Occupational Health Care Research Articles

178 A RETROSPECTIVE EVALUATION OF PROCESS OUTCOMES OF OLDER ADULTS REFERRED TO A COMMUNITY RE-ENABLEMENT TEAM FROM THE EMERGENCY DEPARTMENT

Abstract Background Emergency Departments (ED) are complex and challenging environments to provide care to older adults. There is currently a paucity of high quality methodological research investigating the effectiveness of interventions focused on transitions of care from the ED to primary care services (Hughes et al, 2019). This study aims to evaluate the impact of a collaborative model of care between primary and secondary care services for older adults discharged home following ED index visit. Methods This was an observational retrospective study. Participants aged ≥65 years discharged home from the ED of a University Teaching Hospital and referred to a Multidisciplinary Community Intervention Team (MDCIT) were included. Referral pathways were via the OPTIMEND team (Cassarino et al, 2021) and MDCIT, which is a rapid access re-enablement team based in the community and compromises nursing staff, an occupational therapist, physiotherapist, therapy and healthcare assistants. Descriptive statistics were used to profile the baseline characteristics of study participants and to summarise data related to process outcomes. Ethical approval was granted for this study (020/2021). Results In the study period, January—December 2020, 54 patients were referred to the MDCIT. The mean age of participants was 80.1 years (SD 8.2), 57% were female, and the most common Manchester Triage System presenting complaint was ‘limb problems’. The median Patient Experience Time within the ED was 7.4 hours (IQR 13.1); 55% of participants were seen in their home within 24 hours of discharge. A mean of 10 interventions were delivered by the MDCIT. A 9.1% incidence rate of 30 day unscheduled hospital readmission was recorded. Conclusion Integrated care programmes have been advocated to improve the continuum of care from the ED into the community. This evaluation has demonstrated the feasibility of implementing such a model of care. However, further methodologically robust research is required to advance the evidence base and should also focus on patient outcomes.

Reconfiguration of the boundaries of occupational risk prevention observed during the COVID-19 pandemic: the case of personal protective equipment and collective protection in France

During the COVID-19 pandemic, national risk management scenarios took an unexpected course at different individual and collective scales. In France, in the field of occupational risk, long-established practices, rules, and categories have been disturbed and placed ‘under stress’. The field of prevention of occupational risk, which has constituted a distinct field in health policies, with its own bodies, missions and approaches, was similarly disturbed. To describe and analyse these social phenomena, we propose using two complementary concepts: the British ‘risk work’ and the French ‘prevention work’ [‘travail de prévention’]. We show some of the empirical manifestations of risk work associated with prevention work and their effects on the boundaries instituted in the field of prevention at work. Our investigation used data from documentation and interviews in order to explore the experiences of two categories of professionals – physicians specialising in occupational health and home care aides – concerned with prevention during an acute phase of the pandemic. We point out that the question of protective means and equipment has been a central issue, in a context characterised by tensions between knowledge and available material resources. We also show that contradictions and points of tension between actors reveal the subjects under discussion and the more or less porous nature of the boundaries. Amid these processes, however, the principles underlying occupational health were reaffirmed, along with the need for a cooperation between workers and prevention professionals.

Factors associated with different levels of daytime sleepiness among Korean construction drivers: a cross-sectional study

BackgroundCommercial vehicle accidents are the leading cause of occupational fatalities and an increased risk of traffic accidents is associated with excessive fatigue, other health problems as well as poor sleep during work. This study explores individual and occupational factors associated with different levels of daytime sleepiness and identifies their association with driving risk among occupational drivers working at construction sites.MethodsThis cross-sectional and correlational study adopted a self-reported questionnaire of Korean construction drivers (N = 492). The data were collected from October 2018 to February 2019 using a battery of six validated instruments about participants’ sociodemographic, health-related, and occupational characteristics. One-way ANOVA and multinomial logistic regression were conducted using IBM SPSS WIN/VER 25.0, with a two-tailed alpha of .05.ResultsBased on the Epworth Sleepiness Scale, “moderate” (31.7%) and “severe” (10.2%) daytime sleepiness groups were identified. There were significant differences in break time, driving fatigue, depressive symptom, subjective sleep quality, physical and mental health, and driving risk among the three groups (all p-values < .001). Driving fatigue (Adjusted Odds Ratio [aOR] = 1.08, 1.17), depressive symptoms (aOR = 0.91, 0.98), subjective sleep quality (aOR = 1.18 in moderate only), and driving over the speed limit (aOR = 1.43, 2.25) were significant factors for determining “moderate” and “severe” daytime sleepiness groups, respectively.ConclusionA significant number of construction drivers experience excessive daytime sleepiness; thus it is important to reduce the negative impact of driving fatigue and other factors on daytime sleepiness. Our study findings suggest that occupational health care providers should pay attention to development and implementation of health management interventions to reduce driving fatigue that incorporate the drivers’ physical, mental, and occupational factors. Professional organizations need to establish internal regulations and public policies to promote health and safety among occupational drivers who specifically work at construction sites.

