Stefan Lang

Health and safety protection for chemical industry employees in a rotating shift system: program design and acute injury and illness experience at work.

Objectives: To describe a comprehensive health protection program for rotating shift employees and evaluate the program effectiveness in injury and illness prevention. Methods: For 14,128 shift and 17,218 day wage employees, occupational medical records were linked to job assignment records and studied over an 11-year period. Results: Between 1995 and 2005, initiatives directed to shift employees contributed to their 59% and 100% greater participation in medical examinations and health seminar days, respectively, compared to day wage employees. Injury rates declined over time and with increasing employee age and were not elevated among rotating shift compared to day wage employees. Clinic visit rates for acute illnesses were generally higher for day than shift work employees. Conclusion: Coupling of active medical monitoring with additional health and safety initiatives appears to mitigate the expected adverse physiological and psychosocial stresses of shift work.

Occupational stress perception and its potential impact on work ability

OBJECTIVE To examine perceived stress across employees with different occupational status, to investigate the impact of stress on work ability and to derive conclusions regarding health promotion activities. PARTICIPANTS AND METHODS A comprehensive survey combining questionnaire and medical examination was offered in one division in BASF Ludwigshafen. Among 867 voluntary participants, 653 returned complete questionnaires. The questions were directed at perception of safety at the workplace, self-rated health status, frequency of stress symptoms, unrealistic job demands, time pressure and maladjustment of work life balance. The outcome of interest was self-estimated health measured by the Work Ability Index (WAI). RESULTS Occupational stressors were perceived differently across occupational status groups. Frontline operators had more health concerns due to workplace conditions, while professional and managerial staff reported higher frequencies of perceived tension, time pressure, and maladjustment of work life balance. After adjustment for occupational status, demographic and lifestyle factors, perceived stress was associated with a modest to strong decline in WAI scores. CONCLUSION While perceived occupational stress had an apparent impact on WAI, and WAI has been demonstrated to be predictive of early retirement, more intensive and employee group-specific stress management interventions are being implemented beyond traditional strategies of routine occupational medical surveillance.

Are chronotype, social jetlag and sleep duration associated with health measured by Work Ability Index?

ABSTRACT The present study investigates the impact of chronotype, social jetlag and sleep duration on self-perceived health, measured by Work Ability Index (WAI), within an industrial setting. Between 2011 and 2013, 2474 day and shift workers participated in a health check offered by an occupational health promotion program and filled out the Munich ChronoType Questionnaire (adapted to the rotational 12-h schedule for shift workers) and the WAI. We computed sleep duration on work and free days, chronotype, and social jetlag. We used linear regression models to examine chronotype, sleep duration and social jetlag for association with the WAI sum score, and proportional odds models to estimate the combined effect of social jetlag and sleep duration. Participants reported an average daily sleep duration of 7.35 h (SD: 1.2 h), had an average chronotype of 3:08 a.m. (SD: 1 h), and the average social jetlag corresponded to 1.96 h (SD: 2.05 h). Increasing social jetlag and shorter sleep duration were independently associated with a decreasing WAI, while chronotype per se was not associated with WAI. Short sleep duration combined with high social jetlag significantly increased the risk of poor WAI (OR = 1.36; 95% CI: 1.09–1.72), while long sleep duration and high social jetlag were not associated with poor WAI (OR = 1.09; 95% CI: 0.88–1.35). Our results add to a growing body of literature, suggesting that circadian misalignment, but not chronotype per se, may be critical for health. Our results indicate that longer sleep may override the adverse effects of social jetlag on WAI.

Pregnant Employee Protection Program in a Large Chemical Company.

Objectives: To assess whether a structured employee protection program for pregnant workers at a chemical company has an impact on pregnancy outcomes. Methods: Reported pregnancies (n = 1402) between 2003 and 2010 and their outcomes were documented using questionnaires at the time of pregnancy report, end of pregnancy, and 1 year later. Potential maternal exposures were assessed using job histories, workplace inspections, and questionnaires. Results: Participation was 86% overall and was consistently high across subgroups. Pregnancy losses (10.9%), pregnancy complications, and preterm births (8.1%) were in agreement with rates in the general population and were independent of type of work and maternal exposure category. Conclusions: Pregnancy complication rates in this chemical company are not statistically elevated than that in the general population, as suggested in a previous study. The protection program may play a role in preventing complications that may have occurred.

