Methods This paper reviews briefly the common neurocognitive causes for performance problems in doctors and provides an updated account of the current literature. Search on Medline and PsychINFO for English language articles between 1956 and September 2006 was performed, as well as a manual search by the authors for other relevant articles.

Results Neuropsychiatric and neuropsychological assessment is increasingly accepted as an accurate evaluation tool to clarify the performance problems in doctors. Furthermore, it seems that neurocognitive difficulties are commonly found to be the cause for such problems.

Conclusions The performance problems in doctors need to be acknowledged ‘better too soon than too late’. Neuropsychiatric and neuropsychological assessment helps to create an accurate treatment and rehabilitation plan for the specific functional tasks of the particular doctor's duties.

Methods The present study involved a prospective cohort of 4500 Iranian industrial workers. Data were gathered by means of a self-reported questionnaire about LBP, as well as working life exposure, lifestyle factors, social exposures, co-morbidity, life events and psychosomatic complaints in 2004. All new episodes of disabling LBP resulting in medically certified sick leave during the 1-year follow-up registered by occupational health clinic inside the factory.

Results The participation rate was good (85%). A total of 744 subjects reported current LBP (point prevalence cases). A total of 52 (<2%) new episodes of disabling LBP were observed during the 1-year follow-up (incident cases). Male employees reported higher demands, lower control and lower support than female employees. Employees with high demands, low control, job strain, low job satisfaction and low job appreciation showed increased odds ratios, and these results were statistically significant.

Conclusions Few prospective studies in this field have been published, but all of them are related to industrialized countries. This prospective study suggests the aetiological role of job strain for LBP. The findings of this study indicate a substantial potential for disease prevention and health promotion at the workplace.

Aims To investigate whether work-related injury rates differ by employment category (part time, full time or casual) for registered nurses (RNs) in acute care and care aides (CAs) in long-term facilities.

Methods Incidents of occupational injury resulting in compensated time loss from work, over a 1-year period within three health regions in British Columbia (BC), Canada, were extracted from a standardized operational database. Detailed analysis was conducted using Poisson regression modeling.

Results Among 8640 RNs in acute care, 37% worked full time, 24% part time and 25% casual. The overall rates of injuries were 7.4, 5.3 and 5.5 per 100 person-years, respectively. Among the 2967 CAs in long-term care, 30% worked full time, 20% part time and 40% casual. The overall rates of injuries were 25.8, 22.9 and 18.1 per 100 person-years, respectively. In multivariate models, having adjusted for age, gender, facility and health region, full-time RNs had significantly higher risk of sustaining injuries compared to part-time and casual workers. For CAs, full-time workers had significantly higher risk of sustaining injuries compared to casual workers.

Conclusions Full-time direct patient care occupations have greater risk of injury compared to part-time and casual workers within the health care sector.

Aim To confirm whether specific risk factors identified at the pre-placement health assessment could predict subsequent sickness absence.

Methods A total of 400 National Health Service pre-placement health questionnaires were analysed to allocate employees to low-, medium- or high-risk categories for subsequent sickness absence, using the risk table developed by C. J. M. Poole (Can sickness absence be predicted at the pre-placement health assessment? Occup Med (Lond) 1999; 49:337–339) [1]. Subsequent sickness absence was analysed to assess if there was an association between the allocated category and sickness absence taken.

Results Mean sickness absence hours per 1000 h worked were 22.5 (95% CI 18.2–27.2) in the low-risk group, 33.6 (27.2–40.7) in the medium-risk group and 44.7 (25.1–69.9) in the high-risk group (analysis of variance, P ≤ 0.002), demonstrating a statistically significant difference in sickness absence taken in subsequent years.

Conclusions The results confirmed Poole's hypothesis that future sickness absence can be predicted at the pre-placement health assessment. Certain risk factors, namely female sex, age, smoking, history of at least two previous episodes of low-back pain and previous days sickness absence identified at pre-placement assessment, predict a greater than average subsequent sickness absence. However, the best model using identified risk factors only predicted 10–12% of the variation in sickness absence.

Methods A cross-sectional survey was conducted in seven medical schools representing all geographical regions of Turkey. All physicians in speciality training in the selected medical schools were asked to complete a semi-structured ‘violence questionnaire’ addressing the type (emotional, physical and sexual) and extent of violence experienced, the perpetrators of the violence and the victim's reactions to the experience.

