratory consultants in the UK. A random sample of 100 UK general respiratory physicians were invited to participate, and asked to provide information on their diagnostic approach to a case scenario of a patient with possible occupational asthma relating to flour exposure. Participation rates were 42% for the main part of the study.

Work-related asthma symptoms and attitudes to the workplace.

Background: The Health & Safety Executive estimate that between 1500-3000 UK workers develop asthma through potentially avoidable workplace exposures each year.

Aims: To assess the perception of health, safety and the work environment by workers with symptoms suggestive of occupational asthma.

Methods: A total of 97 workers referred to hospital specialists with symptoms suggestive of occupational asthma were studied in order to investigate their attitudes to the workplace, safety and health.

Occupational asthma: an assessment of diagnostic agreement between physicians.

Objectives: To investigate the levels of agreement between expert respiratory physicians when making a diagnosis of occupational asthma.

Methods: 19 cases of possible occupational asthma were identified as part of a larger national observational cohort. A case summary for each case was then circulated to 12 physicians, asking for a percentage likelihood, from the supplied information, that this case represented occupational asthma.

Opinions of Polish occupational medicine physicians on workplace health promotion.

Objectives: According to the current Polish legislation on occupational health services, occupational medicine physicians should perform workplace health promotion (WHP) activities as a part of their professional work. The concept of workplace health promotion or health promotion programs, however, has not been defined in this legislation in any way. Therefore, two essential questions arise.