Occupational Health Screening Research Articles

Exploring stroke survivors’ and physiotherapists’ perspectives of the potential for markerless motion capture technology in community rehabilitation

IntroductionMany stroke survivors do not receive optimal levels of personalised therapy to support their recovery. Use of technology for stroke rehabilitation has increased in recent years to help minimise gaps in service provision. Markerless motion capture technology is currently being used for musculoskeletal and occupational health screening and could offer a means to provide personalised guidance to stroke survivors struggling to access rehabilitation.AimsThis study considered context, stakeholders, and key uncertainties surrounding the use of markerless motion capture technology in community stroke rehabilitation from the perspectives of stroke survivors and physiotherapists with a view to adapting an existing intervention in a new context.MethodsThree focus groups were conducted with eight stroke survivors and five therapists. Data were analysed using reflexive thematic analysis.ResultsFive themes were identified: limited access to community care; personal motivation; pandemic changed rehabilitation practice; perceptions of technology; and role of markerless technology for providing feedback.ConclusionsParticipants identified problems associated with the access of community stroke rehabilitation, exacerbated by Covid-19 restrictions. Participants were positive about the potential for the use of markerless motion capture technology to support personalised, effective stroke rehabilitation in the future, providing it is developed to meet stroke survivor specific needs.

Real-time estimation of immunological responses against emerging SARS-CoV-2 variants in the UK: a mathematical modelling study.

The emergence of SARS-CoV-2 variants and COVID-19 vaccination have resulted in complex exposure histories. Rapid assessment of the effects of these exposures on neutralising antibodies against SARS-CoV-2 infection is crucial for informing vaccine strategy and epidemic management. We aimed to investigate heterogeneity in individual-level and population-level antibody kinetics to emerging variants by previous SARS-CoV-2 exposure history, to examine implications for real-time estimation, and to examine the effects of vaccine-campaign timing. Our Bayesian hierarchical model of antibody kinetics estimated neutralising-antibody trajectories against a panel of SARS-CoV-2 variants quantified with a live virus microneutralisation assay and informed by individual-level COVID-19 vaccination and SARS-CoV-2 infection histories. Antibody titre trajectories were modelled with a piecewise linear function that depended on the key biological quantities of an initial titre value, time the peak titre is reached, set-point time, and corresponding rates of increase and decrease for gradients between two timing parameters. All process parameters were estimated at both the individual level and the population level. We analysed data from participants in the University College London Hospitals-Francis Crick Institute Legacy study cohort (NCT04750356) who underwent surveillance for SARS-CoV-2 either through asymptomatic mandatory occupational health screening once per week between April 1, 2020, and May 31, 2022, or symptom-based testing between April 1, 2020, and Feb 1, 2023. People included in the Legacy study were either Crick employees or health-care workers at three London hospitals, older than 18 years, and gave written informed consent. Legacy excluded people who were unable or unwilling to give informed consent and those not employed by a qualifying institution. We segmented data to include vaccination events occurring up to 150 days before the emergence of three variants of concern: delta, BA.2, and XBB 1.5. We split the data for each wave into two categories: real-time and retrospective. The real-time dataset contained neutralising-antibody titres collected up to the date of emergence in each wave; the retrospective dataset contained all samples until the next SARS-CoV-2 exposure of each individual, whether vaccination or infection. We included data from 335 participants in the delta wave analysis, 223 (67%) of whom were female and 112 (33%) of whom were male (median age 40 years, IQR 22-58); data from 385 participants in the BA.2 wave analysis, 271 (70%) of whom were female and 114 (30%) of whom were male (41 years, 22-60); and data from 248 participants in the XBB 1.5 wave analysis, 191 (77%) of whom were female, 56 (23%) of whom were male, and one (<1%) of whom preferred not to say (40 years, 21-59). Overall, we included 968 exposures (vaccinations) across 1895 serum samples in the model. For the delta wave, we estimated peak titre values as 490·0 IC50 (95% credible interval 224·3-1515·9) for people with no previous infection and as 702·4 IC50 (300·8-2322·7) for people with a previous infection before omicron; the delta wave did not include people with a previous omicron infection. For the BA.2 wave, we estimated peak titre values as 858·1 IC50 (689·8-1363·2) for people with no previous infection, 1020·7 IC50 (725·9-1722·6) for people with a previous infection before omicron, and 1422·0 IC50 (679·2-3027·3) for people with a previous omicron infection. For the XBB 1.5 wave, we estimated peak titre values as 703·2 IC50 (415·0-3197·8) for people with no previous infection, 1215·9 IC50 (511·6-7338·7) for people with a previous infection before omicron, and 1556·3 IC50 (757·2-7907·9) for people with a previous omicron infection. Our study shows the feasibility of real-time estimation of antibody kinetics before SARS-CoV-2 variant emergence. This estimation is valuable for understanding how specific combinations of SARS-CoV-2 exposures influence antibody kinetics and for examining how COVID-19 vaccination-campaign timing could affect population-level immunity to emerging variants. Wellcome Trust, National Institute for Health Research University College London Hospitals Biomedical Research Centre, UK Research and Innovation, UK Medical Research Council, Francis Crick Institute, and Genotype-to-Phenotype National Virology Consortium.

