The perspective of European researchers of national occupational safety and health institutes for contributing to a European research agenda: a modified Delphi study

Development of family resource indicators for people with schizophrenic disorder in community by modified Delphi method in Beijing, China

INTRODUCTION

Most people with schizophrenia in China are supported by their family members in community. The patient's family is confronted with severe care burden and pressure, which directly affects the caregiver's own health and social life, and indirectly affects the patient's rehabilitation. Adequate family resources can reduce the burden and pressure on families. But there is an absence of systematic family resource indicators for people with schizophrenic disorder in China.

OBJECTIVES

This study aimed to develop a set of family resource indicators for people with schizophrenic disorder in China.

DESIGN

Preliminary family resource indicators were generated and refined by literature review and an expert consultation meeting. Two rounds of email-based Delphi survey were carried out to identify family resource indicators.

SETTING

Two rounds of email-based Delphi survey were performed from July to September 2021 in Beijing, China.

PARTICIPANTS

There were 15 mental health doctors from community health service centres and four psychiatrists from tertiary hospitals, and two primary care researchers from universities in the first and second rounds Delphi survey.

RESULTS

All the 21 experts participated in both rounds of Delphi survey. A total of 46 indicators achieved consensus for inclusion in the final set of indicators after two rounds of Delphi survey. The final set of indicators was grouped into 10 domains: financial support (three indicators), psychological and spiritual support (eight indicators), medical treatment (three indicators), information and education (three indicators), structural support (two indicators), external family resources included social resources (five indicators), cultural resources (two indicators), economic resources (seven indicators), environmental resources (four indicators) and medical resources (nine indicators).

CONCLUSIONS

A set of 46 family resource indicators for people with schizophrenic disorder in community was identified by an iterative Delphi process in Beijing, China. However, the indicators still need to be validated by testing in further studies.

Partnership for European Research in Occupational Safety and Health (PEROSH) - Celebrating 20 years of collaboration

In September 2023, researchers and research directors from the Partnership for European Research in Occupational Safety and Health (PEROSH) convene at its conference in Stockholm. The conference marks the 20th anniversary of European collaboration. PEROSH is comprised of 14 research institutes from 13 European countries: the Austrian Social Insurance for Occupational Risks (AUVA), the (German) Federal Institute for Occupational Safety and Health (BAuA), the (Polish) Central Institute for Labour Protection - National Research Institute (CIOP-PIB), the Finnish Institute of Occupational Health (FIOH), the (UK) Health and Safety Executive (HSE), the Italian Workers Compensation Authority (INAIL), the (German) Institute for Occupational Safety and Health (IFA), the (French) National Institute of Occupational Research and Risk Prevention (INRS), the (Spanish) National Institute of Safety and Health at Work (INSST), the (Danish) National Research Centre for the Working Environment (NFA), the Swedish Agency for Work Environment Expertise (SAWEE), the (Norwegian) National Institute of Occupational Health (STAMI), the (Dutch) Organisation for Applied Scientific Research (TNO), and the (Swiss) Center for Primary Care and Public Health (Unisanté). Together, PEROSH`s member institutes comprise more than 2000 occupational safety and health (OSH) experts and provide a significant research contribution to OSH research in Europe and globally. In a study of six OSH networks from different parts of the world, the International Labor Organization (ILO) identified that PEROSH had “strong national and regional policy impact” and profiled the partnership in detail (1, 2).

The history of PEROSH The establishment of PEROSH was inspired by the continued relevance of the international “Sheffield Group”, an informal network of directors general of national OSH research institutes across the globe. The network first met in 1989 at the laboratory of the HSE (at that time based in Sheffield). Its members span four continents: North America (IRSST – Canada and NIOSH – USA); Oceania (NIOH –New Zealand), Asia (IIOSH – Israel, JNIOSH – Japan, KOSHA – South Korea and WSHI – Singapore), and Europe. The institutes host annual meetings on a rotating basis. After the turn of the millennium, European members realized the need to address OSH transnational issues at the European level. National institutes for OSH research in Europe play a distinctive role in identifying salient or emerging OSH issues, producing, and synthesizing evidence to inform decisions for a plethora of system actors such as national policymakers, regulators, health and insurance systems, and industry and trade unions. In an increasingly globalized world, OSH challenges transcend national borders and the European Union continues to play an important role. European members recognized the opportunity to exploit role synergies and leverage national funding through collaboration. This opportunity initiated the establishment of PEROSH.

Structure and organization The partnership operates through a formal agreement renewed in 2018 and is formally governed by a Steering Committee (SC), consisting of the directors general or research directors of each member institute. The SC is responsible for the strategy and management of PEROSH, including financial decisions and admitting new members to its ranks. Further, the Executive Committee supports the SC in managing operations. The Scientific Steering Group, which comprises the Research Director or Head of Science for each institute, sets priorities, and manages all joint research activities and events.

