Diagnoses of common mental disorders among social workers in Sweden: A register-based cohort study

BACKGROUND

Little is known about common mental disorders (CMD) diagnoses among social workers, i.e., depression, anxiety, or stress-related disorders. This study aims to examine the risk of CMD among social workers in comparison to other workers and to further investigate differences between men and women and specific occupational titles.

METHODS

This register-based cohort study consists of 3,034,304 persons, of which 26,610 were social workers (0.9 % of all workers), aged 30-64 years, living in Sweden in 2015. The risk of diagnosed CMDs was followed up until 2020. Cox regression models were used to calculate hazard ratios (HR) and 95 % confidence intervals (CI), adjusting for sex, birth country, education, and birth year.

RESULTS

The participants were followed up by a total of 16,833,742.9 person-years, with an average follow-up of 5.5 years. Social workers, compared to other workers, were at a higher risk of CMD (HR 1.3, 95 % CI 1.2-1.4) after adjustment. The HR was equal, 1.3, for depression (95 % CI 1.2-1.5) and anxiety or stress-related disorder (95 % CI 1.2-1.4). The association between social work and CMD was stronger among men (HR 1.7, 95 % CI 1.6-1.9) compared to women (HR 1.2, 95 % CI 1.1-1.3). Further, men working as assistance analysts had the highest risk among the occupational categories (HR 2.2, 95 % CI 1.2-3.9).

LIMITATIONS

CMD diagnoses only included cases treated in secondary care.

CONCLUSIONS

Social workers, especially male social workers, had a higher risk of CMD. This deserves attention for future research and interventions aimed at improving the mental health of social workers.

Integrative Review of Workplace Health Promotion in the Business Process Outsourcing Industry: Focus on the Philippines

Objective

The Business Process Outsourcing (BPO) industry in the Philippines has experienced substantial growth, making a significant contribution to the country's economy. However, concerns about work-related health and safety issues have emerged, necessitating effective workplace health promotion strategies for BPO employees.

Study design

An integrative review of relevant literature was conducted to explore workplace health promotion in the BPO sector.

Methods

The search included quantitative, qualitative, and mixed-method studies, pertinent laws, policies, news articles, and reports published between 2000 and 2022. The scope was intentionally broad to encompass a diverse range of relevant evidence related to workplace health in this field. Articles published both in the English and Filipino languages were considered.

Results

Findings revealed that BPO workers face risks related to physical and psychological stress, sleep disturbances, and occupational diseases owing to the unique challenges inherent to the nature of their jobs. While there are existing occupational health and labor laws, compliance among BPO companies remains a problem, and only a few organizations offer comprehensive wellness programs. Building upon the available evidence, a conceptual framework was developed to provide guidance for enhancing workplace health promotion initiatives specifically designed for BPOs in the country.

Conclusion

Workplace health promotion is vital to warrant the health and safety of BPO workers. This study offers evidence-based recommendations for implementing effective well-being strategies, highlighting the importance of collaboration among employers, employees, and society to prioritize employee health in the workplace.

Agricultural exposures and DNA damage in PBMC of female farmers measured using the alkaline comet assay

OBJECTIVE

Several studies investigated the link between agricultural occupational exposures and DNA damage, in an attempt to bring elements of biological plausibility to the increased cancer risk associated with them. However, only a few of these studies focused on females.

METHODS

The comet assay was performed on PBMC (Peripheral Blood Mononuclear Cells) samples from 245 females working in open field farming and cattle raising, located in the Normandy area of France. Individual questionnaires on tasks performed were administered at the time of sampling to directly assess exposures. Environmental exposures were issued from a questionnaire assessing the farm productions. Linear regression analyses were done using the DNA damage scores.

RESULTS

Regarding direct exposures, several tasks associated with exposure to potentially harmful chemicals were not associated with DNA damage, but a longer duration of use of herbicide on meadows (p = 0.05) or of cleaning and upkeep of agricultural equipment (p = 0.06) revealed higher DNA damage levels, although the number of exposed women was low. Several indirect and/or environmental exposures were associated with DNA damage in multivariate analyses: a larger surface of meadows (p = 0.006) or the presence of poultry (p = 0.03) was associated with less DNA damage, while the presence of swine (p = 0.01) was associated with higher DNA damage. Smokers and former smokers had less DNA damage than non-smokers (p = 0.0008 and p = 0.03).

CONCLUSIONS

We report modified levels of DNA damage for those environmentally exposed to meadows, poultry and pig farming, underlining the need for a better knowledge of the potential health risks experienced by females in this setting.

Association between physical fitness and perceived work ability among Finnish population: a cross-sectional study

OBJECTIVE

This cross-sectional study aims to examine association between different components of physical fitness and perceived work ability among working age population.

METHODS

The population-based study sample included 2050 participants aged 18-74 from the Finnish national Health 2011 study. Physical fitness was assessed by the single leg stand test, the modified push-up test, the vertical jump test and the six-minute walk test, and perceived work ability was assessed via interview. Logistic regression was used for examining the associations between physical fitness and work ability.

RESULTS

After adjusting for potential confounders (age, sex, marital status, educational level, work characteristics, total physical activity, daily smoking, BMI and number of diseases), odds ratios indicated that good work ability was more likely among those who had better balance in single leg stand test (OR = 1.54; 95% CI 1.07-2.24), and who belonged in the high fitness thirds in six-minute walking test (OR = 2.08; 95% CI 1.24-3.49) and in vertical jump test (OR = 2.51; 95% CI 1.23-5.12) compared to lowest third. Moreover, moderate (OR = 1.76; 95% CI 1.02-3.05) to high fitness (OR = 2.87; 95% CI 1.40-5.92) in modified push-up test increased the likelihood of good work ability compared to lowest third.

CONCLUSION

These study results indicate that good musculoskeletal as well as cardiorespiratory fitness are associated with better perceived work ability. Promoting physical fitness in individual and societal level may be potential targets for maintaining good work ability in working age population.

Relationship between night work and health-related quality of life: an analysis based on profiles and cumulative duration of exposure to night work among French workers in the CONSTANCES cohort

OBJECTIVE

The aim of this study is to estimate the association between night work and health-related quality of life (HRQoL) among French workers. The association between cumulative duration of night work and HRQoL was also investigated.

METHODS

Three career-long night work exposure groups were defined at inclusion in the CONSTANCES cohort: permanent night workers, rotating night workers and former night workers. Day workers with no experience of night work were the reference group. HRQoL was assessed using the Short Form Health Survey (SF-12), in particular the physical component summary (PCS) and mental component summary (MCS) scores, with a higher score indicating better HRQoL. Several linear regression models were built to test the association between night work exposure and HRQoL. The relationship between cumulative duration of night work and HRQoL scores was analyzed using generalised additive models.

RESULTS

The sample consisted of 10,372 participants. Former night workers had a significantly lower PCS score than day workers (β [95% CI]: - 1.09 [- 1.73; - 0.45], p = 0.001), whereas permanent night workers had a significantly higher MCS score (β [95% CI]: 1.19 [0.009; 2.36], p = 0.048). A significant decrease in PCS score from 5 to 20 years of cumulative night work was observed among former night workers.

CONCLUSIONS

Former night workers had poorer physical HRQoL in contrast to permanent and rotating night workers who had similar or even better HRQoL than day workers, suggesting the well-known healthy worker survivor effect. Consequently, both current and former night workers require regular and specific follow-up focused on the physical components of their health.

Academic entitlement and Ratemyprofessors.com evaluations bias student teaching evaluations: Implications for faculty evaluation and policy-lenient professors' occupational health

This study explored relationships between academic entitlement (AE) and Ratemyprofessors.com (RMP) use. It also investigated, while controlling for AE, if RMP evaluation positivity influences students' intentions to ask for policy exemptions, beliefs professors would provide them, intentions to reward and punish professors contingent upon provision of policy exemptions by improving or lowering their student teaching evaluations, and intentions to evaluate and reenroll with professors. Following exposure to RMP evaluations, participants (n = 320) rated their intentions and beliefs toward a fictional professor. They also completed an AE measure. AE was related to frequency of writing RMP evaluations as well as participants' intentions to ask for exemptions, beliefs they would receive them, and intentions to reward and punish professors. RMP evaluation positivity affected participants' intentions to ask for and beliefs they would receive policy exemptions as well as intention to evaluate and reenroll with professors. Effects did not differ by professor or student gender. Participants reported intention to improve the evaluation of professors who provide any policy exemption. This study's findings suggest that student attitudes related to AE and impacted by RMP evaluations have significant implications for professors' occupational health via requests for policy exemptions and the consequences of professors' responses to them. These findings also contribute to the body of evidence that student teaching evaluations do not exclusively measure teaching effectiveness. Similar to grade leniency, policy leniency may bias student teaching evaluations. These contribute to the ongoing discussion of the use of student teaching evaluations in faculty personnel decisions and underscore the need for robust approaches to professor evaluation.

Hearing Difficulties Among Farmworkers in the México-US Southwest Border Region

Migrant and seasonal farmworkers are a vulnerable population with a potentially high risk for hearing loss due to farm-related noise exposures. Occupational noise-induced hearing loss (NIHL) is permanent, and it is associated with an increased risk for injuries on the job, as well as communication difficulties, isolation, and depression. The México/US border region is one of the most productive agricultural regions in the country, however, no known studies have explored hearing loss among farmworkers in this area. This pilot study was a first step toward measuring and addressing hearing loss and noise exposure among this region's farmworkers. We conducted a cross-sectional survey to estimate the prevalence of subjective hearing difficulties among Yuma County, Arizona farmworkers. Survey interviews took place during a late-night farmworker health fair from 2 am to 6 am to accommodate local farms' labor schedules. Multivariable regression adjusted for demographic and work covariates estimated subjective hearing loss prevalence ratios. Among 132 farmworker participants, 36% reported they have or might have hearing loss, and 62% reported no hearing loss. Subjective hearing loss prevalence was lower in farmworkers who report not working in noise compared to prevalence in farmworkers who work in noise [prevalence ratio, 0.44 (95% CI 0.23-0.82)]. This report contributes to understanding the perception of hearing-related health and occupational exposures among farmworkers in the México-US Southwest border region. The information from this line of research will inform appropriate safety measures known to lower the risk of experiencing occupational NIHL.

