Occupational Health Care Research Articles

Evaluation of participatory learning approach for developing competency of human immunodeficiency virus risk assessment skills among MBBS undergraduate students.

BACKGROUND:An Indian medical graduate needs to be competent in the diagnosis and management of human immunodeficiency virus (HIV) patients. This is crucial in terms of occupational safety. A participatory learning approach could be a possible way to change behavior and improve HIV risk assessment skills among medical students for better occupational safety and health care. The present study was planned to identify the need, provide different learning experiences for acquiring competency, and compare the effectiveness of participatory learning over traditional in developing HIV risk assessment skills.MATERIALS AND METHODS:An educational interventional (randomized controlled trial) was carried out at GEMS and Hospital. Needs assessment survey was conducted, which identified HIV risk assessment as a key competency. For which the outcome-specific learning objectives were defined, two different learning experiences were employed. A pretest was conducted to assess the baseline knowledge and attitude (n = 92); they were then divided into two equal groups (A and B). “A” group was taught by participatory approach, whereas “B” by traditional techniques followed by posttest and objective structured clinical examination (OSCE) to assess their HIV risk assessment skills. Statistical analysis: Paired t-test for assessing knowledge and attitude within the same group and unpaired t-test for assessing skills between the two groups were used in this study.RESULTS:Statistically significant improvement (P < 0.001) in knowledge and attitude scores was noticed that OSCE scores were significantly higher in the intervention group “A” (P < 0.001) as compared to “B” taught by traditional techniques.CONCLUSION:Participatory learning effectively builds upon existing knowledge and attitude to develop better HIV risk assessment skills.

COVID-19: Evaluation of Occupational Health Risk and Healthcare Workers

COVID-19: Evaluation of Occupational Health Risk and Healthcare Workers

L'infirmier de santé au travail : prévention et sécurité en équipe pluridisciplinaire

The presence of nurses within occupational health care teams is now mandatory. Their role, centred on prevention, health protection and employees' safety, is practised under the authority and in close collaboration with the occupational health doctor, within a multidisciplinary team. Over recent years, their scope of practice has been expanded to include the individual monitoring of employees' health. It could be further expanded in future.

Prevalence and Factors associated with sickness absenteeism among Pharmaceutical Industrial workers of Hyderabad, India

Background: Sickness absenteeism is a potential epidemiological issue leading to loss of productivity in addition to increasing the cost of health care and provides a major tool in enhancing occupational health care preventive strategies.&#x0D; Aim and Objectives: To determine the prevalence of sickness absenteeism and their associated factors among Industrial Workers of Pharmaceutical Manufacturing industries in Hyderabad.&#x0D; Materials and Methods: A cross sectional study was taken up among 160 Workers at two Pharmaceutical Manufacturing companies in Hyderabad using simple random sampling technique. Data included Individual, Occupational and Organizational factors influencing their sickness absenteeism and general health conditions in the past six months through camp based approach. Data was analysed using descriptive statistics and multinomial logistic regression analysis to predict the variables associated with the outcome.&#x0D; Results: The prevalence of sickness absenteeism was found among 19% of the workers. Common causes were due to sickness among 25(84%) and social responsibilities among 5(16%). On multinomial logistic regression analysis- poor superior relationships, poor co-workers relationship and high mental stress were found to be significant.&#x0D; Conclusion: Sickness absenteeism was found to be high which can be reduced by improving relationships with superiors and co-workers and also by reducing mental stress among the workers.

Importance of occupational dentistry for companies - a literature review.

Due attention has not been given yet to workers’ health problems arising from oral diseases and to the impacts of not having an appropriate professional, i.e., dental surgeon, as part of the specialized service team of large companies, even acknowledging that the participation of these professionals is positive for improving workers’ quality of life and the productive performance of the company. Based on these premises, and through a literature review conducted from a search on the electronic portal of Brazilian Dentistry Bibliography, SciELO, and MEDLINE databases, the present study aimed to demonstrate factors that justify the integration of dental surgeons in occupational health programs of companies. The following advantages were mentioned: reduction in absenteeism and in the number of work accidents, productivity growth, and improvement in company image and in employees’ quality of life. In conclusion, the occupational health care model cannot be dissociated from oral health, considering the significant benefits both for employees and for companies themselves.