Biomarkers for Prediction of Alcohol-Related Liver Cirrhosis: A General Population–Based Swedish Study of 537,250 Individuals

The study sought to examine which biomarkers have the best predictive capabilities for future alcohol-related liver cirrhosis (ARLC) in a general population setting. This population-based cohort study includes approximately 35% of the inhabitants of Stockholm County who had left a blood sample at an outpatient visit in primary care or occupational health screening from 1985 to 1996. All subjects with a blood sample measurement of alanine aminotransferase and aspartate aminotransferase (AST) were included, exclusions were made for persons with known liver disease. We ascertained incident ARLC by linkage to Swedish national health registers between to the end of 2011. Associations between biomarkers and incident ARLC were analyzed with Cox regression models and discrimination was assessed using C-statistics. In all, 537,230 adult subjects were included. The mean age was 45 years and 53% were men. During a mean follow-up of 19.0 years, 2725 (0.51%) subjects developed ARLC. The biomarkers with the highest discrimination (C-index) for incident ARLC at 5 years were: AST (0.89), mean corpuscular volume (0.88), and γ-glutamyltransferase (0.81). Scoring systems including Fibrosis-4 (0.86) and the AST/alanine aminotransferase ratio (0.81) performed similarly well. The negative predictive value for ARLC was generally high (∼99.6%) across biomarkers, using routine clinical cutoffs to identify pathological values. However, positive predictive values were generally low (0.6%-15.9%). Biomarkers commonly used in primary care settings are highly associated with incident ARLC in the general population. Elevation of these commonly available biomarkers should prompt consideration of further investigation of a possible high level of alcohol consumption.

Prevalence Estimate for Adjustment Disorders in the South African Navy.

Adjustment Disorder is among the most commonly diagnosed mental disorders in the armed forces, with a mean prevalence estimated at 7.4% across military populations. The prevalence in South African military populations is not known. This study aimed to estimate the prevalence of Adjustment Disorders in the South African Navy and to explore potential risk factors. In this cross-sectional study, a representative sample of 714 sailors completed the International Adjustment Disorder Questionnaire, and also provided information from their biennial occupational health assessment mental health screening, which included other clinical screeners of mental health and adjustment history. The estimated prevalence of Adjustment Disorders in the South African Navy was 6.9%, and was proportionally distributed across gender and age categories. Depression and PTSD were the main comorbid conditions. Risk factors included a) history of adjustment difficulties during military deployment or family adjustment difficulties, b) domestic discord (difficulties in relationship with spouse/partner or immediate family), and c) the experience of stress overload (i.e., that the demands of life are overwhelming available resources). The estimated prevalence was similar to the expectation of military personnel generally, although the self-report data needs to be interpreted cautiously. The contributing risk factors offer possible direction for targeted intervention, e.g., skills training and relationship counselling to enhance coping with military service and family challenges, and cognitive behaviour therapy generally to address sailors' experience of stress overload.