Magnification in preclinical procedures: effect on muscle activity and angular deviations of the neck and trunk

Objectives

This study aimed to assess the effects of different magnification systems on the angular deviations of the neck and trunk and the muscle activities of the upper back and neck during preclinical cavity preparation.

Methods

This was an experimental laboratory study, with the angular deviations from the neutral positions of the neck and trunk and the activities of the bilateral upper back (the descending and ascending trapezius) and neck (sternocleidomastoid) muscles as the dependent variables. The independent variables were the different magnification systems used (Simple, Galilean, and Keplerian loupes, with direct vision as the control) and prepared teeth (teeth 16, 26, 36, and 46). A dental mannequin phantom head with artificial resin teeth was used, and Class I cavity preparations for composite resin were performed on teeth 16, 26, 36, and 46 using a 1012 round diamond bur at low speed. To analyze the angular deviations, the postures adopted during the procedure were recorded using a tripod-mounted camera positioned to provide a lateral view of the operator. A trained researcher measured the angular deviations using the software entitled "Software for Postural Assessment"-SAPO (version 0.69). Bilateral muscle activity was assessed using surface electromyography. Descriptive statistical analysis was performed, and after verifying the assumptions of normality and homoscedasticity, two-way analysis of variance and the Tukey and Games-Howell post-hoc tests were used to compare the data (α=0.05).

Results

The angular deviation from the neutral position of the neck was found to be significantly higher during cavity preparations performed with the naked eye and the Simple loupe, irrespective of the prepared tooth. With regard to tooth location, the angular deviation of the neck was significantly greater during cavity preparation on teeth 16 and 26, and the angular deviation of the trunk was significantly greater during cavity preparation on tooth 26, regardless of the magnification system used. There were significant differences in right sternocleidomastoid muscle activity between the Simple, Galilean, and Keplerian loupes, with activity being the lowest for the Galilean loupe (p = 0.008). There were no significant differences in left sternocleidomastoid muscle activity between the loupes, regardless of the prepared tooth (p = 0.077). The activities of the bilateral descending trapezius and the right ascending trapezius muscles were significantly lower when the Galilean loupe was used (p < 0.010).

Conclusion

These results suggest that the Galilean loupe resulted in lower muscle activity in the neck and back regions and that the Galilean and Keplerian loupes resulted in less angular deviations of the neck and trunk during cavity preparation.

Videoconference-Supervised Group Exercise Reduces Low Back Pain in Eldercare Workers: Results from the ReViEEW Randomised Controlled Trial

PURPOSE

To assess the effects of a group exercise intervention conducted by real-time videoconference on the low back pain of eldercare workers.

METHODS

We randomly assigned 130 eldercare workers to an experimental group (EG: n = 65) or control group (CG: n = 65). Participants from both groups took part in routine prevention programs carried out in their workplace, and participants from the EG received an additional 12-week resistance-exercise intervention supervised by real-time videoconference. Assessments were conducted before and after the intervention, and the primary outcome was average low back pain intensity during the last 7 days, measured by the 0-10 numerical rating scale. Secondary outcomes included additional measures of low back, neck, shoulder and hand/wrist pain, as well as psycho-affective parameters, medication consumption and muscle performance. Both intention-to-treat and per-protocol analyses were applied with a group-by-time ANCOVA including baseline measurements as covariates.

RESULTS

125 participants completed post-intervention assessments (EG: n = 63, CG: n = 62). The intention-to-treat analysis showed an effect favouring the EG on average low back pain intensity (p = 0.034). Improvements in additional low back and hand/wrist pain outcomes were also observed, as well as on upper limb muscle performance (p < 0.05). The per-protocol analysis demonstrated additional benefits in depression, quality of life, hypnotic/anxiolytic medication consumption and lower limb and trunk muscle performance in participants with ≥ 50% adherence (p < 0.05).

CONCLUSIONS

The intervention was effective for reducing the low back and hand/wrist pain of eldercare workers and increasing upper limb muscle performance. The per-protocol analysis showed additional benefits in psycho-affective parameters, medication consumption and muscle performance.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT05050526. Registered 20 September 2021-Prospectively registered, https://www.

CLINICALTRIALS

gov/study/NCT05050526.

Adjustment for duration of employment in occupational epidemiology

PURPOSE

In occupational epidemiology, the healthy worker survivor effect can manifest as a time-dependent confounder because healthier workers can accrue greater amounts of exposure over longer periods of employment. For example, in occupational studies of radiation exposure that focus on cumulative annualized radiation dose, workers can accrue greater amounts of cumulative radiation exposure over longer periods of employment, while workers with longer periods of employment can transition into jobs with a reduced potential for annualized radiation exposure. The extent to which confounding arising from the healthy worker survivor effect impacts radiation risk estimates is unknown.

METHODS

We assessed the impact of the healthy worker survivor effect on estimates of radiation risk among nuclear workers in a Million Person Study cohort. In simulation studies, we contrasted the ability of marginal structural Cox models with inverse probability weighting and Cox proportional hazards models to account for time-dependent confounding arising from the healthy worker survivor effect.

RESULTS

Marginal structural Cox models and Cox proportional hazards models with flexible functional forms for duration of employment provided reliable results.

CONCLUSIONS

It is crucial to flexibly adjust for duration of employment to account for confounding arising from the healthy worker survivor effect in occupational epidemiology.

Managing acoustic noise within MRI: A qualitative interview study among Swedish radiographers

INTRODUCTION

Acoustic noise from magnetic resonance imaging (MRI) can cause hearing loss and needs to be mitigated to ensure the safety of patients and personnel. Capturing MR personnel's insights is crucial for guiding the development and future applications of noise-reduction technology. This study aimed to explore how MR radiographers manage acoustic noise in clinical MR settings.

METHODS

Using a qualitative design, we conducted semi-structured individual interviews with fifteen MR radiographers from fifteen hospitals around Sweden. We focused on the clinical implications of participants' noise management, using an interpretive description approach. We also identified sociotechnical interactions between People, Environment, Tools, and Tasks (PETT) by adopting a Human Factors/Ergonomics framework. Interview data were analyzed inductively with thematic analysis (Braun and Clarke).

RESULTS

The analysis generated three main themes regarding MR radiographers' noise management: (I) Navigating Occupational Noise: Risk Management and Adaptation; (II) Protecting the Patient and Serving the Exam, and (III) Establishing a Safe Healthcare Environment with Organizational Support.

CONCLUSION

This study offers insights into radiographers' experiences of managing acoustic noise within MRI, and the associated challenges. Radiographers have adopted multiple strategies to protect patients and themselves from adverse noise-related effects. However, they require tools and support to manage this effectively, suggesting a need for organizations to adopt more proactive, holistic approaches to safety initiatives.

IMPLICATIONS FOR PRACTICE

The radiographers stressed the importance of a soundproofed work environment to minimize occupational adverse health effects and preserve work performance. They acknowledge noise as a common contributor to patient distress and discomfort. Providing options like earplugs, headphones, mold putty, software-optimized "quiet" sequences, and patient information were important tools. Fostering a safety culture requires proactive safety efforts and support from colleagues and management.

Long-term impact of COVID-19 on nursing and care delivery: A national survey among anaesthetic and critical care nurses

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has put an exceptional strain on intensive care delivery and has significantly impacted nursing practice in the intensive care unit, consequently affecting nurses' working environment and health. Little is known about the long-term impact on the nursing workforce and care delivery in intensive care and anaesthetic departments.

AIM/OBJECTIVE

This cross-sectional study aimed to describe the long-term impact of the COVID-19 pandemic on the nursing profession and nursing care from the perspectives of anaesthetic and critical care nurses.

METHODS

In this study, an online questionnaire with open- and close-ended questions was distributed to registered nurses working in anaesthesia and intensive care between February 8 and March 7, 2022. The data were analysed using content analysis and descriptive statistics.

RESULTS

Of the 514 registered nurses who responded to the questionnaire, 256 (50%) worked in anaesthesia care and 215 (42%) in intensive care. The long-term impact of COVID-19 was expressed in three categories: nursing care on hold, insights and experiences forming a new professional identity, and the impact of organisational conditions on the profession. Critical care nurses considered nursing care comparable to that before the COVID-19 pandemic. Nurse anaesthetics experienced changes in nursing tasks and activities compared to that before the COVID-19 pandemic.

CONCLUSIONS

Nursing care is still influenced by the pandemic due to the lack of resources and persistent high workload and needs to be reclaimed and prioritised. Re-establishing high-quality nursing care is a shared responsibility of the organisation and nursing profession, and the organisation needs to create prerequisites for this. Furthermore, nurses' views and insights into their profession developed both positively and negatively during the pandemic, which must be further considered, including the profession's values.

