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Bello A, Quinn MM, Milton DK, Perry MJ [2013]. Determinants of exposure to 2-butoxyethanol from cleaning tasks: a quasi-experimental study. Ann Occup Hyg. 57(1):125‒135.</strong></p> Abstract. </u>BACKGROUND: The quantitative assessment of airborne cleaning exposures requires numerous measurement methods, which are costly and difficult to apply in the workplace. Exposure determinants can be used to predict exposures but have yet to be investigated for cleaning activities. We identified determinants of exposure to 2-butoxyethanol (2-BE), a known respiratory irritant and suspected human carcinogen, commonly found in cleaning products. In addition, we investigated whether 2-BE exposures can be predicted from exposure determinants and total volatile organic compounds (TVOCs) measured with direct reading methods, which are easier to apply in field investigations. METHODS: Exposure determinants were studied in a quasi-experimental study design. Cleaning tasks were performed similarly as in the workplace, but potential factors that can impact exposures were controlled. Simultaneously for each task, we measured concentrations of (1) 2-BE according to the National Institute for Occupational Health and Safety 1430 method and (2) TVOC with photoionization detectors (PIDs). Simple and multiple linear regression analyses were performed to identify 2-BE exposure determinants and to develop exposure prediction models. RESULTS: Significant determinants from univariate analyses consisted of product type, tasks performed, room volume, and ventilation. The best-fit multivariable model was the one comprised of product type, tasks performed, 2-BE product concentration, room volume, and ventilation (R(2) = 77%). We found a strong correlation between the 2-BE and the TVOC concentrations recorded by the PID instruments. A multivariable model with TVOC explained a significant portion of the 2-BE concentrations (R(2) = 72%) when product type and room ventilation were included in the model.</p> CONCLUSIONS: Our results suggest that quantitative exposure assessment for an epidemiologic investigation of cleaning health effects may be feasible even without performing integrated sampling and analytic measurements.</p> CATEGORIES: CANCER; CHEMICAL HAZARDS; RESPIRATORY</em></p> –</u></strong></p> Colt JS, Karagas MR, Schwenn M, Baris D, Johnson A, Stewart P, Verrill C, Moore LE, Lubin J, Ward MH, Samanic C, Rothman N, Cantor KP, Beane Freeman LE, Schned A, Cherala S, Silverman DT [2011]. Occupation and bladder cancer in a population-based case-control study in Northern New England. Occup Environ Med 68(4):239‒249. </strong></p> Abstract: </u>OBJECTIVES: We used data from a large, population-based case-control study in Maine, New Hampshire, and Vermont to examine relationships between occupation, industry and bladder cancer risk. METHODS: Lifetime occupational histories were obtained by personal interview from 1158 patients newly diagnosed with urothelial carcinoma of the bladder in 2001-2004, and from 1402 population controls. Unconditional logistic regression was used to calculate ORs and 95% CIs, adjusted for demographic factors, smoking and employment in other high-risk occupations. RESULTS: Male precision metalworkers and metalworking/plasticworking machine operators had significantly elevated risks and significant trends in risk with duration of employment (precision metalworkers: OR 2.2, 95% CI 1.4 to 3.4, p(trend) = 0.0065; metalworking/plasticworking machine operators: OR 1.6, 95% CI 1.01 to 2.6, p(trend) = 0.047). Other occupations/industries for which risk increased significantly with duration of employment included: for men, textile machine operators, mechanics/repairers, automobile mechanics, plumbers, computer systems analysts, information clerks, and landscape industry workers; for women, service occupations, health services, cleaning and building services, management-related occupations, electronic components manufacturing and transportation equipment manufacturing. Men reporting use of metalworking fluids (MWF) had a significantly elevated bladder cancer risk (OR 1.7, 95% CI 1.1 to 2.5). CONCLUSIONS: Our findings support the hypothesis that some component(s) of MWF may be carcinogenic to the bladder. Our results also corroborate many other previously reported associations between bladder cancer risk and various occupations. More detailed analyses using information from the study’s job-specific questionnaires may help to identify MWF components that may be carcinogenic, and other bladder carcinogens associated with a variety of occupations.</p> CATEGORIES: CANCER; CUSTODIAL WORKERS</em></p>  </u></strong></p> Zheng T, Cantor KP, Zhang Y, Lynch CF [2002]. Occupation and bladder cancer: a population-based, case-control study in Iowa. J Occup Environ Med 44</em>(7):685–691.</strong></p> Abstract</u>: While considerable efforts have been made to investigate the role of occupation and industry in the risk of bladder cancer, many reported associations have not been consistent, and strong evidence of increased risk is apparent for few occupational groups. To further examine the issue, a large, population-based, case-control study was conducted in the state of Iowa among both men and women. A total of 1452 incident bladder cancer cases and 2434 controls were included in the study. Occupational history was collected from respondents for each job held for 5 years or longer since age 16. Among men, excess risk was observed for industries including plumbing, heating, and air conditioning (odds ratio [OR], = 2.2; 95% confidence interval [CI], 1.0 to 5.0); rubber and plastic products (OR = 3.1; 95% CI, 1.2 to 8.5), motor vehicle parts and supplies (OR = 4.5; 95% CI, 1.2 to 16.5), and occupations including supervisors for transportation and material moving (OR = 6.5; 95% CI, 1.4 to 29.9), material-moving-equipment operators (OR = 1.9; 95% CI, 1.0 to 3.6), automobile mechanics (OR = 1.6; 95% CI, 1.0 to 2.6), painters (OR = 2.7; 95% CI, 1.0 to 7.7), and metal- and plastic-working machine operators (OR = 2.0; 95% CI, 1.1 to 3.4). Among women, significant excess risk was observed for secondary school teachers and record clerks. Housekeepers and butlers and workers in laundering and dry cleaning were also at increased risk. In conclusion, these results suggest that occupational exposures may play a significant role in the risk of bladder cancer.</p> CATEGORIES: CANCER; DOMESTIC WORKERS</em></p>

Belkic KL, Landsbergis PA, Schnall PL, Baker D [2004]. Is job strain a major source of cardiovascular disease risk? Scand J Work Environ Health. 30</em>(2):85</strong>–</strong>128.</strong></p> Abstract.</u> Empirical studies on job strain and cardiovascular disease (CVD), their internal validity, and the likely direction of biases were examined. The 17 longitudinal studies had the highest validity ratings. In all but two, biases towards the null dominated. Eight, including several of the largest, showed significant positive results; three had positive, nonsignificant findings. Six of nine case-control studies had significant positive findings; recall bias leading to overestimation appears to be fairly minimal. Four of eight cross-sectional studies had significant positive results. Men showed strong, consistent evidence of an association between exposure to job strain and CVD. The data of the women were more sparse and less consistent, but, as for the men, most of the studies probably underestimated existing effects. Other elements of causal inference, particularly biological plausibility, corroborated that job strain is a major CVD risk factor. Additional intervention studies are needed to examine the impact of ameliorating job strain upon CVD-related outcomes.</p> CATEGORIES: WORK STRESS; CVD</em></p>  </u></strong></p> Krause N, Lynch JW, Kaplan GA, Cohen RD, Salonen R, Salonen JT [2000]. Standing at work and progression of carotid atherosclerosis. Scand J Work Environ Health 26</em>(3): 227–236.</strong></p> CATEGORIES: CVD</em></p> Kristensen TS [1989]. Cardiovascular diseases and the work environment: a critical review of the epidemiologic literature on nonchemical factors. Scand J Work Environ Health 15</em>:165</strong>–</strong>179.</strong></p> CATEGORIES: CVD; WORK ENVIRONMENT</em></p>  </u></strong></p> Messing K (2004). Physical exposures in work commonly done by women. Can J Appl Physiol 29(5):639-656.</strong> Abstract.</u> The North American work force is still highly sex-segregated, with most members of each sex in jobs composed primarily of workers of the same sex. This division is accentuated when jobs involve physical demands. Women have traditionally been assigned to tasks whose physical demands are considered to be light. Nevertheless, these tasks can have biological effects, sometimes serious. Phenomena related to physical demands of women’s work can be considered in three categories: (a) musculoskeletal and cardiovascular demands of tasks often assigned to women in factories and service work; (b) sex- and gender-specific effects of toxic substances found in the workplace; and (c) interactions between work and the domestic responsibilities of many women. These phenomena are described, using examples recently gathered from workplaces. Effects of biological sex are distinguished, as far as possible, from effects of gender (social roles). CATEGORIES: WOMEN’S HEALTH; MSDs; CVD; CHEMICAL HAZARDS</em></p> Sjogren B, Fredlund P, Lundberg I, Weiner J [2003]. Ischemic heart disease in female cleaners. Int J Occup Environ Health 9</em>(2):134</strong>–13</strong>7.</strong></p> CATEGORIES: CVD; WOMEN’S HEALTH</em></p>  </em></p> Tüchsen F, Krause N, Hannerz H, Burr H, Kristensen T [2000]. A 3 year prospective study of standing at work and varicose veins. Scand J Work Environ Health 26</em>(5):414</strong>–</strong>420.</strong></p> CATEGORIES: CVD</em></p>

Bello A, Quinn MM, Perry MJ, Milton DK [2009]. Characterization of occupational exposures to cleaning products used for common cleaning tasks―a pilot study of hospital cleaners. Environ Health Mar 27</em>(8):11.</strong></p> Abstract.</u> BACKGROUND: In recent years, cleaning has been identified as an occupational risk because of an increased incidence of reported respiratory effects, such as asthma and asthma-like symptoms among cleaning workers. Due to the lack of systematic occupational hygiene analyses and workplace exposure data, it is not clear which cleaning-related exposures induce or aggravate asthma and other respiratory effects. Currently, there is a need for systematic evaluation of cleaning products ingredients and their exposures in the workplace. The objectives of this work were to: a) identify cleaning products’ ingredients of concern with respect to respiratory and skin irritation and sensitization; and b) assess the potential for inhalation and dermal exposures to these ingredients during common cleaning tasks. METHODS: We prioritized ingredients of concern in cleaning products commonly used in several hospitals in Massachusetts. Methods included workplace interviews, reviews of product Materials Safety Data Sheets and the scientific literature on adverse health effects to humans, reviews of physico-chemical properties of cleaning ingredients, and occupational hygiene observational analyses. Furthermore, the potential for exposure in the workplace was assessed by conducting qualitative assessment of airborne exposures and semi-quantitative assessment of dermal exposures. RESULTS: Cleaning products used for common cleaning tasks were mixtures of many chemicals, including respiratory and dermal irritants and sensitizers. Examples of ingredients of concern include quaternary ammonium compounds, 2-butoxyethanol, and ethanolamines. Cleaning workers are at risk of acute and chronic inhalation exposures to volatile organic compounds (VOC) vapors and aerosols generated from product spraying, and dermal exposures mostly through hands. CONCLUSION: Cleaning products are mixtures of many chemical ingredients that may impact workers’ health through air and dermal exposures. Because cleaning exposures are a function of product formulations and product application procedures, a combination of product evaluation with workplace exposure assessment is critical in developing strategies for protecting workers from cleaning hazards. Our task based assessment methods allowed classification of tasks in different exposure categories, a strategy that can be employed by epidemiological investigations related to cleaning. The methods presented here can be used by occupational and environmental health practitioners to identify intervention strategies.</p> CATEGORIES: CHEMICAL HAZARDS; RESPIRATORY; HOSPITAL WORKERS</em></p>  </em></p> Bello A, Quinn MM, Milton DK, Perry MJ [2013]. Determinants of exposure to 2-butoxyethanol from cleaning tasks: a quasi-experimental study. Ann Occup Hyg. 57(1):125‒135.</strong></p> Abstract. </u>BACKGROUND: The quantitative assessment of airborne cleaning exposures requires numerous measurement methods, which are costly and difficult to apply in the workplace. Exposure determinants can be used to predict exposures but have yet to be investigated for cleaning activities. We identified determinants of exposure to 2-butoxyethanol (2-BE), a known respiratory irritant and suspected human carcinogen, commonly found in cleaning products. In addition, we investigated whether 2-BE exposures can be predicted from exposure determinants and total volatile organic compounds (TVOCs) measured with direct reading methods, which are easier to apply in field investigations. METHODS: Exposure determinants were studied in a quasi-experimental study design. Cleaning tasks were performed similarly as in the workplace, but potential factors that can impact exposures were controlled. Simultaneously for each task, we measured concentrations of (1) 2-BE according to the National Institute for Occupational Health and Safety 1430 method and (2) TVOC with photoionization detectors (PIDs). Simple and multiple linear regression analyses were performed to identify 2-BE exposure determinants and to develop exposure prediction models. RESULTS: Significant determinants from univariate analyses consisted of product type, tasks performed, room volume, and ventilation. The best-fit multivariable model was the one comprised of product type, tasks performed, 2-BE product concentration, room volume, and ventilation (R(2) = 77%). We found a strong correlation between the 2-BE and the TVOC concentrations recorded by the PID instruments. A multivariable model with TVOC explained a significant portion of the 2-BE concentrations (R(2) = 72%) when product type and room ventilation were included in the model.</p> CONCLUSIONS: Our results suggest that quantitative exposure assessment for an epidemiologic investigation of cleaning health effects may be feasible even without performing integrated sampling and analytic measurements.</p> CATEGORIES: CANCER; CHEMICAL HAZARDS; RESPIRATORY</em></p>  </em></p> Charles LE, Loomis D, Demissie Z [2009]. Occupational hazards experienced by cleaning workers and janitors: a review of the epidemiologic literature. Work 34(1):105‒116.</strong></p> Abstract: </u>Building cleaners are an important group of workers who experience diverse occupational hazards resulting in health problems. A review of epidemiologic studies conducted between 1981 and 2005 was performed using PubMed and PsychLit, to identify health outcomes and the associated hazards in the work environment of cleaners. Among 35 studies, respiratory diseases (n=17) and dermatologic diseases (n=9) were the most common and were associated with exposure to cleaning agents, wet work, and rubber latex. The potential for infectious diseases (n=3) was identified among cleaners in medical laboratories and was associated with exposure to broken glass and uncapped needles in the trash. Musculoskeletal disorders (n=5) were associated with several physical stressors (e.g., awkward postures, prolonged standing) and psychosocial stressors (e.g., monotonous job, low potential for promotion). Mental disorders (n=1) were also associated with psychosocial stressors and societal stigma. Future studies may be enhanced by better assessment of the specific job exposures of cleaners and implementation of a prospective design.</p> CATEGORIES: CUSTODIAL WORKERS; ERGONOMICS; CHEMICAL HAZARDS; WORK STRESS; REVIEW ARTICLES; RESPIRATORY</em></p>  </p> Ham JE</strong></a>, </strong>Wells JR</strong></a> [2011]. Surface chemistry of a pine-oil cleaner and other terpene mixtures with ozone on vinyl flooring tiles. </strong>Chemosphere.</strong></a> 83</em></strong>(3):327‒333.</strong></p> Abstract. </u>Indoor environments are dynamic reactors where consumer products (such as cleaning agents, deodorants, and air fresheners) emit volatile organic compounds (VOCs) that can subsequently interact with indoor oxidants such as ozone (O(3)), hydroxyl radicals, and nitrate radicals. Typically, consumer products consist of mixtures of VOCs and semi-VOCs which can react in the gas-phase or on surfaces with these oxidants to generate a variety of oxygenated products. In this study, the reaction of a pine-oil cleaner (POC) with O(3) (100ppb) on a urethane-coated vinyl flooring tile was investigated at 5% and 50% relative humidity. These results were compared to previous α-terpineol+O(3) reactions on glass and vinyl surfaces. Additionally, other terpene and terpene alcohol mixtures were formulated to understand the emission profiles as seen in the POC data. Results showed that the α-terpineol+O(3) reaction products were the prominent species that were also observed in the POC/O(3) surface experiments. Furthermore, α-terpineol+O(3) reactions generate the largest fraction of oxygenated products even in equal mixtures of other terpene alcohols. This finding suggests that the judicial choice of terpene alcohols for inclusion in product formulations may be useful in reducing oxidation product emissions.</p> CATEGORIES: CHEMICAL HAZARDS</em></p>  </strong></p> Hansen KS [1983]. Occupational dermatoses in hospital cleaning women. Contact Dermatitis 9</em>(5):343–351.</strong></p> Abstract</u>. In an investigation of 541 members of a hospital cleaning department, a prevalence rate of occupational skin diseases of 15.3% was found. During their hospital employment, 39.1% had a skin disease. Higher prevalence in the younger age groups can be explained by the selection of those with skin diseases for work away from the cleaning department. A large number developed their disease shortly after employment began. This was an indication that the observed prevalent conditions were irritant diseases. The distribution by diagnosis confirms this conclusion in as much as 75% of the occupational skin diseases were irritant dermatitis, 21% allergic contact dermatitis, and 4% monilia of the finger webs. The causes of allergic contact dermatitis were found to be formaldehyde,</p> glutaraldehyde and chloramine in addition to nickel and rubber. Among the causes of irritant dermatitis were detergents, alkaline substances, acids and sodium perborate as well as hypochlorite and hypobromite combinations. In order to reduce occupational skin diseases among cleaning personnel, it is necessary to extend both local and more general prophylactic measures.</p> CATEGORIES: HOSPITAL WORKERS; DERMAL; CHEMICAL HAZARDS</em></p>  </p> Henneberger PK (NIOSH) [2005]. How “clean” is the cleaning profession? Occup Environ Med. 2005 Sep;62(9):586-7 Comment on: Occup Environ Med 62</em>(9):598-606.</strong></p> CATEGORIES: CHEMICAL HAZARDS</em></p>  </em></p> Herdt-Losavio ML, Lin S, Chapman BR, Hooiveld M, Olshan A, Liu X, DePersis RD, Zhu J, Druschel CM [2010]. Maternal occupation and the risk of birth defects: an overview from the National Birth Defects Prevention Study. Occup Environ Med. 67(1):58‒66.</strong></p> Abstract </u>OBJECTIVES:  To examine the association between a spectrum of 24 maternal occupations and 45 birth defects for hypothesis generating purposes. METHODS: Cases of isolated and multiple birth defects (n = 8977) and all non-malformed live-born control births (n = 3833) included in the National Birth Defects Prevention Study (NBDPS) with estimated dates of delivery from 1 October 1997 through 31 December 2003 were included. A computer-assisted telephone interview with mothers was conducted. Occupational coding using the 2000 Standard Occupational Classification System and the 1997 North American Industry Classification System was completed for all jobs held by mothers. Jobs held from 1 month before pregnancy to the end of the third pregnancy month were considered exposures. Logistic regression models were run, adjusted for potential confounders. We also used a Bayesian approach to logistic regression. RESULTS: Approximately 72% of case mothers and 72% of control mothers in the NBDPS were employed. Several occupational groups were positively associated with one or more birth defects, including janitors/cleaners, scientists and electronic equipment operators. Using standard logistic regression, we found 42 (26 for Bayesian) significantly elevated risks of birth defects in offspring of working mothers. In addition, several other occupational groups were found to be negatively associated with one or more birth defects, including teachers and healthcare workers. Using standard logistic regression, we found 12 (11 for Bayesian) significantly reduced risks of birth defects among offspring of working women. CONCLUSIONS: Results from these analyses can be used for hypothesis generating purposes and guiding future investigations of occupational exposures and birth defects.</p> CATEGORIES: CHEMICAL HAZARDS</p>  </em></p> Loddé B</strong></a>, </strong>Paul M</strong></a>, </strong>Roguedas-Contios AM</strong></a>, </strong>Eniafe-Eveillard MO</strong></a>, </strong>Misery L</strong></a>, </strong>Dewitte JD</strong></a> [2012]. Occupational dermatitis in workers exposed to detergents, disinfectants, and antiseptics. </strong>Skinmed.</strong></a> 10</em>(3):144‒150.</strong></p> Abstract: </u>Anti-infective prevention has led to a significant use of disinfectants, detergents, and antiseptics in various areas of activities. Most of these products are skin irritants and allergens, which can cause skin disorders in exposed workers. The authors conducted a descriptive and retrospective study on occupational dermatitis diagnosed at an occupational dermatology hospital consultation service, targeting exposed workers in the health, food, and cleaning industries. These included 20.9% (61 of 291) of the patients seen at this consultation. An occupational origin was proven for 50 of these 61 patients. The most frequent dermatoses were irritant contact dermatitis (42%) and allergic contact dermatitis (26.3%). The main allergens were disinfectants and antiseptics (26.3%), especially quaternary ammoniums, aldehydes, and nickel. Patients exposed to disinfectants, detergents, and antiseptics in the workplace represent an important part (about 1 of 5) of occupational dermatology consultations, although factors may be contributory. Prevention and knowledge are necessary for this increasing issue.</p> CATEGORIES: CHEMICAL HAZARDS; DERMAL</em></p>  </p> Massin N, Hecht G, Ambroise D, Héry M, Toamain JP, Hubert G, Dorotte M, Bianchi B [2007]. Respiratory symptoms and bronchial responsiveness among cleaning and disinfecting workers in the food industry. Occup Environ Med 64</em>(2):75–81.</strong></p> Abstract:</u> OBJECTIVES: To measure the levels of exposure to nitrogen trichloride (NCl3) and aldehydes among cleaning and disinfecting workers in the atmosphere of food industry plants during cleaning and disinfecting operations, and to examine how they relate to irritant and chronic respiratory symptoms-which are indices of pulmonary function-and bronchial hyperresponsiveness (BHR) to methacholine. METHODS: 175 exposed workers (M = 149; F = 26) recruited from 17 enterprises of the food industry (8 cattle, pig, and ovine slaughterhouses, 8 fowl slaughterhouses, and 1 catering firm) and 70 non-exposed workers (M = 52; F = 18) were examined. Concentration levels of NCl3 and aldhehydes were measured by personal sampling. Symptoms were assessed by means of a questionnaire and the methacholine bronchial challenge (MBC) test using an abbreviated method. Subjects were labelled MBC+ if forced expiratory volume in one second (FEV1) fell by 20% or more. The linear dose-response slope (DRS) was calculated as the percentage fall in FEV1 at last dose divided by the total dose administered. RESULTS: 277 air samples were taken in the 17 food industry plants. For a given plant and in a given workshop, the actual concentrations of chloramines, aldehydes, and quaternary ammonium compounds were measured with personal samplers during the different steps of the procedures. For each cleaner, a total exposure index Sigma was calculated. A statistically significant concentration-response relationship was found between eye, nasal, and throat symptoms of irritation–but not chronic respiratory symptoms–and exposure levels or exposure duration. No relation was found between BHR and exposure. CONCLUSIONS: These data show that cleaning and disinfecting workers in the food industry are at risk of developing eye, nasal, and throat irritation symptoms. Although NCl3 exposure does not seem to carry a risk of developing permanent BHR, the possibility of transient BHR cannot be ruled out entirely.</p> CATEGORIES: RESPIRATORY; CHEMICAL HAZARDS</em></p>  </p> Mei-Lien C, Wan-Ping L, Hsin-Yi C, Bey-Rong G, I-Fang M (2005). Biomonitoring of alkylphenols exposure for textile and housekeeping workers. Int J Environ Anal Chem 85(4/5):335-347</strong> Abstract.</u> 4-Nonylphenols (NP), 4- tert -ocytylphenols (OP), and 2,4-di- tert –butylphenols (BP) are ubiquitous in daily foodstuffs. These alkylphenols are widely used in industry, and NP and OP are endocrine disruptors. This study involved biomonitoring of the alkylphenols in plasma and urine from textile and housekeeping workers. The objective was to measure the internal level of alkylphenols and clarify the occupational exposure of alkylphenols for these two working groups. Forty textile workers and 33 housekeeping workers were recruited in this study. Urine and plasma samples were enzymatic deconjugation, followed by cleanup with solid-phase extraction. After extraction, the samples were analysed with reverse-phase high-performance liquid chromatography coupled with uorescence detection. The method was validated with the recovery and reproducibility test. The measurement results demonstrated apparent occupational exposure, since the urinary alkylphenols were significantly higher in the end-of-shift samples, 42.06plusmn;46.63 ng/mL, than in the preshift samples, 23.50±17.34 ng/mL, for the textile exposed workers. Meanwhile, the three kinds of alkylphenols were commonly detected in the biological samples. The plasma concentrations were higher than the urine concentrations. The average plasma concentrations of NP, OP, and BP were 53.21± 49.74, 16.02±2.81, and 25.83±7.10 ng/g for the housekeeping workers and 6.25±4.83, 6.52±8.67, and 6.47±13.34 ng/mL in urine, respectively. The results of this study suggest that multiple exposure routes, including dietary intake, inhalation, and skin absorption, might contribute to the internal alkylphenol dose. The potential adverse effects caused by exposure of occupational workers is concerned. © 2005 Taylor & amp; Francis Group Ltd. (31refs.)Controlled terms: Enzymes – Extraction – Fluorescence – Food products – Occupational diseases – PlasmasUncontrolled terms: Biomonitoring – Endocrine disruptor -NonylphenolsClassification Code: 932.3 Plasma Physics – 914.3.1 Occupational Diseases – 822.3 Food Products – 804.1 Organic Compounds – 802.3 Chemical Operations – 741. Light/Optics – 461.2 Biological Materials and Tissue Engineering. CATEGORIES: HOTEL WORKERS; CHEMICAL HAZARDS</em></p> Messing K (2004). Physical exposures in work commonly done by women. Can J Appl Physiol 29(5):639-656.</strong> Abstract.</u> The North American work force is still highly sex-segregated, with most members of each sex in jobs composed primarily of workers of the same sex. This division is accentuated when jobs involve physical demands. Women have traditionally been assigned to tasks whose physical demands are considered to be light. Nevertheless, these tasks can have biological effects, sometimes serious. Phenomena related to physical demands of women’s work can be considered in three categories: (a) musculoskeletal and cardiovascular demands of tasks often assigned to women in factories and service work; (b) sex- and gender-specific effects of toxic substances found in the workplace; and (c) interactions between work and the domestic responsibilities of many women. These phenomena are described, using examples recently gathered from workplaces. Effects of biological sex are distinguished, as far as possible, from effects of gender (social roles). CATEGORIES: WOMEN’S HEALTH; MSDs; CVD; CHEMICAL HAZARDS</em></p>  </p> Okumura K [2009]. Comment: the use of third-party review to reduce health and environmental hazards from surfactants and cleaning products in the janitorial industry (Vol. 71(9)). J Environ Health 72</em>(1):61.</strong></p> The Boeing Company, Seattle, WA 98125, USA. Kzokum@hotmail.com</strong></p> The demand for environmentally preferable products is increasing in the area of Institutional and Industrial (I&I) cleaners. The GreenBlue Institute (GreenBlue) and U.S. Environmental Protection Agency’s (U.S. EPA’s) Design for Environment (DfE) launched two programs to review surfactant ingredients and final cleaning products, with the National Sanitation Foundation (NSF) conducting third-party reviews. The Local Hazardous Waste Management Program (LHWMP) in King County, Washington, has a strategic goal to reduce the risk of exposure of hazardous chemicals to vulnerable populations such as janitorial workers. This report summarizes the NSF partnership with GreenBlue, CleanGredients, and U.S. EPA’s DfE to perform third-party reviews of cleaning product ingredients and its relevance to LHWMP’s interest in reducing risks to workers in the janitorial industry. Due to information barriers, workers in the janitorial industry are at risk daily to these hazardous chemicals. The surfactant and formulator review program will make positive contributions towards the reduction of toxic chemical exposure to the employees of the janitorial industry. With proper communication and an increased use of less toxic cleaners, exposures to vulnerable populations can be reduced.</p> CATEGORIES: CUSTODIAL WORKERS; CHEMICAL HAZARDS</em></p>  </p> Pearson D, Angulo A, Bourcier E, Freeman E, Valdez R, Pearson AF, Angulo D,    Bourcier A, Freeman E, Valdez R. Hospitality workers’ attitudes and exposure to secondhand smoke, hazardous chemicals, and working conditions. </strong>PUBLIC HEALTH REPORTS 122</em>(5):670–678.</strong></p> Abstract:</u> Objective. Compelling reasons exist for labor and public health to collaborate. For example, compared to white-collar workers, blue-collar and service workers are much more likely to be targeted by the tobacco industry and become smokers. The purpose of this descriptive study was to assess if there were ways public health and labor could collaborate to document the health attitudes and needs of hospitality industry workers. Methods. Eligible union members were identified through an electronic enrollment file consisting of 3,659 names maintained by the union. The mail survey instrument covered exposure to secondhand smoke, exposure to hazardous chemicals and materials, time pressure and job demands, and work-related pain/disability. Additional questions related to age, gender, race/ethnicity, level of education, employment history, English proficiency, and self-reported health status. Results. Study results demonstrated that important health information could be successfully collected on unionized workers. Survey data showed that union members were a very diverse group who were exposed to secondhand smoke and supported working in clean-air settings. Workers, especially housekeeping staff, characterized their work as being chaotic and demanding, while almost half of workers reported work-related pain. Conclusions. Key to the successful collaboration was establishing trust between the parties and emphasizing data collection that served the information needs of both organizations. Opportunities exist to improve the health and working conditions of this population. Health interventions need to be designed to take into consideration the very diverse, mostly female, and limited English proficiency of this group of workers.</p> CATEGORIES: HOTEL WORKERS; CHEMICAL HAZARDS; WORK STRESS</em></p>  </em></p> Pechter E, Azaroff LS, López I, Goldstein-Gelb M [2009]. Reducing hazardous cleaning product use: a collaborative effort. Public Health Rep 24(Suppl 1):45‒52.</strong></p> Abstract.</u> Workplace hazards affecting vulnerable populations of low-wage and immigrant workers present a special challenge to the practice of occupational health. Unions, Coalition for Occupational Safety and Health (COSH) groups, and other organizations have developed worker-led approaches to promoting safety. Public health practitioners can provide support for these efforts.</p> This article describes a successful multiyear project led by immigrant cleaning workers with their union, the Service Employees International Union (SEIU) Local 615, and with support from the Massachusetts COSH (MassCOSH) to address exposure to hazardous chemicals. After the union had identified key issues and built a strategy, the union and MassCOSH invited staff from the Massachusetts Department of Public Health’s Occupational Health Surveillance Program (OHSP) to provide technical information about health effects and preventive measures. Results included eliminating the most hazardous chemicals, reducing the number of products used, banning mixing products, and improving safety training. OHSP’s history of public health practice regarding cleaning products enabled staff to respond promptly. MassCOSH’s staff expertise and commitment to immigrant workers allowed it to play a vital role.</p> Vulnerable populations, including low-wage and immigrant workers, frequently work in the most hazardous environments and also have the fewest resources to address workplace dangers.1,2 As global economic and political forces move large numbers of immigrant workers into at-risk jobs, labor unions, Coalition for Occupational Safety and Health (COSH) groups, and workers’ centers have led creative efforts to combat occupational hazards. These methods involve workers as leaders in identifying priority hazards, health effects, and solutions, as well as building power to promote change.3–5</p> Public health practitioners and people with technical expertise can support these workers and their organizations by contributing to efforts to increase mutual support for labor and public health regarding issues that are important to everyone.6 This article describes a successful occupational health campaign led by janitors and their union with a COSH group, Massachusetts Department of Public Health (MDPH), and academics contributing valuable skills and information.</p> CATEGORIES: IMMIGRANT WORKERS; CHEMICAL HAZARDS</em></p>  </em></p> Repace J [2004]. Respirable particles and carcinogens in the air of Delaware hospitality venues before and after a smoking ban. J Occup Environ Med 46</em>(9):887–905.</strong></p> Abstract</u>: How do the concentrations of indoor air pollutants known to increase risk of respiratory disease, cancer, heart disease, and stroke change after a smoke-free workplace law? Real-time measurements were made of respirable particle (RSP) air pollution and particulate polycyclic aromatic hydrocarbons (PPAH), in a casino, six bars, and a pool hall before and after a smoking ban. Secondhand smoke contributed 90% to 95% of the RSP air pollution during smoking, and 85% to 95% of the carcinogenic PPAH, greatly exceeding levels of these contaminants encountered on major truck highways and polluted city streets. This air-quality survey demonstrates conclusively that the health of hospitality workers and patrons is endangered by tobacco smoke pollution. Smoke-free workplace laws eliminate that hazard and provide health protection impossible to achieve through ventilation or air cleaning.</p> CATEGORIES: HOTEL WORKERS; CHEMICAL HAZARDS</em></p>  </p> Rosenman KD, Reilly MJ, Schill DP, Valiante D, Flattery J, Harrison R, Reinisch F, Pechter E, Davis L, Tumpowsky CM, Filios M [2003]. Cleaning products and work-related asthma. J Occup Environ Med 45</em>(5):556–563.</strong></p> Abstract</u>: To describe the characteristics of individuals with work-related asthma associated with exposure to cleaning products, data from the California-, Massachusetts-, Michigan-, and New Jersey state-based surveillance systems of work-related asthma were used to identify cases of asthma associated with exposure to cleaning products at work. From 1993 to 1997, 236 (12%) of the 1915 confirmed cases of work-related asthma identified by the four states were associated with exposure to cleaning products. 80% of the reports were of new-onset asthma and 20% were work-aggravated asthma. Among the new-onset cases, 22% were consistent with reactive airways dysfunction syndrome. Individuals identified were generally women (75%), white non-Hispanic (68%), and 45 years or older (64%). Their most likely exposure had been in medical settings (39%), schools (13%), or hotels (6%), and they were most likely to work as janitor/cleaners (22%), nurse/nurses’ aides (20%), or clerical staff (13%). However, cases were reported with exposure to cleaning products across a wide range of job titles. Cleaning products contain a diverse group of chemicals that are used in a wide range of industries and occupations as well as in the home. Their potential to cause or aggravate asthma has recently been recognized. Further work to characterize the specific agents and the circumstances of their use associated with asthma is needed. Additional research to investigate the frequency of adverse respiratory effects among regular users, such as housekeeping staff, is also needed. In the interim, the authors recommend attention to adequate ventilation, improved warning labels and Material Safety Data Sheets, and workplace training and education.</p> CATEGORIES: RESPIRATORY; CHEMICAL HAZARDS</em></p>  </em></p> Sarlo K</strong></a>, </strong>Kirchner DB</strong></a>, </strong>Troyano E</strong></a>, </strong>Smith LA</strong></a>, </strong>Carr GJ</strong></a>, </strong>Rodriguez C</strong></a> [2010]. Assessing the risk of type 1 allergy to enzymes present in laundry and cleaning products: evidence from the clinical data.  </strong>Toxicology</strong></a> 271</em>(3):87‒93.</strong></p> Abstract. </u>Microbial enzymes have been used in laundry detergent products for several decades. These enzymes have also long been known to have the potential to give rise to occupational type 1 allergic responses. A few cases of allergy among consumers using dusty enzyme detergents were reported in the early 1970s. Encapsulation of the enzymes along with other formula changes were made to ensure that consumer exposure levels were sufficiently low that the likelihood of either the induction of IgE antibody (sensitization) or the elicitation of clinical symptoms be highly improbable. Understanding the consumer exposure to enzymes which are used in laundry and cleaning products is a key step to the risk management process. Validation of the risk assessment conclusions and the risk management process only comes with practical experience and evidence from the marketplace. In the present work, clinical data from a range of sources collected over the past 40 years have been analysed. These include data from peer reviewed literature and enzyme specific IgE antibody test results in detergent manufacturers’ employees and from clinical study subjects. In total, enzyme specific IgE antibody data were available on 15,765 individuals. There were 37 individuals with IgE antibody. The majority of these cases were from the 1970s where 23 of 4687 subjects (0.49%) were IgE positive and 15 of the 23 were reported to have symptoms of allergy. The remaining 14 cases were identified post-1977 for a prevalence of 0.126% (14/11,078). No symptoms were reported and no relationship to exposure to laundry and cleaning products was found. There was a significant difference between the pre- and post-1977 cohorts in that the higher rates of sensitization with symptoms were associated with higher exposure to enzyme. The clinical testing revealed that the prevalence of enzyme specific IgE in the population is very rare (0.126% since 1977). This demonstrates that exposure to these strong respiratory allergens via use of laundry and cleaning products does not lead to the development of sensitization and disease. These data confirm that the risk to consumers has been properly assessed and managed and support the concept that thresholds of exposure exist for respiratory allergy. Expansion of enzyme use into new consumer product categories should follow completion of robust risk assessments in order to continue ensuring the safe use of enzymes among consumers.</p> CHEMICAL HAZARDS</em></p>  </p> Simcox N, Wakai S, Welsh L, Westinghouse C, Morse T [2012]. Transitioning from traditional to green cleaners: an analysis of custodian and manager focus groups. New Solut 22(4):449‒471.</strong></p> Abstract. </u>Custodians represent one of the largest occupational groups using cleaning agents, and yet their voices are infrequently heard in relation to the introduction of “green” cleaners and the laws regarding environmentally preferable products (EPP). This study reflects worker voices on use and effectiveness of chemicals, as well as incentives and obstacles for green cleaning programs. Sixty-four custodians and staff participated in 10 focus groups. Data were entered into Atlas Ti and the constant comparative method of qualitative data analysis was used to identify themes. Themes included satisfaction in a “well-done” job, more effort required for job, lack of involvement in EPP selection process, EPP’s ease of use for workers with English as a Second Language (ESL), misuse of disinfectants, health complaints, and need for training. This study shows that custodians have a voice, and that improved communication and feedback among all the stakeholders are needed to make the transition to green cleaning more effective.</p> CATEGORIES: CUSTODIAL WORKERS; CHEMICAL HAZARDS</em></p>