Metabolic Profile and Long-Term Risk of Depression, Anxiety, and Stress-Related Disorders

Biomarkers of lipid, apolipoprotein, and carbohydrate metabolism have been previously suggested to be associated with the risk for depression, anxiety, and stress-related disorders, but results are inconsistent. To examine whether the biomarkers of carbohydrate, lipid, and apolipoprotein metabolism are associated with the risk of depression, anxiety, and stress-related disorders. This population-based cohort study with longitudinal data collection assessed 211 200 participants from the Apolipoprotein-Related Mortality Risk (AMORIS) cohort who underwent occupational health screening between January 1, 1985, and December 31, 1996, mainly in the Stockholm region in Sweden. Statistical analysis was performed during 2022 to 2023. Lipid, apolipoprotein, and carbohydrate biomarkers measured in blood. The associations between biomarker levels and the risk of developing depression, anxiety, and stress-related disorders through the end of 2020 were examined using Cox proportional hazards regression models. In addition, nested case-control analyses were conducted within the cohort, including all incident cases of depression, anxiety, and stress-related disorders, and up to 10 control individuals per case who were individually matched to the case by year of birth, sex, and year of enrollment to the AMORIS cohort, using incidence density sampling. Population trajectories were used to illustrate the temporal trends in biomarker levels for cases and controls. A total of 211 200 individuals (mean [SD] age at first biomarker measurement, 42.1 [12.6] years; 122 535 [58.0%] male; 188 895 [89.4%] born in Sweden) participated in the study. During a mean (SD) follow-up of 21.0 (6.7) years, a total of 16 256 individuals were diagnosed with depression, anxiety, or stress-related disorders. High levels of glucose (hazard ratio [HR], 1.30; 95% CI, 1.20-1.41) and triglycerides (HR, 1.15; 95% CI, 1.10-1.20) were associated with an increased subsequent risk of all tested psychiatric disorders, whereas high levels of high-density lipoprotein (HR, 0.88; 95% CI, 0.80-0.97) were associated with a reduced risk. These results were similar for male and female participants as well as for all tested disorders. The nested case-control analyses demonstrated that patients with depression, anxiety, or stress-related disorders had higher levels of glucose, triglycerides, and total cholesterol during the 20 years preceding diagnosis, as well as higher levels of apolipoprotein A-I and apolipoprotein B during the 10 years preceding diagnosis, compared with control participants. In this cohort study of more than 200 000 participants, high levels of glucose and triglycerides and low levels of high-density lipoprotein were associated with future risk of depression, anxiety, and stress-related disorders. These findings may support closer follow-up of individuals with metabolic dysregulations for the prevention and diagnosis of psychiatric disorders.

Lärm in Kindertagesstätten als Risikofaktor für die Gesundheit von Erzieherinnen

Noise in day-care centres as a risk factor for the health of educators Objective: Noise can cause health problems. Day-care educators tend to perceive noise as “normal” and part of the job. The aim of the study was to find out the extent to which noise in day-care centres or insufficient noise protection measures influence the health of the educators. Methods: A total of 185 educators in day-care centres in Magdeburg and the surrounding area voluntarily participated in the study. The noise level in the group room was measured with the PCE-322A sound level meter (PCE Instruments, Meschede, Germany) and the hearing ability of the educators was measured with the SD 25 mobile audiometer from Siemens (Germany). Questionnaires were used for subjective assessment of exposure to noise. Results: The noise level (LAeq) in the group rooms varied between 65 and 91 dB(A) with respective maximum levels (LAmax) of 74–106.5 dB(A). 165 educators (94.3 %) had no hearing impairment, 8 (4.6 %) had mild and 2 (1.1 %) had moderate hearing loss on both sides. Exposure to noise in the group room correlates slightly with hearing impairment and with burnout symptoms (p &lt; 0.001). Conclusion: Noise protection measures must be taken. The hearing of daycare workers should also be tested regularly as part of occupational health screening. Keywords: early childhood education – noise levels – hearing impairment – mental health – burnout

