Carel Hulshof

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Anna M. Czarnecka

Medical University of Warsaw

Michael J. Gonzalez

Universidad de Puerto Rico Rio

Dr. Gary Kao

University of Pennsylvania

Joan M Dizon

Southern Luzon State University

Emmanuel Azuike

Chukwuemeka Odumegwu Ojukwu University, Igbariam Campus

Eduardo Meditsch

Universidade Federal de Santa Catarina - UFSC (Federal University of Santa Catarina)

Leonardo Briceño Ayala

Universidad del Rosario

Logan Molyneux

Temple University

Ibtessam R Hussein

King AbdulAziz University (KAU) Jeddah, Saudi Arabia

Khalid Sait

King AbdulAziz University (KAU) Jeddah, Saudi Arabia

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Papers by Carel Hulshof

Ach, die mannen…

TBV – Tijdschrift voor Bedrijfs- en Verzekeringsgeneeskunde

Improving fit to work assessments for rail safety workers by exploring work limitations

International Archives of Occupational and Environmental Health, Feb 11, 2016

Conclusions Our results indicate that fit to work assessments should include both health complain... more

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approach to the public health. In Turkey, the health transformation program for the development o... more approach to the public health. In Turkey, the health transformation program for the development of healthcare services was initiated in 2002 and primary health care services were prioritised. Also within this scope, the OSH Department of Public Health Institution of Turkey (PHIT) is actively involved with occupational health since 2011. In addition, after the law enacted in 2012, Community Health Centres (CHC) serving under the PHIT started to give OSH services to the sector. Smaller companies hire OSH services from a private organisation or from a CHC (currently 84 out of 900 CHCs provide OSH services). Family physician system has been introduced, and as of today, approximately 23 000 family physician are widely available throughout the country. The fight against chronic diseases is at the main agenda of Turkey. Surveillance studies for awareness, data collection, analysis and prevention and protection are also continuing, especially in primary health care services. Taking advantage of the knowledge and experience of international studies with the public health approach and sharing our own experiences will contribute to the worldwide OSH services.

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Do overweight/obesity and low levels of leisure-time vigorous physical activity moderate the effect of occupational physical activity on self-rated health of construction workers?

International Archives of Occupational and Environmental Health, Oct 7, 2021

Purpose To investigate the combined effects of occupational physical activity (OPA) and either ov... more Purpose To investigate the combined effects of occupational physical activity (OPA) and either overweight/obesity or low levels of leisure-time vigorous physical activity (LTVPA) on self-rated health. Methods A longitudinal study was performed among 29,987 construction workers with complete data on 2 Workers' Health Surveillance Programs during 2010-2018. Self-reported OPA involved strenuous work postures and manual material handling. Low level of LTVPA was defined as self-reported vigorous activity for less than three times per week lasting at least 20 min per session. Overweight and obesity were based on Body Mass Index (BMI) (25.0 ≤ BMI < 30.0 kg/m 2 and BMI ≥ 30.0 kg/m 2 , respectively) using measured body height and weight. Self-rated health was measured using a single item question. Logistic regression analysis was used to investigate the associations between the separate risk factors at baseline and self-rated health at follow-up. The combined effects of demanding OPA and either overweight/obesity or low level of LTVPA on self-rated health were analyzed using the relative excess risk due to interaction (RERI).

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The process evaluation of a citizen science approach to design and implement workplace health promotion programs

BMC Public Health, Aug 24, 2022

Background: Many workplace health promotion programs (WHPPs) do not reach blue-collar workers. To... more Background: Many workplace health promotion programs (WHPPs) do not reach blue-collar workers. To enhance the fit and reach, a Citizen Science (CS) approach was applied to co-create and implement WHPPs. This study aims to evaluate i) the process of this CS approach and ii) the resulting WHPPs. Methods: The study was performed in two companies: a construction company and a container terminal company. Data were collected by questionnaires, interviews and logbooks. Using the framework of Nielsen and Randall, process measures were categorized in the intervention, context and mental models. Interviews were transcribed and thematically coded using MaxQDA software. Results: The involvement in the CS approach and co-creating the WHPPs was positively experienced. Information provision, sustained engagement over time and alignment with the workplace's culture resulted in barriers in the CS process. As to the resulting WHPPs, involvement and interaction during the intervention sessions were particularly experienced in small groups. The reach was affected by the unfavorable planning off the WHPPs and external events of re-originations and the covid-19 pandemic. Discussion: Continuous information provision and engagement over time, better alignment with the workplace's culture and favorable planning are considered to be important factors for facilitating involvement, reach and satisfaction of the workers in a Citizen science approach to design and implement a WHPP. Further studies continuously monitoring the process of WHPPs using the CS approach could be helpful to anticipate on external factors and increase the adaptability. Conclusions: Workers were satisfied with the involvement in WHPPs. Organizational and social cultural factors were barriers for the CS approach and its reach. Involvement and interaction in WHPPs were particularly experienced in small grouped sessions. Consequently, contextual and personal factors need be considered in the design and implementation of WHPPs with CS approach among blue-collar workers.