The transcriptomic signature of respiratory sensitizers using an alveolar model

Environmental contaminants are ubiquitous in the air we breathe and can potentially cause adverse immunological outcomes such as respiratory sensitization, a type of immune-driven allergic response in the lungs. Wood dust, latex, pet dander, oils, fragrances, paints, and glues have all been implicated as possible respiratory sensitizers. With the increased incidence of exposure to chemical mixtures and the rapid production of novel materials, it is paramount that testing regimes accounting for sensitization are incorporated into development cycles. However, no validated assay exists that is universally accepted to measure a substance's respiratory sensitizing potential. The lungs comprise various cell types and regions where sensitization can occur, with the gas-exchange interface being especially important due to implications for overall lung function. As such, an assay that can mimic the alveolar compartment and assess sensitization would be an important advance for inhalation toxicology. Some such models are under development, but in-depth transcriptomic analyses have yet to be reported. Understanding the transcriptome after sensitizer exposure would greatly advance hazard assessment and sustainability. We tested two known sensitizers (i.e., isophorone diisocyanate and ethylenediamine) and two known non-sensitizers (i.e., chlorobenzene and dimethylformamide). RNA sequencing was performed in our in vitro alveolar model, consisting of a 3D co-culture of epithelial, macrophage, and dendritic cells. Sensitizers were readily distinguishable from non-sensitizers by principal component analysis. However, few differentially regulated genes were common across all pair-wise comparisons (i.e., upregulation of genes SOX9, UACA, CCDC88A, FOSL1, KIF20B). While the model utilized in this study can differentiate the sensitizers from the non-sensitizers tested, further studies will be required to robustly identify critical pathways inducing respiratory sensitization.

Interventions on gender equity in the workplace: a scoping review

BACKGROUND

Various studies have demonstrated gender disparities in workplace settings and the need for further intervention. This study identifies and examines evidence from randomized controlled trials (RCTs) on interventions examining gender equity in workplace or volunteer settings. An additional aim was to determine whether interventions considered intersection of gender and other variables, including PROGRESS-Plus equity variables (e.g., race/ethnicity).

METHODS

Scoping review conducted using the JBI guide. Literature was searched in MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, ERIC, Index to Legal Periodicals and Books, PAIS Index, Policy Index File, and the Canadian Business & Current Affairs Database from inception to May 9, 2022, with an updated search on October 17, 2022. Results were reported using Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension to scoping reviews (PRISMA-ScR), Sex and Gender Equity in Research (SAGER) guidance, Strengthening the Integration of Intersectionality Theory in Health Inequality Analysis (SIITHIA) checklist, and Guidance for Reporting Involvement of Patients and the Public (GRIPP) version 2 checklist. All employment or volunteer sectors settings were included. Included interventions were designed to promote workplace gender equity that targeted: (a) individuals, (b) organizations, or (c) systems. Any comparator was eligible. Outcomes measures included any gender equity related outcome, whether it was measuring intervention effectiveness (as defined by included studies) or implementation. Data analyses were descriptive in nature. As recommended in the JBI guide to scoping reviews, only high-level content analysis was conducted to categorize the interventions, which were reported using a previously published framework.

RESULTS

We screened 8855 citations, 803 grey literature sources, and 663 full-text articles, resulting in 24 unique RCTs and one companion report that met inclusion criteria. Most studies (91.7%) failed to report how they established sex or gender. Twenty-three of 24 (95.8%) studies reported at least one PROGRESS-Plus variable: typically sex or gender or occupation. Two RCTs (8.3%) identified a non-binary gender identity. None of the RCTs reported on relationships between gender and other characteristics (e.g., disability, age, etc.). We identified 24 gender equity promoting interventions in the workplace that were evaluated and categorized into one or more of the following themes: (i) quantifying gender impacts; (ii) behavioural or systemic changes; (iii) career flexibility; (iv) increased visibility, recognition, and representation; (v) creating opportunities for development, mentorship, and sponsorship; and (vi) financial support. Of these interventions, 20/24 (83.3%) had positive conclusion statements for their primary outcomes (e.g., improved academic productivity, increased self-esteem) across heterogeneous outcomes.

CONCLUSIONS

There is a paucity of literature on interventions to promote workplace gender equity. While some interventions elicited positive conclusions across a variety of outcomes, standardized outcome measures considering specific contexts and cultures are required. Few PROGRESS-Plus items were reported. Non-binary gender identities and issues related to intersectionality were not adequately considered. Future research should provide consistent and contemporary definitions of gender and sex.

TRIAL REGISTRATION

Open Science Framework https://osf.io/x8yae .

Implementation of an internet-based stress management program in micro- and small-sized enterprises: a study protocol for a pre-post feasibility study of the effectiveness-implementation hybrid type 2 trial

BACKGROUND

Although internet-based stress management programs are proven effective in improving mental health among workers, micro- and small-sized enterprises (MSEs), lacking in occupational healthcare services, face challenges implementing them. To address this gap, this study will develop the program with stakeholders at MSEs to aim for real-world implementation.

OBJECTIVES

This paper describes a study protocol for a pre-post feasibility study of an effectiveness-implementation hybrid type 2 trial of text-based internet-based programs ("WellBe-LINE") in MSEs with less than 50 employees. This feasibility study primarily aims to evaluate trial methods for future effectiveness-implementation hybrid type 2 trials.

METHODS

For this study protocol, an internet- and text-based self-care intervention program using the LINE app (a popular message tool in Japan) will be prepared according to evidence-based psychoeducational topics. Based on our online survey findings, personalized algorithms will be implemented according to employees' gender, age, and psychological distress levels. A personalized program using a popular pre-existing text app is expected to reduce employees' burdens and be attractive to them, resulting in successful implementation outcomes and mental health benefits. A pre-post design feasibility study will be conducted on ten companies to evaluate trial methods (e.g., recruitment and procedures). The primary outcome will involve individual-level penetration, defined as the proportion of the number of employees who register for the program divided by the total number of invited employees at the company. The progression criterion to go next trial specifies that more than 50% of the recruited companies obtain 60% individual penetration, which is set based on the findings of the prior survey of employees at MSEs and of interviews of stakeholders involved in this study, and will be measured by LINE system. Finally, acceptability, appropriateness, and feasibility will be measured using internet-based questionnaires and interviews.

DISCUSSION

This pre-post feasibility study for future effectiveness-implementation hybrid type 2 trials will provide in-depth knowledge about the successful implementation of text-based, semi-personalized, self-care mental health interventions in real-world settings using both quantitative and qualitative data.

CONCLUSIONS

This feasibility study will help validate the effectiveness of text-based interventions using a widely used social networking service (SNS) tool for employees in MSEs.

TRIAL REGISTRATION

UMIN clinical trial registration, UMIN000046960. Registered on February 21, 2022. https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000053570.

Asian Intensive Reader of Pneumoconiosis program: examination for certification during 2008-2020

This study examined physicians' participation and performance in the examinations administered by the Asian Intensive Reader of Pneumoconiosis (AIR Pneumo) program from 2008 to 2020 and compared radiograph readings of physicians who passed with those who failed the examinations. Demography of the participants, participation trends, pass/fail rates, and proficiency scores were summarized; differences in reading the radiographs for pneumoconiosis of physicians who passed the examinations and those who failed were evaluated. By December 2020, 555 physicians from 20 countries had taken certification examinations; the number of participants increased in recent years. Reported background specialty training and work experience varied widely. Passing rate and mean proficiency score for participants who passed were 83.4% and 77.6 ± 9.4 in certification, and 76.8% and 88.1 ± 4.5 in recertification examinations. Compared with physicians who passed the examinations, physicians who failed tended to classify test radiographs as positive for pneumoconiosis and read a higher profusion; they likely missed large opacities and pleural plaques and had a lower accuracy in recognizing the shape of small opacities. Findings suggest that physicians who failed the examination tend to over-diagnose radiographs as positive for pneumoconiosis with higher profusion and have difficulty in correctly identifying small opacity shape.

Comparison of self-management and spa therapy for upper-extremity musculoskeletal disorders: A randomized controlled trial

BACKGROUND

Musculoskeletal disorders (MSDs) are common in the workplace and are a public health issue. Persistent pain despite conservative treatment or surgery may lead to poor long-term outcomes.

OBJECTIVE

To compare the effect of a combined 6-day program of exercise, self-management workshops and spa therapy with self-management on functional capacity in personal and professional daily life at 3 months in people with musculoskeletal disorders.

METHODS

We conducted a prospective, randomized controlled trial. Participants were employed (any type of work) and aged between 18 and 65 years, with latent or symptomatic upper extremity MSDs, with or without a history of sick leave. They were randomized to participate in 6 days (2 h per day) of spa therapy, exercise, and self-management workshops immediately (intervention) or at 3 months (control). The control group performed self-management until 3 months. The primary outcome was the score on the self-reported Quick Disability of Arm-Shoulder-Hand (QuickDASH) at 3 months. The primary analysis was conducted using analysis of covariance with baseline QuickDASH score as the covariate.

RESULTS

In total, 150 participants were randomized (85 % women): 78 to the control group and 72 to the intervention group. At 3 months, the QuickDASH total and work scores did not differ between groups (effect-size [ES] = -0.15, 95 %CI, -0.38 to 0.09, p = 0.215, and ES = -0.11, 95 % CI, -0.35 to 0.12, p = 0.343). However, QuickDASH sport/performing arts score was significantly different between randomization groups at 3 months (ES =-0.25, 95 % CI, -0.48 to -0.02, p = 0.035).

CONCLUSIONS

This study provided no evidence in favor of a short-course, personalized self-management, intensive spa therapy intervention over self-management alone for the management of upper-extremity MSDs.

TRIAL REGISTRATION

ClinicalTrials.gov (NCT02702466) retrospectively registered.

The global distribution of epidemiological studies involving waste pickers: A systematic review

Waste pickers, who work with the collection of recyclable materials in search of a source of income, are subject to various risks and diseases that are very well researched. The aim of this systematic review was therefore to identify and analyze the results of epidemiological research on waste pickers over the last 20 years as well as to investigate the geographical distribution and quality of these studies. The studies were selected from the literature by creating search keys with representative keywords in different databases. This systematic review exceptionally includes research qualified according to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. In total, 61 epidemiological studies with waste pickers were found in 15 different countries, with the largest number of studies carried out in the American continent compared to the African and Asian, respectively. Regarding the quality, 91.80 % were classified as excellent and 8.20 % as good. Although the results show a significant number of epidemiological studies with waste pickers, demonstrating scientific evidence, that there is still a lack of research focusing on waste pickers in different work scenarios, from different health perspectives and in different parts of the world, and it is not possible to highlight the trends in health research for this profession.

