Aims To obtain a better understanding of factors that are associated with cognitive limitations in employed MBTS.

Methods The study was performed by means of a web-based survey. Occupationally active MBTS (n = 113) and a non-cancer comparison group (n = 123) were recruited. While accounting for demographics, medical factors, health behaviours and problem-solving orientation, the relationship among measures of symptom burden (fatigue, depression and anxiety) and cognitive limitations were investigated.

Results MBTS (average 4 years post-diagnosis) reported higher levels of physical fatigue (P < 0.001), depression (P < 0.001) and anxiety (P < 0.01). MBTS reported more overall cognitive limitations (P < 0.001), memory (P < 0.001), executive function (P < 0.001) and attention (P < 0.001) deficits. Education (B = –3.4, 95% CI = –6.7 to 0.1), ethnicity (B = 5.2, 95% CI = 0.6–9.8), job stress (B = 3.9, 95% CI = 1.5–6.4), depressive symptoms (B = 0.7, 95% CI = 0.1–1.3) and negative problem solving (B = 4.2, 95% CI = 1.5–7.0) were also associated with higher levels of cognitive limitations in both groups.

Conclusions Occupationally active MBTS report higher levels of cognitive limitations. However, modifiable factors were related to cognitive limitations in both groups and should be considered when developing approaches to improve cognitive limitations in the workplace.

Methods A cohort of 308 male production workers from seven factories have been enumerated. All employees had a minimum of 12 months employment and were first employed at one of the participating factories in the period 1973–2000. Mortality and cancer incidence data for the period 1979–2007 were compared with expected values based on national rates.

Results Mortality from all cancers combined was below the expected value [observed (Obs) 5, standardized mortality ratio (SMR) 68]. There was a single death from bladder cancer (SMR 560). The incidence of all cancers combined was also below expectation [Obs 9, standardized registration ratio (SRR) 77]. Site-specific incidence was unexceptional except there was a non-significant excess of bladder cancer based on two cases (SRR 328).

Conclusions The findings for bladder cancer should be treated with caution as they relate to a relatively early period of follow-up and are based on very small numbers.

Aims To evaluate the hypothesis of increased risk of HAV infection in WWs.

Methods The prevalence of antibodies to HAV in 869 WWs was compared to 311 other subjects and analysed to detect the main potentially confounding variables.

Results Univariate analysis demonstrated that occupational exposure to sewage was not significantly associated with the prevalence of anti-HAV(+). The anti-HAV(+) prevalence was strongly associated with age and shellfish consumption (P < 0.05) when the subcategories of workers were examined separately (WWs and control group) and jointly. In the logistic regression model, a significant association between anti-HAV(+) prevalence and duration of employment (P < 0.05) was found. The interaction term (age x duration of employment) was significant (P < 0.001) when included in the logistic model.

Conclusions This study shows that working in a wastewater treatment plant does not seem to be related to a greater prevalence of antibodies to hepatitis A. Moreover, the relative risk of HAV infection among WWs seems to be correlated with low anti-HAV(+) prevalence in the general population.

Aims To describe a case of occupational asthma (OA) related to chengal wood dust.

Methods The patient was evaluated clinically for asthma in relation to occupational history, serial peak flow monitoring and specific inhalation challenge (SIC) test.

Results Peak flow monitoring showed significant deterioration during exposure to chengal wood dust at work. SIC test resulted in an isolated immediate asthmatic reaction.

Conclusions Exposure to chengal wood dust can lead to OA and possibly rhinitis. The underlying mechanism should be investigated.

Aims To investigate associations between the frequency of previous sickness absence and self-reported perceptions of health and work.

Methods Cross-sectional study of female hospital care workers in which health, work characteristics and coping styles were assessed by questionnaire and linked to the number of sickness absence episodes recorded in the preceding 5 years using negative binomial regression analysis for counts distinguishing between short (1–7 days) and long (>7 days) episodes of absence after adjusting for age and duration of employment in December 2007 and hours worked between 2003 and 2007.

Results Of 350 women employed for at least 5 years, 237 (68%) answered the questionnaire. The hours worked over the 5 year period [rate ratio (RR) = 1.2] and problem solving coping style score (RR = 1.1) were positively associated with the number of short sickness absence episodes. Age (RR = 0.8) and good general health (RR = 0.7) were inversely related to the number of both short and long episodes. Self-reported mental health and work characteristics were not shown to be related to the frequency of sickness absence.

Conclusions Hours worked, problem-solving coping style, age and general health showed associations with the frequency of previous sickness absence among women who had worked at least 5 years in health care. Future prospective studies on the frequency of sickness absence should consider the impact of these factors further.

