Occupational Threat Research Articles

Synergistically achieving particulate matter reduction and production performance optimization for zinc electrolysis by ultrasonication coupling anode-coated MnO2

Abating particulate matter (PM) from electrolysis processes is significant because this PM poses occupational threats to workers and has a negative impact on air quality. However, it remains a challenge to synergize the reduction of PM production and the improvement of electrolysis performance. This study developed a green method, termed as the coupling of ultrasonication and pre-coating MnO2 anode treatment (UMT). The effects on PM generation rate and electrolysis performance indicators were estimated using the bench-scale zinc electrolysis device, and the synergistic mechanism of UMT was expanded from the perspective of electrochemical reactions and bubble characteristics using analysis of reaction products, camera technique, and PM generation prediction models. The results showed UMT not only overcame the degradation of deposited zinc quality caused by the ultrasonication treatment but also solved the increased PM generation by the pre-coating MnO2 film treatment. The UMT simultaneously reduced PM (33.9 %-57.5 %), decreased zinc impurity content by (11.2 %-54.3 %), improved current efficiency of zinc deposition (0.19 %-1.71 %), and conserved electrolysis energy (0.27 %-1.01 %). The optimal performance of UMT occurred at 80 kHz. The UMT suppressed the gas evolution reactions and prematurely bursting bubbles, in favor of reducing the number and size of bubbles, to reduce PM generation. Meanwhile, the UMT improved the electrolysis performance by inhibiting the corrosion of lead-based anodes, promoting the mass transfer rate of Zn2+, providing more active surfaces, and decreasing the overpotential of reactions. The findings may provide references for the green development of the metal electrolysis industry.

Effects of midwifery and nursing students' readiness about medical Artificial intelligence on Artificial intelligence anxiety

BackgroundArtificial intelligence technologies are one of the most important technologies of today. Developments in artificial intelligence technologies have widespread and increased the use of artificial intelligence in many areas. The field of health is also one of the areas where artificial intelligence technologies are widely used. For this reason, it is considered important that healthcare professionals be prepared for artificial intelligence and do not experience problems while training them. In this study, midwife and nurse candidates, as future healthcare professionals, were discussed. AimThis study aims to examine the effect of the artificial intelligence readiness on the artificial intelligence anxiety and the effect of artificial intelligence characteristic variables (artificial intelligence knowledge, daily life, occupational threat, artificial intelligence trust) on the medical artificial intelligence readiness and artificial intelligence anxiety of students. MethodsThis study was planned and carried out as a relational survey study, which is a quantitative research. A total of 480 students, consisting of 240 nursing and 240 midwifery students, were included in this study. SPSS 26.0 and AMOS 26 package programs were used to analyse the data and descriptive statistics (frequency, percentage, mean, standard deviation) and path analysis for the structural equation model were used. ResultsNo significant difference was found between the medical artificial intelligence readiness (p=0.082) and artificial intelligence anxiety (p=0.486) scores of midwifery and nursing students. The model of the relationship between medical artificial intelligence readiness and artificial intelligence anxiety had a good goodness of fit. Artificial intelligence knowledge and using artificial intelligence in daily life are predictors of medical artificial intelligence readiness. Using artificial intelligence in daily life, occupational threat and artificial intelligence trust are predictors of artificial intelligence anxiety. ConclusionMidwifery and nursing students' AI anxiety and AI readiness levels were found to be at a moderate level and students' AI readiness affected AI anxiety.

Firefighter Health: A Narrative Review of Occupational Threats and Countermeasures.

Structural firefighters are responsible for protecting properties and saving lives during emergency operations. Despite efforts to prepare firefighters for these hazardous occupational demands, the unfortunate reality is that the incidence of health morbidities is increasing within the fire service. Specifically, cardiovascular disease, cancer, and mental health disorders are among the most documented morbidities in firefighters. Pubmed and Google Scholar search engines were used to identify peer-reviewed English language manuscripts that evaluated firefighters' occupational health threats, allostatic factors associated with their occurrence, and evidence-based strategies to mitigate their impact. This narrative review provides fire departments, practitioners, and researchers with evidence-based practices to enhance firefighters' health.

