Nursing student evaluation of NIOSH workplace violence prevention for nurses online course

Introduction: As primary targets of workplace violence in health care settings, nurses may suffer negative physical and psychological consequences. NIOSH created an online course to educate nurses about violence prevention techniques. Method: A mixed-methods approach assessed workplace violence awareness and knowledge among nursing students. A pre/post/post-test survey and focus group discussions evaluated participant awareness and knowledge, assessed course design, and solicited recommendations for increasing participation and strategies for improving message retention. Results: The mean awareness scores differed significantly between pre-course and both post-course time points (Wilk's λ = 0.319, F(2, 46) = 49.01, p < 0.001). Post hoc tests using the Bonferroni correction revealed that course participation increased awareness of workplace violence from pre-course scores (M = 0.75, SD = 0.438) to immediate post-course (M = 2.13, SD = 0.789) and four-week post-course (M = 1.96, SD = 0.771) scores on a 3-item measure. Similarly, mean knowledge scores increased between pre-course and both post-course time points (Wilk's λ = 0.495, F(1.57, 73.66) = 37.26, p < 0.001). Post hoc tests using the Bonferroni correction revealed that course participation increased knowledge of workplace violence from pre-course scores (M = 6.65, SD = 1.45) to immediate post-course (M = 8.56, SD = 1.32) and four-week post-course (M = 8.19, SD = 1.42) scores on a 10-item measure. Qualitative data from the focus groups reinforced the quantitative findings. Participants citing benefits from the content strongly recommended including the course in nursing curriculums. Incorporating the course early in the nursing educational experience will better prepare students to deal with workplace violence when they enter health care professions. Conclusions: The results indicate that NIOSH and its partners created an effective online workplace violence awareness and prevention course. Practical applications: Nursing students and professionals can be effectively educated about workplace violence using an online format.

Source: Brann, M., & Hartley, D. (2016). Journal of Safety Research.

Working anytime, anywhere: The effects on the world of work

This report considers the impact of telework/ICT-mobile work on the world of work. It synthesises research carried out by Eurofound’s network of European correspondents and ILO country experts.


Emergent risks to workplace safety as a result of IT connections of and between work equipment

The ever-greater integration of new technologies in work equipment is regarded by some as the fourth industrial revolution and referred to as ‘smart industry'. Examples that come to mind include automation through the use of embedded software, remotely controlling heavy materials, and the connecting of work equipment to local and public networks such as the internet. As well as the opportunities this entails for industry, new threats are also presenting themselves. This includes employees who have to move among robots or autonomous freight vehicles, but also malicious actors who can penetrate computers and computer networks and thereby disrupt processes or bring them to a standstill. The focus in this report lies on the connection between work equipment and cyberspace, including connections to local and public networks such as the internet.


Fundamentals of Total Worker Health Approaches

Essential Elements for Advancing Worker Safety, Health, and Well-Being
A Total Worker Health (TWH) approach is defined as policies, programs, and practices that integrate protection from work-related safety and health hazards with promotion of injury and illness–prevention efforts to advance worker well-being. This workbook is a practical starting point for employers, workers, labor representatives, and other professionals interested in implementing workplace safety and health programs aligned with the Total Worker Health (TWH) approach. The workbook focuses on five Defining Elements of TWH.


