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To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.apergo.2006.04.008 Byline: Daniela Colombini, Enrico Occhipinti Keywords: UL-WMSDs; Risk assessment; Job design; Standards Abstract: In industrialized countries, upper limb work-related musculoskeletal disorders (UL-WMSDs) are the most common form of occupational diseases. They are generating a growing population of workers with reduced working capacity. The link between these pathologies and different aspects of work organization has been convincingly proven. Recent experiences in Europe supporting the combination of traditional work design methods used in manufacturing companies with ergonomics methods are reported briefly, with special focus on the use of the occupational repetitive action (OCRA) method for risk assessment and management of manual repetitive tasks. The combined approach strives to achieve the goal of maintaining a satisfactory level of productivity while respecting ergonomics criteria and, definitely, workers' health. New ergonomics standards provide for interaction between job and machinery designers and ergonomists in the design of work processes and workplaces. These standards generally refer only to the healthy adult working population and do not always provide criteria for protecting particular working populations, such as that represented by workers affected by UL-WMSDs. The results of preliminary studies concerning productive re-employment of workers with UL-WMSDs allow the introduction of some criteria for implementing current ergonomics standards in this connection. One aim of this paper is to summarize experiences of close cooperation between ergonomists, machinery designers and job designers to guarantee productivity and the prevention of musculoskeletal disorders. A second aim is to examine current ergonomics standards in the field of manual physical work (designed for healthy workers) and to suggest preliminary criteria for their implementation taking into account the capabilities and needs of specific sub-groups of the working population. Author Affiliation: Research Unit Ergonomics of Posture and Movement (E.P.M), Via Riva Villasanta 11, Milan, Italy

In industrialized countries, upper limb work-related musculoskeletal disorders (UL-WMSDs) are the most common form of occupational diseases. They are generating a growing population of workers with reduced working capacity. The link between these pathologies and different aspects of work organization has been convincingly proven. Recent experiences in Europe supporting the combination of traditional work design methods used in manufacturing companies with ergonomics methods are reported briefly, with special focus on the use of the occupational repetitive action (OCRA) method for risk assessment and management of manual repetitive tasks. The combined approach strives to achieve the goal of maintaining a satisfactory level of productivity while respecting ergonomics criteria and, definitely, workers' health. New ergonomics standards provide for interaction between job and machinery designers and ergonomists in the design of work processes and workplaces. These standards generally refer only to the healthy adult working population and do not always provide criteria for protecting particular working populations, such as that represented by workers affected by UL-WMSDs. The results of preliminary studies concerning productive re-employment of workers with UL-WMSDs allow the introduction of some criteria for implementing current ergonomics standards in this connection. One aim of this paper is to summarize experiences of close cooperation between ergonomists, machinery designers and job designers to guarantee productivity and the prevention of musculoskeletal disorders. A second aim is to examine current ergonomics standards in the field of manual physical work (designed for healthy workers) and to suggest preliminary criteria for their implementation taking into account the capabilities and needs of specific sub-groups of the working population. Keywords: UL-WMSDs; Risk assessment; Job design; Standards

The director of the US Centers for Disease Control and Prevention provides her recommendations for treating healthcare workers who are exposed to HIV while treating an HIV-infected patient. These workers should take two AIDS drugs that the patient is not taking, and even three drugs if the patient's disease is advanced or if the virus is resistant to some AIDS drugs.

In October 2001, four cases of inhalational anthrax occurred in workers in a Washington, D.C., mail facility that processed envelopes containing Bacillus anthracis spores. We reviewed the envelopes' paths and [...]

Objectives. This study assessed the effectiveness of an intervention to reduce wood dust, a carcinogen, by approximately 26% in small woodworking businesses. Methods. We randomized 48 businesses to an intervention (written recommendations, technical assistance, and worker training) or comparison (written recommendations alone) condition. Changes from baseline in dust concentration, dust control methods, and worker behavior were compared between the groups 1 year later. Results. At follow-up, workers in intervention relative to comparison businesses reported greater awareness, increases in stage of readiness, and behavioral changes consistent with dust control. The median dust concentration change in the intervention group from baseline to follow-up was 10.4% (95% confidence interval = -28.8%, 12.7%) lower than the change in comparison businesses. Conclusions. We attribute the smaller-than-expected reduction in wood dust to the challenge of conducting rigorous intervention effectiveness research in occupational settings.