A Context Analysis with Stakeholders’ Views for Future Implementation of Interventions to Prevent Health Problems Among Employees with a Lower Socioeconomic Position

Purpose Health problems among employees with a lower socioeconomic position (SEP) often result from an interplay of problems on multiple life domains. Contextual factors greatly affect implementation of interventions that aim to solve these type of problems. The aim of this study was to gain insight into the organizational and socio-political context for implementation of preventive interventions that consider multiple life domains among employees with a lower SEP. Methods In total 16 semi-structured interviews were conducted with stakeholders at organizational level, occupational health service (OHS) level, and at socio-political macro level. Thematic analysis was performed to identify themes that describe the perceptions of stakeholders about the impact of contextual factors on implementation. Results The following themes were identified: (1) the importance of addressing problems on multiple life domains among employees with a lower SEP, (2) unclarity of responsibilities for solving problems on multiple life domains, (3) necessity of better collaboration between occupational and curative healthcare, (4) insufficient investments in prevention by employers, (5) difficulties in early identification of employees at risk for health problems, and (6) risk of conflicting role for supervisors in addressing problems on multiple life domains. Conclusions Implementation of preventive interventions considering multiple life domains among lower SEP employees is challenging, due to various contextual factors. To improve the feasibility, many different stakeholders both in- and outside occupational health practice need to be involved, collaborate, and need to be convinced of the added value to prevent problems on multiple life domains among employees with a lower SEP.

Therapists\u2019 experiences and needs with regard to providing work-focused care: a focus group study

BackgroundMusculoskeletal disorders (MSDs) can create a temporary or permanent disability that reduce a person’s ability to work. Physiotherapists (PTs), occupational therapists (OTs) and exercise therapists (ETs) are often involved in the early management of MSDs. There is a need for additional insights into therapists’ experiences, barriers and needs to work-focused care. Moreover, there is no evidence on how OTs and ETs address work participation. Therefore, the aim of this qualitative study was 1) to investigate how generalist PTs, OTs and ETs provide work-focused healthcare and 2) to obtain insight into their perceived barriers and needs that affect their ability to address occupational factors.MethodsAn exploratory qualitative study using three focus groups. Generalist PTs, OTs and ETs were eligible to participate if they treated working patients with MSDs. A semi-structured interview guide with open-ended questions was developed. Two moderators facilitated each focus group using the interview guide, and all the groups were audio recorded. Data were analysed using inductive thematic analysis.ResultsSixteen therapists (mean age 44 years, range 25-59) participated in this study. Participants were aware of the importance of taking occupational factors into account. Whether they address occupational factors is largely dependent on the patient’s request for help. However, ETs and OTs consider it normal to ask about occupational factors during the diagnostic process, while PTs often address this in later consultations. Almost all participants were unaware of the existence of PTs, OTs or ETs who are specialised in occupational health. Moreover, almost all participants struggled with when to refer a patient to other (occupational) healthcare professionals. This study identified several needs of therapists. These included knowledge about laws and legislation and skills for identifying and addressing work-related or work-relevant complaints.ConclusionsParticipants in this qualitative study were aware of the importance of taking occupational factors into account. However, how PTs, OTs and ETs address work participation and the extent to which they do so can be improved. There was a lack of knowledge about and cooperation with occupational health professionals, including PTs, OTs or ETs specialised in occupational health.

Work functioning among young adults: the role of mental health problems from childhood to young adulthood

ObjectivesMental health problems (MHPs) during childhood and adolescence are negatively associated with having a paid job in young adulthood. Yet, little is known about how young adults function at work,...

