Occupational Medicine 2016;66:1 doi:10.1093/occmed/kqv215
In this issue of Occupational Medicine be exposed to hand-transmitted vibration irrespective of their Stockholm staging. Outdoor workers have significantly increased skin cancer risk from solar radiation at work. Houdmont et al. [5] evaluated a DVD-based health education intervention for sun safety in UK construction workers. Safety knowledge and protective practice have been traditionally poor in the UK; however, they report positive changes in reported sun safety practices at follow-up. Next Skogstad et al. [6] report on their systematic literature review into the effects of workplace noise on health. Exposure to noise at work appears positively associated with hypertension and cardiovascular disease but the effect of noise exposure on cardiovascular mortality seems weak. Some evidence of a dose–response effect of noise on hypertension and cardiovascular disease was found. Another reason to keep workplace noise levels as low as possible. Finally, health care workers (HCW) with exposure to wet work or hand hygiene practices are at increased risk for developing occupational skin diseases such as dermatitis. Identification of risk factors and workplace screening can assist early detection, avoiding chronicity. Nichol et al. [7] used a new rapid workplace screening tool to identify a high proportion of HCW with hand dermatitis. Risk factors for mitigation are proposed. Peter Noone Assistant Editor
References 1. Halford JV, Lam KBH, Folkes SEF, Sadhra S. Anterior cruciate ligament reconstruction and service in the British Army. Occup Med (Lond) 2016;66:17–19. 2. Colquhoun CP, Casolin A. Impact of rail medical standard on obstructive sleep apnoea prevalence. Occup Med (Lond) 2016;66:62–68. 3. Howard ME, O’Donoghue FJ. The hidden burden of OSA in safety critical workers: how should we deal with it? Occup Med (Lond) 2016;66:2–4. 4. Poole CJM, Cleveland TJ. Vascular hand–arm vibration syndrome—magnetic resonance angiography. Occup Med (Lond) 2016;66:75–78. 5. Houdmont J, Madgwick P, Randall R. Sun safety in construction: a UK intervention study. Occup Med (Lond) 2016;66:20–26. 6. Skogstad M, Johannessen HA, Tynes T, Mehlum IS, Nordby K-C, Lie A. Systematic review of the cardiovascular effects of occupational noise. Occup Med (Lond) 2016;66:10–16. 7. Nichol K, Copes R, Spielmann S, Kersey K, Eriksson J, Holness DL. Workplace screening for hand dermatitis: a pilot study. Occup Med (Lond) 2016;66:46–49.
© The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: [email protected]
Downloaded from http://occmed.oxfordjournals.org/ by guest on April 10, 2016
This issue of Occupational Medicine includes several articles on the effects of health on work in terms of fitness for work and work on health with mitigation of work health risks. Halford et al. [1] reviewed the evidence base supporting British Army recruiting policy since 2005, where some individuals with a history of anterior cruciate ligament reconstruction (ACLR) were accepted based on studies showing successful return to sport following ACLR without increased risk of re-injury. This study explored whether sports injury evidence extrapolates to a military population. New recruits to the British Army with a prior history of ACLR had a 3-fold increased risk of medical discharge compared to those without; 61% experienced significant complications, with 25% being subsequently medically discharged, despite rigorous pre-placement assessment. The success of ACLR in returning persons to their pre-injury level of activity appears temporary. The authors recommend that 2005 Army recruitment policy in respect of ACLR be reviewed in light of this new evidence. Colquhoun and Casolin [2] screened for obstructive sleep apnoea (OSA) using the 2012 revised Australian National Standard for Health Assessment of Rail Safety Workers. Including new objective clinical criteria of either (i) a body mass index (BMI) over 40 kg/m2, (ii) a BMI over 35 kg/m2 in conjunction with hypertension, diabetes or OSA symptoms, or (iii) self-reported excessive sleepiness, increased OSA detection rates in rail workers from 2 to 7%. Previously, OSA identification relied on self-reports of sleepiness alone. They stress that the Epworth Scale score alone is unreliable for clinical screening for OSA. Subjective sleepiness may not be recognized by many individuals with significant sleep disorders. These new medical standards appear to have good specificity in the identification and treatment of OSA in rail workers. Challenges remain to accurately and objectively stratify the severity and impact of OSA on sleepiness and accident risk. In an accompanying editorial, Howard and O’Donoghue [3] highlight that sleepiness due to inadequate sleep, circadian effects or sleep disorders accounts for most of the 20% of motor vehicle crashes attributed to fatigue. OSA, the most commonly implicated sleep disorder, increased the risk 2- to 3-fold, although this is unproven yet for professional drivers. Poole and Cleveland [4] report on using magnetic resonance angiography to investigate cases of vibrationexposed workers with only one artery supplying a hand, or with only one palmar arch. They advocate that such cases are at increased risk of progression and should not