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Outcomes of seafarer work fitness qualifications in the Netherlands

Occupational Medicine, Mar 6, 2014

Background Seafaring is a dangerous profession involving high fatality rates and little research ... more Background Seafaring is a dangerous profession involving high fatality rates and little research has been done to identify conditions that may lead to failing the seafarer's medical qualification (SMQ). Aims To determine the proportion of seafarers failing to pass the SMQ in the Netherlands during 2012, to analyse the outcomes of the SMQ according to qualification, age, duties and requirements of additional evaluations and to describe the reasons for considering a seafarer unfit for duty. Methods A retrospective descriptive study of SMQs registered in the Netherlands Shipping Inspectorate database. Results Less than 1% (46 cases; 0.6%) of the 7617 final SMQ candidates were considered unfit for duty with 53% (24) of these being temporarily unfit. Four per cent (276) of cases were classified 'fit with restrictions' and 1% (66) 'fit by exemption' (FEx). Re-examination was required in 2% (122) of cases. A second opinion from a medical referee was sought in 4% of cases. The highest rate of FEx was found in older seafarers (aged over 55) due to restrictions in hearing and vision in the majority (59%) of cases. The leading causes of unfitness were other medical reasons, mainly associated with cardiovascular conditions and morbid obesity, in 52% of cases and visual impairment in 34%. Conclusions The proportion of seafarers considered unfit in the SMQ carried out in the Netherlands in 2012 is relatively low. The proportion of FEx was higher in older groups, mainly due to hearing or visual impairments.

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Economic Evaluation of an Occupational Health Care Guideline for Prevention of Weight Gain Among Employees

Journal of Occupational and Environmental Medicine, Sep 1, 2013

Objective: To determine the cost-effectiveness and the financial return of a guideline for occupa... more Objective: To determine the cost-effectiveness and the financial return of a guideline for occupational physicians (OPs), aimed at the prevention of weight gain among employees. Methods: The guideline consisted of a company-environment scan and up to five individual sessions with an OP. Sixteen OPs randomized to the guideline (n = 7) or usual care group (n = 9) recruited 275 and 249 employees. Costs were collected by using 3-monthly retrospective questionnaires. Quality-adjusted lifeyears gained were determined with 6-monthly administered EuroQol-5D. Waist circumference and body weight were measured at baseline and 18 months. Results: Unfavorable differences were found on waist circumference (+1.6 cm; 95% confidence interval [CI], 0.27 to 2.90) and weight (+1.1 kg; 95% CI, 0.01 to 2.15). Probabilities of cost-effectiveness were consistently less than 55%. Net employer loss was €-158 (95% CI,-2865 to 2672). Conclusions: The occupational health care guideline was not cost-effective and no financial return was shown.

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Which outcomes should always be measured in intervention studies for improving work participation for people with a health problem? An international multistakeholder Delphi study to develop a core outcome set for Work participation (COS for Work)

BMJ Open

ObjectiveSynthesising evidence of the effects of interventions to improve work participation amon... more ObjectiveSynthesising evidence of the effects of interventions to improve work participation among people with health problems is currently difficult due to heterogeneity in outcome measurements. A core outcome set for work participation is needed.Study design and settingFollowing the Core Outcome Measures in Effectiveness Trials methodology, we used a five-step approach to reach international multistakeholder consensus on a core outcome set for work participation. Five subgroups of stakeholders took part in two rounds of discussions and completed two Delphi voting rounds on 26 outcomes. A consensus of ≥80% determined core outcomes and 50%–80% consensus was required for candidate outcomes.ResultsFifty-eight stakeholders took part in the Delphi rounds. Core outcomes were: ‘any type of employment including self-employment’, ‘proportion of workers that return to work after being absent because of illness’ and ‘time to return to work’. Ten candidate outcomes were proposed, among others:...