Value for all? Dynamics of partnership formation in occupational healthcare collaboration

Interorganizational relationships take advantages of surrounding networks to create value. However, there is little processual understanding of how cooperative partnerships ‘work’ in healthcare collaboration. From the value creation perspective, their mobilization, management and maintenance are challenging. To understand the value of cooperative partnerships, we explore the dynamics of partnership formation in occupational healthcare collaboration. The empirical data is based on a two-year qualitative case study examining e-value co-creation in healthcare. The research data was obtained through a participatory action research method. We facilitated and followed up a developmental process of the partnership between an occupational health service company and its customer organization. This partnership aimed to add strategic value through the co-creation method to improve the well-being of employees and to promote eHealth solutions. In analyzing the data, we adopted a process orientation that allowed us to explore dynamics in partnership formation and its e-value co-creation. We used Ring and Van de Ven’s [1] framework to examine how cooperative interorganizational relationship develops through the stages of negotiation, commitment and execution. Our longitudinal case study analysis reveals how interaction, mutual sensemaking and institutional logics affect partnership and its value creation. The results show that the formation of a cooperative partnership is a challenging inter-organizational learning process. Our study demonstrates three tensions characterizing the dynamics of partnership: asymmetrical roles and positions between partners (customer and service provider) in co-creation, exploitation of institutionalized practices versus the exploration of new methods for collaboration, and tradeoffs between the operational logic and the co-creation logic. To create value for all in cooperative partnership, we emphasize the necessity of dialogue, mutual trust, interorganizational learning and processual feedback of accomplishments. At its best, cooperative partnership in healthcare collaboration can challenge existing practices of service provision and develop new concepts, roles and tools to promote health and well-being at workplaces through co-creation as a working method in occupational health collaboration.

Prevalence and predictors of insomnia and sleep medication use in a large tri-service US military sample

The presence of insomnia in the general military population is not well known. This study aimed to determine the prevalence of probable clinical insomnia and identify factors leading to new-onset insomnia and/or sleep medication use in a large military population. Cross-sectional and longitudinal analyses of a prospective cohort study. A tri-service US military and veteran cohort (sample range 99,383-137,114). Participants were surveyed in 2013 (Time 1 [T1]) and 2016 (Time 2 [T2]) using the clinically validated Insomnia Severity Index. The prevalence of insomnia and sleep medication use was quantified at both times. Multivariable models identified military factors associated with new-onset insomnia and/or sleep medication use while adjusting for covariates. The prevalence of insomnia at T1 and T2 was 16.3% and 11.2%, respectively. New-onset insomnia at T2 was reported by 6.0% of participants screening negative at T1; risk factors included Army service, combat deployment experience, and separation from military service. The prevalence of sleep medication use at T1 and T2 was 23.1% and 25.1%, respectively. Sleep medication use at T2 was newly-reported by 17.1% of participants not reporting sleep medication use at T1; risk factors included number of deployments and having a healthcare occupation. The prevalence of probable clinical insomnia in this large general military population is within the range of previous reports in military and civilian populations. Certain military factors that predict new-onset insomnia and/or sleep medication use should be considered when designing and implementing sleep interventions in military populations.

Mental Health and Work-Related Behaviors in Management of Work Requirements of University Lecturers in Ukraine-An Age Group Comparison.

Background: There are only a few national and international studies on the health of third-level professor lecturers at universities and colleges. Work-related diseases are important and relevant for occupational medicine. The aim of the study was to examine the mental health and work-related behavior and experience patterns of Ukrainian university lecturers in age group comparisons. Methods: Data were collected from 81 Ukrainian university lecturers (General Health Questionnaire (GHQ-12), Questionnaire on Work-Related Behavior and Experience Patterns (AVEM)). The university lecturers were split into 4 age groups. Results: 9.9% of higher education lecturers reported impaired mental health (GHQ-12). In all, 64.8% of the total sample showed AVEM risk patterns. There were differences in age groups (third age group scoring lower than the first age group on the GHQ total score). The first age group had significantly lower opinions of the subjective importance of work on their personal lives compared to the third and fourth age group, while the second age group had significantly lower opinions compared to the fourth age group. All individuals with impaired mental health in GHQ-12 had AVEM risk patterns. Conclusions: These results offer novel insights into the health of Ukrainian university lecturers. Occupational healthcare practitioners should take them into consideration in order to initiate appropriate interventions.