Bell AF, Steele JR (2011). Risk of musculoskeletal injury among cleaners during vacuuming. Ergonomics:1-11.</strong> Abstract:</u> This study aimed to examine the risk of work-related upper-limb musculoskeletal disorders in cleaning workers during the work task of vacuuming. In total, 24 cleaning workers were observed while they performed vacuum cleaning tasks in the normal course of their employment in government schools, hospitality and commercial office space sectors. Risk of upper-limb musculoskeletal disorders were rated using three observational assessment tools: Manual Task Risk Assessment (ManTRA); Quick Exposure Check (QEC); the Rapid Upper Limb Assessment (RULA). Mean results (e.g. ManTRA wrist/hand cumulative wrist score 18.67 ± 1.27, QEC neck score 13 ± 1.77, RULA score 6.54 ± 0.509) demonstrated that cleaning workers who perform the task of vacuum cleaning are at risk of work-related upper-limb musculoskeletal injury, regardless of whether they use a back-pack or canister machine. Government school cleaners experienced greater risk of work-related upper-limb musculoskeletal disorders than workers in either the hospitality or commercial office space sectors. STATEMENT OF RELEVANCE: Cleaning workers in Australia are mostly female, ageing and of non-English-speaking backgrounds and involved in repetitive manual tasks. Their occupation is low status. This research confirms that vacuuming tasks are a risk for cleaning workers and highlights the need for further research to improve conditions for these workers. http://www.tandfonline.com/doi/full/10.1080/00140139.2011.592605</a> CATEGORIES: MSDs; WOMEN’S HEALTH; IMMIGRANT WORKERS; CUSTODIAL WORKERS; HOTEL WORKERS; INJURIES</em></p>  </strong></p> Boulet LP, Lemière C, Gautrin D, Cartier A [2007]. New insights into occupational asthma. Curr Opin Allergy Clin Immunol 7</em>(1):96‒101.</strong></p> Abstract PURPOSE OF REVIEW: To examine recent publications on the types of agents involved in occupational asthma, the mechanisms by which they induce asthma, and how best to evaluate and treat workers suspected of this respiratory condition. RECENT FINDINGS: High rates of occupational asthma and inhalation accidents were found in workers in crafts and related occupations in the manufacturing industries, and in plant and machine operatives; cleaners and construction workers may also be at risk. Further data support a role for CD4 T cells in low-molecular-weight agent-induced asthma, such as with isocyanates, and neurogenic mechanisms may also be involved. The use of noninvasive measures of airway inflammation in the diagnosis and management of occupational asthma such as sputum eosinophils monitoring is promising, although this is less obvious for exhaled nitric oxide. Finally, the persistence of troublesome asthma even after withdrawal from relevant exposure has been re-emphasized and surveillance programs have been proposed. SUMMARY: Further data have been gathered on the prevalence of occupational asthma in various working populations, its mechanisms of development, the contribution of noninvasive measures of airway inflammation in the diagnosis and management of this condition, and its management and prevention.</p> CATEGORIES: RESPIRATORY; CUSTODIAL WORKERS</em></p>  </em></p> Charles LE, Loomis D, Demissie Z [2009]. </strong>Occupational hazards experienced by cleaning workers and janitors: a review of the epidemiologic literature. Work 34</em>(1):105‒116.</strong></p> Abstract: </u>Building cleaners are an important group of workers who experience diverse occupational hazards resulting in health problems. A review of epidemiologic studies conducted between 1981 and 2005 was performed using PubMed and PsychLit, to identify health outcomes and the associated hazards in the work environment of cleaners. Among 35 studies, respiratory diseases (n=17) and dermatologic diseases (n=9) were the most common and were associated with exposure to cleaning agents, wet work, and rubber latex. The potential for infectious diseases (n=3) was identified among cleaners in medical laboratories and was associated with exposure to broken glass and uncapped needles in the trash. Musculoskeletal disorders (n=5) were associated with several physical stressors (e.g., awkward postures, prolonged standing) and psychosocial stressors (e.g., monotonous job, low potential for promotion). Mental disorders (n=1) were also associated with psychosocial stressors and societal stigma. Future studies may be enhanced by better assessment of the specific job exposures of cleaners and implementation of a prospective design.</p> CATEGORIES: CUSTODIAL WORKERS; ERGONOMICS; CHEMICAL HAZARDS; WORK STRESS; REVIEW ARTICLES; RESPIRATORY</em></p>  </p> Colt JS, Karagas MR, Schwenn M, Baris D, Johnson A, Stewart P, Verrill C, Moore LE, Lubin J, Ward MH, Samanic C, Rothman N, Cantor KP, Beane Freeman LE, Schned A, Cherala S, Silverman DT [2011]. Occupation and bladder cancer in a population-based case-control study in Northern New England. Occup Environ Med 68(4):239‒249. </strong></p> Abstract: </u>OBJECTIVES: We used data from a large, population-based case-control study in Maine, New Hampshire, and Vermont to examine relationships between occupation, industry and bladder cancer risk. METHODS: Lifetime occupational histories were obtained by personal interview from 1158 patients newly diagnosed with urothelial carcinoma of the bladder in 2001-2004, and from 1402 population controls. Unconditional logistic regression was used to calculate ORs and 95% CIs, adjusted for demographic factors, smoking and employment in other high-risk occupations. RESULTS: Male precision metalworkers and metalworking/plasticworking machine operators had significantly elevated risks and significant trends in risk with duration of employment (precision metalworkers: OR 2.2, 95% CI 1.4 to 3.4, p(trend) = 0.0065; metalworking/plasticworking machine operators: OR 1.6, 95% CI 1.01 to 2.6, p(trend) = 0.047). Other occupations/industries for which risk increased significantly with duration of employment included: for men, textile machine operators, mechanics/repairers, automobile mechanics, plumbers, computer systems analysts, information clerks, and landscape industry workers; for women, service occupations, health services, cleaning and building services, management-related occupations, electronic components manufacturing and transportation equipment manufacturing. Men reporting use of metalworking fluids (MWF) had a significantly elevated bladder cancer risk (OR 1.7, 95% CI 1.1 to 2.5). CONCLUSIONS: Our findings support the hypothesis that some component(s) of MWF may be carcinogenic to the bladder. Our results also corroborate many other previously reported associations between bladder cancer risk and various occupations. More detailed analyses using information from the study’s job-specific questionnaires may help to identify MWF components that may be carcinogenic, and other bladder carcinogens associated with a variety of occupations.</p> CATEGORIES: CANCER; CUSTODIAL WORKERS</em></p>  </p> de Fátima Maçãira E, Algranti E, Medina Coeli Mendonça E, Antônio Bussacos M [2007]. </strong>Rhinitis and asthma symptoms in non-domestic cleaners from the Sao Paulo metropolitan area, Brazil. Occup Environ Med 64(7):446‒453.</strong></p> Abstract. </u>BACKGROUND: Exposure to cleaning products has frequently been reported as a symptom trigger by workers with work-related asthma diagnosed in workers’ health clinics in the city of São Paulo, Brazil. OBJECTIVES: To estimate rhinitis and asthma symptoms prevalence and to analyse associated risk factors. METHOD: A respiratory symptoms questionnaire (Medical Research Council 1976) and the International Study of Asthma and Allergies in Childhood questionnaire were applied to 341 cleaners working in the city of São Paulo, along with obtaining full occupational histories, skin prick tests and spirometry. Timing their symptoms onset in relation to occupational history allowed estimation of work-related asthma and/or rhinitis. Risk factors related to selected outcomes were analysed by logistic regression. RESULTS: 11% and 35% of the cleaners had asthma and rhinitis, respectively. The risk of work-related asthma/rhinitis increased with years of employment in non-domestic cleaning (OR 1.09, 95% CI 1.00 to 1.18, >0.92-3 years; OR 1.28, 95% CI 1.01 to 1.63, >3-6.5 years; OR 1.71, 95% CI 1.02 to 2.89, >6.5 years). Atopy was associated with asthma and rhinitis (OR 2.91, 95% CI 1.36 to 6.71; OR 2.06, 95% CI 1.28 to 3.35, respectively). There was a higher risk of rhinitis in women (OR 2.07, 95% CI 1.20 to 3.70). CONCLUSIONS: Cleaning workers are at risk of contracting work-related asthma and/or rhinitis, and the risk increases with years of employment in non-domestic cleaning. Women present higher risk of rhinitis than men.</p> CATEGORIES: RESPIRATORY; CUSTODIAL WORKERS</em></p>  </p> Flores LY, Deal JZ (2003). Work-related pain in Mexican American custodial workers. Hispanic J Behavioral Sciences 25(2):254-270.</strong> Abstract:</u> Mexican American janitors and custodians are at risk for developing work-related musculoskeletal injuries. These injuries may render them physically disabled, unable to provide for themselves and their families, and dependent on an already strained public health care system. Despite this growing health crisis and the United States’s growing Latino population, no research has been published examining musculoskeletal pain among Mexican American custodial workers. In this article, the authors examine the working and social conditions of Mexican American service workers, as well as the reasons why there is so little research on this population. The authors present results from a study they conducted and discuss the implications of their findings for future research with this population. http://hjb.sagepub.com/content/25/2/254.full.pdf</a> CATEGORIES: CUSTODIAL WORKERS; IMMIGRANT WORKERS; MSDs; PAIN; INJURIES</em></p>  </p> Goggins R (2007). Hazards of cleaning strategies for reducing exposures to ergonomic risk factors. Professional Safety 52(3).</strong> Abstract:</u> Cleaning workers are found in every setting and the work that they do is essential in every industry. According to the Bureau of Labor Statistics (BLS, 2005), more than 4 million people are employed as cleaning workers in the U.S., many working in low-paying, temporary or part-time jobs, with little opportunity for training or advancement. Much of the work is performed in the evening or at night, and many of these workers also have another job, attend school or perform other duties during the day. These working conditions combine to create a high turnover rate—estimated to be as high as 300% (Valentine & C&MM Staff, 1998; SEIU, 2006). Cleaning work creates exposure to many hazards, including wet floors, working on ladders, use of chemicals and motor vehicle accidents. Cleaning workers also are exposed to risk factors for musculoskeletal disorders (MSDs), such as lifting, carrying, awkward postures, repetitive motions and high hand forces. These exposures result in a high rate of injuries. According to Washington state workers’ compensation data from the Department of Labor and Industries (DLI, 2006), cleaning workers have an annual incidence rate of 10.4 new injury claims per 100 full-time equivalents (FTEs), while the overall service industry sector in Washington has an incidence rate of 5.8 per 100 FTEs and the general industry incidence rate is 6.9 per 100 FTEs. By way of comparison, BLS (2005) reports a recordable injury incidence rate of 3.9 per 100 FTEs for janitorial services, which is less than the national incidence rate for all of private industry (4.6 per 100 FTEs). The large difference in numbers between Washington state and national injury rates may be explained by underreporting of injuries in BLS statistics (Leigh, Marcin & Miller, 2004). A review of Washington state workers’ compensation data (DLI, 2006) reveals that the largest single category of injury and illness claims among cleaning workers is overexertion, followed by struck by and against, and falls. Exposure to chemicals and motor vehicle accidents were also significant categories of interest (Figure 1, p. 22). Looking at severity of claims, overexertion and falls accounted for the most days of time loss, while many of the struck by and against claims appear to be of low severity, accounting for a relatively small percentage of all time loss days (Figure 2, p. 22). Overexertion claims, primarily MSDs, were reported as occurring in all phases of cleaning work, while many of the falls were reported as occurring while working on ladders, while sweeping or vacuuming stairs, or while mopping floors. Each phase of cleaning work presents unique risk factors for MSDs. Fortunately, much attention has been focused on MSDs in cleaning work and new technologies offer opportunities to reduce the risk of injury. This article reviews risk factors present in common cleaning tasks and describes some solutions. Risk factors and some potential solutions are summarized in (figure in paper) Dusting and Scrubbing. One risk factor introduced by dusting and scrubbing with cloths and brushes is awkward postures, especially reaching overhead, and bending, kneeling or squatting to clean at floor level. CATEGORIES: CUSTODIAL WORKERS; INJURIES; ERGONOMICS; MSDs</em></p>  </p> Jungbauer FHW, Van Der Harst JJ, Schuttelaar ML, Groothoff JW, Coenraads PJ [2004]. Characteristics of wet work in the cleaning industry. Contact Dermatitis 51</em>(3):131–134.</strong></p> Abstract</u>: Wet work is the main cause of occupational contact dermatitis in the cleaning industry. Dermatologists and occupational physicians need to base their primary and secondary prevention for workers in the cleaning industry on the characteristics of wet work exposures. The authors quantified the burden of wet work in professional office cleaning activities with a continuous standardized observation by trained observers of 41 office cleaners. Duration and frequency of wet work exposure and of different cleaning activities were assessed. Wet work made up 50% of such cleaning work. Within a typical 3-hr shift, a mean frequency of 68 episodes of wet work was observed, which classifies office cleaning as wet work. Skin exposure to irritants was markedly different among cleaners who did the same cleaning activities. Reduction in skin irritation can be achieved by training the workers. Because this group of workers, who have a low level of education, has a high risk of developing irritant hand dermatitis, a special effort on training and instruction should be made. A reduction of exposure can be achieved by: using gloves more often; using gloves for a shorter period of time; using gloves while doing activities that otherwise cause the skin to be in contact with water and cleaning substances and washing hands with water only, reserving soap for when the hands are visibly dirty.</p> CATEGORIES: DERMAL, CUSTODIAL WORKERS</em></p>  </p> Koehoorn M, Ostry A, Hossain S, Village J [2011]. Injury risk associated with physical demands and school environment characteristics among a cohort of custodial workers. 54(8):767‒775.</strong></p> Abstract: </u>Few epidemiological studies have investigated the relationship between work exposures and injury risk among custodians. The relationship between injury risk and occupational physical demands (e.g. pushing/pulling, lifting) and school environment characteristics (e.g. school type, season) was investigated among a cohort of 581 school custodians over a 4-year period. In the final Poisson regression models, the risk of injury was associated with time spent in pushing/pulling tasks in a dose-response manner increasing to a five-fold risk among the highest quartile of exposure (risk ratio = 5.15, 95% CI 1.00, 26.5). Injury risk was also associated with working during the school year compared to the summer, working in a school with grass vs. gravel grounds and working in a school with detached classrooms. Results help to target interventions such as alternative methods for floor cleaning to reduce the pushing/pulling demands of custodial work and to support decisions for alternatives to detached classrooms and grass surfaces. Statement of Relevance: This study examines ergonomic factors (physical demand exposures, school environment characteristics) associated with injury risk among custodial school workers. The findings help schools to target interventions to reduce the physical demands associated with injuries and to design school environments to reduce exposures.</p> CATEGORIES: CUSTODIAL WORKERS; ERGONOMICS</em></p>  </em></p> Leigh JP, Wiatrowski WJ, Gillen M, Steenland NK [2008]. Characteristics of persons and jobs with needlestick injuries in a national data set. Am J Infect Control 36(6):414‒420.</strong></p> Abstract </u>BACKGROUND: Physicians, nurses, and others are at risk of needlesticks, yet little national information is available regarding incidence across demographic and occupational categories. METHODS: Analysis was conducted on national data on occupational injuries for 1992-2003 from the Bureau of Labor Statistics (BLS). Because BLS data were limited to cases with 1 or more days of work loss, and reasons related to reporting of incidents, the data only reflected a subset of all needlesticks. Nevertheless, the data were internally consistent across categories so that relative magnitudes were reliable. Statistical tests for differences in proportions were conducted that compared needlesticks with all other occupational injuries and employment. RESULTS: Cases with 1 or more days of work loss numbered 903 per year, on average, from 1992 through 2003. Women comprised 73.3% (95% CI: 72.5%-74.2%) of persons injured. For those reporting race, white, non-Hispanic comprised 69.3% of the total (95% CI: 68.1%-70.4%); black, non-Hispanic, 14.8% (95% CI: 13.9%-15.6%); and Hispanic, 13.8% (95% CI: 12.9%-14.6%). The age bracket 35 to 44 years had the highest percentage of injuries at 34.0% (95% CI: 33.1%-34.9%). Ages over 54 years reported smaller percentages of needlestick injuries than either all other injuries or employment. Occupations with greatest frequencies included registered nurses, nursing aides and orderlies, janitors and cleaners, licensed practical nurses, and maids and housemen. Occupations with greatest risks included biologic technicians, janitors and cleaners, and maids and housemen. Almost 20% (95% CI: 18.88%-20.49%) of needlesticks occurred outside the services industry. Seven percent (95% CI: 6.56%-7.53%) of needlesticks resulted in 31 or more days of work loss in contrast to 20.46% (95% CI: 20.44%-20.48%) of all other injuries. CONCLUSION: In this nationally representative sample, the most frequent demographic and occupational categories were women; white, non-Hispanic; ages 35 to 44 years; and registered nurses.</strong></p> CATEGORIES: HOSPITAL WORKERS; CUSTODIAL WORKERS</em></p>  </em></p> Lillienberg L, Andersson E, Janson C, Dahlman-Höglund A, Forsberg B, Holm M, Glslason T, Jögi R, Omenaas E, Schlünssen V, Sigsgaard T, Svanes C, Torén K. Occupational exposure and new-onset asthma in a population-based study in Northern Europe (RHINE). Ann Occup Hyg 57</em>(4):482‒492</strong>.</p> Abstract OBJECTIVES: In a large population-based study among adults in northern Europe the relation between occupational exposure and new-onset asthma was studied. METHODS: The study comprised 13 284 subjects born between 1945 and 1973, who answered a questionnaire 1989-1992 and again 1999-2001. Asthma was defined as ‘Asthma diagnosed by a physician’ with reported year of diagnose. Hazard ratios (HR), for new-onset adult asthma during 1980-2000, were calculated using a modified job-exposure matrix as well as high-risk occupations in Cox regression models. The analyses were made separately for men and women and were also stratified for atopy. RESULTS: During the observation period there were 429 subjects with new-onset asthma with an asthma incidence of 1.3 cases per 1000 person-years for men and 2.4 for women. A significant increase in new-onset asthma was seen for men exposed to plant-associated antigens (HR = 3.6; 95% CI [confidence interval] = 1.4-9.0), epoxy (HR = 2.4; 95% CI = 1.3-4.5), diisocyanates (HR = 2.1; 95% CI = 1.2-3.7) and accidental peak exposures to irritants (HR = 2.4; 95% CI = 1.3-4.7). Both men and women exposed to cleaning agents had an increased asthma risk. When stratifying for atopy an increased asthma risk were seen in non-atopic men exposed to acrylates (HR = 3.3; 95% CI = 1.4-7.5), epoxy compounds (HR = 3.6; 95% CI = 1.6-7.9), diisocyanates and accidental peak exposures to irritants (HR = 3.0; 95% CI = 1.2-7.2). Population attributable risk for occupational asthma was 14% for men and 7% for women. CONCLUSIONS: This population-based study showed that men exposed to epoxy, diisocyanates and acrylates had an increased risk of new-onset asthma. Non-atopics seemed to be at higher risk than atopics, except for exposure to high molecular weight agents. Increased asthma risks among cleaners, spray painters, plumbers, and hairdressers were confirmed.</p> CATEGORIES: RESPIRATORY; CUSTODIAL WORKERS</em></p>  </em></p> Louhevaara V, Hopsu L, Sjogaard K (2000). Cardiorespiratory strain during floor mopping with different methods. Proceedings of the IEA2000/HFES 2000 Congress. 518-520.</strong> Abstract.</u> The cardiorespiratory strain of professional female cleaners was quantified as they used different floor mopping methods with respect to the amount of water ranging from dry to wet. The results of oxygen consumption, heart rate and the rating of perceived exertion indicated that the cardiorespiratory strain of dry mopping methods was systematically lighter than that of the more watery methods. http://pro.sagepub.com/content/44/30/5-518.full.pdf</a> CATEGORIES: CUSTODIAL WORKERS; WOMEN’S HEALTH</em></p>  </strong></p> Mirabelli MC</strong></a>, </strong>Vizcaya D</strong></a>, </strong>Martí Margarit A</strong></a>, </strong>Antó JM</strong></a>, </strong>Arjona L</strong></a>, </strong>Barreiro E</strong></a>, </strong>Orriols R</strong></a>, </strong>Gimenez-Arnau A</strong></a>, </strong>Zock JP</strong></a> [2012]</strong>. </strong>Occupational</strong> risk factors for hand dermatitis among professional cleaners in Spain. </strong>Contact Dermatitis.</strong></a> 66</em>(4):188‒196.</strong></p> Abstract: </u>BACKGROUND: Dermatitis is an important health outcome for workers whose jobs put them in contact with irritants or sensitizing agents. OBJECTIVES: We conducted an analysis of data from the Epidemiological Study on the Risk of Asthma in Cleaning Workers 2 (EPIASLI2) to assess worksites and cleaning products as risk factors for hand dermatitis among professional cleaning workers. MATERIALS/METHODS: We distributed 4993 questionnaires to employees of 37 cleaning companies, and used data from 818 (16%) respondents who provided information about skin symptoms and cleaning-related exposures. We assessed associations between the frequencies of worksite and cleaning product exposures and a symptom-based definition of hand dermatitis among current cleaning workers (n = 693) and a comparison population (n = 125). RESULTS: Hand dermatitis was reported by 28% of current cleaning workers, versus 18% of the comparison population, and was associated with cleaning outdoor areas and schools, and the use of hydrochloric acid [prevalence ratio (PR) 1.92, 95% confidence interval (CI) 1.22-3.02] and dust mop products (PR 1.75, 95% CI 1.11-2.75). CONCLUSIONS: Professional cleaning workers may not be sufficiently protected from cutaneous disease at work. Future research should further investigate the roles of multiple product exposures and personal protective equipment.</p> CATEGORIES: DERMAL; CUSTODIAL WORKERS</em></p>  </em></p> Obadia M</strong></a>, </strong>Liss GM</strong></a>, </strong>Lou W</strong></a>, </strong>Purdham J</strong></a>, </strong>Tarlo SM</strong></a> [2009]. Relationships between asthma and work exposures among non-domestic cleaners in Ontario. </strong>Am J Ind Med</strong></a> 52</em>(9):716‒723</strong>. http://onlinelibrary.wiley.com/doi/10.1002/ajim.20730/pdf</a></p> CATEGORIES: RESPIRATORY; CUSTODIAL WORKERS</em></p>  </strong></p> Okumura K [2009]. Comment: the use of third-party review to reduce health and environmental hazards from surfactants and cleaning products in the janitorial industry (Vol. 71(9)). J Environ Health 72</em>(1):61. </strong>The Boeing Company, Seattle, WA 98125, USA. Kzokum@hotmail.com</strong></p> The demand for environmentally preferable products is increasing in the area of Institutional and Industrial (I&I) cleaners. The GreenBlue Institute (GreenBlue) and U.S. Environmental Protection Agency’s (U.S. EPA’s) Design for Environment (DfE) launched two programs to review surfactant ingredients and final cleaning products, with the National Sanitation Foundation (NSF) conducting third-party reviews. The Local Hazardous Waste Management Program (LHWMP) in King County, Washington, has a strategic goal to reduce the risk of exposure of hazardous chemicals to vulnerable populations such as janitorial workers. This report summarizes the NSF partnership with GreenBlue, CleanGredients, and U.S. EPA’s DfE to perform third-party reviews of cleaning product ingredients and its relevance to LHWMP’s interest in reducing risks to workers in the janitorial industry. Due to information barriers, workers in the janitorial industry are at risk daily to these hazardous chemicals. The surfactant and formulator review program will make positive contributions towards the reduction of toxic chemical exposure to the employees of the janitorial industry. With proper communication and an increased use of less toxic cleaners, exposures to vulnerable populations can be reduced.</p> CATEGORIES: CUSTODIAL WORKERS; CHEMICAL HAZARDS</em></p>  </p> Rui F, Bovenzi M, Prodi A, Fortina AB, Romano I, Peserico A, Corradin MT, Carrabba E, Filon FL [2010]. </strong>Nickel, cobalt and chromate sensitization and occupation. Contact Dermatitis 62(4):225‒231.</strong> http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0536.2009.01650.x/pdf</p> CATEGORIES: DERMAL; CUSTODIAL WORKERS</em></p>  </p> Simcox N, Wakai S, Welsh L, Westinghouse C, Morse T [2012]. Transitioning from traditional to green cleaners: an analysis of custodian and manager focus groups. New Solut 22(4):449‒471.</strong></p> Abstract. </u>Custodians represent one of the largest occupational groups using cleaning agents, and yet their voices are infrequently heard in relation to the introduction of “green” cleaners and the laws regarding environmentally preferable products (EPP). This study reflects worker voices on use and effectiveness of chemicals, as well as incentives and obstacles for green cleaning programs. Sixty-four custodians and staff participated in 10 focus groups. Data were entered into Atlas Ti and the constant comparative method of qualitative data analysis was used to identify themes. Themes included satisfaction in a “well-done” job, more effort required for job, lack of involvement in EPP selection process, EPP’s ease of use for workers with English as a Second Language (ESL), misuse of disinfectants, health complaints, and need for training. This study shows that custodians have a voice, and that improved communication and feedback among all the stakeholders are needed to make the transition to green cleaning more effective.</p> CATEGORIES: CUSTODIAL WORKERS; CHEMICAL HAZARDS</em></p>  </p> Village J, Koehoorn M, Hossain S, Ostry A. Quantifying tasks, ergonomic exposures and injury rates among school custodial workers [2009]. Ergonomics 52(6):723‒734.</strong></p> Abstract: </u>A job exposure matrix of ergonomics risk factors was constructed for school custodial workers in one large school district in the province of British Columbia using 100 h of 1-min fixed-interval observations, participatory worker consensus on task durations and existing employment and school characteristic data. Significant differences in ergonomics risk factors were found by tasks and occupations. Cleaning and moving furniture, handling garbage, cleaning washrooms and cleaning floors were associated with the most physical risks and the exposure was often higher during the summer vs. the school year. Injury rates over a 4-year period showed the custodian injury rate was four times higher than the overall injury rate across all occupations in the school district. Injury rates were significantly higher in the school year compared with summer (12.2 vs. 7.0 per 100 full-time equivalents per year, p < 0.05). Custodial workers represent a considerable proportion of the labour force and have high injury rates, yet ergonomic studies are disproportionately few. Previous studies that quantified risk factors in custodial workers tended to focus on a few tasks or specific risk factors. This study, using participatory ergonomics and observational methods, systematically quantifies the broad range of musculoskeletal risk factors across multiple tasks performed by custodial workers in schools, adding considerably to the methodological literature.</p> CATEGORIES: CUSTODIAL WORKERS; ERGONOMICS</em></p>  </em></p> Vizcaya D, Mirabelli MC, Orriols R, Antó JM, Barreiro E, Burgos F, Arjona L, Gomez F, Zock JP [2013]. </strong>Functional and biological characteristics of asthma in cleaning workers. Respir Med 107(5):673‒683. </strong>http://www.sciencedirect.com/science/article/pii/S0954611113000371</p> CATEGORIES: RESPIRATORY; CUSTODIAL WORKERS</em></p> Wang TN</strong></a>, </strong>Lin MC</strong></a>, </strong>Wu CC</strong></a>, </strong>Leung SY</strong></a>, </strong>Huang MS</strong></a>, </strong>Chuang HY</strong></a>, </strong>Lee CH</strong></a>, </strong>Wu DC</strong></a>, </strong>Ho PS</strong></a>, </strong>Ko AM</strong></a>, </strong>Chang PY</strong></a>, </strong>Ko YC</strong></a> [2010]. Risks of exposure to occupational asthmogens in atopic and nonatopic asthma: a case-control study in Taiwan. </strong>Am J Respir Crit Care Med</strong></a> 182</em>(11):1369‒1376. </strong>http://www.atsjournals.org/doi/full/10.1164/rccm.200906-0969OC</a></p> CATEGORIES: RESPIRATORY; CUSTODIAL WORKERS</em></p>

Alamgir H, Yu S [2008]. Epidemiology of occupational injury among cleaners in the healthcare sector. Occup Med 58</em>(6):393–399.</strong></p> Abstract:</u> BACKGROUND: The cleaning profession has been associated with multiple ergonomic and chemical hazards which elevate the risk for occupational injury. AIMS: This study investigated the epidemiology of occupational injury among cleaners in healthcare work settings in the Canadian province of British Columbia. METHODS: Incidents of occupational injury among cleaners, resulting in lost time from work or medical care, over a period of 1 year in two healthcare regions were extracted from a standardized operational database and with person-years obtained from payroll data. Detailed analysis was conducted using Poisson regression modeling. RESULTS: A total of 145 injuries were identified among cleaners, with an annual incidence rate of 32.1 per 100 person-years. After adjustment for age, gender, subsector, facility, experience and employment status, Poisson regression models demonstrated that a significantly higher relative risk (RR) of all injury, musculoskeletal injury and cuts was associated with cleaning work in acute care facilities, compared with long-term care facilities. Female cleaners were at a higher RR of all injuries and contusions than male cleaners. A lower risk of all injury and allergy and irritation incidents among part-time or casual workers was found. Cleaners with >10 years of experience were at significantly lower risk for all injury, contusion and allergy and irritation incidents. CONCLUSION: Cleaners were found to be at an elevated risk of all injury categories compared with healthcare workers in general.</p> CATEGORIES: HOSPITAL WORKERS; INJURIES; MSDs; DERMAL; RESPIRATORY</em></p>  </p> Desciak EB, Marks JG Jr. [1997]. Dermatoses among housekeeping personnel. Am J Contact Dermat 8</em>(1):32–34.</strong></p> Abstract</u>. BACKGROUND: Housekeepers are exposed to irritants and allergens in their work and are at significant risk for developing occupationally induced contact dermatitis.</p> OBJECTIVE: We studied housekeepers at the Hershey Medical Center to determine the cause and frequency of contact dermatitis and contact urticaria in these workers.</p> METHODS: All housekeepers were examined. Those with hand dermatitis had an extensive history, patch testing, and latex RAST testing. RESULTS: Eight of 130 had hand dermatitis. None had a relevant positive patch test or positive RAST test. CONCLUSIONS: Of our housekeepers, 6.2% had occupationally induced irritant contact dermatitis. None had allergic contact dermatitis or contact urticaria to latex.</p> CATEGORIES: HOTEL WORKERS; DERMAL</em></p>  </p> Feveile H, Christensen KB, Flyvholm MA. Self-reported occupational skin contact with cleaning agents and the risk of disability pension. Contact Dermatitis 60(3):131‒135</strong>. http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0536.2008.01495.x/pdf</a></p> CATEGORIES: DERMAL</em></p>  </p> Flyvholm MA, Frydendall Jensen K [2008]. Experiences with implementation of evidence-based prevention programs to prevent occupational skin diseases in different occupations. G Ital Dermatol Venereol 143</em>(1):71–78.</strong></p> Abstract</u>. Occupational skin diseases are among the most frequently recognized occupational diseases in many industrialized countries. This paper describes and review experiences with implementation of interventions to prevent occupational skin diseases in different occupational settings representing the food processing industry and a hospital. The study populations were gut cleaners with all participants being exposed to wet work, cheese dairies and a hospital where all employees were included. The effect of implementation of evidence-based prevention programs were tested by questionnaire surveys on baseline and follow-up. A significant reduction in eczema at hands or forearms was observed among gut cleaners. At cheese dairies the eczema frequencies were low except for a comparison dairy where significant changes were seen. At the hospital a non significant reduction in hand eczema was observed. Changes related to use of protective measures and knowledge on prevention of occupational skin diseases were observed. A process evaluation carried out at the gut cleaning departments showed association between the eczema frequency at follow-up, activities related to prevention and implementation of an occupational health management system. In addition to documenting the scientific background for evidence-based prevention programs to prevent occupational skin diseases in different occupations, both the study population and the study design should be considered carefully when testing the implementation of workplace interventions. These aspects may influence the outcome in different directions and either facilitate or hamper the possibilities to provide scientific documentation of the effect of the intervention tested.</p> CATEGORIES: INTERVENTION STRATEGIES; DERMAL; HOSPITAL WORKERS</em></p>  </p> Hansen KS [1983]. Occupational dermatoses in hospital cleaning women. Contact Dermatitis 9</em>(5):343–351.</strong></p> Abstract</u>. In an investigation of 541 members of a hospital cleaning department, a prevalence rate of occupational skin diseases of 15.3% was found. During their hospital employment, 39.1% had a skin disease. Higher prevalence in the younger age groups can be explained by the selection of those with skin diseases for work away from the cleaning department. A large number developed their disease shortly after employment began. This was an indication that the observed prevalent conditions were irritant diseases. The distribution by diagnosis confirms this conclusion in as much as 75% of the occupational skin diseases were irritant dermatitis, 21% allergic contact dermatitis, and 4% monilia of the finger webs. The causes of allergic contact dermatitis were found to be formaldehyde, glutaraldehyde and chloramine in addition to nickel and rubber. Among the causes of irritant dermatitis were detergents, alkaline substances, acids and sodium perborate as well as hypochlorite and hypobromite combinations. In order to reduce occupational skin diseases among cleaning personnel, it is necessary to extend both local and more general prophylactic measures.</p> CATEGORIES: HOSPITAL WORKERS; DERMAL; CHEMICAL HAZARDS</em></p>  </p> Health and Safety Executive [2007]. Preventing contact dermatitis at work. London: HSE Books.</strong></p> Abstract</u>: Aimed at workers, this leaflet explains that contact dermatitis can be caused by contact with a wide range of substances including detergents, toiletries, chemicals and even some natural products. While it can concern all parts of the body, the hands are most commonly affected. Contents: definition and description of contact dermatitis; high risk-jobs and workplaces (health care personnel, hairdressers, printers, cleaners, metal workers); prevention (substitution, automation, enclosure, protective gloves); legal aspects (compliance with the Control of Substances Hazardous to Health Regulations 2002 (COSHH, see CIS 03-1023). Replaces CIS 06-6. URL:http://www.hse.gov.uk/pubns/indg233.pdf</a></p> CATEGORIES: INTERVENTION STRATEGIES; DERMAL</em></p>  </strong></p> Liskowsky J, Geier J, Bauer A [2011]. Contact allergy in the cleaning industry: analysis of contact allergy surveillance data of the Information Network of Departments of Dermatology. Contact Dermatitis 65</em>(3):159‒166.</strong> http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0536.2011.01937.x/pdf</p> CATEGORIES: DERMAL; RESPIRATORY</em></p>  </strong></p> Loddé B</strong></a>, </strong>Paul M</strong></a>, </strong>Roguedas-Contios AM</strong></a>, </strong>Eniafe-Eveillard MO</strong></a>, </strong>Misery L</strong></a>, </strong>Dewitte JD</strong></a> [2012]. Occupational dermatitis in workers exposed to detergents, disinfectants, and antiseptics. </strong>Skinmed.</strong></a> 10</em>(3):144‒150.</strong></p> Abstract: </u>Anti-infective prevention has led to a significant use of disinfectants, detergents, and antiseptics in various areas of activities. Most of these products are skin irritants and allergens, which can cause skin disorders in exposed workers. The authors conducted a descriptive and retrospective study on occupational dermatitis diagnosed at an occupational dermatology hospital consultation service, targeting exposed workers in the health, food, and cleaning industries. These included 20.9% (61 of 291) of the patients seen at this consultation. An occupational origin was proven for 50 of these 61 patients. The most frequent dermatoses were irritant contact dermatitis (42%) and allergic contact dermatitis (26.3%). The main allergens were disinfectants and antiseptics (26.3%), especially quaternary ammoniums, aldehydes, and nickel. Patients exposed to disinfectants, detergents, and antiseptics in the workplace represent an important part (about 1 of 5) of occupational dermatology consultations, although factors may be contributory. Prevention and knowledge are necessary for this increasing issue.</p> CATEGORIES: CHEMICAL HAZARDS; DERMAL</em></p>  </strong></p> Lynde CB, Obadia M, Liss GM, Ribeiro M, Holness DL, Tarlo SM [2009]. </strong>Cutaneous and respiratory symptoms among professional cleaners. Occup Med 59</em>(4):249–254.</strong></p> Abstract</u>. BACKGROUND: Occupational dermatitis is very common and has a large economic impact. Cleaners are at an increased risk for both work-related cutaneous and respiratory symptoms. AIMS: To compare the prevalence of occupational cutaneous symptoms among professional indoor cleaners to other building workers (OBW) and to determine associations with exposures and with respiratory symptoms among cleaners. METHODS: A questionnaire completed by indoor professional cleaners and OBW to compare rash and respiratory symptoms between these groups examined workplace factors such as training, protective equipment and work tasks. RESULTS: In total, 549 of the 1396 professional cleaners (39%) and 593 of the 1271 OBW (47%) completed questionnaires. The prevalence of rash was significantly higher in the cleaners compared to the OBW. For male cleaners, 21% (86/413) had a rash in the past 12 months compared to only 11% (13/115) of OBW (P < 0.05). The rashes experienced by the cleaners were more likely to be on their hands and worse at work. Cleaners washed their hands significantly more often than OBW. Cleaners with a rash were less likely to have received workplace training regarding their skin and were more likely to find the safety training hard to understand. Cleaners with a rash within the past year were significantly more likely to have work-related asthma symptoms than cleaners without a rash (P < 0.001). CONCLUSIONS: This study demonstrates a strong link between work-related symptoms of asthma and dermatitis among cleaners. Effective preventive measures, such as the use of protective skin and respiratory equipment, should be emphasized.</p> CATEGORIES: RESPIRATORY; DERMAL</em></p>  </p> Mirabelli MC</strong></a>, </strong>Vizcaya D</strong></a>, </strong>Martí Margarit A</strong></a>, </strong>Antó JM</strong></a>, </strong>Arjona L</strong></a>, </strong>Barreiro E</strong></a>, </strong>Orriols R</strong></a>, </strong>Gimenez-Arnau A</strong></a>, </strong>Zock JP</strong></a> [2012]</strong>. </strong>Occupational</strong> risk factors for hand dermatitis among professional cleaners in Spain. </strong>Contact Dermatitis.</strong></a> 66</em>(4):188‒196.</strong></p> Abstract: </u>BACKGROUND: Dermatitis is an important health outcome for workers whose jobs put them in contact with irritants or sensitizing agents. OBJECTIVES: We conducted an analysis of data from the Epidemiological Study on the Risk of Asthma in Cleaning Workers 2 (EPIASLI2) to assess worksites and cleaning products as risk factors for hand dermatitis among professional cleaning workers. MATERIALS/METHODS: We distributed 4993 questionnaires to employees of 37 cleaning companies, and used data from 818 (16%) respondents who provided information about skin symptoms and cleaning-related exposures. We assessed associations between the frequencies of worksite and cleaning product exposures and a symptom-based definition of hand dermatitis among current cleaning workers (n = 693) and a comparison population (n = 125). RESULTS: Hand dermatitis was reported by 28% of current cleaning workers, versus 18% of the comparison population, and was associated with cleaning outdoor areas and schools, and the use of hydrochloric acid [prevalence ratio (PR) 1.92, 95% confidence interval (CI) 1.22-3.02] and dust mop products (PR 1.75, 95% CI 1.11-2.75). CONCLUSIONS: Professional cleaning workers may not be sufficiently protected from cutaneous disease at work. Future research should further investigate the roles of multiple product exposures and personal protective equipment.</p> CATEGORIES: DERMAL; CUSTODIAL WORKERS</em></p>  </p> Mygind K, Sell L, Flyvholm MA, Frydendall JK [2006]. High-fat petrolatum-based moisturizers and prevention of work-related skin problems in wet-work operations. Contact Dermatitis 54</em>(1):35–41.</strong></p> Abstract</u>: The purpose of this study was to explore whether a high-fat petrolatum-based moisturizer could be an alternative to protective gloves in wet-work occupations. The study population consisted of gut cleaners in Danish swine slaughterhouses, divided into intervention and comparison groups. The intervention group was given written and oral information on the use of gloves and skin care. Data were collected by telephone interviews using a standardized questionnaire. 644 (88%) gut cleaners responded at baseline and 622 (72%) at a one-year follow-up. In the intervention group, the eczema frequency was reduced significantly. Detailed analyses revealed that protective gloves were the most effective means of protection and did not indicate that a high-fat moisturizer could be an alternative. A continuous focus on prevention of skin problems with information and discussions on the shop floor seemed to be most important for reducing skin problems.</p> CATEGORIES: DERMAL; INTERVENTION STRATEGIES</em></p>  </p> Pal TM, de Wilde NS, van Beurden MM, Coenraads PJ, Bruynzeel DP [2009]. Notification of occupational skin diseases by dermatologists in The Netherlands. Occup Med 59</em>(1):38–43</strong>.</p> Abstract</u>. BACKGROUND: A voluntary surveillance scheme of occupational skin diseases (OSDs) in The Netherlands starting in 2001 aimed to improve insight in the incidence of OSD especially occupational contact dermatitis (OCD), risk professions and causal agents. This paper presents the results of this scheme during 2001-05. METHODS:</p> Reports of new cases of OSD received from the participating dermatologists on a monthly basis were analyzed. Data evaluated included information on diagnosis, sex, age, sickness, absenteeism, profession and causal agents. Relative differences in incidence rates between industries or branches were estimated by calculating incidence rate ratios. RESULTS: About 80% of the notifications concerned OCD. The highest number of notifications was recorded in the first year of the scheme. This was probably due to reporting of a mixture of incident and prevalent cases. During the following 5 years, the number of yearly notifications of OSD declined. Hairdressers, nurses, metalworkers, mechanics and cleaners were the most commonly affected professions. Wet work and irritating substances were the most frequently reported causal agents. Most patients with OCD were not absent from work. CONCLUSIONS: A voluntary surveillance scheme with dermatologists provides valuable data about the distribution of OCD in risk professions and the causal agents. However, it has certain limitations in assessing trends in incidence. Active medical surveillance in populations at risk should be encouraged not only to improve secondary prevention but also to obtain more reliable information about the incidence of OCD.</p> CATEGORIES: DERMAL</em></p>  </em></p> Rui F, Bovenzi M, Prodi A, Fortina AB, Romano I, Peserico A, Corradin MT, Carrabba E, Filon FL [2010]. </strong>Nickel, cobalt and chromate sensitization and occupation. Contact Dermatitis 62(4):225‒231.</strong> http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0536.2009.01650.x/pdf</p> CATEGORIES: DERMAL; CUSTODIAL WORKERS</em></p>  </p> Rui F, Bovenzi M, Prodi A, Fortina AB, Romano I, Corradin MT, Filon FL [2012]. Concurrent sensitization to metals and occupation. Contact Dermatitis. 67(6):359‒366.</strong></p> Abstract. </u>BACKGROUND: Cosensitization to nickel, cobalt and chromium occurs in the general population and in some occupational groups. OBJECTIVES: To estimate the isolated and concurrent occurrence of nickel, cobalt and chromium contact sensitization and their association with individual and occupational risk factors. PATIENTS/METHODS: Twelve thousand four hundred and ninety-two patients were patch tested with the European baseline series between 1997 and 2004 in north-eastern Italy. The associations between patch test results and patient characteristics and occupations were investigated by means of multinomial logistic regression analysis. RESULTS: Of the patients, 34.7% (4334 patients) had one or more positive patch test reactions to metals. As compared with those with negative reactions to all three metals, nickel sensitization was significantly higher in females than in males, not only as monosensitization, but also as cosensitization with cobalt, with chromium, or with both metals. Building and related trades workers showed positive reactions to chromium + nickel [odds ratio (OR) 1.99; 95% confidence interval (CI) 1.05-3.76) and chromium + cobalt (OR 2.61; 95% CI 1.46-4.67]. Cleaning workers showed a high prevalence of nickel, chromium, nickel + chromium and nickel + cobalt + chromium cosensitization (ORs 1.29, 1.66, 2.11, and 1.79, respectively). An excess risk for cosensitization to all three metals was found in textile and leather workers (OR 2.19; 95% CI 1.10-4.33), and in bartenders (OR 2.10; 95% CI 1.03-4.26). CONCLUSIONS: Some occupational groups are more likely to develop nickel, cobalt and chromium cosensitization.</p> CATEGORIES: DERMAL</em></p>  </p> Weisshaar E, Radulescu M, Soder S, Apfelbacher CJ, Bock M, Grundmann JU, Albrecht U,  Diepgen TL [2007]. Secondary individual prevention of occupational skin diseases in health care workers, cleaners and kitchen employees: aims, experiences and descriptive results. Int Arch Occup Environ Health 80</em>(6):477–484.</strong></p> Abstract</u>: Objectives Due to increased occupational dermatoses in certain professions such as health care workers (HCW), cleaning and kitchen employees (CKE), measures of prevention and skin protection are of high significance. Skin protection courses focus on educational aims (e.g. improving skin care habits, influencing the participants’ attitudes towards health) and medical aims (e.g. optimizing diagnostic procedures, complementing individual therapy). Methods Participants are patients who have been suspected to suffer from an occupational skin disease and are insured with the German Accident Prevention & Insurance Association (BGW). Teaching units of the skin protection courses focus on basics of skin functioning and important aspects of occupational skin diseases. Practical parts include information and instructions about the correct implementation of skin protection, skin care and skin cleansing. Every participant is seen by a dermatologist obtaining a precise patient’s history and performing a skin examination. All this results in working out individually adapted and professional skin protection strategies. Results In total, 791 participants (93 men and 698 women) completed the skin protections courses. Six hundred and sixty-seven patients (mean age: 36.9 years, SD = 11.6) were HCW and 124 patients (mean age: 40.4 years, SD = 10.8) were CKE. In HCW 82.5% (n = 550) and in CKE 86.3% (n = 107) suffered from hand eczema of the atopic, irritant or allergic type. Irritant contact dermatitis as a single diagnosis was the most frequent one in both groups (HCW: 34.5.%, n = 230; CKE: 49.2% n = 61). According to regularly performed evaluations, the participants rated the course as good to excellent. Nearly 80% of the participants had skin lesions while attending the course, in 27% the dermatosis was severe. Conclusions: There is a high need for health education, advisory services, diagnostics and additional therapy in occupational dermatology. Prevention of occupational skin diseases and maintenance of health through educational programmes are important complementary measures for dermatological care but still missing in endangered professions.</p> CATEGORIES: DERMAL; HOSPITAL WORKERS; INTERVENTION STRATEGIES</em></p>

Arif AA, Hughes PC, Delclos GL [2008]. Occupational exposures among domestic and industrial professional cleaners. Occup Med (London) 58</em>(7):458–463.</strong></p> Abstract</u>. Background: Despite being a large part of the workforce, cleaners</strong> remain a relatively understudied occupational</strong> group in the USA. Aims: The aims of this focus group study were to identify and</strong> characterize occupational</strong> exposures</strong>, symptoms and</strong> job tasks among</strong> domestic</strong> and</strong> industrial</strong> professional</strong> cleaners</strong>.</strong> Methods: Twelve focus group sessions were conducted in Lubbock, TX, and</strong> Houston, TX. Participants were asked about their job tasks, type of products they use to clean, bodily symptoms, job training and</strong> work environment. Results: Out of 99 attendees, 79 domestic</strong> and</strong> industrial</strong> cleaners</strong> participated actively in the focus group sessions. Three general themes emerged regarding cleaning professional</strong>s’ work experiences: (i) job training, (ii) chemical exposure and</strong> use and</strong> (iii) competence. Domestic</strong> cleaners</strong> demonstrated significant skills deficit across each of these three themes as compared to industrial</strong> cleaners</strong>. Domestic</strong> cleaners</strong> reported more frequent exposure to respiratory irritants and</strong> sensitizers and</strong> also reported adverse respiratory symptoms as compared to industrial</strong> cleaners</strong>.</strong> Conclusions: The results from this qualitative study are consistent with earlier findings from quantitative studies placing domestic</strong> cleaners</strong> at risk of exposure to chemicals that are respiratory irritants and</strong>/or sensitizers.</p> CATEGORIES: DOMESTIC WORKERS; INDUSTRIAL WORKERS</em></p>  </strong></p> Medina-Ramón M, Zock JP, Kogevinas M, Sunyer J, Antó JM [2003]. Asthma symptoms in women employed in domestic cleaning: a community based study. Thorax 58</em>(11):950–954.</strong></p> Abstract</u>. BACKGROUND: Epidemiological studies have shown an association between cleaning work and asthma, but the risk factors are uncertain. The aim of this study was to assess the risk of asthma in women employed in domestic cleaning. METHODS: A cross sectional study was conducted in 4521 women aged 30 to 65 years. Information on respiratory symptoms and cleaning work history was obtained using a postal questionnaire with telephone follow up. Asthma was defined as reported symptoms in the last year or current use of drugs to treat asthma. Odds ratios (OR) with 95% confidence intervals (CI) for asthma in different cleaning groups were estimated using adjusted unconditional logistic regression models. RESULTS: 593 women (13%) were currently employed in domestic cleaning work. Asthma was more prevalent in this group than in women who had never worked in cleaning (OR 1.46 (95% CI, 1.10 to 1.92)). Former domestic cleaning work was reported by 1170 women (26%), and was strongly associated with asthma (OR 2.09 (1.70 to 2.57)). Current and former non-domestic cleaning work was not significantly associated with asthma. Consistent results were obtained for other respiratory symptoms. Twenty five per cent of the asthma cases in the study population were attributable to domestic cleaning work. CONCLUSIONS: Employment in domestic cleaning may induce or aggravate asthma. This study suggests that domestic cleaning work has an important public health impact, probably involving not only professional cleaners but also people undertaking cleaning tasks at home.</p> CATEGORIES: DOMESTIC WORKERS; RESPIRATORY</em></p>  </p> Medina-Ramon, M; Zock, JP; Kogevinas, M; Sunyer, J; Torralba, Y; Borrell, A; Burgos, F; Anto, JM. Asthma, chronic bronchitis, and exposure to irritant agents in occupational domestic cleaning: a nested case-control study Occup Environ Med 2005 62: 598-606</strong></p> CATEGORIES: DOMESTIC WORKERS; RESPIRATORY</em></p>  </p> Zheng T, Cantor KP, Zhang Y, Lynch CF [2002]. Occupation and bladder cancer: a population-based, case-control study in Iowa. J Occup Environ Med 44</em>(7):685–691.</strong></p> Abstract</u>: While considerable efforts have been made to investigate the role of occupation and industry in the risk of bladder cancer, many reported associations have not been consistent, and strong evidence of increased risk is apparent for few occupational groups. To further examine the issue, a large, population-based, case-control study was conducted in the state of Iowa among both men and women. A total of 1452 incident bladder cancer cases and 2434 controls were included in the study. Occupational history was collected from respondents for each job held for 5 years or longer since age 16. Among men, excess risk was observed for industries including plumbing, heating, and air conditioning (odds ratio [OR], = 2.2; 95% confidence interval [CI], 1.0 to 5.0); rubber and plastic products (OR = 3.1; 95% CI, 1.2 to 8.5), motor vehicle parts and supplies (OR = 4.5; 95% CI, 1.2 to 16.5), and occupations including supervisors for transportation and material moving (OR = 6.5; 95% CI, 1.4 to 29.9), material-moving-equipment operators (OR = 1.9; 95% CI, 1.0 to 3.6), automobile mechanics (OR = 1.6; 95% CI, 1.0 to 2.6), painters (OR = 2.7; 95% CI, 1.0 to 7.7), and metal- and plastic-working machine operators (OR = 2.0; 95% CI, 1.1 to 3.4). Among women, significant excess risk was observed for secondary school teachers and record clerks. Housekeepers and butlers and workers in laundering and dry cleaning were also at increased risk. In conclusion, these results suggest that occupational exposures may play a significant role in the risk of bladder cancer.</p> CATEGORIES: CANCER; DOMESTIC WORKERS</em></p>