Occupations and the new HEIC job market in the context of the Covid-19 pandemic

This study investigates the new job market in the Health Economic-Industrial Complex (HEIC 4.0) and its influence on occupations. It also discusses the structural characteristics of the HEIC dynamics and the Unified Health System (SUS) sustainability in the pandemic context. Divided into three sections, this article highlights that health occupations are simultaneously impacted by a general social and job market degradation. There are also restrictions imposed on the HEIC modernization process, which is the cornerstone of SUS. In the second section, it focuses on the health care occupation conditions and fragilities, heightened during the pandemic. Finally, it establishes relations between structural movements in the job market and the needs for modernizing HEIC and its impact on the health care working conditions. The HEIC conditions and fragilities seen during the pandemic reflect general issues in Brazil's development pattern.

Economic Consequences of Hospital Closures

Hospitals anchor much of US health care and receive a third of all medical spending, including various subsidies. Nevertheless, some become insolvent and exit the market. Research has documented subsequent access problems; however, less is understood about broader implications. We examine over 100 rural hospital closures spanning 2005-2017 to quantify the effects on the local economy. We find sharp and persistent reductions in employment, but these localize to health care occupations and are largely driven by areas experiencing complete closures. Aggregate consumer financial health is only modestly affected, and housing markets were already depressed prior to hospital closures.

Allergic contact dermatitis and other occupational skin diseases in health care workers in the Finnish Register of Occupational Diseases in 2005-2016.

Health care workers are an important risk group for occupational skin disease (OSD). To study diagnoses and causes of OSDs in health care workers in the Finnish Register of Occupational Diseases (FROD) in 2005-2016. We searched the FROD for dermatological cases (a) in health care-related occupations defined by ISCO-08 and (b) in the industrial branch of health care defined by European industry standard classification system (NACE rev. 2). Health care workers comprised 19% of all OSD cases in the FROD, and irritant contact dermatitis dominated the diagnoses. Nurses and assistant nurses were the largest occupational groups with incidence rates of 3.3 and 2.7/10 000 person years, respectively. Rubber chemicals were by far the most common causative agents of allergic contact dermatitis (ACD) followed by preservatives, the latter mainly comprising isothiazolinones and formaldehyde. Acrylates were important allergens in dental professions. Metals and coconut fatty acid derivatives were the next largest causative groups for ACD. Drugs caused only 1% of the ACD cases. Workers in different health care occupations do not have a uniform risk for OSD, but they share the risk for ACD due to rubber chemicals and various preservatives.

Cybernetic Communications: Focusing Interactions on Goal-Centered Care.

In nursing homes, due to time constraints, lack of communication can influence the quality of information exchanged, which influences the outcomes of healthcare for residents. Nurses' proximity to the nursing home resident, their knowledge, and skill serve as an opportunity to communicate and facilitate patient-centered goals and improve treatment decision-making. Concepts within the cybernetic communication literature entail systemic interactive relationships that enable the sharing of knowledge and expertise. These interactions are based on nursing's theoretical knowledge, clinical judgment, and empowerment and are based on patient-centered goals.