Time to consider blunt needles for implant surgery? A systematic review and meta-analysis shows that blunt suture needles reduce glove perforation

BACKGROUND

Despite a recent Cochrane Review demonstrating blunt suture needles are safer for surgeons, the use of blunt suture needles has not become widely adopted. In the 'Implant Era', with the value of medical implant companies to surpass $145 billion by 2027, should we re-examine the use of blunt suture needles, especially to reduce infection in implant surgery? We performed a systematic review and meta-analysis of randomised controlled trials (RCTs) assessing whether blunt suture needles reduce risks to surgeons and patients.

METHODS

A systematic review and meta-analysis was performed per PRISMA guidelines. PubMed, Cochrane and EMBASE databases were searched for RCTs. Dichotomous variables were pooled as risk ratios (RR) and associated 95% confidence intervals (CI) using the MH method. Random or fixed effects modelling use was based on statistical heterogeneity (I2).

RESULTS

14 RCTs were identified with 2488 patients. The RCTs included laparotomies, caesarean sections, episiotomies, and orthopaedic surgeries. Blunt suture needles when compared with sharp needles resulted in a significant reduction in glove perforation; RR: 0.47, 95% CI [0.37 to 0.60] and needlestick injuries, RR: 0.50, 95% CI [0.26 to 0.97]. Sharp needles caused more wound infections, but the result was not statistically significant; RR: 2.73, 95% CI [0.54 to 13.76], p 0.22. Surgeon's satisfaction decreased with blunt needles compared with sharp (RR: 1.22, 95% CI [1.09 to 1.37]).

CONCLUSION

Blunt suture needles are safer than sharp needles for surgeons and likely reduce risks to patients. This, however, comes at the cost of decreased ease of use. The authors recommend the routine use of blunt suture needles, especially in implant surgery.

Atherogenic Index as a Cardiovascular Biomarker in Mexican Workers from Marginalized Urban Areas Occupationally Exposed to Metals

BACKGROUND

Cardiovascular disease (CVD) is one of the main causes of death and disability worldwide. The etiology of CVD is often associated with multiple risk factors, with environmental factors receiving considerable attention. Individuals with precarious jobs are among the groups most affected by chronic exposure to environmental pollutants.

AIM

This study aimed to evaluate occupational exposure to heavy metals among individuals in precarious job settings and investigate atherogenic indices as biomarkers of cardiovascular risk.

METHODS

A total of 137 workers participated in this cross-sectional study conducted in three work environments in San Luis Potosi, Mexico. Urine and blood samples were collected to assess metal exposure and biochemical profiles, including atherogenic indices.

RESULTS

The results showed that workers in the brick sector exhibited the highest levels of metal exposure, particularly arsenic (44.06 µg/L), followed by stonecutters and garbage collectors (24.7 and 16.9 µg/L, respectively). Similarly, Castelli risk index (CRI) and the atherogenic index of plasma (AIP) were higher in brickmakers (3.883 and 0.499) compared to stonecutters (3.285 and 0.386) and garbage collectors (3.329 and 0.367).

CONCLUSIONS

Evidence of exposure to heavy metals was observed in the three populations, in addition to the fact that individuals with greater exposure to arsenic also exhibited higher CRI and AIP.

Heavy Drinking by Occupation in Spain: Differences Between Weekdays and the Weekend

Estimating occupational disparity in heavy drinking jointly for weekdays and the weekend may be misleading for prevention purposes, because reasons for disparity in both periods may differ. The main objective was to assess occupational disparity in heavy average drinking (HAD) by week period and sex. 42,108 employees aged 16-64 were recruited from national surveys in Spain between 2011 and 2020. The outcome was HAD, defined as daily alcohol intake over 20 g (men) or 10 g (women). Occupation was classified in 15 categories. HAD adjusted prevalence ratios (HAD-aPRs) taking all occupations as reference, and relative adjusted excess prevalences (HAD-aEPs) comparing the weekend to weekdays in each occupation, were estimated using Poisson regression models with robust variance adjusted for sociodemographic and health covariates. The HAD-aPRs comparing each occupation with all occupations ranged 0.63-1.92 on weekdays and 0.65-1.45 on the weekend, with the highest aPRs on weekdays in construction, hospitality and primary-sector workers (1.92-1.62). The weekend-weekdays HAD-aEPs by occupation ranged 2.60-8.33, with the highest values in technicians/administrators, other professionals, teachers and health professionals (8.33-6.44). The global aEP was higher in women (6.04) than in men (3.92), especially in occupations just mentioned (8.70-11.73 in women vs. 3.64-6.32 in men). There was a considerable relative disparity in HAD risk between occupations on weekdays, with the highest risks in certain low-skilled occupations. Such disparity decreased on the weekend. The relative weekend increase in HAD risk was greater in women and in certain high-skilled occupations. This should be considered when designing prevention interventions on harmful drinking.

Relationship between diabetes treatment status and occupational accidents

AIMS

To evaluate the relationship between diabetes treatment status and occupational accidents.

METHODS

A cross-sectional study was conducted using an online questionnaire survey completed in March 2022 among workers aged 20 years or older. The questionnaire included questions about diabetes treatment status and occupational accidents. The association between the treatment status of diabetes and occupational accidents was examined using a logistic regression analysis.

RESULTS

The study included 25,756 participants with no diabetes, 1,364 participants receiving diabetes treatment, 177 participants who had interrupted diabetes treatment, and 396 participants who needed diabetes treatment but had not seen a doctor. Compared with those with diabetes treatment, the odds ratio of occupational accidents among participants without diabetes was 0.40 (95% CI: 0.32-0.49), the odds ratio among participants with interrupted diabetes treatment was 4.15 (95% CI: 2.86-6.01), and the odds ratio among participants who needed diabetes treatment but had not seen a doctor was 1.25 (95% CI: 0.89-1.77).

CONCLUSIONS

This study showed that diabetes treatment status was related to occupational accidents, and it may be important for workers with diabetes to be supported to balance their diabetes management and their work commitments.

Quality of life and work functionality in severe asthma patients: the impact of biological therapies

BACKGROUND

Severe asthma can cause poor health status, poor health-related quality of life (HRQoL) and an impaired functioning at work. However, to date, limited data are available on the impact of the biological therapies on such outcomes. Therefore, aim of the present study was to prospectively assess the clinical, quality of life and work functionality issues in severe asthma patients both at baseline and after 6 months of biological therapies and determine which individual, pathological and occupational factors can influence such parameters.

METHODS

Fifty-two patients were enrolled between December 2022 and June 2023. Patients' personal, clinical, functional and occupational features were assessed. The Short Form Health Survey (SF-12), the Work Productivity and Activity Impairment (WPAI) questionnaire and the Work Ability Index (WAI) were employed to assess HRQoL, the employee's productivity and perception of work ability, respectively.

RESULTS

Among the enrolled patients, 30 (57.70%) were employed. Biological therapy induced a significant improvement in clinical and functional parameters, e.g., FEV1% (72 ± 12 vs.87 ± 13%; 72 ± 14 vs. 86 ± 14%), FVC% (92 ± 11 vs. 101 ± 11%; 90 ± 13 vs. 98 ± 14%) and FEV1/FVC (62 ± 11 vs. 71 ± 8%; 64 ± 9 vs. 70 ± 8%) in workers and non-workers, respectively (P < 0.001). Comparably, the perception of life quality significantly improved, as physical and mental health scores, in the overall cohort, increased from 40.7 ± 10.3 and 48.5 ± 8.5 to 46.8 ± 8.6 and 51.6 ± 6.4, respectively (P < 0.001). The work ability perception significantly improved from a moderate to a good one (34 ± 6 vs. 40 ± 6, P = 0.001). A significant reduction in the absenteeism (19 ± 15 vs. 3 ± 11%; P < 0.001) and presenteeism rate (53 ± 24 vs. 29 ± 26%; P < 0.001), and an improvement in daily (40 ± 27.5% vs. 28.9 ± 24.7%, P < 0.001, in the overall population) and work activities (57 ± 25 vs. 29 ± 27%, P < 0.001) was determined. Gender, age, symptoms control and pulmonary functionality were correlated with the physical and mental health perception, daily activity impairment and work ability.

CONCLUSIONS

Our study pointed out that biological therapies improved clinical, general life and occupational outcomes in patients with severe asthma. The correlation between clinical aspects and psychological and occupational issues suggest the relevance for a multidisciplinary management of the disease for an effective participation of patients in the world of work.

Understanding the interplay of occupational, public health, and climate-related risks for informal workers: A new framework with findings from Zimbabwe and India

Globally, there are 2 billion 'informal' workers, who lack access to social protection while facing profound health risks and socioeconomic exclusions. The informal economy has generated most jobs in Low and Middle-Income Countries (LMICs), but few studies have explored informal workers' complex health vulnerabilities, including in the face of climate change. This paper will discuss recent action-research in Indore (India), Harare, and Masvingo (Zimbabwe) with informal workers like vendors, waste-pickers, and urban farmers. We conducted qualitative interviews (N = 110 in India), focus group discussions (N = 207 in Zimbabwe), and a quantitative survey (N = 418 in Zimbabwe). Many informal workers live in informal settlements ('slums'), and we highlight the interrelated health risks at their homes and workplaces. We explore how climate-related threats-including heatwaves, drought, and floods-negatively affect informal workers' health and livelihoods. These challenges often have gender-inequitable impacts. We also analyse workers' individual and collective responses. We propose a comprehensive framework to reveal the drivers of health in the informal economy, and we complement this holistic approach with a new research agenda. Our framework highlights the socioeconomic, environmental, and political determinants of informal workers' health. We argue that informal workers may face difficult trade-offs, due to competing priorities in the face of climate change and other risks. Future interventions will need to recognise informal workers' array of risks and co-develop multifaceted solutions, thereby helping to avoid such impossible choices. We recommend holistic initiatives to foster health and climate resilience, as well as participatory action-research partnerships and qualitative, intersectional data-collection with informal workers.