Beemsterboer W, Stewart R, Groothoff J, Nijhuis F [2009]. On regional differences in determinants of </strong>sick leave frequency for cleaning workers in two regions of the Netherlands: a comparative study. Int J Occup Med Environ Health.22(3):203‒214.</strong></p> Abstract: </u>OBJECTIVES: To explore regional differences in the effects of the sick leave frequency determinants between two homogeneous groups of workers from two comparable socio-economic regions in the Netherlands, namely Utrecht and South Limburg. MATERIALS AND METHODS: Data on sick leave frequency for 137 cleaning workers in the regions of Utrecht (mean sick leave frequency: 0.89 spells) and South Limburg (mean sick leave frequency: 1.66 spells) were obtained from a Dutch social fund, and the data regarding their job, and health-related and individual characteristics were elicited by an interview. RESULTS: A statistical analysis of the sick leave frequency in the two regions showed little differences, except for the determinant ‘perceived physical workload’ which was associated with the sick leave frequency in South Limburg but not in Utrecht. CONCLUSION: A regional difference in the sick leave frequency was noted with respect to ‘perceived physical workload’ as the study parameter. This would indicate that the findings of our earlier studies performed in the nineties of the last century. are still relevant. In further research, the principles of the new certification system on sick leave frequency should also be considered, as the previous uniform statutory compensation system has been terminated.</p> CATEGORIES: WORK STRESS; ERGONOMICS</em></p>  </p> Bell AF, Steele JR (2011). Risk of musculoskeletal injury among cleaners during vacuuming. Ergonomics:1-11.</strong> Abstract:</u> This study aimed to examine the risk of work-related upper-limb musculoskeletal disorders in cleaning workers during the work task of vacuuming. In total, 24 cleaning workers were observed while they performed vacuum cleaning tasks in the normal course of their employment in government schools, hospitality and commercial office space sectors. Risk of upper-limb musculoskeletal disorders were rated using three observational assessment tools: Manual Task Risk Assessment (ManTRA); Quick Exposure Check (QEC); the Rapid Upper Limb Assessment (RULA). Mean results (e.g. ManTRA wrist/hand cumulative wrist score 18.67 ± 1.27, QEC neck score 13 ± 1.77, RULA score 6.54 ± 0.509) demonstrated that cleaning workers who perform the task of vacuum cleaning are at risk of work-related upper-limb musculoskeletal injury, regardless of whether they use a back-pack or canister machine. Government school cleaners experienced greater risk of work-related upper-limb musculoskeletal disorders than workers in either the hospitality or commercial office space sectors. STATEMENT OF RELEVANCE: Cleaning workers in Australia are mostly female, ageing and of non-English-speaking backgrounds and involved in repetitive manual tasks. Their occupation is low status. This research confirms that vacuuming tasks are a risk for cleaning workers and highlights the need for further research to improve conditions for these workers. http://www.tandfonline.com/doi/full/10.1080/00140139.2011.592605</a> CATEGORIES: MSDs; WOMEN’S HEALTH; IMMIGRANT WORKERS; CUSTODIAL WORKERS; HOTEL WORKERS; INJURIES; ERGONOMICS</em></p>  </p> Bergqvist U, Wolgast E, Nilsson B, Voss M [1995]. </strong>Musculoskeletal disorders among visual display terminal workers: individual, ergonomic, and work organizational factors. Ergonomics 38</em>:763–776.</strong></p> Abstract:</u> A number of individual, ergonomic, and organizational factors of presumed importance for the occurrence of musculoskeletal disorders were investigated in a group of 260 visual display terminal (VDT) workers. The cross-sectional study utilized medical and workplace investigations as well as questionnaires. The results were subjected to a multivariate analysis in order to find the major factors associated with various upper-body muscular problems. Several such factors were identified for each investigated type of musculoskeletal problem. Some were related to the individual: age, gender, woman with children at home, use of spectacles, smoking, stomach-related stress reactions, and negative affectivity. Organizational variables of importance were opportunities for flexible rest breaks, extreme peer contacts, task flexibility, and overtime. Identified ergonomic variables were static work posture, hand position, use of lower arm support, repeated work movements, and keyboard or VDT vertical position.</p> CATEGORIES: MSDs; ERGONOMICS; WORK ENVIRONMENT</em></p>  </p> Charles LE, Loomis D, Demissie Z [2009]. Occupational hazards experienced by cleaning workers and janitors: a review of the epidemiologic literature. Work 34(1):105‒116.</strong></p> Abstract: </u>Building cleaners are an important group of workers who experience diverse occupational hazards resulting in health problems. A review of epidemiologic studies conducted between 1981 and 2005 was performed using PubMed and PsychLit, to identify health outcomes and the associated hazards in the work environment of cleaners. Among 35 studies, respiratory diseases (n=17) and dermatologic diseases (n=9) were the most common and were associated with exposure to cleaning agents, wet work, and rubber latex. The potential for infectious diseases (n=3) was identified among cleaners in medical laboratories and was associated with exposure to broken glass and uncapped needles in the trash. Musculoskeletal disorders (n=5) were associated with several physical stressors (e.g., awkward postures, prolonged standing) and psychosocial stressors (e.g., monotonous job, low potential for promotion). Mental disorders (n=1) were also associated with psychosocial stressors and societal stigma. Future studies may be enhanced by better assessment of the specific job exposures of cleaners and implementation of a prospective design.</p> CATEGORIES: CUSTODIAL WORKERS; ERGONOMICS; CHEMICAL HAZARDS; WORK STRESS; REVIEW ARTICLES; RESPIRATORY</em></p>  </p> Cleaners mopped up by injuries [1999]. J Occup Health Safety Environ 3</em>(5):8</strong></p> Abstract:</u> Looks at the findings of a research report, “Musculoskeletal health of cleaners”, funded by the Health and Safety Executive (HSE) and the trade union UNISON. The results of a postal survey of 5,000 cleaning staff and follow-up ergonomic risk assessments indicate widespread musculoskeletal pain and discomfort often leading to time off work. The high risks of such pain have been associated with equipment design, job organization and poor training. HSE and UNISON will be holding a seminar for equipment manufacturers, employers and worker representatives in London on 28 September 1999, to review the study’s recommendations.</p> CATEGORIES: MSDs; INJURIES; PAIN; ERGONOMICS; WORK ENVIRONMENT</em></p>  </em></p> Hopsu L, Toivonen R, Louhevaara V, Sjøgaard K (2000). Muscular strain during floor mopping with different cleaning methods. Proceedings of the IEA2000/HFES2000 Congress. 521-524.</strong> Abstract:</u> Mopping is one of the most used cleaning methods. The aim of this study was to quantify and compare local muscular strain during floor mopping with seven different mopping methods with respect to the amount of water ranging from dry to wet. The results showed that the local strain measured with EMG from the trapezius and forearm muscles was higher with the use of wet and damp mopping methods than with the use of dry methods. CATEGORIES: ERGONOMICS</em></p>  </p> Jansen JP, Burdorf A, Steyerberg E [2001]. A novel approach for evaluating level, frequency and duration of lumbar posture simultaneously during work. Scan J Work Environ Health 27</em>(6):373–380</strong>.</p> Abstract</u>. OBJECTIVES: Electrogoniometers are used to collect continuous information on postural distributions among workers. Enormous quantities of data are generated that have to be reduced to meaningful parameters (angle, frequency, and duration). In this study we propose statistical models to determine these essential characteristics of postural load on nurses, housekeepers, and office workers. METHODS: A direct registration of the lumbar posture was made over a workday with an inclinometer. An exposure variation analysis was used to summarize information on the angle of trunk flexion, the time period of maintained postures, and the percentage of worktime in a data matrix. A hierarchical regression analysis was used to compare these characteristics among nurses (N=64), housekeepers (N=16), and office workers (N=27). RESULTS: The occupational groups did not differ for either frequency or duration of trunk flexion over 30 degrees since frequency and duration were inversely related. Nurses experienced longer worktimes than the office workers did for trunk flexion between 30 and 70 degrees maintained CATEGORIES: ERGONOMICS</em></p>  </em></p> Jørgensen MB, Faber A, Jespersen T, Hansen K, Ektor-Andersen J, Hansen JV, Holtermann A, Søgaard K [2012]. Implementation of physical coordination training and cognitive behavioural training interventions at cleaning workplaces–secondary analyses of a randomised controlled trial. Ergonomics. 55(7):762‒772.</strong></p> Abstract: </u>This study evaluates the implementation of physical coordination training (PCT) and cognitive behavioural training (CBTr) interventions in a randomised controlled trial at nine cleaners’ workplaces. Female cleaners (n = 294) were randomised into a PCT, a CBTr or a reference (REF) group. Both 12-week interventions were performed in groups guided by an instructor. Records were kept on intervention dose (adherence) unanticipated events at the work place (context) and quality of intervention delivery (fidelity). Participant adherence was 37% in the PCT and 49% in the CBTr interventions. Optimal implementation was reached by only 6% in PCT and 42% in the CBTr. Analysis of the barriers to successful implementation indicated that the intervention process is sensitive to unanticipated events. In order to succeed in improving the health of high-risk populations such as cleaners and to correctly interpret intervention effects, more research on implementation is needed. Trial registration: ISRCTN96241850. PRACTITIONER SUMMARY: Both physical coordination training and cognitive behavioural training are potential effective workplace interventions among low educated job groups with high physical work demands. However, thorough consideration should be given to feasibility in the design of interventions. The optimal intervention should be tailored to closely match the implementation context and be robust and flexible to minimize susceptibility to changes in work organization.</p> CATEGORIES: ERGONOMICS</em></p>  </em></p> Koehoorn M, Ostry A, Hossain S, Village J [2011]. Injury risk associated with physical demands and school environment characteristics among a cohort of custodial workers. 54(8):767‒775.</strong></p> Abstract: </u>Few epidemiological studies have investigated the relationship between work exposures and injury risk among custodians. The relationship between injury risk and occupational physical demands (e.g. pushing/pulling, lifting) and school environment characteristics (e.g. school type, season) was investigated among a cohort of 581 school custodians over a 4-year period. In the final Poisson regression models, the risk of injury was associated with time spent in pushing/pulling tasks in a dose-response manner increasing to a five-fold risk among the highest quartile of exposure (risk ratio = 5.15, 95% CI 1.00, 26.5). Injury risk was also associated with working during the school year compared to the summer, working in a school with grass vs. gravel grounds and working in a school with detached classrooms. Results help to target interventions such as alternative methods for floor cleaning to reduce the pushing/pulling demands of custodial work and to support decisions for alternatives to detached classrooms and grass surfaces. Statement of Relevance: This study examines ergonomic factors (physical demand exposures, school environment characteristics) associated with injury risk among custodial school workers. The findings help schools to target interventions to reduce the physical demands associated with injuries and to design school environments to reduce exposures.</p> CATEGORIES: CUSTODIAL WORKERS; ERGONOMICS</em></p>  </p> Kumar R, Chaikumarn M, Kumar S [2005]. </strong>Physiological, subjective, and postural loads in passenger train wagon cleaning using a conventional and redesigned cleaning too. Int J Ind Ergonomics 35</em>(10):931–938.</strong></p> Abstract</u>: In this study, cleaning process was studied and analyzed with special reference to cleaning tools. A group of 13 professional cleaners participated in this study. While they performed their normal tasks, their oxygen consumption, heart rate, rating of perceived exertion and postural data were obtained. The perceived exertion during cleaning task using the “redesigned cleaning tool” was less than that of the “conventional cleaning tool”. The oxygen consumption when cleaning with the redesigned tool (mean 0.84 l/m, SD +/-0.17) was significantly less (p < 0.05) compared to the conventional cleaning tool (mean 0.94 l/m, SD +/- 0.18). Heart rate was also found significantly lower using redesigned cleaning tool (mean 101 bpm, SD +/- 11.10) compared to that of conventional cleaning tool (mean 105 bpm, SD +/- 12.59) (p < 0.05). Using redesigned cleaning tool the trunk postural load was also found significantly less than that of conventional cleaning tool (p CATEGORIES: ERGONOMICS; INTERVENTION STRATEGIES</em></p>  </p> Messing K, Vezina N, Major M, Ouellet S, Tissot F, Couture V, Riel J (2008). Body maps: an indicator of physical pain for worker-oriented ergonomics interventions. Policy Practice in Health and Safety 2:31-49. </strong>Abstract.</u> Work-related musculoskeletal health damage causes pain and suffering, and can lead to disability. To prevent it, it is important to detect not only diagnosed musculoskeletal disorders but also early signs of impending damage. Workers have important information on workplace risks and health damage, and should be involved in the process of identifying damage. However, controversy surrounds the pain reports of workers and their claims for compensation. We have found that a body map is a useful tool for systematising and analysing workers’ pain reports. CATEGORIES: MSDs; PAIN; ERGONOMICS; INTERVENTION STRATEGIES</em></p> Milburn PD, Barrett RS [1999]. Lumbosacral loads in bedmaking. Appl Ergon 30</em>(3):263</strong>–2</strong>73.</strong></p> CATEGORIES: ERGONOMICS; HOTEL WORKERS</em></p>  </p> Muraca G, Martino LB, Abbate A, De Pasquale D, Barbuzza O, Brecciaroli R (2007). </strong>The risk of manual handling loads in the hotel sector G Ital Med Lav Ergon 3:569-570. </strong>Abstract.</u> The aim of our study is to evaluate the manual handling risk and the incidence of muscle-skeletal pathologies in the hotel compartment. Our study is conducted on 264 workers of the hotel compartment. The sample is divided on the base of the working turn in the following groups: porter (both to the plans and in the kitchen); waiters to the plans; services (gardeners and workers). The duties have been valued according to the method NIOSH. The presence of muscle-skeletal pathologies has been verified on the base to the accused symptomology, and on the presence of clinical objectivity and to the reports of checks. The data has been compared to a control group. The application of the NIOSH method has showed for each working profile an elevated synthetic index, > 3, and for porter the index is 5. The clinical data has shown an elevated incidence of pathologies of the spine, especially lumbar spine, with a high prevalence in the group of male porters. In conclusion we believe that the manual handling represents a particularly remarkable risk for the workers in the hotel compartment. CATEGORIES: HOTEL WORKERS; ERGONOMICS</em></p>  </p> Nordander C, Ohlsson K, Åkesson I, Arvidsson I, Balogh I, Hansson G, Skerfving S (2009). Risk of musculoskeletal disorders among females and males in repetitive/constrained work. Ergonomics 52(10):1226-1239.</strong> Abstract</u>. This paper combines epidemiological data on musculoskeletal morbidity in 40 female and 15 male occupational groups (questionnaire data 3720 females, 1241 males, physical examination data 1762 females, 915 males) in order to calculate risk for neck and upper limb disorders in repetitive/constrained vs. varied/mobile work and further to compare prevalence among office, industrial and non-office/non-industrial settings, as well as among jobs within these. Further, the paper aims to compare the risk of musculoskeletal disorders from repetitive/constrained work between females and males. Prevalence ratios (PR) for repetitive/constrained vs. varied/mobile work were in neck/shoulders: 12-month complaints females 1.2, males 1.1, diagnoses at the physical examination 2.3 and 2.3. In elbows/hands PRs for complaints were 1.7 and 1.6, for diagnoses 3.0 and 3.4. Tension neck syndrome, cervicalgia, shoulder tendonitis, acromioclavicular syndrome, medial epicondylitis and carpal tunnel syndrome showed PRs > 2. In neck/shoulders PRs were similar across office, industrial and non-office/non-industrial settings, in elbows/hands, especially among males, somewhat higher in industrial work. There was a heterogeneity within the different settings (estimated by bootstrapping), indicating higher PRs for some groups. As in most studies, musculoskeletal disorders were more prevalent among females than among males. Interestingly, though, the PRs for repetitive/constrained work vs. varied/mobile were for most measures approximately the same for both genders. In conclusion, repetitive/constrained work showed elevated risks when compared to varied/mobile work in all settings. Females and males showed similar risk elevations. This article enables comparison of risk of musculoskeletal disorders among many different occupations in industrial, office and other settings, when using standardised case definitions. It confirms that repetitive/constrained work is harmful not only in industrial but also in office and non-office/non-industrial settings. The reported data can be used for comparison with future studies. CATEGORIES: MSDs; ERGONOMICS; WOMEN’S HEALTH</em></p>  </strong></p> Öhrling T</strong></a>, </strong>Kumar R</strong></a>, </strong>Abrahamsson L</strong></a> [2012]. Assessment of the development and implementation of tools in contract cleaning. </strong>Appl Ergon</strong></a> 43</em>(4):687‒94.</strong></p> Abstract: </u>This paper illustrates and discusses problems with the implementation and use of ergonomic tools and techniques in the process of cleaning. Cleaning is an occupation with a high risk of developing work-related disorders. One high-strain task where recommended tools and techniques are difficult to apply is cleaning staircases. This study evaluated the muscular activity of cleaners while mopping staircases using two different mop handles and found that an easily adjustable mop handle can decrease a cleaner’s physical load. The results also show that the implementation and contextualization of the mop are of great importance for how a mop is used. A more holistic approach is needed to improve the benefits of good tools and techniques in cleaning work. More research is needed on how workplace organization can be improved to support the implementation of strategies to increase the health of professional cleaners.</p> CATEGORIES: ERGONOMICS</em></p>  </p> Rasmussen CD, Jørgensen MB, Carneiro IG, Flyvholm MA, Olesen K, Søgaard K, Holtermann A [2012]. Participation of Danish and immigrant cleaners in a 1-year worksite intervention preventing physical deterioration. 55(2):256‒264.</strong></p> Abstract: </u>Worksite health promotion is seldom offered to workers who are low-educated and multi-ethnic, possibly due to an assumption that they are more reluctant to participate. Furthermore, little has been done to promote health at female-dominated workplaces. The main aim of this study was to investigate differences in participation among immigrant and Danish cleaners throughout a 1-year randomised controlled study tailored to cleaners and carried out in predominantly female workplaces. No significant differences in ethnicity were found in consent and participation throughout the 1-year intervention. Dropout was equally distributed among Danish and immigrant cleaners. This study indicates that a worksite health promotion intervention among a female-dominated, high-risk occupation such as cleaning can be equally appealing for Danes and immigrants. PRACTITIONER SUMMARY: This study provides insight about participation of Danish and immigrant cleaners in a worksite health promotion intervention in a predominantly female occupation. For attaining high participation and low dropout in future worksite health promotion interventions among cleaners, the intervention ought to not only target the ethnic background of the workers, but also to be specifically tailored to the job group.</p> CATEGORIES: ERGONOMICS; IMMIGRANT WORKERS</em></p>  </em></p> Skoglind-Ohman I, Shahnavaz H [2004]. Assessment of future workshop’s usefulness as an ergonomics tool. Int J Occup Safe Ergonomics 10</em>(2):119–128.</strong></p> Abstract</u>. This study was carried out to assess Future Workshop (FW) regarding its usefulness as a participatory ergonomics method, using a descriptive evaluation design analyzed by phenomenographical approach. The study was conducted among professional cleaners, health care personnel and miners, with a sample of 105 participating subjects in 8 different FWs. Multiple methods, giving a combination of both qualitative and quantitative data, were used for data collection. Good involvement of participants was observed during workshops. Evaluations immediately after FWs and 3 months later showed a strong relationship with high correlation, indicating that the perception of FW participants was very positive. Interviews revealed conformity between developed problem identification and proposed changes. Participants’ own perceptions of FW’s influence on creativity depict their belief of developed ideas and solutions in order to identify and solve workplace problems. FW is considered to be a useful ergonomics tool, and its qualities are related to structure and practical performance.</p> CATEGORIES: INTERVENTION STRATEGIES; ERGONOMICS</em></p>  </p> Van der Grinten M, Houptman I [2000]. Improving work load and comfort of operators on modified hydraulic excavotors in railroad maintance. San Diego, CA: International Ergonomics Association and Human Factors and Ergonomics Society.</strong></p> CATEGORIES: ERGONOMICS</em></p>  </em></p> Village J, Koehoorn M, Hossain S, Ostry A. Quantifying tasks, ergonomic exposures and injury rates among school custodial workers [2009]. Ergonomics 52(6):723‒734.</strong></p> Abstract: </u>A job exposure matrix of ergonomics risk factors was constructed for school custodial workers in one large school district in the province of British Columbia using 100 h of 1-min fixed-interval observations, participatory worker consensus on task durations and existing employment and school characteristic data. Significant differences in ergonomics risk factors were found by tasks and occupations. Cleaning and moving furniture, handling garbage, cleaning washrooms and cleaning floors were associated with the most physical risks and the exposure was often higher during the summer vs. the school year. Injury rates over a 4-year period showed the custodian injury rate was four times higher than the overall injury rate across all occupations in the school district. Injury rates were significantly higher in the school year compared with summer (12.2 vs. 7.0 per 100 full-time equivalents per year, p < 0.05). Custodial workers represent a considerable proportion of the labour force and have high injury rates, yet ergonomic studies are disproportionately few. Previous studies that quantified risk factors in custodial workers tended to focus on a few tasks or specific risk factors. This study, using participatory ergonomics and observational methods, systematically quantifies the broad range of musculoskeletal risk factors across multiple tasks performed by custodial workers in schools, adding considerably to the methodological literature.</p> CATEGORIES: CUSTODIAL WORKERS; ERGONOMICS</em></p>  </em></p> Woods V, Buckle P [2005]. An investigation into the design and use of workplace cleaning equipment. Int J Ind Ergonomics 35</em>(3):247–266.</strong></p> Abstract</u>. This paper presents the findings from a 2 year investigation into the musculoskeletal health of UK cleaners and focuses on the potential association of these problems with the design and use of cleaning equipment. The five-stage study employed a participative approach using a number of different methodologies to explore the use and design of commonly used cleaning equipment. The methodologies included: questionnaire studies, workplace assessments, an ergonomics assessment of cleaning equipment, a user trial of this equipment in the laboratory and focus groups with interested parties. Based on the findings of the study, previous research work (e.g. Report from Kilpatrick and Associates PTY LTD for Miscellaneous Workers’ Union, 1991) and the use of ergonomic guidelines (e.g. Int. J. Ind. Ergonom. 10 (1992) 7), modifications were recommended for the design of buffing machines (e.g. machine height, design of triggers/grips/levers, pressure to activate controls), mopping systems (e.g. mop length, pressure required to squeeze mop, bucket stability) and vacuum machines (e.g. attachment length, grip design, provision of safety lights). A checklist was also compiled to aid in the purchase of new workplace equipment. This paper concentrates on equipment and postures adopted when in use. It is acknowledged that this represents only one aspect of the work system that influences musculoskeletal health. Inadequate work organization, task scheduling and social support are also associated with an increased risk for musculoskeletal problems among UK cleaners (Musculoskeletal Health of Cleaners, HSE Books, Suffolk, 1999).</p> CATEGORIES: ERGONOMICS</em></p>

Alamgir H, Yu S [2008]. Epidemiology of occupational injury among cleaners in the healthcare sector. Occup Med 58</em>(6):393–399.</strong></p> Abstract:</u> BACKGROUND: The cleaning profession has been associated with multiple ergonomic and chemical hazards which elevate the risk for occupational injury. AIMS: This study investigated the epidemiology of occupational injury among cleaners in healthcare work settings in the Canadian province of British Columbia. METHODS: Incidents of occupational injury among cleaners, resulting in lost time from work or medical care, over a period of 1 year in two healthcare regions were extracted from a standardized operational database and with person-years obtained from payroll data. Detailed analysis was conducted using Poisson regression modeling. RESULTS: A total of 145 injuries were identified among cleaners, with an annual incidence rate of 32.1 per 100 person-years. After adjustment for age, gender, subsector, facility, experience and employment status, Poisson regression models demonstrated that a significantly higher relative risk (RR) of all injury, musculoskeletal injury and cuts was associated with cleaning work in acute care facilities, compared with long-term care facilities. Female cleaners were at a higher RR of all injuries and contusions than male cleaners. A lower risk of all injury and allergy and irritation incidents among part-time or casual workers was found. Cleaners with >10 years of experience were at significantly lower risk for all injury, contusion and allergy and irritation incidents. CONCLUSION: Cleaners were found to be at an elevated risk of all injury categories compared with healthcare workers in general.</p> CATEGORIES: HOSPITAL WORKERS; INJURIES; MSDs; DERMAL; RESPIRATORY</em></p>  </p> Bell JL, Collins JW, Wolf L, Gronqvist R, Chiou S, Chang WR, Sorock GS, Courtney TK, Lombardi DA, Evanoff B [2008]. Evaluation of a comprehensive slip, trip and fall prevention programme for hospital employees. Ergonomics 51</em>(12):1906–1925.</strong></p> Abstract.</u> In 2007, the Bureau of Labor Statistics reported that the incidence rate of lost workday injuries from slips, trips and falls (STFs) on the same level in hospitals was 35.2 per 10,000 full-time equivalents (FTE), which was 75% greater than the average rate for all other private industries combined (20.2 per 10,000 FTEs). The objectives of this 10-year (1996-2005) longitudinal study were to: 1) describe occupational STF injury events in hospitals; 2) evaluate the effectiveness of a comprehensive programme for reducing STF incidents among hospital employees. The comprehensive prevention programme included analysis of injury records to identify common causes of STFs, on-site hazard assessments, changes to housekeeping procedures and products, introduction of STF preventive products and procedures, general awareness campaigns, programmes for external ice and snow removal, flooring changes and slip-resistant footwear for certain employee subgroups. The hospitals’ total STF workers’ compensation claims rate declined by 58% from the pre-intervention (1996-1999) rate of 1.66 claims per 100 FTE to the post-intervention (2003-2005) time period rate of 0.76 claims per 100 FTE (adjusted rate ratio = 0.42, 95% CI: 0.33-0.54). STFs due to liquid contamination (water, fluid, slippery, greasy and slick spots) were the most common cause (24%) of STF claims for the entire study period 1996-2005. Food services, transport/emergency medical service and housekeeping staff were at highest risk of a STF claim in the hospital environment. Nursing and office administrative staff generated the largest numbers of STF claims. STF injury events in hospitals have a myriad of causes and the work conditions in hospitals are diverse. This research provides evidence that implementation of a broad-scale prevention programme can significantly reduce STF injury claims.</p> CATEGORIES: INJURIES; HOSPITAL WORKERS; INTERVENTION STRATEGIES</em></p>  </p> Bello A, Quinn MM, Perry MJ, Milton DK [2009]. Characterization of occupational exposures to cleaning products used for common cleaning tasks―a pilot study of hospital cleaners. Environ Health Mar 27</em>(8):11.</strong></p> Abstract.</u> BACKGROUND: In recent years, cleaning has been identified as an occupational risk because of an increased incidence of reported respiratory effects, such as asthma and asthma-like symptoms among cleaning workers. Due to the lack of systematic occupational hygiene analyses and workplace exposure data, it is not clear which cleaning-related exposures induce or aggravate asthma and other respiratory effects. Currently, there is a need for systematic evaluation of cleaning products ingredients and their exposures in the workplace. The objectives of this work were to: a) identify cleaning products’ ingredients of concern with respect to respiratory and skin irritation and sensitization; and b) assess the potential for inhalation and dermal exposures to these ingredients during common cleaning tasks. METHODS: We prioritized ingredients of concern in cleaning products commonly used in several hospitals in Massachusetts. Methods included workplace interviews, reviews of product Materials Safety Data Sheets and the scientific literature on adverse health effects to humans, reviews of physico-chemical properties of cleaning ingredients, and occupational hygiene observational analyses. Furthermore, the potential for exposure in the workplace was assessed by conducting qualitative assessment of airborne exposures and semi-quantitative assessment of dermal exposures. RESULTS: Cleaning products used for common cleaning tasks were mixtures of many chemicals, including respiratory and dermal irritants and sensitizers. Examples of ingredients of concern include quaternary ammonium compounds, 2-butoxyethanol, and ethanolamines. Cleaning workers are at risk of acute and chronic inhalation exposures to volatile organic compounds (VOC) vapors and aerosols generated from product spraying, and dermal exposures mostly through hands. CONCLUSION: Cleaning products are mixtures of many chemical ingredients that may impact workers’ health through air and dermal exposures. Because cleaning exposures are a function of product formulations and product application procedures, a combination of product evaluation with workplace exposure assessment is critical in developing strategies for protecting workers from cleaning hazards. Our task based assessment methods allowed classification of tasks in different exposure categories, a strategy that can be employed by epidemiological investigations related to cleaning. The methods presented here can be used by occupational and environmental health practitioners to identify intervention strategies.</p> CATEGORIES: CHEMICAL HAZARDS; RESPIRATORY; HOSPITAL WORKERS</em></p>  </p> Carrivick PJ, Lee AH, Yau KK [2001]. Consultative team to assess manual handling and reduce the risk of occupational injury. Occup Environ Med 58</em>(5):339–344.</strong></p> Abstract.</u> OBJECTIVES: To describe the formation of a consultative team to assess the risk of manual handling in the workplace that started in October 1992 within the cleaning services department of a 600 bed hospital, and to evaluate the effectiveness of its recommendations in reducing the rate and severity (time lost and cost) of workers’ compensation injury. METHODS: The consultative team identified, assessed, and recommended controls for manual handling and other injury risks. Data on injuries counted before and after implementation of the team’s recommendations were obtained for the cleaning services study group, an orderly services comparison group, as well as cleaners from a peer hospital and for the State of Western Australia. Evaluation of the four groups was undertaken 3 years after the end of the study period, to allow maturation of the costs of the claims (adjusted to July 1998 consumer price index) and hours lost from work. RESULTS: Statistical analysis showed that implementation of the recommendations significantly reduced numbers and rates of injury, but not the severity of injury, in the cleaning services study group. There was no difference in numbers or severity of injuries for the comparison groups before and after implementation of the recommendations. CONCLUSIONS: The recommendation of the consultative team can produce a meaningful and sustained reduction in rates of injury within an at risk population. The results support a consultative approach to reducing workplace injuries from manual handling. The team process has potential for application to occupational groups at risk of exposure to other types of hazards.</p> CATEGORIES: INJURIES; INTERVENTION STRATEGIES; HOSPITAL WORKERS</em></p>  </p> Carrivick PJW, Lee AH [2002]. Effectiveness of a workplace risk assessment team in reducing the rate, cost, and duration of occupational injury. J Occup Environ Med 44</em>(2):155–159.</strong></p> Abstract.</u> Evaluates the effectiveness of a consultative workplace risk assessment team in reducing the rate and severity of injury among cleaners within a 600-bed hospital. Cohorts of Cleaning Services and Orderly Services staff ever employed within both a 4-year pre-intervention and a 3-year post-intervention period were assigned to the intervention and comparison groups respectively. The date, compensation claims’ cost, and hours lost from work were obtained for each injury during the study period. Age, gender, work experience and hours worked were ascertained for every subject whether injured or not. Reductions of two thirds in injury rate, 73 per cent in cost rate, and 43 per cent in duration rate were evident in the intervention group. In comparison the orderlies experienced a post-intervention increase in all three rates. It is concluded that the success of the workplace risk assessment team intervention supports the adoption of a participatory approach to reducing the rate and consequence of work-place injury.</p> CATEGORIES: INTERVENTION STRATEGIES; HOSPITAL WORKERS; INJURIES</em></p>  </p> Carrivick PJW, Lee AH, Yau KKW Effectiveness of a participatory workplace risk assessment team in reducing the risk and severity of musculoskeletal injury [2002]. J Occup Health 44</em>(4):221–225.</strong></p> Abstract</u>. This study evaluates the effectiveness of a participatory workplace risk assessment team (the intervention) in reducing the rate and severity of musculoskeletal and non-musculoskeletal injuries among a cohort of 137 cleaners within a hospital setting. The date, workers’ compensation claims cost and hours lost from work were obtained for each injury occurring during the 4-yr pre-intervention and 3-yr post-intervention period. The age, gender and hours worked during the study period, were ascertained for every cleaner whether injured or not. For musculoskeletal injuries, the intervention was associated with significant reductions of two-thirds in injury rate, 65% in workers’ compensation claims cost per hour worked, and 40% in hours lost per hour worked. Cleaners also experienced a significant two-third post-intervention reduction in non-musculoskeletal injury rate; but the corresponding changes in severity rates were not significant. The intervention supports the adoption of a participatory approach to reducing the rate and consequence of musculoskeletal injuries in the workplace.</p> CATEGORIES: INTERVENTION STRATEGIES; HOSPITAL WORKERS; INJURIES</em></p>  </p> Carrivick PJ, Lee AH, Yau KK, Stevenson MR [2005]. Evaluating the effectiveness of a participatory approach in reducing the risk and severity of injuries from manual handling. Ergonomics 48</em>(8):907–914.</strong></p> Abstract</u>. Manual handling is the greatest contributor to non-fatal injury and disease in the workplace, commonly accounting for one-third of national injury counts. Interventional strategies that have focused on selecting or modifying the worker have been ineffective in reducing injury risk. In recent times, participatory ergonomics has been widely adopted as a process to reduce the risk of injury from manual handling but it is not well validated as an intervention. This study evaluated the effectiveness of a participatory ergonomics risk assessment approach in reducing the rate and severity of injuries from manual and non-manual handling sustained by a cohort of 137 cleaners within a hospital setting. The date of injury and the workers’ compensation claim cost and hours lost from work were obtained for each injury incurred during the 4-year pre-intervention and 3-year intervention period. The age, gender and hours worked were ascertained for every cleaner whether injured or not. Using generalized linear mixed modeling analysis, reductions of rate of injury by two-thirds, workers compensation claim costs by 62% and hours lost by 35% for manual handling injuries were found to be associated with the intervention period. Although the cleaners experienced a significant intervention period reduction in non-manual handling injury rate, the corresponding changes in severity of injury were not significant. The success of the intervention supports the adoption of a participatory ergonomics approach in reducing the rate and consequence of injuries in the workplace.</p> CATEGORIES: INTERVENTION STRATEGIES; HOSPITAL WORKERS; INJURIES</em></p>  </em></p> Deasy E, Balfe C [1988]. When is a hospital like a hotel? Health Serv J 98</em>(5105):674–675.</strong></p> CATEGORIES: HOSPITAL WORKERS; HOTEL WORKERS</em></p> Demirturk N, Demirdal T [2006]. Effect of a training program for hospital cleaning staff on prevention of hospital-acquired infection. Infect Control Hosp Epidemiol 27</em>:1410–1412</strong>.</strong></p> CATEGORIES: INTERVENTION STRATEGIES; HOSPITAL WORKERS</em></p>  </em></p> Flyvholm MA, Frydendall Jensen K [2008]. Experiences with implementation of evidence-based prevention programs to prevent occupational skin diseases in different occupations. G Ital Dermatol Venereol 143</em>(1):71–78.</strong></p> Abstract</u>. Occupational skin diseases are among the most frequently recognized occupational diseases in many industrialized countries. This paper describes and review experiences with implementation of interventions to prevent occupational skin diseases in different occupational settings representing the food processing industry and a hospital. The study populations were gut cleaners with all participants being exposed to wet work, cheese dairies and a hospital where all employees were included. The effect of implementation of evidence-based prevention programs were tested by questionnaire surveys on baseline and follow-up. A significant reduction in eczema at hands or forearms was observed among gut cleaners. At cheese dairies the eczema frequencies were low except for a comparison dairy where significant changes were seen. At the hospital a non significant reduction in hand eczema was observed. Changes related to use of protective measures and knowledge on prevention of occupational skin diseases were observed. A process evaluation carried out at the gut cleaning departments showed association between the eczema frequency at follow-up, activities related to prevention and implementation of an occupational health management system. In addition to documenting the scientific background for evidence-based prevention programs to prevent occupational skin diseases in different occupations, both the study population and the study design should be considered carefully when testing the implementation of workplace interventions. These aspects may influence the outcome in different directions and either facilitate or hamper the possibilities to provide scientific documentation of the effect of the intervention tested.</p> CATEGORIES: INTERVENTION STRATEGIES; DERMAL; HOSPITAL WORKERS</em></p>  </em></p> Hansen KS [1983]. Occupational dermatoses in hospital cleaning women. Contact Dermatitis 9</em>(5):343–351.</strong></p> Abstract</u>. In an investigation of 541 members of a hospital cleaning department, a prevalence rate of occupational skin diseases of 15.3% was found. During their hospital employment, 39.1% had a skin disease. Higher prevalence in the younger age groups can be explained by the selection of those with skin diseases for work away from the cleaning department. A large number developed their disease shortly after employment began. This was an indication that the observed prevalent conditions were irritant diseases. The distribution by diagnosis confirms this conclusion in as much as 75% of the occupational skin diseases were irritant dermatitis, 21% allergic contact dermatitis, and 4% monilia of the finger webs. The causes of allergic contact dermatitis were found to be formaldehyde,</p> glutaraldehyde and chloramine in addition to nickel and rubber. Among the causes of irritant dermatitis were detergents, alkaline substances, acids and sodium perborate as well as hypochlorite and hypobromite combinations. In order to reduce occupational skin diseases among cleaning personnel, it is necessary to extend both local and more general prophylactic measures.</p> CATEGORIES: HOSPITAL WORKERS; DERMAL; CHEMICAL HAZARDS</em></p>  </em></p> Landstad BJ, Ekholm J, Broman L, Schüldt K [2000].Working environmental conditions as experienced by women working despite pain. Work 15</em>(3):141–152.</strong></p> Abstract</u>. OBJECTIVE: This study looked at female hospital cleaners and home help personnel who continued working despite problems or pain in their musculoskeletal system and where there was a risk of increase in sickness absence. The aim was to determine whether supportive intervention for these personnel at the workplace had an effect on the way that they experienced the physical and psychosocial aspects of their working environments. METHODS: The design was prospective with non-randomized intervention and reference groups. A selection of 55 questions about physical and psychosocial working environment from a national survey were used. Comparisons were made between intervention and reference groups and with data on a selection of the Swedish population of people in these professions. RESULTS: The results showed that in the hospital cleaners’ intervention group the introduction of new cleaning materials and new cleaning methods seemed to contribute to a reduction in workload during the intervention period, which in turn gave them a better chance of taking rest breaks during working time. In the home helps’ intervention group the results showed that the group had had a reduction both in workload and in more responsible tasks, and at the same time the psychosomatic stress reactions reduced after the intervention. CONCLUSIONS: The results indicate that effects on the working environmental conditions as experienced could be obtained by a general multi-component support program at the workplace, but the number of variables influenced by the program was very small. The relatively limited effects may be explained by the fact that the impact of a support program depends on how well the remedial measures fulfill the need for such measures either at the workplace, in a work group or among the individual people at the workplace. This emphasizes the importance of designing effective analysis tools for judging what remedial measures are needed before the measures themselves are tried out.</p> CATEGORIES: PAIN; WOMEN’S HEALTH; HOSPITAL WORKERS</em></p>  </strong></p> Landstad B, Vinberg S, Ivergård T, Gelin G, Ekholm J [2001]. Change in pattern of absenteeism as a result of workplace intervention for personnel support. Ergonomics 44</em>(1):63–81.</strong></p> Abstract</u>: The aim was to investigate whether a preventive intervention carried out in a predominantly female workplace: that of hospital cleaners (consisting of a group of 97 women) had any effect on patterns of absenteeism. As a background, a model for analyzing complex patterns of absenteeism, including sickness absences, was also developed. A further aim was to study the interactions between different forms of absenteeism. Comparison was made with a reference group consisting of employees in the same job category who only received the customary personnel support. For individuals in the intervention group who were 42 years, short-term absence decreased for those who had been in the same jobs for a long time. The combination of increased age and experience showed a tendency to enhance this decline in short-term absenteeism due to sickness. For those >42 years, and who at the same time have a previous history of high absenteeism, long-term absenteeism due to sickness seemed to be increasing. Increased experience tended to reduce this increase in long-term sickness absence. This combination of different effects possibly indicated the presence of a process of selection which determined who remained in the job as opposed to those who did not. An important conclusion is that different forms of absenteeism need to be looked at in parallel, and at the same time multivariate statistical analysis needs to be carried out to determine the different interactions between the factors.</p> CATEGORIES: WOMEN’S HEALTH; INTERVENTION STRATEGIES; HOSPITAL WORKERS</em></p>  </em></p> Leigh JP, Wiatrowski WJ, Gillen M, Steenland NK [2008]. Characteristics of persons and jobs with needlestick injuries in a national data set. Am J Infect Control 36(6):414‒420.</strong></p> Abstract </u>BACKGROUND: Physicians, nurses, and others are at risk of needlesticks, yet little national information is available regarding incidence across demographic and occupational categories. METHODS: Analysis was conducted on national data on occupational injuries for 1992-2003 from the Bureau of Labor Statistics (BLS). Because BLS data were limited to cases with 1 or more days of work loss, and reasons related to reporting of incidents, the data only reflected a subset of all needlesticks. Nevertheless, the data were internally consistent across categories so that relative magnitudes were reliable. Statistical tests for differences in proportions were conducted that compared needlesticks with all other occupational injuries and employment. RESULTS: Cases with 1 or more days of work loss numbered 903 per year, on average, from 1992 through 2003. Women comprised 73.3% (95% CI: 72.5%-74.2%) of persons injured. For those reporting race, white, non-Hispanic comprised 69.3% of the total (95% CI: 68.1%-70.4%); black, non-Hispanic, 14.8% (95% CI: 13.9%-15.6%); and Hispanic, 13.8% (95% CI: 12.9%-14.6%). The age bracket 35 to 44 years had the highest percentage of injuries at 34.0% (95% CI: 33.1%-34.9%). Ages over 54 years reported smaller percentages of needlestick injuries than either all other injuries or employment. Occupations with greatest frequencies included registered nurses, nursing aides and orderlies, janitors and cleaners, licensed practical nurses, and maids and housemen. Occupations with greatest risks included biologic technicians, janitors and cleaners, and maids and housemen. Almost 20% (95% CI: 18.88%-20.49%) of needlesticks occurred outside the services industry. Seven percent (95% CI: 6.56%-7.53%) of needlesticks resulted in 31 or more days of work loss in contrast to 20.46% (95% CI: 20.44%-20.48%) of all other injuries. CONCLUSION: In this nationally representative sample, the most frequent demographic and occupational categories were women; white, non-Hispanic; ages 35 to 44 years; and registered nurses.</strong></p> CATEGORIES: HOSPITAL WORKERS; CUSTODIAL WORKERS</em></p>  </strong></p> Toivanen H, Helin P, Hänninen O [1993]. Impact of regular relaxation training and psychosocial working factors on neck-shoulder tension and absenteeism in hospital cleaners. J Occup Med 35</em>(11):1123–1130.</strong></p> Abstract</u>. Occupational stress in hospital cleaners (n = 50), and the effect of relaxation training (n = 25, age matched, randomized), were studied by recording the electrical activity of the upper trapezius muscle at rest and during working conditions at the beginning, middle, and end of a 6-month follow-up period. A short (15-minute) relaxation program was practiced daily at the workplace to provide stress management. The amount of sick leave was counted, and the extent of depression and some psychosocial working factors were screened. Intercorrelations were found between the neck-shoulder tension, psychosocial factors, depression, and the absentee rate. The relaxation training diminished tension in the neck-shoulder region efficiently; nevertheless, the decrease in absenteeism might have been related mainly to the social support offered by the research maneuver itself.</p> CATEGORIES: INTERVENTION STRATEGIES; HOSPITAL WORKERS; WORK STRESS</em></p>  </p> Toivanen H, Laensimies E [1993]. Impact of regular relaxation training on the cardiac autonomic nervous system of hospital cleaners and bank employees. Scand J Work Environ Health 19</em>(5):319–325.</strong></p> Abstract</u>: Work related strain of female hospital cleaners and female bank employees were recorded during a period of rationalization in the workplace and the effect of daily relaxation to help the workers cope was tested. Results suggest that occupational strain caused the functioning of the autonomic nervous system to deteriorate. Regular deep relaxation normalized the function and improved the ability to cope.</p> CATEGORIES: INTERVENTION STRATEGIES; HOSPITAL WORKERS; WORK STRESS</em></p>  </strong></p> Weisshaar E, Radulescu M, Soder S, Apfelbacher CJ, Bock M, Grundmann JU, Albrecht U,  Diepgen TL [2007]. Secondary individual prevention of occupational skin diseases in health care workers, cleaners and kitchen employees: aims, experiences and descriptive results. Int Arch Occup Environ Health 80</em>(6):477–484.</strong></p> Abstract</u>: Objectives Due to increased occupational dermatoses in certain professions such as health care workers (HCW), cleaning and kitchen employees (CKE), measures of prevention and skin protection are of high significance. Skin protection courses focus on educational aims (e.g. improving skin care habits, influencing the participants’ attitudes towards health) and medical aims (e.g. optimizing diagnostic procedures, complementing individual therapy). Methods Participants are patients who have been suspected to suffer from an occupational skin disease and are insured with the German Accident Prevention & Insurance Association (BGW). Teaching units of the skin protection courses focus on basics of skin functioning and important aspects of occupational skin diseases. Practical parts include information and instructions about the correct implementation of skin protection, skin care and skin cleansing. Every participant is seen by a dermatologist obtaining a precise patient’s history and performing a skin examination. All this results in working out individually adapted and professional skin protection strategies. Results In total, 791 participants (93 men and 698 women) completed the skin protections courses. Six hundred and sixty-seven patients (mean age: 36.9 years, SD = 11.6) were HCW and 124 patients (mean age: 40.4 years, SD = 10.8) were CKE. In HCW 82.5% (n = 550) and in CKE 86.3% (n = 107) suffered from hand eczema of the atopic, irritant or allergic type. Irritant contact dermatitis as a single diagnosis was the most frequent one in both groups (HCW: 34.5.%, n = 230; CKE: 49.2% n = 61). According to regularly performed evaluations, the participants rated the course as good to excellent. Nearly 80% of the participants had skin lesions while attending the course, in 27% the dermatosis was severe. Conclusions: There is a high need for health education, advisory services, diagnostics and additional therapy in occupational dermatology. Prevention of occupational skin diseases and maintenance of health through educational programmes are important complementary measures for dermatological care but still missing in endangered professions.</p> CATEGORIES: DERMAL; HOSPITAL WORKERS; INTERVENTION STRATEGIES</em></p>