Methods Workers were recruited from a biological detergent formulating and packaging company. Those with occupational asthma symptoms and/or specific IgE to a detergent enzyme were asked to complete 2 hourly PEF measurements for 4 weeks. Outputs from the Oasys program (Oasys score, rest–work score and rest–work difference in diurnal variation) assessed PEF response. These were then related to the levels of sensitization and current occupational exposure to detergent enzymes.

Results In all, 67/72 workers returned PEF records; 97% were able to return a record with at least four readings per day and 87% at least 3 weeks in length. Of total, 79% (n = 27) of those with a final diagnosis of occupational asthma had peak flow records confirming the disease using Oasys. PEF response was similar in those with high, medium and low levels of exposures and those with negative, low–moderate and high specific IgE levels.

Conclusions The Oasys program is a sensitive tool for the diagnosis of detergent enzyme occupational asthma, but the levels of exposure and specific IgE sensitization to enzymes do not affect the magnitude of PEF response in symptomatic workers.

Aims To compare the reported incidence of work-related (WR) MSDs by specialist OPs and specialist rheumatologists and to relate it to self-reported and general practitioners-reported WR MSDs.

Methods Analysis of data reported to surveillance schemes within The Health and Occupation Reporting network and comparison to denominator data derived from the Labour Force Survey and occupational/work activity classifications.

Results There are significant differences between the patterns of WR MSDs seen by the different specialist groups. Thus OPs report three times as many back and lower limb conditions. However, both specialist groups report similar numbers of cases of hand–arm vibration syndrome (12/9%) and ‘vague and ill-defined’ upper limb conditions (16/14%). The absolute risk of physician reported that WR MSDs increases 5-fold between ages 15–24 and 45–64.

Conclusions The specialist reporting schemes give an indication of current practice and are useful both to update and to strategically inform planning. The data are amenable, with appropriate statistical analysis, for comparison with self-reporting and to the characterization of risk in broad categories of occupation and work activity.

Aims To investigate the minimum data requirements to maintain the sensitivity and specificity of the ABC score.

Methods A total of 196 sets of measurements from workers with occupational asthma confirmed by methods other than serial PEFs and 206 records from occupational and non-occupational asthmatics who were not at work at the time of PEF monitoring were analysed according to their mean number of readings per day. Measurements from work and rest days were sequentially removed separately and the ABC score calculated at each reduction. The sensitivity and specificity of the ABC score (using a cut-off of 15 l/min/h) was calculated for each duration.

Results Two-hourly measurements (~8 readings per day) with eight workdays and three rest days had 68% sensitivity and 91% specificity for occupational asthma diagnosis. As readings decreased to ≤4 readings per day, ≥15 workdays were required to provide a specificity above 90%.

Conclusions To be sensitive and specific in the diagnosis of occupational asthma, the ABC score requires 2-hourly PEF measurements on eight workdays and three rest days. This is a short assessment period that should improve patient compliance.

Aims To investigate psychosocial working conditions, self-reported causes of work-related stress and satisfaction among a representative sample of vets practising in the UK.

Methods A cross-sectional study using a questionnaire mailed to a stratified random sample of 3200 vets. The Health & Safety Executive Management Standards Indicator Tool and a series of bespoke questions were embedded in a 120 item questionnaire, which also assessed anxiety and depressive symptoms, alcohol consumption, suicidal ideation, positive mental well-being and work–home interaction.

Results A total of 1796 useable questionnaires were returned (response rate 56%). Number of hours worked and making professional mistakes were the main reported contributors to stress. Good clinical outcomes and relationships with colleagues were the greatest sources of satisfaction. Anxiety and depressive symptoms are associated with less favourable working conditions.

Conclusions Compared to the general population, the sample reported higher risk of work-related stress for demands and managerial support but lower risk for relationships and change. The results could be used to inform the development of targeted interventions.

Aims To describe the characteristics of serious injuries and the use of safety precautions at the time of injury in Australian veterinarians.

Methods Graduates in veterinary medicine from Australian universities completed questionnaires asking about injuries during their professional career including type of injury and circumstances during which injury occurred.

Results A total of 2188 significant injuries were reported. Injuries were most frequently sustained on farms (55%) and associated with undertaking procedural activities (37%) and examining and moving animals (37%). The hand (33%) was the commonest site involved. Injuries to the head and face regions accounted for 15% of all injuries.

