Occupational Health Consultation Research Articles

A report on a survey among Portuguese Association of Interventional Cardiology associates regarding ionizing radiation protection practices in national interventional cath-labs

Introduction and objectivesConcerns surrounding the consequences of ionizing radiation (IR) have increased in interventional cardiology (IC). Despite this, the ever-growing complexity of diseases as well as procedures can lead to greater exposure to radiation. The aim of this survey, led by Portuguese Association of Interventional Cardiology (APIC), was to evaluate the level of awareness and current practices on IR protection among its members. MethodsAn online survey was emailed to all APIC members, between August and November 2021. The questionnaire consisted of 50 questions focusing on knowledge and measures of IR protection in the catheterization laboratory. Results were analyzed using descriptive statistics. ResultsFrom a response rate of 46.9%, the study obtained a total sample of 159 responses (156 selected for analysis). Most survey respondents (66.0%) were unaware of the radiation exposure category, and only 60.4% reported systematically using a dosimeter. A large majority (90.4%) employed techniques to minimize exposure to radiation. All participants used personal protective equipment, despite eyewear protection only being used frequently by 49.2% of main operators. Ceiling suspended shields and table protectors were often used. Only two-thirds were familiar with the legally established limit on radiation doses for workers or the dose that should trigger patient follow-up. Most of the survey respondents had a non-certified training in IR procedures and only 32.0% had attended their yearly occupational health consultation. ConclusionsSafety methods and protective equipment are largely adopted among interventional cardiologists, who have shown some IR awareness. Despite this, there is room for improvement, especially concerning the use of eyewear protection, monitoring, and certification.

A Preliminary Study of Gut Microbiota in Airline Pilots: Comparison With Construction Workers and Fitness Instructors.

The term "WORKbiota" has been used to describe the impact of occupational exposure and work types on human microbiota composition. Airline pilots, construction workers, and fitness instructors encompass three diverse professional groups, each with distinct work environments and lifestyle factors that may significantly influence their intestinal "WORKbiota." The current preliminary investigation was aimed to compare the relative abundanceof specific gut microbes among airline pilots, construction workers, and fitness instructorsto shed light on any significant differences. By scrutinizing these diverse professional groups, our objective was to enhance our understanding of how occupational factors influence gut microbiotawhile identifying possible implications for occupational medicine. A convenience sample consisting of 60 menrepresenting three different professional domains - airline pilots, construction workers, and fitness instructors (with 20 individuals in each group) - was selected during regular outpatient occupational health consultations. The abundance of selected gut microbiota constituents, including Escherichia coli, Methanobrevibacter smithii, Akkermansia muciniphila, Faecalibacterium prausnitzii, Lactobacillus spp., Bifidobacterium spp., and Bacteroides spp., was quantified using quantitative SYBR Green quantitative real-time polymerase chain reaction (qRT-PCR) in stool samples. There were no significant variations among the groups concerning Escherichia coli, Methanobrevibacter smithii, Bifidobacterium spp., and Bacteroides spp. However, Lactobacillus spp. and Faecalibacterium prausnitzii were significantly more abundant in the microbiota of fitness instructors compared to both airline pilots and construction workers, with no significant differences observed between the latter two groups. Notably, the abundance of Akkermansia muciniphila demonstrated a progressive decline from fitness instructors to construction workersand ultimately to airline pilots, who exhibited the lowest levels. Airline pilots' gut microbiota was characterized by a lower abundance of health-promoting bacterial species, including Lactobacillus spp., Faecalibacterium prausnitzii, and Akkermansia muciniphila. Future research is essential to determine whether targeted interventions, such as probiotic and prebiotic supplementation, could potentially enhance gut microbiota composition and overall health in particular occupational groups.

Experience, user satisfaction, and difficulties of online occupational health consultations during the COVID-19 pandemic: A cross-sectional survey of workers in Japan

COVID-19 has led to an increased use of online consultations in occupational health. We examined experience, satisfaction, and difficulties with online consultations during the first year after the COVID-19 pandemic by surveying a sample of workers. An online survey was conducted in March 2021 among full-time employees of an online panel survey (E-COCO-J: The Employee Cohort Study on the COVID-19 Pandemic in Japan). Respondents were asked to report whether they had online or face-to-face consultations with occupational health professionals in the past year, their level of satisfaction, and their difficulties and problems related to the online consultations. Of the 1,153 respondents, 1,102 (excluding those who were unemployed or on leave) were included in the analysis. Fifty respondents had had online consultations in the past year and 57 had face-to-face consultations. The proportion of respondents who reported satisfaction with online consultations was high (more than 70%) for general health, follow-ups, and guidance consultations, among others. However, the proportion of satisfaction with online occupational consultations was low (less than 40%) for employees who worked long hours, or took leave or returned to work. Over 30% of the respondents indicated that the difficulties with online consultations were due to incongruence with their expectations ("I preferred a face-to-face consultation instead of an online one"), quality of communication ("I did not feel like I was able to consult sufficiently"), and concerns about confidentiality ("I was worried that someone could hear our conversation"). The experience of online consultations was similar to that of face-to-face consultations. Satisfaction with online occupational consultations for those who worked long hours and those who took leave or returned to work was low. In the online consultation for occupational health, the occupational health professional may be required to judge its suitability depending on type of the consultation and take necessary consideration and measures to maintain the quality of the online consultation.

