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Objective: Methods for assessing the costs and benefits of administering vaccines to international business/occupational travelers, assignees, and expatriates have neglected the impact of health and treatment on work productivity. The research objective is to evaluate the benefit to cost ratio of the Japanese encephalitis (JE) vaccine for international business/occupational travelers to Asia and other endemic areas incorporating a health and productivity approach. Methods: Costs and benefits were estimated using actuarial methods with data obtained from secondary sources describing prevalence of infection risk and health outcomes, and business traveler demographic and travel characteristics. Results assumed 2018 salaries and prices, with employee time valued according to total compensation. Results: Risks contracting JE vary widely on the basis of length of trip, season, and destination. The productivity benefits of vaccinating a traveler outweigh the vaccination costs for those staying 30 days or longer in endemic areas during one or more transmission seasons ($2009 vs $750 per traveler), and for business travelers to endemic areas during the transmission season with outdoor activities for the average 2-week/15.4-day international business trip ($502 to $815 vs $500). Vaccination costs outweigh the productivity benefits for short-term travelers who remain in urban areas or travel outside of the transmission season ($10 vs $500). Conclusion: JE Vaccination for business travelers in the active transmission season has a net benefit under certain conditions that are not commonly considered risky, such as average-length trips to peri-urban areas, in situations where contracting disease would result in significant business disruption, or when multiple trips are anticipated over several years. [ABSTRACT FROM AUTHOR]

The article discusses a study to evaluate the self-reported health and productivity burden of three autoimmune disorders: rheumatoid arthritis (RA), psoriasis, and inflammatory bowel disease. The study concluded that when employees with autoimmune disorders with lower severity or no symptoms do not progress to higher severity, their work performance remains on par with healthy employees. The findings of the study offer much promise for lowering costs through benefit design.

The article presents a study on the health care costs of employers in the U.S. It investigates the need of the employers to design better health benefits for the improvement of the health and productivity (H&P) of their workforces. It proposes the employers to apply the evidence-based medicine approach. It analyzes and integrates the relevant literature and employer-specific data which are incorporated in the evidence-based benefit design.

The article presents a case study on Navistar Inc., major manufacturer of commercial trucks and engines in the U.S., which applies evidence-based benefit design (EBD). The fundamental elements of the company's measurement and management approach to EBD were projected. It presents the descriptive results on the direct and indirect cost and utilization trends of the company's U.S. active workforce during 2002 to 2008. The article discusses the evidence-based medicine and prevention programs.

While the International Agency for Research on Cancer (IARC) classified diesel exhaust (DE) as a“probable”carcinogen in 1989 based primarily on“sufficient”animal data, other investigators have since concluded that the lung tumors found in the rat studies were a result of particle overloading. Subsequent health risk assessments of DE have not used the rat cancer data. The U.S. Environmental Protection Agency (EPA), in developing its 2002 Health Assessment Document (HAD) for DE, primarily considered the epidemiology studies of railroad workers and truck drivers to develop health risk assessments of DE. However, both sets of epidemiology studies have serious weaknesses that make them unsuitable for cancer risk assessment. Major shortcomings were the lack of contemporaneous measurements of exposures to DE, difficulties with exposure history reconstruction, and adequately accounting for other exposures such as gasoline exhaust and cigarette smoke. To compound these problems, there was not, and there is still not, a specific exposure marker for DE. Interestingly, in the underground mining industry, where diesel exposures are much higher than observed in railroad workers and truck drivers, there was no increase in lung cancer. These problems and concerns led the U.S. EPA to conclude that while DE was a“likely”carcinogen, a unit risk value or range of risk cannot be calculated from existing data and that the risk could be zero. In addition, the DE emissions have changed and continue to change with the implementation of new emission control technologies. The HAD recognized this fact and noted that further studies are needed to assess new diesel engine emissions. Recent chemical characterization studies on low-emitting diesel engines with catalyzed particulate filters have shown emissions rates for several chemicals of concern that are even lower than comparable compressed natural gas (CNG)-fueled engines. With lower emissions, better fire safety, and improved cost-effectiveness of new low-emitting diesels compared to CNG, current efforts to restrict use of low-emitting diesels seems misguided. [ABSTRACT FROM AUTHOR]

The extent to which employee responses to productivity surveys assess what they are intended to assess has become a pivotal issue for employers and providers. Much work is now being devoted to the validity and reliability of these self-reports. Such issues will likely be resolved only over the long term. In the interim, the skepticism of business decision-makers who are unfamiliar with survey techniques needs to be addressed. This article taps the widespread acceptance that administrative adverse events have gained as indicators of productivity loss to address this issue. Joint analyses of adverse event measures and productivity self-reports on employees at International Truck and Engine Corporation are conducted to test 2 types of criterion validity: 1) concurrent validity; do prior/concurrent adverse events associate with self-reports as logic and common sense dictate? and 2) predictive validity; do self-reports distinguish the risk of subsequent adverse events? Self-reports are found to perform well in both sets of tests. The results are explored in light of: 1) concerns that users have with respect to how self-reports are now being applied, and 2) ways in which self-reports serve as a cornerstone for 3 articles that follow in this issue. [ABSTRACT FROM AUTHOR]

The use of survey data to measure and monitor health and productivity differences between groups is an issue of increasing importance. This article examines the capacity of productivity self-reports (derived from surveys) and adverse event measures (derived from administrative sources) to differentiate groups with a priori known characteristics. A replication strategy is used to test the contributions that productivity self-reports make, alone as well as above and beyond measures of adverse events, to the discrimination of 5 pairs of groups classified by clinical, job type, and demographic criteria. These tests are conducted on representative samples of the active, largely blue-collar employee population at,International Truck and Engine Corporation. The results show that both productivity self-reports and adverse event measures differentiate and track known groups. Even in the presence of highly significant effects from adverse event measures, self-reports improve the assessment of productivity. We conclude that: 1) although the joint use of self-reports and adverse event measures is the better approach, practitioners can use self-reports with the expectation that this method will track group differences in health and productivity when adverse event measures are not available; and 2) survey self-reports make unique and independent contributions when adverse events measures are used. [ABSTRACT FROM AUTHOR]

Deals with the emergence of the concept of the physician as risk assessor in the hazard communication standard of the U.S. Occupational Safety and Health Administration. Objective of the hazard communication standard; Importance of the health hazard section of the standard's material safety data sheet for physicians; Limitations of the material safety data sheet.

The article discusses the significance of employing the physician assistance concept in occupational medicine. It states that physician assistants are health care professionals who are licensed to practice medicine with physician supervision. It cites the increase in demand for occupational and environmental medicine physicians in health plan management design.