Zur Effektivität der Spülung mit fließendem Wasser als Erste-Hilfe Maßnahme nach chemischer Augenkontamination

ZusammenfassungZur Überprüfung der Wirksamkeit der Augenspülung unter fließendem Wasser als Erste-Hilfe-Maßnahme führten wir eine retrolektive Analyse von Langzeitergebnissen nach chemischer Augenkontamination durch. Hierzu identifizierten wir aus den Gesundheitsakten und Notfalleinsatzprotokollen in der Abteilung Arbeitsmedizin und Gesundheitsschutz der BASF SE im Zeitraum zwischen 1. Januar 1995 und 31. Dezember 2010 insgesamt 2.533 Unfallereignisse mit Chemikalienkontakt der Augen. Hiervon waren 157 als „potenziell schwer” eingestuft worden. Für eine Untergruppe von 73 „schweren” Fällen lagen Sehtestergebnisse vor dem Unfallereignis, am Unfalltag und nach dem Unfall vor. Wir untersuchten die Veränderung der Sehschärfe zwischen der ersten Untersuchung und dem Unfalltag (T1) sowie zwischen dem Unfalltag und der nachfolgenden Untersuchung (T2) mit Generalized Linear Models.Bei einseitiger Augenbeteiligung zeigte sich über den Zeitraum T1 eine Minderung der Sehschärfe auf dem betroffenen im Vergleich zum nicht betroffenen Auge, die sich im folgenden Zeitraum T2 statistisch signifikant wieder verbesserte. In den Fällen mit beidäugiger Betroffenheit beobachteten wir die Visusveränderung über die Zeit. Hier war eine tendenzielle Verschlechterung in T1, gefolgt von einer ebenfalls tendenziellen Verbesserung in T2, zu beobachten. Diese Veränderungen waren jeweils statistisch nicht signifikant. Über den gesamten Beobachtungszeitraum zeigte sich eine tendenzielle, mit dem zunehmenden Alter assoziierte Visusminderung. Ein bleibender Effekt des Unfallereignisses war nicht nachweisbar.Somit waren die am Unfalltag beobachteten Visusminderungen vorübergehend, mit offenkundiger Erholung in der Folgezeit. Auf Gruppenbasis ergab sich kein Hinweis auf bleibende Visusbeeinträchtigungen bei den Betroffenen. Auch die Durchsicht der individuellen Gesundheitsakten der „schweren Fälle” erbrachte keinen Fall einer bleibenden unfallbedingten Visusminderung.AbstractWe conducted a retrolective assessment of chemical eye injury outcomes to evaluate the efficiency of immediate flushing with water as first treatment.BASF’s medical files were searched for the time period between January 1995 and December 2010 for incidents which involved eye contact with chemicals. From a total of 2,533 incidents, 157 were rated as “potentially severe”. In a subset of 73 “severe” cases visual acuity (VA) test results were available before, at the day of, and after the incident.The change over time of VA between first examination and accident (T1), and between accident and post-accident examination (T2) was examined using generalized linear models.In T1, the injured eyes showed an excess decline of VA immediately after treatment, compared to the non-injured eyes. In T2, the injured eyes showed improvement of VA.In the sub-group of bilateral injuries, the effect of duration between the VA tests was estimated. In T1, a decline of VA was observed, followed by improvement in T2, but neither change was statistically significant. Across the whole observation period, the observed change of VA was attributable to a time effect with increasing age, with no significant impact caused by the injury.The decline in visual acuity observed on the day of the accident was transient. An apparent recovery occurred between the accident and the next examination, independent of time. A long-term impact on eyesight was not evident on group basis. No cases of long-term VA impairment were identified in our population after individual review of the medical files.

Job duration as a surrogate measure of exposure to shiftwork in relation to mortality

Objectives Human evidence of carcinogenicity concerning shiftwork is inconsistent. In a previous study, we found no effect on mortality in relation to ever / never working nightshift. The present analyses examined the dose-response-relationship between mortality outcomes and job duration as a surrogate of cumulative exposure. Methods The cohort consisted of male production workers (14 037 shift and 17 095 day), employed for at least 1 year between 1995 and 2006. Vital status was followed from 2000 to 2009. Cause-specific mortality was obtained from death certificates. While lifetime job history was not available, job duration in the company was derived from personal data, which was then categorised at the quartiles. Cox proportional hazard model was used to adjust for potential confounders. The effect estimates were calculated as hazard ratio (HR) with 95% CI. Results Comparing to never shiftwork, the lower quartile of shift exposure (<18 yrs) was not associated with all-cause mortality after adjustment for age at entry in the study, job level and smoking (HR=1.05, 95% CI 0.81-1.37). In the upper three quartiles (18–23; 24–29; ≥30 years) we found non-significantly lowered hazard ratios with no significant trend (P=0.24). Similar patterns were found regarding cancer (P=0.40) and non-cancer mortality (P=0.24). Conclusions The present analyses did not suggest a positive dose-response-relationship between shift duration and the risk of cancer or non-cancer mortality. Potential sources of bias will be discussed.