Velferdsteknologi i helse- og oppvekstyrker: Digitalt kompetansebehov i yrkesfaglig utdanning

The fast-paced changes of the Western world community require vocational education and training (VET) that meets the future working-life needs for competence. One challenge in Norwegian health education is the lack of up-to-date teacher competence in welfare technology and digital competence. This article is based on a case study of how vocational teachers in health education programmes (HO) meet the future needs for competence in welfare technology. This research questions what can be changed in VET with these new technologies and how the technology challenges the vocational content of health and education work, and VET. This need for technological competence is also linked to the renewal of curriculum in Norwegian VET, which entails requirements for previous vocational specialisation. The study involved qualitative methods and development experiments. The results show examples of how vocational teachers and students at HO can meet the future needs for competence in welfare technology related to ethics. The results indicate the need for close collabo­ration between school and working life to meet the new technology-competence need in the content in both the HO education and the health care occupations. Didactical planned intern­ship in companies using welfare technology, were important for the participants learning about digital tools.

Modeling the impact of education on individual earnings: 2019 evidence from Sudan

The impact of education on individual earnings has not been adequately discussed in the Sudanese literature. This paper estimates the rate of return on education by modeling individual-level Sudanese survey data for 2019. The importance of these data lies in the fact that they represent the period of Islamist rule in Sudan, which spanned thirty years and ended in April 2019 as a result of a peaceful youth popular revolution. A secondary aim is to trace how demographic characteristics (marital status, gender, locale) affect individual earnings. Results show, on average, an additional year of education increases individual earnings 4% (4.4% for men, 9.2% for women). Marital status exhibits the largest impact on Sudanese individual earnings, with married respondents’ earnings 78.7% more than singles. Almost 90% of the variation in wages is determined by all levels of education, and trade pays the highest wage among surveyed occupations. Mincer models prove that the return on education was significantly positive for occupations in healthcare and electricity and significantly negative in real estate.

Rural Employment of Health Care Workers: A Longitudinal Cohort Study.

Preserving and increasing the health care workforce in rural areas has become imperative due to the shortage of health care workers serving rural populations. However, limited data are available on long-term patterns of employment in rural settings among health care workers. We analyzed the National Longitudinal Survey of Youth, which enrolled a nationally representative sample of adolescents in 1979 and tracked their career outcomes through 2016. Using the US Census Bureau occupation codes, we identified participants who worked in health care occupations, and we classified their employment in rural versus urban areas. Of the 1,007 respondents (including 109 doctoral health professionals), 70% worked only in urban locations, 13% worked only in rural locations, and 17% worked in both rural and urban locations during their health care career. Rural upbringing, White race, and female gender were associated with rural employment. Among nondoctoral health professionals, lower educational attainment was associated with increased likelihood of working only in rural settings. Our study indicates the rural workforce is split between workers who are only employed in rural settings, and those who are intermittently employed in rural and urban settings. Therefore, retention of health care workers in rural settings and recruitment of workers from urban settings to practice in rural areas are important strategies for addressing the rural health care worker shortage. Rural upbringing, previously described as predictive of physician practice in rural locations, appears the strongest predictor of rural employment for both doctoral health professionals and nondoctoral health professionals.

Estimation of differential occupational risk of COVID-19 by comparing risk factors with case data by occupational group.

BackgroundThe disease burden of coronavirus disease 2019 (COVID‐19) is not uniform across occupations. Although healthcare workers are well‐known to be at increased risk, data for other occupations are lacking. In lieu of this, models have been used to forecast occupational risk using various predictors, but no model heretofore has used data from actual case numbers. This study assesses the differential risk of COVID‐19 by occupation using predictors from the Occupational Information Network (O*NET) database and correlating them with case counts published by the Washington State Department of Health to identify workers in individual occupations at highest risk of COVID‐19 infection.MethodsThe O*NET database was screened for potential predictors of differential COVID‐19 risk by occupation. Case counts delineated by occupational group were obtained from public sources. Prevalence by occupation was estimated and correlated with O*NET data to build a regression model to predict individual occupations at greatest risk.ResultsTwo variables correlate with case prevalence: disease exposure (r = 0.66; p = 0.001) and physical proximity (r = 0.64; p = 0.002), and predict 47.5% of prevalence variance (p = 0.003) on multiple linear regression analysis. The highest risk occupations are in healthcare, particularly dental, but many nonhealthcare occupations are also vulnerable.ConclusionsModels can be used to identify workers vulnerable to COVID‐19, but predictions are tempered by methodological limitations. Comprehensive data across many states must be collected to adequately guide implementation of occupation‐specific interventions in the battle against COVID‐19.

