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Abstract: This article presents information on pregnant women with incident blood lead levels (BLLs) of 20 μg per deciliter or greater as reported to the New York City Department of Health between September 1996 and June 1999 (n=33). Almost half of the women were diagnosed during their third trimester of pregnancy, often at their first prenatal visit. The median BLLs at incidence and at last report among women who were retested were 25 and 15 γ/dL, respectively, a 40% decline. The median incident BLL among newborns (n=25) was 12 μg/dL. The BLLs were inversely associated with maternal age and length of time in the United States and directly associated with gestational age and pica behavior. Cases were more than twice as likely to be foreign-born women than all women who gave birth in New York City. Prenatal care facilities employing a policy of universal blood lead testing of all pregnant women at the time of their first visit reported disproportionate numbers of cases, accounting for 77% of cases yet only 11% of all births citywide. The findings suggest that (1) the promulgation of recent rules and guidelines for lead risk assessment and screening among pregnant women appears to have been effective in identifying cases that might not have otherwise come to light; (2) case management and environmental interventions were initiated promptly; (3) cases experienced, on average, significant BLL reductions over time; and (4) there is a need for additional public health interventions for pregnant women in urban, multicultural centers. While the data suggest that universal screening may increase case finding among high-risk, immigrant populations, further studies and surveillance are needed to determine systematically the most effective approach.

A joint labor-management training program intended to bring a large US manufacturing firm into compliance with the training requirements of the Federal Hazard Communication Standard appeared to achieve increases in employee knowledge and improved work practices. The program also evidenced positive indirect effects on management's institution of hazard control measures and organizational handling of health and safety issues. Most observed effects were maintained over a 2-year period after the training. More interactive, trainer-intensive delivery methods to smaller groups were associated with more positive effects on reported training usefulness and changes in work practices and working conditions.

This paper examines the interface between work stress and nonwork stress and how it relates to health. Results indicate that the way people feel at work is largely a function of conditions at work. Similarly, the way people feel outside of work is largely a function of things that occur outside the job. Both work and nonwork stress are independently associated with physical and mental health, although the relationship between nonwork stress and health is slightly stronger. Excessive demands or stresses in one domain can interfere with life in the other. Such conflict operates equally in both directions. When present it can be an added source of stress and adversely affect health. Taken together these findings suggest that the stress people experience at work is not simply a reflection of their “personal problems.” This has implications for the design of health promotion and stress prevention programs in the workplace.

A survey of office workers at four sites was conducted by Columbia University School of Public Health during 1981 and 1982 to explore the relationships between office working conditions and employee health. Walk through surveys of each site were conducted by the research team with joint labor-management sponsorship. A total of 2074 non-managerial office workers filled out a 30-minute self-administered questionnaire at their respective workplaces. Multiple item scales were tested and constructed to measure indoor air quality and ergonomic factors. Significant differences in ergonomic conditions and air quality between the sites were observed. These differences corresponded with researcher observations prior to the surveys. Significant associations between the reported air quality and respiratory symptoms and between ergonomic factors and musculoskeletal symtoms were found. Specificity of the relationship between reports about the environment and health symptoms was demonstrated. The implications of this approach for industrial hygiene investigations of non-industrial environments are discussed.

This article describes the design, implementation, and evaluation of a workplace health and safety education program intended to bring a large U.S. manufacturing firm into compliance with a Federal regulation, the Hazard Communication Standard. The methods of program delivery and levels of resources allocated were decided by local plant management and union representatives resulting in marked variations among the five plants studied. These differences in program delivery were associated with differ ences in employee assessment of the training's usefulness, changes in employee work practices, working conditions, and organizational handling of health and safety prob lems. In all five plants, the program evidenced indirect beneficial effects on the use of hazard control measures and organizational approaches to health and safety issues which went beyond the requirements of the federal Standard. The results appear well- explained by an ecological model which views health and disease as outcomes of a complex system of interactions between the individual worker and multiple levels of environmental influences. Implications of these findings for health educators are discussed.

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