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Extensive variability of work participation outcomes measured in randomized controlled trials: a systematic review

Journal of Clinical Epidemiology

OBJECTIVE To investigate how work participation outcomes in randomized controlled trials are meas... more OBJECTIVE To investigate how work participation outcomes in randomized controlled trials are measured internationally and across disciplines. STUDY DESIGN AND SETTING We identified trials that reported on work participation in Medline, Embase, PsycINFO and Cochrane Central published between 2014 and 2019. Screening, selection and data extraction were done by two authors independently. We grouped outcomes into four categories ("employment status", "absence from work", "at-work productivity loss" and "employability") and created sub-categories according to how the outcome was measured. RESULTS From 10,022 database hits we selected 269 trials reporting on 435 work participation outcomes. Authors used inconsistent outcome terminology to describe the measured constructs. Grouped in four main categories we identified 70 outcomes that reported on "employment status", 196 on "absence from work" and return-to-work, 132 on "at-work productivity loss" and 37 on "employability" outcomes. Variability in measurement methods existed across all categories. Employment status and absenteeism measures consisted mostly of clinimetrically unvalidated tools. "At-work productivity loss" and "employability" were measured by at least 41 different questionnaires. CONCLUSION Extensive variability exists among trials in the measurement of outcomes, measurement methods and measurement instruments that focus on work participation. This study is a first step towards the development of a Core Outcome Set for work participation.

Low back pain in drivers exposed to whole-body vibration: the vibrisks multicenter study

4th International Conference on Whole Body Vibration (WBV2009), 2009

ABSTRACT

Legal banning of asbestos for preventing asbestos exposure

Cochrane Database of Systematic Reviews, 2022

The reporting of work participation outcomes and measurement methods in randomized controlled trials: a systematic review

Safety and Health at Work, 2022

Perceptions on best ways to measure work participation. An international survey among randomized controlled trialists and Cochrane systematic reviewers

Safety and Health at Work, 2022

E-nergEYEze, a vision-specific eHealth intervention based on cognitive behavioral therapy and self-management to reduce fatigue in adults with visual impairment: study protocol for a randomized controlled trial

Trials, 2021

Background More than half of the adults with visual impairment experience severe symptoms of fati... more Background More than half of the adults with visual impairment experience severe symptoms of fatigue, with a negative impact on daily life. Since there is no evidence-based treatment to reduce fatigue in adults with visual impairment, we developed E-nergEYEze, an eHealth intervention based on cognitive behavioral therapy and self-management tailored to the needs of visually impaired adults. The aim is to describe the study protocol of a randomized controlled trial testing E-nergEYEze. Methods A randomized controlled trial will be conducted to investigate the cost-effectiveness and cost-utility of E-nergEYEze to reduce fatigue severity compared to care as usual from a healthcare and societal perspective. A total of 172 severely fatigued adults with visual impairment will be recruited and randomized to either the E-nergEYEze intervention plus care as usual or to care as usual only (ratio 1:1). Inclusion criteria are having a visual impairment, experiencing severe fatigue (Checklist In...

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Nachtwerk? Nee, tenzij

TBV – Tijdschrift voor Bedrijfs- en Verzekeringsgeneeskunde, 2021

Praktijktest van de Praktijkwijzer PreventieConsult Cardiometabool Risico voor Bedrijfsartsen

Herstel van whiplash volgens de patiënt: bijdrage van kwalitatief onderzoek

TBV – Tijdschrift voor Bedrijfs- en Verzekeringsgeneeskunde, 2020

tbv jaargang 28 | nr.9 | oktober 2020 6 J.L. Hoving, M.A.C. van Son, C. Zemouri, M.H.W. Frings-Dr... more tbv jaargang 28 | nr.9 | oktober 2020 6 J.L. Hoving, M.A.C. van Son, C. Zemouri, M.H.W. Frings-Dresen, C.T.J. Hulshof CTJ Amsterdam UMC, Universiteit van Amsterdam, Afdeling Coronel Instituut voor Arbeid en Gezondheid. Amsterdam Public Health research institute, Amsterdam Correspondentieadres: j.l.hoving@amsterdamumc.nl Inleiding Volgens de Quebec Task Force (QTF) is bij whiplash associated disorder (WAD) sprake geweest van een acceleratie-deceleratiemechanisme waarbij versnellende en vertragende krachten hebben ingewerkt op de nek.1 Hierbij is whiplash de naam voor het ongevalsmechanisme dat kan zorgen voor verschillende symptomen. De meest beschreven en relatief milde vorm van WAD is graad I, waarbij met name pijn optreedt. Bij graad II treden tevens nekklachten en andere klachten zoals afgenomen mobiliteit of drukpuntgevoeligheid op. Een deel van de whiplashklachten verdwijnt na verloop van tijd spontaan, maar ongeveer 43% van de patiënten heeft één jaar na het ongeval nog steeds nekpijn en één op de vijf patiënten met een particuliere arbeidsongeschiktheidsverzekering is na één jaar nog niet aan het werk.2 Ook blijkt een derde van de patiënten vijf jaar na het ongeval nog steeds klachten als vermoeidheid, hoofdpijn, een verminderd geheugen en beperkingen bij het autorijden te ervaren.3 Het perspectief van patiënten met WAD over de inschatting van en verhouding tussen fysieke, psychische en sociale aspecten, mogelijkheden en belemmeringen is van belang bij de multidisciplinaire begeleiding van mensen met WAD4, maar ontbreekt veelal in bestaande richtlijnen over whiplash.5-7 Het patiëntenperspectief kan de behoeften van patiënten met betrekking tot het zorgaanbod mede vormgeven en kan daarmee ook de doeltreffendheid van de zorg verbeteren.8 Het patiëntenperspectief en de ervaringskennis van patiënten kan een belangrijke aanvulling zijn op wetenschappelijke kennis en praktijkkennis van zorgverleners. Hoewel evidence-based medicine (EBM) de integratie beoogt van het best beschikbare wetenschappelijke bewijs met individuele geneeskundige expertise en de waarden en verwachtingen van patiënten9, wordt aan dit laatste aspect nog betrekkelijk weinig aandacht besteedt in richtlijnen over whiplash. De vraagstelling van dit onderzoek is daarom: wat is het perspectief van patiënten ten aanzien van hun herstel na een whiplashongeval?