HEALTH WORKERS HEALTH - EPIDEMIOLOGIC PROFILE OF 11400 MEDICAL APPOINTMENTS NOT REGULATED BY IN LATIN AMERICA'S LARGEST HOSPITAL COMPLEX

Hospital das Clínicas is the biggest hospital complex in Latin America and it has around 21 thousand employees. Nowadays, Brazilian law ensures occupational healthcare as in hiring medical examination, dismissal, periodical, change of function and return to work examination, but not always those exams provide health whole profile or workers' complaints. It is essential to search alternatives that enable to identify and to characterize those professionals, so they would be better assisted. To analyze not regulated by law occupational medical appointments of the hospital and to identify their epidemiological profile. Descriptive review of corporative system data of HCFMUSP, 2014 - 2019. Inclusion criteria: Occupational health appointments which involve spontaneous demand of the worker or scheduled by supervisor and are due to complaint or need that may have to do with work activity. Exclusion criteria: Routine occupational appointments planned by the legislation; consultations outside of the analyzed period; occupational health appointments not performed. Analyzed a total of 11421 appointments. The major percent of patients was nursing assistants and technicians (30%). More prevalent workplaces were Central Institute and Heart Institute, which presented 34% and 18%, respectively. The unit that had the highest frequency was the ICU, with 80%. Women were the most prevalent in all years, with 74%. The average age was 49 years, but 25 workers, over the entire period, were over 75 yo. The results allowed us to identify that nursing and ICU professionals are those who seek care the most and are most likely those who need more attention from occupational physicians and multidisciplinary staff. Conclusion: By ensuring that occupational services in hospitals meet the staff through spontaneous demand and not just through standard consultation that follow routine examinations imposed by law, we can improve the adoption of preventive measures, appropriate referrals and treat illness early in occupational health.

Work ability of teachers associated with voice disorders, stress, and the indoor environment: A questionnaire study in Finland

ObjectivesThe purpose of this study was to determine whether self-reported work ability is associated with voice disorders, stress at work, and the quality of the perceived indoor environment. Study designA cross-sectional study. MethodsWe conducted a questionnaire study of 1 198 Finnish teachers utilizing the Work Ability Score. ResultsThe Work Ability Score median was 8 (Q1: 7, Q3: 9), and 71% (CI 95% 69%–74%) of the subjects reported that they had good work ability. Female teachers had a significantly lower Work Ability Score than male teachers. The median number of days absent due to sickness during the previous year was 4 (Q1: 2, Q3: 10). Voice disorders (adjusted odds ratio (aOR) 2.44; CI95% 1.73–3.44), stress at work (rather or very much vs. not at all or little; aOR 6.53; CI95% 4.31–9.90), and poor perceived indoor environment quality (aOR 2.63; CI95% 1.86–3.71) were all clear risk factors for the Work Ability Score. ConclusionWe determined that decreased work ability in teachers is connected to voice disorders, stress at work, and poor perceived indoor environment quality. Thus, in order to better maintain teachers’ work ability, we recommend that special attention should be paid to occupational health care when there are problems in the indoor environment of teachers, and they suffer from voice disorders and stress.