The most frequent injuries sustained were open wounds (36%), fractures and dislocations (27%) and soft tissue bruising (12%). There were 63 reports of intracranial injury and 19 traumatic amputations reported. Bites, kicks or strikes, animal contact and cutting or scratching were the most frequent mechanisms of injury reported. The major factors reported in association with injury were cattle (22%), horses (21%), dogs (20%) and cats (8%). Fifty-five per cent of veterinarians reported the use of safety precautions at the time of injury.

Conclusions Veterinarians are a high-risk group for significant injury from animal contacts. The reported use of safety measures and their effectiveness when used by veterinarians appear less than optimal. Further efforts aimed at addressing injury prevention may include developing and implementing improved safe handling practices and safety precautions.

Aims To investigate the influence of green tea and coffee ingestion on urinary HA concentrations.

Methods Time-weighted average exposures to toluene were monitored by measuring urinary HA in 245 car painters in 2005 and again in 2006. Samples of both urine and blood were collected during work hours. All the participants were also asked about their alcohol intake, smoking and dietary and beverage habits, especially green tea and coffee. To clarify the relationship between green tea and coffee ingestion, workers were prohibited from consuming green tea and coffee for 1 day before the health check-up in 2006.

Results The frequency of positive urinary HA concentrations (>1.0 g/l) in heavy consumers of green tea and/or coffee was significantly higher than that of the non-consumer or light consumers (OR 2.34, 95% CI 1.15–4.74). Prohibiting green tea and coffee ingestion was effective in decreasing the frequency of falsely elevated urinary HA concentrations (P < 0.01).

Conclusions The consumption of green tea and/or coffee can result in an overestimation of urinary HA concentrations and cause false-positive results during the biological monitoring of workers exposed to low doses of toluene.

Aims To investigate the potential association of these occupational and lifestyle factors, as well as medical history and skin type, with non-melanoma skin cancer in pilots.

Methods Data were collected using a confidential Internet survey administered in collaboration with the Air Line Pilots Association International to all active pilots in four US commercial airlines. Pilots with non-melanoma skin cancer were compared to those without using multivariable analysis.

Results The response rate was 19%. Among pilots flying <20 years prior to diagnosis, factors associated with increased odds of non-melanoma skin cancer were at-risk skin type, childhood sunburns and family history of non-melanoma skin cancer. Off-duty sunscreen use and family history of melanoma were protective. Among pilots with ≥20 years flight time prior to diagnosis, childhood sunburns and family history of non-melanoma skin cancer persisted as risk factors, with the addition of flight time at high latitude.

Conclusions Further investigation regarding the potential health impact of long-term flying at high latitudes is recommended. Additionally, occupational health programmes for pilots should stress awareness of and protection against established risk factors for non-melanoma skin cancer.

Aims To determine the prevalence of workplace violence in paediatric residency training programmes.

Methods In 2007, a 25-item web-based questionnaire about experiences of verbal and/or physical abuse while on duty was distributed to 1211 paediatric residents at all training levels from 25 paediatric programmes.

Results A total of 541 questionnaires were returned giving a 45% response rate. In total, 33% of the respondents had been verbally abused or physically assaulted by patients and/or patients’ families during their residency programme, although verbal abuse was much more common than physical assaults. In total, 71% of respondents reported having no teaching about workplace violence during their residency training. The majority (74%) indicated that they would like to receive more training in managing angry patients and families.

Conclusions Paediatric residents are often exposed to verbal threats during the course of their work. They are also at risk of physical assaults by angry patients and/or families. Paediatric residents require more training on how to prevent and respond to workplace violence, and this important topic should be incorporated into the paediatric residency curriculum.

Aims To examine the association between the hand–arm vibration syndrome (HAVS) Stockholm sensorineural scale stages and tests of peripheral neurological function including measurement of current perception threshold (CPT) and nerve conduction.

Methods All the subjects were men who were assessed for HAVS with a medical and occupational history and physical examination to determine the Stockholm stage, CPT testing at frequencies of 5, 250 and 2000 Hz for the median and ulnar nerves and measurement of nerve conduction carried out in a blinded fashion.

Results A total of 155 of the 157 recruited subjects agreed to take part in the study, a 99% participation rate. CPT was statistically significantly increased (P < 0.001) in both Stockholm sensorineural Stages 1 and ≥2 in comparison to Stage 0 for every frequency and nerve combination. However, CPT could not discriminate well between Stages 1 and ≥2. There was no association between median or ulnar neuropathy measured by nerve conduction and the Stockholm stages. Polychotomous multinomial logistic regression indicated that the CPT measurements at 2000 Hz, corresponding to damage to large myelinated nerve fibres, were most predictive of both Stockholm Stages 1 and ≥2 in comparison to Stage 0.