Evaluation of a pilot consultation for maternity protection at work in Switzerland.

Switzerland's Labour Law and its Ordonnance on Maternity Protection aim to protect the health of pregnant employees and their unborn children while enabling them to continue to pursue their professional activities. Some companies encounter difficulties implementing the law's provisions. The Department of Occupational and Environmental Health, part of the Center for Primary Care and Public Health (Unisanté), has provided specialist occupational medicine consultations for pregnant employees since 2015. This study aimed to evaluate how well Swiss' maternity protection legislation is implemented by examining a list of relevant indicators measured during the occupational health consultation. The study also sought to investigate the consultation support provided to the relevant stakeholders and the adjustments made to pregnant employees' working conditions. Descriptive variables and indicators relative to the application of the Swiss maternity protection legislation for 83 pregnant employees were collected during the consultation's pilot phase (between 2015 and 2016). Descriptive statistics and cross-analyses of these indicators were made. Most pregnant employees faced multiple exposures to occupational risks. Preventive risk analyses were rare. Few adjustments to workstations were proposed. We found a tendency for employees to leave their workstations early on in their pregnancies due to sick leave certificate prescriptions. Specialist consultation and collaboration with occupational health physicians to recommend interventions for pregnant employees can provide significant benefits and help some pregnant women to continue at their workstations with appropriate adjustments. A specialised occupational health consultation is a useful instrument for identifying occupational hazards for both the pregnant woman and her unborn child. It is also an opportunity to explain employers' legal responsibilities and obligations to safeguard the health of their pregnant employees and to give specific advice for their company's situation. This consultation also enables employers to maintain their employees' valuable professional competencies in the workplace for as long as possible. Finally, occupational health consultation helps and supports healthcare providers who must, according to the law, make decisions about whether pregnant employees can continue working safely or not.

Workplace Disruption in the Public Sector and HRM Practices to Enhance Employee Resilience

This article aims to analyze workplace dynamics in the public sector under highly disruptive environments. Survey data collected from 1,430 public employees in South Korea reveal that workload and work intensity have increased 13% to 15% on average compared to pre-pandemic conditions. Yet this impact on working conditions seems to be unevenly distributed across the public sector; the proportion of pandemic-affected workforce in each public organization ranged from 10% to 80%. More than 70% reported flexible work arrangements in place to alleviate the disruption, though less than 20% enjoyed access to occupational health and safety consultation to handle this change. We found that baby boomer men, who have the fewest family responsibilities, are most satisfied with flexible work arrangements, while millennial women, with the most domestic commitments, are least satisfied, leaving ample room for improvement. Results of a randomized survey experiment showed that resilience-enhancing Human Resource Management (HRM) practices such as special leave assistance programs influenced civil servants’ perceptions of workload and work intensity. Higher levels of satisfaction with resilience-enhancing HRM were found to be associated with lower levels of turnover intention, though this relationship was weaker among employees whose work became too intense or heavy (“numbing effect”) under the pandemic.