Results A total of 1712 residents out of 2442 completed the questionnaire. In all, 68% indicated they had experienced some form of workplace violence, 67% had experienced verbal violence, 16% had experienced physical violence and 3% had experienced sexual violence. The victims' most prevalent reactions to violence included being deeply disturbed but feeling they had to cope with it for the sake of their career (39%), being distressed (26%) but considering that such events are common in all occupations and discounting it and being confused and bewildered and unsure how to respond (19%). The most frequently named perpetrators of verbal violence were relatives/friends of patients (36%) and academic staff (36%), followed by other residents/senior residents (21%), patients (20%), heads of department (13%) and non-medical hospital staff (6%).

Conclusions Physicians in speciality training in medical schools in Turkey are subject to significant verbal, physical or sexual violence. Precautions to prevent such exposure are urgently needed.

Aims To verify the prevalence of work-related musculoskeletal disorders (WRMDs) in hairdressers through symptom reports, to characterize the most frequently affected anatomical parts and to identify and analyse risk factors of WRMDs in hairdressing.

Methods A cross-sectional epidemiological study of 220 hairdressers from beauty parlours in São Paulo (Brazil) was carried out. Each hairdresser completed a self-administered questionnaire which included information on socio-demographic characteristics, working conditions and health-related musculoskeletal system complaints. Ergonomic analyses were also performed in six parlours.

Results The prevalence of WRMDs was 71%. Risk factors were associated with psychosocial factors and factors related to discomfort and work fatigue such as lack of acknowledgement of work and uncomfortable posture at work [odds ratio (OR) = 3.54; 95% confidence interval (CI) 1.51–8.30], not feeling comfortable with body/neck/shoulders while working (OR = 2.78; 95% CI 1.40–5.54) and having >15 years of professional activity (OR = 3.04; 95% CI 1.17–7.91).

Conclusion Occupational risk factors associated with the development of WRMDs in hairdressers are related to biomechanical, organizational and psychosocial work factors. The high prevalence of WRMDs found highlights the importance of disseminating recommendations for prevention of symptoms with regards to the provision of suitable furniture, equipment and work tools, environmental conditions, size of workplace, work organization and psychosocial work factors.

Aim To evaluate the effect of e-learning on knowledge on mental health issues as compared to lecture-based learning in a CME programme for OPs.

Methods Within the context of a postgraduate meeting for 74 OPs, a randomized controlled trial was conducted. Test assessments of knowledge were made before and immediately after an educational session with either e-learning or lecture-based learning.

Results In both groups, a significant gain in knowledge on mental health care was found (P < 0.05). However, there was no significant difference between the two educational approaches.

Conclusion The effect of e-learning on OPs' mental health care knowledge is comparable to a lecture-based approach. Therefore, e-learning can be beneficial for the CME of OPs.

Aim: To study the effectiveness of an active multifaceted workshop aimed at improving OPs’ reporting of occupational diseases.

Methods: We undertook a comparative study with 112 OPs in the intervention group and 571 OPs as comparisons. The intervention was a 1-day workshop. Measurements of occupational disease reporting activity in both groups in 6-month periods before and after the intervention were collected via the national registration system. Measurements of OPs’ knowledge, self-efficacy and satisfaction were made in the intervention group. Differences between the groups and predictive factors for reporting were subsequently analysed statistically.

Results: The percentage of reporting OPs after the intervention was significantly higher in the intervention group compared to the comparison group at 19 versus 11% (P < 0.01). No differences were found in the average number of reported occupational diseases per reporting physician after the intervention: 3.7 (SD 5.37) versus 3.4 (SD 4.56) (not significant). The self-efficacy score was a predictive factor for reporting occupational diseases (P < 0.05). Measurements of knowledge and self-efficacy increased significantly (both parameters P < 0.001) and remained after half a year. Satisfaction was high (7.85 of 10).

Conclusions: An active, multifaceted workshop on occupational diseases is effective in increasing the number of physicians reporting occupational diseases. Self-efficacy measures are a predictive factor for such reporting.

Aim To determine relationships between body mass index (BMI), weight gain, ergonomic and exercise variables in sedentary workers.