Combatting the occurrence of needle-stick injuries in a medical school: why is it still an issue?

BACKGROUND

Needle-stick injuries (NSIs) pose a safety risk for healthcare workers with great potential for serious infections. The aim was to determine numbers and causes of NSIs as well as the frequency with which medical students report NSIs in the final stages of study.

METHODS

An online questionnaire was developed and made available in January and February 2023 to all undergraduate medical students (n = 423) in the last 1.5 years of their degree course at Würzburg University, Germany.

RESULTS

The response rate was 19.6% (n = 84). Among respondents, 27.4% (n = 23) reported at least one NSI. Occurrence was particularly frequent in surgery, obstetrics and gynaecology, and internal medicine. Assisting with procedures, suturing, and blood sampling were considered high-risk activities. Lack of concentration, distraction, and time pressure played a role in incidents. Respondents did not report 18.8% of NSIs with the main reasons being fear of the consequences, self-assessment of the injury as minor, or the opinion of supervisors that reporting was unnecessary. Students with previous practice on simulators or patients were significantly more likely to suffer NSIs. Instructions from occupational health specialists beforehand correlated with fewer NSIs.

CONCLUSION

We assume that trained students are more experienced in handling invasive procedures, leading to a greater adoption of corresponding activities and thus an increased risk of injuries in absolute numbers. This does not counter the need for didactic interventions prior to workplace-based training to raise awareness of NSI risks. Simultaneously, concepts must be developed and implemented to support reporting and alleviate fears regarding consequences.

Occupational orthopedic problems and its relation to personal radiation protection in interventional radiology

PURPOSE

Several studies report occupational orthopedic problems among interventional cardiologists. These health problems are usually multifactorial. However, the personal protective equipment used should play a major role. An online survey was conducted to determine the frequency of such health problems among interventional radiologists and to correlate them with the use of personal radiation protective clothing.

MATERIAL AND METHODS

An anonymous online survey that comprised of 17 questions was sent via e-mail to 1427 members of the German Society for Interventional Radiology (DeGIR) in Germany, Austria and Switzerland. The questions were focused on interventional workload, the use of personal radiation protection apparel and orthopedic problems. Given the different scale levels, the associations between the variables were analyzed using different statistical methods. A significance level of p < 0.05 was chosen.

RESULTS

There were 221 survey responders (15.5% response rate). About half of responders (47.7%) suffered from more than five episodes of orthopedic problems during their interventional career. Lumbar spine was involved in 81.7% of these cases, cervical spine in 32.8%, shoulder in 28.5% and knee in 24.7%. Because of orthopedic problems, 16.1% of the responders had to reduce and 2.7% had to stop their interventional practice. The number of affected body regions correlates with the fit of the radiation protection means (p < 0.05, r = 0.135) and the reduction of activity as an interventional radiologist (p < 0.05, r = -0.148).

CONCLUSION

Overall, the survey reveals widespread orthopedic problems at several body regions among interventional radiologists, associated with the fit of radiation protection systems, among other factors. A connection between the orthopaedic complaints and the radiation protection system used could not be established.

Sudden cardiac death among workers: a systematic review and meta-analysis

OBJECTIVE

Sudden cardiac death (SCD) is a rare and yet unexplained condition. The most frequent cause is myocardial infarction, while a small proportion is due to arrhythmogenic syndromes (e.g., channelopathies). This systematic review and meta-analysis aimed to provide a comprehensive overview of the prevalence and risk factors associated with SCD in workers.

MATERIAL AND METHODS

A search for eligible studies was performed utilizing three databases (PubMed, ISI Web of Knowledge, and Scopus). The inclusion criteria were fulfilled if sudden cardiac death due to channelopathy in workers was mentioned.

RESULTS

Out of the 1408 articles found across three databases, 6 articles were included in the systematic review but the meta-analysis was conducted on 3 studies The total sample included was 23,450 participants. The pooled prevalence of channelopathies in employees was 0.3% (95% CI 0.07-0.43%), of sudden cardiac death in employees was 2.8% (95% CI 0.37-5.20%), and of sudden cardiac death in employees with a diagnosis of cardiac channelopathies was 0.2% (95% CI 0.02- 0.30%).

CONCLUSIONS

SCD is a serious and potentially preventable condition that can occur among workers. By identifying and addressing work-related risk factors, providing appropriate screening and interventions, and promoting healthy lifestyle behaviors, we can work to reduce the incidence of SCD and improve the cardiovascular health and well-being of workers.

Psychometric properties of the Perceived Stress Scale (PSS-10) in silica-exposed workers from diverse cultural and linguistic backgrounds

BACKGROUND

The Perceived Stress Scale (PSS-10) has been used in a range of occupational cohorts, but only recently in stone benchtop workers undergoing screening for silicosis. The aim of this study was to compare psychometric properties of the PSS-10 in stone benchtop workers amongst those born overseas or who used an interpreter.

METHODS

Stone benchtop workers in Melbourne, Australia completed the PSS-10 as part of their occupational screening for silicosis. Internal consistency was assessed with Cronbach's α for the total score and the positive and negative subscales. Validity was assessed using confirmatory factor analysis (CFA). Analysis was performed for the total group and for subgroups according to sex, interpreter use, overseas-born, and language spoken at home.

RESULTS

The results of 682 workers with complete PSS-10 scores were included in analysis. Most participants were male (93%), with mean age 36.9 years (SD 11.4), with just over half (51.6%) born in Australia, 10.1% using an interpreter, and 17.5% using a language other than English at home. Cronbach's α for the overall group (α = 0.878) suggested good internal consistency.

DISCUSSION

CFA analysis for validity testing suggested PSS-10 performance was good for both sexes, moderate for country of birth and language spoken at home categories, but poorer for those who used an interpreter. Whilst professional interpreters provide a range of benefits in the clinical setting, the use of translated and validated instruments are important, particularly in cohorts with large numbers of migrant workers.

CONCLUSION

This study describes the psychometric properties of the PSS-10 in a population of stone benchtop workers, with good internal consistency, and mixed performance from validity testing across various subgroups.

Associations between occupational physical activity and left ventricular structure and function over 25 years in CARDIA

AIMS

Leisure time physical activity (LTPA) confers cardiovascular health benefits, while occupational physical activity (OPA) may have paradoxically negative health associations. This study tested the explanatory hypothesis that unfavourable cardiac remodelling may result from chronic OPA-induced cardiovascular strain.

METHODS AND RESULTS

Longitudinal associations of OPA and left ventricular (LV) structure and function were examined in 1462 participants {50.0% female, 56.4% White, aged 30.4 ± 3.4 years at baseline [Year 5 exam (1990-91)]} from the Coronary Artery Risk Development in Young Adults study. Left ventricular structure and function were measured as LV mass (LVMi), end-diastolic volume (LVEDVi), end-systolic volume (LVESVi), ejection fraction (LVEF), stroke volume (LVSVi), and e/a-wave ratio (EA ratio) via echocardiography at baseline and 25 years later. Occupational physical activity was reported at seven exams during the study period as months/year with 'vigorous job activities such as lifting, carrying, or digging' for ≥5 h/week. The 25-year OPA patterns were categorized into three trajectories: no OPA (n = 770), medium OPA (n = 410), and high OPA (n = 282). Linear regression estimated associations between OPA trajectories and echocardiogram variables at follow-up after adjusting for baseline values, individual demographic/health characteristics, and LTPA. Twenty-five-year OPA exposure was not significantly associated with LVMi, LVEDVi, LVSVi, or EA ratio (P > 0.05). However, higher LVESVi (β = 1.84, P < 0.05) and lower LVEF (β = -1.94, P < 0.05) were observed at follow-up among those in the high- vs. no-OPA trajectories.

CONCLUSION

The paradoxically adverse association of OPA with cardiovascular health was partially supported by null or adverse associations between high OPA and echocardiogram outcomes. Confirmation is needed using more precise OPA measures.

Psychosocial interventions for healthcare workers during the COVID-19 pandemic: rapid review and meta-analysis

This rapid review was conducted by following a predefined protocol developed by the Cochrane Rapid Reviews Methods Group. A total of 172 potential reviews and 167 primary studies of interest were found. AMSTAR II was used to assess the quality of the included reviews and the JBI Checklist for Randomized Controlled Trials for primary studies. Overall, four studies were included in this review. The study quality ranged from 5 to 12 out of 13 possible stars. No robust evidence was found that psychosocial interventions can reduce psychological distress. No significant effect could be found regarding post-traumatic stress. Two studies on anxiety were identified, one which showed an effect and another which did not. The psychosocial intervention had no beneficial effect on burnout and depression, whereas providing a mindfulness- or relaxation-based intervention resulted in a significant improvement in sleep quality. By considering the secondary results and results of previous reviews, a combination of training and mindfulness seems to be beneficial for decreasing anxiety and stress in home care workers. In summary, the evidence-based recommendations are still limited and, therefore, more evidence is needed to make a general statement of high certainty about the effects.

Why do physicians go to work when they are sick? Presenteeism at different career stages

INTRODUCTION AND OBJECTIVE

Physicians find it difficult to take on the role of the patient and they show unusual behaviors when ill. One of these behaviors is presenteeism, which is working while sick. The objective of this research is to analyze the factors that contribute to the phenomenon of presenteeism in Spanish physicians.

