Based on the Statistical Yearbook of 119 Emergency Medical Services in 2017 (National Fire Agency, 2018) and Population Projection by Province: 2015~2045 (Statistics Korea, 2017), this study analyzed the effects of population changes, such as low fertility and aging on the use of ambulance services in the future. The population of Korea is expected to decline after peaking in 2031, but the number of elderly people aged over 70 is expected to continue to increase. The rates of emergency ambulance transport (REAT, the number of patients transferred per 1,000 inhabitants) are not changed significantly, compared to the recent trends, but the ambulance services for elderly over 70 years of age will increase exponentially. Therefore, the population changes due to low fertility and aging is accompanied by a quantitative and qualitative change in ambulance services, and from the long term perspectives, it is necessary to consider not only the effective response of ambulance services due to aging, but also the adjustment of existing jurisdictions due to population changes and the relocation of manpower and resources.
This study was conducted to find out factors affecting patient safety management activities at nursing devisions of two university hospitals. The indicators of patient safety activities used in the study were selected from Hospital Survey on Patient Safety Culture which was developed by The Agency for Healthcare Research and Quality in the United States. Data were collected from 372 nurses working at inpatient wards at two university hospitals located in Seoul and Won-Ju cities through the self-administered questionnaires, and analyzed using frequency analysis, t-test, correlation, and regression analysis. The result of this study were as follows. First, The mean of patient safety management activities was 3.41 which was a little bit higher than the average level. The mean of communication within the ward was the highest, whereas that of patient safety management culture was the lowest. Second, there were significant differences in the perception of nurses on patient safety management activities in terms of the educational background, length of employment, and work hours per week. Third, three variables of communication within the unit, attitude of top management, and attitude of nurses have significant positive effects on patient safety management activities. Fourth, 37.4% of the variation in the patient safety management activities was explained by the study variables. In conclusion, hospital administration and nursing managers should make an effort to learn the knowledge of patient safety program, show their deep interest on the patient safety to the employees and motivate them to communicate effectively each other within the work unit to develop a good patient safety culture and system.
The purpose of this study was to investigate effect of hospital-based physical and occupational therapy on Modified Barthel Index (MBI) score in stroke inpatients at least 3 months after stroke, to predict MBI score at discharge from subscales of MBI, and determine the characteristics of stroke at admission. Forty-five stroke inpatients participated and received physical and occupational therapy for two months. All participants were assessed on MBI at admission and discharge. The collected data was analyzed by dependency level (MBI${\leq}$74 and MBI${\geq}$75) at admission. The results revealed that the MBI score at discharge was significantly improved compared to the MBI score at admission in the group with more than moderate dependency level (MBI${\leq}$74). In particular, personal hygiene, dressing, ambulation, and chair/bed transfer were improved. But only ambulation was improved significantly in the group with a less than mild dependency level (MBI${\geq}$75). The chair/bed transfer, dressing, ambulation, and Mini-Mental State Exam-Korea score at admission were important factors in the MBI score at discharge. Eighty-six percent of the variation in MBI score function at discharge can be explained. Therefore, it is suggested that hospital-based physical and occupational therapy in subacute stroke improve independent living status, especially for patients with a more than moderate dependency level.
Occupational neurotoxic diseases have become increasingly common in Taiwan due to industrialization. Over the past 40 years, Taiwan has transformed from an agricultural society to an industrial society. The most common neurotoxic diseases also changed from organophosphate poisoning to heavy metal intoxication, and then to organic solvent and semiconductor agent poisoning. The nervous system is particularly vulnerable to toxic agents because of its high metabolic rate. Neurological manifestations may be transient or permanent, and may range from cognitive dysfunction, cerebellar ataxia, Parkinsonism, sensorimotor neuropathy and autonomic dysfunction to neuromuscular junction disorders. This study attempts to provide a review of the major outbreaks of occupational neurotoxins from 1968 to 2012. A total of 16 occupational neurotoxins, including organophosphates, toxic gases, heavy metals, organic solvents, and other toxic chemicals, were reviewed. Peer-reviewed articles related to the electrophysiology, neuroimaging, treatment and long-term follow up of these neurotoxic diseases were also obtained. The heavy metals involved consisted of lead, manganese, organic tin, mercury, arsenic, and thallium. The organic solvents included n-hexane, toluene, mixed solvents and carbon disulfide. Toxic gases such as carbon monoxide, and hydrogen sulfide were also included, along with toxic chemicals including polychlorinated biphenyls, tetramethylammonium hydroxide, organophosphates, and dimethylamine borane. In addition we attempted to correlate these events to the timeline of industrial development in Taiwan. By researching this topic, the hope is that it may help other developing countries to improve industrial hygiene and promote occupational safety and health care during the process of industrialization.