Aging and MSD: Strategies for older workers

The global population is aging with a projection that one in five people will be over the age of 60 by 2050. The Canadian population aged 65 and over is expected to double over the next 25 years. The Canadian workforce is also aging with a large proportion of workers (42.4%) in the 45 to 64 age group in 2011 and the average age of labor market participant predicted to continue to rise until 20314. However, it appears that very few Canadian companies have addressed the impact of an aging workforce on occupational health.
Musculoskeletal disorders (MSD) are a burden to all industrial sectors. They present with pain and symptoms such as numbness and tingling. These symptoms may be warning signs of current or impending MSD, such as peripheral nerve entrapments, peripheral enthesopathies, and many other non-specific musculoskeletal pain disorders such as low back pain. There are concerns that MSD maybe more prevalent and costly among older workers, although the evidence supporting these concerns is not consistent. However, it would seem prudent for workplaces to consider strategies for healthy aging to address an aging workforce regardless.
The World Health Organization (WHO) recently released their World Report on Ageing and Health which defines healthy aging as “the process of developing and maintaining the functional ability that enables well-being in older age”6. The WHO report provides a framework for healthy aging. As part of the framework there are proposed strategies for creating age friendly environments that we propose can be adapted and applied to workplaces. The strategies include: i) combating ageism; ii) enabling autonomy, and iii) supporting healthy aging in policy. We suggest that these strategies are valuable for workplaces and by extension MSD and show some supporting research for each of them below.
As part of a scoping review of the literature we present some recent research addressing the WHO strategies and how they may apply to workplaces. We also drew on recent searches for larger ongoing systematic reviews carried out by a team of Institute for Work & Health researchers as part of the prevention review program, including: aging and return to work, return to work and upper extremity MSD prevention. Overall, we note that there is a lack of literature evaluating interventions or strategies related to older workers and MSD.


« Mal aux pattes à en pleurer » : penser les articulations entre santé physique et santé mentale au travail

Ce numéro spécial de la revue Pistes s'intéresse aux liens, rarement explorés, entre dimensions physiques et psychiques de la santé au travail. Si, à première vue, dans une approche globale de la santé, ces deux dimensions seraient évidemment et naturellement liées, à regarder de près la jurisprudence, le déploiement de la prévention sur le terrain, ou encore les travaux académiques sur la santé au travail, troubles et risques, physiques et mentaux, semblent plutôt segmentés, voire cloisonnés. Un système d'oppositions binaires entre activités, risques et troubles, socialement situés, perdure, renforçant les frontières entre corps et âme. Ce numéro, en croisant le regard de chercheurs et de praticiens de disciplines diverses (ergonomie, droit du travail, médecine, psychologie, sociologie) offre, avec ses cinq articles et deux entretiens, un vaste panorama de réflexions sur l'articulation entre corps et esprit en santé au travail et réaffirme que le travail a des effets conjugués sur l'un comme sur l'autre.


Are there any job resources capable of moderating the effect of physical demands on work ability?

A study among kindergarten teachers
Background. It is recognized that teaching in a preschool context is physically demanding. Despite this, the consequences of physical demands on psychophysical health (including work ability) are significantly understudied among kindergarten teachers. Objectives. The aim of the present study is to examine (a) the association between physical demands and work ability and (b) whether psychosocial job resources buffer the negative impact of physical demands among kindergarten teachers. Method. A total of 426 kindergarten teachers employed in the municipal educational services of a city in northwest Italy filled out a self-reported questionnaire. Results. High association was found between physical demand and work ability. Moderated hierarchical regressions showed that decision authority, skill discretion, reward and meaning of work buffer the hampering effect of physical demands and work ability. No buffering effects were observed for support from superiors and colleagues. Conclusion. The present study has relevant, practical implications, highlighting the importance of investing in interventions encompassing a holistic perspective (e.g., psychosocial and ergonomic) in order to effectively combat the hampering effect of physical demands on work ability.

Source: Viotti, Sara, Martini, Mara, & Converso, Daniela. (2016). JOSE : International Journal of Occupational Safety and Ergonomics. 1-28.

Psychosocial safety climate, emotional exhaustion, and work injuries in healthcare workplaces

Preventing work injuries requires a clear understanding of how they occur, how they are recorded, and the accuracy of injury surveillance. Our innovation was to examine how psychosocial safety climate (PSC) influences the development of reported and unreported physical and psychological workplace injuries beyond (physical) safety climate, via the erosion of psychological health (emotional exhaustion). Self-report data (T2, 2013) from 214 hospital employees (18 teams) were linked at the team level to the hospital workplace injury register (T1, 2012; T2, 2013; and T3, 2014). Concordance between survey-reported and registered injury rates was low (36%), indicating that many injuries go unreported. Safety climate was the strongest predictor of T2 registered injury rates (controlling for T1); PSC and emotional exhaustion also played a role. Emotional exhaustion was the strongest predictor of survey-reported total injuries and underreporting. Multilevel analysis showed that low PSC, emanating from senior managers and transmitted through teams, was the origin of psychological health erosion (i.e., low emotional exhaustion), which culminated in greater self-reported work injuries and injury underreporting (both physical and psychological). These results underscore the need to consider, in theory and practice, a dual physical–psychosocial safety explanation of injury events and a psychosocial explanation of injury underreporting.

