Marie-Christine J. Plat

A systematic review of job-specific workers’ health surveillance activities for fire-fighting, ambulance, police and military personnel

PurposeSome occupations have tasks and activities that require monitoring safety and health aspects of the job; examples of such occupations are emergency services personnel and military personnel. The two objectives of this systematic review were to describe (1) the existing job-specific workers’ health surveillance (WHS) activities and (2) the effectiveness of job-specific WHS interventions with respect to work functioning, for selected jobs.MethodsThe search strategy systematically searched the PubMed, PsycINFO and OSH-update databases. The search strategy consisted of several synonyms of the job titles of interest, combined with synonyms for workers’ health surveillance. The methodological quality was checked.ResultsAt least one study was found for each of the following occupations fire fighters, ambulance personnel, police personnel and military personnel. For the first objective, 24 studies described several job-specific WHS activities aimed at aspects of psychological, ‘physical’ (energetic, biomechanical and balance), sense-related, environmental exposure or cardiovascular requirements. The seven studies found for the second objective measured different outcomes related to work functioning. The methodological quality of the interventions varied, but with the exception of one study, all scored over 55% of the maximum score. Six studies showed effectiveness on at least some of the defined outcomes. The studies described several job-specific interventions: a trauma resilience training, healthy lifestyle promotion, physical readiness training, respiratory muscle training, endurance and resistance training, a physical exercise programme and comparing vaccines.ConclusionsSeveral examples of job-specific WHS activities were found for the four occupations. Compared to studies focusing on physical tasks, a few studies were found that focus on psychological tasks. Effectiveness studies for job-specific WHS interventions were scarce, although their results were promising. We recommend studying job-specific WHS in effectiveness studies.

Which subgroups of fire fighters are more prone to work-related diminished health requirements?

PurposeTo determine whether certain subgroups of fire fighters are prone to work-related diminished health requirements.MethodsThe health requirements for fire-fighting were tested in a workers’ health surveillance (WHS) setting. These health requirements included psychological, physical and sense-related components as well as cardiovascular risk factors. The odds ratio (OR) and 95% confidence interval (95% CI) for the presence of the diminished health requirements were calculated for the subgroups of gender, professionalism and age.ResultsThe prevalence of diminished psychological requirements was equivalent among the subgroups, and no significant high-risk group was identified. As compared to men fire fighters, women fire fighters were more likely to have diminished physical requirements (OR 28.5; 95% CI 12.1–66.9) and less likely to have cardiovascular risk factors (OR 0.3; 0.1–0.5). As compared to volunteer fire fighters, professionals were less likely to have diminished physical requirements (OR 0.5; 0.3–0.9), but professionals had a higher prevalence of cardiovascular risk factors with an odds ratio of 1.9 (1.1–3.2). As compared to the youngest fire fighters, the oldest fire fighters were more likely to have diminished sense-related requirements (OR 7.1; 3.4–15.2); a similar comparison could be made between oldest and middle-aged fire fighters (OR 5.1; 2.5–10.5). In addition, the oldest fire fighters were more likely to have cardiovascular risk factors when compared to the youngest (OR 4.4; 1.7–11.1) and to the middle-aged fire fighters (OR 3.1; 1.2–7.9).ConclusionsSubgroups (gender, professionalism and age) of fire fighters are prone to at least one specific work-related diminished health requirement. Therefore, parts of the WHS could be applied with more attention to these high-risk groups.

Impact of Chronic Diseases on Work Ability in Ageing Firefighters

Impact of Chronic Diseases on Work Ability in Ageing Firefighters: Marie‐Christine J PLAT, et al. Academic Medical Center, University of Amsterdam, Department of Coronel Institute of Occupational Health, The Netherlands—