Rationalization efforts in industry, both in the Scientific Management tradition and also based on recent rationalization theories, have as one of their main aims to increase the utilization of workers. Clearly, there is a limit to the amount of physical work each employee can perform without developing musculoskeletal disorders. Such limits are generally set by guidelines for acceptable work load. This paper reviews the physical work load concept, the historical development of guidelines, and current guidelines as found in ergonomics textbooks. The focus is on the change in the aim of the guidelines over time: increased productivity, reduced fatigue and finally improved musculoskeletal health. Current guidelines for physical work load mostly emphazise a reduction in the level of work load, while there are few guidelines that consider the repetitiveness and duration of work load. As the guidelines in general only consider one exposure variable, this is a particular problem in rationalization where all three exposure dimensions may be changed simultaneously. Present guidelines are mainly based on laboratory studies aiming to eliminate short-term physiological or psychological responses. These guidelines are clearly inadequate and may be misleading in view of recent research regarding the relationship between physical work load exposure and the development of musculoskeletal complaints at the work place. Keywords: ergonomic guidelines, physical work load, mechanical exposure

Interventions against occupational musculoskeletal disorders are usually performed by ergonomists. An overview of the literature shows that ergonomists often are unsuccessful; musculoskeletal disorders may be prevalent at workplaces where large ergonomic resources have been put in, thus illustrating the significance of other factors in addition to those against which the intervention is applied. It is claimed that some modern rationalization strategies may offer a potential for 'good' ergonomics. Thus, prevailing management approaches often now focus on team building, flat organizations, training of multiple skills and so on. The main scope of the present issue of Applied Ergonomics is to throw light on this possibility of 'achieving ergonomics impact through management intervention'. This present paper presents a historical overview of occupational physical work load as a function of ergonomics, as well as rationalizations and concludes with a more elaborate discussion of the present intervention concept for solving work related musculoskeletal problems in a profitable way. Rationalization and guidelines for physical work load are the basic parameters in the present intervention concept. Due to this the present special issue also presents historical overviews of the development of these parameters (Westgaard and Winkel; Bjorkman). 'Achieving ergonomics impact through management intervention' is illustrated through two case studies (Kadefors et al and Bao et al). They demonstrate an obvious ergonomic potential offered by the presented intervention concept. However, the two case studies also describe several practical obstacles which need to be further investigated in future intervention research. Keywords: ergonomics, intervention, musculoskeletal, rationalization

Health care workers may be exposed to hepatitis B (HBV), hepatitis C (HCV), or HIV while on the job, and guidelines exist for post-exposure care. The best strategy for preventing occupational infection, however, may be to avoid exposure in the first place. Blood tests to detect infection may be the most reliable way of assessing the risk of exposure. Estimates of the infection potential of HBV range from 2% to 40%. Persons who have an adequate antibody titer to the HBV e antigen (HBeAg) may be immune to HBV. Post-exposure therapy for nonimmune persons may include administration of HBV hyperimmune globulin and recombinant HBV vaccine. The risk of occupational exposure to HCV is not fully known. Post-exposure therapy with interferon alfa may not be altogether effective, and no other antiviral agents are known to prevent HCV infection after exposure. HCV infection may lead to chronic hepatitis in 50% of infected adults. The risk of becoming infected with HIV through occupational exposure is estimated to be 0.2%. Zidovudine may be the only drug known to have clinical benefit in HIV-infected persons. Follow-up testing is recommended.

Dentists should be aware of the risks of HIV transmission to themselves, their employees and their patients, and they should institute stringent infection control policies and practices. The incidence of occupationally acquired HIV infection is much lower than that of hepatitis B, but safety procedures should help protect against both. As of Sep 1993, there were 39 cases of occupationally acquired HIV infection among health care workers, and 81 possible occupational cases. The greatest risk factor for occupational exposure is needlestick injuries. The risk has been calculated to be approximately one infection per 325 needlestick exposures. After a needlestick injury, zidovudine may be offered as an extra precaution to prevent possible HIV infection. Dental personnel need to be consistent in wearing gloves and other protective apparel and in sterilizing or disinfecting instruments and workspace.