Peter Orris

Occupational injury disparities in the US hotel industry

BACKGROUND Hotel employees have higher rates of occupational injury and sustain more severe injuries than most other service workers. METHOD OSHA log incidents from five unionized hotel companies for a three-year period were analyzed to estimate injury rates by job, company, and demographic characteristics. Room cleaning work, known to be physically hazardous, was of particular concern. RESULTS A total of 2,865 injuries were reported during 55,327 worker-years of observation. The overall injury rate was 5.2 injuries per 100 worker-years. The rate was highest for housekeepers (7.9), Hispanic housekeepers (10.6), and about double in three companies versus two others. Acute trauma rates were highest in kitchen workers (4.0/100) and housekeepers (3.9/100); housekeepers also had the highest rate of musculoskeletal disorders (3.2/100). Age, being female or Hispanic, job title, and company were all independently associated with injury risk. CONCLUSION Sex- and ethnicity-based disparities in injury rates were only partially due to the type of job held and the company in which the work was performed.

Downsizing, Role Demands, and Job Stress

This is a cross-sectional study consisting of self-administered survey instruments to measure psychological distress and stress-inducing work demands after 6 months of rumors about an upcoming corporate downsizing event. The workforce consisted predominantly of white males who were married, college-educated, and nonsmokers. Higher stress levels were seen among older, more educated workers, who had longer company tenure. Role boundary problems, noxious physical environments, and company tenure were retained in the final multivariable model predicting distress level. The ongoing time delay for management to implement the threatened layoff and peer rankings for a new job performance appraisal contributed to a decline in worker solidarity because of concerns about career and job security. These uncertainties reduced worker productivity and effective teamwork.

Stress among package truck drivers.

In 1992, a cross-sectional questionnaire study of package truck drivers in one company was conducted at four widely scattered sites throughout the US; 317 drivers participated, representing 82% of those eligible. The package truck drivers scored significantly above the US working population comparison norm on all summary and individual scales derived from the SCL 90-R, indicating a substantial increase in psychologic distress for this group. The Global Severity Index, the best single summary measure of psychological distress in the SCL 90-R, revealed a mean T score for the drivers of 64.20, 91st percentile of the normative population. The group perceived significantly more daily stressful events than the average working adult, and their sensitivity to these events was also increased. Role overload, a component of the Occupational Stress Inventory, was the most consistent factor associated with symptoms of psychological distress on multiple regression analysis. This study suggests that job stress is a psychological health hazard for these drivers.

Alternatives to the mercury sphygmomanometer

The mercury sphygmomanometer was introduced over 100 years ago. Mercury, however, is a potent human neurotoxin. An international effort has developed to eliminate health-care sources of mercury – the thermometer and sphygmomanometer – and replace them with less toxic alternatives. There is concern regarding the accuracy of these alternative devices. We conducted a literature review of articles published between 1995 and 2009 evaluating the accuracy of mercury, aneroid, and oscillometric blood pressure devices. Mercury sphygmomanometers fared the best although they do not always perform as expected, failing calibration tests between 1 and 28 per cent of the time. Up to 61 per cent of aneroid sphygmomanometers failed. Recently calibrated aneroid devices performed well. Oscillometric devices were less studied and their performance was variable. All three devices showed variable performance. They should be validated before purchase and calibrated on a regular basis.

The emerging role of salaried physicians: An organizational proposal

D AALARIED medical practice has had a relatively slow development in the United States. Our public health and military services have employed small numbers of t 3 > salaried doctors for the past 200 years, and during most of this century American medical schools employed *tZ? physicians as faculty, administrators, and occasional researchers. In general, however, U.S. physicians have been dedicated to independent, entrepreneurial practice with fee-for-service reimbursement. Nevertheless, the medical profession in the United States has begun to move in the direction of salaried practice. Over the past several decades we have seen rapid growth of voluntary and proprietary hospitals, and more recently, of corporate medical care systems. Large numbers of doctors now pursue their increasingly technical work in major institutions where salaried practice is common. The arrival of HMOs and neighborhood health centers on our medical scene has brought us salaried outpatient clinicians in unprecedented numbers. The expanding number of recent medical school graduates, combined with the modern expectations of a prolonged, compensated, hospital training period, have added many thousands of resident physicians to the list of salaried doctors. And expanding biomedical research, medical administrative, and regulatory roles have created new jobs filled by physicians on salary. We have now reached the point where salaried physicians constitute approximately one half of the active physicians in the United States. This estimate is derived from data collected by the American Medical Association in its Physicians Masterfile (1) and its 198o Periodic Survey of Physicians (2). Using the AMA definitions, physicians who are reimbursed predomi-

Beyond black lung: scientific evidence of health effects from coal use in electricity generation.

While access to electricity affects health positively, combustion of coal in power plants causes well-documented adverse health effects. We review respiratory, cardiovascular, reproductive, and neurologic health outcomes associated with exposure to coal-fired power plant emissions. We also discuss population-level health effects of coal combustion and its role in climate change. Our review of scientific studies suggests that those we present here can be used to inform energy policy.

From Extraction to Renewal: A Global Campaign for Healthy Energy.

A global movement is emerging in the health sector to engage in discourse and advocacy on the health impacts and health costs of energy choices—specifically the health harms of extractive, climate-disrupting energy sources such as coal and gas. Individuals and organizations in the health sector have begun to address climate and energy issues at multiple levels of engagement, including with others in the health sector, with pollution-affected communities, with policy makers, and with the media. We present recent examples of health sector advocacy and leadership on the health impacts of energy choices and opportunities for broadening and deepening the movement.

Green Commuting in the Health Care Sector: Obstacles and Best Practices

Objective: Fossil fuel transportation by health care providers contributes to the prevalence of diseases they treat. We conducted an exploratory study to understand obstacles to, and best practices for, greener commuting among health care providers. Methods: We surveyed staff of three hospital clinics as to how they commute and why, and interviewed key staff of five hospital leaders in green commuting about their programs. Results: Factors that might change respondents’ commuting choices from driving alone included financial incentives, convenience, and solutions to crime and safety concerns. Successful green commuting programs offer benefits including free or reduced transit passes, shuttle buses to transit stations, and free emergency rides home. Conclusions: Exemplary programs throughout the country demonstrate that modifying those factors within reach can impact the amount of fossil fuel energy used for health care provider transportation.