THE IMPACT OF COVID-19 PANDEMIC ON THE CHOICE OF SUB-SPECIALTY TRAINING IN US MEDICAL RESIDENCY PROGRAMS

TOPIC: Education, Research, and Quality Improvement TYPE: Original Investigations PURPOSE: The Covid-19 pandemic led to critical shortage of personal protective equipment worldwide & challenged the motto of safety in healthcare occupations. Pulmonary & critical care medicine (PCCM) is one of the specialties that was heavily involved in care of Covid-19 infected patients. It is not yet determined how an active pandemic can shape the minds of Internal Medicine (IM) residents who wished to pursue fellowship training. While some may deem PCCM to be too high a risk and avoid it altogether, others may process it as a calling. The purpose of this survey study was to determine these effects. METHODS: We surveyed the IM residents enrolled in ACGME accredited residency programs in the United States. The survey invitation link was distributed to the preferred contact email listed on the American Medical Association: Residency & Fellowship Database (FREIDA™) using a mass emailing service. Programs were requested to distribute the survey to IM residents to complete voluntarily. Study data were collected & managed using REDCap electronic data capture tools hosted at Case Western Reserve University. A reminder email was sent at 2-week period to the programs that didn't open the initial enrollment email. Data analysis was completed using REDCap & Microsoft Excel. RESULTS: Of the 258 responses, 12 were excluded due to incomplete data or not meeting criteria. A total of 245 responses were used for analysis of which 48.4% self-identified as male & 51.6% as female. Subgroups based on year of training were: PGY1(66, 26.9%), PGY2(94, 38.4%), PGY3(75, 30.6%) & PGY4(10, 4.1%). Majority of residents were in age group 26-35 (226, 92.2%) with geographical distribution into Northeast (55, 22.4%), Midwest (82, 33.5%), South (61, 24.9%) & West (47, 19.2%). Of the respondents, 179/245(73.1%) were residents aspiring for fellowship positions, 30/245(12.2 %) were undecided & 36/245(14.69%) were not interested in pursuing fellowship. The pandemic events of year 2020 altered the decision to pursue fellowship with an average influence factor of 59.08 (SD 23.4) on a linear scale of 0-100. This change affected 10.6% (26/245) of the respondents, swaying 46.1% of these residents against the field of PCCM & 23% for it. CONCLUSIONS: The COVID-19 pandemic affected only a small proportion of residents into altering their decisions to pursue fellowship of their original choice. However, when applicable it mostly deterred residents from applying to a high risk fellowship such as PCCM. This survey study is limited by the relatively small number of respondents, general limitations of voluntary surveys & lack of responses from some geographic locations. CLINICAL IMPLICATIONS: Covid-19 pandemic may have influenced the decision to pursue fellowship training with a potentially deleterious effect on PCCM. This could be due to ongoing concerns for personal safety. Additional studies are needed to determine underlying factors. DISCLOSURES: No relevant relationships by Samantha DiBenedetto, source=Web Response No relevant relationships by Enambir Josan, source=Web Response No relevant relationships by Ziad Shaman, source=Web Response No relevant relationships by vikrant singh, source=Web Response

Sickness absence and return to work among employees with knee osteoarthritis with and without total knee arthroplasty: a prospective register linkage study among Finnish public sector employees.

Objective:This study aimed to examine duration of sickness absence due to knee osteoarthritis (OA) and sustained return to work (RTW) among municipal employees who had at least one compensated sickness absence period due to knee OA. The contribution of sociodemographic characteristics, diabetes and previous sickness absence were assessed. We differentiated between participants with and without total knee arthroplasty (TKA).Methods:Data from 123 506 employees in the Finnish Public Sector Study were linked with national health and mortality register information. There were 3 231 sickness absence periods (2372 participants) due to knee OA in 2005−2011. Kaplan-Meier curves for sustained RTW were obtained and median time with inter-quartile range (IQR) calculated for those with and without TKA. Cox regression analyses were carried out in multivariable analyses.Results:The median time to RTW from the beginning of sickness absence was 21–28 days when TKA was not related to sickness absence and 92–145 days when it was. Among participants with no TKA, age 60−64, non-sedentary work, diabetes, and previous sickness absences predicted longer time to RTW, while pain medication predicted a shorter time. Among participants with TKA, non-sedentary work and previous sickness absences predicted a longer time to RTW.Conclusions:The clinical relevance of the difference in time to RTW between employees with or without TKA was substantial. Employees with knee OA working in physically demanding jobs need work modifications after TKA, and this calls for a dialog between occupational health care professionals and workplaces.