Investigating occupational threats in informal recyclers of solid waste in Kerman city

Introduction: The valuable activity of informal recyclers, or salters, itinerants in the direction of sustainability and environmental protection is not hidden from anyone. Unfortunately, this occupational group has been neglected, and organizational, support, and health institutions pay less attention to these people, so we felt it necessary to investigate the threats related to the occupation of these people in Kerman City.
 Materials and Methods: This is a cross-sectional descriptive study. The statistical population in the form of a census includes 232 informal recycling centers and 294 informal recyclers who entered the study voluntarily and with their consent at first, field research collecting information and completing questionnaires through observation and interviews with a face-to-face referral from 2021 to 2022, and then the data were collected. In the end, the necessary analysis and interpretation were done using SPSS software version 19 and the Chi-score test.
 Results: Results showed that 51.4% of the participants declared health and health problems as the most important threat to their jobs, and there was a significant relationship between job threats and gender (p-value=0.003). About 20% of people did not use any personal protective equipment. There was a significant relationship between the lack of use of personal protective equipment and the number of visits to health centers (p-value=0.048). The most occupational threats of the recyclers were sharp objects, contact with chemicals and vapors and smoke from waste fuel, musculoskeletal problems, especially back and leg pain, bites by stray animals, and skin dermatitis.
 Conclusion: The government and the Ministry of Health, Treatment, and Medical Education should pay more attention to the threats related to the job of informal recyclers, the most obvious of which is health and safety.

Lung Function Indices among Marble Workers with Age Matched Healthy Individuals in Lahore

Background: Marble dust predominantly comprises of free silica which is a principal constituent of Earth’s crust. Production of toxic substances, chemicals, and respirable dust in marble industry offers an occupational threat to the workers. Free silica dust is generated during quarrying, grinding cutting and polishing of marble and is responsible for occupational pulmonary diseases. Objective: This study was conducted to compare pulmonary function test results among the workers of marble industry and healthy persons of same age in district, Lahore. Study Design: Cross-sectional study. Settings: Study was conducted in marble workshops workers, located in Township area College Road, Institute of Public Health, Lahore Pakistan. Duration: Six months from 05 May 2021 to 04 August 2021. Methods: A cross-sectional study was conducted among 225 individuals. Forty-five male persons, each were selected from cutting, grinding and polishing sections along with office workers from the marble workshop. Forty-five age matched healthy individuals selected from the same community. After getting approval from the Institutional Review board, the data was collected in a pretested standardized questionnaire after taking informed written consent by the respondents. Lung function tests were conducted by a Spiro Lab Spirometer which included forced vital capacity, forced expiratory volume in one second and ratio of forced expiratory volume to forced vital capacity. Results: The mean years of work experience of respondents was 11.58 ±5.92 and that of non-exposed healthy individuals was 11.23±5.32 years. A significant relationship of marble dust and deranged pulmonary function tests (p-value≤0.001) was noted which was normal in case of non-exposed individuals. Duration of work in marble industry and age in years had significant relationship with reduction in pulmonary function tests (p- value<0.001 in each). About 83 (46%) marble workers working in different sections had reported abnormal spirometry as compared to non-exposed individuals (p-value<0.001). Conclusion: According to the current study, individuals who had worked in the marble industry for more than 15 years had a steady reduction in their lung function indices, which ultimately had a detrimental effect on their health and when compared to healthy individuals of the same community, marble workers' pulmonary function tests showed significant impairments.