Each member institute pays an annual membership fee. The fees fund support activities, including the Manager of International Affairs (MIA), the Secretariat, digital resource management and dissemination.

Mission and vision The mission of PEROSH is to create and exchange new research-based OSH knowledge and practice and make it accessible to policymakers, organizations, employees, and employers in the worklife and other stakeholders in Europe for better decision-making in policy and practice (3). PEROSH’s vision is that policymakers, organisations, employees and employers in the worklife and other stakeholders across Europe are informed by and use PEROSH-generated knowledge in their efforts to develop innovative and sustainable, healthy and safe workplaces.

The partnership seeks impact and adds value through the exchange of knowledge and good practices across Europe to the benefit of all its members and stakeholders. The PEROSH strategy outlines four areas of activity to attain its mission: (i) pooling resources and create new OSH evidence by joint activities; (ii) disseminating and exchanging knowledge on OSH issues between members and to relevant stakeholders nationally and European institutions; (iii) providing evidence that informs decisions by national and European policymakers on healthy and safe working lives; and (iv) identifying emerging research challenges in the OSH field.

Research priorities The Joint Research Programme was introduced in 2009 and aimed at realizing synergies in distinctive research needs that transcend national boundaries across the European institutes. Today, PEROSH’s Joint Research Programme consists of a set of collaborative activities (research projects, exploratory workshops, scientific conferences etc.) between member institutes driven by member institutes’ research priorities. Around 6–10 activities are ongoing every year. Normally, about half of the 14 partner institutes are involved in each one. Some projects also include research institutes outside PEROSH.

Many projects address the need to both facilitate and undertake the synthesis of existing research evidence. Across the PEROSH collaboration projects, cross-cutting aims include:

• Generating or synthesizing evidence that can be used at national level to underpin and inform decision-making at policy, intermediary, and workplace levels; • Collective development of practical tools and guidelines for use by OSH professionals and companies to support occupational health and safety; • Development of data review methodologies, taxonomies and databases to enable national-level research and survey data to be captured and used systematically for transnational evidence synthesis; and • Comparisons of national-level health and safety practices and guidelines to identify new avenues for exploration by the wider research community to deliver common needs for Europe.

A few years ago, an interdisciplinary group of researchers from PEROSH member institutes conducted a review of European research priorities. The research team applied a modified Delphi study, which was a first attempt to provide the European OSH research community perspectives on priorities for further OSH research. They noted differences across European geographical areas. Overall the most important research topics identified were: older workers; nanomaterials; emerging technological devices; chemical agents; and working conditions, working organisation and job content. Gauging across research priorities variations, priority was also given to emergent issues such as OSH management in new forms of employment (ie. precarious work); impacts of innovation and new ways of working (ie, telework, boundary less work); health and safety in human–computer interaction (ie, artificial intelligence); and the introduction of unsafe and unhealthy work equipment.

Further, two transversal priorities were identified: knowledge translation and exchange of research results into practical and effective tools; and supporting implementation of OSH research findings in micro, small and medium enterprises (4). Some of these priorities are reflected in current joint research projects in PEROSH. Over the years, the collaboration in PEROSH has resulted in more than 40 joint research publications, several researcher exchange programs, development of methodology guidelines, establishment of databases, position papers, and advocacy towards the European Commission and Parliament on research priorities in OSH policy development. For PEROSH and its member institutes, it remains a continuous priority to identify and utilize pathways to influence OSH policy decisions at European level and at national level.

Knowledge dissemination Outcomes of PEROSH’s joined activities are disseminated through its website, social media (Twitter, LinkedIn), newsletters and webinars. Special PEROSH sessions were organized at the last World Congress for Safety and Health and ICOH Congress. PEROSH has a publicly accessible repository with all its report, articles, and presentations. This repository can be disclosed using any search term one prefers. Policy-makers at the European level are reached through personal contacts with the European Commission and its agencies and through the distribution of fact sheets. A close link is established with the Commission`s Directorate General for Employment on guidance issues and the EU Agency for Occupational Safety and Health (EU-OSHA) on research priorities. Policy-makers on the national level are reached through the individual members. Prolonging Working Life, research into how prolonged working life is tackled in Europe, was initiated on a request from the Danish Government and NFA, the Danish PEROSH member, who sought to use the PEROSH network to see other countries deal with this issue.

Conclusion Despite policy and practical efforts throughout Europe, occupational exposures resulting in health and safety challenges remains a considerable burden for the individual, society and the economy (5). If the challenges are to be met, it is essential to leverage scarce research funds, exchange knowledge and improve the evidence base for political priorities. Over the past 20 years, PEROSH has become an important platform for leveraging discussions and providing input to policymakers at the European level.

