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Induced sputum, exhaled NO, and breath condensate in occupational medicine.
Chérot-Kornobis, N, Hulo, S, de Broucker, V, Hassoun, S, Lepage, N, Edmé, JL, Sobaszek, A
Journal of occupational and environmental medicine. 2012;(8):922-7
Abstract
OBJECTIVE Studies of fractional exhaled NO (FeNO) or induced sputum are now well standardized and the exponential increase in publications about exhaled breath condensate reflects growing interest in a noninvasive diagnosis of pulmonary diseases in occupational medicine. METHODS This review describes current techniques (FeNO, induced sputum, and exhaled breath condensate) for the study of inflammation and oxidative stress biomarkers. RESULTS These biomarkers are FeNO, cytokines, H2O2, 8-isoprostane, malondialdehyde, and nitrogen oxides. These techniques also include the study of markers of the toxic burden in the lungs (heavy metals and mineral compounds) that are important in occupational health exposure assessment. CONCLUSIONS In occupational medicine, the study of both volatile and nonvolatile respiratory biomarkers can be useful in medical surveillance of exposed workers, the early identification of respiratory diseases, or the monitoring of their development.
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2.
Can worksite nutritional interventions improve productivity and firm profitability? A literature review.
Jensen, JD
Perspectives in public health. 2011;(4):184-92
Abstract
AIMS: This paper investigates whether and how worksite nutrition policies can improve employee productivity. METHODS The questions are pursued through a literature review, including a systematic search of literature--combined with literature identified from backward references--on randomized controlled or quasi-experimental worksite intervention trials and observational cross-sectional studies. Studies were selected on the basis of topic relevance, according to publication title and subsequently according to abstract content. A quality appraisal of the studies was based on study design and clarity in definition of interventions, as well as environmental and outcome variables. RESULTS The search identified 2,358 publications, 30 of which were found suitable for the review. Several of the reviewed studies suggest that diet-related worksite interventions have positive impacts on employees' nutritional knowledge, food intake and health and on the firm's profitability, mainly in terms of reduced absenteeism and presenteeism. CONCLUSIONS Well-targeted and efficiently implemented diet-related worksite health promotion interventions may improve labour productivity by 1%-2%. On larger worksites, such productivity gains are likely to more than offset the costs of implementing such interventions. These conclusions are subject to some uncertainty due to the relatively limited amount of literature in the field.
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3.
Lifestyle-focused interventions at the workplace to reduce the risk of cardiovascular disease--a systematic review.
Groeneveld, IF, Proper, KI, van der Beek, AJ, Hildebrandt, VH, van Mechelen, W
Scandinavian journal of work, environment & health. 2010;(3):202-15
Abstract
OBJECTIVE The goal of this review was to summarize the evidence for an effect of lifestyle-targeted interventions at the workplace on the main biological risk factors for cardiovascular disease (CVD). METHODS We performed an extensive systematic literature search for randomized controlled trials (RCT) that met the following inclusion criteria: (i) targeted at workers; (ii) aimed at increasing physical activity and/or improving diet; and (iii) measured body weight, body fat, blood pressure, blood lipids and/or blood glucose. We used a nine-item methodological quality list to determine the quality of each study. A best-evidence system was applied, taking into account study quality and consistency of effects. RESULTS Our review included 31 RCT, describing a diversity of interventions (eg counseling, group education, or exercise). Of these studies, 18 were of high quality. Strong evidence was found for a positive effect on body fat, one of the strongest predictors of CVD risk. Among populations "at risk", there was strong evidence for a positive effect on body weight. Due to inconsistencies in results between studies, there was no evidence for the effectiveness of interventions on the remaining outcomes. CONCLUSIONS We found strong evidence for the effectiveness of workplace lifestyle-based interventions on body fat and, in populations at risk for CVD, body weight. Populations with an elevated risk of CVD seemed to benefit most from lifestyle interventions; supervised exercise interventions appeared the least effective intervention strategy. To gain better insight into the mechanisms that led to the intervention effects, the participants' compliance with the intervention and the lifestyle changes achieved should be reported in future studies.
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4.
Health promotion trials at worksites and risk factors for cancer.
Janer, G, Sala, M, Kogevinas, M
Scandinavian journal of work, environment & health. 2002;(3):141-57
Abstract
Studies of worksite health promotion have frequently reported larger effects than those at the community level. Many of these studies have serious methodological problems. Forty-five worksite health promotion trials following specific quality criteria were selected and estimated for behavioral changes in cancer risk factors and the effectiveness of different intervention components. Tobacco control programs found quit rates of about 5% with relapse rates of 40% to 80% at 6 months after the intervention. Effectiveness increased with the duration of the intervention for at least 6 months, repeated contacts with the participants, continuous support, and tailored messages. There was less evidence for the long-term effectiveness of incentives. Trials on diet, alcohol, physical activity, overweight, and solar radiation showed the same positive trends. The overall evidence indicates a modest but positive effect of health promotion trials at worksites and the effect, for smoking cessation trials, is slightly larger than that of community-based trials. Many of the recommendations made to increase participation and effectiveness were not based on empirical data.
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5.
Financial impact of health promotion programs: a comprehensive review of the literature.
Aldana, SG
American journal of health promotion : AJHP. 2001;(5):296-320
Abstract
PURPOSE The purpose of this review is to summarize the literature on the ability of health promotion programs to reduce employee-related health care expenditures and absenteeism. SEARCH PROCESS Using key words in a literature-searching program, a comprehensive search was conducted on the following databases: MEDLINE, Embase, HealthSTAR. SPORTDiscus, PsycINFO, SciSearch, ERIC, and ABI Inform. STUDY INCLUSION AND EXCLUSION CRITERIA All data-based studies that appeared in peer reviewed journals in the English language. Theses, dissertations, or presentation abstracts that were not published in peer reviewed journals were excluded. The initial search identified 196 studies, but only 72 met the inclusion criteria and were included in the review. DATA EXTRACTION METHODS Summary tables were created that include design classification, subject size, results, and other key information for each study. DATA SYNTHESIS Both the nature of the findings and the overall quality of the literature were evaluated in an attempt to answer two questions: Do individuals or populations with high health risks have worse financial outcomes than individuals or populations with low health risks? Do health promotion programs improve financial outcomes? MAJOR CONCLUSIONS There are good correlational data to suggest that high levels of stress, excessive body weight, and multiple risk factors are associated with increased health care costs and illness-related absenteeism. The associations between seat belt use, cholesterol, diet, hypertension, and alcohol abuse and absenteeism and health care expenditures are either mixed or unknown. Health promotion programs are associated with lower levels of absenteeism and health care costs, and fitness programs are associated with reduced health care costs.