Efficacy of threshold inspiratory muscle trainer versus diaphragmatic plus pursed lip breathing in occupational COPD

BackgroundSmoking mainly induces COPD, but occupational threats play a significant role in the development of COPD. Previous studies concerning pulmonary rehabilitation mainly focus on COPD caused by smoking, but COPD induced by occupational hazards has not been studied yet. We aimed to identify the efficacy of IMT (Inspiratory Muscle training) using classic POWERbreathe versus DB (Diaphragmatic breathing) plus PLB (Pursed-lip Breathing) exercise in dyspnea, exercise capacity and pulmonary function parameters in occupational COPD farmers with moderate-to-severe COPD (GOLD II–III) FEV1% 30–79%.MethodsA prospective supervised RCT (Randomized Controlled Trial) included 60 farmers with COPD assigned randomly into two groups; Group A performed IMT using a classic POWERbreathe, and Group B performed DB plus PLB. Both groups completed two daily sessions for three months, seven days/week.ResultsBetween-group differences outcome scores were compared, and there was a more remarkable significant improvement in exercise capacity, lung parameters, and dyspnea using the mMRC scale in the IMT group compared to DB plus PLB group. The 6MWT distance (effect size Cohen’s d: 1.69), FEV1 (effect size Cohen’s d: 0.78), FEV1/FVC (effect size Cohen’s d: 0.86), FVC (effect size Cohen’s d: 1.01), and mMRC score (effect size Cohen's d: 1.12) were significantly improved in group A (p < 0.05).ConclusionThis study demonstrated that the IMT group showed better exercise capacity, dyspnea, and pulmonary function outcomes in occupational COPD farmers. Further studies require COPD patients from different occupations.

Sociodemographic Factors, Mental Health, and Emotional Eating Associated With Concern for COVID-19 Contagion in Nurses: A Cross-Sectional Study.

To determine the association between sociodemographic factors, stress, depression and anxiety, emotional eating, and concern about COVID-19 contagion in first and second-line Peruvian nurses. The study was cross-sectional and conducted with 500 Peruvian nurses of both sexes, over 18 years of age. Validated questionnaires were used to measure sociodemographic aspects, concern about COVID-19, generalized anxiety, depression, self-perceived stress, and emotional eating. Multiple linear regression analysis was performed to analyze the factors affecting concern about COVID-19 contagion. The multiple linear regression analysis showed that stress, being between the ages of 18 and 29 years, being male, being from the coastal region or the jungle region, having a bachelor's degree, severe anxiety, and severe depression were associated with higher concern about COVID-19. On the other hand, having more than 5 to 10 years of experience and more than 10 years of experience, low emotional eating, and non-emotional eating were negatively associated with concern. This model explained 44.05% of the variability among the participating nurses. These findings provide resources for future research on the comprehensive well-being of nursing staff by exploring various sociodemographic aspects and mental conditions associated with greater concern about COVID-19. Meanwhile, years of experience and emotional eating behavior were associated with lower concern about COVID-19. Future studies could incorporate this information to preserve the mental and physical health of nurses in the face of potential occupational threats.

Current Status of Workplace Violence and Coping Strategies among Home Healthcare and Long-Term Care Workers