Source: Zadow, A. J., Dollard, M. F., Mclinton, S. S., Lawrence, P., & Tuckey, M. R. (2017). Stress and Health.

New NIOSH Training Offers Fatigue Management for Pilots in the Land of the Midnight Sun

For a pilot working in Western Alaska, the amount of daylight during their work day can vary as much as 14 hours between the summer and winter solstice (or more the farther north you go). These aviators often fly multiple legs each day, serving as a transportation link to over 250 villages across the state. In fact, over 80% of Alaska's communities are not connected by roads. Vast distances, long hours of daylight, short flying seasons, and wildly variable weather can all contribute to the development of fatigue.
Fatigue is a general lack of alertness and degradation in mental and physical performance, and can affect pilot alertness, performance, and judgment during flight. Fatigue has repeatedly been shown to be an important risk factor for aviation accidents. A NASA survey of regional airline pilots found that 89% of respondents identified fatigue as a moderate or serious concern, 88% reported that fatigue was a common occurrence, and 86% reported that they received no training from their companies that addressed fatigue. Of the 1424 flight crew members responding in this survey, 80% acknowledged having “nodded off” during a flight at some time. Previous research by NIOSH has shown that 22% of pilots working in Alaska made a decision to fly when fatigued either weekly or monthly. Current Federal Aviation Regulations govern pilot flight times and duty limits, but do not ensure that pilots get adequate rest.


Lifetime report of perceived stress at work and cancer among men

A case-control study in Montreal, Canada
Background: The association between perceived workplace psychological stress, over the entire work career, and cancer among men has never been assessed. This was explored in the context of a population-based case-control study conducted in Montreal, Canada.
Methods: 3103 incident cancer cases (11 types) diagnosed in 1979–1985 and 512 population controls were interviewed. Subjects described in detail each job held during their lifetime, including the occurrence of stress, and its reason. Logistic regression estimated odds ratios (OR) and 95% confidence intervals (CI) for the association between perceived workplace stress and its duration, and each cancer site, adjusting for lifestyle and occupational factors.
Results: Employment in at least one stressful job was associated with increased odds of cancers of the lung (OR = 1.33, 95% CI: 1.01–1.75), colon (OR = 1.51, 95% CI: 1.15–1.98), bladder (OR = 1.37, 95% CI: 1.03–1.81), rectal (OR = 1.52, 95% CI: 1.10–2.10), and stomach (OR = 1.53, 95% CI: 1.08–2.15). A duration-response trend was found for cancers of the lung, colon, rectum, stomach, and for NHL. Subjects reported changes in stress level over their career. Perceived stress was ascribed to several sources, including high demand and time pressure, financial issues, job insecurity, and hazardous conditions.
Conclusion: Prolonged exposure to perceived stress at work was associated with greater odds of cancer at 5 out of 11 sites. While over reporting of stress by cases cannot be fully ruled out, these associations, if substantiated, would bear important public health significance. Prospective studies building on detailed stress assessment protocols considering all sources and changes over the career are necessary.

Source: Blanc-Lapierre, A., Rousseau, M. C., Weiss, D., El-Zein, M., Siemiatycki, J., & Parent, M. É. (2017). Preventive Medicine, 96, 28-35.