Laharnar, Naima;Glass, Nancy;Perrin, Nancy;Hanson, Ginger;Anger, W. Kent
Safety and Health at Work
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v.4
no.3
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pp.166-176
/
2013
Background: Effective policy implementation is essential for a healthy workplace. The Ryan-Kossek 2008 model for work-life policy adoption suggests that supervisors as gatekeepers between employer and employee need to know how to support and communicate benefit regulations. This article describes a workplace intervention on a national employee benefit, Family and Medical Leave Act (FMLA), and evaluates the effectiveness of the intervention on supervisor knowledge, awareness, and experience with FMLA. Methods: The intervention consisted of computer-based training (CBT) and a survey measuring awareness and experience with FMLA. The training was administered to 793 county government supervisors in the state of Oregon, USA. Results: More than 35% of supervisors reported no previous training on FMLA and the training pre-test revealed a lack of knowledge regarding benefit coverage and employer responsibilities. The CBT achieved: (1) a significant learning effect and large effect size of d = 2.0, (2) a positive reaction to the training and its design, and (3) evidence of increased knowledge and awareness regarding FMLA. Conclusion: CBT is an effective strategy to increase supervisors' knowledge and awareness to support policy implementation. The lack of supervisor training and knowledge of an important but complex employee benefit exposes a serious impediment to effective policy implementation and may lead to negative outcomes for the organization and the employee, supporting the Ryan-Kossek model. The results further demonstrate that long-time employees need supplementary training on complex workplace policies such as FMLA.
Background: The aim of this study is to illustrate the historical role of the International Commission on Occupational Health (ICOH) congresses as an arena where national and international occupational medicine can dialogue and as the first example of scientific transferability of the research and prevention results that have had such an impact on global public health. Methods: We used the ICOH Heritage Repository, in which ICOH congress proceedings (from the first congress in Milan in 1906 to the last congress, held in Dublin in 2018), are organised in an orderly way, updated and easily accessible according to open access logic. Results: We describe studies by three physicians who submitted significant scientific work to ICOH congresses, one on the battle against ancylostomiasis (Volante, 1906), the second (Quarelli, 1928) on carbon disulphide poisoning, and the third (Viola, 1969) on the carcinogenicity of vinyl chloride monomer. Priority is given to Italian cases, on account of the authors' obvious familiarity with the issues. Conclusion: The visibility offered in ICOH conferences and their published proceedings has boosted the international spread of their findings, contributing to the scientific transferability of the research results and influencing the development of policies and prevention interventions that have had a great impact on global public health.
Background: Indoor air dampness microbiota (DM) is a big health hazard. Sufficient evidence exists that exposure to DM causes new asthma or exacerbation, dyspnea, infections of upper airways and allergic alveolitis. Less convincing evidence has yet been published for extrapulmonary manifestations of dampness and mold hypersensitivity syndrome). Methods: We investigated the prevalence of extrapulmonary in addition to respiratory symptoms with a questionnaire in a cohort of nurses and midwives (n = 90) exposed to DM in a Helsinki Obstetric Hospital. The corresponding prevalence was compared with an unexposed cohort (n = 45). Particular interest was put on neurological symptoms and multiple chemical sensitivity. Results: The results show that respiratory symptoms were more common among participants of the study vs. control cohort, that is, 80 vs 29%, respectively (risk ratio [RR]: 2.56, p < 0.001). Symptoms of the central or peripheral nervous system were also more common in study vs. control cohort: 81 vs 11% (RR: 6.63, p < 0.001). Fatigue was reported in 77 vs. 24%, (RR: 3.05, p < 0.001) and multiple chemical sensitivity in 40 vs. 9%, (RR: 3.44, p = 0.01), the so-called "brain fog", was prevalent in 62 vs 11% (RR: 4.94, p < 0.001), arrhythmias were reported in 57 vs. 2.4% (RR: 19.75, p < 0.001) and musculoskeletal pain in 51 vs 22% (RR: 2.02, p = 0.02) among participants of the study vs. control cohort, respectively. Conclusion: The results indicate that the exposure to DM is associated with a plethora of extrapulmonary symptoms. Presented data corroborate our recent reports on the health effects of moist and mold exposure in a workplace.