Hospital Nurses’ Risk of Injury: A Mixed Methods Study in Indonesia

Various risks of injury become the background of incidents and health and safety problems for nurses globally, impacting a nurse’s right to a safe work environment. No studies have examined the relationship between individual conditions and various aspects of the nurse’s risk of injury. This study explored nurses’ risk of injury in hospitals and the relationship between the individual characteristics of nurses with the surveillance, screening and injury prevention activities undertaken in hospitals.This mixed methods study using an exploratory sequential design was conducted in Indonesia involving 176 registered nurses from 17 urban hospitals for the quantitative phase and 21 registered nurses from five hospitals for the qualitative phase. The quantitative data shows that more than half stated they were not good at occupational health and safety surveillance or screening or efforts to reduce occupational health and safety risks. The surveillance, screening, and injury prevention activities of the nurses in the hospitals were not found to be influenced by their age, working experience, marital status, gender, education level, and employment status. The qualitative data analysis revealed four main themes: (1) Causes of the nurses’ risk of injury, (2) Preventing injuries, (3) Resilience, and (4) Acting to prevent risk of injury. The effective methods to prevent the risk of injury included optimizing nurses’ roles, improving the work environment, and making organizational programs on health and safety. Nurses are exposed to multiple risks of injury, and their monitoring, screening, and injury prevention activities are influenced by factors other than the individual.

Erhalt der Beschäftigungsfähigkeit von Mitarbeiterinnen und Mitarbeitern

Maintaining the employability of employees: gradual reintegration in a large German chemical company Objectives: Gradual reintegration is a measure in the return-to-work process and is part of the occupational health management at BASF SE, which is the responsibility of Corporate Health Management. This article aims to describe the gradual reintegration of employees of BASF SE in Ludwigshafen in the years 2016 to 2021. Methods: Data on the start and end of the gradual reintegration, the results of reintegration and the duration of previous incapacity for work, including relevant diagnoses, was entered into the electronic patient file (AMEDIS) by the responsible occupational physicians and supplemented by information on age, gender, working time system and occupational group as well as occupational health screening data on smoking status, weight and height. Results: From 2016 to 2021, 3260 gradual reintegrations were carried out on 2826 people at BASF SE’s main site in Ludwigshafen. The participants were on average 49 years old and 18 % were female. More than 90 % of the reintegrations were successfully completed (with or without health restrictions). Ill-health retirement was required for less than 1 % (n = 11). Participants were unable to work for 137 days (median; IQR: 92–218) prior to the start of reintegration. The most common diagnosis groups were mental and behavioural disorders and diseases of the musculoskeletal system, followed by cardiovascular diseases, injuries and cases of poisoning. A successful gradual reintegration took a median of 27 days (IQR: 23–40) to complete. Conclusions: Gradual reintegration is well established as a successful tool for maintaining employability after prolonged incapacity for work. Occupational physicians bring their knowledge of the jobs and the organisational structure within the company and are thus able to shape the gradual reintegration individually and according to requirements. Keywords: gradual reintegration – corporate integration management – incapacity for work – preservation of employability

Occupational health screening during Gurkha Central Selection: a retrospective cohort study

ObjectiveThe selection process to the British Army’s Brigade of Gurkhas is rigorous, demanding and competitive. The ethos of recruitment to the Gurkhas is grounded in an overarching tenant: that selection...

A Concise Occupational Mental Health Screening Tool for South African Workplaces.

