A postal survey was conducted among 200 Finnish occupational physicians and nurses on their ethical values and problems. Both groups considered 'expertise' and 'confidentiality' as the most important core values of occupational health services (OHS) corresponding with newly published national ethical guidelines for occupational physicians and nurses in Finland. Nearly all respondents had encountered ethically problematic situations in their work, but ethical problems with gene testing in the near future were not considered likely to occur. Only 41% of the nurses and 36% of the physicians had received some training in the ethics of OHS, and 76% of all respondents never used available ethical guidelines. According to the results, even if ethics play a vital role in OHS, the ability to critically evaluate one's own performance seems quite limited. This creates a need for further training and more practicable national guidelines.
Supported by an economic evaluation, rotavirus vaccine is introduced into the national immunisation schedule in Finland. The vaccination programme has been estimated to be reasonably cost-effective. Given at the age of two, three and five months, the vaccine is expected to prevent annually in Finland among children under the age of five years approximately 2,000 rotavirus diarrhoea episodes needing hospitalisation, and over 10,000 outpatient visits. The impact of the programme will be evaluated in 2011 by repeating the economic analysis and carefully monitoring adverse events.
This paper describes 2 outbreaks of hepatitis A infection in Finland, a very low endemic area of hepatitis A infection, where a large proportion of the population is now susceptible to infection by hepatitis A virus (HAV). The first outbreak involved people attending several schools and day-care centres; the second employees of several bank branches in a different city. The initial investigation revealed that both were related to food distributed widely from separate central kitchens. Two separate case-control studies implicated imported salad food items as the most likely vehicle of infection. HAV was detected in the stool of cases from both outbreaks using reverse-transcriptase polymerase chain reaction; however, comparison of viral genome sequences proved that the viruses were of different origin and hence the outbreaks, although occurring simultaneously, were not linked. Foodborne outbreaks of HAV may represent an increasing problem in populations not immune to HAV.
Natural immunity to Haemophilus influenzae type b (Hib) invasive disease is based on antibodies arising in response to encounters with Hib or cross-reactive (CR) bacteria. The relative importance of Hib and CR contacts is unknown. We applied a statistical model to estimate the total rate of immunizing infections of Hib and CR prior to wide-scale vaccinations in Finland and the UK. The average rates of these contacts were 0.7 and 1.2 per year per child in Finland and the UK, respectively. Using a rough estimate of 0.1 Hib acquisitions per year per child in the UK based on carriage rates, the proportion of Hib among all immunizing contacts was in the order of 10%, suggesting that CR bacteria have a major role. In general, varying frequency of CR contacts may explain some differences in the pre-vaccination incidence and age-distribution of invasive disease in different countries.
Selection into and out of a profession is a known phenomenon in jobs such as hairdressing, in which the workers are exposed to agents and conditions capable of causing work-related symptoms and diseases.
To assess the risk for departure from the profession due to health and other reasons among hairdressers as compared with women engaged in commercial work.
We used a self-administered questionnaire to provide data on 3484 female hairdressers and 3357 referents with regard to their reasons for leaving the profession during the 15-year follow-up period of 1980 1995, for which the relative risks (RR) and 95% confidence intervals (CI) were calculated. The data were collected in August 1995.
Of the reasons studied, only the concern for health increased the risk of leaving the profession (RR 1.33; 95% CI 1.16-1.52) among hairdressers. The risk of hairdressers having to leave the profession (1) because of asthma or hand eczema was 3.5 times as great as that found among the control group, (2) because of a strain injury of the wrist or elbow was 2.7 times as great, and (3) because of diseases of the neck or shoulders was 1.7 times as great. The risk of leaving the profession was approximately 20% higher for hairdressers who had suffered at some point in their lives from an atopic disease.
Hairdressers suffering from atopic diseases, hand eczema, and strain injuries of the elbow and wrist are at higher risk of leaving the profession. Active modes of intervention are needed to maintain their working ability. The tools available in the occupational health service are: information on hazards, optimization of working conditions, personal protection, and timely medical care and rehabilitation.
The effects of psychological workload on inflight heart rate were studied in five experienced (flight instructors) and five less experienced (cadets) military pilots of the Finnish Air Force (FAF).
The subjects performed the same flight mission twice; first with the BA Hawk MK 51 simulator with minimal G-forces and after that with the BA Hawk MK 51 jet trainer with Gz-forces below +2. The mission included: a) 2 min rest after seating; b) take-off; c) ILS approach in the minimum weather conditions (initial, intermediate and final approach); d) landing tour (visual approach); and e) landing. The heart rates were continuously measured using a small portable recorder developed at the University of Jyv?skyl?, Finland. The R-R intervals were stored and analyzed with an accuracy of 1 ms. The different phases of each flight were marked in the data by using codes given beforehand for each critical event.
The take-off resulted in a significant increase in the heart rate from the resting levels both in the cadets and the flight instructors in both planes. In the simulator the heart rate decreased during the initial approach and slightly increased after it during the intermediate approach. Thereafter the heart rate decreased during the landing tour which seemed to be the least psychologically demanding phase of the simulated flight. The heart rate increased again during the landing but did not exceed the heart rates measured during the take-off and the ILS-approach. There were no statistical differences between the groups. In the jet trainer no decrease in the heart rate could be observed immediately after the take-off, unlike in the case of the simulated flight. The inflight heart rate increased during the final approach, decreased during the landing tour and finally increased during the landing. According to the heart rate analysis the final approach was the most loaded phase of the real flight. The changes towards the phases of final approach and landing were greater among the flight instructors.
There were no statistically significant differences between the mean heart rates during the real and the simulated flight. It is suggested that the heart rate changes for most reflected the changes in cognitive workload.