Methods An anonymous questionnaire was administered regarding body weight, height, weight gained since employment, body part discomfort, shift fatigue, time to achieve job adaptation, physical activity, fitness centre membership, previous employment type and previous injury.

Results Subjects were 393 volunteers (mean age 34 years, 71% female) employed in a call centre. Sixty-eight per cent of participants gained weight averaging 0.9 kg/month for 8 months. Significant findings (P < 0.05) were as follows: non-obese individuals gained less weight than obese individuals, fitness club members had higher BMIs and weight gains than non-members, previously injured individuals gained more weight than non-injured individuals, non-weight gainers reported higher metabolic equivalent-min/week expenditure in relation to vigorous exercise.

Conclusions Participants reported substantial weight gain over a period of 8 months. In contrast to walking and moderate exercise, only vigorous exercise was significantly associated with non-weight gain. Three risk factors were identified for weight gain: obese when hired, history of previous injury and lack of vigorous exercise.

Aim To examine the association between obesity and risk of job disability among firefighters.

Methods A prospective cohort study design was employed in following 358 Massachusetts firefighters enrolled in a statewide medical surveillance program. We prospectively evaluated time to development of adverse employment outcomes >6 years of follow-up.

Results In multivariable-adjusted Cox proportional hazard models, we found that every one-unit increase in body mass index (BMI) was associated with a 5% increased risk of job disability. Compared to firefighters in the lowest tertile of BMI (BMI < 27.2), those in the highest tertile (BMI ≥ 30.2) had a significantly increased risk of an adverse employment event with a multivariable-adjusted hazard ratio (HR) of 1.98 (95% CI 1.06–3.72). There was also a significant dose–response relationship of increasing risk across tertiles, as well as a significant trend: HR 1.39 (95% CI 1.04–1.86). The highest categories of BMI had a 60–90% increased risk of job disability compared to the lowest or normal-weight categories, respectively.

Conclusions Obesity is associated with higher risk of job disability in firefighters. Additional research is needed to further explore our findings. Our study may have economic and public health implications in other occupational settings.

Aims To measure physical fitness and body mass index (BMI) and to assess their association with sickness absence in male soldiers.

Methods Data regarding BMI and physical fitness (aerobic endurance and muscle fitness) were collected for male Finnish military personnel and combined with sickness absence data collected in the year 2004. The duration and costs of sickness absence were obtained from the personnel administration.

Results A total of 7179 male military personnel (mean age 37, range 18–59; mean BMI 26.0, range 17–50) participated. There were large inter-individual variations in physical fitness and body mass. The group with the longest sickness absences (>7 days) exhibited lower muscle fitness in three of four tests and shorter running distance compared to the groups with shorter sickness absence (P < 0.001). In addition, high BMI, poor muscle fitness and poor aerobic endurance were associated with increased sickness absence.

Conclusions The present results showed that poor muscle fitness and endurance as well as high BMI are risk factors for productivity loss causing additional costs for the employer. Therefore, workers at a greater risk should be offered more multifaceted information about potential health risks, as well as motivational support to improve their lifestyle.

Aim To evaluate the effectiveness of a protocol helping GPs in recording risks of LTSA and in co-operating with occupational physicians (OPs).

Methods Twenty-six GPs (co-operating in four groups) in Amsterdam, The Netherlands, participated in a controlled intervention study. Fourteen GPs were the protocol-supported intervention group and twelve GPs were the reference group. Outcome measures were consultations containing work-related information, information about two risk factors for LTSA, referrals to OPs and contacts of OPs with GPs and patients. Outcomes were identified through an electronic search in the GPs' information systems. Entries containing information were independently scored by two investigators. The proportions of patients with consultations documenting LTSA-pertinent items were compared between the groups, accounting for differences at baseline.

Results There was no increase in consultations containing work-related information. Recording of risk factor information increased in the intervention group; the difference was 4.5% [95% CI 1.5–7.6] and 1.8% (95% CI –0.8 to 4.4) for the two risk factors. The referral rate to the OP increased by 2.9% (95% CI 1.2–4.5). There was no effect on contacts of OPs with GPs or with patients.

Conclusion Protocol-supported consultations may lead to a modest increase in information regarding two risk factors for LTSA in GPs' electronic records and to more referrals to OPs.