Mental health in the workplace is becoming of ever greater importance. General occupational health surveillance programmes are already in widespread use, with established referral systems for treatment and rehabilitation, and the same mechanisms could be expanded to include mental health screening and intervention. This study aimed to develop a concise composite mental health screening tool, based on analysis of existing data, for application in routine occupational health surveillance in South Africa. Data from workplace occupational health surveillance programs from 2,303 participants were analysed. Participants completed a number of questions/scaled items collated into a survey format, and partook in an interview with a psychologist. The data was analysed using frequency of positive self-reports, Chi square to calculate associations with outcomes, Receiver Operator Characteristic curve analysis to explore predictive ability, and binomial logistic regression to calculate the relative contribution of markers to outcomes. An exploratory factor analysis was further conducted on identified items. A general workplace model with 14 markers (and a maritime workplace model with 17 markers) were identified. The factor analysis suggested their organisation into five domains (similar for both models), namely neurocognitive health, common mental disorders, history of adaptation in occupational specific contexts, family-work interface, and stress overload. The study’s data-driven approach proposed a concise composite screener with less than 50 items, comprising five domains. This tool appears useful in identifying employees at risk for workplace injuries or poor mental health outcomes, and could be applied to related workplace settings in South Africa.

COVID-19 boosters and building trust among UK minority ethnic communities

COVID-19 boosters and building trust among UK minority ethnic communities

Psychosocial Work Stress and Health Risks - A Cross-Sectional Study of Shift Workers From the Hotel and Catering Industry and the Food Industry.

PurposePsychosocial work stress, and shift and night work are considered risk indicators for impaired health. Using the effort-reward (ER) model, it was possible to examine which relationships exist for shift workers between clusters (CL) of different levels of psychosocial work stress and overcommitment (OC) and cardiovascular or psychological health indicators, and which predictive value is evident in individual health indicators to explain the clusters.MethodsThe data were collected as part of an occupational health prevention program. The analysis sample consisted of 199 shift workers from alternating shift systems with and without night work (43%) (average age: 40 ± 12 years, men: 47%). Psychosocial work stress was recorded using the ER imbalance (ERI) questionnaire. To determine the clusters, ERI and OC were entered into a cluster analysis. Blood pressure, body mass index, waist-hip ratio, PROCAM score (risk of a heart attack within the next 10 years), sporting activity, and smoking were included as cardiovascular indicators, psychological wellbeing (GHQ-12) and inability to recovery (IR) (FABA) as psychological health indicators. Shift system, sex, and age were entered into the statistical analyses as control variables. Multinomial logistic regression models were used to identify health-related predictors to explain the ER-OC clusters.ResultsThree different ER-OC clusters emerged: low-stress: 36%, normal: 44%, risk: 20%. While normal psychosocial work stress is present in the low-stress and the normal CL, in the risk CL 28% of the shift workers show a health-endangering ERI and 48% show an excessive OC. No significant cluster-specific differences were determined for the cardiovascular health indicators. Rather, the known sex and age effects were confirmed and the shift system had no significant effect. Significantly more shift workers in the risk CL had impaired psychological health (18 vs. 1/6%) and an IR (52 vs. 0/12%) than in the low-stress and normal CL. IR turned out to be the strongest predictor of the explanation for the ER-OC clusters (49%).ConclusionIR could be assigned an independent diagnostic value for the assessment of psychosocial work stresses and discussed as a new component of occupational health screening concepts for shift workers. Independently of this, the health indicators signal an urgent need for occupational health prevention and care.

