High altitude is not just an issue for mountain climbers. Elevation can have implications for employees ranging from laborers to office workers to scientists. Awareness is key to effective management.

During the past decade, interest in the public and environmental health effects of trace levels of pharmaceuticals and personal care products in the water supply has evolved. Although most pharmaceuticals are tested for human safety and efficacy prior to marketing and distribution, the potential for adverse effects in nontarget populations exposed to minute environmental medication doses has not been established. Several recent studies have demonstrated adverse effects from longstanding, low-dose exposures in both aquatic and terrestrial wildlife, although human toxicity related to trace levels of pharmaceuticals in the water supply remains unknown. This article provides a brief overview of the routes through which pharmaceuticals are introduced into the environment; a description of the effects of longstanding, low-dose exposures in aquatic and terrestrial animals, including human health effects; an update on the current regulations and solutions regarding pharmaceutical disposal practices; and a discussion of implications for reducing pharmaceuticals in the environment for occupational health nurses and other allied health professionals.

Much has been written about how to facilitate an effective meeting, but apparently not every meeting facilitator has read the literature because every occupational health nurse has endured a "bad" meeting. Individuals who chair meetings have a responsibility to create meetings that are worthwhile to the attendees; attendees have a responsibility to be prepared for meetings so meetings are productive. This article reviews key meeting strategies, providing readers with ways to improve meetings they attend or facilitate.

Worker health is influenced by workplace, work processes, and workmates. This case study shows it is possible to create health connections for vulnerable working populations through health and wellness coaching. The health and safety of team members has been improved by providing on-site health coaching linked to mental and emotional well-being, as well as financial security. By leveraging the collective efficacy of the workplace, more vulnerable populations can become better health care consumers, with increased self-efficacy in promoting their own health and wellness and that of their families.

Population health-based chronic care models of care are useful in improving the health of a population while decreasing the health care dollars spent on the population. Diabetes is a disease that can be evaluated and treated using these models of care. The Metro Nashville Public Schools Diabetes Health Management Program has been shown to be beneficial to both clients and their insurance trust in improving the health of this population of individuals and decreasing the dollars spent on this disease.

Daily administration of soy isoflavones for 2 years did not prevent bone loss or menopausal symptoms.

Employee health, prevention, and maintenance programs are growing exponentially each year as costs continue to rise across the health care continuum. Employers and payers alike continue to be challenged by chronic health risks, effective prevention strategies, optimal health and wellness strategies, and programs that are effective for America's work force. In light of these challenges, new and exciting health management approaches are evolving. Changes in occupational health nursing practice can ultimately affect the way occupational health nurses plan, structure, and conduct education sessions. New trends, such as health coaching, embrace the incorporation of health research through evidence-based practice and standards of care to provide the science clinicians need to support interventions. Through knowledge of chronic conditions, evidence-based practice, and health coaching, occupational health nurses possess the skills and strategies that form the foundation necessary to affect and safely guide employee self-discovery and self-management and produce optimal health outcomes.

The Deepwater Horizon oil spill is the most recent manmade disaster to challenge occupational health nurses caring for a unique worker population. The effects of oil spills on wildlife, marine life, and the ecosystem are well studied and documented, but the effects on workers who contain and abate such disasters are not. These workers can suffer from a multitude of illnesses and injuries, such as ataxia, migraines, and various lung diseases, which can be a challenge for occupational health nurses.

Medical surveillance is mandated for workers with potential exposure to hazardous materials. However, little guidance is provided regarding the components of a medical surveillance testing program for these individuals. This article describes the medical surveillance program for a group of 72 employees who respond to hazardous material releases throughout the United States. Conditions related to chemical exposures were not identified in this group. However, several non-occupational health conditions were identified, including a relatively high prevalence of one or more signs of metabolic syndrome. Medical surveillance may provide valuable information regarding an individual's underlying health status and non-occupational health conditions to be addressed at an early stage.

This review sought to assess compliance concerns, determine risk management strategies, and identify opportunities for future research to contribute to employers' understanding of the laws and regulations that apply to on-site care. A comprehensive review of databases, professional organizations' websites, and journals resulted in 22 publications reporting on the consequences of noncompliance among on-site health centers accepted for inclusion. None of those studies reported a study design or quantifiable outcome data. Two noncompliance themes were repeated among the publications. First, direct penalties included fines, civil actions, loss of licensure, and, potentially, criminal charges. Second, noncompliance also resulted in indirect costs such as employee mistrust and lowered standards of care, which jeopardize on-site health centers' ability to demonstrate a return on investment. Further research with rigorous methodology is needed to inform employer decisions about on-site health services and associated risk management.

Occupational health nurses are at the forefront of obesity assessment and intervention and must be aware of potential inaccuracies of obesity measurement. The purpose of this study was to identify the prevalence of obesity among a sample of 84 male police officers 22 to 63 years old and determine the accuracy of body mass index (BMI) in estimating obesity compared to body fat percent (BF %). BMI identified 39.3% of the participants as obese, compared to 70.2% by BF %. BMI misclassified normal-weight officers as obese or overweight and obese officers as normal 48.8% (n = 41) of the time. The two misclassified groups had similar average BMIs but significantly different BF %. BMI was not an accurate measure of obesity among adult males. BMI underestimated the true prevalence of obesity and could represent a missed opportunity for early intervention and disease prevention.

CDC statistics reflect the dramatic increase in obesity in the United States in the past 20 years, with 33 states having a prevalence of 25% or greater. Eating disorders and obesity have major implications for occupational health nurses.

This article discusses select characteristics of the aging work force, health-related issues that can impact work productivity, and strategies and resources that can foster a more productive work environment. The older work force is vital to the future of the U.S. economy. Employers should recognize the value of older workers. Occupational health nurses can assist older workers in maintaining and optimizing their health.