Health behaviours and psychosocial working conditions as predictors of disability pension due to different diagnoses: a population-based study

BackgroundTo investigate whether the clustering of different health behaviours (i.e. physical activity, tobacco use and alcohol consumption) influences the associations between psychosocial working conditions and disability pension due to different diagnoses.MethodsA population-based sample of 24,987 Swedish twins born before 1958 were followed from national registers for disability pension until 2013. Baseline survey data in 1998–2003 were used to assess health behaviours and psychosocial Job Exposure Matrix for job control, job demands and social support. Cox proportional hazards models were used to calculate hazard ratios (HR) with 95% confidence intervals (CI).ResultsDuring follow-up, 1252 disability pensions due to musculoskeletal disorders (5%), 601 due to mental diagnoses (2%) and 1162 due to other diagnoses (5%) occurred. In the models controlling for covariates, each one-unit increase in job demands was associated with higher (HR 1.16, 95%CI 1.01–1.33) and in job control with lower (HR 0.87, 95%CI 0.80–0.94) risk of disability pension due to musculoskeletal disorders among those with unhealthy behaviours. Among those with healthy behaviours, one-unit increase of social support was associated with a higher risk of disability pension due to mental and due to other diagnoses (HRs 1.29–1.30, 95%CI 1.04–1.63).ConclusionsJob control and job demands were associated with the risk of disability pension due to musculoskeletal disorders only among those with unhealthy behaviours. Social support was a risk factor for disability pension due to mental or other diagnoses among those with healthy behaviours. Workplaces and occupational health care should acknowledge these simultaneous circumstances in order to prevent disability pension.

Development and Operation of a Video Teleconsultation System Using Integrated Medical Equipment Gateway: a National Project for Workers in Underserved Areas

Worker health centers and health zones provide occupational healthcare services to workers in underserved areas of industrial health. Health zones cannot counsel workers on occupational disease prevention; worker health center personnel have to provide such services through in-person visits. Video teleconsultation can increase the accessibility of high-quality services to workers who visit health zones and improve professional personnel’s efficiency. This study aimed to develop a system and an infrastructure that could facilitate video teleconsultation services between worker health centers and health zones, and analyze the services’ operation status. A video teleconsultation process based on the role of local and remote institutions was designed. Based on the designed services, a web system supporting teleconsultation and an integrated gateway guaranteeing the interface with medical equipment in the web environment was developed. After analyzing the working environment, an infrastructure consisting of networks, video equipment, medical equipment, and servers necessary for teleconsultation was designed. Statistical results from the developed system and a satisfaction survey conducted by the Korea Occupational Safety and Health Agency were used to analyze the video teleconsultation services’ operation status. A system, gateway, and hardware infrastructure within 21 worker health centers and 21 health zones has been operating this service since January 1, 2018. Over two years, the total number of teleconsultation service users was 4979, and the total number of questionnaire respondents was 1270. The total number of service activities was 6388 and total satisfaction was rated as 4.58 (± 0.59) out of 5. In this study, video teleconsultation services were evaluated as being very satisfactory. In particular, service accessibility and local medical personnel service were rated highly, demonstrating that the developed system and infrastructure were well designed according to the goals of the project.

Weight Reduction by the Low-Insulin-Method-A Randomized Controlled Trial.

Continuous high insulin levels are associated with weight gain and lead to cardiometabolic diseases. Therefore, we have developed the Low-Insulin-Method and integrated it into the multi-component, occupational healthcare program SHAPE-AND-MOTION-Medical-Accompanied-Slimming (SAMMAS) to reduce daily insulin levels for long-term weight reduction in overweight or obesity. Employees were randomized into a starting intervention group (SI, n = 15) or waiting list control group (WL, n = 15). SAMMAS consisted of group-based seminars, low-carbohydrate nutrition including formula diet, continuous glucose monitoring, telemetric monitoring, and telemedical coaching. Both groups received telemetric devices at baseline. Intention-to-treat analyses were performed after 12, 26, and 52 weeks. The estimated treatment difference in weight reduction after 12 weeks, which is the primary endpoint of the study, showed a pronounced effect in favour of SI (−6.3 kg with (95% confidence interval) (−7.4; −4.5) (p < 0.001)) after 12 weeks. Furthermore, SI improved fasting blood glucose, HbA1c, quality of life, fasting insulin, blood pressure, and eating behaviour (all p < 0.05) in the within-group analysis, while WL did not. After 26 and 52 weeks, weight reduction could be maintained in the whole group (both groups together) by −6.7 kg (−9.5; −3.8) (p < 0.001) and −6.1 kg (−9.2; −2.7) (p < 0.01). SAMMAS supports clinically relevant weight reduction and long-term weight loss maintenance in individuals with overweight or obesity.