Aim To establish if a relationship exists between standard measures of deprivation, used by the UK central government to determine regional health and social welfare funding, and sickness absence and ill-health early retirement rates in English local government employers.

Methods Local authority sickness absence rates for 2001–02 were regressed against the 2004 Indices of Multiple Deprivation in a multiple regression model that also included size and type of organization as independent variables. A second model using ill-health retirement as the dependent variable was also estimated.

Results In the full regression models, organization size was not significant and reduced models with deprivation and organization type (depending on whether teachers were employed by the organization or not) were estimated. For the sickness absence model, the adjusted R² was 0.20, with 17% of the variation in sickness absence rates being explained by deprivation rank. Ill-health retirement showed a similar relationship with deprivation. In both models, the deprivation coefficients were highly significant: for sickness absence [t = –7.85 (P = 0.00)] and for ill-health retirement [t = –4.79 (P = 0.00)].

Conclusions A significant proportion of variation in sickness absence and ill-health retirement rates in local government in England are associated with local measures of deprivation. Recognition of the impact of deprivation on sickness absence has implications for a number of different areas of work. These include target setting for Local Government Best Value Performance Indicators, history taking in sickness absence consultations and the role of deprivation as a confounding factor in sickness absence intervention studies.

Aim To monitor sickness absence among frequent and long-term absentees in order to investigate their risk of recurrent absence.

Methods Longitudinal cohort study in employees working in three large Dutch postal and telecommunications companies. In the first year of study, we distinguished employees who were absent four times or more (frequent absence), employees who were absent for ≥6 weeks (long-term absence), combined frequent and long-term absence and a reference population. The absence rates in these groups were followed-up for 4 years.

Results The study population (n = 53 990) comprised 4126 frequent absentees, 3585 long-term absentees, 979 combined frequent and long-term absentees and a reference population (n = 45 300). Frequent absentees had a higher risk of recurrent frequent absence when compared to the reference population, with rate ratios (RR) amounting to 4.9 [95% confidence interval (CI) 4.7–5.1] in men and 3.2 (95% CI 3.0–3.4) in women. They also had a higher risk of developing long-term absence: RR = 1.9 (95% CI 1.8–2.0) in men and 1.5 (95% CI 1.4–1.6) in women. Long-term absentees had high risk of recurrence: RR = 1.9 (95% CI 1.8–2.0) in men and RR = 1.4 (95% CI 1.3–1.5) in women.

Conclusions Employees with prior frequent and/or long-term absence were at risk of recurrent absence. Frequent absence was a prognostic factor predicting future long-term absence.

Aim To investigate job stressors and coping strategies among New Zealand dentists.

Methods A nationwide postal survey of a representative sample of 700 dentists.

Results The response rate was 65%. The most commonly reported stressors were treating difficult children (52%), constant time pressure (48%) and maintaining high levels of concentration (43%). The strategies most utilized for managing work-related stress included interactions with people (78%), sports (64%) and forgetting about work (59%). Dentists who had graduated overseas reported more sources of stress than New Zealand graduates. There were differences in the strategies used by male and female practitioners to manage stress.

Conclusions There is considerable variation in the number of stressors experienced by dentists. Overseas-qualified dentists appear to be under more stress than New Zealand-trained dentists and may need greater professional support. Dentists should be encouraged to make greater use of active coping strategies.

Aims To identify hospital line managers' knowledge, attitudes and beliefs regarding LBP and its management; the difficulties encountered in managing the worker with LBP and the organizational needs in relation to managing LBP at work.

Methods Cross-sectional survey of line managers (n = 92) at an Irish University Hospital using a self-administered questionnaire. Quantitative data were entered onto the Statistical Package for the Social Sciences (V 11) and analysed using descriptive statistics. Qualitative data were coded and analysed for common themes.

Results A 64% (n = 59) response rate was achieved. Contrary to current evidence, 54% (n = 32) of respondent managers reported that a staff member needs to be pain free prior to return to work (RTW). Managers reported difficulties in dealing with colleagues of workers with LBP and in knowing the work capacity of the worker with LBP. Managers demonstrated poor awareness of the importance of the manager–worker relationship in influencing RTW. Managers believed more information, easier access to health services, more ergonomic training and better staff resources were necessary supports in facilitating the management of workers with LBP.

