Database

Stress is frequently assumed to affect the functioning of the immune system. If so, stress could increase vulnerability to disease. Reduced resilience could be described as a material contribution to outcome, or as a risk factor. It could also be that reduced immune system capacity increases a sense of lack of well-being. Views may be pieced together from research. Evidence from: Cohen S, et al. Psychological Stress and Antibody Response to Immunisation: A Critical Review of the Human Literature. Psychosomatic medicine 63(2001), 7-18 Not having found any evidence that stress moderates responses to immunisation, the authors propose that the stress effect must be in real life exposures, but don’t provide any evidence of this. The Radar report is available to subscribers: SK 1#2 9 Evidence from: SK Agarwal et al. Clinical and Experimental Allergy. Jan (2001) Vol. 31 p.25. A study of teenagers under stress, and effects on asthma. The hypothesis is that stress induces dysregulation of

A causal link between stress and heart disease would prompt significant liability exposure. Heart disease is very common. Feelings of being hassled are very common, and may be caused by heart disease or high blood pressure. Unravelling this knot will draw on disparate and incomplete studies. Evidence from: T.Hallman et al. Journal of Cardiovascular Risk Feb (2001) Vol.8 #1 p.39. After suffering manifest coronary disease it was found that compared with controls, there was excess family strife, physical stress, burn-out, daily hassles. Some of these could be subject to modification at work. The Radar report is available to subscribers: SK 1#2 7 Evidence from: GW Evans et al. Journal of Applied Psychology. Oct (2000) Vol. 85 #5 p.779. 40 experienced female office workers were assigned at random to a well-controlled trial of office work with or without open office noise at 55 dBA. Epinephrine, nor epinephrine and cortisol were measured before and after the test period. Subjects were asked

Identification of risk factors is a sensible precursor to designing interventions and seeing if they work as expected. It would seem obvious then that if a supposed risk factor turns out not to be valid then it should not feature in intervention studies or duty of care standards. Evidence from:  M.Hakkanen et al. Occupational and Environmental Medicine (2001) Vol.58 #2 p.129. Results show that the most significant risk factor for absence with diagnosable arm, neck and shoulder disorders is age: Age 30-40 Risk Ratio = 2.9 (95% confidence interval 1.2 to 7.1). High physical load was protective. The Radar report is available to subscribers: SK 1#2 5 Evidence from: G.A.M.Ariens et al. Occupational and Environmental Medicine (2001) Vol.58 #3 p.200. Among those sitting, neck pain (but not a diagnosis) was more likely if the neck was flexed by 20 degrees for more than 70% of the time. The Radar report is available to subscribers: SK 1#2 6 Evidence from: RSI conference 2nd March 2001. RSI was

Fibromyalgia (FM) is probably multi factorial in origin. Evidence from: A.Hakkinen et al. Annals of Rheumatic Disease (2001) Vol. 60 #1, p. 21. Muscle strength training works just as well for FM as for health people. This very small study shows that people with FM may have completely normal muscle health. If so, some other cause must be sought. The Radar report is available to subscribers: SK 1#2 2 Evidence from: R.Kwaitek et al. Arthritis and Rheumatism (Dec 2000) Vol. 43 #12. Small reductions in blood flow were detected in the thalamus of the Fibromyalgia cases. These were not sufficiently distinct to be diagnostic. The Radar report is available to subscribers: SK 1#2 3 Evidence from: V.Hadhazy et al. Journal of Rheumatology (2000) Vol.27 p.2911. Strenuous exercise improves quality of life for FM cases. But doesn’t cure FM. The suggestion is that there is no organic disease sufficient to negate the effects of fitness improvement. The Radar report is available to subscribers: SK

OSHA (USA) have published a framework and supporting tools for the prevention and management of work-related musculoskeletal disorders. The approach is essentially one of responding to significant symptoms by first deciding if they are significant and then, caused by work. the latter includes cases where the initial injury was not at work but where work could slow recovery or aggravate the injury. By responding to symptoms, the standard selects the most vulnerable rather than the average worker. Evidence from: OSHA Ergonomics Standard and supporting evidence review. SK 1#2 1 Evidence from: Occupational Health Review May/June 2001 p 3 Confirmation that the “Ergonomics Standard” which was accepted in the last few days of the Clinton administration, has now been revoked. The standard has been discussed in detail in a previous issue of The State of Knowledge journal Vol. 1#2. The argument against the standard seems to have revolved around the economic burden on business. It is not clear th

This review was created at the outset of the Radar project. The summary here covers diagnosis, causation, foreseeability, duty of care, prognosis, rehabilitation, mitigation, exposure variation. Evidence from: Andrew@reliabilityoxford.co.uk Early attempts to audit stress risk were conceptually flawed. The Radar report is available to subscribers: SK 1#1 3