MATERIAL AND METHODS

Mixed methodology study: one national survey through the General Council of Medical Associations website (quantitative part), 22 semistructured interviews with sick residents and practicing physicians, and three focus groups involving professionals from the occupational health services (qualitative). A bivariate analysis using parametric and non-parametric tests. The significance level was p<0.05 (95% confidence interval). Qualitative analysis using the comparative-constant method until saturation of information.

RESULTS

Presenteeism is reported by 89.4% of doctors who responded to the survey, and it is more common among women. Contributing factors include fear of overburdening colleagues (the main reason and more common among women 58.14% vs 48.35%), self-perception of doing one's duty (the second reason and more common among men, 44.63% vs 33.14%) and economic impact and difficulty in accepting the role of a sick person. This behavior has an impact on patient safety, and is part of the hidden curriculum that also affects the training of medical professionals.

CONCLUSIONS

Presenteeism is a widespread and accepted practice among medical professionals. Although normalized, and even appreciated as a way to avoid overburdening colleagues, presenteeism has important implications for clinical ethics and patient safety.

Association between long working hours and the development of suicidal ideation among female workers: An 8-year population-based study using the Korean Longitudinal Survey of Women & Family (2012-2020)

Long working hours and overwork have recently emerged as pressing public health concerns. We explored the association between long working hours and suicidal ideation in female workers. A total of 8017 women (24,331 observations) from the fourth to eighth waves of the Korean Longitudinal Survey of Women and Families (2012-2020) were analyzed. To address the repeated measurements within each participant, we employed a generalized estimating equation to estimate the odds ratio (OR) and 95% confidence intervals (CIs). The prevalence of suicidal ideation was 1.9% for those working 35-40 h/week and 4.4% for those working ≥55 h/week. Compared to individuals working 35-40 h/week, those working ≥55 h/week were more likely to experience concurrent suicidal ideation (OR [95% CI]:1.85 [1.43-2.39]). The OR (95% CI) of the association between long working hours and onset of suicidal ideation in the subsequent wave was 1.69 (1.20-2.38) for ≥55 h/week. In subgroup analysis, this association was pronounced among workers with low-income levels (OR [95% CI]: 1.97 [1.29-3.02]) and blue-collar occupations (OR [95% CI]: 2.27 [1.41-3.66]). Policy efforts are required to protect the mental health of female workers exposed to long working hours.

Can Better Leadership Reduce Nursing Home Staff Turnover?

OBJECTIVES

To assess whether a measure of leadership support for worker safety, health, and well-being predicts staff turnover in nursing homes after controlling for other factors.

DESIGN

This paper uses administrative payroll data to measure facility-level turnover and uses a survey measure of nursing home leadership commitment to workers. In addition, we use data from Medicare to measure various nursing home characteristics.

SETTING AND PARTICIPANTS

Nursing homes with at least 30 beds serving adults in California, Ohio, and Massachusetts were invited to participate in the survey. The analysis sample included 495 nursing homes.

METHODS

We used a multivariable ordinary least squares model with turnover rate as the dependent variable. We used an indicator for nursing homes who scored above the median on the measure of leadership that supports worker safety, health, and well-being. Control variables include bed count (deciles), ownership (corporate/noncorporate × for-profit/not-for-profit), percent of residents on Medicaid, state, being in a nonmetropolitan county, and total nurse staffing per patient day in the 2 quarters before the survey.

RESULTS

The unadjusted turnover rate was lower for those nursing homes that scored higher on leadership commitment to worker safety, health, and well-being. After controlling for additional variables, greater leadership commitment was still associated with lower turnover but with some attenuation.

CONCLUSIONS AND IMPLICATIONS

We find that nursing homes with leadership that communicated and demonstrated commitment to worker safety, health, and well-being had relatively fewer nurses leave during the study period, with turnover rates approximately 10% lower than homes without. These findings suggest that leadership may be a valuable tool for reducing staff turnover.

Physical, functional and personal variables affecting shoulder complaints in healthcare workers

BACKGROUND

Work related shoulder disorders adversely affect the quality of life and lead to increased costs related to decreased productivity and injury treatment. Therefore, understanding the relationship between strength, upper extremity function and work ability contributes to the development of interventions aimed to improve the well-being of healthcare workers.

OBJECTIVE

Correlate shoulder abduction and handgrip strength with upper extremity function and work ability in healthcare workers with shoulder complaints.

METHODS

67 workers with shoulder pain in the last year were assessed by Disability of Arm, Shoulder and Hand (QuickDASH), Work Ability Index (WAI), isokinetic shoulder strength and isometric handgrip strength dynamometers. Data were analysed with Spearman's Correlation Coefficient (ρ= 0.05), SPSS 20.0 ®.

RESULTS

52% males, mean age 48.4 years, 42% physically active, most administrative and general services workers. Low correlation between handgrip strength and QuickDASH (r=-0.359; p = 0.004); low correlation between handgrip strength and WAI (r = 0.359; p = 0.003) and between shoulder abduction strength and the QuickDASH (r = -0.267; p = 0.049); no significant correlation between shoulder abduction strength and WAI (r = 0.001; p = 0.997).

CONCLUSIONS

Handgrip and shoulder abduction strength were inversely associated with upper extremity dysfunction. Shoulder abduction strength was associated with work ability. The inclusion of strength assessment in workers is important to guide strategies to prevent musculoskeletal disorders.

The role of MicroRNAs as early biomarkers of asbestos-related lung cancer: A systematic review and meta-analysis

BACKGROUND

Asbestos is still the leading cause of occupational cancer mortality worldwide. Asbestos-related lung cancer (LC) and malignant pleural mesothelioma (MPM) prognosis is still poor especially at advanced stage, so early diagnosis biomarkers are needed. MicroRNAs (miRNAs) have been proposed as potential early diagnostic biomarkers of asbestos-related LC and MPM.

AIM

To evaluate the role of miRNAs as diagnostic and prognostic biomarkers of asbestos-related LC and MPM by performing a literature systematic review and meta-analysis.

METHODS

MEDLINE, EMBASE via Ovid, PUBMED and Cochrane library databases were systematically searched up to April 2023 to identify relevant articles. A grey literature search was also conducted using the Google Scholar platform. MeSH and free text terms for 'asbestos', 'occupational exposure', 'lung cancer', 'mesothelioma' and 'miRNAs' were used to search the literature. Our systematic review protocol was registered in the PROSPERO database. Study quality was assessed via the Newcastle-Ottawa Scale.

RESULTS

From the search, 331 articles were retrieved, and, after applying our selection criteria, and exclusion of one study for poor quality, 27 studies were included in the review. Most of the studies were hospital-based case-control, conducted in Europe, and evaluated MPM among men only. MiRNAs expression was measured mainly in plasma or serum. MiR-126, miR-132-3p, and miR-103a-3p were the most promising diagnostic biomarkers for MPM, and we estimated a pooled area under the curve (AUC) of 85 %, 73 %, and 50 %, respectively. In relation to MPM prognosis, miR-197‑3p resulted associated with increased survival time. MiR-126, alone and combined with miR-222, was confirmed associated also to LC diagnosis, together with miR-1254 and miR-574-5p; no miRNA was found associated to LC prognosis.

CONCLUSION

Based on our systematic literature review there is suggestive evidence that the expression of specific miRNAs in the blood serum or plasma are associated with asbestos-related LC and MPM diagnosis and prognosis. Further large longitudinal studies are urgently needed to validate these findings and elucidate the underlying mechanisms given the potential important implications for patients' survival.

A validation study of the Occupational Depression Inventory in Poland and Ukraine

This study examined the psychometric and structural properties of the Polish and Ukrainian versions of the Occupational Depression Inventory (ODI). We relied on two samples of Polish employees (NSample1 = 526, 47% female; NSample2 = 164, 64% female) and one sample of Ukrainian employees (NSample3 = 372, 73% female). In all samples, the ODI exhibited essential unidimensionality and high total-score reliability (e.g., McDonald's omegas > 0.90). The homogeneity of the scale was strong (e.g., 0.59 ≤ scale-level Hs ≤ 0.68). The ODI's total scores thus accurately ranked individuals on a latent occupational depression continuum. We found evidence of complete measurement invariance across our samples, a prerequisite for between-group comparisons involving observed scores. Looking into the criterion validity of the ODI, we found occupational depression to correlate, in the expected direction, with resilience and job-person fit in six areas of working life-workload, control, rewards, community, fairness, and values. The prevalence of occupational depression was estimated at 5% in Sample 1, 18% in Sample 2, and 3% in Sample 3. Our findings support the use of the ODI's Polish and Ukrainian versions. This study adds to a growing corpus of research suggesting that the ODI is a robust instrument.

Mixed-methods research of motivational processes in workers' adoption of healthy behavior

BACKGROUND

In occupational health, the maintenance and promotion of workers' health, especially lifestyle motivation-based interventions, have gained considerable attention and are actively implemented. Motivational theories include self-determination theory, and some studies focus on healthy lifestyles. However, the effectiveness of health promotion interventions varies depending on the health awareness and motivation of the participants. Therefore, this study aimed to clarify the processes by which workers are motivated to improve their health and to identify the need for and type of support according to their motivation.

METHODS

Using a mixed-research design, an initial questionnaire survey of 94 employees (mean age = 40.97 ± 9.65) at a multicenter company in Japan, followed by semi-structured interviews with 16 employees (mean age = 40.13 ± 9.45) from the high- and low-motivation groups, were conducted. Multiple regression analysis followed by modified grounded theory-based analysis of the results of the first stage was used and the quantitative and qualitative results were integrated.