Bell AF, Steele JR (2011). Risk of musculoskeletal injury among cleaners during vacuuming. Ergonomics:1-11.</strong> Abstract:</u> This study aimed to examine the risk of work-related upper-limb musculoskeletal disorders in cleaning workers during the work task of vacuuming. In total, 24 cleaning workers were observed while they performed vacuum cleaning tasks in the normal course of their employment in government schools, hospitality and commercial office space sectors. Risk of upper-limb musculoskeletal disorders were rated using three observational assessment tools: Manual Task Risk Assessment (ManTRA); Quick Exposure Check (QEC); the Rapid Upper Limb Assessment (RULA). Mean results (e.g. ManTRA wrist/hand cumulative wrist score 18.67 ± 1.27, QEC neck score 13 ± 1.77, RULA score 6.54 ± 0.509) demonstrated that cleaning workers who perform the task of vacuum cleaning are at risk of work-related upper-limb musculoskeletal injury, regardless of whether they use a back-pack or canister machine. Government school cleaners experienced greater risk of work-related upper-limb musculoskeletal disorders than workers in either the hospitality or commercial office space sectors. STATEMENT OF RELEVANCE: Cleaning workers in Australia are mostly female, ageing and of non-English-speaking backgrounds and involved in repetitive manual tasks. Their occupation is low status. This research confirms that vacuuming tasks are a risk for cleaning workers and highlights the need for further research to improve conditions for these workers. http://www.tandfonline.com/doi/full/10.1080/00140139.2011.592605</a> CATEGORIES: MSDs; WOMEN’S HEALTH; IMMIGRANT WORKERS; CUSTODIAL WORKERS; HOTEL WORKERS; INJURIES; ERGONOMICS</em></p>  </p> Blackwell RH. Out of the frying pan: a study of stress in the hospitality industry.  Leeds, UK: Leeds Metropolitan University, Leeds Polytechnic, Leisure, and Consumer Studies.</strong> CATEGORIES: HOTEL WORKERS; WORK STRESS</em></p> Bohle P, Quinlan M, Kennedy D, Williamson A [2004]. Working hours, work-life conflict, and health in precarious and “permanent” employment. Rev Saúde Pública 38</em>(Suppl):19–25.</strong></p> Abstract.</u> OBJECTIVE: The expansion of precarious employment in OECD countries has been widely associated with negative health and safety effects. Although many shift workers are precariously employed, shift work research has concentrated on full-time workers in continuing employment. This paper examines the impact of precarious employment on working hours, work-life conflict and health by comparing casual employees to full-time, “permanent” employees working in the same occupations and workplaces. METHODS: Thirty-nine convergent interviews were conducted in two five-star hotels. The participants included 26 full-time and 13 casual (temporary) employees. They ranged in age from 19 to 61 years and included 17 females and 22 males. Working hours ranged from zero to 73 hours per week. RESULTS: Marked differences emerged between the reports of casual and full-time employees about working hours, work-life conflict and health. Casuals were more likely to work highly irregular hours over which they had little control. Their daily and weekly working hours ranged from very long to very short according to organizational requirements. Long working hours, combined with low predictability and control, produced greater disruption to family and social lives and poorer work-life balance for casuals. Uncoordinated hours across multiple jobs exacerbated these problems in some cases. Health-related issues reported to arise from work-life conflict included sleep disturbance, fatigue and disrupted exercise and dietary regimes. CONCLUSIONS: This study identified significant disadvantages of casual employment. In the same hotels, and doing largely the same jobs, casual employees had less desirable and predictable work schedules, greater work-life conflict and more associated health complaints than “permanent” workers.</p> CATEGORIES: HOTEL WORKERS; WORK ENVIRONMENT</em></p>  </strong></p> Susan Buchanan, Pamela Vossenas, Niklas Krause, Joan Moriarty, Eric Frumin, Jo Anna  Shimek, Franklin Mirer, Peter Orris, and Laura Punnett, (2009) Occupational Injury Disparities in the US Hotel Industry. Am. J. Ind. Med. (coming in January)</strong></p> Abstract</u>. 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.</p> KEY WORDS: occupational injury; hotel workers; housekeepers; musculoskeletal disorders; health disparities CATEGORIES: INJURIES; HOTEL WORKERS; MSDs</em></p>  </em></p> Burgel BJ, White MC, Gillen MG, Krause N (2010). Psychosocial work factors and shoulder pain in hotel room cleaners. Am J Ind Med 53:743-756. </strong>Abstract</u>: BACKGROUND: Hotel room cleaners have physically demanding jobs that place them at high risk for shoulder pain. Psychosocial work factors may also play a role in shoulder pain, but their independent role has not been studied in this group. METHODS: Seventy-four percent (941 of 1,276) of hotel room cleaners from five Las Vegas hotels completed a 29-page survey assessing health status, working conditions, and psychosocial work factors. For this study, 493 of the 941 (52%) with complete data for 21 variables were included in multivariate logistic regression analyses. RESULTS: Fifty-six percent reported shoulder pain in the prior four weeks. Room cleaners with effort-reward imbalance (ERI) were three times as likely to report shoulder pain (OR 2.99, 95% CI 1.95-4.59, P = 0.000) even after adjustment for physical workload and other factors. After adjustment for physical workload, job strain and iso-strain were not significantly associated with shoulder pain. CONCLUSIONS: ERI is independently associated with shoulder pain in hotel room cleaners even after adjustment for physical workload and other risk factors. CATEGORIES: HOTEL WORKERS; PAIN; WORK ENVIRONMENT</em></p>  </p> Clean sweep: Molly Maid brushes up its approach to health and safety [2001]. Safety mosaic 4</em>(1):4–5.</strong></p> Abstract</u>: Housekeeping services can be a hazardous business. From potentially dangerous chemicals and equipment risks to slips and trips, and strains and sprains, staying safe at work takes education, knowledge and reinforcement. This article describes how one London, Ont. Molly Maid franchise makes health and safety a top priority.</p> CATEGORIES: INTERVENTION STRATEGIES; HOTEL WORKERS</em></p>  </strong></p> Crum AJ, Langer EJ [2007]. Mind-set matters: exercise and the placebo effect. Psychol Sci 18</em>(2):165–171.</strong></p> Abstract.</u> In a study testing whether the relationship between exercise and health is moderated by one’s mind-set, 84 female room attendants working in seven different hotels were measured on physiological health variables affected by exercise. Those in the informed condition were told that the work they do (cleaning hotel rooms) is good exercise and satisfies the Surgeon General’s recommendations for an active lifestyle. Examples of how their work was exercise were provided. Subjects in the control group were not given this information. Although actual behavior did not change, 4 weeks after the intervention, the informed group perceived themselves to be getting significantly more exercise than before. As a result, compared with the control group, they showed a decrease in weight, blood pressure, body fat, waist-to-hip ratio, and body mass index. These results support the hypothesis that exercise affects health in part or in whole via the placebo effect.</p> CATEGORIES: INTERVENTION STRATEGIES; HOTEL WORKERS</em></p>  </p> Deasy E, Balfe C [1988]. When is a hospital like a hotel? Health Serv J 98</em>(5105):674–675.</strong></p> CATEGORIES: HOSPITAL WORKERS; HOTEL WORKERS</em></p>  </strong></p> Delevoye A, Derieux N, Hunzinger E, Mzabi MI, Roux F, Van Brederode A, Van Rooj B [2005a]. </strong>Lingère en hôtellerie (Hotel linen maids). Cahiers de médecine interprofessionnelle 45</em>(3).</strong></p> Abstract:</u> The main task of hotel linen maids to ensure the proper management of linen, including the reception of clean linen, its storage and its distribution, together with the recovery and sorting of used linen. Contents of this information sheet on the job of hotel linen maid: general characteristics of the job; technical and organizational characteristics; exposures and constraints (work environment, work organization, tasks and equipment); hazard evaluation techniques; health effects and occupational pathology; prevention; medical supervision; regulations; evaluation of work aptitude.</p> CATEGORIES: HOTEL WORKERS; WORK ENVIRONMENT</em></p>  </strong></p> Delevoye A, Derieux N, Hunzinger E, Mzabi MI, Roux F, Van Brederode A, Van Rooj B [2005b]. La lingère en hôtellerie (Hotel linen maids). Cahiers de médecine interprofessionnelle 45</em>(3):305–319.</strong></p> This study describes the various types of material flows for linen (delivery and distribution of clean linen, collection and sorting of used linen) observed in four hotels of different classes. The strenuousness of the work of linen maids was evaluated based on the estimated weight of linen carried, work posture and cardiofrequency measurements. Results indicated that this occupation involves a moderate to high physical workload, primarily due to the manual handling of the linen and the loading and unloading of carts.</p> CATEGORIES: HOTEL WORKERS; WORK ENVIRONMENT</em></p>  </em></p> Desciak EB, Marks JG Jr. [1997]. Dermatoses among housekeeping personnel. Am J Contact Dermat 8</em>(1):32–34.</strong></p> Abstract</u>. BACKGROUND: Housekeepers are exposed to irritants and allergens in their work and are at significant risk for developing occupationally induced contact dermatitis.</p> OBJECTIVE: We studied housekeepers at the Hershey Medical Center to determine the cause and frequency of contact dermatitis and contact urticaria in these workers.</p> METHODS: All housekeepers were examined. Those with hand dermatitis had an extensive history, patch testing, and latex RAST testing. RESULTS: Eight of 130 had hand dermatitis. None had a relevant positive patch test or positive RAST test. CONCLUSIONS: Of our housekeepers, 6.2% had occupationally induced irritant contact dermatitis. None had allergic contact dermatitis or contact urticaria to latex.</p> CATEGORIES: HOTEL WORKERS; DERMAL</em></p>  </em></p> DiGiulio LM (2008). Issues in hotel housekeeping. Executive housekeeping today 30(5):14-25.</strong> CATEGORIES: HOTEL WORKERS</em></p> Empowering the housekeeper (2003).  Lodging Hospitality. 59(10):48. </strong>CATEGORIES: HOTEL WORKERS</em></p>  </p> Eriksson T, Jingkun L (2009). Working at the boundary between market and flexicurity: housekeeping in Danish hotels. International Labour Review 148(4):357-373.</strong> Abstract:</u> Though housekeeping in Danish hotels is unskilled, low-paid work, because of Denmark’s compressed wage structure it is comparatively well paid. The authors examine the working conditions and experience of housekeepers in eight hotels of various types, to establish the industry’s response to growing competition and pressure to restructure. Approaches include reorganizing work, increased work intensity, outsourced and in-house housekeeping, and Denmark’s own “flexicurity”. Flexible work arrangements, job security and in-kind social benefits prove to compensate for scanty unemployment insurance and career prospects. CATEGORIES: HOTEL WORKERS; WORK ENVIRONMENT</em></p>  </p> Esbenshade J, Mitrosky M, Morgan E, Navarro M, Rotundi M, Vazquez C 92006). Profits, pain, and pillows: hotels and housekeepers in San Diego. WorkingUSA: The Jounal of Labor and Society 9:265-292.</strong> Abstract:</u> The accommodations industry is hitting record-breaking profits nationally and locally, often with subsidies provided by government entities. Globalization is actually contributing to rising employment and a trade surplus in the tourism industry. However, increasing amenities and new work regimes are causing deteriorating conditions for many workers. In 2006, hotel workers across the country will be coordinating contract negotiations. Housekeepers, who make up almost a quarter of the hotel workforce, are the “face” of the national campaign. Through management interviews, analysis of government data, and a worker survey, this article provides a more complete picture of the living and working conditions of housekeepers in San Diego and nationally. http://onlinelibrary.wiley.com/doi/10.1111/j.1743-4580.2006.00113.x/full</a> CATEGORIES: HOTEL WORKERS; WORK ENVIRONMENT; PAIN</em></p>  </p> Faulkner B, Patiar A (1997). Workplace-induced stress among operational staff in the hotel industry. Int J Hospitality Management 16(1):99-117.</strong> Abstract:</u> Stress is an integral part of all aspects of an individual’s life. In the workplace, as in other areas, stress can play a positive role by increasing alertness among staff and mobilizing their adaptive capabilities. To some extent, therefore, a certain level of stress has the potential to actually contribute to organizational effectiveness. However, stress can become counterproductive once excessive levels of unresolved stress begin to affect the health and productivity of the workforce. Employers in any setting therefore have both commercial and moral reasons for being sensitive to the incidence of stress and developing management approaches for controlling it. This is particularly so in industries such as the hotel industry, which are both labour intensive and dependent upon face to face contact with guests in the delivery of services. This paper examines the sources of stress among front office and housekeeping operational staff in four star international standard hotels on the Gold Coast (Queensland, Australia) with a view to exploring the management implications of this phenomenon. While the sample size and the context of the study limit our ability to generalize from survey results, an indication of problems requiring adjustments in management approach is provided. In particular, it appears that, while staff in both areas are susceptible to stress, front office staff are more vulnerable owing to the nature of their duties and aspects of their background that make them more sensitive to organizational deficiencies. CATEGORIES: HOTEL WORKERS; WORK STRESS</em></p>  </p> George R, Hancer M (2008). Housekeeping managers and the administration of housekeeping service. Int J Hospitality Tourism Administration 9(4):365-383.</strong> Abstract:</u> This study was concerned with executive housekeepers in a lodging setting. It used a self-completed questionnaire containing both choice and open-ended items to solicit the opinions of executive housekeepers and the delivery of quality service in the housekeeping department. The results indicated the executive housekeepers believed the department members delivered a high level of service, but more could be done. They also indicated a belief that the housekeepers felt they delivered high quality service and they did a better job of delivering quality service than other departments in the hotel. Executive housekeeper comments regarding the administration of the housekeeping department are presented. CATEGORIES: HOTEL WORKERS</em></p> Gill AS, Mathur N (2007). Improving employee dedication and pro-social behavior. Int J Contemporary Hospitality Mangement 19(4):328-334.</strong> Abstract</u>: PURPOSE: The purpose of this paper is to examine the relationship between transformational leadership and employee dedication and the relationship between transformational leadership and pro-social behaviour. This study seeks to extend Gill et al.’s findings regarding the impact of transformational leadership on job stress and the impact of job stress on burnout. DESIGN/METHODOLOGY/APPROACH – Hospitality industry employees were interviewed to find out if transformational leadership used by their managers improves employee dedication and pro-social behaviour. FINDINGS – Results suggest that employee dedication and pro-social behaviour are positively related to the improvement in the level of perceived transformational leadership implementation. PRACTICAL IMPLICATIONS – If employees perceive that their managers are using high-level transformational leadership, employee dedication and pro-social behaviour are perceived as higher level than if it is perceived as being used at lower level. ORIGINALITY/VALUE – This paper offers useful insights for hotel managers based on empirical evidence. CATEGORIES:  HOTEL WORKERS; WORK STRESS; WORK ENVIRONMENT</em></p>  </p> Greenhouse S (2006). Hotel rooms get plusher, adding to maids’ injuries. New York Times, April 21</strong>. http://www.nytimes.com/2006/04/21/us/21hotel.html?pagewanted=all</a> CATEGORIES: HOTEL WORKERS; INJURIES</em></p> Greenhouse S (2009).  Female hotel workers injured more than men, study shows. New York Times, November 10</strong>. http://www.nytimes.com/2009/11/11/business/11injury.html</a> CATEGORIES: HOTEL WORKERS; INJURIES; WOMEN’S HEALTH</em></p>  </p> Hannerz H, Tüchsen F, Kristensen TS (2002). Hospitalizations among employees in the Danish hotel and restaurant industry. European J Public Health 12:192-197. </strong>Abstract:</u> BACKGROUND: The aim of the present study was to provide a broad picture of the morbidity among employees in the Danish hotel and restaurant industry. METHODS: Cohorts of all 20–59‐year‐old employees in the Danish hotel and restaurant industry in the years 1981, 1986, 1991 and 1994 were formed to calculate age‐standardized hospitalization ratios (SHR) and time trends (1981–1997) for many different diagnoses. RESULTS: Both for women and men, significantly higher SHRs were found for infectious and parasitic diseases, neoplasms, diseases in the nervous system and sense organs, diseases of the circulatory system, diseases of the respiratory system, diseases of the digestive system and diseases of the musculoskeletal system among employees in hotels and restaurants than in the working population at large. Furthermore, among women a significantly elevated risk was found for injuries in the lower extremities, injuries in the upper extremities and head injuries, and among men a high risk was found for head injuries and a low risk for ruptures in ligaments and muscles. The trend assessments did not detect any significant changes in SHRs over time. CONCLUSION: Employment in the Danish hotel and restaurant industry is associated with an elevated hospitalization risk due to many diseases, which may be related to occupation and lifestyle. In line with the official policy of reducing inequality in health, focus should be placed on the health problems in this group. http://eurpub.oxfordjournals.org/content/12/3/192.full.pdf+html</a> CATEGORIES: HOTEL WORKERS; INJURIES</em></p> Higley J (1997). Language barrier leads to resignations. Hotel and Motel Management 212(9):20</strong>. CATEGORIES: HOTEL WORKERS; IMMIGRANT WORKERS</em></p> Higley J (2006). Maid to order: housekeepers earn respect. Hotel and Motel Management 221(9):6. </strong>CATEGORIES: HOTEL WORKERS</em></p>  </p> Hopsu L, Toivonen R, Louhevaara V, Sjøgaard K (2000). Muscular strain during floor mopping with different cleaning methods. Proceedings of the IEA2000/HFES2000 Congress. 521-524.</strong> Abstract:</u> Mopping is one of the most used cleaning methods. The aim of this study was to quantify and compare local muscular strain during floor mopping with seven different mopping methods with respect to the amount of water ranging from dry to wet. The results showed that the local strain measured with EMG from the trapezius and forearm muscles was higher with the use of wet and damp mopping methods than with the use of dry methods. CATEGORIES: ERGONOMICS</em></p> Hotel housekeepers report alarming job injury rate (2006). Industrial Safety and Hygiene News 40(6):12. </strong>CATEGORIES: HOTEL WORKERS; INJURIES</em></p> Hotel housekeeping is getting more dangerous (2006). Safety Compliance Letter (2466)12. </strong>CATEGORIES: HOTEL WORKERS</em></p>  </p> Intilli H [1999]. The effects of converting wheels on housekeeping carts in a large urban hotel. Program evaluation. Am Assoc Occup Health Nurs J 47</em>(10):466–469</strong></p> Abstract</u>. Occupational and environmental health nurses can identify the causes of injuries and use analytical skills to show how the prevention of a problem can save the company money and demonstrate a caring attitude from management. Nurses can expand their traditional roles to position themselves as both advocates for the employees and profit enhancers to management as demonstrated by this program evaluation project. Initial outcomes included improved employee morale and reduced soft tissue injuries in hotel housekeeping employees. Changes in the workplace made by a proactive occupational and environmental health nurse and a committed management can reap rewards beneficial for both the employer and the work force.</p> CATEGORIES: INTERVENTION STRATEGIES; HOTEL WORKERS; INJURIES</em></p>  </p> Kim JE, Moon DH (2010). Job characteristics and musculoskeletal symptom prevalence in hotel employees. Korean J Occup Health Nurs 19(2):190-204.</strong> Abstract:</u> PURPOSE: This study was conducted to obtain the fundamental data on prevention and management of musculoskeletal symptoms, and to assess the prevalence, risk factors and job characteristics of musculoskeletal symptoms in hotel employees. METHODS: The work sampling analysis was carried out by OWAS, and the prevalence was surveyed in term of NIOSH diagnostic criteria and work related risk factors on 263 hotel employees in Busan, Korea, using structured self-administered questionnaire from Jan. 20 to Feb. 26, 2010. The collected data were analysed by the SPSS 18.0. RESULTS: 1) The prevailing rate of musculoskeletal symptoms by NIOSH diagnostic criteria was 43.80% for total subjects and 27.91% for shoulders, 12.79% for neck, and 11.24% for back/waist, respectively. 2) Factors affecting the prevalence of musculoskeletal symptoms were examined and multivariate logistic regression analysis was performed. As a result, women, having a burden of musculoskeletal work, increased work time in case of a higher risk of the prevalence of musculoskeletal symptoms (P</p>  </p> Krause N, Tau Lee P, Thompson P, Rugulies R, Baker L [1999]. Working conditions and health of San Francisco hotel room cleaners. Report to the Hotel Employees and Restaurant Employees International Union. Berkeley, CA: University of California, School of Public Health, p. 79.</strong></p> CATEGORIES: HOTEL WORKERS</em></p> Krause N, Lee PT, Scherzer T, Rugulies R., Sinnott P, Baker RL [2002]. Health and working conditions of hotel guest room attendants in Las Vegas. Report to the Culinary Workers’ Union, Local 226, Las Vegas. San Francisco, CA, p. 112.</strong></p> CATEGORIES: HOTEL WORKERS</em></p>  </p> Krause N, Scherzer T, Rugulies R [2005]. Physical workload, work intensification, and prevalence of pain in low wage workers: results from a participatory research project with hotel room cleaners in Las Vegas. Am J Ind Med 48</em>(5):326–337.</strong></p> Abstract</u>. BACKGROUND: Occupational injury rates among hotel workers exceed the national service sector average. This study assesses the prevalence of back and neck pain, and its associations with physical workload, ergonomic problems, and increasing work demands. METHODS: Nine hundred forty-one unionized hotel room cleaners completed a survey about health and working conditions. Associations between job demands and pain were determined by logistic regression models adjusting for individual characteristics, cumulative work demands, care-taking responsibilities at home, and psychosocial job factors. RESULTS: The 1-month prevalence of severe bodily pain was 47% in general, 43% for neck, 59% for upper back, and 63% for low back pain. Workers in the highest exposure quartiles for physical workload and ergonomic problems were between 3.24 and 5.42 times more likely to report severe pain than workers in the lowest quartile. Adjusted odds ratios for work intensification ranged from 1.74 (upper back) to 2.33 (neck). CONCLUSIONS: Most room cleaners experience severe back or neck pain. Severe pain showed strong associations with physical workload, work intensification, and ergonomic problems.</p> CATEGORIES: HOTEL WORKERS; WORK ENVIRONMENT; PAIN</em></p>  </em></p> Landers M, Maguire L [2004]. Effects of a work injury prevention program for housekeeping in the hotel industry. Work 22</em>(3):239–246.</strong></p> Abstract</u>. OBJECTIVE: The aim of this retrospective study was to determine the effectiveness of a work injury prevention program in the housekeeping department of a hotel. Studies have validated the use of different injury prevention strategies to decrease the incidence of work-related injuries. Few studies, however, have reported the efficacy of an on-site work injury prevention program by a physical therapist. STUDY DESIGN: In 1995, implementation of a work injury prevention program by a physical therapist to 50 housekeeping supervisors, 60 house persons and 340 guest room attendants at a large hotel began. This program included a detailed work risk analysis of the work environment, development of job descriptions, identification of injury-related problematic work situations, and implementation of a job specific supervisor-training program. Supervisor, house person and guest room attendant training was also conducted at the end of 1995 and the beginning of 1997. RESULTS: Data of injury reports in 1995, 1996, and 1997 were analyzed to determine the results of the program. There was a reduction in total injury claims, total medical expenses, total lost work time and total restricted duty time. CONCLUSION: These results demonstrate the cost effectiveness of implementing a work injury prevention program for housekeeping guest room attendants in the hotel industry.</p> CATEGORIES: HOTEL WORKERS; INJURIES; INTERVENTION STRATEGIES</em></p>  </em></p> Lee PT, Krause N [2002]. The impact of a worker health study on working conditions. J Public Health Policy 23</em>(3):268–285.</strong></p> Abstract</u>. A research partnership of representatives from labor, academia, and public health enabled unionized San Francisco hotel workers to achieve important policy changes in workplace health and safety. Known as the “Housekeeping Study,” the project took sixteen months to complete. A unique aspect of the project was that it utilized participatory action research methods, involving workers themselves as full participants in the study. A core group of 25 hotel room cleaners was involved in each phase of the project. The study developed health data which enabled room cleaners and their union to formulate and justify a contract proposal calling for a significant reduction in housekeeping workloads. The employer association agreed to a contract which reduced the maximum required room assignment from 15 rooms to 14 rooms per day in 14 San Francisco hotels. By lowering the maximum work assignment, these workers set a new standard which can potentially protect the health of room cleaners across the country. The project can serve as a model for worker and union participation in academic research, as well as for the application of research to improving working conditions, particularly for low-wage immigrant workers.</p> CATEGORIES: HOTEL WORKERS; INTERVENTION STRATEGIES; IMMIGRANT WORKERS</em></p>  </p> Lee-Ross D (1995). Attitudes and work motivation of subgroups of seasonal hotel workers. Services Industries J 15(3):295-313.</strong> Abstract.</u> Labour turnover is a strong feature of hotels in the UK, especially in the seasonal seaside sector. However, the link between job mobility and job satisfaction is complex and cannot be adequately explained by ‘traditional’ theories of motivation. In an attempt to account for the impact of individual worker differences on job attitudes, Hackman and Oldham’s [1974, 1980] job diagnostic survey was distributed to 163 hotel workers. The results suggest that hotel workers can be divided into subgroups, characterized by both residential status and work preference. Furthermore, these additional dimensions explain work attitudes and motivation more effectively than Hackman and Oldham’s original ‘growth need strength’ dimension. CATEGORIES: HOTEL WORKERS; WORK ORGANIZATION</em></p>  </p> Liladrie S (2010). “Do not disturb/please clean room”: hotel housekeepers in Greater Toronto. Race & Class 52(1):57-69.</strong> Abstract</u>. </strong>This study of the experiences of hotel housekeepers in Toronto, who are predominantly immigrant women of colour, reveals the damaging health impact of their work. As the hotel industry in this ‘global city’ has moved upmarket and sought to offer more luxury services to its wealthy customers, hotel housekeeping work has become more physically demanding and burdensome, resulting in the majority of workers experiencing a high degree of pains and injuries. The hotel industry is seen as operating a racialised division of labour, with those at the bottom vulnerable to being discarded as they approach retirement age and their health deteriorates. Finally, an account is given of the impact of unionisation and the hotel workers’ ongoing struggles for change. http://rac.sagepub.com/content/52/1/57.full.pdf+html</a> CATEGORIES: HOTEL WORKERS; WOMEN’S HEALTH; PAIN; INJURIES; WORK ENVIRONMENT</em></p> Lo K, Lamm F (2005). Occupational stress in the hospitality industry – an employment relations perspective. New Zealand J Employment Relations 30(1):23-47.</strong> Abstract:</u> This article endeavors to draw attention to occupational stress amongst workers in so-called ‘low risk industries’ – namely the service and hospitality industries – and to explore their perceptions of stress, their attitudes to managing stress and their responses to the recent inclusion of stress in the Health and Safety in Employment Amendment Act, 2002. It is also the intention to broaden the scope of analysis by investigating a range of employment factors – such as heavy workloads, interpersonal relationships and organizational factors – which can contribute to occupational stress amongst workers. Findings from two case studies are reported and they indicate that working in the hospitality industry can be stressful and that many workers are vulnerable in terms of their poor working conditions and low wages. Consistent with other studies, it was also found that there was low trade union presence and a high rate of casualization and staff turnover. At the same time, there was a lack of overt conflict between management and workers, with an apparent close alignment of goals between the two parties and a style of management that could be described as unitarist. CATEGORIES:WORK  STRESS; HOTEL WORKERS; WORK ENVIRONMENT</em></p> Lugwe LY (1994). Room attendants training programs as a prerequisite to job satisfaction (Master´s thesis). Providence, RI: Johnson and Wales University. </strong>CATEGORIES: HOTEL WORKERS; INTERVENTION STRATEGIES</em></p>  </p> Magnini  VP, Lee G, Kim B (2011). The cascading affective consequences of exercise among hotel workers. Int J Contemporary Hospitality Management. 23(5):624-642. </strong>http://www.deepdyve.com/lp/emerald-publishing/the-cascading-affective-consequences-of-exercise-among-hotel-workers-YakyiKqPPn</a> CATEGORIES: HOTEL WORKERS; INTERVENTION STRATEGIES</em></p> McNamara M, Bohle P, Quinlan M (2011). </strong>Precarious employment, working hours, work-life conflict and health in hotel work. Applied Ergonomics 42:225-232.</strong> Abstract.</u> Precarious or temporary work is associated with adverse outcomes including low control over working hours, work-life conflict and stress. The rise in precarious employment is most marked in the service sector but little research has been done on its health effects in this sector. This study compares permanent and temporary workers in the hotel industry, where working hours are highly variable. Survey data from 150 workers from eight 3-Star hotels in urban and regional areas around Sydney were analyzed. Forty-five per cent were male and 52 per cent were female. Fifty four per cent were permanent full-time and 46 per cent were temporary workers. The effects of employment status on perceived job security, control over working hours, and work-life conflict are investigated using PLS-Graph 3.0. The effects of control over working hours, on work-life conflict and subsequent health outcomes are also explored. Temporary workers perceived themselves as less in control of their working hours, than permanent workers (β = .27). However, they also reported lower levels of work intensity (β = .25) and working hours (β = .38). The effects of low hours control (β = .20), work intensity (β = .29), and excessive hours (β = .39) on work-life conflict (r² = .50), and subsequent health effects (r² = .30), are illustrated in the final structural equation model. CATEGORIES: HOTEL WORKERS; WORK ENVIRONMENT</em></p>  </p> Mei-Lien C, Wan-Ping L, Hsin-Yi C, Bey-Rong G, I-Fang M (2005). Biomonitoring of alkylphenols exposure for textile and housekeeping workers. Int J Environ Anal Chem 85(4/5):335-347</strong> Abstract.</u> 4-Nonylphenols (NP), 4- tert -ocytylphenols (OP), and 2,4-di- tert –butylphenols (BP) are ubiquitous in daily foodstuffs. These alkylphenols are widely used in industry, and NP and OP are endocrine disruptors. This study involved biomonitoring of the alkylphenols in plasma and urine from textile and housekeeping workers. The objective was to measure the internal level of alkylphenols and clarify the occupational exposure of alkylphenols for these two working groups. Forty textile workers and 33 housekeeping workers were recruited in this study. Urine and plasma samples were enzymatic deconjugation, followed by cleanup with solid-phase extraction. After extraction, the samples were analysed with reverse-phase high-performance liquid chromatography coupled with uorescence detection. The method was validated with the recovery and reproducibility test. The measurement results demonstrated apparent occupational exposure, since the urinary alkylphenols were signifcantly higher in the end-of-shift samples, 42.06plusmn;46.63 ng/mL, than in the preshift samples, 23.50±17.34 ng/mL, for the textile exposed workers. Meanwhile, the three kinds of alkylphenols were commonly detected in the biological samples. The plasma concentrations were higher than the urine concentrations. The average plasma concentrations of NP, OP, and BP were 53.21± 49.74, 16.02±2.81, and 25.83±7.10 ng/g for the housekeeping workers and 6.25±4.83, 6.52±8.67, and 6.47±13.34 ng/mL in urine, respectively. The results of this study suggest that multiple exposure routes, including dietary intake, inhalation, and skin absorption, might contribute to the internal alkylphenol dose. The potential adverse e_ects caused by exposure of occupational workers is concerned. © 2005 Taylor & amp; Francis Group Ltd. (31refs.)Controlled terms: Enzymes – Extraction – Fluorescence – Food products – Occupational diseases – PlasmasUncontrolled terms: Biomonitoring – Endocrine disruptor -NonylphenolsClassification Code: 932.3 Plasma Physics – 914.3.1 Occupational Diseases – 822.3 Food Products – 804.1 Organic Compounds – 802.3 Chemical Operations – 741. Light/Optics – 461.2 Biological Materials and Tissue Engineering. CATEGORIES: HOTEL WORKERS; CHEMICAL HAZARDS</em></p> Milburn PD, Barrett RS [1999]. Lumbosacral loads in bedmaking. Appl Ergon 30</em>(3):263</strong>–2</strong>73.</strong></p> CATEGORIES: ERGONOMICS; HOTEL WORKERS</em></p>  </strong></p> Muraca G, Martino LB, Abbate A, De Pasquale D, Barbuzza O, Brecciaroli R (2007). </strong>The risk of manual handling loads in the hotel sector G Ital Med Lav Ergon 3:569-570. </strong>Abstract.</u> The aim of our study is to evaluate the manual handling risk and the incidence of muscle-skeletal pathologies in the hotel compartment. Our study is conducted on 264 workers of the hotel compartment. The sample is divided on the base of the working turn in the following groups: porter (both to the plans and in the kitchen); waiters to the plans; services (gardeners and workers). The duties have been valued according to the method NIOSH. The presence of muscle-skeletal pathologies has been verified on the base to the accused symptomology, and on the presence of clinical objectivity and to the reports of checks. The data has been compared to a control group. The application of the NIOSH method has showed for each working profile an elevated synthetic index, > 3, and for porter the index is 5. The clinical data has shown an elevated incidence of pathologies of the spine, especially lumbar spine, with a high prevalence in the group of male porters. In conclusion we believe that the manual handling represents a particularly remarkable risk for the workers in the hotel compartment. CATEGORIES: HOTEL WORKERS; ERGONOMICS</em></p>  </p> O’Neill J, Davis K (2009). Differences in work and family stress experienced by managers and hourly employees in the hotel industry. Amherst, MA: University of Massachussetts. 2009 ICHRIE Conference. </strong>Abstract</u>. During economic downturns, hospitality industry employees are often asked to do more with less, and this situation creates stress among employees. Employee stress is becoming a significant issue in the hospitality industry, and it is costly for employers and employees alike. Stress results in overall declines in employee productivity, job performance, and customer service, and also results in increases in hostility, withdrawal, and costly turnover and health care costs. Although addressing and reducing stress in the hospitality industry is both a noble goal and is capable of resulting in expense reductions for employers, the nature and quantity of hospitality employee stress is not fully understood. Research regarding stress in the hospitality industry is an understudied topic. This study aims to identify the most common work stressors of a sample of 164 managerial and hourly workers who were each interviewed for eight consecutive days, and were employed at 65 different hotels across the United States. Further, this study examines whether there are differences in the types and frequency of work and family stressors between managers and non-managers, and also for men/women, parents/non-parents, married/single, and based on the quantity of working hours. http://scholarworks.umass.edu/cgi/viewcontent.cgi?article=1075&context=refereed&sei-redir=1&referer=http%3A%2F%2Fwww.google.com%2Furl%3Fsa%3Dt%26rct%3Dj%26q%3Ddifferences%2520in%2520work%2520and%2520family%2520stress%2520experienced%2520by%2520managers%2520and%2520hourly%2520employees%2520in%2520the%2520hotel%2520industry.%26source%3Dweb%26cd%3D1%26ved%3D0CB4QFjAA%26url%3Dhttp%253A%252F%252Fscholarworks.umass.edu%252Fcgi%252Fviewcontent.cgi%253Farticle%253D1075%2526context%253Drefereed%26ei%3Ddn-hTr_1MsGutwfr4aSVBQ%26usg%3DAFQjCNHtL9I14igbLyohdAQ2e1pe3tMAeg#search=%22differences%20work%20family%20stress%20experienced%20by%20managers%20hourly%20employees%20hotel%20industry.%22</a> CATAGORIES: HOTEL WORKERS; WORK STRESS; WORK ENVIRONMENT</em></p>  </p> Onsøyen LE, Mykletun RJ, Steiro TJ (2009). </strong>Silenced and invisible: the work experience of room attendants in Norwegian hotels. Scand J Hospitality Tourism 9(1):81-102. </strong>CATEGORIES: HOTEL WORKERS; WORK ENVIRONMENT</em></p> Premji S, Krause N (2010). Disparities by ethnicity, language, and immigrant status in occupational health experiences among Las Vegas hotel room cleaners. Am J Ind Med 53:960-975. </strong>Abstract.</u> OBJECTIVE: We examined disparities in workers’ occupational health experiences. METHODS: We surveyed 941 unionized Las Vegas hotel room cleaners about their experiences with work-related pain and with employers, physicians, and workers’ compensation. Data were analyzed for all workers and by ethnicity, language, and immigrant status. RESULTS: Hispanic and English as second language (ESL) workers were more likely than their counterparts to report work-related pain and, along with immigrant workers, to miss work because of this pain. Hispanic, ESL, and immigrant workers were not consistently at a disadvantage with regard to their own responses to work-related pain but were so with respect to reported responses by workers’ compensation, physicians, and employers. CONCLUSIONS: There are indications of disparities in occupational health experiences within this job title. The use of different group classifications, while implying different mechanisms, produced similar results. CATEGORIES: HOTEL WORKERS; IMMIGRANT WORKERS: PAIN; HEALTH DISPARITIES</em></p>  </p> Pearson D, Angulo A, Bourcier E, Freeman E, Valdez R, [2007] Hospitality workers’ attitudes and exposure to secondhand smoke, hazardous chemicals, and working conditions. PUBLIC HEALTH REPORTS 122</em>(5):670–678.</strong></p> Abstract:</u> Objective. Compelling reasons exist for labor and public health to collaborate. For example, compared to white-collar workers, blue-collar and service workers are much more likely to be targeted by the tobacco industry and become smokers. The purpose of this descriptive study was to assess if there were ways public health and labor could collaborate to document the health attitudes and needs of hospitality industry workers. Methods. Eligible union members were identified through an electronic enrollment file consisting of 3,659 names maintained by the union. The mail survey instrument covered exposure to secondhand smoke, exposure to hazardous chemicals and materials, time pressure and job demands, and work-related pain/disability. Additional questions related to age, gender, race/ethnicity, level of education, employment history, English proficiency, and self-reported health status. Results. Study results demonstrated that important health information could be successfully collected on unionized workers. Survey data showed that union members were a very diverse group who were exposed to secondhand smoke and supported working in clean-air settings. Workers, especially housekeeping staff, characterized their work as being chaotic and demanding, while almost half of workers reported work-related pain. Conclusions. Key to the successful collaboration was establishing trust between the parties and emphasizing data collection that served the information needs of both organizations. Opportunities exist to improve the health and working conditions of this population. Health interventions need to be designed to take into consideration the very diverse, mostly female, and limited English proficiency of this group of workers.</p> CATEGORIES: HOTEL WORKERS; CHEMICAL HAZARDS; WORK STRESS</em></p>  </p> Pollert A, Wright T [2006]. The experience of ethnic minority workers in the hotel and catering industry: routes to support and advice on workplace problems. London: Working Lives Research Institute.</strong></p> CATEGORIES: HOTEL WORKERS; WORK ENVIRONMENT</em></p>  </strong></p> Repace J [2004]. Respirable particles and carcinogens in the air of Delaware hospitality venues before and after a smoking ban. J Occup Environ Med 46</em>(9):887–905.</strong></p> Abstract</u>: How do the concentrations of indoor air pollutants known to increase risk of respiratory disease, cancer, heart disease, and stroke change after a smoke-free workplace law? Real-time measurements were made of respirable particle (RSP) air pollution and particulate polycyclic aromatic hydrocarbons (PPAH), in a casino, six bars, and a pool hall before and after a smoking ban. Secondhand smoke contributed 90% to 95% of the RSP air pollution during smoking, and 85% to 95% of the carcinogenic PPAH, greatly exceeding levels of these contaminants encountered on major truck highways and polluted city streets. This air-quality survey demonstrates conclusively that the health of hospitality workers and patrons is endangered by tobacco smoke pollution. Smoke-free workplace laws eliminate that hazard and provide health protection impossible to achieve through ventilation or air cleaning.</p> CATEGORIES: HOTEL WORKERS; CHEMICAL HAZARDS</em></p>  </u></strong></p> Rugulies R, Scherzer T, Krause N [2008]. Associations between psychological demands, decision latitude, and job strain with smoking in female hotel room cleaners in Las Vegas. Int J Behav Med 15</em>(1):34–43.</strong></p> Abstract</u>. BACKGROUND: Little is known of the impact of the work environment on smoking among women holding low-paid jobs in the service sector. PURPOSE: To study the associations between the components of the demand-control model with smoking in hotel room cleaners. METHODS: We conducted a survey on work and health among 776 female hotel room cleaners in Las Vegas. Associations between psychosocial work characteristics and smoking were analyzed with multivariate regression analyses.</p> RESULTS: Psychosocial work characteristics were associated with smoking after adjustment for covariates. Effect estimates were substantially reduced by additional adjustment for ethnicity, but remained significant for high psychological demands and smoking prevalence (OR = 1.97, p = 0.02), high job strain and smoking prevalence (OR = 1.87, p = 0.04), and high job strain and smoking intensity (coefficient = 3.52, p = 0.03). When analyses were restricted to Hispanic workers and further adjusted for place of birth, low decision latitude (coefficient = 3.94, p = 0.04) and high job strain (coefficient = 4.57, p = 003) were associated with smoking intensity but not with smoking status.</p> CONCLUSION: Workplace smoking cessation programs may benefit from a primary prevention component reducing job strain among service workers. More research is needed on perceived and objective differences in psychosocial work characteristics across ethnic, immigrant, and other social groups within the same occupation.</p> CATEGORIES: HOTEL WORKERS; WORK ENVIRONMENT</em></p>  </u></strong></p> Scherzer T, Rugulies R, Krause N [2005]. Work-related pain and injury and barriers to workers’ compensation among Las Vegas hotel room cleaners. Am J Public Health 95</em>(3):483–488.</strong></p> Abstract</u>. OBJECTIVES: We examined the prevalence of work-related pain and injury and explored barriers to and experiences of reporting among workers. METHODS: We surveyed 941 unionized hotel room cleaners about work-related pain, injury, disability, and reporting. RESULTS: During the past 12 months, 75% of workers in our study experienced work-related pain, and 31% reported it to management; 20% filed claims for workers’ compensation as a result of work-related injury, and 35% of their claims were denied. Barriers to reporting injury included “It would be too much trouble” (43%), “I was afraid” (26%), and “I didn’t know how” (18%). An estimated 69% of medical costs were shifted from employers to workers.  CONCLUSIONS: The reasons for underreporting and the extent of claim denial warrant further investigation. Implications for worker health and the precise quantification of shifting costs to workers also should be addressed.</p> CATEGORIES: INJURIES; PAIN; HOTEL WORKERS</em></p>  </u></strong></p> Seifert AM, Messing K (2006). Cleaning up after globalization: an ergonomic analysis of work activity of hotel cleaners. Antipode 38:557-578. </strong>Abstract.</u> Hotels and hotel chains are responding to globalization and increased competition through new marketing initiatives, employment practices, and restructuring decisions that are intensifying the work of cleaners. In this paper, we report on how such work intensification at two hotels in Montre´al, Canada, is changing the nature of cleaners’ jobs. Specifically, we found that the numbers of operations to be completed, the numbers and weights of items to be cleaned, and the effort involved have all increased. ‘‘Flexible’’ employment relationships and outsourcing have also worsened cleaners’ workloads. In response to our research, the labour union representing cleaners has negotiated a lower number of room assignments per cleaner, as well as an improved way of taking into account the variability of work when determining the quota of rooms to be cleaned. Despite this, new marketing strategies continue to intensify work. We conclude that standards and regulation on a governmental level are a necessary complement to union actions. http://onlinelibrary.wiley.com/doi/10.1111/j.0066-4812.2006.00595.x/pdf</a> CATEGORIES: HOTEL WORKERS; WORK ENVIRONMENT</em></p>  </p> Shani A, Pizam A (2009). Work-related depression among hotel employees. Cornell Hospitality Quarterly 50(4):446-459.</strong> Abstract</u>.</u> Given the putative cost of work-related depression, this article reports the results of a pilot study conducted among hotel employees in Central Florida. The study finds an initial indication of a small but noteworthy incidence of depression among workers in the hospitality industry. The article explores the antecedents and possible origins of depression, as well as critical issues related to depression in the workplace, particularly its effects on organizations and employees. The findings indicate a need for greater organizational awareness of depression. http://cqx.sagepub.com/content/50/4/446.full.pdf+html</a> CATEGORIES: HOTEL WORKERS; WORK ENVIRONMENT</em></p> Stanislaw D (2005). How to reduce housekeeping injuries. Lodging Hospitality 61(5):76.</strong> Abstract.</u> This article discusses findings of a study commissioned by the Canadian Center for National Occupational Health and Safety to investigate the health risks associated with hotel housekeeping. The study determined the following: (1) hotel housekeepers clean at least 16 rooms per shift; (2) a housekeeper can finish an average hotel room in 20 minutes; (3) a housekeeper changes body positions every three seconds, or approximately 8,000 times in an eight-hour shift; and (4) the workload, classified as moderately heavy to heavy burns up approximately four calories per minute. Because hotel housekeeping and other types of janitorial work involve repeating the same tasks repeatedly, the study also evaluated repetitive motion injuries (RMI) associated with cleaning a hotel room. It found the main RMI risk factors in housekeeping to include: heavy physical workloads and forceful upper-limb motions. The study suggested a variety of ways to reduce RMI injuries when cleaning hotel guest rooms. It include: rotate cleaning duties; use teams to clean guest rooms so duties can be more easily rotated and the work moves along faster; provide training on how to properly lift and move items; and use easier-to-use vacuum cleaners. CATEGORIES: HOTEL WORKERS; INJURIES</em></p> Wial H, Rickert J (2002). US hotels and their workers:  room for improvement. Washington, DC: AFL-CIO Working for America Institute.</strong> Abstract.</u> The U.S. hotel industry, a low-wage industry that has grown rapidly over the past two decades provides jobs for workers with little formal education or training, including some people leaving welfare. Hotels have also received public economic development subsidies as part of central city economic development projects. This report summarizes the industry’s performance on issues of interest to its workers and to those who are concerned about low-wage workers and wage inequality, the opportunities available to people leaving welfare and the quality of jobs created by businesses receiving public economic development subsidies. http://www.hotel-online.com/News/PR2002_3rd/Aug02_HotelJobs.html</a> CATEGORIES: HOTEL WORKERS; WORK ENVIRONMENT</em></p>

Arif AA, Hughes PC, Delclos GL [2008]. Occupational exposures among domestic and industrial professional cleaners. Occup Med (London) 58</em>(7):458–463.</strong></p> Abstract</u>. Background: Despite being a large part of the workforce, cleaners</strong> remain a relatively understudied occupational</strong> group in the USA. Aims: The aims of this focus group study were to identify and</strong> characterize occupational</strong> exposures</strong>, symptoms and</strong> job tasks among</strong> domestic</strong> and</strong> industrial</strong> professional</strong> cleaners</strong>.</strong> Methods: Twelve focus group sessions were conducted in Lubbock, TX, and</strong> Houston, TX. Participants were asked about their job tasks, type of products they use to clean, bodily symptoms, job training and</strong> work environment. Results: Out of 99 attendees, 79 domestic</strong> and</strong> industrial</strong> cleaners</strong> participated actively in the focus group sessions. Three general themes emerged regarding cleaning professional</strong>s’ work experiences: (i) job training, (ii) chemical exposure and</strong> use and</strong> (iii) competence. Domestic</strong> cleaners</strong> demonstrated significant skills deficit across each of these three themes as compared to industrial</strong> cleaners</strong>. Domestic</strong> cleaners</strong> reported more frequent exposure to respiratory irritants and</strong> sensitizers and</strong> also reported adverse respiratory symptoms as compared to industrial</strong> cleaners</strong>.</strong> Conclusions: The results from this qualitative study are consistent with earlier findings from quantitative studies placing domestic</strong> cleaners</strong> at risk of exposure to chemicals that are respiratory irritants and</strong>/or sensitizers.</p> CATEGORIES: DOMESTIC WORKERS; INDUSTRIAL WORKERS</em></p>  </strong></p> Kristal-Boneh E, Harari G, Melamed S, Froom P [2000]. Association of physical activity at work with mortality in Israeli industrial employees: the CORDIS study. J Occup Environ Med 42</em>(2): 127</strong>–1</strong>35</strong>.</p> CATEGORIES: INDUSTRIAL WORKERS</em></p>  </strong></p> Massin N, Hecht G, Ambroise D, Héry M, Toamain JP, Hubert G, Dorotte M, Bianchi B [2007]. Respiratory symptoms and bronchial responsiveness among cleaning and disinfecting workers in the food industry. Occup Environ Med 64</em>(2):75–81.</strong></p> Abstract</u>. OBJECTIVES: To measure the levels of exposure to nitrogen trichloride (NCl3) and aldehydes among cleaning and disinfecting workers in the atmosphere of food industry plants during cleaning and disinfecting operations, and to examine how they relate to irritant and chronic respiratory symptoms-which are indices of pulmonary function-and bronchial hyperresponsiveness (BHR) to methacholine. METHODS: 175 exposed workers (M = 149; F = 26) recruited from 17 enterprises of the food industry (8 cattle, pig, and ovine slaughterhouses, 8 fowl slaughterhouses, and 1 catering firm) and 70 non-exposed workers (M = 52; F = 18) were examined. Concentration levels of NCl3 and aldhehydes were measured by personal sampling. Symptoms were assessed by means of a questionnaire and the methacholine bronchial challenge (MBC) test using an abbreviated method. Subjects were labelled MBC+ if forced expiratory volume in one second (FEV1) fell by 20% or more. The linear dose-response slope (DRS) was calculated as the percentage fall in FEV1 at last dose divided by the total dose administered. RESULTS: 277 air samples were taken in the 17 food industry plants. For a given plant and in a given workshop, the actual concentrations of chloramines, aldehydes, and quaternary ammonium compounds were measured with personal samplers during the different steps of the procedures. For each cleaner, a total exposure index Sigma was calculated. A statistically significant concentration-response relationship was found between eye, nasal, and throat symptoms of irritation–but not chronic respiratory symptoms–and exposure levels or exposure duration. No relation was found between BHR and exposure. CONCLUSIONS: These data show that cleaning and disinfecting workers in the food industry are at risk of developing eye, nasal, and throat irritation symptoms. Although NCl3 exposure does not seem to carry a risk of developing permanent BHR, the possibility of transient BHR cannot be ruled out entirely.</p> CATEGORIES: RESPIRATORY; CHEMICAL HAZARDS; INDUSTRIAL WORKERS</em></p>