Conclusions Hospital line managers' knowledge of the evidence regarding their role in LBP management needs to be improved. Managers believed better information, improved staff resources and easier access to health and ergonomic services would facilitate their management of workers with LBP.

Aims The study aimed to develop and validate a screening questionnaire, capturing relevant psychosocial issues and musculoskeletal symptoms, to measure work instability (WI) in office workers.

Methods The staged methodology was based upon Rasch analysis and included item banking from existing Work Instability scales and analysis of new data from postal surveys. The criterion validity of the emerging scale was examined using vocational assessments by occupational physiotherapists.

Results A 62-item questionnaire was returned by 153 employees from two different settings. The data were fitted to the Rasch model and 26 items were found to fit model expectations (chi-square P= 0.07), satisfy strict requirements for unidimensionality and discriminate across expert defined levels of WI. Reliability was 0.9, indicating suitability for use at the individual level. Absence of item bias was shown for age, gender and if the individual had been off sick from work in the past 3 months, suggesting the scale is robust to variations in workforce composition and sickness absence rates.

Conclusions The Office Work Screen is a short questionnaire incorporating both musculoskeletal symptoms and relevant psychosocial factors in one dimension. This new questionnaire may facilitate workforce screening, individual monitoring and proactive targeting of interventions (for example, vocational rehabilitation) to prevent or minimize sickness absence in office workers.

Aim To identify factors which may help to reduce depressive symptoms in a sample of employees sick listed due to mental health problems.

Methods Longitudinal cohort study of employees sick listed for 12–20 weeks due to mental health problems. Individuals were followed for 1 year. After a screening questionnaire, we conducted standardized interviews by telephone, assessing individuals' mental health, work characteristics and actions by employers.

Results A total of 555 employees commenced the study and 436 participated in the second interview. Response rates were 42% for the screening questionnaire, 93% for the first interview and 79% for the second interview. Individuals with low education and sole breadwinners showed a less favourable course of depressive symptoms. Work resumption (partial and full) and changing the employee's tasks (action by employer) promoted a more favourable course of depressive symptoms.

Conclusion The findings point to the importance of work resumption and a change in work tasks in order to promote recovery. Using these insights, management of employees suffering from depressive complaints may be improved.

Aims The aim of this prospective study was to predict the hazard ratio (HR) of short- and long-term sickness absence due to shift work in Danish shift workers.

Methods A total of 1008 shift workers and 4009 day workers were followed up for short- and long-time sickness absence.

Results Among shift workers, the HR of sickness absence lasting ≥2 weeks was 0.92 (95% CI: 0.71–1.18) for men and 0.90 for women (95% CI: 0.71–1.14). For sickness absence lasting ≥8 weeks, the HR was 1.33 (95% CI: 0.91–1.94) for men and 1.13 (95% CI: 0.81–1.59) for women.

Conclusion This study was inconclusive in proving any link between shift work and absenteeism after controlling for age, education, body mass index, smoking status, alcohol consumption, leisure time physical activity, psychosocial and physical work environment factors.

Methods A nationwide database was constructed by linking Swedish Census data to the Hospital Discharge Register (1987–2004). The hospital diagnoses of asthma were based on the International Classification of Diseases. Standardized incidence ratios were calculated for different socioeconomic and occupational groups. Ninety-five per cent confidence intervals were calculated assuming a Poisson distribution.

Results A total of 13 202 male and 11 876 female hospitalizations for asthma were retrieved at ages >30 years. The socioeconomic groups with <9 years of education were associated with a significantly increased risk of hospitalization for asthma. Among male occupations, increased risks were noted for farmers, mechanics and iron and metal workers, welders, bricklayers, workers in food manufacture, packers, loaders and warehouse workers, waiters and chimney sweeps with prolonged exposures in two censuses. For female occupations, increased risks were observed among assistant nurses, religious, juridical and other social science-related workers, drivers, mechanics and iron and metalware workers and wood workers.

Conclusions The present study suggests that socioeconomic status (low educational level) and occupation have an effect on the population's risk of hospitalization for asthma.

Aim To assess trends in OA in an industrialized part of the UK over a 15-year period.

Methods Occupational and chest physicians in the West Midlands were invited to submit details of newly diagnosed cases with OA. Data were then transferred to the regional centre for occupational lung diseases for analysis.