&lt;p&gt;本文著重在職場暴力對居家醫療與長期照護從業人員的健康威脅。職場暴力可分為四種類型：第一型為具犯罪意圖之暴力，第二型是「客戶對員工」施加之暴力，第三型是「員工間」發生的暴力，第四型是親密伴侶間的暴力。其中，醫療保健與社會服務業之勞工被認為是職場暴力之高風險族群，其所受到的暴力通常來自患者或患者親屬（第二型職場暴力）。而對於居家醫療與長期照護工作者而言，由於其工作環境與工作性質，於各類型之職場暴力皆有很高的暴露風險。研究顯示，相當比例的居家醫療與長期照護從業人員經歷過第二型職場暴力，其中，居家醫療從業人員的發生率普遍高於長期照護從業人員。然而，由於通報率偏低，學者們認為醫療場域之職場暴力盛行率有被低估的可能性。本文提出對居家醫療與長期照護從業人員有所裨益的職場暴力預防策略，囊括四種面向。首先，健康與安全之教育訓練可以有效促進居家訪視的安全性，包含成立安全及諮詢委員會、提供教育訓練、加強溝通技巧、強化事件通報流程，以及重視事件之後續追蹤等。其次，對於居家訪視進行風險評估有助於改善居家之環境安全，目前已有數種評量工具。其三，防身物品、緊急電話及合宜之應對態度是面對暴力事件時的重要應對技巧。其四，為預防醫療職場暴力，《職業安全衛生法》與《醫療法》也逐年修訂。綜上所述，本文蒐集醫療場域之職場暴力現況，並提供預防及因應策略，以期居家醫療與長期照護從業人員能擁有更友善健康的工作環境。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;Workplace violence (WPV) is a serious occupational threat for healthcare workers (HCWs). WPV can be divided into the following four types: Type I concerning criminal intent, Type II client-on-worker violence, Type III worker-on-worker violence, and Type IV personal relationship (or intimate partner violence). A high level of exposure to WPV has been identified in the healthcare and social work settings where patients form a common source of WPV (more specifically Type II WPV). Of all healthcare professionals, home healthcare workers (HHCWs) and long-term care workers (LTCWs) are particularly vulnerable to WPV due to the unique characteristics and requirements of their services, and home healthcare workers appear to be at a greater risk of experiencing WPV than their long-term care counterparts. Moreover, most scholars are of the opinion that the prevalence of WPV is very likely to be underestimated due to underreporting. Accordingly, the paper proposed four major WPV coping strategies for the two groups of healthcare workers. First, training courses should be planned and implemented to improve communication skills of workers and safeguard their safety during home and long-term care visits. Relevant committees or advisory boards should be established to streamline incident reporting SOP, provide counseling, develop safety manual, and monitor follow-ups of reported incidents. Second, home environment safety should be assessed using one of the several tools that have already been developed. Third, HHCWs and LTCWs should equip themselves with personal defense and protection gadgets and memorize emergency phone numbers for every visit. Fourth, related laws and regulations, notably Occupational Safety and Health Act and Medical Care Act, should be reviewed and amended on a regular basis to better prevent WPV in the home and long-term care settings. In the paper, we comprehensively report the prevalence of medical workplace violence, prevention and intervention strategies for HHCWs and LTCWs to stay safe while working.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Occupational Threat of Recycling Spent Lithium-Ion Batteries by Vacuum Reduction

Occupational Threat of Recycling Spent Lithium-Ion Batteries by Vacuum Reduction

Climate change and its effects on farm workers

Background: One of the biggest global occupational threats, especially in the outdoor workplace, is climate change and global warming, as workers are exposed to the heat stress leading to reduced performance. The aim of this study was to investigate the effect of workplace climate on labor productivity index in the agricultural sector. Methods: In this study, data related to environmental variables of 215 synoptic meteorological stations in Khuzestan province were collected from three climatic regions (hot, mild, and cold). Using MATLAB R 2018b mathematical software based on ASHRAE/ISO7730 standard values by designing some scenarios, predicted mean vote (PMV) index, and then, labor productivity index (P) were estimated. The data were analyzed using SPSS version 25 software. Results: The results showed that in the hot regions, there is a significant inverse relationship between P index and the main environmental variables (ta, tr, pa). In the cold regions, increasing the amount of ta and tr in light and medium workload improved the P index, but for heavy workload, it reduced productivity, and the most effective factor was increasing air vapor pressure. In the mild regions, the most effective factor in productivity was air vapor pressure. In addition, the results of Spearman’s correlation coefficient showed that PMV index has a direct and significant relationship with P index. Conclusion: Regarding the increasing trend of climate change and its effect on the desired thermal comfort and productivity, well structure and planning is needed to manage farm workers health.

Human brucellosis: Seroprevalence and associated exposure factors among the rural population in Nagpur, Maharashtra, India.