Screening of Hepatitis A and B Seropositivity among Turkish Healthcare Providers Admitted to Occupational Health Services

This study aimed to determine the protection rates against hepatitis A virus (HAV) and hepatitis B virus (HBV), among healthcare providers (HCPs). The occupational health service data of Gaziosmanpaşa Training and Research Hospital between January 2020 and December 2020 were evaluated for this retrospective observational study. Of the 1,722 participants aged 34.40 ± 9.16 years, 48.6% (n = 861) were male, and 55.0% (n = 975) were doctors and nurses. The anti-HBs seropositivity rate was 87.5% (n = 1,501). None of the participants had anti-HCV antibodies. Twelve participants were HBsAg positive. A level of anti-HBs titer ≥10 mIU/mL was maintained in 66.7% of the HCPs vaccinated in childhood, while 71.3% (n = 1,263) of the participants had anti-HAV IgG. HAV vaccination needs were higher in the doctor and nurse groups than in the other groups (60.5% and 39.5%, respectively, p = 0.003). HBV protection was higher among HCPs in polyclinics/wards and surgery/intensive care units than in those working in the emergency department (odds ratio (OR): 2.099, 95% confidence interval (CI) = 1.285–3.429; OR: 1.592, 95% CI = 1.037–2.443, respectively). HAV protection was higher in HCPs aged 31–50 years and over 50 years than in those aged 18–30 years (OR: 2.046, 95% CI = 1.647–2.541; OR: 3.615, 95% CI = 2.164–6.037, respectively). In this study, one out of every two HCPs aged 18–30 years admitted to the occupational health control services had not yet received the HAV vaccine. The low levels of HBV protection among HCPs in the emergency department highlight the need for occupational health screening and HBV vaccination for HCPs working in emergency services in hospitals.

Short-term effectiveness of face-to-face periodic occupational health screening versus electronic screening with targeted follow-up: results from a quasi-randomized controlled trial in four Belgian hospitals.

ObjectivesIn many countries, organisations are legally obliged to have occupational physicians screen employees regularly. However, this system is time-intensive, and there may be more cost-effective alternatives. Our objective is to compare the short-term effectiveness of periodic occupational health screening of hospital employees by an occupational physician with a system of electronic screening with targeted follow-up.MethodsA randomized controlled trial was set up among personnel of four Belgian hospitals, with three measurement moments between June 2019 and December 2020, to compare differences in self-assessed health, healthcare use, productivity and intermediate outcomes over 19 months. Mixed effects models were used to assess differences in effectiveness. Superiority and non-inferiority post-hoc tests were used as a robustness check. The experiment coincided with the first two COVID-19 waves during which hospital employees were exposed to an exceptional period of occupational stress.ResultsIn total, 1077 employees (34% of the target population) participated. Although we observed some immediate effects of the intervention (less trust in the physician, absenteeism, and healthcare use), all these effects disappeared over time. After 19 months, including two waves of COVID-19 hospitalizations, no significant differences were observed between employees screened through face-to-face contact and those screened electronically.ConclusionsOur study finds no indication that, in the short-term, substituting physician screening of the workforce with a quicker survey-based screening with targeted follow-up has different effects on the studied endpoints. However, as health and disease are often the result of a long-term process, more evidence is needed to determine long-term effects.

Prevalence of intestinal parasites, Salmonella and Shigella species among food handlers working in a tertiary care hospital of South India

Background: Infected food handlers act as potential sources of food borne illnesses. Consequences of such outbreaks in healthcare settings are more severe affecting their vulnerable sick patients. We aimed to determine the prevalence of intestinal parasites, Salmonella and Shigella species, and associated risk factors in our hospital food handlers in this cross-sectional study. Materials and Methods: Data on sociodemographic details, past medical illness, hygiene awareness practices, occupational prophylaxis undertaken were collected from 110 food handlers in hospital kitchen area. Their stool samples were collected for microbiological analyses of common intestinal parasites using saline and Lugol’s iodine wet mount preparations. Stool samples were inoculated onto Selenite F broth and subcultured onto Nutrient agar, MacConkey’s agar, Salmonella Shigella agar for isolation of Salmonella, Shigella species. Chi-square test and Odds ratio were used to determine risk factors in infected food handlers. Results: Only 4 (3.6%) food handlers were positive for intestinal parasites of Entamoeba histolytica (1.8%), Ascaris lumbricoides (0.9%) and Giardia lamblia (0.9%). None had Salmonella or Shigella species isolated from stool culture. All infected food handlers were aged over 50 years. Noncompliance to hand hygiene standards and illiteracy rates raised above 50 years. Conclusion: The negligible prevalence of intestinal parasites, Salmonella and Shigella species in food handlers testify our efficient hospital infection control program. Age over 50 years, uneducated and incompetent in hand hygiene practices were predominant risk factors for IPI. Scrupulous occupational health screening and trainings targeting high risk food handlers above 50 years of age, could prevent enteric pathogen spread in healthcare settings.