Vers l’amélioration des services et des soins palliatifs de fin de vie

Adapter et implanter des programmes de soutien en milieu de travail et évaluer leur effet sur la satisfaction, le sens au travail et le bien-être des infirmières (SATIN II)
Le projet SATIN II propose l'étude de quatre programmes de soutien en milieu de travail. Ces initiatives ont pour but l'amélioration de la satisfaction et du bien-être au travail ainsi que la diminution des FRPS chez des infirmières et des cliniciens qui assurent les SFV. La démarche est guidée par les recommandations du Medical Research Council (MRC-UK) afin d'encadrer l'élaboration, l'implantation et l'évaluation des interventions, selon deux phases. L'objectif principal de la phase I est l'élaboration d'une intervention permettant d'intégrer aux pratiques en cours une approche palliative aux unités de soins. La phase II inclut à la fois l'évaluation de la faisabilité et de l'impact de l'intervention ainsi qu'un prétest de cet impact sur certains indicateurs (satisfaction, bien être et FRPS).


The relationship between occupational health and safety vulnerability and workplace injury

This study employs a recently developed conceptual framework and measurement tool that moves beyond defining occupational health and safety (OH&S) vulnerability using population or occupational characteristics, and instead examines how work and workplace characteristics shape an individual worker's risk of injury (Smith et al., 2015). The measurement tool captures information on four dimensions of OH&S vulnerability: (1) exposure to workplace hazards; (2) workplace safety policies and procedures; (3) worker awareness of health and safety-related rights and responsibilities; and (4) worker empowerment to act to protect themselves and colleagues. The conceptual framework posits that in isolation exposure to workplace hazards, or poor access to protective policies and procedures, awareness or empowerment places workers at increased risk of injury but that the greatest risk arises for workers who are both exposed to hazards and experience one or more deficits in resources to manage these hazards. We contend that ‘vulnerability' arises from exposure to on-the-job hazards in conjunction with inadequate access to resources (policies and procedures, awareness or empowerment) to mitigate the effects of these risks.

Source: A. Morgan Lay, Ron Saunders, Marni Lifshen, F. Curtis Breslin, Anthony D. LaMontagne, Emile Tompa et Peter M. Smith. (2017). Safety Science, 85–93.

A systematic review of brief mental health and well-being interventions in organizational settings

The present study offers an overview of the evidence on the effectiveness of brief mental health and well-being interventions in organizational settings and comparison of their effects with corresponding interventions of common (ie, longer) duration. It discusses the findings in the light of quality appraisal of included studies and emphasizes the need for further research with methodologically rigorous study designs and enhanced reporting of methods.

Source: Ivandic, I., Freeman, A., Birner, U., Nowak, D., & Sabariego, C. (2017). Scandinavian Journal of Work, Environment & Health.

Effectiveness of participatory training in preventing accidental occupational injuries

A randomized-controlled trial in China
This is the first large scale randomized controlled trial documenting the effectiveness of a participatory approach to occupational health and safety training in reducing work injuries and re-injuries among industrial workers. This approach can be adopted and tried out in other settings, and is expected to help reduce the huge burdens of work injuries to workers, their families and society.

Source: Yu, I. T., Yu, W., Li, Z., Qiu, H., Wan, S., Xie, S., & Wang, X. (2017). Scandinavian Journal of Work, Environment & Health.

Fifth International Conference on Violence in the Health Sector

Broadening our view, responding together
In 2009, Professor Klaus Wahl of Germany published an interesting, comprehensive analytical model of aggression and violence that links microcosmic and macrocosmic levels (Figure 1). The level of the microcosm encompasses genes, the brain and psychic processes, bio-physiological survival mechanisms and various types of aggression. The level of the macrocosm encompasses the environment, socialization and situation-induced social dynamics. Between these two poles lies the interplay of an individual's personality and society determines the phylogeny (development or evolution of a particular group of individuals) and the ontogeny (origination and development of an individual) of violent behavior. This model – although probably not yet well known beyond the boundaries of German- speaking countries – allows for a comprehensive understanding of the “big picture” of aggression and violence at the societal and the personal level and may thus be appealing to persons working within the health sector.

Source: Needham, Ian, McKenna, Kevin, Frank, Odile, & Oud, Nico. (2016). Violence in the Health Sector: Proceedings of the Fifth International Conference on Violence in the Health Sector: Broadening our view, responding together, 26-28 October 2016, Dublin, Ireland. Amsterdam : Netherlands : KAVANAH, 480 p.

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