Quality assurance audits of medical surveillance programs for hazardous waste workers

Article Abstract:

The management and disposal of hazardous wastes has become a major industry in the US. The Occupational Safety and Health Administration (OSHA) requires periodic medical examinations for workers involved in the clean-up, transportation, or disposal of hazardous wastes. According to OSHA, the medical examination should include a work-related history, with particular attention to the development of symptoms that may be related to hazardous waste exposure. The physician is required to provide a written report stating the worker's fitness for duty, which should include any special limitations or restrictions. The results of the examination should be reported to the employee. A study was performed to evaluate the medical services provided for hazardous waste workers to determine how closely the guidelines established by OSHA are followed. During the study, the medical records from 328 examinations performed at 17 different medical facilities were reviewed. In most cases, the required paperwork for evaluations of fitness for duty had been completed and appropriate referrals for further medical care were made when major illnesses were identified. However, in many cases, a complete work history was not performed and lung function tests were often performed incorrectly. Also, many patients were not informed of the results of their examination. It is concluded that physicians and technical staff may need better training on how to perform medical evaluations of hazardous waste workers. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Medical examination, Medical care, Quality management, Medical care quality, Hazardous waste management industry, Workers, Periodic health examinations

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Work site smoking cessation: a meta-analysis of long-term quit rates from controlled studies

Article Abstract:

Programs that promote health have consistently been providing opportunities for employees to stop smoking. Programs aimed at smoking cessation that are based in the work place seem to be more effective than those programs that are clinic-based. Meta-analytic methods were applied to 20 studies of work place smoking cessation in an attempt to identify factors influencing program efficacy, circumstances, and for whom a program is effective. Meta-analysis is a quantitative synthesis of the literature on a particular subject. There were 34 comparisons of long-term quite rate (QR). The average follow-up quit rate was 13 percent. The largest effect was seen in smaller work sites of 100 to 249 employees with programs lasting two to six hours that included heavy smokers. The majority of programs reported were in companies having more than 750 employees, yet these companies had the lowest quite rate at 12 percent. It is noted that large companies can be 'made smaller' by grouping employees in smoking cessation programs by department. Other factors with a strong association with quit rate were a simple program and programs that involved both company and employee time. (Consumer Summary produced by Reliance Medical Information, Inc.)

Environmental aspects, Smoking cessation programs, Smoking cessation, Smoking, Wellness programs

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