Health research priorities for wildland firefighters: a modified Delphi study with stakeholder interviews

OBJECTIVES

The increase in global wildland fire activity has accelerated the urgency to understand health risks associated with wildland fire suppression. The aim of this project was to identify occupational health research priorities for wildland firefighters and related personnel.

DESIGN

In order to identify, rank and rate health research priorities, we followed a modified Delphi approach. Data collection involved a two-stage online survey followed by semi-structured interviews.

SETTING

British Columbia, Canada.

PARTICIPANTS

Participants included any current or past wildland firefighter or individuals engaged in related roles. There were 132 respondents to the first survey. Responses to the first survey were analysed to produce 10 research topics which were ranked by 75 participants in the second survey (response rate: 84%).

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome was the identification, ranking and level of agreement of research priorities through a two-round online survey. We contextualised these findings through deductive and inductive qualitative content analysis of semi-structured interviews.

RESULTS

The most important research priorities identified were (% consensus): effects of smoke inhalation on respiratory health (89%), fatigue and sleep (80%), mental health (78%), stress (76%) and long-term risk of disease (67%). Interviews were completed with 14 individuals. Two main themes were developed from an inductive content analysis of interview transcripts: (1) understanding the dynamic risk environment; and (2) organisational fit of mitigation strategies.

CONCLUSIONS

Participants expressed a general concern with the unknown mental and physical health impacts of their jobs, including the long-term risk of morbidity and mortality. Future research must address knowledge gaps in our understanding of the health impacts of wildland fire and work to develop appropriate mitigation strategies while considering the needs of workers and unpredictable workplace environment.

TRIAL REGISTRATION NUMBER

Open Science Framework, https://osf.io/ugz4s/.

Development of a competency model for general practitioners after standardized residency training in China by a modified Delphi method

BACKGROUND

The "5 + 3" residency training is the main stream general practitioner training program in China. However, a competency model is absent for evaluating the clinical competence attained by general practitioners after training. This study was conducted to develop a consensus set of competencies for general practitioners after standardized residency training in China.

METHODS

A modified Delphi process was deployed to develop the competency model, including two stages: (1) generation of an initial set of competencies derived from literature review, behavioral observation of GP-patient consultations, and critical incidents interview of GPs; (2) a 2-round, web-based Delphi survey of experts in general practice, selected using purposive sampling, to prioritize and gain consensus on the essential competencies of GPs.

RESULTS

From literature review, behavioral observation, and critical incidents interview, 46 competencies in 7 domains were identified. After two rounds of Delphi survey of 28 participants (the mean age was 47.9 [9.3] years and 64.3% were women) representing a range of health professionals (GPs, managers, and researchers), a consensus was reached on 50 competencies categorized into 7 domains.

CONCLUSION

A consensus-based competency model for general practitioners in China has been identified which may be used to evaluate the general practitioners' clinical competence after standardized training.

Contribution of ICOH to Address the Different OSH Needs among Countries: Results of a Survey

The aim of this study is to map the coverage of occupational safety and health (OSH) rules and provisions and their enforcement at a country level worldwide. Members' participation in the International Commission on Occupational Health (ICOH) activities was also investigated. We used a questionnaire-based survey to collect data. An online questionnaire was administered from February 14 to March 18, 2018 to all ICOH members for the triennium 2015 to 2017 (n = 1929). We received 384 completed questionnaires from 79 countries, with a 20% response rate. To synthesize information about the coverage of OSH rules and provisions and their level of enforcement, a synthetic coverage index was calculated and combined with country, gross domestic product (GDP) per capita and the human development index (HDI). We used multiple correspondence analysis (MCA) to analyze the members' participation in ICOH activities. More than 90.0% of the sample declared that in their own country there is a set of rules and provisions regulating OSH in the workplace, and training procedures and tools to improve workers' awareness. However, these rules and training procedures are mainly "partially" enforced and utilized (39.0% and 45.4%). There was no statistically significant association between country and GDP per capita and the synthetic coverage index, whilst controlling for HDI. The level of engagement in ICOH activities is higher in senior members (aged 65 years or older), coming from high-income countries, having held a position within ICOH, with a higher level of education and a researcher position. An integrated and multidisciplinary approach, which includes research, education and training, is needed to address OSH issues and their impact both at global and country level.

Exploring prevention and mitigation strategies to reduce the health impacts of occupational exposure to wildfires for wildland firefighters and related personnel: protocol of a scoping study

BACKGROUND

With an increase in wildfire activity across the globe and growing numbers of personnel involved each year, it is necessary to explore the health impacts of occupational exposure to wildfires and the practices and policies that can be implemented to mitigate these effects. The aim of this work is to (1) identify the impact occupational exposure to wildfires has on health outcomes including physical, mental, and social wellbeing; (2) examine the characteristics and effectiveness of mitigation strategies or policies to reduce negative health impacts as reported by current literature and reports; and (3) develop a program of research to address and understand the health impacts of occupational exposure to wildfires based on gaps in the literature and stakeholder priorities.