Occupational stressors in healthcare workers in France

ObjectivesTo describe psychosocial constraints and mental health of hospital workers, and to identify the psychosocial constraints significantly associated with mental health difficulties, especially in two groups: caregivers and other hospital workers. MethodData about working conditions and health status collected by the Evrest National observatory in 2018–2019 during occupational health consultation were used. Psychosocial constraints and mental health among caregivers, other hospital workers and non-hospital workers were described. ResultsThere were 1251 hospital workers (843 caregivers, 408 other hospital workers) and 25 129 other workers. Intensity and working time (time pressure, extra working time, missing or shortening a meal), and ethical dilemmas (not having the means to ensure high-quality work, too rapidly handling a procedure that would require more painstaking care) were significantly more reported by the caregivers than by the other hospital workers (50.8% vs 44.2%, 43.4% vs 32.5%, 47.2% vs 17.2%, 21.4% vs 16.4% and 41.5% vs 29.0% respectively). Prevalence of psychological distress was not significantly higher for caregivers (12.3%) than for other hospital workers (12.4%) but was significantly higher than for other workers (7.3%). For caregivers, factors significantly associated with psychological distress were time pressure (Odds Ratio adjusted on sociodemographic factors (OR) = 2.33 CI95% [1.35–4.04]), “difficulties to reconcile private life and work life” (OR = 2.95 [1.54–5.69]), “work not recognized in the professional setting” (OR = 1.89 [1.08–3.31]) and “fear of losing one's job” (OR = 2.98 [1.53–5.8]). For other hospital workers, they were “difficulties to reconcile private life and work life (OR = 2.76 [1.04–7.30]), “insufficient possibilities of mutual aid” (OR = 2.85 [1.24–6.53] and “not having the means to ensure high-quality work” (OR = 3.42 [1.62–7.21]). ConclusionFactors significantly associated with psychological distress were not the same for caregivers and other hospital workers, nor were they the most frequently reported. Detailed description of the constraints according to group of workers could help to develop a high-priority preventive program regarding psychosocial risk factors.

Online occupational health consultations in the COVID-19 pandemic: experience, user satisfaction, and difficulties from a nationwide cross-sectional online survey of workers in Japan

Online occupational health consultations in the COVID-19 pandemic: experience, user satisfaction, and difficulties from a nationwide cross-sectional online survey of workers in Japan

Mobbing, uma realidade presente em meio hospitalar

Introduction Mobbing can significantly affected not only the mental and physical health of the working population, but also organizational health. Clinical Case Report This is a case report of a healthcare worker, 62 years old, working in a Hospital Centre. She attended to an Occupational Health consultation due to an anxious and/or panic crisis. In the assessment by Psychiatry, it was found that she was experiencing multiple labour conflicts. Professional burn-out symptoms were found, associated with anxiety and easy crying spells on a daily basis, particularly on days of work, as well as marked feelings of sadness related to it. She was medicated and was followed up at Liaison Psychiatry, and her clinical status was made known to Occupational Health through a medical report. Discussion/Conclusion: In the last decade, Mobbing has become a frequent form of problem reported in modern societies, showing serious effects both on workers' health and on the rate of absenteeism and staff turnover in companies. The report of this case is a warning to the existence of cases of Mobbing in a professional activity in which, due to the high level of health literacy, could not be expected. In addition, it reinforces the importance, which is sometimes mandatory for Occupational Health, of contacting the heads of workers to solve some conflicts that may eventually exist. Keywords: Mobbing; Harassment at work; Occupational Health.

Occupational health management of work-related stress: guidelines versus practice.

BackgroundWork-related stress, anxiety and depression (WRSAD) are common, overlapping mental health problems burdened with major medical, occupational, institutional and societal implications. Current occupational health (OH) management of WRSAD is based on clinical and managerial guidelines and individual risk assessment.AimsThe study sought to identify patterns of OH advice in WRSAD and the relationships between the OH advice, available evidence, experience and expertise of the OH doctors (OHDs).MethodsA retrospective cross-sectional analysis of 101 first-time OH consultations for WRSAD by nine OHDs.ResultsThe three most common OH interventions included follow-up OH consultations, adjusted duties and referrals for counselling. All OHDs preferred a light-touch approach but the less experienced and qualified OHDs were more proactive and prescriptive.ConclusionsIn the absence of a specific occupational medical guideline for the management of WRSAD, the OH interventions may be guided by clinical guidelines, individual risk assessment, the client’s circumstances or the experience, expertise and preferences of the OHDs. In the study group, OH interventions were under-utilized and not consistently applied. Our findings support the argument for OH guideline for WRSAD to improve the consistency and effectiveness of OH interventions. This is important given the scale of the problem and the recent increase in WRSAD during the COVID-19 pandemic.

Mental Health Support to Health Care Workers During COVID-19 Pandemic: Is the Front Line Necessarily the Priority Line?

Mental Health Support to Health Care Workers During COVID-19 Pandemic: Is the Front Line Necessarily the Priority Line?

The accessibility of state occupational safety and health consultation websites

This study examines the accessibility of state occupational safety and health agency (SOSHA) websites for users with disabilities. To examine accessibility, we used a combination of AChecker-based automated analysis and manual code inspection to evaluate SOSHA consultation website accessibility. Manual code inspection looked at image ALT attribute, form label, and linked text quality, as well as the presence of skip-to-content links. Only two sites passed federal accessibility requirements based on WCAG 2.0 Level A and AA guidelines. Accessibility problems may impede a user’s quest for safety information, both for employers and employees. The results of this study also emphasize the need for researchers using automated analysis tools to supplement their research with manual site inspection.