Introduction:Brucellosis is a recognised occupational threat among animal handler and raw animal product consumers. In India, there is a likelihood of missed diagnoses and under-reporting cases by physicians causing an extended debilitating illness. We steered research to conclude the seroprevalence and risk factors allied with Human Brucellosis (HB) among the rural population in Nagpur District, Maharashtra, India.Methods:Closed-ended questionnaires used for a cross-sectional study to collect data for demographics and risk exposure variables. 382 subjects' serum-samples were tested by using Rose-Bengal (RBPT) and ELISA technique. An odd ratio calculated for risk factors for HB reported positive or negative. Data were analysed by using SPSS.Results:The brucellosis seroprevalence in rural Nagpur was 1.83%. The mean age was 42.32 years, 78.5% were male, and 21.5% were female. Prevalence was higher among males [85.7%] than females [14.3%]. The risk for brucellosis among males (OR = 1.65, 95% CI = 0.19–13.92, P = 0.64) was more than females. Handling raw meat had more risk (OR = 3.14, 95% CI = 0.40 – 28.6, P = 0.23) than those not handling raw meat. Milking animal was protective (OR = 0.88, 95% CI = 0.80 – 0.96, P < 0.001) for brucellosis than those not milking animal. Subjects reported more likely to be a seropositive to human brucellosis those involved in assisted animal delivery (P = 0.001), drinking unpasteurised milk (P<0.001), consuming milk products made from raw milk (P<0.001) and eating raw meat (P = 0.001)Conclusion:Health education program is essential to generate awareness for brucellosis in the rural community to prevent animal to human disease transmission.

A Cross-Sectional Study on Prevalence and Predictors of Burnout among a Sample of Pharmacists Employed in Pharmacies in Central Italy.

Burnout is defined as an occupational phenomenon linked to chronic workplace stress that has not been successfully managed and included among the factors influencing health status or contact with health services. Although several studies were performed for assessing this phenomenon, there is a lack of data on the prevalence of burnout and associated predictors, due to different definitions of the syndrome and heterogeneity of assessment methods. One of the well-known evidences on burnout is related to the highest risk professions, which include policemen, firemen, teachers, psychologists, medical students, nurses, physicians, and other health professionals, such as pharmacists. Objective. The aims of the present study were to (1) assess the occurrence of burnout syndrome among a sample of pharmacists employed in public and private pharmacies located in Rome province (Latium Region; central Italy); (2) evaluate the role of some potential predictors for the development of the syndrome. Materials and Methods. A questionnaire elaborated ad hoc was administered online to 2,000 members of the Association of Professional Pharmacists of Rome and its province and employed in public or private pharmacies. The questionnaire included the 14-item Shirom–Melamed Burnout Measure (SMBM) tool and questions on demographic characteristics and working conditions. Results. Physical exhaustion was the burnout dimension with the highest score; besides, approximately 11% of the studied pharmacists were categorized as having clinically relevant burnout levels (≥4.40). Several of the investigated variables significantly influenced the single burnout dimensions at the univariate analyses; multivariate analyses demonstrated that alcohol consumption and workplace location have a significant independent role on the overall SMBM index, while working time significantly influences clinically relevant burnout level. Conclusions. The results revealed that pharmacists are at risk of burnout, and thus, it is necessary to perform specific preventive intervention for managing this occupational threat.

An Exploration of Work Related Stressors Experienced by Rural Emergency Nurses

Purpose: Nursing in a rural emergency department is a physically and emotionally demanding job. The challenges of working under these conditions can be very stressful for nurses. Work place stress can result in nurses developing mental health issues with subsequent physical consequences. These mental health issues, when experienced by nurses, can compromise patient care and safety. The consequences of work related mental health challenges are not isolated to the workplace but also have the potential to disrupt and destroy nurses’ careers and family life. This article addresses the following research question: What are the experiences of rural emergency nurses that can contribute to, or leave rural emergency nurses vulnerable to, the development of work related mental health issues.&nbsp;&nbsp;Sample Participants were emergency department registered nursing staff from one hospital located in a rural community north of Toronto.Method: An exploratory qualitative descriptive study design was chosen, in which rural emergency department nurses were invited to share their stories through face-to-face in-depth interviews.Findings: Rural emergency nurses are challenged by a lack of resources, anxious about working outside their scope of practice, and are concerned about issues related to patient privacy and their own anonymity in the community. Added to this is the emotional impact of caring for young trauma patients, family, and people they know from the community. These experiences also affect their family members and can be expressed by lashing out, impatience, and withdrawing from interactions with them.Conclusion: Workplace challenges faced by rural emergency nurses can contribute to occupational mental health issues such as compassion fatigue and burnout. Managers of rural emergency departments need to acknowledge the unique working conditions of the nurses, improve communication, and tailor support programs to meet the needs of each individual nurse who has experienced an occupational threat to their mental well-being.Keywords: Rural Emergency Nurses, Mental Health, Compassion Fatigue, Stress, Burnout, Occupational HealthDOI:&nbsp;http://dx.doi.org/10.14574/ojrnhc.v19i2.550&nbsp; &nbsp;&nbsp; &nbsp