Voorkomen is beter dan herstellen

TBV – Tijdschrift voor Bedrijfs- en Verzekeringsgeneeskunde, 2020

Infection control and standard precautions is evidence-based practices that can reduce the risk o... more Infection control and standard precautions is evidence-based practices that can reduce the risk of transmission of microorganisms. Infection control education is a fundamental component of the Nursing curriculum. A cross-sectional study was conducted to assess the level of knowledge and practices regarding infection control among nurses in secondary level hospital at 250 beds Chittagong General Hospital and Fouzderhat TB Hospital, Chittagong. The study period was 1 st January to 31 st December 2018. Total 182 nurses were included in this study. The respondents were selected by purposive sampling technique and data were collected by face to face interview. The study was found that (78.0%) respondents had fair knowledge and (90.2%) had fair practices regarding infection control. The study also revealed that, 161 (88.5%) respondents awarded about hand washing, 179 (98.4%) respondents were concerned about waste management and 93 (51.1%) respondents agree and 85 (46.7%) respondents strongly agree about PPE use is important. Significant statistical difference was found between working experience and knowledge level. This study can be concluded that in spite of practice level regarding infection control, nurses had fair knowledge level. These finding suggest that nurse knowledge and practice regarding infection control need further improvement.

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P.2.31 Association between work and chronic obstructive pulmonary disease review of systematic reviews

Occupational and Environmental Medicine, 2019

IntroductionChronic Obstructive Pulmonary Disease (COPD) is a highly prevalent disease with repor... more IntroductionChronic Obstructive Pulmonary Disease (COPD) is a highly prevalent disease with reported prevalence up to 12%. Although smoking is one of the main factors in causing COPD, evidence from systematic reviews grows that also occupational exposures contribute. To examine whether work-related risk factors are associated with chronic pulmonary obstructive disease (COPD) a review of systematic reviews was performed.MethodsMedline was searched from 2009 until 20 June 2017 for systematic reviews. Systematic reviews were included when outcome data were described in terms of clinically assessed COPD by means of data on lung function and at least two levels of work-related exposure were mentioned (exposed versus low or non-exposed). One author selected studies and extracted data, two authors assessed study quality with AMSTAR.ResultEight systematic reviews met the inclusion criteria. In all reviews various exposures to vapour, dusts, gases, and fumes (VGDF) at work are associated wit...

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1710d Systematic reviews and evidence-based guidelines, two of a different kind?

Epidemiology, 2018

the editorial base alike. It is therefore important that the reviews that are eventually publishe... more the editorial base alike. It is therefore important that the reviews that are eventually published provide the most informative answers to the most relevant questions to guide decision-making. Asking vague questions leads to vague answers and is a waste of time, money and resources. Methods Any question arising from practice that has to do with choosing a suitable intervention for a particular health issue can be formulated to contain the elements p=Participants, I=Intervention(s), C=Control and O=Outcome(s). Similarly, a research study evaluating the effectiveness of a particular intervention and a systematic review aiming to make a summary of all sufficiently similar studies ought to use this recipe. This talk will explore how each of these elements influence the whole review process from searching studies to making a synthesis of their findings and reporting results. Result We will compare a convenience sample of five recent Cochrane Work reviews with another five recent non-Cochrane reviews for their use of PICO and how it is implemented throughout the review. Discussion PICO is a simple tool that will ensure that research will answer the question of interest that has arisen from practice. Ignoring PICO almost certainly leads to a biassed review process and consequently biassed review results. PICO is the most important ingredient in enabling evidence-based medicine.

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Ach, die mannen…

TBV – Tijdschrift voor Bedrijfs- en Verzekeringsgeneeskunde