Potential Cross-Reactive Immunity to COVID-19 Infection in Individuals With Laboratory-Confirmed MERS-CoV Infection: A National Retrospective Cohort Study From Saudi Arabia.

BackgroundA growing number of experiments have suggested potential cross-reactive immunity between severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and previous human coronaviruses. We conducted the present retrospective cohort study to investigate the relationship between previous Middle East respiratory syndrome-coronavirus (MERS-CoV) infection and the risk of SARS-CoV-2 infection as well as the relationship between previous MERS-CoV and COVID-19-related hospitalization and mortality.MethodsStarting in March 2020, we prospectively followed two groups of individuals who tested negative for COVID-19 infection. The first group had a previously confirmed MERS-CoV infection, which was compared to a control group of MERS-negative individuals. The studied cohort was then followed until November 2020 to track evidence of contracting COVID-19 infection.FindingsA total of 82 (24%) MERS-positive and 260 (31%) MERS-negative individuals had COVID-19 infection. Patients in the MERS-positive group had a lower risk of COVID-19 infection than those in the MERS-negative group (Risk ratio [RR] 0.696, 95% confidence interval [CI] 0.522-0.929; p =0.014). The risk of COVID-19-related hospitalization in the MERS-positive group was significantly higher (RR 4.036, 95% CI 1.705-9.555; p =0.002). The case fatality rate (CFR) from COVID-19 was 4.9% in the MERS-positive group and 1.2% in the MERS-negative group (p =0.038). The MERS-positive group had a higher risk of death than the MERS-negative group (RR 6.222, 95% CI 1.342-28.839; p =0.019). However, the risk of mortality was similar between the two groups when death was adjusted for age (p =0.068) and age and sex (p =0.057). After controlling for all the independent variables, only healthcare worker occupation and >1 comorbidity were independent predictors of SARS-CoV-2 infection.InterpretationIndividuals with previous MERS-CoV infection can exhibit a cross-reactive immune response to SARS-CoV-2 infection. Our study demonstrated that patients with MERS-CoV infection had higher risks of COVID-19-related hospitalization and death than MERS-negative individuals.

Characteristics and Circumstances Associated with Work-Related Suicides from the National Violent Death Reporting System, 2013-2017.

Workplaces are critical in suicide prevention because work-related factors can be associated with suicide, and because workplaces can be effective suicide prevention sites. Understanding the circumstances associated with work-related suicides can advance worksite prevention efforts. Data from the United States Centers for Disease Control and Prevention, National Violent Death Reporting System from 2013 to 2017 were used to examine characteristics and circumstances associated with work compared with non-work suicides. Work-related suicides included those indicated as work-related on the death certificate or in which the death investigation mentioned a work problem or work crisis. Of the 84,389 suicides, 12.1% had some relation to the decedent’s work. Males, those aged 21–54, and with at least a college education, were most likely to have work-related suicides. The circumstances most strongly associated with work-related suicide were financial problems (Odds Ratio (OR) = 4.7; 95% Confidence Interval (CI) = 4.5–5.0), prior depressed mood (OR = 2.4; 95% CI = 2.3–2.5), and eviction/loss of home (OR = 1.6; 95% CI = 1.4–1.7). Suicides among healthcare practitioners and management occupations had the highest odds of being work-related. Workplace wellness programs can consider incorporating services, such as financial planning and mental health services, as potentially up-stream approaches to prevent work-related suicide.

Examining Wage Disparities by Race and Ethnicity of Health Care Workers.

Prior studies demonstrated that wage disparities exist across race and ethnicity within selected health care occupations. Wage disparities may negatively affect the industry's ability to recruit and retain a diverse workforce throughout the career ladder. To determine whether wage disparities by race and ethnicity persist across health care occupations and whether disparities vary across the skill spectrum. Retrospective analysis of 2011-2018 data from the Current Population Survey using Blinder-Oaxaca decomposition regression methods to identify sources of variation in wage disparities. Separate models were run for 9 health care occupations. Employed individuals 18 and older working in health care occupations, categorized by race/ethnicity. Annual wages were predicted as a function of race/ethnicity, age, sex, marital status, having a child under 5 in the household, living in a metro area, highest education attained, and usual hours worked. Non-Hispanics consistently made more than Hispanic licensed practical/vocational nurses (LPNs/LVNs), aides/assistants, technicians, and community-based workers. Asian/Pacific Islanders consistently made more than Black, American Indian/Alaska Native, and Multiracial individuals across occupations except physicians, advanced practitioners, or therapists. Asian/Pacific Islanders only made significantly less when compared with White physicians, but more than White advanced practitioners, registered nurses, LPNs/LVNs, and aides/assistants. Based on observed attributes, Black registered nurses, LPNs/LVNs, and aides/assistants were predicted to make more than their White peers, but unexplained variation negated these gains. Many wage gaps remained unexplained based on measured factors warranting further study. Addressing wage disparities is critical to advance in careers and reduce job turnover.