Alamgir H, Yu S [2008]. Epidemiology of occupational injury among cleaners in the healthcare sector. Occup Med 58</em>(6):393–399.</strong></p> Abstract:</u> BACKGROUND: The cleaning profession has been associated with multiple ergonomic and chemical hazards which elevate the risk for occupational injury. AIMS: This study investigated the epidemiology of occupational injury among cleaners in healthcare work settings in the Canadian province of British Columbia. METHODS: Incidents of occupational injury among cleaners, resulting in lost time from work or medical care, over a period of 1 year in two healthcare regions were extracted from a standardized operational database and with person-years obtained from payroll data. Detailed analysis was conducted using Poisson regression modeling. RESULTS: A total of 145 injuries were identified among cleaners, with an annual incidence rate of 32.1 per 100 person-years. After adjustment for age, gender, subsector, facility, experience and employment status, Poisson regression models demonstrated that a significantly higher relative risk (RR) of all injury, musculoskeletal injury and cuts was associated with cleaning work in acute care facilities, compared with long-term care facilities. Female cleaners were at a higher RR of all injuries and contusions than male cleaners. A lower risk of all injury and allergy and irritation incidents among part-time or casual workers was found. Cleaners with >10 years of experience were at significantly lower risk for all injury, contusion and allergy and irritation incidents. CONCLUSION: Cleaners were found to be at an elevated risk of all injury categories compared with healthcare workers in general.</p> CATEGORIES: HOSPITAL WORKERS; INJURIES; MSDs; DERMAL; RESPIRATORY</em></p>  </p> Bell JL, Collins JW, Wolf L, Gronqvist R, Chiou S, Chang WR, Sorock GS, Courtney TK, Lombardi DA, Evanoff B [2008]. Evaluation of a comprehensive slip, trip and fall prevention programme for hospital employees. Ergonomics 51</em>(12):1906–1925.</strong></p> Abstract.</u> In 2007, the Bureau of Labor Statistics reported that the incidence rate of lost workday injuries from slips, trips and falls (STFs) on the same level in hospitals was 35.2 per 10,000 full-time equivalents (FTE), which was 75% greater than the average rate for all other private industries combined (20.2 per 10,000 FTEs). The objectives of this 10-year (1996-2005) longitudinal study were to: 1) describe occupational STF injury events in hospitals; 2) evaluate the effectiveness of a comprehensive programme for reducing STF incidents among hospital employees. The comprehensive prevention programme included analysis of injury records to identify common causes of STFs, on-site hazard assessments, changes to housekeeping procedures and products, introduction of STF preventive products and procedures, general awareness campaigns, programmes for external ice and snow removal, flooring changes and slip-resistant footwear for certain employee subgroups. The hospitals’ total STF workers’ compensation claims rate declined by 58% from the pre-intervention (1996-1999) rate of 1.66 claims per 100 FTE to the post-intervention (2003-2005) time period rate of 0.76 claims per 100 FTE (adjusted rate ratio = 0.42, 95% CI: 0.33-0.54). STFs due to liquid contamination (water, fluid, slippery, greasy and slick spots) were the most common cause (24%) of STF claims for the entire study period 1996-2005. Food services, transport/emergency medical service and housekeeping staff were at highest risk of a STF claim in the hospital environment. Nursing and office administrative staff generated the largest numbers of STF claims. STF injury events in hospitals have a myriad of causes and the work conditions in hospitals are diverse. This research provides evidence that implementation of a broad-scale prevention programme can significantly reduce STF injury claims.</p> CATEGORIES: INJURIES; HOSPITAL WORKERS; INTERVENTION STRATEGIES</em></p>  </p> Bell AF, Steele JR (2011). Risk of musculoskeletal injury among cleaners during vacuuming. Ergonomics:1-11.</strong> Abstract:</u> This study aimed to examine the risk of work-related upper-limb musculoskeletal disorders in cleaning workers during the work task of vacuuming. In total, 24 cleaning workers were observed while they performed vacuum cleaning tasks in the normal course of their employment in government schools, hospitality and commercial office space sectors. Risk of upper-limb musculoskeletal disorders were rated using three observational assessment tools: Manual Task Risk Assessment (ManTRA); Quick Exposure Check (QEC); the Rapid Upper Limb Assessment (RULA). Mean results (e.g. ManTRA wrist/hand cumulative wrist score 18.67 ± 1.27, QEC neck score 13 ± 1.77, RULA score 6.54 ± 0.509) demonstrated that cleaning workers who perform the task of vacuum cleaning are at risk of work-related upper-limb musculoskeletal injury, regardless of whether they use a back-pack or canister machine. Government school cleaners experienced greater risk of work-related upper-limb musculoskeletal disorders than workers in either the hospitality or commercial office space sectors. STATEMENT OF RELEVANCE: Cleaning workers in Australia are mostly female, ageing and of non-English-speaking backgrounds and involved in repetitive manual tasks. Their occupation is low status. This research confirms that vacuuming tasks are a risk for cleaning workers and highlights the need for further research to improve conditions for these workers. http://www.tandfonline.com/doi/full/10.1080/00140139.2011.592605</a> CATEGORIES: MSDs; WOMEN’S HEALTH; IMMIGRANT WORKERS; CUSTODIAL WORKERS; HOTEL WORKERS; INJURIES; ERGONOMICS</em></p>  </p> Buchanan S, Vo</strong>ssenas P, Krause N, Moriarty J, Frumin E, Shimek J, Mirer F, Orris P, Punnett L [2009]. Occupational Injury Disparities in the US Hotel Industry. Am J Ind Med (coming in January)</strong></p> Abstract</u>. 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.</p> KEY WORDS: occupational injury; hotel workers; housekeepers; musculoskeletal disorders; health disparities CATEGORIES: INJURIES; HOTEL WORKERS; MSDs</em></p>  </em></p> Carrivick PJ, Lee AH, Yau KK [2001]. Consultative team to assess manual handling and reduce the risk of occupational injury. Occup Environ Med 58</em>(5):339–344.</strong></p> Abstract.</u> OBJECTIVES: To describe the formation of a consultative team to assess the risk of manual handling in the workplace that started in October 1992 within the cleaning services department of a 600 bed hospital, and to evaluate the effectiveness of its recommendations in reducing the rate and severity (time lost and cost) of workers’ compensation injury. METHODS: The consultative team identified, assessed, and recommended controls for manual handling and other injury risks. Data on injuries counted before and after implementation of the team’s recommendations were obtained for the cleaning services study group, an orderly services comparison group, as well as cleaners from a peer hospital and for the State of Western Australia. Evaluation of the four groups was undertaken 3 years after the end of the study period, to allow maturation of the costs of the claims (adjusted to July 1998 consumer price index) and hours lost from work. RESULTS: Statistical analysis showed that implementation of the recommendations significantly reduced numbers and rates of injury, but not the severity of injury, in the cleaning services study group. There was no difference in numbers or severity of injuries for the comparison groups before and after implementation of the recommendations. CONCLUSIONS: The recommendation of the consultative team can produce a meaningful and sustained reduction in rates of injury within an at risk population. The results support a consultative approach to reducing workplace injuries from manual handling. The team process has potential for application to occupational groups at risk of exposure to other types of hazards.</p> CATEGORIES: INJURIES; INTERVENTION STRATEGIES; HOSPITAL WORKERS</em></p>  </p> Carrivick PJW, Lee AH [2002]. Effectiveness of a workplace risk assessment team in reducing the rate, cost, and duration of occupational injury. J Occup Environ Med 44</em>(2):155–159.</strong></p> Abstract.</u> Evaluates the effectiveness of a consultative workplace risk assessment team in reducing the rate and severity of injury among cleaners within a 600-bed hospital. Cohorts of Cleaning Services and Orderly Services staff ever employed within both a 4-year pre-intervention and a 3-year post-intervention period were assigned to the intervention and comparison groups respectively. The date, compensation claims’ cost, and hours lost from work were obtained for each injury during the study period. Age, gender, work experience and hours worked were ascertained for every subject whether injured or not. Reductions of two thirds in injury rate, 73 per cent in cost rate, and 43 per cent in duration rate were evident in the intervention group. In comparison the orderlies experienced a post-intervention increase in all three rates. It is concluded that the success of the workplace risk assessment team intervention supports the adoption of a participatory approach to reducing the rate and consequence of work-place injury.</p> CATEGORIES: INTERVENTION STRATEGIES; HOSPITAL WORKERS; INJURIES</em></p>  </p> Carrivick PJW, Lee AH, Yau KKW Effectiveness of a participatory workplace risk assessment team in reducing the risk and severity of musculoskeletal injury [2002]. J Occup Health 44</em>(4):221–225.</strong></p> Abstract</u>. This study evaluates the effectiveness of a participatory workplace risk assessment team (the intervention) in reducing the rate and severity of musculoskeletal and non-musculoskeletal injuries among a cohort of 137 cleaners within a hospital setting. The date, workers’ compensation claims cost and hours lost from work were obtained for each injury occurring during the 4-yr pre-intervention and 3-yr post-intervention period. The age, gender and hours worked during the study period, were ascertained for every cleaner whether injured or not. For musculoskeletal injuries, the intervention was associated with significant reductions of two-thirds in injury rate, 65% in workers’ compensation claims cost per hour worked, and 40% in hours lost per hour worked. Cleaners also experienced a significant two-third post-intervention reduction in non-musculoskeletal injury rate; but the corresponding changes in severity rates were not significant. The intervention supports the adoption of a participatory approach to reducing the rate and consequence of musculoskeletal injuries in the workplace.</p> CATEGORIES: INTERVENTION STRATEGIES; HOSPITAL WORKERS; INJURIES</em></p>  </p> Carrivick PJ, Lee AH, Yau KK, Stevenson MR [2005]. Evaluating the effectiveness of a participatory approach in reducing the risk and severity of injuries from manual handling. Ergonomics 48</em>(8):907–914.</strong></p> Abstract</u>. Manual handling is the greatest contributor to non-fatal injury and disease in the workplace, commonly accounting for one-third of national injury counts. Interventional strategies that have focused on selecting or modifying the worker have been ineffective in reducing injury risk. In recent times, participatory ergonomics has been widely adopted as a process to reduce the risk of injury from manual handling but it is not well validated as an intervention. This study evaluated the effectiveness of a participatory ergonomics risk assessment approach in reducing the rate and severity of injuries from manual and non-manual handling sustained by a cohort of 137 cleaners within a hospital setting. The date of injury and the workers’ compensation claim cost and hours lost from work were obtained for each injury incurred during the 4-year pre-intervention and 3-year intervention period. The age, gender and hours worked were ascertained for every cleaner whether injured or not. Using generalized linear mixed modeling analysis, reductions of rate of injury by two-thirds, workers compensation claim costs by 62% and hours lost by 35% for manual handling injuries were found to be associated with the intervention period. Although the cleaners experienced a significant intervention period reduction in non-manual handling injury rate, the corresponding changes in severity of injury were not significant. The success of the intervention supports the adoption of a participatory ergonomics approach in reducing the rate and consequence of injuries in the workplace.</p> CATEGORIES: INTERVENTION STRATEGIES; HOSPITAL WORKERS; INJURIES</em></p>  </p> Cleaners mopped up by injuries [1999]. J Occup Health Safety Environ 3</em>(5):8</strong></p> Abstract:</u> Looks at the findings of a research report, “Musculoskeletal health of cleaners”, funded by the Health and Safety Executive (HSE) and the trade union UNISON. The results of a postal survey of 5,000 cleaning staff and follow-up ergonomic risk assessments indicate widespread musculoskeletal pain and discomfort often leading to time off work. The high risks of such pain have been associated with equipment design, job organization and poor training. HSE and UNISON will be holding a seminar for equipment manufacturers, employers and worker representatives in London on 28 September 1999, to review the study’s recommendations.</p> CATEGORIES: MSDs; INJURIES; PAIN; ERGONOMICS; WORK ENVIRONMENT</em></p>  </p> Flores LY, Deal JZ (2003). Work-related pain in Mexican American custodial workers. Hispanic J Behavioral Sciences 25(2):254-270.</strong> Abstract:</u> Mexican American janitors and custodians are at risk for developing work-related musculoskeletal injuries. These injuries may render them physically disabled, unable to provide for themselves and their families, and dependent on an already strained public health care system. Despite this growing health crisis and the United States’s growing Latino population, no research has been published examining musculoskeletal pain among Mexican American custodial workers. In this article, the authors examine the working and social conditions of Mexican American service workers, as well as the reasons why there is so little research on this population. The authors present results from a study they conducted and discuss the implications of their findings for future research with this population. http://hjb.sagepub.com/content/25/2/254.full.pdf</a> CATEGORIES: CUSTODIAL WORKERS; IMMIGRANT WORKERS; MSDs; PAIN; INJURIES</em></p> Gany F, Dobslaw R, Ramirez J, Tonda J, Lobach I, Leng J [2011]. Mexican urban occupational health in the US: a population at risk. J Community Health 36(2):175‒179.</strong></p> Abstract: </u>Mexicans are the largest immigrant group in the US. Little is known about their urban occupational health status. We assess occupational illness, injury, and safety training among New York City Mexican immigrants. This study is a consecutive sample of the Mexican immigrant population utilizing Mexican Consulate services in New York City over two weeks in March 2009. Bilingual research assistants approached persons waiting in line at the Consulate and administered an occupational health questionnaire. 185 people agreed to participate. Most work in restaurants (37%), cleaning (18%), construction (12%), babysitting/nanny (7%), retail (9%), and factories (5%). 22% had received safety training. 18% reported work-related pain or illness. 18% suffered from a job-related injury since immigrating. Most injuries were in construction, factories, and restaurants. 29% had not reported their injury. This study provides evidence that the urban Mexican immigrant population is at high risk for work-related illness and injury, is not receiving adequate safety training, and is under-reporting occupational injury. Culturally and linguistically responsive community outreach programs are needed to provide occupational health and safety information and resources for urban Mexican workers.</p> CATEGORIES: WORK STRESS; IMMIGRANT WORKERS; INJURIES</em></p>  </em></p> Goggins R (2007). Hazards of cleaning strategies for reducing exposures to ergonomic risk factors. Professional Safety 52(3).</strong> Abstract:</u> Cleaning workers are found in every setting and the work that they do is essential in every industry. According to the Bureau of Labor Statistics (BLS, 2005), more than 4 million people are employed as cleaning workers in the U.S., many working in low-paying, temporary or part-time jobs, with little opportunity for training or advancement. Much of the work is performed in the evening or at night, and many of these workers also have another job, attend school or perform other duties during the day. These working conditions combine to create a high turnover rate—estimated to be as high as 300% (Valentine & C&MM Staff, 1998; SEIU, 2006). Cleaning work creates exposure to many hazards, including wet floors, working on ladders, use of chemicals and motor vehicle accidents. Cleaning workers also are exposed to risk factors for musculoskeletal disorders (MSDs), such as lifting, carrying, awkward postures, repetitive motions and high hand forces. These exposures result in a high rate of injuries. According to Washington state workers’ compensation data from the Department of Labor and Industries (DLI, 2006), cleaning workers have an annual incidence rate of 10.4 new injury claims per 100 full-time equivalents (FTEs), while the overall service industry sector in Washington has an incidence rate of 5.8 per 100 FTEs and the general industry incidence rate is 6.9 per 100 FTEs. By way of comparison, BLS (2005) reports a recordable injury incidence rate of 3.9 per 100 FTEs for janitorial services, which is less than the national incidence rate for all of private industry (4.6 per 100 FTEs). The large difference in numbers between Washington state and national injury rates may be explained by underreporting of injuries in BLS statistics (Leigh, Marcin & Miller, 2004). A review of Washington state workers’ compensation data (DLI, 2006) reveals that the largest single category of injury and illness claims among cleaning workers is overexertion, followed by struck by and against, and falls. Exposure to chemicals and motor vehicle accidents were also significant categories of interest (Figure 1, p. 22). Looking at severity of claims, overexertion and falls accounted for the most days of time loss, while many of the struck by and against claims appear to be of low severity, accounting for a relatively small percentage of all time loss days (Figure 2, p. 22). Overexertion claims, primarily MSDs, were reported as occurring in all phases of cleaning work, while many of the falls were reported as occurring while working on ladders, while sweeping or vacuuming stairs, or while mopping floors. Each phase of cleaning work presents unique risk factors for MSDs. Fortunately, much attention has been focused on MSDs in cleaning work and new technologies offer opportunities to reduce the risk of injury. This article reviews risk factors present in common cleaning tasks and describes some solutions. Risk factors and some potential solutions are summarized in (figure in paper) Dusting and Scrubbing. One risk factor introduced by dusting and scrubbing with cloths and brushes is awkward postures, especially reaching overhead, and bending, kneeling or squatting to clean at floor level. CATEGORIES: CUSTODIAL WORKERS; INJURIES; ERGONOMICS; MSDs</em></p> Greenhouse S (2006). Hotel rooms get plusher, adding to maids’ injuries. New York Times, April 21</strong>. http://www.nytimes.com/2006/04/21/us/21hotel.html?pagewanted=all</a> CATEGORIES: HOTEL WORKERS; INJURIES</em></p> Greenhouse S (2009).  Female hotel workers injured more than men, study shows. New York Times, November 10</strong>. http://www.nytimes.com/2009/11/11/business/11injury.html</a> CATEGORIES: HOTEL WORKERS; INJURIES; WOMEN’S HEALTH</em></p> Hales T, Seligman PJ, Newman SC, Timbrook CL [1988]. Occupational injuries due to violence. J Occup Med 30</em>(6):483</strong>–487</strong>.</p> CATEGORIES: INJURIES</em></p>  </p> Hannerz H, Tüchsen F, Kristensen TS (2002). Hospitalizations among employees in the Danish hotel and restaurant industry. European J Public Health 12:192-197. </strong>Abstract:</u> BACKGROUND: The aim of the present study was to provide a broad picture of the morbidity among employees in the Danish hotel and restaurant industry. METHODS: Cohorts of all 20–59‐year‐old employees in the Danish hotel and restaurant industry in the years 1981, 1986, 1991 and 1994 were formed to calculate age‐standardized hospitalization ratios (SHR) and time trends (1981–1997) for many different diagnoses. RESULTS: Both for women and men, significantly higher SHRs were found for infectious and parasitic diseases, neoplasms, diseases in the nervous system and sense organs, diseases of the circulatory system, diseases of the respiratory system, diseases of the digestive system and diseases of the musculoskeletal system among employees in hotels and restaurants than in the working population at large. Furthermore, among women a significantly elevated risk was found for injuries in the lower extremities, injuries in the upper extremities and head injuries, and among men a high risk was found for head injuries and a low risk for ruptures in ligaments and muscles. The trend assessments did not detect any significant changes in SHRs over time. CONCLUSION: Employment in the Danish hotel and restaurant industry is associated with an elevated hospitalization risk due to many diseases, which may be related to occupation and lifestyle. In line with the official policy of reducing inequality in health, focus should be placed on the health problems in this group. http://eurpub.oxfordjournals.org/content/12/3/192.full.pdf+html</a> CATEGORIES: HOTEL WORKERS; INJURIES</em></p> Hotel housekeepers report alarming job injury rate (2006). Industrial Safety and Hygiene News 40(6):12. </strong>CATEGORIES: HOTEL WORKERS; INJURIES</em></p> Intilli H [1999]. The effects of converting wheels on housekeeping carts in a large urban hotel. Program evaluation. Am Assoc Occup Health Nurs J 47</em>(10):466–469</strong></p> Abstract</u>. Occupational and environmental health nurses can identify the causes of injuries and use analytical skills to show how the prevention of a problem can save the company money and demonstrate a caring attitude from management. Nurses can expand their traditional roles to position themselves as both advocates for the employees and profit enhancers to management as demonstrated by this program evaluation project. Initial outcomes included improved employee morale and reduced soft tissue injuries in hotel housekeeping employees. Changes in the workplace made by a proactive occupational and environmental health nurse and a committed management can reap rewards beneficial for both the employer and the work force.</p> CATEGORIES: INTERVENTION STRATEGIES; HOTEL WORKERS; INJURIES</em></p>  </p> Kines P, Hannerz H, Mikkelsen KL, Tüchsen F [2007]. Industrial sectors with high risk of women’s hospital-treated injuries. Am J Ind Med 50</em>(1):12–21.</strong></p> Abstract</u>: Women’s occupational injury rates are converging with those of males. Associations between female workers’ hospital treated injury rates, industrial sector and injured body area were analyzed to provide for better-focused injury prevention of women’s hazardous jobs. Females’ standardized hospital treatment ratios (SHR) and the excess fraction for five body regions (head/neck, thorax, back, upper and lower extremities) were calculated for 58 industrial sectors for 1999-2003. Five industrial sectors, “Cleaning, laundries and dry cleaners,” “Transport of passengers,” “Hotels and restaurants,” “Hospitals” and “Transport of goods” had significantly high SHRs for all five body regions. The excess fraction for upper extremity injuries revealed that 14%-27% of injuries could theoretically have been avoided. There is strong evidence for an association between women’s hospital treated injuries and industrial sector. The results justify the need for gender-sensitive analyses to orient injury prevention programs.</p> CATEGORIES: WOMEN’S HEALTH; INJURIES</em></p>  </p> Landers M, Maguire L [2004]. Effects of a work injury prevention program for housekeeping in the hotel industry. Work 22</em>(3):239–246.</strong></p> Abstract</u>. OBJECTIVE: The aim of this retrospective study was to determine the effectiveness of a work injury prevention program in the housekeeping department of a hotel. Studies have validated the use of different injury prevention strategies to decrease the incidence of work-related injuries. Few studies, however, have reported the efficacy of an on-site work injury prevention program by a physical therapist. STUDY DESIGN: In 1995, implementation of a work injury prevention program by a physical therapist to 50 housekeeping supervisors, 60 house persons and 340 guest room attendants at a large hotel began. This program included a detailed work risk analysis of the work environment, development of job descriptions, identification of injury-related problematic work situations, and implementation of a job specific supervisor-training program. Supervisor, house person and guest room attendant training was also conducted at the end of 1995 and the beginning of 1997. RESULTS: Data of injury reports in 1995, 1996, and 1997 were analyzed to determine the results of the program. There was a reduction in total injury claims, total medical expenses, total lost work time and total restricted duty time. CONCLUSION: These results demonstrate the cost effectiveness of implementing a work injury prevention program for housekeeping guest room attendants in the hotel industry.</p> CATEGORIES: HOTEL WORKERS; INJURIES; INTERVENTION STRATEGIES</em></p>  </p> Liladrie S (2010). “Do not disturb/please clean room”: hotel housekeepers in Greater Toronto. Race & Class 52(1):57-69.</strong> Abstract</u>. </strong>This study of the experiences of hotel housekeepers in Toronto, who are predominantly immigrant women of colour, reveals the damaging health impact of their work. As the hotel industry in this ‘global city’ has moved upmarket and sought to offer more luxury services to its wealthy customers, hotel housekeeping work has become more physically demanding and burdensome, resulting in the majority of workers experiencing a high degree of pains and injuries. The hotel industry is seen as operating a racialised division of labour, with those at the bottom vulnerable to being discarded as they approach retirement age and their health deteriorates. Finally, an account is given of the impact of unionisation and the hotel workers’ ongoing struggles for change. http://rac.sagepub.com/content/52/1/57.full.pdf+html</a> CATEGORIES: HOTEL WORKERS; WOMEN’S HEALTH; PAIN; INJURIES; WORK ENVIRONMENT</em></p> Pranski G, Moshenberg D, Benjamin K, Portillo S, Thackrey JL, Hill-Fotouhi C [2002]. Occupational risks and injuries in nonagricultural immigrant Latino workers. Am J Ind Med 42</em>(2):117–123</strong>. Abstract</u>: To investigate occupational health in urban immigrant Latino workers, a survey was conducted through door-to-door interviews. The response rate was 80% (n=427). The average time of residence in the United States was 7.6 years, and the average job tenure was 2.8 years. 27% of the respondents reported exposures to over 10 different hazards, and 18% believed these hazards had harmed their health. Only 31% had received job safety training. 55% had no workers’ compensation coverage. Among the 11% with a work injury in the past three years, 27% reported difficulty obtaining treatment, 91% lost time from work (median=13 days) and 29% had to change jobs because of the injury. The annual occupational injury rate was 12.2/100 full-time workers, compared to an expected rate of 7.1.</p> CATEGORIES: IMMIGRANT WORKERS; INJURIES</em></p>  </p> Rugulies R, Krause N [2005]. Job strain, isostrain, and incidence of back and neck injury:  a 7.5-year prospective study of San Francisco transit operators. Soc Sci Med 61</em>(1):27</strong>–39</strong>.</strong></p> CATEGORIES: INJURIES; WORK STRESS</em></p>  </p> Scherzer T, Rugulies R, Krause N [2005]. Work-related pain and injury and barriers to workers’ compensation among Las Vegas hotel room cleaners. Am J Public Health 95</em>(3):483–488.</strong></p> Abstract</u>. OBJECTIVES: We examined the prevalence of work-related pain and injury and explored barriers to and experiences of reporting among workers. METHODS: We surveyed 941 unionized hotel room cleaners about work-related pain, injury, disability, and reporting. RESULTS: During the past 12 months, 75% of workers in our study experienced work-related pain, and 31% reported it to management; 20% filed claims for workers’ compensation as a result of work-related injury, and 35% of their claims were denied. Barriers to reporting injury included “It would be too much trouble” (43%), “I was afraid” (26%), and “I didn’t know how” (18%). An estimated 69% of medical costs were shifted from employers to workers.  CONCLUSIONS: The reasons for underreporting and the extent of claim denial warrant further investigation. Implications for worker health and the precise quantification of shifting costs to workers also should be addressed.</p> CATEGORIES: INJURIES; PAIN; HOTEL WORKERS</em></p>  </p> Stanislaw D (2005). How to reduce housekeeping injuries. Lodging Hospitality 61(5):76.</strong> Abstract.</u> This article discusses findings of a study commissioned by the Canadian Center for National Occupational Health and Safety to investigate the health risks associated with hotel housekeeping. The study determined the following: (1) hotel housekeepers clean at least 16 rooms per shift; (2) a housekeeper can finish an average hotel room in 20 minutes; (3) a housekeeper changes body positions every three seconds, or approximately 8,000 times in an eight-hour shift; and (4) the workload, classified as moderately heavy to heavy burns up approximately four calories per minute. Because hotel housekeeping and other types of janitorial work involve repeating the same tasks repeatedly, the study also evaluated repetitive motion injuries (RMI) associated with cleaning a hotel room. It found the main RMI risk factors in housekeeping to include: heavy physical workloads and forceful upper-limb motions. The study suggested a variety of ways to reduce RMI injuries when cleaning hotel guest rooms. It include: rotate cleaning duties; use teams to clean guest rooms so duties can be more easily rotated and the work moves along faster; provide training on how to properly lift and move items; and use easier-to-use vacuum cleaners. CATEGORIES: HOTEL WORKERS; INJURIES</em></p> Vredenburgh AG [2002]. Occupational Safety: which management practices are most effective in reducing employee injury rates? J Safety Research 33</em>(2):259–276.</strong></p> CATEGORIES: WORK ENVIRONMENT; INJURIES</em></p>

Bell JL, Collins JW, Wolf L, Gronqvist R, Chiou S, Chang WR, Sorock GS, Courtney TK, Lombardi DA, Evanoff B [2008]. Evaluation of a comprehensive slip, trip and fall prevention programme for hospital employees. Ergonomics 51</em>(12):1906–1925.</strong></p> Abstract.</u> In 2007, the Bureau of Labor Statistics reported that the incidence rate of lost workday injuries from slips, trips and falls (STFs) on the same level in hospitals was 35.2 per 10,000 full-time equivalents (FTE), which was 75% greater than the average rate for all other private industries combined (20.2 per 10,000 FTEs). The objectives of this 10-year (1996-2005) longitudinal study were to: 1) describe occupational STF injury events in hospitals; 2) evaluate the effectiveness of a comprehensive programme for reducing STF incidents among hospital employees. The comprehensive prevention programme included analysis of injury records to identify common causes of STFs, on-site hazard assessments, changes to housekeeping procedures and products, introduction of STF preventive products and procedures, general awareness campaigns, programmes for external ice and snow removal, flooring changes and slip-resistant footwear for certain employee subgroups. The hospitals’ total STF workers’ compensation claims rate declined by 58% from the pre-intervention (1996-1999) rate of 1.66 claims per 100 FTE to the post-intervention (2003-2005) time period rate of 0.76 claims per 100 FTE (adjusted rate ratio = 0.42, 95% CI: 0.33-0.54). STFs due to liquid contamination (water, fluid, slippery, greasy and slick spots) were the most common cause (24%) of STF claims for the entire study period 1996-2005. Food services, transport/emergency medical service and housekeeping staff were at highest risk of a STF claim in the hospital environment. Nursing and office administrative staff generated the largest numbers of STF claims. STF injury events in hospitals have a myriad of causes and the work conditions in hospitals are diverse. This research provides evidence that implementation of a broad-scale prevention programme can significantly reduce STF injury claims.</p> CATEGORIES: INJURIES; HOSPITAL WORKERS; INTERVENTION STRATEGIES</em></p>  </u></strong></p> Carrivick PJ, Lee AH, Yau KK [2001]. Consultative team to assess manual handling and reduce the risk of occupational injury. Occup Environ Med 58</em>(5):339–344.</strong></p> Abstract.</u> OBJECTIVES: To describe the formation of a consultative team to assess the risk of manual handling in the workplace that started in October 1992 within the cleaning services department of a 600 bed hospital, and to evaluate the effectiveness of its recommendations in reducing the rate and severity (time lost and cost) of workers’ compensation injury. METHODS: The consultative team identified, assessed, and recommended controls for manual handling and other injury risks. Data on injuries counted before and after implementation of the team’s recommendations were obtained for the cleaning services study group, an orderly services comparison group, as well as cleaners from a peer hospital and for the State of Western Australia. Evaluation of the four groups was undertaken 3 years after the end of the study period, to allow maturation of the costs of the claims (adjusted to July 1998 consumer price index) and hours lost from work. RESULTS: Statistical analysis showed that implementation of the recommendations significantly reduced numbers and rates of injury, but not the severity of injury, in the cleaning services study group. There was no difference in numbers or severity of injuries for the comparison groups before and after implementation of the recommendations. CONCLUSIONS: The recommendation of the consultative team can produce a meaningful and sustained reduction in rates of injury within an at risk population. The results support a consultative approach to reducing workplace injuries from manual handling. The team process has potential for application to occupational groups at risk of exposure to other types of hazards.</p> CATEGORIES: INJURIES; INTERVENTION STRATEGIES; HOSPITAL WORKERS</em></p>  </p> Carrivick PJW, Lee AH [2002]. Effectiveness of a workplace risk assessment team in reducing the rate, cost, and duration of occupational injury. J Occup Environ Med 44</em>(2):155–159.</strong></p> Abstract.</u> Evaluates the effectiveness of a consultative workplace risk assessment team in reducing the rate and severity of injury among cleaners within a 600-bed hospital. Cohorts of Cleaning Services and Orderly Services staff ever employed within both a 4-year pre-intervention and a 3-year post-intervention period were assigned to the intervention and comparison groups respectively. The date, compensation claims’ cost, and hours lost from work were obtained for each injury during the study period. Age, gender, work experience and hours worked were ascertained for every subject whether injured or not. Reductions of two thirds in injury rate, 73 per cent in cost rate, and 43 per cent in duration rate were evident in the intervention group. In comparison the orderlies experienced a post-intervention increase in all three rates. It is concluded that the success of the workplace risk assessment team intervention supports the adoption of a participatory approach to reducing the rate and consequence of work-place injury.</p> CATEGORIES: INTERVENTION STRATEGIES; HOSPITAL WORKERS; INJURIES</em></p> Carrivick PJW, Lee AH, Yau KKW Effectiveness of a participatory workplace risk assessment team in reducing the risk and severity of musculoskeletal injury [2002]. J Occup Health 44</em>(4):221–225.</strong></p> Abstract</u>. This study evaluates the effectiveness of a participatory workplace risk assessment team (the intervention) in reducing the rate and severity of musculoskeletal and non-musculoskeletal injuries among a cohort of 137 cleaners within a hospital setting. The date, workers’ compensation claims cost and hours lost from work were obtained for each injury occurring during the 4-yr pre-intervention and 3-yr post-intervention period. The age, gender and hours worked during the study period, were ascertained for every cleaner whether injured or not. For musculoskeletal injuries, the intervention was associated with significant reductions of two-thirds in injury rate, 65% in workers’ compensation claims cost per hour worked, and 40% in hours lost per hour worked. Cleaners also experienced a significant two-third post-intervention reduction in non-musculoskeletal injury rate; but the corresponding changes in severity rates were not significant. The intervention supports the adoption of a participatory approach to reducing the rate and consequence of musculoskeletal injuries in the workplace.</p> CATEGORIES: INTERVENTION STRATEGIES; HOSPITAL WORKERS; INJURIES</em></p>  </p> Carrivick PJ, Lee AH, Yau KK, Stevenson MR [2005]. Evaluating the effectiveness of a participatory approach in reducing the risk and severity of injuries from manual handling. Ergonomics 48</em>(8):907–914.</strong></p> Abstract</u>. Manual handling is the greatest contributor to non-fatal injury and disease in the workplace, commonly accounting for one-third of national injury counts. Interventional strategies that have focused on selecting or modifying the worker have been ineffective in reducing injury risk. In recent times, participatory ergonomics has been widely adopted as a process to reduce the risk of injury from manual handling but it is not well validated as an intervention. This study evaluated the effectiveness of a participatory ergonomics risk assessment approach in reducing the rate and severity of injuries from manual and non-manual handling sustained by a cohort of 137 cleaners within a hospital setting. The date of injury and the workers’ compensation claim cost and hours lost from work were obtained for each injury incurred during the 4-year pre-intervention and 3-year intervention period. The age, gender and hours worked were ascertained for every cleaner whether injured or not. Using generalized linear mixed modeling analysis, reductions of rate of injury by two-thirds, workers compensation claim costs by 62% and hours lost by 35% for manual handling injuries were found to be associated with the intervention period. Although the cleaners experienced a significant intervention period reduction in non-manual handling injury rate, the corresponding changes in severity of injury were not significant. The success of the intervention supports the adoption of a participatory ergonomics approach in reducing the rate and consequence of injuries in the workplace.</p> CATEGORIES: INTERVENTION STRATEGIES; HOSPITAL WORKERS; INJURIES</em></p>  </p> Clean sweep: Molly Maid brushes up its approach to health and safety [2001]. Safety mosaic 4</em>(1):4–5.</strong></p> Abstract</u>: Housekeeping services can be a hazardous business. From potentially dangerous chemicals and equipment risks to slips and trips, and strains and sprains, staying safe at work takes education, knowledge and reinforcement. This article describes how one London, Ont. Molly Maid franchise makes health and safety a top priority.</p> CATEGORIES: INTERVENTION STRATEGIES; HOTEL WORKERS</em></p>  </p> Crum AJ, Langer EJ [2007]. Mind-set matters: exercise and the placebo effect. Psychol Sci 18</em>(2):165–171.</strong></p> Abstract.</u> In a study testing whether the relationship between exercise and health is moderated by one’s mind-set, 84 female room attendants working in seven different hotels were measured on physiological health variables affected by exercise. Those in the informed condition were told that the work they do (cleaning hotel rooms) is good exercise and satisfies the Surgeon General’s recommendations for an active lifestyle. Examples of how their work was exercise were provided. Subjects in the control group were not given this information. Although actual behavior did not change, 4 weeks after the intervention, the informed group perceived themselves to be getting significantly more exercise than before. As a result, compared with the control group, they showed a decrease in weight, blood pressure, body fat, waist-to-hip ratio, and body mass index. These results support the hypothesis that exercise affects health in part or in whole via the placebo effect.</p> CATEGORIES: INTERVENTION STRATEGIES; HOTEL WORKERS</em></p>  </p> Demirturk N, Demirdal T [2006]. Effect of a training program for hospital cleaning staff on prevention of hospital-acquired infection. Infect Control Hosp Epidemiol 27</em>:1410–1412</strong>.</strong></p> CATEGORIES: INTERVENTION STRATEGIES; HOSPITAL WORKERS</em></p> Flyvholm MA, Frydendall Jensen K [2008]. Experiences with implementation of evidence-based prevention programs to prevent occupational skin diseases in different occupations. G Ital Dermatol Venereol 143</em>(1):71–78.</strong></p> Abstract</u>. Occupational skin diseases are among the most frequently recognized occupational diseases in many industrialized countries. This paper describes and review experiences with implementation of interventions to prevent occupational skin diseases in different occupational settings representing the food processing industry and a hospital. The study populations were gut cleaners with all participants being exposed to wet work, cheese dairies and a hospital where all employees were included. The effect of implementation of evidence-based prevention programs were tested by questionnaire surveys on baseline and follow-up. A significant reduction in eczema at hands or forearms was observed among gut cleaners. At cheese dairies the eczema frequencies were low except for a comparison dairy where significant changes were seen. At the hospital a non significant reduction in hand eczema was observed. Changes related to use of protective measures and knowledge on prevention of occupational skin diseases were observed. A process evaluation carried out at the gut cleaning departments showed association between the eczema frequency at follow-up, activities related to prevention and implementation of an occupational health management system. In addition to documenting the scientific background for evidence-based prevention programs to prevent occupational skin diseases in different occupations, both the study population and the study design should be considered carefully when testing the implementation of workplace interventions. These aspects may influence the outcome in different directions and either facilitate or hamper the possibilities to provide scientific documentation of the effect of the intervention tested.</p> CATEGORIES: INTERVENTION STRATEGIES; DERMAL; HOSPITAL WORKERS</em></p>  </p> Health and Safety Executive [2007]. Preventing contact dermatitis at work. London: HSE Books.</strong></p> Abstract</u>: Aimed at workers, this leaflet explains that contact dermatitis can be caused by contact with a wide range of substances including detergents, toiletries, chemicals and even some natural products. While it can concern all parts of the body, the hands are most commonly affected. Contents: definition and description of contact dermatitis; high risk-jobs and workplaces (health care personnel, hairdressers, printers, cleaners, metal workers); prevention (substitution, automation, enclosure, protective gloves); legal aspects (compliance with the Control of Substances Hazardous to Health Regulations 2002 (COSHH, see CIS 03-1023). Replaces CIS 06-6. URL:http://www.hse.gov.uk/pubns/indg233.pdf</a></p> CATEGORIES: INTERVENTION STRATEGIES; DERMAL</em></p>  </p> Intilli H [1999]. The effects of converting wheels on housekeeping carts in a large urban hotel. Program evaluation. Am Assoc Occup Health Nurs J 47</em>(10):466–469</strong></p> Abstract</u>. Occupational and environmental health nurses can identify the causes of injuries and use analytical skills to show how the prevention of a problem can save the company money and demonstrate a caring attitude from management. Nurses can expand their traditional roles to position themselves as both advocates for the employees and profit enhancers to management as demonstrated by this program evaluation project. Initial outcomes included improved employee morale and reduced soft tissue injuries in hotel housekeeping employees. Changes in the workplace made by a proactive occupational and environmental health nurse and a committed management can reap rewards beneficial for both the employer and the work force.</p> CATEGORIES: INTERVENTION STRATEGIES; HOTEL WORKERS; INJURIES</em></p>  </p> Kumar R, Chaikumarn M, Kumar S [2005]. </strong>Physiological, subjective, and postural loads in passenger train wagon cleaning using a conventional and redesigned cleaning too. Int J Ind Ergonomics 35</em>(10):931–938.</strong></p> Abstract</u>: In this study, cleaning process was studied and analyzed with special reference to cleaning tools. A group of 13 professional cleaners participated in this study. While they performed their normal tasks, their oxygen consumption, heart rate, rating of perceived exertion and postural data were obtained. The perceived exertion during cleaning task using the “redesigned cleaning tool” was less than that of the “conventional cleaning tool”. The oxygen consumption when cleaning with the redesigned tool (mean 0.84 l/m, SD +/-0.17) was significantly less (p < 0.05) compared to the conventional cleaning tool (mean 0.94 l/m, SD +/- 0.18). Heart rate was also found significantly lower using redesigned cleaning tool (mean 101 bpm, SD +/- 11.10) compared to that of conventional cleaning tool (mean 105 bpm, SD +/- 12.59) (p < 0.05). Using redesigned cleaning tool the trunk postural load was also found significantly less than that of conventional cleaning tool (p CATEGORIES: ERGONOMICS; INTERVENTION STRATEGIES</em></p>  </p> Landers M, Maguire L [2004]. Effects of a work injury prevention program for housekeeping in the hotel industry. Work 22</em>(3):239–246.</strong></p> Abstract</u>. OBJECTIVE: The aim of this retrospective study was to determine the effectiveness of a work injury prevention program in the housekeeping department of a hotel. Studies have validated the use of different injury prevention strategies to decrease the incidence of work-related injuries. Few studies, however, have reported the efficacy of an on-site work injury prevention program by a physical therapist. STUDY DESIGN: In 1995, implementation of a work injury prevention program by a physical therapist to 50 housekeeping supervisors, 60 house persons and 340 guest room attendants at a large hotel began. This program included a detailed work risk analysis of the work environment, development of job descriptions, identification of injury-related problematic work situations, and implementation of a job specific supervisor-training program. Supervisor, house person and guest room attendant training was also conducted at the end of 1995 and the beginning of 1997. RESULTS: Data of injury reports in 1995, 1996, and 1997 were analyzed to determine the results of the program. There was a reduction in total injury claims, total medical expenses, total lost work time and total restricted duty time. CONCLUSION: These results demonstrate the cost effectiveness of implementing a work injury prevention program for housekeeping guest room attendants in the hotel industry.</p> CATEGORIES: HOTEL WORKERS; INJURIES; INTERVENTION STRATEGIES</em></p>  </p> Landstad B, Vinberg S, Ivergård T, Gelin G, Ekholm J [2001]. Change in pattern of absenteeism as a result of workplace intervention for personnel support. Ergonomics 44</em>(1):63–81.</strong></p> Abstract</u>: The aim was to investigate whether a preventive intervention carried out in a predominantly female workplace: that of hospital cleaners (consisting of a group of 97 women) had any effect on patterns of absenteeism. As a background, a model for analyzing complex patterns of absenteeism, including sickness absences, was also developed. A further aim was to study the interactions between different forms of absenteeism. Comparison was made with a reference group consisting of employees in the same job category who only received the customary personnel support. For individuals in the intervention group who were 42 years, short-term absence decreased for those who had been in the same jobs for a long time. The combination of increased age and experience showed a tendency to enhance this decline in short-term absenteeism due to sickness. For those >42 years, and who at the same time have a previous history of high absenteeism, long-term absenteeism due to sickness seemed to be increasing. Increased experience tended to reduce this increase in long-term sickness absence. This combination of different effects possibly indicated the presence of a process of selection which determined who remained in the job as opposed to those who did not. An important conclusion is that different forms of absenteeism need to be looked at in parallel, and at the same time multivariate statistical analysis needs to be carried out to determine the different interactions between the factors.</p> CATEGORIES: WOMEN’S HEALTH; INTERVENTION STRATEGIES; HOSPITAL WORKERS</em></p>  </p> Lee PT, Krause N [2002]. The impact of a worker health study on working conditions. J Public Health Policy 23</em>(3):268–285.</strong></p> Abstract</u>. A research partnership of representatives from labor, academia, and public health enabled unionized San Francisco hotel workers to achieve important policy changes in workplace health and safety. Known as the “Housekeeping Study,” the project took sixteen months to complete. A unique aspect of the project was that it utilized participatory action research methods, involving workers themselves as full participants in the study. A core group of 25 hotel room cleaners was involved in each phase of the project. The study developed health data which enabled room cleaners and their union to formulate and justify a contract proposal calling for a significant reduction in housekeeping workloads. The employer association agreed to a contract which reduced the maximum required room assignment from 15 rooms to 14 rooms per day in 14 San Francisco hotels. By lowering the maximum work assignment, these workers set a new standard which can potentially protect the health of room cleaners across the country. The project can serve as a model for worker and union participation in academic research, as well as for the application of research to improving working conditions, particularly for low-wage immigrant workers.</p> CATEGORIES: HOTEL WORKERS; INTERVENTION STRATEGIES; IMMIGRANT WORKERS</em></p>  </p> Lugwe LY (1994). Room attendants training programs as a prerequisite to job satisfaction (Master´s thesis). Providence, RI: Johnson and Wales University. </strong>CATEGORIES: HOTEL WORKERS; INTERVENTION STRATEGIES</em></p> Magnini  VP, Lee G, Kim B (2011). The cascading affective consequences of exercise among hotel workers. Int J Contemporary Hospitality Management. 23(5):624-642. </strong>http://www.deepdyve.com/lp/emerald-publishing/the-cascading-affective-consequences-of-exercise-among-hotel-workers-YakyiKqPPn</a> CATEGORIES: HOTEL WORKERS; INTERVENTION STRATEGIES</em></p> Messing K, Vezina N, Major M, Ouellet S, Tissot F, Couture V, Riel J (2008). Body maps: an indicator of physical pain for worker-oriented ergonomics interventions. Policy Practice in Health and Safety 2:31-49. </strong>Abstract.</u> Work-related musculoskeletal health damage causes pain and suffering, and can lead to disability. To prevent it, it is important to detect not only diagnosed musculoskeletal disorders but also early signs of impending damage. Workers have important information on workplace risks and health damage, and should be involved in the process of identifying damage. However, controversy surrounds the pain reports of workers and their claims for compensation. We have found that a body map is a useful tool for systematising and analysing workers’ pain reports. CATEGORIES: MSDs; PAIN; ERGONOMICS; INTERVENTION STRATEGIES</em></p>  </p> Mygind K, Sell L, Flyvholm MA, Frydendall JK [2006]. High-fat petrolatum-based moisturizers and prevention of work-related skin problems in wet-work operations. Contact Dermatitis 54</em>(1):35–41.</strong></p> Abstract</u>: The purpose of this study was to explore whether a high-fat petrolatum-based moisturizer could be an alternative to protective gloves in wet-work occupations. The study population consisted of gut cleaners in Danish swine slaughterhouses, divided into intervention and comparison groups. The intervention group was given written and oral information on the use of gloves and skin care. Data were collected by telephone interviews using a standardized questionnaire. 644 (88%) gut cleaners responded at baseline and 622 (72%) at a one-year follow-up. In the intervention group, the eczema frequency was reduced significantly. Detailed analyses revealed that protective gloves were the most effective means of protection and did not indicate that a high-fat moisturizer could be an alternative. A continuous focus on prevention of skin problems with information and discussions on the shop floor seemed to be most important for reducing skin problems.</p> CATEGORIES: DERMAL; INTERVENTION STRATEGIES</em></p>  </u></strong></p> Skoglind-Ohman I, Shahnavaz H [2004]. Assessment of future workshop’s usefulness as an ergonomics tool. Int J Occup Safe Ergonomics 10</em>(2):119–128.</strong></p> Abstract</u>. This study was carried out to assess Future Workshop (FW) regarding its usefulness as a participatory ergonomics method, using a descriptive evaluation design analyzed by phenomenographical approach. The study was conducted among professional cleaners, health care personnel and miners, with a sample of 105 participating subjects in 8 different FWs. Multiple methods, giving a combination of both qualitative and quantitative data, were used for data collection. Good involvement of participants was observed during workshops. Evaluations immediately after FWs and 3 months later showed a strong relationship with high correlation, indicating that the perception of FW participants was very positive. Interviews revealed conformity between developed problem identification and proposed changes. Participants’ own perceptions of FW’s influence on creativity depict their belief of developed ideas and solutions in order to identify and solve workplace problems. FW is considered to be a useful ergonomics tool, and its qualities are related to structure and practical performance.</p> CATEGORIES: INTERVENTION STRATEGIES; ERGONOMICS</em></p>  </u></strong></p> Toivanen H, Helin P, Hänninen O [1993]. Impact of regular relaxation training and psychosocial working factors on neck-shoulder tension and absenteeism in hospital cleaners. J Occup Med 35</em>(11):1123–1130.</strong></p> Abstract</u>. Occupational stress in hospital cleaners (n = 50), and the effect of relaxation training (n = 25, age matched, randomized), were studied by recording the electrical activity of the upper trapezius muscle at rest and during working conditions at the beginning, middle, and end of a 6-month follow-up period. A short (15-minute) relaxation program was practiced daily at the workplace to provide stress management. The amount of sick leave was counted, and the extent of depression and some psychosocial working factors were screened. Intercorrelations were found between the neck-shoulder tension, psychosocial factors, depression, and the absentee rate. The relaxation training diminished tension in the neck-shoulder region efficiently; nevertheless, the decrease in absenteeism might have been related mainly to the social support offered by the research maneuver itself.</p> CATEGORIES: INTERVENTION STRATEGIES; HOSPITAL WORKERS; WORK STRESS</em></p>  </p> Toivanen H, Laensimies E [1993]. Impact of regular relaxation training on the cardiac autonomic nervous system of hospital cleaners and bank employees. Scand J Work Environ Health 19</em>(5):319–325.</strong></p> Abstract</u>: Work related strain of female hospital cleaners and female bank employees were recorded during a period of rationalization in the workplace and the effect of daily relaxation to help the workers cope was tested. Results suggest that occupational strain caused the functioning of the autonomic nervous system to deteriorate. Regular deep relaxation normalized the function and improved the ability to cope.</p> CATEGORIES: INTERVENTION STRATEGIES; HOSPITAL WORKERS; WORK STRESS</em></p>  </u></strong></p> Weisshaar E, Radulescu M, Soder S, Apfelbacher CJ, Bock M, Grundmann JU, Albrecht U,  Diepgen TL [2007]. Secondary individual prevention of occupational skin diseases in health care workers, cleaners and kitchen employees: aims, experiences and descriptive results. Int Arch Occup Environ Health 80</em>(6):477–484.</strong></p> Abstract</u>: Objectives Due to increased occupational dermatoses in certain professions such as health care workers (HCW), cleaning and kitchen employees (CKE), measures of prevention and skin protection are of high significance. Skin protection courses focus on educational aims (e.g. improving skin care habits, influencing the participants’ attitudes towards health) and medical aims (e.g. optimizing diagnostic procedures, complementing individual therapy). Methods Participants are patients who have been suspected to suffer from an occupational skin disease and are insured with the German Accident Prevention & Insurance Association (BGW). Teaching units of the skin protection courses focus on basics of skin functioning and important aspects of occupational skin diseases. Practical parts include information and instructions about the correct implementation of skin protection, skin care and skin cleansing. Every participant is seen by a dermatologist obtaining a precise patient’s history and performing a skin examination. All this results in working out individually adapted and professional skin protection strategies. Results In total, 791 participants (93 men and 698 women) completed the skin protections courses. Six hundred and sixty-seven patients (mean age: 36.9 years, SD = 11.6) were HCW and 124 patients (mean age: 40.4 years, SD = 10.8) were CKE. In HCW 82.5% (n = 550) and in CKE 86.3% (n = 107) suffered from hand eczema of the atopic, irritant or allergic type. Irritant contact dermatitis as a single diagnosis was the most frequent one in both groups (HCW: 34.5.%, n = 230; CKE: 49.2% n = 61). According to regularly performed evaluations, the participants rated the course as good to excellent. Nearly 80% of the participants had skin lesions while attending the course, in 27% the dermatosis was severe. Conclusions: There is a high need for health education, advisory services, diagnostics and additional therapy in occupational dermatology. Prevention of occupational skin diseases and maintenance of health through educational programmes are important complementary measures for dermatological care but still missing in endangered professions.</p> CATEGORIES: DERMAL; HOSPITAL WORKERS; INTERVENTION STRATEGIES</em></p>  </u></strong></p> Zarate-Abbott P, Etnyre A, Gilliland I, Mahon M, Allwein D, Cook J, Mikan V, Rauschhuber M, Sethness R, Munoz L, Lowry J, Jones ME. Workplace health promotion–strategies for low-income Hispanic immigrant women. Am Assoc Occup Health Nurs J 56</em>(5).</strong></p> Abstract</u>. Addressing health disparities for vulnerable populations in the United States is a national goal. Immigrant Hispanic women, at increased risk for heart disease, face obstacles in receiving adequate health care. Health promotion, especially for Hispanic women, is hindered by language, access to care, lack of insurance, and cultural factors. Innovative health education approaches are needed to reach this population. This article describes the development and evaluation of a culturally sensitive cardiac health education program based on findings from a study of 21 older immigrant Hispanic women employed as housekeepers at a small university in south Texas. Systolic and diastolic blood pressures had decreased 17 months after the intervention.</p> CATEGORIES: IMMIGRANT WORKERS; WOMEN’S HEALTH; INTERVENTION STRATEGIES</em></p>