The emotional mechanics of maintaining occupational boundaries between change professionals

Purpose This paper aims to review the latest management developments across the globe and pinpoint practical implications from cutting-edge research and case studies. Design/methodology/approach This briefing is prepared by an independent writer who adds his/her own impartial comments and places the articles in context. Findings This research paper concentrates on patterns of behavior exhibited by human resource managers and external organizational development practitioners to retain their occupational boundaries. A sense of competitive occupational threat is pervasive and often erodes the value added by both professionals when organizations proceed through change processes, despite the potential for mutually valuable and organizationally beneficial learning opportunities being there for the taking. Originality/value The briefing saves busy executives and researchers hours of reading time by selecting only the very best, most pertinent information and presenting it in a condensed and easy-to-digest format.

Tuberculin skin test evaluation in healthcare workers and distribution by occupation

OBJECTIVE: Tuberculosis (TB) is a potential occupational threat for healthcare workers (HCWs) worldwide. We aimed to evaluate the tuberculin skin test (TST) and investigated if there was any difference between occupations. METHODS: This was designed as a prospective study. The analysis was performed on 331 participants. Purified protein derivative was administered to all cases. In addition, cases' age, gender, and smoking status were questioned and their comorbidities were recorded. Both shoulder areas were checked, and the Bacille Calmette-Guerin (BCG) scar counts were recorded. RESULTS: Out of a total of 331 participants, 207 were female and 124 were male; mean age was 39 ± 8 (min; 18, max; 61) and TST was 12 ± 6 mm. The cases were categorized by considering participants' exposure to TB (Group-1 - Doctor; Group-2 - Midwife-Nurse-Health Technician-Laboratorian; Group-3 - Technician-Administrative Staff; Group-4 - Secretary-Auxilliary Staff; and Group-5 - Security, Cleaning, Cafeteria Staff). When compared in terms of TST, there was a statistically significant difference (P CONCLUSION: Exposure to TB may vary according to professions, but the socioeconomic situation cannot be determined by professions.

A Theoretical Focus on Cultural Taxation: Who Pays for It in Higher Education

The representation of faculty of color at universities and colleges in the United States has increased. Yet, white professors still account for 84% of full-time faculty. Researchers suggest that along with institutionalized racism the mantra of publish or perish promotes racial disparities in academia. The scholarly demand of publishing is encumbered by all tenure track faculty. However, non-white faculty faces additional challenges as they pursue promotion and tenure. “Cultural taxation” is one of the most major occupational threats for faculty of color. This theoretical paper examines how “cultural taxation” may serve as an obstacle to success for faculty of color in the academy due to implicit and explicit discriminatory practices.

Divided we stand? Occupational boundary work among human resource managers and external organization development practitioners

PurposeUnderstanding occupational boundaries is vital in the contemporary economy, in which knowledge-based work is a central feature. The purpose of this paper is to identify and decipher boundary work which affects the cooperation and demarcation between human resource (HR) managers and external organization development (OD) practitioners during organization change processes.Design/methodology/approachData are based on in-depth interviews with HR managers and external OD practitioners in the Israeli business sector.FindingsEncounters between HR managers and external OD practitioners are potentially volatile given mutual experiences of occupational threat. Three distinct patterns of boundary work for negotiating OD-HR jurisdiction are identified. These yield differential occupational and organizational outcomes.Research limitations/implicationsThis study is based on a medium-sized sample of practitioners of HRM and OD in the Israeli business sector. The data focused on one-sided descriptions of occupational relations.Practical implicationsThe findings shed light on boundary work associated with fruitful HRM-OD partnerships. This may greatly advance the success of costly organization change and development interventions which demand the collaboration of both parties. Implications are offered regarding the academic education and practical daily management of both groups of practitioners.Originality/valueDespite their growing relevance, empirical investigations of daily HRM-OD interfaces are scarce. This exploratory research addresses this gap in the literature and offers theoretical and practical insights.