Can Surface Coating of Circular Saw Blades Potentially Reduce Dust Formation?

Coating of steel is a frequently applied approach to increase the resistance of moving machine parts towards abrasion, surface oxidation, and corrosion. Here, we show that plating circular saw blades with certain metals can help to reduce the electrical charging of wood dust during cutting, which has significant implications for occupational safety, healthcare, and lifetime of filter systems. With the example of beech wood planks, machine net energy consumption EV (J cm−3) and cumulated field strength (kV m−4) as caused by electrically charged particles were compared for cutting of 10- and 20-mm deep grooves (800 mm length) using saw blades of different toothing (24, 60 teeth) and surface coating (Cu, Ag, and Cr). To ensure uniform feed per tooth (fz = 0.063 mm), saw blades were operated at different rotation speeds (4000 vs. 1600 rpm). The results demonstrate that the extent of electrostatic sawdust charging can be manipulated to a certain extent by the type of saw blade plating. Coating with chromium turned out to be most effective in shifting the electrostatic charge of the wood particles towards neutralization. Lowering of rotation speed using circular saw blades of higher toothing was an additional measure significantly reducing electrostatic charging of wood dust. Hence, cutting with a chrome-coated blade with 60 teeth can be specifically recommended as the reduction of electrical saw dust charging is not associated with higher machine power consumption.

Patterns of Virus Exposure and Presumed Household Transmission among Persons with Coronavirus Disease, United States, January-April 2020.

We characterized common exposures reported by a convenience sample of 202 US patients with coronavirus disease during January–April 2020 and identified factors associated with presumed household transmission. The most commonly reported settings of known exposure were households and healthcare facilities; among case-patients who had known contact with a confirmed case-patient compared with those who did not, healthcare occupations were more common. Among case-patients without known contact, use of public transportation was more common. Within the household, presumed transmission was highest from older (>65 years) index case-patients and from children to parents, independent of index case-patient age. These findings may inform guidance for limiting transmission and emphasize the value of testing to identify community-acquired infections.

Prevalence of Psychological Impacts on Healthcare Providers during COVID-19 Pandemic in Asia

COVID-19 has impacted people psychologically globally, including healthcare providers. Anxiety, depression, and stress are the most common impacts that have affected these people. Thus, this study was aimed to ascertain the estimated prevalence of psychological impacts among healthcare providers in the Asian region. A systematic search was performed in the MEDLINE, CINAHL, and Scopus databases for original research articles published between 2020 and April 2021. Only studies published in English were included. The quality of data was assessed using the Joanna Briggs Institute Meta-Analysis, and the analysis was performed using generic inverse variance with a random-effects model by Review Manager software. A total of 80 studies across 18 countries in Asia region were pooled to assess the data prevalence on anxiety (34.81% (95% CI: 30.80%, 38.83%)), depression (34.61% (95% CI: 30.87%, 38.36%)), stress (31.72% (95% CI: 21.25%, 42.18%)), insomnia (37.89% (95% CI: 25.43%, 50.35%)), and post-traumatic stress disorder (15.29% (95% CI: 11.43%, 19.15%)). Subgroup analyses were conducted across regions, type of healthcare providers, sex, and occupation. This review has identified a high prevalence of anxiety, depression, stress, and insomnia but a low prevalence of post-traumatic stress disorder among healthcare providers in Asia regions. Effective intervention support programs are urgently needed to improve psychological health of healthcare providers and maintaining the health system.