Results A total of 1461 cases were reported to the scheme. Sixty-eight per cent were males with mean (standard deviation) age of 44 (12) years. The annual incidence of OA was 42 per million of working population (95% CI = 37–45). OA was most frequently reported in welders (9%) and health care-related professions (9%) while <1% of cases were reported in farmers. Isocyanates were the commonest offending agents responsible for 21% of reports followed by metal working fluids (MWFs) (11%), adhesives (7%), chrome (7%), latex (6%) and glutaraldehyde (6%). Flour was suspected in 5% of cases while laboratory animals only in 1%.

Conclusions Our data confirm a high annual incidence of OA in this part of the UK. MWFs are an emerging problem, while isocyanates remain the commonest cause. Incidence remained at a fairly stable background level with many small and a few large epidemics superimposed. Schemes like Midland Thoracic Society's Rare Respiratory Disease Registry Surveillance Scheme of Occupational Asthma could help in identifying outbreaks by linking cases at the workplace.

Aims To investigate whether lung cancer screening with CT was effective and acceptable in former asbestos workers.

Methods CT scanning was carried out following the protocol previously described in the literature. A questionnaire was used to assess cumulative asbestos exposure. An economic analysis was also performed. Informed consent was obtained from all patients.

Results A total of 1119 male asbestos workers (58% of invited) were examined, of whom 65% were smokers or ex-smokers. Mean age was 57.1 years with mean cumulative exposure to asbestos of 123 fibres/ml x years. Pleural plaques were found in 375 workers (32%), while 338 workers (29%) were included in the radiological follow-up, which led to 25 biopsies (13 of lung, 9 of pleura, 3 of both) and five screen-detected lung cancers (0.4%), one in Stage I. Incidence rate was 149 per 10⁵, equal to that in the male general population of similar age. The expenses for diagnosis were 1014 and 244962 Euro per screened subject and screen-detected lung cancer case, respectively.

Conclusions Screening adherence and frequency of detection were low, while costs and radiation dose were high. In spite of a high cumulative asbestos exposure, lung cancer risk was not increased relative to the general population. The screening programme was not felt to be cost-effective from the perspective of the government as a third-party funding agency.

Aims To define the specificity and sensitivity of thermometry and plethysmography using the SWS as the reference criterion. A secondary goal was to consider cut points for the tests optimizing sensitivity and specificity.

Methods A cross-sectional analysis was conducted on HAVS patients seen at an occupational medicine specialty clinic. Plethysmography and thermometry were analyzed using SWS vascular stage as the outcome variable. Logistic regression controlled for age, smoking and time since last vibration exposure and use of vasoactive medications. The sensitivity and specificity of the combined tests were calculated using varying cut points.

Results A total of 139 patients consented to participate in the study. Plethysmography stage 1 or greater showed the highest sensitivity (sensitivity 94% and specificity 15%). Specificity was optimized combining plethysmography stage 3 and thermometry stage 3 (specificity 98% and sensitivity 23%). Maximal diagnostic accuracy was achieved by plethysmography alone setting the criteria for a positive test as being stage 1 or greater (70%).

Conclusions Neither plethysmography nor thermometry either alone or in combination demonstrated sufficient sensitivity and specificity to serve as an objective correlate for SWS vascular stage. All combinations of plethysmography and thermometry showed a lower specificity than sensitivity indicating that the SWS may be less sensitive in detecting vascular pathology than the objective tests.

Aim To determine relevant factors related to return to work.

Methods Surgical technique, clinical factors, demographic factors, other medical problems, psychosocial factors, work-related and economical factors were reviewed in patients operated on for CTS. Statistical multivariate analyses were performed to identify the baseline factors influencing the work incapacity period.

Results A total of 107 cases were reviewed. Professional exposure to repetitive movements and heavy manual handling activity were associated with a longer return-to-work interval. The duration of work incapacity period was not significantly related to the socioprofessional category of the patient (self-employed or employee) or to the type of the procedure (open versus endoscopic surgery).

Conclusion Work-related features have a more important influence on return to work than personal, pathological or surgical features.

Aims To identify differences in the mental health status and social attitudes towards PG among casino workers in South Korea depending upon whether they report any gambling problems.