METHODS

This scoping study will be conducted in two phases: (1) scoping literature review and (2) modified Delphi process. The literature review will follow a methodologically rigorous scoping review approach that includes (a) identifying the research question (and protocol development), (b) identifying literature (an iterative process), (c) selecting relevant studies, (d) extracting data into tables, and (e) synthesizing, summarizing, and reporting results. Alongside this, a modified Delphi process will be conducted to define priorities for wildland fire occupational health research. A partnership with the British Columbia (BC) Wildfire Service will enable exploring the appropriateness of identified mitigation strategies and health risks for the BC context.

DISCUSSION

This two-phase approach will provide an in-depth review of the literature of the health impacts of occupational exposure to wildfires and identify mitigation strategies or policies implemented to protect workers and reduce negative health impacts. It is anticipated that these findings may provide recommendations for "quick wins" or initial action that can be implemented within the BC context to reduce negative health outcomes, and inform gaps in context-specific research that needs to be addressed through a strategic, collaborative research program over the next 5 years.

SYSTEMATIC REVIEW REGISTRATION

Open Science Framework osf.io/ugz4.

[Examining competencies for labor and social security attorneys in the field of occupational mental health]

AIM

Labor and social security attorneys (LSSAs) are involved in the field of occupational mental health. However, little attention has been paid to the involvement of LSSAs in this field. This study investigated the occupational mental health competencies that are expected of LSSAs.

SUBJECTS AND METHODS

Our investigation utilized the Delphi method. In Step 1, we conducted semi-structured interviews with LSSAs and then created an initial list of competencies based on the interviews and a previous investigation. In Step 2, we recruited LSSAs with 10 or more cases related to occupational mental health. They completed a questionnaire assessing the importance of their work (how important they felt it was to conduct work related to mental health) and level of achievement (how much they felt they had achieved). The respondents were also asked to provide additional competencies (not listed on the questionnaire) if they regarded them as necessary for their work, and these were later added to the list of proposed competencies. In Step 3, we presented the results of Step 2 to the same respondents and asked them to rate their agreement with the proposed competencies. Items with agreement of 80% or higher were set as competencies. We also asked LSSAs about the level of importance of their work and their perceived level of achievement with regard to the additional items created in Step 2. Items for which the level of achievement fell below the median were extracted even if the level of importance of the work fell at or above the median.

RESULTS

We recruited 8 LSSAs in Step 1 and created a list of 68 preliminary competencies in 20 fields. We recruited 57 LSSAs in Step 2, and 45 LSSAs completed the survey (response rate: 78.9%). Seven competencies were added to the list as a result. We recruited 34 LSSAs in Step 3 (response rate: 75.6%) . Two items with an agreement rate of less than 80% were removed, resulting in 73 competencies in 20 fields. One of the items with an agreement rate of 100% was "The plan is based on the merits and disadvantages (risks) for both labor and management."

CONCLUSIONS

This study identified the competencies required of LSSAs in the field of occupational mental health. Our findings suggest that specifying these competencies will enable efficient training of LSSAs.

Current research priorities for UK occupational physicians and occupational health researchers: a modified Delphi study

OBJECTIVES

Studies identifying national occupational health (OH) research priorities have been conducted in several countries to establish where OH research should be focused and where funding should be targeted. However, the UK findings are now over 20 years old, and OH practice is continuously evolving. The aim of this study was to identify current research priorities for UK occupational physicians (OPs) and occupational health researchers (OHRs).

METHODS

Current research priorities in OH were identified using a modified Delphi technique. This was conducted in two rounds to achieve consensus. Research priorities were rated, and then ranked using questionnaires developed from expert panel discussions, key research topics identified from the medical literature and participant feedback. Overall and intergroup comparisons were completed for the ranking scores.

RESULTS

Consensus among OPs and OHRs was high with almost all (9/10) primary domains rated as 'very important' or 'absolutely necessary' by more than 54% of respondents. The research priority areas ranked highest were jointly economic evaluation/cost effectiveness studies and disability management followed by occupational disease/injury/illness. Occupational health policy was ranked lowest after sickness absence management and health promotion. The secondary domain analysis identified priority emphasis on mental health and psychosocial hazards within the workplace and the need to further develop evidence-based guidance for clinical OH practice.

CONCLUSIONS

We identified the current research priorities for UK OPs and OHRs. The findings will inform future national OH research strategy and support research that addresses important knowledge gaps within OH and other interdisciplinary specialties.