Bell AF, Steele JR (2011). Risk of musculoskeletal injury among cleaners during vacuuming. Ergonomics:1-11.</strong> Abstract:</u> This study aimed to examine the risk of work-related upper-limb musculoskeletal disorders in cleaning workers during the work task of vacuuming. In total, 24 cleaning workers were observed while they performed vacuum cleaning tasks in the normal course of their employment in government schools, hospitality and commercial office space sectors. Risk of upper-limb musculoskeletal disorders were rated using three observational assessment tools: Manual Task Risk Assessment (ManTRA); Quick Exposure Check (QEC); the Rapid Upper Limb Assessment (RULA). Mean results (e.g. ManTRA wrist/hand cumulative wrist score 18.67 ± 1.27, QEC neck score 13 ± 1.77, RULA score 6.54 ± 0.509) demonstrated that cleaning workers who perform the task of vacuum cleaning are at risk of work-related upper-limb musculoskeletal injury, regardless of whether they use a back-pack or canister machine. Government school cleaners experienced greater risk of work-related upper-limb musculoskeletal disorders than workers in either the hospitality or commercial office space sectors. STATEMENT OF RELEVANCE: Cleaning workers in Australia are mostly female, ageing and of non-English-speaking backgrounds and involved in repetitive manual tasks. Their occupation is low status. This research confirms that vacuuming tasks are a risk for cleaning workers and highlights the need for further research to improve conditions for these workers. http://www.tandfonline.com/doi/full/10.1080/00140139.2011.592605</a> CATEGORIES: MSDs; WOMEN’S HEALTH; IMMIGRANT WORKERS; CUSTODIAL WORKERS; HOTEL WORKERS; INJURIES; ERGONOMICS</em></p> DHPE [2008]. Focusing the lens: exploring the impact of job stress among Hispanic/Latina blue-collar workers. By Griffin-Blake S, Alarcon-Yohe M, Berktold J, Liburd L. </strong>Washington, DC</strong>: </strong>U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Directors of Health Promotion and Education.</strong></p> CATEGORIES: WORK STRESS; IMMIGRANT WORKERS</em></p>  </u></strong></p> Finch, BK, Kolody B, Vega WA [2000]. Perceived discrimination and depression among Mexican-origin adults in California. J Health Soc Behav 41</em>(3):295–313.</strong></p> Abstract</u>. This study provided a test of the minority status stress model by examining whether perceived discrimination would directly affect health outcomes even when perceived stress was taken into account among 215 Mexican-origin adults. Perceived discrimination predicted depression and poorer general health, and marginally predicted health symptoms, when perceived stress was taken into account. Perceived stress predicted depression and poorer general health while controlling for the effects of perceived discrimination. The influence of perceived discrimination on general health was greater for men than women, and the effect of perceived stress on depression was greater for women than men. Results provide evidence that discrimination is a source of chronic stress above and beyond perceived stress, and the accumulation of these two sources of stress is detrimental to mental and physical health. Findings suggest that mental health and health practitioners need to assess for the effects of discrimination as a stressor along with perceived stress.</p> CATEGORIES: WORK STRESS; IMMIGRANT WORKERS</em></p>  </u></strong></p> Flores LY, Deal JZ (2003). Work-related pain in Mexican American custodial workers. Hispanic J Behavioral Sciences 25(2):254-270.</strong> Abstract:</u> Mexican American janitors and custodians are at risk for developing work-related musculoskeletal injuries. These injuries may render them physically disabled, unable to provide for themselves and their families, and dependent on an already strained public health care system. Despite this growing health crisis and the United States’s growing Latino population, no research has been published examining musculoskeletal pain among Mexican American custodial workers. In this article, the authors examine the working and social conditions of Mexican American service workers, as well as the reasons why there is so little research on this population. The authors present results from a study they conducted and discuss the implications of their findings for future research with this population. http://hjb.sagepub.com/content/25/2/254.full.pdf</a> CATEGORIES: CUSTODIAL WORKERS; IMMIGRANT WORKERS; MSDs; PAIN; INJURIES</em></p>  </strong></p> Gany F, Dobslaw R, Ramirez J, Tonda J, Lobach I, Leng J [2011]. Mexican urban occupational health in the US: a population at risk. J Community Health 36(2):175‒179.</strong></p> Abstract: </u>Mexicans are the largest immigrant group in the US. Little is known about their urban occupational health status. We assess occupational illness, injury, and safety training among New York City Mexican immigrants. This study is a consecutive sample of the Mexican immigrant population utilizing Mexican Consulate services in New York City over two weeks in March 2009. Bilingual research assistants approached persons waiting in line at the Consulate and administered an occupational health questionnaire. 185 people agreed to participate. Most work in restaurants (37%), cleaning (18%), construction (12%), babysitting/nanny (7%), retail (9%), and factories (5%). 22% had received safety training. 18% reported work-related pain or illness. 18% suffered from a job-related injury since immigrating. Most injuries were in construction, factories, and restaurants. 29% had not reported their injury. This study provides evidence that the urban Mexican immigrant population is at high risk for work-related illness and injury, is not receiving adequate safety training, and is under-reporting occupational injury. Culturally and linguistically responsive community outreach programs are needed to provide occupational health and safety information and resources for urban Mexican workers.</p> CATEGORIES: WORK STRESS; IMMIGRANT WORKERS; INJURIES</em></p>  </p> Higley J (1997). Language barrier leads to resignations. Hotel and Motel Management 212(9):20</strong>. CATEGORIES: HOTEL WORKERS; IMMIGRANT WORKERS</em></p>  </strong></p> Jørgensen MB, Rasmussen CD, Carneiro IG, Flyvholm MA, Olesen K, Ekner D, Søgaard K, Holtermann A. Health disparities between immigrant and Danish cleaners [2011]. Int Arch Occup Environ Health. 84(6):665‒674. </strong></p> Abstract</u></p> PURPOSE: It is unknown whether immigrants working in the cleaning industry have a poorer health and work ability than cleaners from the native population. The main aim was to investigate differences in objective and self-reported health measures between immigrant and Danish cleaners. METHODS: Three hundred and fifty-one cleaners, consisting of 166 Danes (88% women) and 179 immigrants (74% women) (6 with unknown ethnicity), from 9 workplaces in Denmark participated in the study. Health and work ability were obtained by objective (e.g., BMI and blood pressure) and self-reported measures (e.g., work ability, self-rated health, and musculoskeletal symptoms). In order to investigate differences between Danish and immigrant cleaners, logistic regression analyses and General Linear Models were performed. RESULTS: When controlling for age, sex, workplace, job seniority, and smoking, more Danish compared with immigrant cleaners were current smokers (42% vs. 28%, p < 0.001 (not controlled for smoking)), had hypertension (46% vs. 26%, p < 0.05) and drank more alcohol (3.0 vs. 0.8 units per day, respectively, p < 0.001). Contrary, more immigrants compared with Danish cleaners were measured to be overweight (47% vs. 30%, p < 0.05), reported less than good work ability (57% vs. 42%, p < 0.01), considered it unthinkable/unsure to be able to perform work 2 years ahead (37% vs. 23%, p < 0.01), reported reduced self-rated health (46% vs. 38%, p < 0.01) and everyday pain in the neck/shoulder (28% vs. 11%, p < 0.01), wrist (18% vs. 7%, p < 0.01), and lower back (21% vs. 10%, p < 0.01). There were no differences in self-reported chronic diseases. CONCLUSIONS: Although the health of the cleaners was alarmingly poor, the immigrant cleaners generally had a poorer self-reported health and work ability than the Danish cleaners. These findings highlight the need for occupational health actions among cleaners, particularly tailored to the immigrant subpopulation.</p> CATEGORIES: IMMIGRANT WORKERS</em></p>  </strong></p> Lee PT, Krause N [2002]. The impact of a worker health study on working conditions. J Public Health Policy 23</em>(3):268–285.</strong></p> Abstract</u>. A research partnership of representatives from labor, academia, and public health enabled unionized San Francisco hotel workers to achieve important policy changes in workplace health and safety. Known as the “Housekeeping Study,” the project took sixteen months to complete. A unique aspect of the project was that it utilized participatory action research methods, involving workers themselves as full participants in the study. A core group of 25 hotel room cleaners was involved in each phase of the project. The study developed health data which enabled room cleaners and their union to formulate and justify a contract proposal calling for a significant reduction in housekeeping workloads. The employer association agreed to a contract which reduced the maximum required room assignment from 15 rooms to 14 rooms per day in 14 San Francisco hotels. By lowering the maximum work assignment, these workers set a new standard which can potentially protect the health of room cleaners across the country. The project can serve as a model for worker and union participation in academic research, as well as for the application of research to improving working conditions, particularly for low-wage immigrant workers.</p> CATEGORIES: HOTEL WORKERS; INTERVENTION STRATEGIES; IMMIGRANT WORKERS</em></p>  </u></strong></p> Liladrie S (2010). “Do not disturb/please clean room”: hotel housekeepers in Greater Toronto. Race & Class 52(1):57-69.</strong> Abstract</u>. </strong>This study of the experiences of hotel housekeepers in Toronto, who are predominantly immigrant women of colour, reveals the damaging health impact of their work. As the hotel industry in this ‘global city’ has moved upmarket and sought to offer more luxury services to its wealthy customers, hotel housekeeping work has become more physically demanding and burdensome, resulting in the majority of workers experiencing a high degree of pains and injuries. The hotel industry is seen as operating a racialised division of labour, with those at the bottom vulnerable to being discarded as they approach retirement age and their health deteriorates. Finally, an account is given of the impact of unionisation and the hotel workers’ ongoing struggles for change. http://rac.sagepub.com/content/52/1/57.full.pdf+html</a> CATEGORIES: HOTEL WORKERS; WOMEN’S HEALTH; PAIN; INJURIES; WORK ENVIRONMENT; IMMIGRANT WORKERS</em></p>  </em></p> Massachusetts Department of Public Health Occupational Health Surveillance Program [2010]. </strong>Asma e os produtos de limpeza no ambiente de trabalho, Boston, 2010.</strong> http://www.mass.gov/eohhs/docs/dph/occupational-health/asthma-cleaning-products-portuguese.pdf</p> CATEGORIES: IMMIGRANT WORKERS; RESPIRATORY</em></p>  </p> Pechter E, Azaroff LS, López I, Goldstein-Gelb M [2009]. Reducing hazardous cleaning product use: a collaborative effort. Public Health Rep 24(Suppl 1):45‒52.</strong></p> Abstract.</u> Workplace hazards affecting vulnerable populations of low-wage and immigrant workers present a special challenge to the practice of occupational health. Unions, Coalition for Occupational Safety and Health (COSH) groups, and other organizations have developed worker-led approaches to promoting safety. Public health practitioners can provide support for these efforts.</p> This article describes a successful multiyear project led by immigrant cleaning workers with their union, the Service Employees International Union (SEIU) Local 615, and with support from the Massachusetts COSH (MassCOSH) to address exposure to hazardous chemicals. After the union had identified key issues and built a strategy, the union and MassCOSH invited staff from the Massachusetts Department of Public Health’s Occupational Health Surveillance Program (OHSP) to provide technical information about health effects and preventive measures. Results included eliminating the most hazardous chemicals, reducing the number of products used, banning mixing products, and improving safety training. OHSP’s history of public health practice regarding cleaning products enabled staff to respond promptly. MassCOSH’s staff expertise and commitment to immigrant workers allowed it to play a vital role.</p> Vulnerable populations, including low-wage and immigrant workers, frequently work in the most hazardous environments and also have the fewest resources to address workplace dangers.1,2 As global economic and political forces move large numbers of immigrant workers into at-risk jobs, labor unions, Coalition for Occupational Safety and Health (COSH) groups, and workers’ centers have led creative efforts to combat occupational hazards. These methods involve workers as leaders in identifying priority hazards, health effects, and solutions, as well as building power to promote change.3–5</p> Public health practitioners and people with technical expertise can support these workers and their organizations by contributing to efforts to increase mutual support for labor and public health regarding issues that are important to everyone.6 This article describes a successful occupational health campaign led by janitors and their union with a COSH group, Massachusetts Department of Public Health (MDPH), and academics contributing valuable skills and information.</p> CATEGORIES: IMMIGRANT WORKERS; CHEMICAL HAZARDS</em></p>  </em></p> Pranski G, Moshenberg D, Benjamin K, Portillo S, Thackrey JL, Hill-Fotouhi C [2002]. Occupational risks and injuries in nonagricultural immigrant Latino workers. Am J Ind Med 42</em>(2):117–123</strong>. Abstract</u>: To investigate occupational health in urban immigrant Latino workers, a survey was conducted through door-to-door interviews. The response rate was 80% (n=427). The average time of residence in the United States was 7.6 years, and the average job tenure was 2.8 years. 27% of the respondents reported exposures to over 10 different hazards, and 18% believed these hazards had harmed their health. Only 31% had received job safety training. 55% had no workers’ compensation coverage. Among the 11% with a work injury in the past three years, 27% reported difficulty obtaining treatment, 91% lost time from work (median=13 days) and 29% had to change jobs because of the injury. The annual occupational injury rate was 12.2/100 full-time workers, compared to an expected rate of 7.1.</p> CATEGORIES: IMMIGRANT WORKERS; INJURIES</em></p>  </u></strong></p> Premji S, Krause N (2010). Disparities by ethnicity, language, and immigrant status in occupational health experiences among Las Vegas hotel room cleaners. Am J Ind Med 53:960-975. </strong>Abstract.</u> OBJECTIVE: We examined disparities in workers’ occupational health experiences. METHODS: We surveyed 941 unionized Las Vegas hotel room cleaners about their experiences with work-related pain and with employers, physicians, and workers’ compensation. Data were analyzed for all workers and by ethnicity, language, and immigrant status. RESULTS: Hispanic and English as second language (ESL) workers were more likely than their counterparts to report work-related pain and, along with immigrant workers, to miss work because of this pain. Hispanic, ESL, and immigrant workers were not consistently at a disadvantage with regard to their own responses to work-related pain but were so with respect to reported responses by workers’ compensation, physicians, and employers. CONCLUSIONS: There are indications of disparities in occupational health experiences within this job title. The use of different group classifications, while implying different mechanisms, produced similar results. CATEGORIES: HOTEL WORKERS; IMMIGRANT WORKERS: PAIN; HEALTH DISPARITIES</em></p>  </strong></p> Rasmussen CD, Jørgensen MB, Carneiro IG, Flyvholm MA, Olesen K, Søgaard K, Holtermann A [2012]. Participation of Danish and immigrant cleaners in a 1-year worksite intervention preventing physical deterioration. 55(2):256‒264.</strong></p> Abstract: </u>Worksite health promotion is seldom offered to workers who are low-educated and multi-ethnic, possibly due to an assumption that they are more reluctant to participate. Furthermore, little has been done to promote health at female-dominated workplaces. The main aim of this study was to investigate differences in participation among immigrant and Danish cleaners throughout a 1-year randomised controlled study tailored to cleaners and carried out in predominantly female workplaces. No significant differences in ethnicity were found in consent and participation throughout the 1-year intervention. Dropout was equally distributed among Danish and immigrant cleaners. This study indicates that a worksite health promotion intervention among a female-dominated, high-risk occupation such as cleaning can be equally appealing for Danes and immigrants. PRACTITIONER SUMMARY: This study provides insight about participation of Danish and immigrant cleaners in a worksite health promotion intervention in a predominantly female occupation. For attaining high participation and low dropout in future worksite health promotion interventions among cleaners, the intervention ought to not only target the ethnic background of the workers, but also to be specifically tailored to the job group.</p> CATEGORIES: ERGONOMICS; IMMIGRANT WORKERS</em></p>  </strong></p> Zarate-Abbott P, Etnyre A, Gilliland I, Mahon M, Allwein D, Cook J, Mikan V, Rauschhuber M, Sethness R, Munoz L, Lowry J, Jones ME. Workplace health promotion–strategies for low-income Hispanic immigrant women. Am Assoc Occup Health Nurs J 56</em>(5).</strong></p> Abstract</u>. Addressing health disparities for vulnerable populations in the United States is a national goal. Immigrant Hispanic women, at increased risk for heart disease, face obstacles in receiving adequate health care. Health promotion, especially for Hispanic women, is hindered by language, access to care, lack of insurance, and cultural factors. Innovative health education approaches are needed to reach this population. This article describes the development and evaluation of a culturally sensitive cardiac health education program based on findings from a study of 21 older immigrant Hispanic women employed as housekeepers at a small university in south Texas. Systolic and diastolic blood pressures had decreased 17 months after the intervention.</p> CATEGORIES: IMMIGRANT WORKERS; WOMEN’S HEALTH; INTERVENTION STRATEGIES</em></p>

Alamgir H, Yu S [2008]. Epidemiology of occupational injury among cleaners in the healthcare sector. Occup Med 58</em>(6):393–399.</strong></p> Abstract:</u> BACKGROUND: The cleaning profession has been associated with multiple ergonomic and chemical hazards which elevate the risk for occupational injury. AIMS: This study investigated the epidemiology of occupational injury among cleaners in healthcare work settings in the Canadian province of British Columbia. METHODS: Incidents of occupational injury among cleaners, resulting in lost time from work or medical care, over a period of 1 year in two healthcare regions were extracted from a standardized operational database and with person-years obtained from payroll data. Detailed analysis was conducted using Poisson regression modeling. RESULTS: A total of 145 injuries were identified among cleaners, with an annual incidence rate of 32.1 per 100 person-years. After adjustment for age, gender, subsector, facility, experience and employment status, Poisson regression models demonstrated that a significantly higher relative risk (RR) of all injury, musculoskeletal injury and cuts was associated with cleaning work in acute care facilities, compared with long-term care facilities. Female cleaners were at a higher RR of all injuries and contusions than male cleaners. A lower risk of all injury and allergy and irritation incidents among part-time or casual workers was found. Cleaners with >10 years of experience were at significantly lower risk for all injury, contusion and allergy and irritation incidents. CONCLUSION: Cleaners were found to be at an elevated risk of all injury categories compared with healthcare workers in general.</p> Tags: Healthcare cleaners; Injuries; MSDs; Dermal; Respiratory</em></p>  </em></p> Bell AF, Steele JR (2011). Risk of musculoskeletal injury among cleaners during vacuuming. Ergonomics:1-11.</strong> Abstract:</u> This study aimed to examine the risk of work-related upper-limb musculoskeletal disorders in cleaning workers during the work task of vacuuming. In total, 24 cleaning workers were observed while they performed vacuum cleaning tasks in the normal course of their employment in government schools, hospitality and commercial office space sectors. Risk of upper-limb musculoskeletal disorders were rated using three observational assessment tools: Manual Task Risk Assessment (ManTRA); Quick Exposure Check (QEC); the Rapid Upper Limb Assessment (RULA). Mean results (e.g. ManTRA wrist/hand cumulative wrist score 18.67 ± 1.27, QEC neck score 13 ± 1.77, RULA score 6.54 ± 0.509) demonstrated that cleaning workers who perform the task of vacuum cleaning are at risk of work-related upper-limb musculoskeletal injury, regardless of whether they use a back-pack or canister machine. Government school cleaners experienced greater risk of work-related upper-limb musculoskeletal disorders than workers in either the hospitality or commercial office space sectors. STATEMENT OF RELEVANCE: Cleaning workers in Australia are mostly female, ageing and of non-English-speaking backgrounds and involved in repetitive manual tasks. Their occupation is low status. This research confirms that vacuuming tasks are a risk for cleaning workers and highlights the need for further research to improve conditions for these workers. http://www.tandfonline.com/doi/full/10.1080/00140139.2011.592605</a> CATEGORIES: MSDs; WOMEN’S HEALTH; IMMIGRANT WORKERS; CUSTODIAL WORKERS; HOTEL WORKERS; INJURIES; ERGONOMICS</em></p> Bergqvist U, Wolgast E, Nilsson B, Voss M [1995]. </strong>Musculoskeletal disorders among visual display terminal workers: individual, ergonomic, and work organizational factors. Ergonomics 38</em>:763–776.</strong></p> Abstract.</u> A number of individual, ergonomic, and organizational factors of presumed importance for the occurrence of musculoskeletal disorders were investigated in a group of 260 visual display terminal (VDT) workers. The cross-sectional study utilized medical and workplace investigations as well as questionnaires. The results were subjected to a multivariate analysis in order to find the major factors associated with various upper-body muscular problems. Several such factors were identified for each investigated type of musculoskeletal problem. Some were related to the individual: age, gender, woman with children at home, use of spectacles, smoking, stomach-related stress reactions, and negative affectivity. Organizational variables of importance were opportunities for flexible rest breaks, extreme peer contacts, task flexibility, and overtime. Identified ergonomic variables were static work posture, hand position, use of lower arm support, repeated work movements, and keyboard or VDT vertical position.</p> CATEGORIES: MSDs; ERGONOMICS; WORK ENVIRONMENT</em></p>  </u></strong></p> Bongers PM, Kremer AM, ter Laak J [2002]. Are psychosocial factors, risk factors for symptoms and signs of the shoulder, elbow, or hand/wrist? A review of the epidemiological literature. Am J Ind Med 41</em>(5): 315</strong>–3</strong>42.</strong></p> Background In 1993, an extensive review on the role of psychosocial factors in the development of musculoskeletal problems was published by Bongers et al (1993). Since then, additional reviews on this topic have been published; however, none of these focused on upper limb problems. Methods In this systematic review, the methodological quality of all studies was assessed and levels of evidence were apriori defined. Results: The large majority of the studies reported an association between at least one work-related psychosocial factor and adverse upper extremity symptoms or signs. High perceived job stress was consistently associated with all upper extremity problems (UEP) in high and lower quality studies. Although not often studied, non-work-related stress was also consistently associated with UEP. In addition, there was some evidence for a relationship between high job demands and UEP, although the results did not meet the pre-set criterion for consistency. Conclusions High job stress and non-work-related stress reactions are consistently associated with UEP. In addition, high job demands is also in most studies associated with these disorders. Firm conclusions on the role of these factors in the etiology of UEP are not possible due to the cross-sectional nature of most studies. Am. J. Ind. Med. 41:315-342, 2002.</p> CATEGORIES: WORK STRESS; MSDs; REVIEW ARTICLES</em></p>  </u></strong></p> Susan Buchanan, Pamela Vossenas, Niklas Krause, Joan Moriarty, Eric Frumin, Jo Anna  Shimek, Franklin Mirer, Peter Orris, and Laura Punnett, (2009) Occupational Injury Disparities in the US Hotel Industry. Am. J. Ind. Med. (coming in January)</strong></p> Abstract</u>. 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.</p> KEY WORDS: occupational injury; hotel workers; housekeepers; musculoskeletal disorders; health disparities CATEGORIES: INJURIES; HOTEL WORKERS; MSDs</em></p>  </em></p> Cleaners mopped up by injuries [1999]. J Occup Health Safety Environ 3</em>(5):8</strong></p> Abstract:</u> Looks at the findings of a research report, “Musculoskeletal health of cleaners”, funded by the Health and Safety Executive (HSE) and the trade union UNISON. The results of a postal survey of 5,000 cleaning staff and follow-up ergonomic risk assessments indicate widespread musculoskeletal pain and discomfort often leading to time off work. The high risks of such pain have been associated with equipment design, job organization and poor training. HSE and UNISON will be holding a seminar for equipment manufacturers, employers and worker representatives in London on 28 September 1999, to review the study’s recommendations.</p> CATEGORIES: MSDs; INJURIES; PAIN; ERGONOMICS; WORK ENVIRONMENT</em></p>  </strong></p> Flores LY, Deal JZ (2003). Work-related pain in Mexican American custodial workers. Hispanic J Behavioral Sciences 25(2):254-270.</strong> Abstract:</u> Mexican American janitors and custodians are at risk for developing work-related musculoskeletal injuries. These injuries may render them physically disabled, unable to provide for themselves and their families, and dependent on an already strained public health care system. Despite this growing health crisis and the United States’s growing Latino population, no research has been published examining musculoskeletal pain among Mexican American custodial workers. In this article, the authors examine the working and social conditions of Mexican American service workers, as well as the reasons why there is so little research on this population. The authors present results from a study they conducted and discuss the implications of their findings for future research with this population. http://hjb.sagepub.com/content/25/2/254.full.pdf</a> CATEGORIES: CUSTODIAL WORKERS; IMMIGRANT WORKERS; MSDs; PAIN; INJURIES</em></p>  </p> Goggins R (2007). Hazards of cleaning strategies for reducing exposures to ergonomic risk factors. Professional Safety 52(3).</strong> Abstract:</u> Cleaning workers are found in every setting and the work that they do is essential in every industry. According to the Bureau of Labor Statistics (BLS, 2005), more than 4 million people are employed as cleaning workers in the U.S., many working in low-paying, temporary or part-time jobs, with little opportunity for training or advancement. Much of the work is performed in the evening or at night, and many of these workers also have another job, attend school or perform other duties during the day. These working conditions combine to create a high turnover rate—estimated to be as high as 300% (Valentine & C&MM Staff, 1998; SEIU, 2006). Cleaning work creates exposure to many hazards, including wet floors, working on ladders, use of chemicals and motor vehicle accidents. Cleaning workers also are exposed to risk factors for musculoskeletal disorders (MSDs), such as lifting, carrying, awkward postures, repetitive motions and high hand forces. These exposures result in a high rate of injuries. According to Washington state workers’ compensation data from the Department of Labor and Industries (DLI, 2006), cleaning workers have an annual incidence rate of 10.4 new injury claims per 100 full-time equivalents (FTEs), while the overall service industry sector in Washington has an incidence rate of 5.8 per 100 FTEs and the general industry incidence rate is 6.9 per 100 FTEs. By way of comparison, BLS (2005) reports a recordable injury incidence rate of 3.9 per 100 FTEs for janitorial services, which is less than the national incidence rate for all of private industry (4.6 per 100 FTEs). The large difference in numbers between Washington state and national injury rates may be explained by underreporting of injuries in BLS statistics (Leigh, Marcin & Miller, 2004). A review of Washington state workers’ compensation data (DLI, 2006) reveals that the largest single category of injury and illness claims among cleaning workers is overexertion, followed by struck by and against, and falls. Exposure to chemicals and motor vehicle accidents were also significant categories of interest (Figure 1, p. 22). Looking at severity of claims, overexertion and falls accounted for the most days of time loss, while many of the struck by and against claims appear to be of low severity, accounting for a relatively small percentage of all time loss days (Figure 2, p. 22). Overexertion claims, primarily MSDs, were reported as occurring in all phases of cleaning work, while many of the falls were reported as occurring while working on ladders, while sweeping or vacuuming stairs, or while mopping floors. Each phase of cleaning work presents unique risk factors for MSDs. Fortunately, much attention has been focused on MSDs in cleaning work and new technologies offer opportunities to reduce the risk of injury. This article reviews risk factors present in common cleaning tasks and describes some solutions. Risk factors and some potential solutions are summarized in (figure in paper) Dusting and Scrubbing. One risk factor introduced by dusting and scrubbing with cloths and brushes is awkward postures, especially reaching overhead, and bending, kneeling or squatting to clean at floor level. CATEGORIES: CUSTODIAL WORKERS; INJURIES; ERGONOMICS; MSDs</em></p> Health and Safety Executive [2003]. Caring for cleaners: guidance and case studies on how to prevent musculoskeletal disorders. London: HSE Books.</strong></p> CATEGORIES: MSDs</em></p>  </u></strong></p> Holtermann A, Blangsted AK, Christensen H, Hansen K, Søgaard K [2009]. What characterizes cleaners sustaining good musculoskeletal health after years with physically heavy work? Int Arch Occup Environ Health 82</em>(8):1015–1022.</strong></p> Abstract</u>. OBJECTIVES: The aim of this case-control study was to investigate characteristics of cleaners with good musculoskeletal health after years with physically heavy work. METHODS: One hundred and 41 female seniority cleaners participated. Twenty-five reported no musculoskeletal symptoms, whereas 83 reported severe symptoms in the low back, neck shoulders or upper limbs. The groups were of matching age, height, body weight and seniority (19 years). Muscular strength was recorded by isometric maximal voluntary contractions on a day without pain. Exposure to physical risk factors at work, psychosocial work factors, and leisure time physical activity were assessed by a postal questionnaire. RESULTS: Cleaners with good musculoskeletal health were not reporting different exposure to physical risk factors at work or leisure time physical activity, but had higher muscular strength and reported higher influence at work than cleaners with severe symptoms. CONCLUSIONS: These findings suggest that muscular strength and influence at work are of relevance for sustaining good musculoskeletal health in workers with physically heavy work.</p> CATEGORIES: MSDs; WORK STRESS; WOMEN’S HEALTH</em></p>  </u></strong></p> Kim JE, Moon DH (2010). Job characteristics and musculoskeletal symptom prevalence in hotel employees. Korean J Occup Health Nurs 19(2):190-204.</strong> Abstract:</u> PURPOSE: This study was conducted to obtain the fundamental data on prevention and management of musculoskeletal symptoms, and to assess the prevalence, risk factors and job characteristics of musculoskeletal symptoms in hotel employees. METHODS: The work sampling analysis was carried out by OWAS, and the prevalence was surveyed in term of NIOSH diagnostic criteria and work related risk factors on 263 hotel employees in Busan, Korea, using structured self-administered questionnaire from Jan. 20 to Feb. 26, 2010. The collected data were analysed by the SPSS 18.0. RESULTS: 1) The prevailing rate of musculoskeletal symptoms by NIOSH diagnostic criteria was 43.80% for total subjects and 27.91% for shoulders, 12.79% for neck, and 11.24% for back/waist, respectively. 2) Factors affecting the prevalence of musculoskeletal symptoms were examined and multivariate logistic regression analysis was performed. As a result, women, having a burden of musculoskeletal work, increased work time in case of a higher risk of the prevalence of musculoskeletal symptoms (P</p> Kumar R, Kumar S [2008]. Musculoskeletal risk factors in cleaning occupation – a literature review. Int J Ind Ergonomics 38</em>(2):158–170.</strong></p> Abstract</u>: The objective of this literature survey on risk factors of musculoskeletal disorders among cleaners was to identify recommended practices, problems, and unresolved issues. The most frequently-cited factors were found to be the high physical and psychosocial workloads. Recommended ergonomic interventions are summarized in a model to present a systematic overview, useful for research and practical applications.</p> CATEGORIES: REVIEW ARTICLES; MSDs</em></p>  </u></strong></p> Messing K (2004). Physical exposures in work commonly done by women. Can J Appl Physiol 29(5):639-656.</strong> Abstract.</u> The North American work force is still highly sex-segregated, with most members of each sex in jobs composed primarily of workers of the same sex. This division is accentuated when jobs involve physical demands. Women have traditionally been assigned to tasks whose physical demands are considered to be light. Nevertheless, these tasks can have biological effects, sometimes serious. Phenomena related to physical demands of women’s work can be considered in three categories: (a) musculoskeletal and cardiovascular demands of tasks often assigned to women in factories and service work; (b) sex- and gender-specific effects of toxic substances found in the workplace; and (c) interactions between work and the domestic responsibilities of many women. These phenomena are described, using examples recently gathered from workplaces. Effects of biological sex are distinguished, as far as possible, from effects of gender (social roles). CATEGORIES: WOMEN’S HEALTH; MSDs; CVD; CHEMICAL HAZARDS</em></p> Messing K, Vezina N, Major M, Ouellet S, Tissot F, Couture V, Riel J (2008). Body maps: an indicator of physical pain for worker-oriented ergonomics interventions. Policy Practice in Health and Safety 2:31-49. </strong>Abstract.</u> Work-related musculoskeletal health damage causes pain and suffering, and can lead to disability. To prevent it, it is important to detect not only diagnosed musculoskeletal disorders but also early signs of impending damage. Workers have important information on workplace risks and health damage, and should be involved in the process of identifying damage. However, controversy surrounds the pain reports of workers and their claims for compensation. We have found that a body map is a useful tool for systematising and analysing workers’ pain reports. CATEGORIES: MSDs; PAIN; ERGONOMICS; INTERVENTION STRATEGIES</em></p> Nordander C, Ohlsson K, Åkesson I, Arvidsson I, Balogh I, Hansson G, Skerfving S (2009). Risk of musculoskeletal disorders among females and males in repetitive/constrained work. Ergonomics 52(10):1226-1239.</strong> Abstract</u>. This paper combines epidemiological data on musculoskeletal morbidity in 40 female and 15 male occupational groups (questionnaire data 3720 females, 1241 males, physical examination data 1762 females, 915 males) in order to calculate risk for neck and upper limb disorders in repetitive/constrained vs. varied/mobile work and further to compare prevalence among office, industrial and non-office/non-industrial settings, as well as among jobs within these. Further, the paper aims to compare the risk of musculoskeletal disorders from repetitive/constrained work between females and males. Prevalence ratios (PR) for repetitive/constrained vs. varied/mobile work were in neck/shoulders: 12-month complaints females 1.2, males 1.1, diagnoses at the physical examination 2.3 and 2.3. In elbows/hands PRs for complaints were 1.7 and 1.6, for diagnoses 3.0 and 3.4. Tension neck syndrome, cervicalgia, shoulder tendonitis, acromioclavicular syndrome, medial epicondylitis and carpal tunnel syndrome showed PRs > 2. In neck/shoulders PRs were similar across office, industrial and non-office/non-industrial settings, in elbows/hands, especially among males, somewhat higher in industrial work. There was a heterogeneity within the different settings (estimated by bootstrapping), indicating higher PRs for some groups. As in most studies, musculoskeletal disorders were more prevalent among females than among males. Interestingly, though, the PRs for repetitive/constrained work vs. varied/mobile were for most measures approximately the same for both genders. In conclusion, repetitive/constrained work showed elevated risks when compared to varied/mobile work in all settings. Females and males showed similar risk elevations. This article enables comparison of risk of musculoskeletal disorders among many different occupations in industrial, office and other settings, when using standardised case definitions. It confirms that repetitive/constrained work is harmful not only in industrial but also in office and non-office/non-industrial settings. The reported data can be used for comparison with future studies. CATEGORIES: MSDs; ERGONOMICS</em></p> Skov T, Borg V, Orhede E [1996]. </strong>Psychosocial and physical risk factors for musculoskeletal disorders of the neck, shoulders, and lower back in salespeople. Occup Environ Med 53</em>:351–356.</strong></p> CATEGORIES: WORK STRESS; MSDs</em></p>

Burgel BJ, White MC, Gillen MG, Krause N (2010). Psychosocial work factors and shoulder pain in hotel room cleaners. Am J Ind Med 53:743-756. </strong>Abstract</u>: BACKGROUND: Hotel room cleaners have physically demanding jobs that place them at high risk for shoulder pain. Psychosocial work factors may also play a role in shoulder pain, but their independent role has not been studied in this group. METHODS: Seventy-four percent (941 of 1,276) of hotel room cleaners from five Las Vegas hotels completed a 29-page survey assessing health status, working conditions, and psychosocial work factors. For this study, 493 of the 941 (52%) with complete data for 21 variables were included in multivariate logistic regression analyses. RESULTS: Fifty-six percent reported shoulder pain in the prior four weeks. Room cleaners with effort-reward imbalance (ERI) were three times as likely to report shoulder pain (OR 2.99, 95% CI 1.95-4.59, P = 0.000) even after adjustment for physical workload and other factors. After adjustment for physical workload, job strain and iso-strain were not significantly associated with shoulder pain. CONCLUSIONS: ERI is independently associated with shoulder pain in hotel room cleaners even after adjustment for physical workload and other risk factors. CATEGORIES: HOTEL WORKERS; PAIN; WORK ENVIRONMENT</em></p> Cleaners mopped up by injuries [1999]. J Occup Health Safety Environ 3</em>(5):8</strong></p> Abstract:</u> Looks at the findings of a research report, “Musculoskeletal health of cleaners”, funded by the Health and Safety Executive (HSE) and the trade union UNISON. The results of a postal survey of 5,000 cleaning staff and follow-up ergonomic risk assessments indicate widespread musculoskeletal pain and discomfort often leading to time off work. The high risks of such pain have been associated with equipment design, job organization and poor training. HSE and UNISON will be holding a seminar for equipment manufacturers, employers and worker representatives in London on 28 September 1999, to review the study’s recommendations.</p> CATEGORIES: MSDs; INJURIES; PAIN; ERGONOMICS; WORK ENVIRONMENT</em></p>  </u></strong></p> Davis K [2000]. The relationship between psychosocial work characteristics and low back pain: underlying methodological issues. Clin Biomech 15</em>(6):389</strong>–</strong>406.</strong></p> Abstract</u>. BACKGROUND. Psychosocial work characteristics have been widely evaluated as potential risk factors for low back injury. However, studies with different study populations and using various types of measures have had conflicting results.</p> METHODS. This review is the most extensive to date, reviewing 66 articles that have provided empirical evidence about the relationship between psychosocial work characteristics and initial reporting of lower back pain. The studies are reviewed with an emphasis on certain methodological issues: controlling for potential confounding; timing of the data collection; and measurement of the exposures and outcomes.</p> RESULTS. The results of this review suggest that controlling for potential confounding from occupational biomechanical demands had a large influence on the associations found between psychosocial work characteristics and lower back pain. In addition, the use of accurate and reliable measures for the occupational exposures (biomechanical and psychosocial) and the lower back pain outcomes appears to influence the strength of the associations found between psychosocial work characteristics and lower back pain. CONCLUSION. Given the methodological concerns discussed in this review, it is difficult to draw strong causal inferences from this literature. However, it does appear that psychosocial characteristics are related to some lower back pain outcomes, and that employees’ reactions to psychosocial work characteristics (e.g., job dissatisfaction and job stress) are more consistently related to lower back pain than are the psychosocial work characteristics themselves (e.g., work overload, lack of influence over work, quality of relationships with coworkers).Relevance: This review attempts to identify and address methodological issues in the literature evaluating the relationship between psychosocial work characteristics and lower back pain. Implications for future research are presented.</p> CATEGORIES: REVIEW ARTICLES; WORK STRESS; PAIN</em></p>  </p> Esbenshade J, Mitrosky M, Morgan E, Navarro M, Rotundi M, Vazquez C 92006). </strong>Profits, pain, and pillows: hotels and housekeepers in San Diego. WorkingUSA: The Jounal of Labor and Society 9:265-292.</strong> Abstract:</u> The accommodations industry is hitting record-breaking profits nationally and locally, often with subsidies provided by government entities. Globalization is actually contributing to rising employment and a trade surplus in the tourism industry. However, increasing amenities and new work regimes are causing deteriorating conditions for many workers. In 2006, hotel workers across the country will be coordinating contract negotiations. Housekeepers, who make up almost a quarter of the hotel workforce, are the “face” of the national campaign. Through management interviews, analysis of government data, and a worker survey, this article provides a more complete picture of the living and working conditions of housekeepers in San Diego and nationally. http://onlinelibrary.wiley.com/doi/10.1111/j.1743-4580.2006.00113.x/full</a> CATEGORIES: HOTEL WORKERS; WORK ENVIRONMENT; PAIN</em></p> Flores LY, Deal JZ (2003). Work-related pain in Mexican American custodial workers. Hispanic J Behavioral Sciences 25(2):254-270.</strong> Abstract:</u> Mexican American janitors and custodians are at risk for developing work-related musculoskeletal injuries. These injuries may render them physically disabled, unable to provide for themselves and their families, and dependent on an already strained public health care system. Despite this growing health crisis and the United States’s growing Latino population, no research has been published examining musculoskeletal pain among Mexican American custodial workers. In this article, the authors examine the working and social conditions of Mexican American service workers, as well as the reasons why there is so little research on this population. The authors present results from a study they conducted and discuss the implications of their findings for future research with this population. http://hjb.sagepub.com/content/25/2/254.full.pdf</a> CATEGORIES: CUSTODIAL WORKERS; IMMIGRANT WORKERS; MSDs; PAIN; INJURIES</em></p> Krause N, Scherzer T, Rugulies R [2005]. Physical workload, work intensification, and prevalence of pain in low wage workers: results from a participatory research project with hotel room cleaners in Las Vegas. Am J Ind Med 48</em>(5):326–337.</strong></p> Abstract</u>. BACKGROUND: Occupational injury rates among hotel workers exceed the national service sector average. This study assesses the prevalence of back and neck pain, and its associations with physical workload, ergonomic problems, and increasing work demands. METHODS: Nine hundred forty-one unionized hotel room cleaners completed a survey about health and working conditions. Associations between job demands and pain were determined by logistic regression models adjusting for individual characteristics, cumulative work demands, care-taking responsibilities at home, and psychosocial job factors. RESULTS: The 1-month prevalence of severe bodily pain was 47% in general, 43% for neck, 59% for upper back, and 63% for low back pain. Workers in the highest exposure quartiles for physical workload and ergonomic problems were between 3.24 and 5.42 times more likely to report severe pain than workers in the lowest quartile. Adjusted odds ratios for work intensification ranged from 1.74 (upper back) to 2.33 (neck). CONCLUSIONS: Most room cleaners experience severe back or neck pain. Severe pain showed strong associations with physical workload, work intensification, and ergonomic problems.</p> CATEGORIES: HOTEL WORKERS; WORK ENVIRONMENT; PAIN</em></p>  </u></strong></p> Liladrie S (2010). “Do not disturb/please clean room”: hotel housekeepers in Greater Toronto. Race & Class 52(1):57-69.</strong> Abstract</u>. </strong>This study of the experiences of hotel housekeepers in Toronto, who are predominantly immigrant women of colour, reveals the damaging health impact of their work. As the hotel industry in this ‘global city’ has moved upmarket and sought to offer more luxury services to its wealthy customers, hotel housekeeping work has become more physically demanding and burdensome, resulting in the majority of workers experiencing a high degree of pains and injuries. The hotel industry is seen as operating a racialised division of labour, with those at the bottom vulnerable to being discarded as they approach retirement age and their health deteriorates. Finally, an account is given of the impact of unionisation and the hotel workers’ ongoing struggles for change. http://rac.sagepub.com/content/52/1/57.full.pdf+html</a> CATEGORIES: HOTEL WORKERS; WOMEN’S HEALTH; PAIN; INJURIES; WORK ENVIRONMENT; IMMIGRANT WORKERS</em></p>  </p> Landstad BJ, Ekholm J, Broman L, Schüldt K [2000].Working environmental conditions as experienced by women working despite pain. Work 15</em>(3):141–152.</strong></p> Abstract</u>. OBJECTIVE: This study looked at female hospital cleaners and home help personnel who continued working despite problems or pain in their musculoskeletal system and where there was a risk of increase in sickness absence. The aim was to determine whether supportive intervention for these personnel at the workplace had an effect on the way that they experienced the physical and psychosocial aspects of their working environments. METHODS: The design was prospective with non-randomized intervention and reference groups. A selection of 55 questions about physical and psychosocial working environment from a national survey were used. Comparisons were made between intervention and reference groups and with data on a selection of the Swedish population of people in these professions. RESULTS: The results showed that in the hospital cleaners’ intervention group the introduction of new cleaning materials and new cleaning methods seemed to contribute to a reduction in workload during the intervention period, which in turn gave them a better chance of taking rest breaks during working time. In the home helps’ intervention group the results showed that the group had had a reduction both in workload and in more responsible tasks, and at the same time the psychosomatic stress reactions reduced after the intervention. CONCLUSIONS: The results indicate that effects on the working environmental conditions as experienced could be obtained by a general multi-component support program at the workplace, but the number of variables influenced by the program was very small. The relatively limited effects may be explained by the fact that the impact of a support program depends on how well the remedial measures fulfill the need for such measures either at the workplace, in a work group or among the individual people at the workplace. This emphasizes the importance of designing effective analysis tools for judging what remedial measures are needed before the measures themselves are tried out.</p> CATEGORIES: PAIN; WOMEN’S HEALTH; HOSPITAL WORKERS</em></p>  </u></strong></p> Messing K, Vezina N, Major M, Ouellet S, Tissot F, Couture V, Riel J (2008). Body maps: an indicator of physical pain for worker-oriented ergonomics interventions. Policy Practice in Health and Safety 2:31-49. </strong>Abstract.</u> Work-related musculoskeletal health damage causes pain and suffering, and can lead to disability. To prevent it, it is important to detect not only diagnosed musculoskeletal disorders but also early signs of impending damage. Workers have important information on workplace risks and health damage, and should be involved in the process of identifying damage. However, controversy surrounds the pain reports of workers and their claims for compensation. We have found that a body map is a useful tool for systematising and analysing workers’ pain reports. CATEGORIES: MSDs; PAIN; ERGONOMICS; INTERVENTION STRATEGIES</em></p> Premji S, Krause N (2010). Disparities by ethnicity, language, and immigrant status in occupational health experiences among Las Vegas hotel room cleaners. Am J Ind Med 53:960-975. </strong>Abstract.</u> OBJECTIVE: We examined disparities in workers’ occupational health experiences. METHODS: We surveyed 941 unionized Las Vegas hotel room cleaners about their experiences with work-related pain and with employers, physicians, and workers’ compensation. Data were analyzed for all workers and by ethnicity, language, and immigrant status. RESULTS: Hispanic and English as second language (ESL) workers were more likely than their counterparts to report work-related pain and, along with immigrant workers, to miss work because of this pain. Hispanic, ESL, and immigrant workers were not consistently at a disadvantage with regard to their own responses to work-related pain but were so with respect to reported responses by workers’ compensation, physicians, and employers. CONCLUSIONS: There are indications of disparities in occupational health experiences within this job title. The use of different group classifications, while implying different mechanisms, produced similar results. CATEGORIES: HOTEL WORKERS; IMMIGRANT WORKERS: PAIN; HEALTH DISPARITIES</em></p> Scherzer T, Rugulies R, Krause N [2005]. Work-related pain and injury and barriers to workers’ compensation among Las Vegas hotel room cleaners. Am J Public Health 95</em>(3):483–488.</strong></p> Abstract</u>. OBJECTIVES: We examined the prevalence of work-related pain and injury and explored barriers to and experiences of reporting among workers. METHODS: We surveyed 941 unionized hotel room cleaners about work-related pain, injury, disability, and reporting. RESULTS: During the past 12 months, 75% of workers in our study experienced work-related pain, and 31% reported it to management; 20% filed claims for workers’ compensation as a result of work-related injury, and 35% of their claims were denied. Barriers to reporting injury included “It would be too much trouble” (43%), “I was afraid” (26%), and “I didn’t know how” (18%). An estimated 69% of medical costs were shifted from employers to workers.  CONCLUSIONS: The reasons for underreporting and the extent of claim denial warrant further investigation. Implications for worker health and the precise quantification of shifting costs to workers also should be addressed.</p> CATEGORIES: INJURIES; PAIN; HOTEL WORKERS</em></p>  </em></p> UNITEHERE! [2006]. Creating luxury, enduring pain: how hotel work is hurting housekeepers. April.</strong></p> CATEGORIES: HOTEL WORKERS; PAIN</em></p>