RESULTS

In the first stage, autonomous motivation scores were predicted by the behavioral change stage and relatedness satisfaction/frustration. The second stage revealed that "the process of reflecting and managing one's own health while receiving support and feedback for maintaining and improving health" was the motivational process of workers. Result integration revealed that motivation increased through repeatedly escaping and adjusting to real problems and situational coping until the behavioral change. Despite interruptions during behavioral change, receiving feedback from others could increase motivation and continued behavioral change.

CONCLUSION

Regardless of their level of motivation for health behaviors, workers indicated that support from others was essential. The nature of this support was found to range from providing information to offering feedback. Interventions individualized by the identified process could enable customized motivation-driven health guidance.

[Application of Delphi method and analytic hierarchy process to construct the evaluation index system of healthy enterprises]

Objective: Explore the application of Delphi method and analytic hierarchy process to explore the construction of scientific, objective and comprehensive evaluation index system for healthy enterprise construction and promote the construction of healthy enterprises. Methods: In October 2022, through Delphi expert consultation and analytic hierarchy process, the indexes were screened and the weights of the indexes were determined, and the evaluation index system of healthy enterprises was established. Results: The positive coefficients of experts in the two rounds were all 100.00%, the authority coefficient of experts was 0.82, the coefficients of variation of the indexes in the two rounds were all less than 0.30. The coordination coefficients of experts in the first and second rounds were 0.64 and 0.77, respectively (P<0.001) . After two rounds of Delphi method expert consultation, a healthy enterprise evaluation index system including 4 first-level indexes, 14 second-level indexes, and 63 third-level indexes was constructed. Conclusion: The constructed health enterprise evaluation index system is highly scientific and reliable, covering the main factors of healthy enterprise construction, and providing a reliable and quantifiable basis and self-assessment basis for the establishment of healthy enterprises.

Are COVID-19 vaccination mandates for healthcare workers effective? A systematic review of the impact of mandates on increasing vaccination, alleviating staff shortages and decreasing staff illness

INTRODUCTION

The rapid development of COVID-19 vaccines is a cornerstone in the global effort to combat the pandemic. Healthcare workers (HCWs), being at the forefront of the pandemic response, have been the focus of vaccine mandate policies. This review aims to evaluate the impacts of COVID-19 vaccine mandates among HCWs, a critical step in understanding the broader implications of such policies in healthcare settings.

OBJECTIVE

The review seeks to synthesize available literature to contribute to greater understanding of the outcomes associated with COVID-19 vaccine mandates for HCWs including vaccine uptake, infection rates, and staffing.

METHODS

A systematic search of relevant literature published from March 2020 to September 2023 was conducted. The Newcastle-Ottawa scale was employed for quality assessment of the included articles. A total of 4,779 publications were identified, with 15 studies meeting the inclusion criteria for the review. A narrative synthesis approach was used to analyze these studies.

RESULTS

COVID-19 vaccine mandates for HCWs were broadly successful in increasing vaccine uptake in most settings. Although the penalties imposed on unvaccinated HCWs did not lead to major disruption of health services, less well-resourced areas may have been more impacted. Furthermore, there is insufficient literature on the impact of the vaccine mandate on reducing SARS-CoV-2 infection among HCWs.

CONCLUSION

COVID-19 vaccine mandates for HCWs have significant implications for public health policy and healthcare management. The findings underscore the need for tailored approaches in mandate policies, considering the specific contexts of healthcare settings and the diverse populations of HCWs. While mandates have shown potential in increasing vaccine uptake with minimal impacts to staffing, more work is needed to investigate the impacts of mandates across various contexts. In addition to these impacts, future research should focus on long-term effects and implications on broader public health strategies.

Exploring workplace mental health: educator perspectives and factors in the medical education system - a mixed method study

INTRODUCTION

The present study aimed to assess the status of workplace mental health from the viewpoints of educators, and explore their experiences concerning influential factors on occupational mental health at Shahid Sadoughi University of Medical Sciences.

METHODS

The study was a sequential mixed-method study that was conducted in quantitative and qualitative phases. In the quantitative phase, the perception of educators (n = 205) was assessed by a Workplace Mental Health Questionnaire, including 37 items in 9 categories (including an opportunity to control, an opportunity to use skills, external goals created, environmental diversity, environmental clarity, access to money, physical security, opportunity to contact others, and valuable social status and position). In the qualitative phase, data were collected using semi-structured interviews (n = 21) and were analyzed based on the conventional content analysis approach.

RESULTS

The results showed that the status of workplace mental health of educators was at a moderate level (mean (± SD) = 115.87 (±3.21). The highest and lowest scores of the median were reported in the domains of "opportunity for control" (median = 4) and "opportunity to contact others" (median = 2.75), respectively. The theme of "contrast between preferences and disappointments in the development path" with two categories including "induced demotivation of system elements" and "tendencies of promotion" was explored from the educators' perspective.

CONCLUSION

The results indicated the moderate level of mental health of educators was influenced by the contrast between preferences and disappointments in the development path. The tendency of educators for promotion was explored as a positive factor in the mental health of educators in the academic environment. A growing desire for creative advancement among educators as a personal factor and a demand to stay updated with all developments as a system factor explained the positive experiences of educators in the university. The results showed the gap between the current situation and the desired state of occupational mental health may result from cultural challenges, lack of adherence to professionalism at the personal level (non-compliance with the principles of well-being and excellence), and interpersonal level (non-compliance with respect, justice, etc.). Moreover, factors disrupting occupational mental health at the system level explored in job stress, a resilient culture, lack of managerial support, ingratitude, lack of reward-effort matching mechanism, and lack of resources.

National vaccination policies for health workers - A cross-sectional global overview

BACKGROUND

Immunization is essential for safeguarding health workers from vaccine-preventable diseases (VPDs) that they may encounter at work; however, information about the prevalence and scope of national policies that protect health workers through vaccination is limited. Understanding the global landscape of health worker immunization programmes can help direct resources, assist decision-making and foster partnerships as nations consider strategies for increasing vaccination uptake among health workers.

METHODS

A one-time supplementary survey was distributed to World Health Organization (WHO) Member States using the WHO/United Nations Children's Fund (UNICEF) Joint Reporting Form on Immunization (JRF). Respondents described their 2020 national vaccination policies for health workers - detailing VPD policies and characterising technical and funding support, monitoring and evaluation activities and provisions for vaccinating health workers in emergencies.

RESULTS

A total of 53 % (103/194) Member States responded and described health worker policies: 51 had a national policy for vaccinating health workers; 10 reported plans to introduce a national policy within 5 years; 20 had subnational/institutional policies; 22 had no policy for vaccinating health workers. Most national policies were integrated with occupational health and safety policies (67 %) and included public and private providers (82 %). Hepatitis B, seasonal influenza and measles were most frequently included in policies. Countries both with and without national vaccination policies reported monitoring and reporting vaccine uptake (43 countries), promoting vaccination (53 countries) and assessing vaccine demand, uptake or reasons for undervaccination (25 countries) among health workers. Mechanisms for introducing a vaccine for health workers in an emergency existed in 62 countries.

CONCLUSION

National policies for vaccinating health workers were complex and context specific with regional and income-level variations. Opportunities exist for developing and strengthening national health worker immunization programmes. Existing health worker immunization programmes might provide a foothold on which broader health worker vaccination policies can be built and strengthened.

Being used for the greater good while fighting on the frontline: care staff's experiences of working with older people during the COVID-19 pandemic in Sweden

BAKGROUND

Worldwide, older people were more severely affected during the COVID-19 pandemic than others. In Sweden, those living in residential care facilities had the highest mortality rate, followed by those receiving home care services. The Swedish and international literature on the working environment for assistant nurses and care aides during the pandemic shows an increase in stress, anxiety, depression and post-traumatic stress syndromes. Care organisations were badly prepared to prevent the virus from spreading and to protect the staff from stress. In order to be better prepared for possible future pandemics, the health and well-being of the staff, the care of older people and the experiences of the staff both during and after a pandemic are important aspects to take into account. Therefore, this study aims to describe the experiences of assistant nurses and care aides working in the care of older people during the COVID-19 pandemic in Sweden, their working conditions and the impact all this had on their lives.

METHODOLOGY

The study has a qualitative, descriptive design. The data was collected in four focus group interviews with 21 participants and analysed using qualitative content analysis.

RESULTS

The results revealed the theme, Being used for the greater good while fighting on the frontline, which was then divided into three categories: portrayed as a risk for older people, not being valued and being burnt out. The worsening working conditions that the pandemic contributed to resulted in a high degree of stress and risk of burnout, with staff members both wanting to and actually leaving their employment. After the pandemic they felt forgotten again and left to cope in an even worse situation than before.

CONCLUSIONS

The pandemic had a major effect on assistant nurses and care aides in terms of their working environment and their private lives. To be better prepared for future pandemics or disasters, organisations with responsibility for the care of older people will need to ensure that their staff have the necessary competencies and that there is adequate staffing in place. This also means that adequate government funding and multiple interventions will be needed.

Vaccine-preventable diseases: Immune response in a large population of healthcare students

BACKGROUND

Students in medicine and other health professions are exposed to numerous occupational hazards, primarily biological hazards, during their academic careers at university. The aim of the present study was to investigate the seroprevalence characteristics of anti-HBsAg, anti-Measles, anti-Mumps, anti-Rubella and anti-Varicella IgG antibodies in healthcare students of a large teaching hospital in Rome.

METHODS

To accomplish the study's aims, antibody serology data were gathered from students of Medicine and Surgery, Dentistry, and Health Professions at the Catholic University of the Sacred Heart (Rome Campus) during their first Health Surveillance visit, that took place from 2013 to 2023.