Conclusions Neuropathy measured by nerve conduction was unrelated to the Stockholm scale stages. CPT was increased above Stage 0 but did not distinguish well between the higher stages of the Stockholm scale.

Aims To investigate alcohol consumption and the prevalence and associations of ‘at-risk’ drinking among vets in the UK.

Methods Alcohol consumption was measured using the Alcohol Use Disorders Identification Test alcohol consumption questions (AUDIT-C) embedded in a questionnaire which included measures of mental health and psychosocial working conditions, administered to a representative sample of 1796 vets. Scores of ≥4 for women and ≥5 for men were used as an indicator of ‘at-risk’ drinking.

Results The response rate was 56%. Five per cent of respondents were non-drinkers, 32% low-risk drinkers and 63% at-risk drinkers. The estimated odds of at-risk drinking was not significantly different for men and women. A 1-year increase in age was associated with a 2% reduction in the odds of at-risk drinking (OR 0.98, 95% CI: 0.97–0.99, P < 0.01). There was no significant difference across hours worked or on call in a typical week. Lower psychological demands at work were associated with reduced odds of at-risk drinking (OR 0.75, 95% CI: 0.63–0.90, P < 0.01).

Conclusions It is estimated that vets drink more frequently than the general population, but consume less on a typical drinking day and have a prevalence of daily and weekly binge drinking that is similar to the general population. The level of alcohol consumption does not appear to be a negative influence on mental health within the profession as a whole.

Aims To estimate the 12-month prevalence of self-reported musculoskeletal symptoms in the head/neck, shoulders, elbows, wrists/hands, upper back, low back, hips, knees and ankles/feet in salespersons.

Methods A cross-sectional survey using a descriptive questionnaire was used to evaluate musculoskeletal symptoms in 1310 female salespersons in 18 department stores.

Results Of the 1200 subjects (92%) who completed the questionnaire, 1189 were eligible for inclusion in the study. The 1-year prevalence of self-reported musculoskeletal symptoms was 77%. The ankle/foot (35%) was the most frequently affected body region followed by low back (34%), knees (33%), hips (28%), shoulders (28%), head/neck (26%), upper back (21%), wrists/hands (14%) and elbows (3%). The older the salespersons were, the more likely they were to report knee symptoms (P < 0.05). Salespersons with a body mass index (BMI) >23 kg/m² were more likely to report knee symptoms than those with a BMI <18.5 kg/m² (P < 0.05).

Conclusions Musculoskeletal symptoms are common among salespersons with a high proportion experiencing symptoms in the low back, knees and ankles/feet. The prevalence of musculoskeletal symptoms in the knees is associated with age and BMI. Attention should be given to developing specific measures to reduce or prevent musculoskeletal symptoms in salespersons.

Aims To determine the prevalence and risk factors for contact dermatitis and burns among restaurant, catering and fast-food outlet (FFO) staff.

Methods Workers were interviewed and then clinical examination and patch and/or prick tests were conducted in selected individuals.

Results In total, 335 of 457 workers (73% response) were interviewed and 65 (19%) had occupational dermatitis or burns and were examined. Of these, contact dermatitis was the commonest diagnosis, with a 12-month period prevalence of 10% (35 workers) and 3-month period prevalence of 8% (26 workers). All 35 workers had irritant contact dermatitis (ICD) and there were no cases of allergic contact dermatitis. The adjusted prevalence rate ratios of risk factors for ICD were 2.78 (95% CI 1.36–5.72) for frequent hand washing >20 times per day, 3.87 (95% CI 1.89–7.93) for atopy and 2.57 (95% CI 1.21–5.47) for contact with squid. The 3-month period prevalence for burns was 6% (20 workers). Ten workers had other occupational dermatoses such as work-related calluses, paronychia, heat rash and allergic contact urticaria to prawn and lobster.

Conclusion ICD and burns are common occupational skin disorders among restaurant, catering and FFO workers.

Aim To understand the interaction between GP and patient in the fitness for work consultation. This study forms part of a larger research project to develop a learning programme for GPs around the fitness for work consultation based on behaviour change methodology.

Methods A qualitative study set in South Wales. Structured discussion groups with seven GPs. Two sessions each lasting 3 h were conducted to explore the GP and patient interaction around the fitness for work consultation. Multiple methods were used to enhance engagement. Thematic analysis was used to analyse the data.