Alamgir H, Yu S [2008]. Epidemiology of occupational injury among cleaners in the healthcare sector. Occup Med 58</em>(6):393–399.</strong></p> Abstract:</u> BACKGROUND: The cleaning profession has been associated with multiple ergonomic and chemical hazards which elevate the risk for occupational injury. AIMS: This study investigated the epidemiology of occupational injury among cleaners in healthcare work settings in the Canadian province of British Columbia. METHODS: Incidents of occupational injury among cleaners, resulting in lost time from work or medical care, over a period of 1 year in two healthcare regions were extracted from a standardized operational database and with person-years obtained from payroll data. Detailed analysis was conducted using Poisson regression modeling. RESULTS: A total of 145 injuries were identified among cleaners, with an annual incidence rate of 32.1 per 100 person-years. After adjustment for age, gender, subsector, facility, experience and employment status, Poisson regression models demonstrated that a significantly higher relative risk (RR) of all injury, musculoskeletal injury and cuts was associated with cleaning work in acute care facilities, compared with long-term care facilities. Female cleaners were at a higher RR of all injuries and contusions than male cleaners. A lower risk of all injury and allergy and irritation incidents among part-time or casual workers was found. Cleaners with >10 years of experience were at significantly lower risk for all injury, contusion and allergy and irritation incidents. CONCLUSION: Cleaners were found to be at an elevated risk of all injury categories compared with healthcare workers in general.</p> CATEGORIES: HOSPITAL WORKERS; INJURIES; MSDs; DERMAL; RESPIRATORY</em></p>  </u></strong></p> Arif AA, Delclos GL, Whitehead LW, Tortolero SR, Lee ES [2003]. </strong>Occupational exposures associated with work-related asthma and work-related wheezing among U.S. workers. Am J Ind Med 44</em>(4):368–376.</strong></p> Abstract:</u> National estimates of occupational asthma (OA) in the United States are sparse. Using data from the Third National Health and Nutrition Examination Survey (NHANES III) 1988-1994, associations between occupation and work-related asthma and work-related wheezing among U.S. workers were analyzed. This study identified several occupations that were at risk of developing work-related asthma and/or wheezing, with cleaners and equipment cleaners showing the highest risks. Other major occupations identified were farm and agriculture; entertainment; protective services; construction; mechanics and repairers; textile; fabricators and assemblers; other transportation and material moving occupations; freight, stock, and material movers; and motor vehicle operators. The population attributable risks for work-related asthma and work-related wheezing were 26% and 27%, respectively. This study adds evidence to the literature that identifies work-related asthma as an important public health problem. Several occupations are targeted for additional evaluation and study. Of particular interest are cleaners, which are being increasingly reported as a risk group for asthma. Future intervention strategies need to be developed for effective control and prevention of asthma in the workplace.</p> CATEGORIES: RESPIRATORY</em></p>  </u></strong></p> Bello A, Quinn MM, Perry MJ, Milton DK [2009]. Characterization of occupational exposures to cleaning products used for common cleaning tasks―a pilot study of hospital cleaners. Environ Health Mar 27</em>(8):11.</strong></p> Abstract.</u> BACKGROUND: In recent years, cleaning has been identified as an occupational risk because of an increased incidence of reported respiratory effects, such as asthma and asthma-like symptoms among cleaning workers. Due to the lack of systematic occupational hygiene analyses and workplace exposure data, it is not clear which cleaning-related exposures induce or aggravate asthma and other respiratory effects. Currently, there is a need for systematic evaluation of cleaning products ingredients and their exposures in the workplace. The objectives of this work were to: a) identify cleaning products’ ingredients of concern with respect to respiratory and skin irritation and sensitization; and b) assess the potential for inhalation and dermal exposures to these ingredients during common cleaning tasks. METHODS: We prioritized ingredients of concern in cleaning products commonly used in several hospitals in Massachusetts. Methods included workplace interviews, reviews of product Materials Safety Data Sheets and the scientific literature on adverse health effects to humans, reviews of physico-chemical properties of cleaning ingredients, and occupational hygiene observational analyses. Furthermore, the potential for exposure in the workplace was assessed by conducting qualitative assessment of airborne exposures and semi-quantitative assessment of dermal exposures. RESULTS: Cleaning products used for common cleaning tasks were mixtures of many chemicals, including respiratory and dermal irritants and sensitizers. Examples of ingredients of concern include quaternary ammonium compounds, 2-butoxyethanol, and ethanolamines. Cleaning workers are at risk of acute and chronic inhalation exposures to volatile organic compounds (VOC) vapors and aerosols generated from product spraying, and dermal exposures mostly through hands. CONCLUSION: Cleaning products are mixtures of many chemical ingredients that may impact workers’ health through air and dermal exposures. Because cleaning exposures are a function of product formulations and product application procedures, a combination of product evaluation with workplace exposure assessment is critical in developing strategies for protecting workers from cleaning hazards. Our task based assessment methods allowed classification of tasks in different exposure categories, a strategy that can be employed by epidemiological investigations related to cleaning. The methods presented here can be used by occupational and environmental health practitioners to identify intervention strategies.</p> CATEGORIES: CHEMICAL HAZARDS; RESPIRATORY; HOSPITAL WORKERS</em></p>  </em></p> Bello A, Quinn MM, Perry MJ, Milton DK [2010]. Quantitative assessment of airborne exposures generated during common cleaning tasks: a pilot study.</strong> Environ Health 30(9):76. http://www.ehjournal.net/content/9/1/76</p> CATEGORIES: RESPIRATORY</em></p>  </em></p>  </em></p> Bello A, Quinn MM, Milton DK, Perry MJ [2013]. Determinants of exposure to 2-butoxyethanol from cleaning tasks: a quasi-experimental study. Ann Occup Hyg. 57(1):125‒135.</strong></p> Abstract. </u>BACKGROUND: The quantitative assessment of airborne cleaning exposures requires numerous measurement methods, which are costly and difficult to apply in the workplace. Exposure determinants can be used to predict exposures but have yet to be investigated for cleaning activities. We identified determinants of exposure to 2-butoxyethanol (2-BE), a known respiratory irritant and suspected human carcinogen, commonly found in cleaning products. In addition, we investigated whether 2-BE exposures can be predicted from exposure determinants and total volatile organic compounds (TVOCs) measured with direct reading methods, which are easier to apply in field investigations. METHODS: Exposure determinants were studied in a quasi-experimental study design. Cleaning tasks were performed similarly as in the workplace, but potential factors that can impact exposures were controlled. Simultaneously for each task, we measured concentrations of (1) 2-BE according to the National Institute for Occupational Health and Safety 1430 method and (2) TVOC with photoionization detectors (PIDs). Simple and multiple linear regression analyses were performed to identify 2-BE exposure determinants and to develop exposure prediction models. RESULTS: Significant determinants from univariate analyses consisted of product type, tasks performed, room volume, and ventilation. The best-fit multivariable model was the one comprised of product type, tasks performed, 2-BE product concentration, room volume, and ventilation (R(2) = 77%). We found a strong correlation between the 2-BE and the TVOC concentrations recorded by the PID instruments. A multivariable model with TVOC explained a significant portion of the 2-BE concentrations (R(2) = 72%) when product type and room ventilation were included in the model.</p> CONCLUSIONS: Our results suggest that quantitative exposure assessment for an epidemiologic investigation of cleaning health effects may be feasible even without performing integrated sampling and analytic measurements.</p> CATEGORIES: CANCER; CHEMICAL HAZARDS; RESPIRATORY</em></p>  </em></p> Bernstein JA, Brandt D, Rezvani M, Abbott C, Levin L [2009]. Evaluation of cleaning activities on respiratory symptoms in asthmatic female homemakers. Ann Allergy Asthma Immunol 102(1):41‒46.</strong></p> Abstract </u>BACKGROUND: Asthma among professional cleaners is recognized as a common cause of new-onset and aggravated occupational asthma. Women are usually the primary persons responsible for cleaning their homes, but little information is available regarding the health impact of cleaning in the nonoccupational setting. OBJECTIVES: To compare health effects of cleaning among asthmatic and nonasthmatic women who are the primary cleaners in their homes. METHODS: A 12-week, prospective, parallel-group study assessing the effects of cleaning on peak expiratory flow rates and upper and lower respiratory tract symptoms in women with and without asthma. RESULTS: Twenty-five women with asthma and 19 without asthma, ages 18 to 65 years, completed the study. No effect was observed on peak expiratory flow rates after cleaning between groups. Upper respiratory tract symptoms increased after cleaning for both groups, adjusted for chemical severity exposure index and duration of cleaning. However, the change in the number of lower respiratory tract symptoms (after cleaning minus before cleaning) was statistically significant for asthmatic patients compared with nonasthmatic patients (P = .01). CONCLUSIONS: The study suggests that cleaning activities are associated with increased lower respiratory tract symptoms in asthmatic patients independent of chemical severity exposure index and cleaning duration. Women with asthma should be routinely interviewed as to whether they clean their home and cautioned about the potential respiratory health effects of these activities.</p> CATEGORIES: RESPIRATORY</em></p> Boulet LP, Lemière C, Gautrin D, Cartier A [2007]. New insights into occupational asthma. Curr Opin Allergy Clin Immunol 7</em>(1):96‒101.</strong></p> Abstract PURPOSE OF REVIEW: To examine recent publications on the types of agents involved in occupational asthma, the mechanisms by which they induce asthma, and how best to evaluate and treat workers suspected of this respiratory condition. RECENT FINDINGS: High rates of occupational asthma and inhalation accidents were found in workers in crafts and related occupations in the manufacturing industries, and in plant and machine operatives; cleaners and construction workers may also be at risk. Further data support a role for CD4 T cells in low-molecular-weight agent-induced asthma, such as with isocyanates, and neurogenic mechanisms may also be involved. The use of noninvasive measures of airway inflammation in the diagnosis and management of occupational asthma such as sputum eosinophils monitoring is promising, although this is less obvious for exhaled nitric oxide. Finally, the persistence of troublesome asthma even after withdrawal from relevant exposure has been re-emphasized and surveillance programs have been proposed. SUMMARY: Further data have been gathered on the prevalence of occupational asthma in various working populations, its mechanisms of development, the contribution of noninvasive measures of airway inflammation in the diagnosis and management of this condition, and its management and prevention.</p> CATEGORIES: RESPIRATORY; CUSTODIAL WORKERS</em></p>  </em></p> Charles LE, Loomis D, Demissie Z [2009]. Occupational hazards experienced by cleaning workers and janitors: a review of the epidemiologic literature. Work 34(1):105‒116.</strong></p> Abstract: </u>Building cleaners are an important group of workers who experience diverse occupational hazards resulting in health problems. A review of epidemiologic studies conducted between 1981 and 2005 was performed using PubMed and PsychLit, to identify health outcomes and the associated hazards in the work environment of cleaners. Among 35 studies, respiratory diseases (n=17) and dermatologic diseases (n=9) were the most common and were associated with exposure to cleaning agents, wet work, and rubber latex. The potential for infectious diseases (n=3) was identified among cleaners in medical laboratories and was associated with exposure to broken glass and uncapped needles in the trash. Musculoskeletal disorders (n=5) were associated with several physical stressors (e.g., awkward postures, prolonged standing) and psychosocial stressors (e.g., monotonous job, low potential for promotion). Mental disorders (n=1) were also associated with psychosocial stressors and societal stigma. Future studies may be enhanced by better assessment of the specific job exposures of cleaners and implementation of a prospective design.</p> CATEGORIES: CUSTODIAL WORKERS; ERGONOMICS; CHEMICAL HAZARDS; WORK STRESS; REVIEW ARTICLES; RESPIRATORY</em></p>  </em></p> de Fátima Maçãira E, Algranti E, Medina Coeli Mendonça E, Antônio Bussacos M [2007]. </strong>Rhinitis and asthma symptoms in non-domestic cleaners from the Sao Paulo metropolitan area, Brazil. Occup Environ Med 64(7):446‒453.</strong></p> Abstract. </u>BACKGROUND: Exposure to cleaning products has frequently been reported as a symptom trigger by workers with work-related asthma diagnosed in workers’ health clinics in the city of São Paulo, Brazil. OBJECTIVES: To estimate rhinitis and asthma symptoms prevalence and to analyse associated risk factors. METHOD: A respiratory symptoms questionnaire (Medical Research Council 1976) and the International Study of Asthma and Allergies in Childhood questionnaire were applied to 341 cleaners working in the city of São Paulo, along with obtaining full occupational histories, skin prick tests and spirometry. Timing their symptoms onset in relation to occupational history allowed estimation of work-related asthma and/or rhinitis. Risk factors related to selected outcomes were analysed by logistic regression. RESULTS: 11% and 35% of the cleaners had asthma and rhinitis, respectively. The risk of work-related asthma/rhinitis increased with years of employment in non-domestic cleaning (OR 1.09, 95% CI 1.00 to 1.18, >0.92-3 years; OR 1.28, 95% CI 1.01 to 1.63, >3-6.5 years; OR 1.71, 95% CI 1.02 to 2.89, >6.5 years). Atopy was associated with asthma and rhinitis (OR 2.91, 95% CI 1.36 to 6.71; OR 2.06, 95% CI 1.28 to 3.35, respectively). There was a higher risk of rhinitis in women (OR 2.07, 95% CI 1.20 to 3.70). CONCLUSIONS: Cleaning workers are at risk of contracting work-related asthma and/or rhinitis, and the risk increases with years of employment in non-domestic cleaning. Women present higher risk of rhinitis than men.</p> CATEGORIES: RESPIRATORY; CUSTODIAL WORKERS</em></p>  </em></p> Earnest CM, Corsi RL [2013]. Inhalation exposure to cleaning products: application of a two-zone model. J Occup Environ Hyg 10(6):328‒335.</strong></p> Abstract: </u>In this study, modifications were made to previously applied two-zone models to address important factors that can affect exposures during cleaning tasks. Specifically, we expand on previous applications of the two-zone model by (1) introducing the source in discrete elements (source-cells) as opposed to a complete instantaneous release, (2) placing source cells in both the inner (near person) and outer zones concurrently, (3) treating each source cell as an independent mixture of multiple constituents, and (4) tracking the time-varying liquid concentration and emission rate of each constituent in each source cell. Three experiments were performed in an environmentally controlled chamber with a thermal mannequin and a simplified pure chemical source to simulate emissions from a cleaning product. Gas phase concentration measurements were taken in the bulk air and in the breathing zone of the mannequin to evaluate the model. The mean ratio of the integrated concentration in the mannequin’s breathing zone to the concentration in the outer zone was 4.3 (standard deviation, σ = 1.6). The mean ratio of measured concentration in the breathing zone to predicted concentrations in the inner zone was 0.81 (σ = 0.16). Intake fractions ranged from 1.9 × 10(-3) to 2.7 × 10(-3). Model results reasonably predict those of previous exposure monitoring studies and indicate the inadequacy of well-mixed single-zone model applications for some but not all cleaning events.</p> CATEGORIES: RESPIRATORY</em></p>  </u></strong></p> Kogevinas M, Zock JP, Jarvis D, Kromhout H, Lillienberg L, Plana E, et al. [2007]. Exposure to substances in the workplace and new-onset asthma: an international prospective population-based study (ECRHS-II). Lancet 370(9584):336‒341.</strong></p> Abstract. </u>BACKGROUND: The role of exposure to substances in the workplace in new-onset asthma is not well characterised in population-based studies. We therefore aimed to estimate the relative and attributable risks of new-onset asthma in relation to occupations, work-related exposures, and inhalation accidents. METHODS: We studied prospectively 6837 participants from 13 countries who previously took part in the European Community Respiratory Health Survey (1990-95) and did not report respiratory symptoms or a history of asthma at the time of the first study. Asthma was assessed by methacholine challenge test and by questionnaire data on asthma symptoms. Exposures were defined by high-risk occupations, an asthma-specific job exposure matrix with additional expert judgment, and through self-report of acute inhalation events. Relative risks for new onset asthma were calculated with log-binomial models adjusted for age, sex, smoking, and study centre. FINDINGS: A significant excess asthma risk was seen after exposure to substances known to cause occupational asthma (Relative risk=1.6, 95% CI 1.1-2.3, p=0.017). Risks were highest for asthma defined by bronchial hyper-reactivity in addition to symptoms (2.4, 1.3-4.6, p=0.008). Of common occupations, a significant excess risk of asthma was seen for nursing (2.2, 1.3-4.0, p=0.007). Asthma risk was also increased in participants who reported an acute symptomatic inhalation event such as fire, mixing cleaning products, or chemical spills (RR=3.3, 95% CI 1.0-11.1, p=0.051). The population-attributable risk for adult asthma due to occupational exposures ranged from 10% to 25%, equivalent to an incidence of new-onset occupational asthma of 250-300 cases per million people per year.</p> INTERPRETATION: Occupational exposures account for a substantial proportion of adult asthma incidence. The increased risk of asthma after inhalation accidents suggests that workers who have such accidents should be monitored closely.</p> CATEGORIES: RESPIRATORY</em></p>  </u></strong></p> Laborde-Castérot H</strong></a>, </strong>Villa AF</strong></a>, </strong>Rosenberg N</strong></a>, </strong>Dupont P</strong></a>, </strong>Lee HM</strong></a>, </strong>Garnier R</strong></a> [2012]. Occupational rhinitis and asthma due to EDTA-containing detergents or disinfectants. </strong>Am J Ind Med.</strong></a> 55</em>(8):677‒682.</strong></p> Abstract. </u>BACKGROUND: Detergents and disinfectants are an emerging cause of work-related rhinitis and asthma. These products may contain ethylenediamine tetraacetic acid (EDTA). The authors report 10 cases of EDTA-related asthma and/or rhinitis. METHODS: Review of the medical charts of patients who presented with work-related rhinitis (alone or with asthma), with a history of exposure to aerosols of EDTA-containing products and who underwent a nasal provocation test (NPT) with tetrasodium EDTA (1-4%) in our occupational health unit. RESULTS: Twenty-eight patients underwent a NPT with EDTA, which was positive in 10 cases. These patients, mostly cleaners or healthcare workers, used spray formulations of cleaning products.</p> CONCLUSIONS: This case series is the first report of EDTA-related respiratory disease, documented by a specific test. An irritant mechanism is unlikely. Further studies are required to distinguish between an immunoallergic response and a pharmacological mechanism possibly resulting from calcium chelation, as suggested by animal experiments. A ban of spray preparations would be sufficient to prevent respiratory disease induced by EDTA inhalation, regardless of its mechanism.</p> CATEGORIES: RESPIRATORY</em></p>  </em></p>  </u></strong></p> Le Moual N, Varraso R, Siroux V, Dumas O, Nadif R, Pin I, Zock JP, Kauffmann F [2012]. </strong>Epidemiological study on the genetics and environment of asthma. Domestic use of cleaning sprays and asthma activity in females. Eur Respir J 40(6):1381‒1389. </strong></p> Abstract: </u>We aimed to study the associations between the household use of cleaning sprays and asthma symptoms and control of asthma, in females from the Epidemiological Study on the Genetics and Environment of Asthma (EGEA). Data were available for 683 females (mean age 44 yrs, 55% never smokers, 439 without asthma and 244 with current asthma). Both domestic exposures and asthma phenotypes (asthma symptom score, current asthma, poorly-controlled asthma (56%)) were evaluated as previously described in the European Community Respiratory Health Survey. Associations between the use of sprays and asthma phenotypes were evaluated using logistic and nominal regressions, adjusted for age, smoking, body mass index and occupational exposures. Significant associations were observed between the weekly use of at least two types of sprays and a high asthma symptom score (OR (95% CI) 2.50 (1.54-4.03)) compared with a null score. Consistent results were observed for current asthma (1.67 (1.08-2.56)) and poorly-controlled asthma (2.05 (1.25-3.35)) compared with females without asthma. The association for current asthma was higher in females not reporting avoidance of polluted places (2.12 (1.27-3.54)) than in those reporting such avoidance (0.99 (0.53-1.85)). The common use of household cleaning sprays is positively associated with a high asthma symptom score, current asthma and poorly-controlled asthma in females.</p> CATEGORIES: RESPIRATORY</em></p>  </p> Lillienberg L, Andersson E, Janson C, Dahlman-Höglund A, Forsberg B, Holm M, Glslason T, Jögi R, Omenaas E, Schlünssen V, Sigsgaard T, Svanes C, Torén K. Occupational exposure and new-onset asthma in a population-based study in Northern Europe (RHINE). Ann Occup Hyg 57</em>(4):482‒492</strong>.</p> Abstract</u> OBJECTIVES: In a large population-based study among adults in northern Europe the relation between occupational exposure and new-onset asthma was studied. METHODS: The study comprised 13 284 subjects born between 1945 and 1973, who answered a questionnaire 1989-1992 and again 1999-2001. Asthma was defined as ‘Asthma diagnosed by a physician’ with reported year of diagnose. Hazard ratios (HR), for new-onset adult asthma during 1980-2000, were calculated using a modified job-exposure matrix as well as high-risk occupations in Cox regression models. The analyses were made separately for men and women and were also stratified for atopy. RESULTS: During the observation period there were 429 subjects with new-onset asthma with an asthma incidence of 1.3 cases per 1000 person-years for men and 2.4 for women. A significant increase in new-onset asthma was seen for men exposed to plant-associated antigens (HR = 3.6; 95% CI [confidence interval] = 1.4-9.0), epoxy (HR = 2.4; 95% CI = 1.3-4.5), diisocyanates (HR = 2.1; 95% CI = 1.2-3.7) and accidental peak exposures to irritants (HR = 2.4; 95% CI = 1.3-4.7). Both men and women exposed to cleaning agents had an increased asthma risk. When stratifying for atopy an increased asthma risk were seen in non-atopic men exposed to acrylates (HR = 3.3; 95% CI = 1.4-7.5), epoxy compounds (HR = 3.6; 95% CI = 1.6-7.9), diisocyanates and accidental peak exposures to irritants (HR = 3.0; 95% CI = 1.2-7.2). Population attributable risk for occupational asthma was 14% for men and 7% for women. CONCLUSIONS: This population-based study showed that men exposed to epoxy, diisocyanates and acrylates had an increased risk of new-onset asthma. Non-atopics seemed to be at higher risk than atopics, except for exposure to high molecular weight agents. Increased asthma risks among cleaners, spray painters, plumbers, and hairdressers were confirmed.</p> CATEGORIES: RESPIRATORY; CUSTODIAL WORKERS</em></p>  </em></p> Liskowsky J, Geier J, Bauer A [2011]. Contact allergy in the cleaning industry: analysis of contact allergy surveillance data of the Information Network of Departments of Dermatology. Contact Dermatitis 65</em>(3):159‒166.</strong> http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0536.2011.01937.x/pdf</p> CATEGORIES: DERMAL; RESPIRATORY</em></p>  </p> Lynde CB, Obadia M, Liss GM, Ribeiro M, Holness DL, Tarlo SM [2009]. </strong>Cutaneous and respiratory symptoms among professional cleaners. Occup Med 59</em>(4):249–254.</strong></p> Abstract</u>. BACKGROUND: Occupational dermatitis is very common and has a large economic impact. Cleaners are at an increased risk for both work-related cutaneous and respiratory symptoms. AIMS: To compare the prevalence of occupational cutaneous symptoms among professional indoor cleaners to other building workers (OBW) and to determine associations with exposures and with respiratory symptoms among cleaners. METHODS: A questionnaire completed by indoor professional cleaners and OBW to compare rash and respiratory symptoms between these groups examined workplace factors such as training, protective equipment and work tasks. RESULTS: In total, 549 of the 1396 professional cleaners (39%) and 593 of the 1271 OBW (47%) completed questionnaires. The prevalence of rash was significantly higher in the cleaners compared to the OBW. For male cleaners, 21% (86/413) had a rash in the past 12 months compared to only 11% (13/115) of OBW (P < 0.05). The rashes experienced by the cleaners were more likely to be on their hands and worse at work. Cleaners washed their hands significantly more often than OBW. Cleaners with a rash were less likely to have received workplace training regarding their skin and were more likely to find the safety training hard to understand. Cleaners with a rash within the past year were significantly more likely to have work-related asthma symptoms than cleaners without a rash (P < 0.001). CONCLUSIONS: This study demonstrates a strong link between work-related symptoms of asthma and dermatitis among cleaners. Effective preventive measures, such as the use of protective skin and respiratory equipment, should be emphasized.</p> CATEGORIES: RESPIRATORY; DERMAL</em></p>  </em></p> Mäkelä R</strong></a>, </strong>Kauppi P</strong></a>, </strong>Suuronen K</strong></a>, </strong>Tuppurainen M</strong></a>, </strong>Hannu T</strong></a> [2011]. Occupational asthma in professional cleaning work: a clinical study. </strong>Occup Med (London)</strong></a> 61</em>(2):121‒126</strong>. http://occmed.oxfordjournals.org/content/early/2011/01/31/occmed.kqq192.full</a></p> CATEGORIES: RESPIRATORY</em></p>  </em></p> Massachusetts Department of Public Health Occupational Health Surveillance Program [2010]. </strong>Asma e os produtos de limpeza no ambiente de trabalho, Boston, 2010.</strong> http://www.mass.gov/eohhs/docs/dph/occupational-health/asthma-cleaning-products-portuguese.pdf</p> CATEGORIES: IMMIGRANT WORKERS; RESPIRATORY</em></p>  </u></strong></p> Massin N, Hecht G, Ambroise D, Héry M, Toamain JP, Hubert G, Dorotte M, Bianchi B [2007]. Respiratory symptoms and bronchial responsiveness among cleaning and disinfecting workers in the food industry. Occup Environ Med 64</em>(2):75–81.</strong></p> Absent</u>. OBJECTIVES: To measure the levels of exposure to nitrogen trichloride (NCl3) and aldehydes among cleaning and disinfecting workers in the atmosphere of food industry plants during cleaning and disinfecting operations, and to examine how they relate to irritant and chronic respiratory symptoms-which are indices of pulmonary function-and bronchial hyperresponsiveness (BHR) to methacholine. METHODS: 175 exposed workers (M = 149; F = 26) recruited from 17 enterprises of the food industry (8 cattle, pig, and ovine slaughterhouses, 8 fowl slaughterhouses, and 1 catering firm) and 70 non-exposed workers (M = 52; F = 18) were examined. Concentration levels of NCl3 and aldhehydes were measured by personal sampling. Symptoms were assessed by means of a questionnaire and the methacholine bronchial challenge (MBC) test using an abbreviated method. Subjects were labelled MBC+ if forced expiratory volume in one second (FEV1) fell by 20% or more. The linear dose-response slope (DRS) was calculated as the percentage fall in FEV1 at last dose divided by the total dose administered. RESULTS: 277 air samples were taken in the 17 food industry plants. For a given plant and in a given workshop, the actual concentrations of chloramines, aldehydes, and quaternary ammonium compounds were measured with personal samplers during the different steps of the procedures. For each cleaner, a total exposure index Sigma was calculated. A statistically significant concentration-response relationship was found between eye, nasal, and throat symptoms of irritation–but not chronic respiratory symptoms–and exposure levels or exposure duration. No relation was found between BHR and exposure. CONCLUSIONS: These data show that cleaning and disinfecting workers in the food industry are at risk of developing eye, nasal, and throat irritation symptoms. Although NCl3 exposure does not seem to carry a risk of developing permanent BHR, the possibility of transient BHR cannot be ruled out entirely.</p> CATEGORIES: RESPIRATORY; CHEMICAL HAZARDS</em></p>  </u></strong></p> Medina-Ramón M, Zock JP, Kogevinas M, Sunyer J, Antó JM [2003]. Asthma symptoms in women employed in domestic cleaning: a community based study. Thorax 58</em>(11):950–954.</strong></p> Abstract</u>. BACKGROUND: Epidemiological studies have shown an association between cleaning work and asthma, but the risk factors are uncertain. The aim of this study was to assess the risk of asthma in women employed in domestic cleaning. METHODS: A cross sectional study was conducted in 4521 women aged 30 to 65 years. Information on respiratory symptoms and cleaning work history was obtained using a postal questionnaire with telephone follow up. Asthma was defined as reported symptoms in the last year or current use of drugs to treat asthma. Odds ratios (OR) with 95% confidence intervals (CI) for asthma in different cleaning groups were estimated using adjusted unconditional logistic regression models. RESULTS: 593 women (13%) were currently employed in domestic cleaning work. Asthma was more prevalent in this group than in women who had never worked in cleaning (OR 1.46 (95% CI, 1.10 to 1.92)). Former domestic cleaning work was reported by 1170 women (26%), and was strongly associated with asthma (OR 2.09 (1.70 to 2.57)). Current and former non-domestic cleaning work was not significantly associated with asthma. Consistent results were obtained for other respiratory symptoms. Twenty five per cent of the asthma cases in the study population were attributable to domestic cleaning work. CONCLUSIONS: Employment in domestic cleaning may induce or aggravate asthma. This study suggests that domestic cleaning work has an important public health impact, probably involving not only professional cleaners but also people undertaking cleaning tasks at home.</p> CATEGORIES: DOMESTIC WORKERS; RESPIRATORY</em></p>  </u></strong></p> Medina-Ramon, M; Zock, JP; Kogevinas, M; Sunyer, J; Torralba, Y; Borrell, A; Burgos, F; Anto, JM. Asthma, chronic bronchitis, and exposure to irritant agents in occupational domestic cleaning: a nested case-control study Occup Environ Med 2005 62: 598-606</strong></p> CATEGORIES: DOMESTIC WORKERS; RESPIRATORY</em></p>  </u></strong></p> Minov J, Karadzinska-Bislimovska J, Vasilevska K, Risteska-Kuc S, Stoleski S [2009]. Effects of passive smoking at work on respiratory symptoms, lung function, and bronchial responsiveness in never-smoking office cleaning women. Arh Hig Rada Toksikol 60(3):327‒334.</strong></p> Abstract: </u>This cross-sectional study compares respiratory symptoms, lung function, and bronchial responsiveness between 27 office cleaning women exposed to environmental tobacco smoke at work and 57 unexposed controls. The age range of both groups was 24 to 56 years, and none of the women had ever smoked. Information on respiratory symptoms, cleaning work history, and passive smoking in the workplace were obtained with a questionnaire. The subjects also took a skin prick test to common inhalant allergens, a lung function test, and a histamine challenge. Despite smoking restriction in indoor environments, we found a high prevalence of passive smokers in the workplace (32.1 %). In these subjects we found a significantly higher prevalence of wheezing with breathlessness (25.9 % vs. 8.8 %; P=0.036), wheezing without cold (25.9 % vs. 7.0 %; P=0.016), and breathlessness after effort (29.6 % vs. 8.8 %; P=0.014) than in control subjects. Objective measurements showed a significantly lower MEF25 (53.6 % vs. 63.7 %; P=0.001) and a significantly higher prevalence of borderline bronchial hyperresponsiveness (22.2 % vs. 7.0 %; P=0.044) in the passive smokers in the workplace. This study provides evidence of adverse respiratory effects in office cleaning women associated with passive smoking in the workplace. Our findings support a stricter implementation of the current national law to protect respiratory health of all workers.</em></p> CATEGORIES: RESPIRATORY</em></p>  </u></strong></p> Moscato G, Siracusa A [2009]. Rhinitis guidelines and implications for occupational rhinitis. Curr Opin Allergy Clin Immunol 9</em>(2):110–115.</strong></p> Abstract</u>. PURPOSE OF REVIEW: To review the most recent rhinitis guidelines in the aspects pertaining the link between rhinitis and work, and to summarize the specific literature on occupational rhinitis published in 2007 and 2008. RECENT FINDINGS:</p> Recently there has been a growing scientific interest in work-related rhinitis. Health personnel, cleaners, bakers, apprentices in high-risk occupations, and workers exposed to multiple agents are at increased risk of rhinitis, especially in the very first years of employment. Flour allergens are often involved and may induce non-allergic and enhance allergic airway inflammation. The specific nasal challenge remains the gold standard for diagnosis. Acoustic rhinometry and nasal lavage are validated tools for monitoring nasal response. Occupational rhinitis seems to have an impact on quality of life of affected workers and allergic rhinitis impairs work productivity. SUMMARY: This review updated recent findings on epidemiology, mechanisms, diagnosis, management, and prevention of occupational rhinitis. This article also provides new information on the impact of occupational rhinitis on quality of life and on the impact of rhinitis on work productivity. Occupational rhinitis should be considered in daily clinical practice and research.</p> CATEGORIES: RESPIRATORY</em></p>  </strong></p> Nielsen GD, Larsen ST, Olsen O, Løvik M, Poulsen LK, Glue C, Wolkoff P  [2007]. Do indoor chemicals promote development of airway allergy? Indoor Air 17(3):236‒255.</strong></p> CATEGORIES: RESPIRATORY</em></p>  </p> Obadia M</strong></a>, </strong>Liss GM</strong></a>, </strong>Lou W</strong></a>, </strong>Purdham J</strong></a>, </strong>Tarlo SM</strong></a> [2009]. Relationships between asthma and work exposures among non-domestic cleaners in Ontario. </strong>Am J Ind Med</strong></a> 52</em>(9):716‒723</strong>. http://onlinelibrary.wiley.com/doi/10.1002/ajim.20730/pdf</a></p> CATEGORIES: RESPIRATORY; CUSTODIAL WORKERS</em></p>  </u></strong></p> Quirce S</strong></a>, </strong>Barranco P</strong></a> [2010]. Cleaning agents and asthma. </strong>J Investig Allergol Clin Immunol</strong></a> 20</em>(7):542‒550. </strong>http://www.jiaci.org/issues/vol20issue7/1.pdf</a></p> CATEGORIES: RESPIRATORY</em></p>  </u></strong></p> Rella R, Sturaro A, Vianello A [2012]. </strong>2-Butoxyethanol from cleaning products responsible for complaints in workplaces: a case study. J Environ Monit 14(10):2659‒2662.</strong></p> Abstract: </u>Indoor air quality is important because people are spending an increasing amount of time in the workplace. They are exposed to outdoor pollutants as well as pollutants emitted from products used indoors. Some chemicals, belonging to the category of volatile organic compounds (VOCs), easily release vapors at room temperature by evaporation. These accumulated vapors are often toxic and irritating. They may be alcohols, glycols, ketones, esters, etc., frequently present in the composition of many products for personal care or household purposes. This study suggests that the exposure levels of 2-butoxyethanol play an important role in the level of complaints of people at work. This study has emphasized the necessity of using different active and passive sampling methods for indoor air to avoid evaluation errors.</p> CATEGORIES: RESPIRATORY</em></p>  </u></strong></p> Rosenman KD, Reilly MJ, Schill DP, Valiante D, Flattery J, Harrison R, Reinisch F, Pechter E, Davis L, Tumpowsky CM, Filios M [2003]. Cleaning products and work-related asthma. J Occup Environ Med 45</em>(5):556–563.</strong></p> Abstract</u>: To describe the characteristics of individuals with work-related asthma associated with exposure to cleaning products, data from the California-, Massachusetts-, Michigan-, and New Jersey state-based surveillance systems of work-related asthma were used to identify cases of asthma associated with exposure to cleaning products at work. From 1993 to 1997, 236 (12%) of the 1915 confirmed cases of work-related asthma identified by the four states were associated with exposure to cleaning products. 80% of the reports were of new-onset asthma and 20% were work-aggravated asthma. Among the new-onset cases, 22% were consistent with reactive airways dysfunction syndrome. Individuals identified were generally women (75%), white non-Hispanic (68%), and 45 years or older (64%). Their most likely exposure had been in medical settings (39%), schools (13%), or hotels (6%), and they were most likely to work as janitor/cleaners (22%), nurse/nurses’ aides (20%), or clerical staff (13%). However, cases were reported with exposure to cleaning products across a wide range of job titles. Cleaning products contain a diverse group of chemicals that are used in a wide range of industries and occupations as well as in the home. Their potential to cause or aggravate asthma has recently been recognized. Further work to characterize the specific agents and the circumstances of their use associated with asthma is needed. Additional research to investigate the frequency of adverse respiratory effects among regular users, such as housekeeping staff, is also needed. In the interim, the authors recommend attention to adequate ventilation, improved warning labels and Material Safety Data Sheets, and workplace training and education.</p> CATEGORIES: RESPIRATORY; CHEMICAL HAZARDS</em></p>  </u></strong></p> Sastre J</strong></a>, </strong>Madero MF</strong></a>, </strong>Fernández-Nieto M</strong></a>, </strong>Sastre B</strong></a>, </strong>del Pozo V</strong></a>, </strong>Potro MG</strong></a>, </strong>Quirce S</strong></a> [2011].</strong></p> Airway response to chlorine inhalation (bleach) among cleaning workers with and without bronchial hyperresponsiveness. </strong>Am J Ind Med.</strong></a> 54</em>(4):293‒299. </strong></p> Abstract. </u>BACKGROUND: Symptoms of obstructive lung disease in domestic cleaning staff have been related to the use of bleach and other irritant cleaning products. MATERIAL AND METHODS: Included in the study were thirteen cleaning employees with work-related asthma-like symptoms, three asthmatic controls and three atopic subjects without bronchial hyperresponsiveness (BHR) who had no exposure to cleaning products. The study protocol consisted of a methacholine test, sputum induction and fraction of exhaled nitric oxide measurement (FENO) both at baseline and 24 hr after a 1-hr inhalation challenge with either placebo or bleach at a concentration of 0.4 ppm of chlorine. RESULTS: The inhalation of the placebo caused no bronchial reactions. Mean maximum fall in FEV(1) during challenge testing with bleach was significantly higher than the values obtained during the placebo challenge. Inhalation challenge with bleach elicited two isolated late asthmatic reactions and one dual asthmatic reaction. Of all the patients who underwent challenge testing with bleach, only one had a ≥2-fold decrease in methacholine PC(20) 24 hr after the challenge. No significant correlation was found between maximum fall in FEV(1) and PC(20) methacholine. Following challenge testing with bleach, no clinically significant changes in sputum cell counts or FENO were detected. CONCLUSIONS: These results suggest that bleach inhalation at a concentration of 0.4 ppm-a concentration below 8-hr permissible occupational exposure level-brings about a substantial decrease in FEV1 in subjects with and without BHR. Some subjects have a positive challenge response to bleach inhalation.</p> CATEGORIES: RESPIRATORY</em></p>  </u></strong></p> Vizcaya D</strong></a>, </strong>Mirabelli MC</strong></a>, </strong>Antó JM</strong></a>, </strong>Orriols R</strong></a>, </strong>Burgos F</strong></a>, </strong>Arjona L</strong></a>, </strong>Zock JP</strong></a> [2011]. </strong>A workforce-based study of occupational exposures and asthma symptoms in cleaning workers. 68</em>(12):914‒919.</strong></p> Abstract. </u>OBJECTIVES: To study associations between use of cleaning products and asthma symptoms in cleaning workers. METHODS: Information on respiratory symptoms, history of asthma, workplaces, use of cleaning products and acute inhalation incidents were obtained through a self-administered questionnaire. 917 employees of 37 cleaning companies in Barcelona were studied. 761 (83%) were current cleaners, 86 (9%) former cleaners and 70 (8%) had never worked as cleaners. Multivariable logistic regression analyses were used to evaluate the associations between specific exposures among current cleaners and wheeze without having a cold, chronic cough and current asthma. Associations with an asthma symptom score were also studied using negative binomial regression analyses to report mean ratios. RESULTS: After adjusting for sex, age, nationality and smoking status, the prevalence of current asthma was non-significantly higher among current (OR 1.9; 95% CI 0.5 to 7.8) and former cleaners (OR 1.9; CI 0.6 to 5.5) than in never cleaners. Cleaners working in hospitals during the last year had a significantly increased prevalence of wheeze, current asthma and a 1.8 (95% CI 1.2 to 2.8) times higher mean asthma score. Use of hydrochloric acid was strongly associated with asthma score (mean ratio 1.7; 95% CI 1.1 to 2.6). Use of ammonia, degreasers, multiple purpose products and waxes was also associated with asthma score. CONCLUSIONS: Cleaning work in places with high demand for disinfection, high cleaning standards and use of cleaning products containing respiratory irritants is associated with higher risk of asthma symptoms. This suggests irritants have an important role in cleaning-related asthma.</p> CATEGORIES: RESPIRATORY</em></p>  </p> Vizcaya D, Mirabelli MC, Orriols R, Antó JM, Barreiro E, Burgos F, Arjona L, Gomez F, Zock JP [2013]. </strong>Functional and biological characteristics of asthma in cleaning workers. Respir Med 107(5):673‒683. </strong>http://www.sciencedirect.com/science/article/pii/S0954611113000371</p> CATEGORIES: RESPIRATORY; CUSTODIAL WORKERS</em></p>  </u></strong></p> Wang TN</strong></a>, </strong>Lin MC</strong></a>, </strong>Wu CC</strong></a>, </strong>Leung SY</strong></a>, </strong>Huang MS</strong></a>, </strong>Chuang HY</strong></a>, </strong>Lee CH</strong></a>, </strong>Wu DC</strong></a>, </strong>Ho PS</strong></a>, </strong>Ko AM</strong></a>, </strong>Chang PY</strong></a>, </strong>Ko YC</strong></a> [2010]. Risks of exposure to occupational asthmogens in atopic and nonatopic asthma: a case-control study in Taiwan. </strong>Am J Respir Crit Care Med</strong></a> 182</em>(11):1369‒1376. </strong>http://www.atsjournals.org/doi/full/10.1164/rccm.200906-0969OC</a></p> CATEGORIES: RESPIRATORY; CUSTODIAL WORKERS</em></p>

Bongers PM, Kremer AM, ter Laak J [2002]. Are psychosocial factors, risk factors for symptoms and signs of the shoulder, elbow, or hand/wrist? A review of the epidemiological literature. Am J Ind Med 41</em>(5): 315</strong>–3</strong>42.</strong></p> Background In 1993, an extensive review on the role of psychosocial factors in the development of musculoskeletal problems was published by Bongers et al (1993). Since then, additional reviews on this topic have been published; however, none of these focused on upper limb problems. Methods In this systematic review, the methodological quality of all studies was assessed and levels of evidence were apriori defined. Results: The large majority of the studies reported an association between at least one work-related psychosocial factor and adverse upper extremity symptoms or signs. High perceived job stress was consistently associated with all upper extremity problems (UEP) in high and lower quality studies. Although not often studied, non-work-related stress was also consistently associated with UEP. In addition, there was some evidence for a relationship between high job demands and UEP, although the results did not meet the pre-set criterion for consistency. Conclusions High job stress and non-work-related stress reactions are consistently associated with UEP. In addition, high job demands is also in most studies associated with these disorders. Firm conclusions on the role of these factors in the etiology of UEP are not possible due to the cross-sectional nature of most studies. Am. J. Ind. Med. 41:315-342, 2002.</p> CATEGORIES: WORK STRESS; MSDs; REVIEW ARTICLES</em></p>  </u></strong></p> Charles LE, Loomis D, Demissie Z [2009]. Occupational hazards experienced by cleaning workers and janitors: a review of the epidemiologic literature. Work 34(1):105‒116.</strong></p> Abstract: </u>Building cleaners are an important group of workers who experience diverse occupational hazards resulting in health problems. A review of epidemiologic studies conducted between 1981 and 2005 was performed using PubMed and PsychLit, to identify health outcomes and the associated hazards in the work environment of cleaners. Among 35 studies, respiratory diseases (n=17) and dermatologic diseases (n=9) were the most common and were associated with exposure to cleaning agents, wet work, and rubber latex. The potential for infectious diseases (n=3) was identified among cleaners in medical laboratories and was associated with exposure to broken glass and uncapped needles in the trash. Musculoskeletal disorders (n=5) were associated with several physical stressors (e.g., awkward postures, prolonged standing) and psychosocial stressors (e.g., monotonous job, low potential for promotion). Mental disorders (n=1) were also associated with psychosocial stressors and societal stigma. Future studies may be enhanced by better assessment of the specific job exposures of cleaners and implementation of a prospective design.</p> CATEGORIES: CUSTODIAL WORKERS; ERGONOMICS; CHEMICAL HAZARDS; WORK STRESS; REVIEW ARTICLES; RESPIRATORY</em></p>  </u></strong></p> Davis K [2000]. The relationship between psychosocial work characteristics and low back pain: underlying methodological issues. Clin Biomech 15</em>(6):389</strong>–</strong>406.</strong></p> Abstract</u>. Background. Psychosocial work characteristics have been widely evaluated as potential risk factors for low back injury. However, studies with different study populations and using various types of measures have had conflicting results.</p> Methods. This review is the most extensive to date, reviewing 66 articles that have provided empirical evidence about the relationship between psychosocial work characteristics and initial reporting of lower back pain. The studies are reviewed with an emphasis on certain methodological issues: controlling for potential confounding; timing of the data collection; and measurement of the exposures and outcomes.</p> Results. The results of this review suggest that controlling for potential confounding from occupational biomechanical demands had a large influence on the associations found between psychosocial work characteristics and lower back pain. In addition, the use of accurate and reliable measures for the occupational exposures (biomechanical and psychosocial) and the lower back pain outcomes appears to influence the strength of the associations found between psychosocial work characteristics and lower back pain.</p> Conclusion. Given the methodological concerns discussed in this review, it is difficult to draw strong causal inferences from this literature. However, it does appear that psychosocial characteristics are related to some lower back pain outcomes, and that employees’ reactions to psychosocial work characteristics (e.g., job dissatisfaction and job stress) are more consistently related to lower back pain than are the psychosocial work characteristics themselves (e.g., work overload, lack of influence over work, quality of relationships with coworkers).Relevance: This review attempts to identify and address methodological issues in the literature evaluating the relationship between psychosocial work characteristics and lower back pain. Implications for future research are presented.</p> CATEGORIES: REVIEW ARTICLES; WORK STRESS; PAIN</em></p>  </u></strong></p> Kumar R, Kumar S [2008]. Musculoskeletal risk factors in cleaning occupation – a literature review. Int J Ind Ergonomics 38</em>(2):158–170.</strong></p> Abstract</u>: The objective of this literature survey on risk factors of musculoskeletal disorders among cleaners was to identify recommended practices, problems, and unresolved issues. The most frequently-cited factors were found to be the high physical and psychosocial workloads. Recommended ergonomic interventions are summarized in a model to present a systematic overview, useful for research and practical applications.</p> CATEGORIES: REVIEW ARTICLES; MSDs</em></p>