In this issue of Occupational Medicine be exposed to hand-transmitted vibration irrespective of their Stockholm staging. Outdoor workers have significantly increased skin cancer risk from solar radiation at work. Houdmont et al. [5] evaluated a DVD-based health education intervention for sun safety in UK construction workers. Safety knowledge and protective practice have been traditionally poor in the UK; however, they report positive changes in reported sun safety practices at follow-up. Next Skogstad et al. [6] report on their systematic literature review into the effects of workplace noise on health. Exposure to noise at work appears positively associated with hypertension and cardiovascular disease but the effect of noise exposure on cardiovascular mortality seems weak. Some evidence of a dose–response effect of noise on hypertension and cardiovascular disease was found. Another reason to keep workplace noise levels as low as possible. Finally, health care workers (HCW) with exposure to wet work or hand hygiene practices are at increased risk for developing occupational skin diseases such as dermatitis. Identification of risk factors and workplace screening can assist early detection, avoiding chronicity. Nichol et al. [7] used a new rapid workplace screening tool to identify a high proportion of HCW with hand dermatitis. Risk factors for mitigation are proposed. Peter Noone Assistant Editor
References 1. Halford JV, Lam KBH, Folkes SEF, Sadhra S. Anterior cruciate ligament reconstruction and service in the British Army. Occup Med (Lond) 2016;66:17–19. 2. Colquhoun CP, Casolin A. Impact of rail medical standard on obstructive sleep apnoea prevalence. Occup Med (Lond) 2016;66:62–68. 3. Howard ME, O’Donoghue FJ. The hidden burden of OSA in safety critical workers: how should we deal with it? Occup Med (Lond) 2016;66:2–4. 4. Poole CJM, Cleveland TJ. Vascular hand–arm vibration syndrome—magnetic resonance angiography. Occup Med (Lond) 2016;66:75–78. 5. Houdmont J, Madgwick P, Randall R. Sun safety in construction: a UK intervention study. Occup Med (Lond) 2016;66:20–26. 6. Skogstad M, Johannessen HA, Tynes T, Mehlum IS, Nordby K-C, Lie A. Systematic review of the cardiovascular effects of occupational noise. Occup Med (Lond) 2016;66:10–16. 7. Nichol K, Copes R, Spielmann S, Kersey K, Eriksson J, Holness DL. Workplace screening for hand dermatitis: a pilot study. Occup Med (Lond) 2016;66:46–49.
© The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: [email protected]
Downloaded from http://occmed.oxfordjournals.org/ by guest on April 10, 2016
This issue of Occupational Medicine includes several articles on the effects of health on work in terms of fitness for work and work on health with mitigation of work health risks. Halford et al. [1] reviewed the evidence base supporting British Army recruiting policy since 2005, where some individuals with a history of anterior cruciate ligament reconstruction (ACLR) were accepted based on studies showing successful return to sport following ACLR without increased risk of re-injury. This study explored whether sports injury evidence extrapolates to a military population. New recruits to the British Army with a prior history of ACLR had a 3-fold increased risk of medical discharge compared to those without; 61% experienced significant complications, with 25% being subsequently medically discharged, despite rigorous pre-placement assessment. The success of ACLR in returning persons to their pre-injury level of activity appears temporary. The authors recommend that 2005 Army recruitment policy in respect of ACLR be reviewed in light of this new evidence. Colquhoun and Casolin [2] screened for obstructive sleep apnoea (OSA) using the 2012 revised Australian National Standard for Health Assessment of Rail Safety Workers. Including new objective clinical criteria of either (i) a body mass index (BMI) over 40 kg/m2, (ii) a BMI over 35 kg/m2 in conjunction with hypertension, diabetes or OSA symptoms, or (iii) self-reported excessive sleepiness, increased OSA detection rates in rail workers from 2 to 7%. Previously, OSA identification relied on self-reports of sleepiness alone. They stress that the Epworth Scale score alone is unreliable for clinical screening for OSA. Subjective sleepiness may not be recognized by many individuals with significant sleep disorders. These new medical standards appear to have good specificity in the identification and treatment of OSA in rail workers. Challenges remain to accurately and objectively stratify the severity and impact of OSA on sleepiness and accident risk. In an accompanying editorial, Howard and O’Donoghue [3] highlight that sleepiness due to inadequate sleep, circadian effects or sleep disorders accounts for most of the 20% of motor vehicle crashes attributed to fatigue. OSA, the most commonly implicated sleep disorder, increased the risk 2- to 3-fold, although this is unproven yet for professional drivers. Poole and Cleveland [4] report on using magnetic resonance angiography to investigate cases of vibrationexposed workers with only one artery supplying a hand, or with only one palmar arch. They advocate that such cases are at increased risk of progression and should not