De mate van inspanning bij functionele testen en ergometrie

SamenvattingIn dit onderzoek wordt nagegaan in welke mate de inspanning tijdens functionele fysieke testen en tijdens een fietsergometertest van repressief brandweerpersoneel met elkaar overeenkomen.Beroepsbrandweerlieden (n=25) uit één brandweerregio voerden zowel een functionele brandbestrijdings- en brandweertraplooptest uit als een maximale fietstest. De mate van inspanning werd gemeten aan de hand van de eindhartfrequentie. De associatie in eindhartfrequentie tussen de brandbestrijdingstest/brandweertraplooptest en de fietstest leidden respectievelijk tot een Pearson-correlatie van 0,70 en 0,63. De door de correlaties te berekenen verklaarde variantie toont aan dat minder dan de helft van de variatie in de score op de ene variabele die in de andere verklaart. De conclusie is dat de associatie tussen geleverde inspanning tijdens de brandbestrijdingstest, brandweertraplooptest en de fietstest redelijk is, maar dat de variatie voor de praktijk hiermee onvoldoende wordt verklaard. Functioneel testen lijkt andere aspecten van inspanning in kaart te brengen dan de fietstest. Op basis van de resultaten en relevante literatuur wordt aanbevolen om zo praktijkgericht mogelijk te testen wanneer inzetbaarheid voor het beroep wordt gemeten; fietstesten worden aanvullend aanbevolen bij verdenking van cardiologische pathologie.SummaryThe level of exertion in functional tests and a cycle ergometer testIn 2006 a Workers’ Health Surveillance (WHS) was developed for Dutch fire fighters, based on the specific functional demands of fire fighting. One specific job demand is an energetic (peak) load, requiring a well-functioning cardiorespiratory system. Traditionally this was tested with a (sub)maximal test on a cycle ergometer. In order to have WHSs geared towards specific professions, standardized job-specific tests are included. For fire fighters these are the fire-fighting test consisting of 12 parts and the fire-fighting stair-climb test.This study verified to what extent the physical exercise of fire fighters during functional physical testing and during a cycle ergometer test are in line with each other. Professional fire fighters (n=25) from one fire department executed a functional fire fighting simulation test and the fire-fighting stair-climb test, as well as a maximal cycle ergometer test. Physical exercise was measured by end heart rate.A Pearson correlation of 0.70 and 0.63 was found between the functional tests and the cycle ergometer test. The percentage explained variance was therefore less than 50%. The association between the physical exercise during the functional tests and the cycle ergometer test was moderate but the variance was insufficiently explained for practical use. The functional tests seem to measure other aspects of physical exercise in fire fighting activities compared to a cycle ergometer test. Based on existing evidence, it is recommended to test as functional as possible for measuring work ability in a specific occupation. Cycle ergometers are additionally recommended in cases of suspected cardiac pathology.

The reproducibility of two task-specific functional capacity evaluation protocols for household waste collectors

OBJECTIVE The aim of this study was to assess the reproducibility (i.e., agreement and inter-rater reliability) of two task-specific functional capacity evaluation protocols meant to simulate the daily workload of collectors using either two-wheeled waste containers or bags. METHODS A within-subjects design was used to assess reproducibility in terms of agreement and reliability. Twenty-one household waste collectors were assessed twice with both task-specific protocols with a time interval of seven days. Agreement was assessed using the Standard Error of Measurement (SEM), and inter-rater reliability was assessed using the Intra-Class Correlation Coefficient (ICC). RESULTS For the task-specific protocol for waste collection using two-wheeled containers, agreement was excellent (SEM=0.9 points; 0-340 scale; mean score 339), but inter-rater reliability was poor (ICC=0.22). For the task-specific protocol for bag collection, agreement was acceptable (SEM=53 s; continuous scale; mean time 779 s), and inter-rater reliability was good (ICC=0.79). CONCLUSIONS Reproducibility of the task-specific protocol for bag collection is acceptable to good, while the task-specific protocol for waste collection using two-wheeled containers has an excellent agreement but a poor reliability. Although face and content validity have been covered within the development of both protocols, further studies should evaluate the construct and criterion-related validity of both task-specific protocols.

Return to work: Police personnel and PTSD

OBJECTIVE This study i) describes the number of police personnel with PTSD who are working and those who are on sick leave before and after an out-patient-clinic treatment program and ii) examines which factors are related to return to work. PARTICIPANTS Police personnel treated for PTSD (n=121). METHODS In this retrospective study all police officers had an intake interview before and an outtake interview following a 16-week treatment for PTSD. Information about several personal characteristics, PTSD complaints, and work related factors were gathered. A t-test and chi-square test were used to evaluate differences between working police personnel and police personnel on sick leave at intake and outtake. Binary logistic regression was used to test whether the intake data were related to returning to work at outtake. RESULTS At the start of the treatment half of the police personnel were on sick leave (n=59) and at outtake 48 participants who were not working at intake had returned to work. None of the variables at intake contributed significantly to return to work at outtake. CONCLUSION The majority of police officers returned to work after the treatment program. We recommend that attention be paid to successful return to work as part of the treatment program, therefore the occupational health professional and employer should be involved.

Het PreventieConsult Cardiometabool Risico. iets voor de bedrijfsarts

SamenvattingDe prevalentie van cardiometabole aandoeningen, zoals hart- en vaatziekten, diabetes mellitus en chronische nierinsufficiëntie in de algemene populatie neemt toe.