Bell AF, Steele JR (2011). Risk of musculoskeletal injury among cleaners during vacuuming. Ergonomics:1-11.</strong> Abstract:</u> This study aimed to examine the risk of work-related upper-limb musculoskeletal disorders in cleaning workers during the work task of vacuuming. In total, 24 cleaning workers were observed while they performed vacuum cleaning tasks in the normal course of their employment in government schools, hospitality and commercial office space sectors. Risk of upper-limb musculoskeletal disorders were rated using three observational assessment tools: Manual Task Risk Assessment (ManTRA); Quick Exposure Check (QEC); the Rapid Upper Limb Assessment (RULA). Mean results (e.g. ManTRA wrist/hand cumulative wrist score 18.67 ± 1.27, QEC neck score 13 ± 1.77, RULA score 6.54 ± 0.509) demonstrated that cleaning workers who perform the task of vacuum cleaning are at risk of work-related upper-limb musculoskeletal injury, regardless of whether they use a back-pack or canister machine. Government school cleaners experienced greater risk of work-related upper-limb musculoskeletal disorders than workers in either the hospitality or commercial office space sectors. STATEMENT OF RELEVANCE: Cleaning workers in Australia are mostly female, ageing and of non-English-speaking backgrounds and involved in repetitive manual tasks. Their occupation is low status. This research confirms that vacuuming tasks are a risk for cleaning workers and highlights the need for further research to improve conditions for these workers. http://www.tandfonline.com/doi/full/10.1080/00140139.2011.592605</a> CATEGORIES: MSDs; WOMEN’S HEALTH; IMMIGRANT WORKERS; CUSTODIAL WORKERS; HOTEL WORKERS; INJURIES; ERGONOMICS</em></p> Greenhouse S (2009).  Female hotel workers injured more than men, study shows. New York Times, November 10</strong>. http://www.nytimes.com/2009/11/11/business/11injury.html</a> CATEGORIES: HOTEL WORKERS; INJURIES; WOMEN’S HEALTH</em></p> Holtermann A, Blangsted AK, Christensen H, Hansen K, Søgaard K [2009]. What characterizes cleaners sustaining good musculoskeletal health after years with physically heavy work? Int Arch Occup Environ Health 82</em>(8):1015–1022.</strong></p> Abstract</u>. OBJECTIVES: The aim of this case-control study was to investigate characteristics of cleaners with good musculoskeletal health after years with physically heavy work. METHODS: One hundred and 41 female seniority cleaners participated. Twenty-five reported no musculoskeletal symptoms, whereas 83 reported severe symptoms in the low back, neck shoulders or upper limbs. The groups were of matching age, height, body weight and seniority (19 years). Muscular strength was recorded by isometric maximal voluntary contractions on a day without pain. Exposure to physical risk factors at work, psychosocial work factors, and leisure time physical activity were assessed by a postal questionnaire. RESULTS: Cleaners with good musculoskeletal health were not reporting different exposure to physical risk factors at work or leisure time physical activity, but had higher muscular strength and reported higher influence at work than cleaners with severe symptoms. CONCLUSIONS: These findings suggest that muscular strength and influence at work are of relevance for sustaining good musculoskeletal health in workers with physically heavy work.</p> CATEGORIES: MSDs; WORK STRESS; WOMEN’S HEALTH</em></p>  </u></strong></p> Kines P, Hannerz H, Mikkelsen KL, Tüchsen F [2007]. Industrial sectors with high risk of women’s hospital-treated injuries. Am J Ind Med 50</em>(1):12–21.</strong></p> Abstract</u>: Women’s occupational injury rates are converging with those of males. Associations between female workers’ hospital treated injury rates, industrial sector and injured body area were analyzed to provide for better-focused injury prevention of women’s hazardous jobs. Females’ standardized hospital treatment ratios (SHR) and the excess fraction for five body regions (head/neck, thorax, back, upper and lower extremities) were calculated for 58 industrial sectors for 1999-2003. Five industrial sectors, “Cleaning, laundries and dry cleaners,” “Transport of passengers,” “Hotels and restaurants,” “Hospitals” and “Transport of goods” had significantly high SHRs for all five body regions. The excess fraction for upper extremity injuries revealed that 14%-27% of injuries could theoretically have been avoided. There is strong evidence for an association between women’s hospital treated injuries and industrial sector. The results justify the need for gender-sensitive analyses to orient injury prevention programs.</p> CATEGORIES: WOMEN’S HEALTH; INJURIES</em></p>  </u></strong></p> Liladrie S (2010). “Do not disturb/please clean room”: hotel housekeepers in Greater Toronto. Race & Class 52(1):57-69.</strong> Abstract</u>. </strong>This study of the experiences of hotel housekeepers in Toronto, who are predominantly immigrant women of colour, reveals the damaging health impact of their work. As the hotel industry in this ‘global city’ has moved upmarket and sought to offer more luxury services to its wealthy customers, hotel housekeeping work has become more physically demanding and burdensome, resulting in the majority of workers experiencing a high degree of pains and injuries. The hotel industry is seen as operating a racialised division of labour, with those at the bottom vulnerable to being discarded as they approach retirement age and their health deteriorates. Finally, an account is given of the impact of unionisation and the hotel workers’ ongoing struggles for change. http://rac.sagepub.com/content/52/1/57.full.pdf+html</a> CATEGORIES: HOTEL WORKERS; WOMEN’S HEALTH; PAIN; INJURIES; WORK ENVIRONMENT; IMMIGRANT WORKERS</em></p> Landstad BJ, Ekholm J, Broman L, Schüldt K [2000].Working environmental conditions as experienced by women working despite pain. Work 15</em>(3):141–152.</strong></p> Abstract</u>. OBJECTIVE: This study looked at female hospital cleaners and home help personnel who continued working despite problems or pain in their musculoskeletal system and where there was a risk of increase in sickness absence. The aim was to determine whether supportive intervention for these personnel at the workplace had an effect on the way that they experienced the physical and psychosocial aspects of their working environments. METHODS: The design was prospective with non-randomized intervention and reference groups. A selection of 55 questions about physical and psychosocial working environment from a national survey were used. Comparisons were made between intervention and reference groups and with data on a selection of the Swedish population of people in these professions. RESULTS: The results showed that in the hospital cleaners’ intervention group the introduction of new cleaning materials and new cleaning methods seemed to contribute to a reduction in workload during the intervention period, which in turn gave them a better chance of taking rest breaks during working time. In the home helps’ intervention group the results showed that the group had had a reduction both in workload and in more responsible tasks, and at the same time the psychosomatic stress reactions reduced after the intervention. CONCLUSIONS: The results indicate that effects on the working environmental conditions as experienced could be obtained by a general multi-component support program at the workplace, but the number of variables influenced by the program was very small. The relatively limited effects may be explained by the fact that the impact of a support program depends on how well the remedial measures fulfill the need for such measures either at the workplace, in a work group or among the individual people at the workplace. This emphasizes the importance of designing effective analysis tools for judging what remedial measures are needed before the measures themselves are tried out.</p> CATEGORIES: PAIN; WOMEN’S HEALTH; HOSPITAL WORKERS</em></p>  </u></strong></p> Landstad B, Vinberg S, Ivergård T, Gelin G, Ekholm J [2001]. Change in pattern of absenteeism as a result of workplace intervention for personnel support. Ergonomics 44</em>(1):63–81.</strong></p> Abstract</u>: The aim was to investigate whether a preventive intervention carried out in a predominantly female workplace: that of hospital cleaners (consisting of a group of 97 women) had any effect on patterns of absenteeism. As a background, a model for analyzing complex patterns of absenteeism, including sickness absences, was also developed. A further aim was to study the interactions between different forms of absenteeism. Comparison was made with a reference group consisting of employees in the same job category who only received the customary personnel support. For individuals in the intervention group who were 42 years, short-term absence decreased for those who had been in the same jobs for a long time. The combination of increased age and experience showed a tendency to enhance this decline in short-term absenteeism due to sickness. For those >42 years, and who at the same time have a previous history of high absenteeism, long-term absenteeism due to sickness seemed to be increasing. Increased experience tended to reduce this increase in long-term sickness absence. This combination of different effects possibly indicated the presence of a process of selection which determined who remained in the job as opposed to those who did not. An important conclusion is that different forms of absenteeism need to be looked at in parallel, and at the same time multivariate statistical analysis needs to be carried out to determine the different interactions between the factors.</p> CATEGORIES: WOMEN’S HEALTH; INTERVENTION STRATEGIES; HOSPITAL WORKERS</em></p>  </u></strong></p> Louhevaara V, Hopsu L, Sjogaard K (2000). Cardiorespiratory strain during floor mopping with different methods. Proceedings of the IEA2000/HFES 2000 Congress. 518-520.</strong> Abstract.</u> The cardiorespiratory strain of professional female cleaners was quantified as they used different floor mopping methods with respect to the amount of water ranging from dry to wet. The results of oxygen consumption, heart rate and the rating of perceived exertion indicated that the cardiorespiratory strain of dry mopping methods was systematically lighter than that of the more watery methods. http://pro.sagepub.com/content/44/30/5-518.full.pdf</a> CATEGORIES: CUSTODIAL WORKERS; WOMEN’S HEALTH</em></p> Messing K (2004). Physical exposures in work commonly done by women. Can J Appl Physiol 29(5):639-656.</strong> Abstract.</u> The North American work force is still highly sex-segregated, with most members of each sex in jobs composed primarily of workers of the same sex. This division is accentuated when jobs involve physical demands. Women have traditionally been assigned to tasks whose physical demands are considered to be light. Nevertheless, these tasks can have biological effects, sometimes serious. Phenomena related to physical demands of women’s work can be considered in three categories: (a) musculoskeletal and cardiovascular demands of tasks often assigned to women in factories and service work; (b) sex- and gender-specific effects of toxic substances found in the workplace; and (c) interactions between work and the domestic responsibilities of many women. These phenomena are described, using examples recently gathered from workplaces. Effects of biological sex are distinguished, as far as possible, from effects of gender (social roles). CATEGORIES: WOMEN’S HEALTH; MSDs; CVD; CHEMICAL HAZARDS</em></p> Pavalko EK, Mossakowski KN, Hamilton VJ [2003]. Does perceived discrimination affect health? Longitudinal relationships between work discrimination and women’s physical and emotional health. J Health Soc Behav 44</em>(1):18–33.</strong></p> CATEGORIES: WOMEN’S HEALTH</em></p>  </u></strong></p> Sjogren B, Fredlund P, Lundberg I, Weiner J [2003]. Ischemic heart disease in female cleaners. Int J Occup Environ Health 9</em>(2):134</strong>–13</strong>7.</strong></p> CATEGORIES: CVD; WOMEN’S HEALTH</em></p>  </u></strong></p> Swanson NG [2000]. Working women and stress. J Am Med Womens Assoc, 55</em>(2):76–79.</strong></p> CATEGORIES: WORK STRESS; WOMEN’S HEALTH</em></p>  </u></strong></p> Zarate-Abbott P, Etnyre A, Gilliland I, Mahon M, Allwein D, Cook J, Mikan V, Rauschhuber M, Sethness R, Munoz L, Lowry J, Jones ME. Workplace health promotion–strategies for low-income Hispanic immigrant women. Am Assoc Occup Health Nurs J 56</em>(5).</strong></p> Abstract</u>. Addressing health disparities for vulnerable populations in the United States is a national goal. Immigrant Hispanic women, at increased risk for heart disease, face obstacles in receiving adequate health care. Health promotion, especially for Hispanic women, is hindered by language, access to care, lack of insurance, and cultural factors. Innovative health education approaches are needed to reach this population. This article describes the development and evaluation of a culturally sensitive cardiac health education program based on findings from a study of 21 older immigrant Hispanic women employed as housekeepers at a small university in south Texas. Systolic and diastolic blood pressures had decreased 17 months after the intervention.</p> CATEGORIES: IMMIGRANT WORKERS; WOMEN’S HEALTH; INTERVENTION STRATEGIES</em></p>  </u></strong></p> Zock JP [2005]. World at work: cleaners. Occup Enviorn Med 62</em>(8):581–584.</strong></p> Abstract</u>: Cleaning workers form an important proportion of the total working population, particularly among women. This paper reviews some of the most common occupational hazards in cleaning work, and discusses possibilities to improve control and prevention. Topics covered: physical workload and strain; accidents; dermal, respiratory and other effects of chemical products; psychosocial problems; measures to protect workers.</p> CATEGORIES: WOMEN’S HEALTH; WORK ENVIRONMENT</em></p>

Bergqvist U, Wolgast E, Nilsson B, Voss M [1995]. </strong>Musculoskeletal disorders among visual display terminal workers: individual, ergonomic, and work organizational factors. Ergonomics 38</em>:763–776.</strong></p> Abstract.</u> A number of individual, ergonomic, and organizational factors of presumed importance for the occurrence of musculoskeletal disorders were investigated in a group of 260 visual display terminal (VDT) workers. The cross-sectional study utilized medical and workplace investigations as well as questionnaires. The results were subjected to a multivariate analysis in order to find the major factors associated with various upper-body muscular problems. Several such factors were identified for each investigated type of musculoskeletal problem. Some were related to the individual: age, gender, woman with children at home, use of spectacles, smoking, stomach-related stress reactions, and negative affectivity. Organizational variables of importance were opportunities for flexible rest breaks, extreme peer contacts, task flexibility, and overtime. Identified ergonomic variables were static work posture, hand position, use of lower arm support, repeated work movements, and keyboard or VDT vertical position.</p> CATEGORIES: MSDs; ERGONOMICS; WORK ENVIRONMENT</em></p>  </em></p> Bohle P, Quinlan M, Kennedy D, Williamson A [2004]. Working hours, work-life conflict, and health in precarious and “permanent” employment. Rev Saúde Pública 38</em>(Suppl):19–25.</strong></p> Abstract.</u> OBJECTIVE: The expansion of precarious employment in OECD countries has been widely associated with negative health and safety effects. Although many shift workers are precariously employed, shift work research has concentrated on full-time workers in continuing employment. This paper examines the impact of precarious employment on working hours, work-life conflict and health by comparing casual employees to full-time, “permanent” employees working in the same occupations and workplaces. METHODS: Thirty-nine convergent interviews were conducted in two five-star hotels. The participants included 26 full-time and 13 casual (temporary) employees. They ranged in age from 19 to 61 years and included 17 females and 22 males. Working hours ranged from zero to 73 hours per week. RESULTS: Marked differences emerged between the reports of casual and full-time employees about working hours, work-life conflict and health. Casuals were more likely to work highly irregular hours over which they had little control. Their daily and weekly working hours ranged from very long to very short according to organizational requirements. Long working hours, combined with low predictability and control, produced greater disruption to family and social lives and poorer work-life balance for casuals. Uncoordinated hours across multiple jobs exacerbated these problems in some cases. Health-related issues reported to arise from work-life conflict included sleep disturbance, fatigue and disrupted exercise and dietary regimes. CONCLUSIONS: This study identified significant disadvantages of casual employment. In the same hotels, and doing largely the same jobs, casual employees had less desirable and predictable work schedules, greater work-life conflict and more associated health complaints than “permanent” workers.</p> CATEGORIES: HOTEL WORKERS; WORK ENVIRONMENT</em></p>  </em></p> Burgel BJ, White MC, Gillen MG, Krause N (2010). Psychosocial work factors and shoulder pain in hotel room cleaners. Am J Ind Med 53:743-756. </strong>Abstract</u>: BACKGROUND: Hotel room cleaners have physically demanding jobs that place them at high risk for shoulder pain. Psychosocial work factors may also play a role in shoulder pain, but their independent role has not been studied in this group. METHODS: Seventy-four percent (941 of 1,276) of hotel room cleaners from five Las Vegas hotels completed a 29-page survey assessing health status, working conditions, and psychosocial work factors. For this study, 493 of the 941 (52%) with complete data for 21 variables were included in multivariate logistic regression analyses. RESULTS: Fifty-six percent reported shoulder pain in the prior four weeks. Room cleaners with effort-reward imbalance (ERI) were three times as likely to report shoulder pain (OR 2.99, 95% CI 1.95-4.59, P = 0.000) even after adjustment for physical workload and other factors. After adjustment for physical workload, job strain and iso-strain were not significantly associated with shoulder pain. CONCLUSIONS: ERI is independently associated with shoulder pain in hotel room cleaners even after adjustment for physical workload and other risk factors. CATEGORIES: HOTEL WORKERS; PAIN; WORK ENVIRONMENT</em></p> Cleaners mopped up by injuries [1999]. J Occup Health Safety Environ 3</em>(5):8</strong></p> Abstract:</u> Looks at the findings of a research report, “Musculoskeletal health of cleaners”, funded by the Health and Safety Executive (HSE) and the trade union UNISON. The results of a postal survey of 5,000 cleaning staff and follow-up ergonomic risk assessments indicate widespread musculoskeletal pain and discomfort often leading to time off work. The high risks of such pain have been associated with equipment design, job organization and poor training. HSE and UNISON will be holding a seminar for equipment manufacturers, employers and worker representatives in London on 28 September 1999, to review the study’s recommendations.</p> CATEGORIES: MSDs; INJURIES; PAIN; ERGONOMICS; WORK ENVIRONMENT</em></p>  </strong></p> Dababneh A, Swanson N, Shell R [2001]. Impact of added rest breaks on the productivity and well being of workers. Ergonomics 44</em>:164–174.</strong></p> Abstract</u>. The impact of frequent short rest breaks on the productivity and well being of a group of 30 workers in a meat-processing plant was studied. Two rest break schedules were tested, both of which provided 36 min of extra break time over the regular break schedule (30-min lunch and two 15-min breaks). In the first experimental rest break schedule, workers were given 12 3-min breaks evenly distributed over the workday (3-min break for every 27 min of work). In the second schedule, workers were given four 9-min breaks evenly distributed over the workday (9-min break every 51 min of work). Outcome measures included production rate and discomfort and stress ratings. Results showed that neither of the two experimental rest break schedules had a negative effect on production, and the 9-min break schedule improved discomfort ratings for the lower extremities. The workers in the study mostly preferred the 9-min rest break schedule, indicating that workers in general might not as readily accept fragmentation of break time into short, frequent breaks.</p> CATEGORIES: WORK ENVIRONMENT</em></p>  </u></strong></p> Delevoye A, Derieux N, Hunzinger E, Mzabi MI, Roux F, Van Brederode A, Van Rooj B [2005a]. </strong>Lingère en hôtellerie (Hotel linen maids). Cahiers de médecine interprofessionnelle 45</em>(3).</strong></p> Abstract:</u> The main task of hotel linen maids to ensure the proper management of linen, including the reception of clean linen, its storage and its distribution, together with the recovery and sorting of used linen. Contents of this information sheet on the job of hotel linen maid: general characteristics of the job; technical and organizational characteristics; exposures and constraints (work environment, work organization, tasks and equipment); hazard evaluation techniques; health effects and occupational pathology; prevention; medical supervision; regulations; evaluation of work aptitude.</p> CATEGORIES: HOTEL WORKERS; WORK ENVIRONMENT</em></p>  </u></strong></p> Delevoye A, Derieux N, Hunzinger E, Mzabi MI, Roux F, Van Brederode A, Van Rooj B [2005b]. La lingère en hôtellerie (Hotel linen maids). Cahiers de médecine interprofessionnelle 45</em>(3):305–319.</strong></p> This study describes the various types of material flows for linen (delivery and distribution of clean linen, collection and sorting of used linen) observed in four hotels of different classes. The strenuousness of the work of linen maids was evaluated based on the estimated weight of linen carried, work posture and cardiofrequency measurements. Results indicated that this occupation involves a moderate to high physical workload, primarily due to the manual handling of the linen and the loading and unloading of carts.</p> CATEGORIES: HOTEL WORKERS; WORK ENVIRONMENT</em></p>  </u></strong></p> Eriksson T, Jingkun L (2009). Working at the boundary between market and flexicurity: housekeeping in Danish hotels. International Labour Review 148(4):357-373.</strong> Abstract:</u> Though housekeeping in Danish hotels is unskilled, low-paid work, because of Denmark’s compressed wage structure it is comparatively well paid. The authors examine the working conditions and experience of housekeepers in eight hotels of various types, to establish the industry’s response to growing competition and pressure to restructure. Approaches include reorganizing work, increased work intensity, outsourced and in-house housekeeping, and Denmark’s own “flexicurity”. Flexible work arrangements, job security and in-kind social benefits prove to compensate for scanty unemployment insurance and career prospects. CATEGORIES: HOTEL WORKERS; WORK ENVIRONMENT</em></p> Esbenshade J, Mitrosky M, Morgan E, Navarro M, Rotundi M, Vazquez C 92006). Profits, pain, and pillows: hotels and housekeepers in San Diego. WorkingUSA: The Jounal of Labor and Society 9:265-292.</strong> Abstract:</u> The accommodations industry is hitting record-breaking profits nationally and locally, often with subsidies provided by government entities. Globalization is actually contributing to rising employment and a trade surplus in the tourism industry. However, increasing amenities and new work regimes are causing deteriorating conditions for many workers. In 2006, hotel workers across the country will be coordinating contract negotiations. Housekeepers, who make up almost a quarter of the hotel workforce, are the “face” of the national campaign. Through management interviews, analysis of government data, and a worker survey, this article provides a more complete picture of the living and working conditions of housekeepers in San Diego and nationally. http://onlinelibrary.wiley.com/doi/10.1111/j.1743-4580.2006.00113.x/full</a> CATEGORIES: HOTEL WORKERS; WORK ENVIRONMENT; PAIN</em></p>  </u></strong></p> Galinsky T L, Swanson NG, Sauter SL, Hurrell JJ, Schleifer LM [2000]. A field study of supplementary rest breaks for data-entry operators. Ergonomics 43</em>:622–638.</strong></p> CATEGORIES: WORK ENVIRONMENT</em></p>  </u></strong></p> Gill AS, Mathur N (2007). Improving employee dedication and pro-social behavior. Int J Contemporary Hospitality Mangement 19(4):328-334.</strong> Abstract</u>: PURPOSE: The purpose of this paper is to examine the relationship between transformational leadership and employee dedication and the relationship between transformational leadership and pro-social behaviour. This study seeks to extend Gill et al.’s findings regarding the impact of transformational leadership on job stress and the impact of job stress on burnout. DESIGN/METHODOLOGY/APPROACH – Hospitality industry employees were interviewed to find out if transformational leadership used by their managers improves employee dedication and pro-social behaviour. FINDINGS – Results suggest that employee dedication and pro-social behaviour are positively related to the improvement in the level of perceived transformational leadership implementation. PRACTICAL IMPLICATIONS – If employees perceive that their managers are using high-level transformational leadership, employee dedication and pro-social behaviour are perceived as higher level than if it is perceived as being used at lower level. ORIGINALITY/VALUE – This paper offers useful insights for hotel managers based on empirical evidence. CATEGORIES:  HOTEL WORKERS; WORK STRESS; WORK ENVIRONMENT</em></p> Henning R, Sauter S, Salvendy G, Krieg Jr, E, [1989]. Microbreak length, performance, and stress in a data entry task. Ergonomics 32 855–864.</strong></p> CATEGORIES: WORK ENVIRONMENT</em></p>  </u></strong></p> Krause N, Scherzer T, Rugulies R [2005]. Physical workload, work intensification, and prevalence of pain in low wage workers: results from a participatory research project with hotel room cleaners in Las Vegas. Am J Ind Med 48</em>(5):326–337.</strong></p> Abstract</u>. BACKGROUND: Occupational injury rates among hotel workers exceed the national service sector average. This study assesses the prevalence of back and neck pain, and its associations with physical workload, ergonomic problems, and increasing work demands. METHODS: Nine hundred forty-one unionized hotel room cleaners completed a survey about health and working conditions. Associations between job demands and pain were determined by logistic regression models adjusting for individual characteristics, cumulative work demands, care-taking responsibilities at home, and psychosocial job factors. RESULTS: The 1-month prevalence of severe bodily pain was 47% in general, 43% for neck, 59% for upper back, and 63% for low back pain. Workers in the highest exposure quartiles for physical workload and ergonomic problems were between 3.24 and 5.42 times more likely to report severe pain than workers in the lowest quartile. Adjusted odds ratios for work intensification ranged from 1.74 (upper back) to 2.33 (neck). CONCLUSIONS: Most room cleaners experience severe back or neck pain. Severe pain showed strong associations with physical workload, work intensification, and ergonomic problems.</p> CATEGORIES: HOTEL WORKERS; WORK ENVIRONMENT; PAIN</em></p>  </u></strong></p> Kristensen TS [1989]. Cardiovascular diseases and the work environment: a critical review of the epidemiologic literature on nonchemical factors. Scand J Work Environ Health 15</em>:165</strong>–</strong>179.</strong></p> CATEGORIES: CVD; WORK ENVIRONMENT</em></p>  </u></strong></p> Liladrie S (2010). “Do not disturb/please clean room”: hotel housekeepers in Greater Toronto. Race & Class 52(1):57-69.</strong> Abstract</u>. </strong>This study of the experiences of hotel housekeepers in Toronto, who are predominantly immigrant women of colour, reveals the damaging health impact of their work. As the hotel industry in this ‘global city’ has moved upmarket and sought to offer more luxury services to its wealthy customers, hotel housekeeping work has become more physically demanding and burdensome, resulting in the majority of workers experiencing a high degree of pains and injuries. The hotel industry is seen as operating a racialised division of labour, with those at the bottom vulnerable to being discarded as they approach retirement age and their health deteriorates. Finally, an account is given of the impact of unionisation and the hotel workers’ ongoing struggles for change. http://rac.sagepub.com/content/52/1/57.full.pdf+html</a> CATEGORIES: HOTEL WORKERS; WOMEN’S HEALTH; PAIN; INJURIES; WORK ENVIRONMENT; IMMIGRANT WORKERS</em></p> Lilley R, Feyer A, Kirk P, Gander P [2002]. A survey of forest workers in New Zealand Do hours of work, rest, and recovery play a role in accidents and injury? J Safety Research 33</em>: 53–71.</strong></p> CATEGORIES: WORK ENVIRONMENT</em></p> </strong>Lo K, Lamm F (2005). Occupational stress in the hospitality industry – an employment relations perspective. New Zealand J Employment Relations 30(1):23-47.</strong> Abstract:</u> This article endeavors to draw attention to occupational stress amongst workers in so-called ‘low risk industries’ – namely the service and hospitality industries – and to explore their perceptions of stress, their attitudes to managing stress and their responses to the recent inclusion of stress in the Health and Safety in Employment Amendment Act, 2002. It is also the intention to broaden the scope of analysis by investigating a range of employment factors – such as heavy workloads, interpersonal relationships and organizational factors – which can contribute to occupational stress amongst workers. Findings from two case studies are reported and they indicate that working in the hospitality industry can be stressful and that many workers are vulnerable in terms of their poor working conditions and low wages. Consistent with other studies, it was also found that there was low trade union presence and a high rate of casualization and staff turnover. At the same time, there was a lack of overt conflict between management and workers, with an apparent close alignment of goals between the two parties and a style of management that could be described as unitarist. CATEGORIES:WORK  STRESS; HOTEL WORKERS; WORK ENVIRONMENT</em></p>  </em></p> McNamara M, Bohle P, Quinlan M (2011). </strong>Precarious employment, working hours, work-life conflict and health in hotel work. Applied Ergonomics 42:225-232.</strong> Abstract.</u> Precarious or temporary work is associated with adverse outcomes including low control over working hours, work-life conflict and stress. The rise in precarious employment is most marked in the service sector but little research has been done on its health effects in this sector. This study compares permanent and temporary workers in the hotel industry, where working hours are highly variable. Survey data from 150 workers from eight 3-Star hotels in urban and regional areas around Sydney were analyzed. Forty-five per cent were male and 52 per cent were female. Fifty four per cent were permanent full-time and 46 per cent were temporary workers. The effects of employment status on perceived job security, control over working hours, and work-life conflict are investigated using PLS-Graph 3.0. The effects of control over working hours, on work-life conflict and subsequent health outcomes are also explored. Temporary workers perceived themselves as less in control of their working hours, than permanent workers (β = .27). However, they also reported lower levels of work intensity (β = .25) and working hours (β = .38). The effects of low hours control (β = .20), work intensity (β = .29), and excessive hours (β = .39) on work-life conflict (r² = .50), and subsequent health effects (r² = .30), are illustrated in the final structural equation model. CATEGORIES: HOTEL WORKERS; WORK ENVIRONMENT</em></p> O’Neill J, Davis K (2009). Differences in work and family stress experienced by managers and hourly employees in the hotel industry. Amherst, MA: University of Massachussetts. 2009 ICHRIE Conference. </strong>Abstract</u>. During economic downturns, hospitality industry employees are often asked to do more with less, and this situation creates stress among employees. Employee stress is becoming a significant issue in the hospitality industry, and it is costly for employers and employees alike. Stress results in overall declines in employee productivity, job performance, and customer service, and also results in increases in hostility, withdrawal, and costly turnover and health care costs. Although addressing and reducing stress in the hospitality industry is both a noble goal and is capable of resulting in expense reductions for employers, the nature and quantity of hospitality employee stress is not fully understood. Research regarding stress in the hospitality industry is an understudied topic. This study aims to identify the most common work stressors of a sample of 164 managerial and hourly workers who were each interviewed for eight consecutive days, and were employed at 65 different hotels across the United States. Further, this study examines whether there are differences in the types and frequency of work and family stressors between managers and non-managers, and also for men/women, parents/non-parents, married/single, and based on the quantity of working hours. http://scholarworks.umass.edu/cgi/viewcontent.cgi?article=1075&context=refereed&sei-redir=1&referer=http%3A%2F%2Fwww.google.com%2Furl%3Fsa%3Dt%26rct%3Dj%26q%3Ddifferences%2520in%2520work%2520and%2520family%2520stress%2520experienced%2520by%2520managers%2520and%2520hourly%2520employees%2520in%2520the%2520hotel%2520industry.%26source%3Dweb%26cd%3D1%26ved%3D0CB4QFjAA%26url%3Dhttp%253A%252F%252Fscholarworks.umass.edu%252Fcgi%252Fviewcontent.cgi%253Farticle%253D1075%2526context%253Drefereed%26ei%3Ddn-hTr_1MsGutwfr4aSVBQ%26usg%3DAFQjCNHtL9I14igbLyohdAQ2e1pe3tMAeg#search=%22differences%20work%20family%20stress%20experienced%20by%20managers%20hourly%20employees%20hotel%20industry.%22</a> CATAGORIES: HOTEL WORKERS; WORK STRESS; WORK ENVIRONMENT</em></p> Onsøyen LE, Mykletun RJ, Steiro TJ (2009). </strong>Silenced and invisible: the work experience of room attendants in Norwegian hotels. Scand J Hospitality Tourism 9(1):81-102. </strong>CATEGORIES: HOTEL WORKERS; WORK ENVIRONMENT</em></p> Pollert A, Wright T [2006]. The experience of ethnic minority workers in the hotel and catering industry: routes to support and advice on workplace problems. London: Working Lives Research Institute.</strong></p> CATEGORIES: HOTEL WORKERS; WORK ENVIRONMENT</em></p>  </u></strong></p> Quirion F, Poirier P, Lehane P [2008]. Improving the cleaning procedure to make kitchen floors less slippery. Ergonomics 51</em>(12):2013–2029.</strong></p> Abstract</u>. This investigation shows that, in most cases, the floor cleaning procedure of typical restaurants could be improved, resulting in a better cleaning efficiency and a better floor friction. This simple approach could help reduce slips and falls in the workplace. Food safety officers visited ten European style restaurants in the London Borough of Bromley (UK) to identify their floor cleaning procedure in terms of the cleaning method, the concentration and type of floor cleaner and the temperature of the wash water. For all 10 restaurants visited, the cleaning method was damp mopping. Degreasers were used in three sites while neutral floor cleaners were used in seven sites. Typically, the degreasers were over diluted and the neutrals were overdosed. The wash water temperature ranged from 10 to 72 degrees C. The on-site cleaning procedures were repeated in the laboratory for the removal of olive oil from new and sealed quarry tiles, fouled and worn quarry tiles and new porcelain tiles. It is found that in 24 out of 30 cases, cleaning efficiency can be improved by simple changes in the floor cleaning procedure and that these changes result in a significant improvement of the floor friction. The nature of the improved floor cleaning procedure depends on the flooring type. New and properly sealed flooring tiles can be cleaned using damp mopping with a degreaser diluted as recommended by the manufacturer in warm or hot water (24 to 50 degrees C). But as the tiles become worn and fouled, a more aggressive floor cleaning is required such as two-step mopping with a degreaser diluted as recommended by the manufacturer in warm water (24 degrees C).</p> CATEGORIES: WORK ENVIRONMENT</em></p>  </u></strong></p> Rugulies R, Scherzer T, Krause N [2008]. Associations between psychological demands, decision latitude, and job strain with smoking in female hotel room cleaners in Las Vegas. Int J Behav Med 15</em>(1):34–43.</strong></p> Abstract</u>. BACKGROUND: Little is known of the impact of the work environment on smoking among women holding low-paid jobs in the service sector. PURPOSE: To study the associations between the components of the demand-control model with smoking in hotel room cleaners. METHODS: We conducted a survey on work and health among 776 female hotel room cleaners in Las Vegas. Associations between psychosocial work characteristics and smoking were analyzed with multivariate regression analyses.</p> RESULTS: Psychosocial work characteristics were associated with smoking after adjustment for covariates. Effect estimates were substantially reduced by additional adjustment for ethnicity, but remained significant for high psychological demands and smoking prevalence (OR = 1.97, p = 0.02), high job strain and smoking prevalence (OR = 1.87, p = 0.04), and high job strain and smoking intensity (coefficient = 3.52, p = 0.03). When analyses were restricted to Hispanic workers and further adjusted for place of birth, low decision latitude (coefficient = 3.94, p = 0.04) and high job strain (coefficient = 4.57, p = 003) were associated with smoking intensity but not with smoking status.</p> CONCLUSION: Workplace smoking cessation programs may benefit from a primary prevention component reducing job strain among service workers. More research is needed on perceived and objective differences in psychosocial work characteristics across ethnic, immigrant, and other social groups within the same occupation.</p> CATEGORIES: HOTEL WORKERS; WORK ENVIRONMENT</em></p>  </u></strong></p> Seifert AM, Messing K (2006). Cleaning up after globalization: an ergonomic analysis of work activity of hotel cleaners. Antipode 38:557-578. </strong>Abstract.</u> Hotels and hotel chains are responding to globalization and increased competition through new marketing initiatives, employment practices, and restructuring decisions that are intensifying the work of cleaners. In this paper, we report on how such work intensification at two hotels in Montre´al, Canada, is changing the nature of cleaners’ jobs. Specifically, we found that the numbers of operations to be completed, the numbers and weights of items to be cleaned, and the effort involved have all increased. ‘‘Flexible’’ employment relationships and outsourcing have also worsened cleaners’ workloads. In response to our research, the labour union representing cleaners has negotiated a lower number of room assignments per cleaner, as well as an improved way of taking into account the variability of work when determining the quota of rooms to be cleaned. Despite this, new marketing strategies continue to intensify work. We conclude that standards and regulation on a governmental level are a necessary complement to union actions. http://onlinelibrary.wiley.com/doi/10.1111/j.0066-4812.2006.00595.x/pdf</a> CATEGORIES: HOTEL WORKERS; WORK ENVIRONMENT</em></p> Shani A, Pizam A (2009). Work-related depression among hotel employees. Cornell Hospitality Quarterly 50(4):446-459.</strong> Abstract</u>.</u> Given the putative cost of work-related depression, this article reports the results of a pilot study conducted among hotel employees in Central Florida. The study finds an initial indication of a small but noteworthy incidence of depression among workers in the hospitality industry. The article explores the antecedents and possible origins of depression, as well as critical issues related to depression in the workplace, particularly its effects on organizations and employees. The findings indicate a need for greater organizational awareness of depression. http://cqx.sagepub.com/content/50/4/446.full.pdf+html</a> CATEGORIES: HOTEL WORKERS; WORK ENVIRONMENT</em></p> Vredenburgh AG [2002]. Occupational Safety: which management practices are most effective in reducing employee injury rates? J Safety Research 33</em>(2):259–276.</strong></p> CATEGORIES: WORK ENVIRONMENT; INJURIES</em></p>  </u></strong></p> Wial H, Rickert J (2002). US hotels and their workers:  room for improvement. Washington, DC: AFL-CIO Working for America Institute.</strong> Abstract.</u> The U.S. hotel industry, a low-wage industry that has grown rapidly over the past two decades provides jobs for workers with little formal education or training, including some people leaving welfare. Hotels have also received public economic development subsidies as part of central city economic development projects. This report summarizes the industry’s performance on issues of interest to its workers and to those who are concerned about low-wage workers and wage inequality, the opportunities available to people leaving welfare and the quality of jobs created by businesses receiving public economic development subsidies. http://www.hotel-online.com/News/PR2002_3rd/Aug02_HotelJobs.html</a> CATEGORIES: HOTEL WORKERS; WORK ENVIRONMENT</em></p>  </u></strong></p> Zock JP [2005]. World at work: cleaners. Occup Enviorn Med 62</em>(8):581–584.</strong></p> Abstract</u>: Cleaning workers form an important proportion of the total working population, particularly among women. This paper reviews some of the most common occupational hazards in cleaning work, and discusses possibilities to improve control and prevention. Topics covered: physical workload and strain; accidents; dermal, respiratory and other effects of chemical products; psychosocial problems; measures to protect workers.</p> CATEGORIES: WOMEN’S HEALTH; WORK ENVIRONMENT</em></p>

Beemsterboer W, Stewart R, Groothoff J, Nijhuis F [2009]. On regional differences in determinants of </strong>sick leave frequency for cleaning workers in two regions of the Netherlands: a comparative study. Int J Occup Med Environ Health. 22</em>(3):203‒214.</strong></p> Abstract: </u>OBJECTIVES: To explore regional differences in the effects of the sick leave frequency determinants between two homogeneous groups of workers from two comparable socio-economic regions in the Netherlands, namely Utrecht and South Limburg. MATERIALS AND METHODS: Data on sick leave frequency for 137 cleaning workers in the regions of Utrecht (mean sick leave frequency: 0.89 spells) and South Limburg (mean sick leave frequency: 1.66 spells) were obtained from a Dutch social fund, and the data regarding their job, and health-related and individual characteristics were elicited by an interview. RESULTS: A statistical analysis of the sick leave frequency in the two regions showed little differences, except for the determinant ‘perceived physical workload’ which was associated with the sick leave frequency in South Limburg but not in Utrecht. CONCLUSION: A regional difference in the sick leave frequency was noted with respect to ‘perceived physical workload’ as the study parameter. This would indicate that the findings of our earlier studies performed in the nineties of the last century. are still relevant. In further research, the principles of the new certification system on sick leave frequency should also be considered, as the previous uniform statutory compensation system has been terminated.</p> CATEGORIES: WORK STRESS; ERGONOMICS</em></p>  </u></strong></p> Belkic KL, Landsbergis PA, Schnall PL, Baker D [2004]. Is job strain a major source of cardiovascular disease risk? Scand J Work Environ Health. 30</em>(2):85</strong>–</strong>128.</strong></p> Abstract.</u> Empirical studies on job strain and cardiovascular disease (CVD), their internal validity, and the likely direction of biases were examined. The 17 longitudinal studies had the highest validity ratings. In all but two, biases towards the null dominated. Eight, including several of the largest, showed significant positive results; three had positive, nonsignificant findings. Six of nine case-control studies had significant positive findings; recall bias leading to overestimation appears to be fairly minimal. Four of eight cross-sectional studies had significant positive results. Men showed strong, consistent evidence of an association between exposure to job strain and CVD. The data of the women were more sparse and less consistent, but, as for the men, most of the studies probably underestimated existing effects. Other elements of causal inference, particularly biological plausibility, corroborated that job strain is a major CVD risk factor. Additional intervention studies are needed to examine the impact of ameliorating job strain upon CVD-related outcomes.</p> CATEGORIES: WORK STRESS; CVD</em></p>  </u></strong></p> Blackwell RH. Out of the frying pan: a study of stress in the hospitality industry.  Leeds, UK: Leeds Metropolitan University, Leeds Polytechnic, Leisure, and Consumer Studies.</strong> CATEGORIES: HOTEL WORKERS; WORK STRESS</em></p> Bongers PM, Kremer AM, ter Laak J [2002]. Are psychosocial factors, risk factors for symptoms and signs of the shoulder, elbow, or hand/wrist? A review of the epidemiological literature. Am J Ind Med 41</em>(5): 315</strong>–3</strong>42.</strong></p> Background In 1993, an extensive review on the role of psychosocial factors in the development of musculoskeletal problems was published by Bongers et al (1993). Since then, additional reviews on this topic have been published; however, none of these focused on upper limb problems. Methods In this systematic review, the methodological quality of all studies was assessed and levels of evidence were apriori defined. Results: The large majority of the studies reported an association between at least one work-related psychosocial factor and adverse upper extremity symptoms or signs. High perceived job stress was consistently associated with all upper extremity problems (UEP) in high and lower quality studies. Although not often studied, non-work-related stress was also consistently associated with UEP. In addition, there was some evidence for a relationship between high job demands and UEP, although the results did not meet the pre-set criterion for consistency. Conclusions High job stress and non-work-related stress reactions are consistently associated with UEP. In addition, high job demands is also in most studies associated with these disorders. Firm conclusions on the role of these factors in the etiology of UEP are not possible due to the cross-sectional nature of most studies. Am. J. Ind. Med. 41:315-342, 2002.</p> CATEGORIES: WORK STRESS; MSDs; REVIEW ARTICLES</em></p>  </strong></p> Charles LE, Loomis D, Demissie Z [2009]. Occupational hazards experienced by cleaning workers and janitors: a review of the epidemiologic literature. Work 34(1):105‒116.</strong></p> Abstract: </u>Building cleaners are an important group of workers who experience diverse occupational hazards resulting in health problems. A review of epidemiologic studies conducted between 1981 and 2005 was performed using PubMed and PsychLit, to identify health outcomes and the associated hazards in the work environment of cleaners. Among 35 studies, respiratory diseases (n=17) and dermatologic diseases (n=9) were the most common and were associated with exposure to cleaning agents, wet work, and rubber latex. The potential for infectious diseases (n=3) was identified among cleaners in medical laboratories and was associated with exposure to broken glass and uncapped needles in the trash. Musculoskeletal disorders (n=5) were associated with several physical stressors (e.g., awkward postures, prolonged standing) and psychosocial stressors (e.g., monotonous job, low potential for promotion). Mental disorders (n=1) were also associated with psychosocial stressors and societal stigma. Future studies may be enhanced by better assessment of the specific job exposures of cleaners and implementation of a prospective design.</p> CATEGORIES: CUSTODIAL WORKERS; ERGONOMICS; CHEMICAL HAZARDS; WORK STRESS; REVIEW ARTICLES; RESPIRATORY</em></p>  </strong></p> Davis K [2000]. The relationship between psychosocial work characteristics and low back pain: underlying methodological issues. Clin Biomech 15</em>(6):389</strong>–</strong>406.</strong></p> Abstract</u>. Background. Psychosocial work characteristics have been widely evaluated as potential risk factors for low back injury. However, studies with different study populations and using various types of measures have had conflicting results.</p> Methods. This review is the most extensive to date, reviewing 66 articles that have provided empirical evidence about the relationship between psychosocial work characteristics and initial reporting of lower back pain. The studies are reviewed with an emphasis on certain methodological issues: controlling for potential confounding; timing of the data collection; and measurement of the exposures and outcomes.</p> Results. The results of this review suggest that controlling for potential confounding from occupational biomechanical demands had a large influence on the associations found between psychosocial work characteristics and lower back pain. In addition, the use of accurate and reliable measures for the occupational exposures (biomechanical and psychosocial) and the lower back pain outcomes appears to influence the strength of the associations found between psychosocial work characteristics and lower back pain.</p> Conclusion. Given the methodological concerns discussed in this review, it is difficult to draw strong causal inferences from this literature. However, it does appear that psychosocial characteristics are related to some lower back pain outcomes, and that employees’ reactions to psychosocial work characteristics (e.g., job dissatisfaction and job stress) are more consistently related to lower back pain than are the psychosocial work characteristics themselves (e.g., work overload, lack of influence over work, quality of relationships with coworkers).Relevance: This review attempts to identify and address methodological issues in the literature evaluating the relationship between psychosocial work characteristics and lower back pain. Implications for future research are presented.</p> CATEGORIES: REVIEW ARTICLES; WORK STRESS; PAIN</em></p>  </u></strong></p> DHPE [2008]. Focusing the lens: exploring the impact of job stress among Hispanic/Latina blue-collar workers. By Griffin-Blake S, Alarcon-Yohe M, Berktold J, Liburd L. </strong>Washington, DC</strong>: </strong>U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Directors of Health Promotion and Education.</strong></p> CATEGORIES: WORK STRESS; IMMIGRANT WORKERS</em></p>  </u></strong></p> Faulkner B, Patiar A (1997). Workplace-induced stress among operational staff in the hotel industry. Int J Hospitality Management 16(1):99-117.</strong> Abstract:</u> Stress is an integral part of all aspects of an individual’s life. In the workplace, as in other areas, stress can play a positive role by increasing alertness among staff and mobilizing their adaptive capabilities. To some extent, therefore, a certain level of stress has the potential to actually contribute to organizational effectiveness. However, stress can become counterproductive once excessive levels of unresolved stress begin to affect the health and productivity of the workforce. Employers in any setting therefore have both commercial and moral reasons for being sensitive to the incidence of stress and developing management approaches for controlling it. This is particularly so in industries such as the hotel industry, which are both labour intensive and dependent upon face to face contact with guests in the delivery of services. This paper examines the sources of stress among front office and housekeeping operational staff in four star international standard hotels on the Gold Coast (Queensland, Australia) with a view to exploring the management implications of this phenomenon. While the sample size and the context of the study limit our ability to generalize from survey results, an indication of problems requiring adjustments in management approach is provided. In particular, it appears that, while staff in both areas are susceptible to stress, front office staff are more vulnerable owing to the nature of their duties and aspects of their background that make them more sensitive to organizational deficiencies. CATEGORIES: HOTEL WORKERS; WORK STRESS</em></p> Finch, BK, Kolody B, Vega WA [2000]. Perceived discrimination and depression among Mexican-origin adults in California. J Health Soc Behav 41</em>(3):295–313.</strong></p> Abstract</u>. This study provided a test of the minority status stress model by examining whether perceived discrimination would directly affect health outcomes even when perceived stress was taken into account among 215 Mexican-origin adults. Perceived discrimination predicted depression and poorer general health, and marginally predicted health symptoms, when perceived stress was taken into account. Perceived stress predicted depression and poorer general health while controlling for the effects of perceived discrimination. The influence of perceived discrimination on general health was greater for men than women, and the effect of perceived stress on depression was greater for women than men. Results provide evidence that discrimination is a source of chronic stress above and beyond perceived stress, and the accumulation of these two sources of stress is detrimental to mental and physical health. Findings suggest that mental health and health practitioners need to assess for the effects of discrimination as a stressor along with perceived stress.</p> CATEGORIES: WORK STRESS; IMMIGRANT WORKERS</em></p>  </em></p> Gany F, Dobslaw R, Ramirez J, Tonda J, Lobach I, Leng J [2011]. Mexican urban occupational health in the US: a population at risk. J Community Health 36(2):175‒179.</strong></p> Abstract: </u>Mexicans are the largest immigrant group in the US. Little is known about their urban occupational health status. We assess occupational illness, injury, and safety training among New York City Mexican immigrants. This study is a consecutive sample of the Mexican immigrant population utilizing Mexican Consulate services in New York City over two weeks in March 2009. Bilingual research assistants approached persons waiting in line at the Consulate and administered an occupational health questionnaire. 185 people agreed to participate. Most work in restaurants (37%), cleaning (18%), construction (12%), babysitting/nanny (7%), retail (9%), and factories (5%). 22% had received safety training. 18% reported work-related pain or illness. 18% suffered from a job-related injury since immigrating. Most injuries were in construction, factories, and restaurants. 29% had not reported their injury. This study provides evidence that the urban Mexican immigrant population is at high risk for work-related illness and injury, is not receiving adequate safety training, and is under-reporting occupational injury. Culturally and linguistically responsive community outreach programs are needed to provide occupational health and safety information and resources for urban Mexican workers.</p> CATEGORIES: WORK STRESS; IMMIGRANT WORKERS; INJURIES</em></p>  </u></strong></p> Gill AS, Mathur N (2007). Improving employee dedication and pro-social behavior. Int J Contemporary Hospitality Mangement 19(4):328-334.</strong> Abstract</u>: PURPOSE: The purpose of this paper is to examine the relationship between transformational leadership and employee dedication and the relationship between transformational leadership and pro-social behaviour. This study seeks to extend Gill et al.’s findings regarding the impact of transformational leadership on job stress and the impact of job stress on burnout. DESIGN/METHODOLOGY/APPROACH – Hospitality industry employees were interviewed to find out if transformational leadership used by their managers improves employee dedication and pro-social behaviour. FINDINGS – Results suggest that employee dedication and pro-social behaviour are positively related to the improvement in the level of perceived transformational leadership implementation. PRACTICAL IMPLICATIONS – If employees perceive that their managers are using high-level transformational leadership, employee dedication and pro-social behaviour are perceived as higher level than if it is perceived as being used at lower level. ORIGINALITY/VALUE – This paper offers useful insights for hotel managers based on empirical evidence. CATEGORIES:  HOTEL WORKERS; WORK STRESS; WORK ENVIRONMENT</em></p> Holtermann A, Blangsted AK, Christensen H, Hansen K, Søgaard K [2009]. What characterizes cleaners sustaining good musculoskeletal health after years with physically heavy work? Int Arch Occup Environ Health 82</em>(8):1015–1022.</strong></p> Abstract</u>. OBJECTIVES: The aim of this case-control study was to investigate characteristics of cleaners with good musculoskeletal health after years with physically heavy work. METHODS: One hundred and 41 female seniority cleaners participated. Twenty-five reported no musculoskeletal symptoms, whereas 83 reported severe symptoms in the low back, neck shoulders or upper limbs. The groups were of matching age, height, body weight and seniority (19 years). Muscular strength was recorded by isometric maximal voluntary contractions on a day without pain. Exposure to physical risk factors at work, psychosocial work factors, and leisure time physical activity were assessed by a postal questionnaire. RESULTS: Cleaners with good musculoskeletal health were not reporting different exposure to physical risk factors at work or leisure time physical activity, but had higher muscular strength and reported higher influence at work than cleaners with severe symptoms. CONCLUSIONS: These findings suggest that muscular strength and influence at work are of relevance for sustaining good musculoskeletal health in workers with physically heavy work.</p> CATEGORIES: MSDs; WORK STRESS; WOMEN’S HEALTH</em></p>  </u></strong></p> O’Neill J, Davis K (2009). Differences in work and family stress experienced by managers and hourly employees in the hotel industry. Amherst, MA: University of Massachussetts. 2009 ICHRIE Conference. </strong>Abstract</u>. During economic downturns, hospitality industry employees are often asked to do more with less, and this situation creates stress among employees. Employee stress is becoming a significant issue in the hospitality industry, and it is costly for employers and employees alike. Stress results in overall declines in employee productivity, job performance, and customer service, and also results in increases in hostility, withdrawal, and costly turnover and health care costs. Although addressing and reducing stress in the hospitality industry is both a noble goal and is capable of resulting in expense reductions for employers, the nature and quantity of hospitality employee stress is not fully understood. Research regarding stress in the hospitality industry is an understudied topic. This study aims to identify the most common work stressors of a sample of 164 managerial and hourly workers who were each interviewed for eight consecutive days, and were employed at 65 different hotels across the United States. Further, this study examines whether there are differences in the types and frequency of work and family stressors between managers and non-managers, and also for men/women, parents/non-parents, married/single, and based on the quantity of working hours. http://scholarworks.umass.edu/cgi/viewcontent.cgi?article=1075&context=refereed&sei-redir=1&referer=http%3A%2F%2Fwww.google.com%2Furl%3Fsa%3Dt%26rct%3Dj%26q%3Ddifferences%2520in%2520work%2520and%2520family%2520stress%2520experienced%2520by%2520managers%2520and%2520hourly%2520employees%2520in%2520the%2520hotel%2520industry.%26source%3Dweb%26cd%3D1%26ved%3D0CB4QFjAA%26url%3Dhttp%253A%252F%252Fscholarworks.umass.edu%252Fcgi%252Fviewcontent.cgi%253Farticle%253D1075%2526context%253Drefereed%26ei%3Ddn-hTr_1MsGutwfr4aSVBQ%26usg%3DAFQjCNHtL9I14igbLyohdAQ2e1pe3tMAeg#search=%22differences%20work%20family%20stress%20experienced%20by%20managers%20hourly%20employees%20hotel%20industry.%22</a> CATAGORIES: HOTEL WORKERS; WORK STRESS; WORK ENVIRONMENT</em></p> Rugulies R, Krause N [2005]. Job strain, isostrain, and incidence of back and neck injury:  a 7.5-year prospective study of San Francisco transit operators. Soc Sci Med 61</em>(1):27</strong>–39</strong>.</strong></p> CATEGORIES: INJURIES; WORK STRESS</em></p>