Kim, Jihyun;Rana, Sohel;Lee, Wanhyung;Haque, Syed Emdad;Yoon, Jin-Ha
Safety and Health at Work
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v.11
no.2
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pp.143-151
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2020
Objective: Bidi is an inexpensive, low-processed, hand-rolled tobacco product. In Bangladesh, especially in Rangpur, tobacco farming and bidi processing are common. In this study, we aimed to evaluate the impact of bidi making on children working in bidi factories. Methods: This qualitative(walk-through survey) and quantitative(questionnaire-based survey and a urine cotinine level quantitation) study was conducted in Rangpur, Bangladesh in 2017. Study population included child-workers aged ≤14 years who were regularly employed as bidi makers. Findings: The results of the walk-through survey revealed hazardous working environments at bidi factories. For the quantitative survey, 171 child-workers were categorized into "less-working"(<5 hours/day) and "more-working"(≥5 hours/day) groups; additionally, "forced-working"(forced into work by parents) and "voluntary-working"(working voluntarily) groups were delineated within the same population. In the logistic regression analysis, odds ratios(ORs) of respiratory symptoms and unusual absence(absent ≥5 days/month) were higher in the "more-working" group than in the "less-working" group(unusual absence: OR, 2.91; 95% confidence interval[CI], 1.43-5.94), and this association became higher in the "forced-working" group with longer working hours(OR, 5.68, 95%CI 2.30-14.00). Conclusions: Cheap, hand-rolled tobacco(bidi) is harmful to the health of bidi-making child-workers. Children in poverty bow to the demands of cheap labor and poverty and jeopardize their health and future prospects by working in bidi factories. Tobacco control policies should consider the social effects of tobacco beyond its biological effects.
Delgado, Diemen;Aguilera, Maria De Los Angeles;Delgado, Fabian;Rug, Ani
Safety and Health at Work
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v.3
no.2
/
pp.140-145
/
2012
Objectives: To understand the personal experiences of mine workers that have experienced job relocation due to silicosis at the Andina Division of Corporaci$\acute{o}$n Nacional del Cobre (CODELCO), Chile. The purpose of the study was to provide useful information for the development of new local, business and public policies for the care of workers with silicosis. Methods: A qualitative study based on a practical case study of 5 workers. The information was collected by means of structured individual interviews. The method of analysis was phenomenology. Results: The corporal axis was the most commented upon. It included awareness of the illness, body pains, fatigue, and antagonistic mood disorders (sadness, or the difficulty in finding meaning in life). As far as personal relationships, there was evidence of strong relationships with family, coworkers and friends, as well as extended family. Over all, the experience of relocation was positive with periods of impatience and uncertainty. The job reassignment provided a new and pleasant context for the relocated workers and in the process improved their perception of their quality of life. Conclusions: A multidisciplinary team should attend mine workers relocated because of silicosis by addressing the mental and physical aspects of their disease, along with the integral participation of close family members. It is suggested that this investigation be maintain over time to record the personal experiences in the medium-term, adding new cases with the intention of shedding more light on the phenomenon being studied. As a preventive measure, continual workshops are needed on the proper use of respiratory protection in addition, a group of monitors is required.
Awodele, Olufunsho;Popoola, Temidayo D.;Ogbudu, Bawo S.;Akinyede, Akin;Coker, Herbert A.B.;Akintonwa, Alade
Safety and Health at Work
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v.5
no.2
/
pp.106-111
/
2014
Background: The manufacture of paint involves a variety of processes that present with medical hazards. Safety initiatives are hence introduced to limit hazard exposures and promote workplace safety. This aim of this study is to assess the use of available control measures/initiatives in selected paint factories in Lagos West Senatorial District, Nigeria. Methods: A total of 400 randomly selected paint factory workers were involved in the study. A well-structured World Health Organization standard questionnaire was designed and distributed to the workers to elicit information on awareness to occupational hazards, use of personal protective devices, and commonly experienced adverse symptoms. Urine samples were obtained from 50 workers randomly selected from these 400 participants, and the concentrations of the heavy metals (lead, cadmium, arsenic, and chromium) were determined using atomic absorption spectroscopy. Results: The results show that 72.5% of the respondents are aware of the hazards associated with their jobs; 30% have had formal training on hazards and safety measures; 40% do not use personal protective devices, and 90% of the respondents reported symptoms relating to hazard exposure. There was a statistically significant (p < 0.05) increase in the mean heavy metal concentrations in the urine samples obtained from paint factory workers as compared with nonfactory workers. Conclusion: The need to develop effective frameworks that will initiate the integration and ensure implementation of safety regulations in paint factories is evident. Where these exist, there is a need to promote adherence to these practice guidelines.
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