Methods Data were collected from 388 full-time casino employees. This data provided information about the prevalence of gambling problems, alcohol and tobacco use and depression. Employees were grouped according to their scores on the Korean version of South Oaks Gambling Screen (SOGS), and those employees who gambled without experiencing any gambling problems (Group NP: SOGS = 0) and those who reported any gambling problems (Group P: SOGS > 0) were compared. An exploratory factor analyses identified the domains of casino employee social attitudes towards gambling.

Results Employees who reported gambling problems (Group P) reported a higher prevalence of smoking, alcohol problems and depression (P < 0.01) compared to employees who did not report gambling problems (Group NP). The primary employee social attitude towards gambling was identified by the factor of ‘Disease concept/social awareness’. Group NP reported more positive attitudes in this domain than Group P (P < 0.01).

Conclusions Employees who reported any gambling problems reported a less positive attitude towards developing the public health system to be responsive to gambling problems. These findings indicate a need to develop health education programmes that focus more specifically on casino employees with gambling problems.

Aims To examine the prevalence of fatigue among seafarers, identify potential risk factors and assess possible links with poor performance and ill-health.

Methods Cross-sectional questionnaire survey of seafarers working in the offshore oil support, short-sea and deep-sea shipping industries. A number of tools were used including the fatigue subscale of the profile of fatigue-related symptoms, the Cognitive Failures Questionnaire, the General Health Questionnaire and the SF36 General Health scale.

Results In all, 1855 questionnaires were completed giving an overall response rate of 20%. Fatigue symptoms were associated with a range of occupational and environmental factors, many unique to seafaring. Reporting a greater number of risk factors was associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35) for those with three or four risk factors and OR = 9.54 (6.95–13.09) for those with five or more risk factors]. There was also a strong link between fatigue and poorer cognitive and health outcomes, with fatigue the most important of a number of risk factors, accounting for 10–14% of the variance.

Conclusions Seafarers' fatigue could impact on safety within the industry and may be linked to longer term individual ill-health. It can only be addressed by considering how multiple factors combine to contribute to fatigue.

Methods A systematic review was undertaken. Abstracts were screened and those selected reviewed against pre-determined diagnostic criteria for RADS.

Results Significant information gaps were identified for all measures of interest. In some articles, even the causative agent was not reported. The most commonly reported agents were chlorine (nine subjects), toluene di-isocyanate (TDI) (n = 6) and oxides of nitrogen (n = 5). Most exposures occurred in the workplace (n = 51) and affected men (60%). Dyspnoea (71%) and cough (65%) were the commonest symptoms. Median symptom duration was 13 months (interquartile range = 6.5–43.5) for RADS.

Conclusions Although the most commonly reported agent associated with RADS was chlorine, the main finding of a general lack of adequate information on exposure, investigation and outcome suggests that to better explore RADS a more structured approach to gathering information is required. A minimum data set for reporting RADS cases is proposed.

Methods Subjects were recruited from a factory of 650 workers and assessed by means of history, physical examination and electrophysiological testing.

Results Seventy-nine subjects from the factory and 53 healthy controls with occupations unrelated to heavy physical work were assessed. None of the worker group had electrophysiological evidence of CTS. One subject in the control group has electrophysiological evidence of CTS. In the worker group, all sensory nerve conduction velocities and ulnar nerve action potential amplitudes in both hands and distal motor latencies were statistically different.

Conclusions In our study, among a group of heavy labourers, no cases of CTS were detected. However, all electrophysiologic parameters of workers were different from controls. Our results point to a diffuse, but subclinical injury of peripheral nerves under heavy physical work conditions, instead of a local effect such as CTS.

Methods All subjects employed at an autocatalyst production plant undertook medical surveillance with symptoms, examination findings and results of skin prick testing and spirometry prospectively recorded. Environmental testing of the workplace was also performed to determine the level of exposure.

Results Twenty-six subjects had a mean duration of employment of 46 (±30) months and undertook a mean 6.8 (±4.3) examinations. No subjects described the development of new respiratory or dermatological symptoms. No patients developed positive skin reactivity to platinum salts. FEV₁ remained unchanged for all subjects over the course of the study period.

Conclusions TPC and platinum-group elements are not associated with the development of PSS or occupational asthma. Identification of chemical compounds is important when advising on occupational health screening. TPC and/or platinum-group elements should be used in preference to chloroplatinic acid in catalyst production to minimize the impact of occupational illness due to PSS.