Understanding Physician’s Experience With Conversational Interfaces During Occupational Health Consultation

This paper presents an exploratory study on using conversational interfaces (CIs) to support physicians in conducting occupational health consultations. The CI was achieved through a web-based information dashboard with a chatbot assistant for providing real-time suggestions through text messages. Two system designs were developed: the first using a proactive chatbot, the second using an on-demand type of interaction. The effectiveness of the proposed CI and the two types of chatbot designs were investigated in a field study consisted of eight healthcare consultations. Quantitative results showed that the CI was positively evaluated as a reliable tool to be used during medical consultations and that occupational health physicians were eager to use this technology in their work. The qualitative data analysis suggested that our design concept might improve the workflow during the consultation, particularly with respect to the access to relevant information and structured decision-making processes using valuable references. The on-demand, lightweight type of chatbot interaction was better perceived than the proactive one. Based on these findings, we discuss implications for the future development of occupational health consultation based on CI and their potential contribution to computer-assisted, data-driven healthcare.

Work disability negotiations: supervisors’ view of work disability and collaboration with occupational health services

Purpose: To introduce the Finnish practice of collaboration aiming to enhance work participation, to ask supervisors about its reasons and usefulness, to study supervisors’ needs when they face work disability, and to compare the experiences of supervisors whose profiles differ.Materials and methods: An online questionnaire based on the Finnish practice of collaboration between supervisor and occupational health services (OHS) went to supervisors in six public and private organizations. A total of 254 supervisors responded, of whom, 133 (52%) had collaborated in work disability negotiations, representing a wide variety with differing professional profiles.Results: In their role of managing work disability, supervisors appeared to benefit from three factors: an explicit company disability management (DM) policy, supervisors’ training in DM, and collaboration with OHS. Reasons for work disability negotiations were long or repeated sick-leaves and reduced work performance. Expectations for occupational health consultations focused on finding vocational solutions and on obtaining information. Supervisors assessed the outcomes of collaboration as both vocational and medical. Supervisors with differing professional profiles prioritized slightly different aspects in collaboration.Conclusions: Collaboration with OHS is an important option for supervisors to enhance work modifications and the work participation of employees with work disability.Implications for RehabilitationWork disability negotiation between supervisor, employee, and occupational health services (OHS) is an effective method to enhance work participation.Collaboration with occupational health can advance work modifications and also lead to medical procedures to improve work performance.Supervisor training, companies’ explicit disability management policy, and collaboration with OHSs all advance employee’s work participation.Collaboration with OHSs may serve as training for supervisors in their responsibility to support work participation.

A consensus for occupational health management of healthcare workers infected with human immunodeficiency virus, hepatitis B virus, and / or hepatitis C virus.

Occupational health management plays an important role in the prevention of provider-to-patient transmission in healthcare workers infected with human immunodeficiency virus (HIV), hepatitis B virus (HBV), and/or hepatitis C virus (HCV). Therefore, the Japan Society for Occupational Health's Research Group on Occupational Health for Health Care Workers has proposed a consensus for the management of healthcare workers infected with HIV, HBV, and/or HCV based on recent evidence for each concerned group. The consensus recommends that: (1) employers in medical institutions should establish a policy of respecting the human rights of healthcare workers, management strategies for occupational blood exposure, and occupational health consultation; (2) occupational health staff should appropriately assess the risk of provider-to-patient transmission of HIV, HBV, and/or HCV infection and rearrange their tasks if necessary. When conducting risk assessment, occupational health staff should obtain informed consent and then cooperate with the physician in charge as well as infection control experts in the workplace; (3) healthcare workers infected with HIV, HBV, and/or HCV should disclose their employment to their treating physician and consult with their doctor regarding the need for special considerations at work; and (4) supervisors and colleagues in medical institutions should correctly understand the risks of HIV, HBV, and HCV infection and should not engage in any behavior that leads to discrimination against colleagues infected with HIV, HBV, and/or HCV.

Patient and physician views of accompanied consultations in occupational health.