Comprehensive occupational health services for healthcare workers in Zimbabwe during the SARS-CoV-2 pandemic.

Healthcare workers are disproportionately affected by COVID-19. In low- and middle- income countries, they may be particularly impacted by underfunded health systems, lack of personal protective equipment, challenging working conditions and barriers in accessing personal healthcare. In this cross-sectional study, occupational health screening was implemented at the largest public sector medical centre in Harare, Zimbabwe, during the "first wave" of the country's COVID-19 epidemic. Clients were voluntarily screened for symptoms of COVID-19, and if present, offered a SARS-CoV-2 nucleic acid detection assay. In addition, measurement of height, weight, blood pressure and HbA1c, HIV and TB testing, and mental health screening using the Shona Symptom Questionnaire (SSQ-14) were offered. An interviewer-administered questionnaire ascertained client knowledge and experiences related to COVID-19. Between 27th July and 30th October 2020, 951 healthcare workers accessed the service; 210 (22%) were tested for SARS-CoV-2, of whom 12 (5.7%) tested positive. Clients reported high levels of concern about COVID-19 which declined with time, and faced barriers including lack of resources for infection prevention and control. There was a high prevalence of largely undiagnosed non-communicable disease: 61% were overweight or obese, 34% had a blood pressure of 140/90mmHg or above, 10% had an HbA1c diagnostic of diabetes, and 7% had an SSQ-14 score consistent with a common mental disorder. Overall 8% were HIV-positive, with 97% previously diagnosed and on treatment. Cases of SARS-CoV-2 in healthcare workers mirrored the national epidemic curve. Implementation of comprehensive occupational health services during a pandemic was feasible, and uptake was high. Other comorbidities were highly prevalent, which may be risk factors for severe COVID-19 but are also important independent causes of morbidity and mortality. Healthcare workers are critical to combatting COVID-19; it is essential to support their physical and psychological wellbeing during the pandemic and beyond.

Caring for the Animal Caregiver—Occupational Health, Human-Animal Bond and Compassion Fatigue

Laboratory Animal Professionals experience many positive and rewarding interactions when caring for and working with research animals. However, these professionals also may experience conflicting feelings and exhaustion when the work is stressful due to factors such as limited resources, making end of life decisions, dealing with conflicting priorities, and negotiating animal care priorities with colleagues. These stresses may be further complicated by each individual's self-understanding and emotional investment in the human-animal bond. The term used for this type of complex emotional conflict and exhaustion is Compassion Fatigue. Compassion Fatigue in the Laboratory Animal Science setting is a combination of physical, emotional and psychological depletion associated with working with and caring for animals and their well-being in a research environment. The University of Washington has developed a Compassion in Science Program called Dare2Care which emphasizes self-care and helps Laboratory Animal Professionals identify stress factors and work toward a personal solution to relieve stress. The first step in developing a resiliency program is to assess the current culture and needs of the organization. At an institutional level we identified that we needed increased communication concerning study endpoints, as well as identified individuals with whom affected personnel can talk about personal concerns. We also implemented community events to reflect on the positive aspects of this field of work. We improved the physical work environment, and provided outlets established for personnel to express feelings via written word or artistically. Lastly, we started working with our Center for One Health to encompass a holisitic approach to the occupational health of our animal caregivers. One health is the relationship and interplay between people, animals and the environment and we needed to include emotional well-being in our assessment of the health of our personnel. A question was added to our occupational health screening form to include additional health or workplace concerns (e.g., Compassion Fatigue) not covered by the questionnaire, and we added a component of Compassion Fatigue awareness in our training program. Here we review the importance of identifying Compassion Fatigue in the animal research setting, focus on developing a compassion resiliency culture and provide tools and coping strategies to validate and strengthen the human-animal bond with research animals and to sustain the care that is necessary for both people and research animals.