Results Four major themes emerged from the meetings: role legitimacy, negotiation, managing the patient and managing the systems. Within these, subthemes emerged around role legitimacy. ‘It's not my job’, ‘It's not what I trained for’ and the ‘shifting agenda’ Negotiation was likened to ‘A polite tug of war’ and subthemes around decision making, managing the agenda and dealing with uncertainty emerged.

Conclusion This study starts to unravel the complexity of the fitness for work consultation. It illustrates how GPs struggle with the ‘importance’ of their role and ‘confidence’ in managing the fitness for work consultation. It addresses the skilful negotiation that is required to manage the consultation effectively.

Aim The primary aim was to assess the effects of changes made to educational material, available online to GPs participating in THOR-GP, 1 year after a needs assessment which informed the changes.

The secondary aim, developed from the findings of the original study, was to compare contributing GPs who undertake work in occupational medicine, with those who do not, in terms of uptake of the educational material and of educational need.

Methods GPs participating in THOR-GP, who responded to a questionnaire to assess their use of THOR-GP's website for CPD, were sent a follow-up questionnaire 1 year after the original survey. Both questionnaires comprised scales derived from the syllabus for the Diploma of the Faculty of Occupational Medicine and questions about attitudes to CPD in occupational medicine.

Results No change was found in uptake of or rating of components of the website, following modification. Responders worked on average seven sessions per week in general practice and 1.5 sessions in occupational medicine. GPs working in occupational medicine reported greater confidence in some subject areas than GPs not currently working in occupational medicine and were also more likely to engage in CPD activity within the specialty of occupational medicine.

Conclusion Undertaking work in occupational medicine increases confidence in the subject and stimulates the use of related educational facilities.

Aim To evaluate the availability of occupational health advice within relevant NICE guidelines.

Methods Guidelines were selected on the basis of the impact of the disease and its treatment on work ability. All selected guidelines were reviewed for occupational health advice. The findings were categorized in five main domains: impact of the disease on work, impact of work on the disease, rehabilitation, fitness to work and modifications.

Results Thirty-one published guidelines met the inclusion criteria. Advice on rehabilitation is most frequently referred to with 12 (39%) full, 8 (26%) NICE and 4 (13%) public information guidelines offering advice on this domain. Advice on return to work is the least frequent. The public versions of guidelines rarely offer advice on the studied domains. Occupational health organizations are enlisted as stakeholders in one guideline only. Two occupational health professionals have contributed to the development of two guidelines.

Conclusion This study suggests that occupational health professionals and organizations should participate more actively in developing NICE guidelines to integrate work-related issues and occupational health advice into NICE guidelines.

Aim To survey UK occupational health physicians (OHPs) regarding their role in rehabilitation of employed survivors of cancer.

Methods Following a pilot study, a questionnaire exploring opinions of OHPs regarding supporting cancer survivors' return to work was posted to all members of the UK Society of Occupational Medicine, with a repeat posting 2 months later. Responses were analyzed for significant correlations with OHP age, sex, qualification level, size of businesses advised and years of experience.

Results There were 797 respondents (response rate 51%). Responses suggested opportunities for developing the knowledge base in relation to prognosis and functional outcomes in patients with a cancer diagnosis; instituting information resources on cancer and work for OHPs and developing communications skills training. Most respondents felt managers treated referral to occupational health (OH) differently for employees with cancer compared with management referral for employees with other diagnoses, with 45% of respondents indicating referral may take place too late to be effective in securing a return to work. A significant lack of understanding of the information requirements of employers and the role of OH by treating doctors was identified.

Discussion This survey raises several possible significant barriers to return to work by cancer survivors. Recommendations to ameliorate these are made.

Aim To investigate the sources of health and safety information used and how health and safety and 12 specific occupational health risks are managed by practices.

Methods A cross-sectional postal survey of all small-animal veterinary practices in Hampshire. A response was mandatory as this was a Health & Safety Executive (HSE) inspection activity.

Results A total of 118 (100%) practices responded of which 93 were eligible for inclusion. Of these, 99 and 86%, respectively, were aware of the Royal College of Veterinary Surgeons (RCVS) practice standards and had British Small Animal Veterinary Association (BSAVA) staff members, while only 51% had previous contact with HSE (publications, advice and visit). Ninety per cent had health and safety policies, but only 31% had trained responsible staff in health and safety. Specific health hazards such as occupational allergens and computer use were relatively overlooked both by practices and the RCVS/BSAVA guidance available in 2002.

Conclusions Failings in active health risk management systems could be due to a lack of training to ensure competence in those with responsibilities. Practices rely on guidance produced by their professional bodies. Current RCVS guidance, available since 2005, has remedied some previous omissions, but further improvements are recommended.