Accompanied (triadic) consultations, or consultations where a third person is present, are poorly researched and little research has been carried out in an occupational health (OH) setting. To elicit the views of patients and OH physicians about accompanied consultations. OH receptionists gave a self-administered questionnaire to patients after they attended OH consultations with a companion. We interviewed participating OH physicians to ascertain their views on accompanied consultations. Twenty-six patient questionnaires were completed (response rate 52%). Seventy-three per cent (19) of responders were accompanied by a spouse and 12% (3) by non-family members. Patients reported their companion was helpful with recall of information (100%), supportive (100%), provided extra information to the physician (81%) and enabled them to discuss the outcome afterwards (92%). In two consultations, the companion attended to provide support on procedural matters. Patients were not concerned that the consultation might involve sensitive discussion or physical examination. OH physicians reported concerns that the companion would make the consultation more difficult or influence its outcome. They felt that written information, guidelines and training in how to manage accompanied consultations would be useful. Patients who attended OH consultations with a companion felt the companion was beneficial to the consultation and did not have concerns about personal issues. OH physicians felt that further guidance and training on accompanied consultations would be useful. Written information could usefully be provided to patients attending an OH consultation with a companion.

Worker expectations of occupational health consultations

Worker beliefs and expectations influence their health and rehabilitation. However, little is known about worker expectations of occupational health (OH) consultations and if these are associated with their perceptions of health and work. To examine worker expectations of OH consultations, and whether the variability of worker expectations is associated with their perception of health and work and personal characteristics. A questionnaire on OH physicians' professional standards was developed from national guidance and validated by a survey of OH physicians. We explored 81 workers' expectations of professional standards along with their perception of health and work. Worker expectations were compared with the OH physician validation score. Associations of worker characteristics, their health and work perceptions and their expectations of professional standards were analysed by linear regression. Worker expectations of professional standards were lower when compared with the OH physician validation score (E = 3.9 versus 4.3, ΔE = 0.48, 95% confidence interval [CI] 0.30-0.66). Perceived manager support and work apprehension were associated with worker expectations (ΔE = 0.58, 95% CI: 0.29-0.86 for least versus most support; ΔE = 0.89, 95% CI: 0.41-1.36 for least versus highest apprehension). Job title, previous OH consultations and recovery expectations were not associated with worker expectations. Worker expectations of OH physicians' professional standards were lower than the standards set by national guidance as validated by the sampled OH physicians. Workers who felt more supported by their manager, and workers who were more apprehensive about the health impact of work had higher expectations of OH physicians' standards.

Development and Implementation of Clinical Algorithms in Occupational Health Practice

Occupational health (OH) practice is framed by legal, ethical, and regulatory requirements. Integrating this information into daily practice can be a difficult task. We devised evidence-based framework standards of good practice that would aid clinical management, and assessed their impact. The clinical algorithm was the method deemed most appropriate to our needs. Using "the first OH consultation" as an example, the development, implementation, and evaluation of an algorithm is described. The first OH consultation algorithm was developed. Evaluation demonstrated an overall improvement in recording of information, specifically consent, recreational drug history, function, and review arrangements. Clinical algorithms can be a method for assimilating and succinctly presenting the various facets of OH practice, for use by all OH clinicians as a practical guide and as a way of improving quality in clinical record-keeping.

Optimal communication from occupational physicians to GPs: a cross-sectional survey

Correspondence from occupational physicians to GPs is infrequent, despite evidence that good communication leads to earlier return to work of sick-listed patients and is cost effective. To explore the circumstances, content, and preferred method of communication GPs would value from an occupational physician, following an occupational health consultation with one of their patients. A cross-sectional survey in the UK. A questionnaire was developed de novo, piloted, and sent to 600 GPs of consecutive employees undergoing occupational physician assessments. Descriptive data were generated using Excel. The response rate was 374/600 (62%). Demographic features of GP responders reflected national figures. A total of 372 (99.5%) GPs wanted information from occupational physicians. Most wanted information on diagnosis (303, 81%), clinical assessment (275, 74%), functional assessment (295, 79%), or advice on the timing (308, 82%) and adjustments 290 (78%) of any return-to-work plan. Over 80% wanted information following every occupational physician consultation, and over 90% wanted information on the timing of a return to work, adjustments suggested, or if different medical diagnosis or management was suggested. The preferred method of communication was letter by post 341/374 (92%). Brief, relevant information was valued and considered useful for completing 'fit notes'. Occupational physicians should send formal letters, by post, to the patient's GP following occupational health assessments. This would assist the GP in completing the patient's 'fit note' and ultimately increase the chances of their patient being rehabilitated back to work.

A randomised controlled study to evaluate the effectiveness of targeted occupational health and safety consultation or inspection in Ontario manufacturing workplaces

ObjectiveFrom 2004 to 2008, the prevention system in Ontario, Canada ran the High Risk Firm Initiative, an injury-experience based targeted consultation or inspection programme. Our objective was to establish whether...

Workers' expectations of occupational health services

ObjectivesPatients' trust in their doctors influences health outcomes. However, it is not known how health and work perceptions affect expectations of or trust in occupational physicians (OHPs). This study examines...