Tuberculosis Screening in Silica-Exposed Workers : Developing a Tool for Health Care Providers.

Both the Occupational Safety and Health Administration and Washington State require safety and health protections for workers exposed to respirable crystalline silica, including tuberculosis (TB) screening as part of occupational medical surveillance. We describe the creation of a TB screening tool for silica-exposed workers receiving regulated medical surveillance examinations in Washington State. The tool provides relevant clinical recommendations to assist health care providers and public health practitioners who choose to use the tool when performing such examinations. A cross-disciplinary team at the Washington State Department of Labor and Industries created the TB screening tool to help health care providers identify silica-exposed workers who should receive a comprehensive evaluation for active TB disease and workers who should or must receive testing for latent TB infection. The Washington State Adult Tuberculosis Screening Tool for Workers Exposed to Respirable Crystalline Silica benefits occupational and respiratory clinicians and public health practitioners by aiding both the individual- and population-level delivery of occupational health and TB screening services to silica-exposed workers receiving required medical surveillance examinations.

Risk of Incident Hypertension According to Physical Activity and Temporal Changes in Weight.

Physical activity (PA) and maintenance of a normal weight contribute to the prevention of hypertension but not always concurrently. Our aim was to investigate whether maintaining PA, regardless of weight change, is associated with a reduced risk of developing hypertension. We conducted a cohort study of 195,045 Koreans (mean age, 37.7 years; standard deviation, 7.1 years) who participated in an occupational health screening program from January 2011 to December 2016. PA levels were measured using the validated Korean version of the International Physical Activity Questionnaire Short Form, and participants were classified into 3 categories as inactive, active, and health-enhancing physically active (HEPA). Weight was tracked, and participants were divided into 2 categories: those whose weight change >0 and those whose weight change ≤0. During 616,326.5 person-years, 12,206 participants developed hypertension (19.8 per 1,000 person-years). A higher PA level and greater reduction in body mass index were associated with lower risk for incident hypertension. Hazard ratio (HR) for incident hypertension was lower (0.83; 95% confidence interval, 0.79-0.88) in subjects with active/HEPA at baseline and decreased weight than in those in the inactive and increased weight groups after adjustment for confounding factors. Even in the increased weight group, HR for incident hypertension was 0.85 (0.81-0.90) in subjects whose PA was consistently maintained at active or HEPA levels during follow-up. In this large cohort of young and middle-aged Koreans, maintaining active or HEPA PA levels was associated with reduced risk of developing hypertension regardless of weight change.

Lack of protection for measles among Italian nurses. A potential for hospital outbreak.

Nurse's job involves staying close to the patient for an extended time period and a high risk of transmission for airborne pathogens, including measles. Previous studies found high rate of operators unprotected for measles. We evaluated the immunization status for measles in nurses of a large hospital in Rome. We retrospectively evaluated the clinical records of nurses working in Tor Vergata hospital who underwent the occupational health screening program. Gender, age, work area and levels measles-specific IgG were evaluated. This study included 358 nurses. 77.7% (217) had a protective measles-specific IgG antibodies level. Protection rate was higher among workers aging 40 years (82.6% vs 68.7%; p < 0.01). The mean value of the anti-measles IgG was 217.2±91.1 AU/ml. Males showed higher values than females (253.3 vs 214.6; p < 0.01). Our study revealed a non-protective anti measles IgG level in a high percentage of nurses, even among those working in high risk areas.