Clinical validation of brief mental health scales for use in South African occupational healthcare

Orientation: South Africa carries a high burden of mental ill-health. Screening to identify individuals for further referral is emerging as one pathway to promote access to mental health interventions. Existing occupational health surveillance infrastructure may be a useful mechanism for clinical mental health screening. Research purpose: This study explored the clinical validity of a range of brief mental health measures in the context of occupational health surveillance. Motivation for the study: To meaningfully screen for mental health as part of occupational health surveillance, tools are required that are empirically validated, clinically useful, locally available and practical to administer. Research approach/design and method: Workers ( n = 1816), recruited through workplace occupational health surveillance programmes, completed the Patient Health Questionnaire-9, Brief Symptom Inventory 18-somatisation subscale, Generalised Anxiety Disorder scale-7, Primary Care Post-Traumatic Stress Disorder Screen, Intense (panic-like) anxiety scale and CAGE scale and partook in a diagnostic interview with a clinical psychologist. Main findings: Basic psychometric characteristics were reported, including confirmatory factor analyses, measurement invariance, internal consistencies and socio-demographic effects. Clinical utility was explored through receiver operating/operator characteristics curve analyses, and calculations of positive and negative predictive values, as well as sensitivity and specificity. These indicators provided evidence of clinical validity in the study context. Practical/managerial implications: The findings support the use of psychological screening as a brief, practicable and easily accessible mode of occupational mental health support. Contribution/value-add: This article presented evidence of structural and criterion validity for these scales and described their clinical application for practical use in occupational mental health surveillance.

Real wage growth in the U.S. health workforce and the narrowing of the gender pay gap

BackgroundHealthcare has been identified as a job engine during recent recessions in the U.S. Whether the healthcare sector provides better than average pay remains a question. This study investigates if wages grew with the expanding demand for healthcare workers between 2001 and 2017. Wage growth in the (1) physicians and surgeons, (2) nurse, (3) healthcare practitioner and technical, (4) healthcare support, and (5) direct patient care jobs are examined. The gender pay gap in each occupation is investigated.MethodsThe American Community Survey (ACS) public use microdata sample (PUMS) for 2001, 2004, 2008, 2013, and 2017 were used to derive hourly wages for full-time, full-year workers aged 18–75. The cumulative percent change in unadjusted, median hourly wages between 2001 and 2017 was calculated for each occupation. Quantile regression estimates predicted a median hourly wage for men and women by year and job after adjusting for differences in demographics, industry, and hours worked.ResultsUnadjusted median wage growth was 9.92% for nurses, 5.68% for healthcare practitioners, and 37.6% for physicians between 2001 and 2017. These rates are roughly above the estimated national rate of wage growth at the 50th wage percentile. In healthcare support and direct patient care occupations, workers experienced either stagnant or negative wage growth. Women had lower occupational wages than men.ConclusionThe slow or negative median wage growth in all but the physician occupation between 2004–2008 and 2008–2013 confirms that healthcare wages in the U.S. are not recession-proof, unlike healthcare employment. Generally, women's earnings grew at rates that were higher or less negative than rates for men. This trend contributed to narrowing the gender pay gap in every occupation except for nurse.

Physical health complaints among healthcare workers engaged in the care of critically ill COVID-19 patients: A single tertiary-care center prospective study from Japan

BackgroundHealthcare workers (HCWs) who manage patients with the novel coronavirus disease 2019 (COVID-19) are at an increased risk and fear of contracting the infection themselves. Hospitals must reduce both the physical and mental burden of HCWs on the front lines and ensure their safety. No prospective study has focused on the physical health complaints among HCWs engaged in the care of critically ill COVID-19 patients. This study aimed to evaluate the prevalence of various physical symptoms experienced by HCWs following their exposure to COVID-19 patients and investigate the association between occupation and the manifestation of physical symptoms among HCWs at a tertiary hospital in Japan during the current ongoing COVID-19 pandemic. MethodsA twice-weekly questionnaire targeting HCWs who care for COVID-19 patients was performed at Osaka City University Hospital from April 30 to May 31, 2020. The demographic characteristics of the participants, frequency of exposure to at-risk care, and physical complaints were evaluated. ResultsSeventy-six HCWs participated in this study, of whom 24 (31.6%) were doctors, 43 (56.6%) were nurses, and 9 (11.8%) were technicians. The frequency of experiencing any physical symptom was 25.0% among HCWs. Exposure to at-risk care was significantly higher among nurses than among doctors (p < 0.001). Notably, the frequency of physical symptoms among the nurses was very high at 39.5% and obviously higher than that of physical symptoms among the doctors (p < 0.01). ConclusionsOur results indicate that hospital occupational health care must be provided to HCWs who are engaged in the care of COVID-19 patients and are thus highly exposed to at-risk care.