Suspicion of Lyme borreliosis in patients referred to an infectious diseases clinic: what did the patients really have?

ObjectiveTo evaluate the conditions behind the symptoms in patients with suspected Lyme borreliosis (LB) who were referred to an infectious diseases clinic. MethodsIn this retrospective, population-based study, we collected data from the medical records of all patients referred for infectious disease consultations in 2013 due to presumed LB from a population of 1.58 million. The patients were classified according to the certainty of LB on the basis of their symptoms, signs and laboratory results. Data on the outcomes and subsequent alternative diagnoses during the 4-year follow-up period were reviewed from all of the available patient records from public, private and occupational healthcare providers. ResultsA total of 256 patients (16/100 000) were referred as a result of suspicion of LB; 30 (12%) of 256 were classified with definite, 36 (14%) with probable and 65 (25%) with possible LB. LB was unlikely in 121 (47%) patients. A novel diagnosis was discovered in the background symptoms in 73 (29%) of patients. Previously diagnosed comorbidities caused at least some of the symptoms in 48 (19%) patients. Other explanations for symptoms were found in 81 (67%) of 121 of unlikely and 22 (34%) of 65 of possible LB patients. The spectrum of conditions behind the symptoms was quite broad and most often were musculoskeletal, neurological, psychological or functional disorders. ConclusionsLB was unlikely in half of the patients with presumed LB. In most cases the patients had other conditions that explained their symptoms.

Mental health among healthcare providers during coronavirus disease (COVID-19) outbreak in Saudi Arabia

BackgroundThe novel coronavirus (COVID-19) was recently declared a pandemic by the World Health Organization (WHO). The first confirmed case in Saudi Arabia was announced on March 2, 2020. Several psychiatric manifestations may appear during pandemics, especially among frontline healthcare providers. ObjectivesThis study sought to explore depression and anxiety levels among healthcare providers during the COVID-19 outbreak in Saudi Arabia. MethodsThis was a cross-sectional study of a convenience sample of 502 healthcare providers in the Ministry of Health. Depression and anxiety were assessed via the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder 7 (GAD-7) questionnaires, respectively. ResultsThe respondents represented various healthcare occupations: administrators (28.49%), nurses (26.29%), physicians (22.11%), non-physician specialists (13.94%), technicians (6.77%), and pharmacists (2.30%). The majority of them were male (68.1%). More than half of them had depressive disorder (55.2%), which ranged from mild (24.9%), moderate (14.5%), and moderately severe (10%) to severe (5.8%). Half of the sample had generalized anxiety disorder (51.4%), which ranged from mild (25.1%) and moderate (11%) to severe (15.3%). Multivariate analysis showed that males were significantly less predicted to have anxiety (Beta=−0.22, P-value <0.04), 30–39 years age group were significantly more predicted to have depression and anxiety group (Beta=0.204, P-value <0.001 and beta=0.521, P-value <0.003 respectively), and nurses had significantly higher mean score of anxiety (Beta=0.445, P-value <0.026). ConclusionsThis study revealed that depression and anxiety are prevailing conditions among healthcare providers. Although efforts were accelerated to support their psychological well-being, more attention should be paid to the mental health of female, 30–39 age group and nursing staff. Promoting healthcare service as a humanitarian and national duty may contribute to making it a more meaningful experience in addition to advocating for solidarity, altruism, and social inclusion. Longitudinal research studies need to be conducted to follow up on healthcare providers’ mental health symptoms and develop evidence-based interventions.