RESULTS

Our study sample included 2523 students, 44.4 % were protected against Hepatitis B, 87.3 % against measles, 85.5 % against mumps, 94.6 % rubella and 95.2 % against varicella. Differences in antibody coverage between age groups were statistically significant (p < 0.001), except for mumps. It found a lower probability of having seronegative anti-HBVs with an older date since the presumed primary vaccination.

CONCLUSION

In our sample, seropositivity rate against vaccine-preventable diseases, especially for Hepatitis B, was often inadequate to prevent possible biological risks connected with the activities carried out on the ward.

Prevalence of musculoskeletal disorders among hotel housekeepers and cleaners: A systematic review with meta-analysis

BACKGROUND

Musculoskeletal disorders (MSD) are among the most frequent and costly occupational health problems with a rising prevalence globally.

OBJECTIVE

This systematic review with meta-analysis was conducted to know and evaluate the prevalence of MSD by anatomic location among hotel housekeepers (HHs) and cleaners.

METHODS

Electronic searches were conducted in PubMed, Web of Science, Scopus, Dialnet Plus, PEDro and Cochrane Database for Systematic Reviews using a search strategy to identify cross-sectional studies reporting on the prevalence of MSD in HHs or cleaners. The risk of bias was assessed with Joanna Briggs Institute tool for systematic reviews. A random-effects model was used in the meta-analysis.

RESULTS

Nineteen studies were included in the systematic review, nine of them in the meta-analysis (n = 2299). The study sample sizes ranged from 24 to 1043 participants. The Standardized Nordic Musculoskeletal Questionnaire was the most common tool used to assess MSD among both HHs and cleaners (9/19 of the included studies). The three most affected anatomic locations were the low back 53.9% (95% CI: 43.3-64.6), shoulders 41.4% (95% CI: 27.1-55.8), and wrists/hands 40.1% (95% CI: 24.5-55.7).

CONCLUSIONS

HHs and cleaners have a high prevalence of MSD. Low back pain is the most prevalent MSD among both HHs and cleaners affecting up to one of two people.

Indoor air quality improvement with filtration and UV-C on mitigation of particulate matter and airborne bacteria: Monitoring and modeling

Indoor air, especially with suspended particulate matter (PM), can be a carrier of airborne infectious pathogens. Without sufficient ventilation, airborne infectious diseases can be transmitted from one person to another. Indoor air quality (IAQ) significantly impacts people's daily lives as people spend 90% of their time indoors. An industrial-grade air cleaner prototype (filtration + ultraviolet light) was previously upgraded to clean indoor air to improve IAQ on two metrics: particulate matter (PM) and viable airborne bacteria. Previous experiments were conducted to test its removal efficiency on PM and airborne bacteria between the inlet and treated air. However, the longer-term improvement on IAQ would be more informative. Therefore, this research focused on quantifying longer-term improvement in a testing environment (poultry facility) loaded with high and variable PM and airborne bacteria concentrations. A 25-day experiment was conducted to treat indoor air using an air cleaner prototype with intermittent ON and OFF days in which PM and viable airborne bacteria were measured to quantify the treatment effect. The results showed an average of 55% reduction of total suspended particulate (TSP) concentration between OFF days (110 μg/m3) and ON days (49 μg/m3). An average of 47% reduction of total airborne viable bacteria concentrations was achieved between OFF days (∼3200 CFU/m3) and ON days (∼2000 CFU/m3). A cross-validation (CV) model was established to predict PM concentrations with five input variables, including the status of the air cleaner, time (h), ambient temperature, indoor relative humidity, and day of the week to help simulate the air-cleaning effect of this prototype. The model can approximately predict the air quality trend, and future improvements may be made to improve its accuracy.

Review on novel toxicological effects and personalized health hazard in workers exposed to low doses of benzene

Several recent reports indicate health hazards for workers with below occupational limit exposure to benzene (BZ). Our updated review indicates that such low exposures induced traditional as well as novel toxicity/genotoxicity, e.g., increased mitochondria copy numbers, prolongation of telomeres, impairment of DNA damage repair response (DDRR), perturbations of expression in non-coding RNAs, and epigenetic changes. These abnormalities were associated with alterations of gene expression and cellular signaling pathways which affected hematopoietic cell development, expression of apoptosis, autophagy, etc. The overarching mechanisms for induction of health risk are impaired DDRR, inhibition of tumor suppressor genes, and changes of MDM2-p53 axis activities that contribute to perturbed control for cancer pathways. Evaluation of the unusual dose-responses to BZ exposure indicates cellular over-compensation and reprogramming to overcome toxicity and to promote survival. However, these abnormal mechanisms also promote the induction of leukemia. Further investigations indicate that the current exposure limits for workers to BZ are unacceptable. Based on these studies, the new exposure limits should be less than 0.07 ppm rather than the current 1 ppm. This review also emphasizes the need to conduct appropriate bioassays, and to provide more reliable decisions on health hazards as well as on exposure limits for workers. In addition, it is important to use scientific data to provide significantly improved risk assessment, i.e., shifting from a population- to an individual-based risk assessment.

An observational study of pain severity, cannabis use, and benefit expenditures in work disability

OBJECTIVE

This study pools two cohorts of workers in Ontario interviewed 18 months following a disabling work-related injury to estimate the association between pain severity, cannabis use, and disability benefit expenditures.

METHODS

Among 1650 workers, disability benefit expenditures obtained from administrative records were combined with self-reported measures of pain symptoms and cannabis use. Disability benefit expenditures comprised wage replacement benefits and expenditures on healthcare services.

RESULTS

Past-year cannabis use was reported by 31% of participants, with approximately one third of cannabis use attributed to the treatment of conditions arising from the work-related injury. Condition-related cannabis use was elevated among the 34% of participants reporting severe pain symptoms. In regression models adjusted for age, sex, nature of injury, opioid prescription, and pre-injury chronic conditions, participants reporting condition-related cannabis use had equivalent wage replacement benefit expenditures (β = 0.254, ns) and higher healthcare benefit expenditures (β = 0.433, p = 0.012) compared to participants who did not use cannabis. Participants reporting cannabis use unrelated to conditions arising from their work-related injury had lower wage replacement benefit expenditures (β =  - 0.309, p = 0.002) and equivalent healthcare benefit expenditures (β =  - 0.251, ns) compared to participants not using cannabis.

CONCLUSION

This novel study of workers' compensation claimants interviewed at 18 months post-injury did not observe a substantial relationship between cannabis use and disability benefit expenditures, suggesting that neither harm nor significant benefit is associated with cannabis use. These findings contribute to understanding the potential benefits and risks associated with cannabis use in settings that have legalized cannabis use.

Evaluating COVID-19 Risk to Essential Workers by Occupational Group: A Case Study in Massachusetts

Occupational exposure to SARS-CoV-2 varies by profession, but "essential workers" are often considered in aggregate in COVID-19 models. This aggregation complicates efforts to understand risks to specific types of workers or industries and target interventions, specifically towards non-healthcare workers. We used census tract-resolution American Community Survey data to develop novel essential worker categories among the occupations designated as COVID-19 Essential Services in Massachusetts. Census tract-resolution COVID-19 cases and deaths were provided by the Massachusetts Department of Public Health. We evaluated the association between essential worker categories and cases and deaths over two phases of the pandemic from March 2020 to February 2021 using adjusted mixed-effects negative binomial regression, controlling for other sociodemographic risk factors. We observed elevated COVID-19 case incidence in census tracts in the highest tertile of workers in construction/transportation/buildings maintenance (Phase 1: IRR 1.32 [95% CI 1.22, 1.42]; Phase 2: IRR: 1.19 [1.13, 1.25]), production (Phase 1: IRR: 1.23 [1.15, 1.33]; Phase 2: 1.18 [1.12, 1.24]), and public-facing sales and services occupations (Phase 1: IRR: 1.14 [1.07, 1.21]; Phase 2: IRR: 1.10 [1.06, 1.15]). We found reduced case incidence associated with greater percentage of essential workers able to work from home (Phase 1: IRR: 0.85 [0.78, 0.94]; Phase 2: IRR: 0.83 [0.77, 0.88]). Similar trends exist in the associations between essential worker categories and deaths, though attenuated. Estimating industry-specific risk for essential workers is important in targeting interventions for COVID-19 and other diseases and our categories provide a reproducible and straightforward way to support such efforts.

Wellbeing After Finalization of a Workers' Compensation Claim: A Systematic Scoping Review

OBJECTIVE

A workers' compensation claim may have significant negative impacts on an injured worker's wellbeing. Wellbeing provides a good global measure of potential effects of a claim on an individual, and is important for contemporary economic modelling. The purpose of this study was to synthesize knowledge about the wellbeing of injured workers after the finalization of a workers' compensation claim and identify gaps in the current literature.

METHODS

A systematic scoping review was conducted.

RESULTS

71 full-text articles were screened for inclusion, with 32 articles eligible for this review. None of the included articles evaluated overall wellbeing. Included articles did evaluate a variety of constructs inherent in wellbeing. Injured workers were generally disadvantaged in some manner following claim finalization. The literature recommends a focus on reducing negative impacts on injured workers after finalization of a compensation claim, with a need for regulatory bodies to review policy in this area.

CONCLUSION

There appears to be potential for ongoing burden for individuals, employers, and society after finalization of a workers' compensation claim. A gap in knowledge exists regarding the specific evaluation of wellbeing of injured workers following finalization of a workers' compensation claim.

Outbreak of anthrax in livestock with human occupational exposures - Minnesota, 2023

In July 2023, the Minnesota Department of Health (MDH) was notified of possible occupational exposures to anthrax during an outbreak in animals. In consultation with the Centers for Disease Control and Prevention, MDH epidemiologists created a questionnaire that assessed exposure risks and helped determine individual illness monitoring and antibiotic post-exposure prophylaxis needs. This investigation and the resources developed for it could be useful in future scenarios where there are occupational exposures to naturally occurring anthrax.