Needle Stick Injury among Health Care Workers and Its Aftermath in a Tertiary Care Hospital in East Delhi, India

Needle stick injuries (NSI) present serious occupational threat to healthcare workers (HCW). Due to lack of epidemiological data on NSI in this geographical region, the present study was conducted to estimate incidence rate of NSI, identify factors associated, assess awareness of HCWs and evaluate post-injury sero-reactivity rates. This cross-sectional observational study involved 524 HCWs (151 medical and 373 paramedical staff). A validated questionnaire was filled by investigator using interviewing technique. Blood sample was collected from study subjects who reported NSI within last 28 days, at the time of NSI and subsequently after 1, 3 and 6 months. Screening for HBsAg, anti-HCV and anti-HIV 1/2 antibodies was done using commercially available Enzyme-Linked Immunosorbent Assay Kit. Sixty-three HCWs, comprising mainly of medical staff, gave history of NSI in preceding 28 days. The most frequent procedure leading to NSI included recapping needles and suturing in 28.57%, while commonest root cause was haste in 61.91%. Majority (61.91%, 39/63) suffered from NSI during latter part of their duty hours. None became HBsAg, anti-HCV or HIV seropositive. The proportion of NSI among HCWs who had received training on prevention and management of NSI was significantly lower than those who were untrained. Hence training programs emphasizing on safe techniques must be conducted regularly and HCWs putting in long working hours must be allowed to take breaks. Needle stick injury among health care workers and its aftermath in a tertiary care hospital in East Delhi, India.

Principles of fatigue in residency education: a qualitative study.

Proposals to implement fatigue-management strategies in residency education assume that medicine shares the view of other risk-adverse industries that fatigue is hazardous. This view is an essential underpinning of fatigue-management strategies that other industries have embedded as part of their workplace occupational health and safety programs. We sought to explore how residents understand fatigue in the context of their training environment. We interviewed 21 residents in 7 surgical and nonsurgical programs at Western University in 2014. All participants met the inclusion criteria of routinely working 24-hour call shifts while enrolled in their training program. Data collection and analysis occurred iteratively in keeping with constructivist grounded theory methodology and informed theoretical sampling to sufficiency. Four predominant principles of fatigue captured how the social learning environment shaped residents' perceptions of fatigue. These included the conceptualization of fatigue as (a) inescapable and therefore accepted, (b) manageable through experience, (c) necessary for future practice and (d) surmountable when required. This study elaborates our understanding of how principles of fatigue are constructed and reinforced by the training environment. Whereas fatigue is seen as a collective hazard in other industries, our data showed that, in residency training, fatigue may be seen as a personal challenge. Consequently, fatigue-management strategies that conceptualize fatigue as an occupational threat may have a limited impact on resident behaviour and patient safety.

Is aneurysm surgery too exciting for our own good?

Bunevicius and colleagues present an observational study on hemodynamic changes recorded from four experienced vascular neurosurgeons during 42 aneurysm clippings (ref). With this rather novel approach studying surgeons instead of patients, they found that heart rates and blood pressures rose during surgery and peaked after aneurysm neck dissection and clipping relative to at rest. They also observed that clipping un-ruptured aneurysms was associated with greater hemodynamic responses than clipping ruptured aneurysms. Although they are to be congratulated for conducting an interesting and different study, it may hardly come as a surprise to the reader that aneurysm surgery can be more stressful than resting in a chair. It also seems reasonable that un-ruptured aneurysms trigger greater hemodynamic responses since only perfect results are acceptable when patients undergo prophylactic neurovascular surgery, while treatment results in patients with subarachnoid hemorrhage are not entirely up to the surgeon. Although too much stress may increase tremor, impair judgment and therefore be undesirable for our patients during complex microneurosurgical procedures, the authors also speculate that aneurysm surgery may pose an occupational threat to our own health. Despite stressful surgeries, the mortality rates of surgeons luckily do not appear to be higher than in other medical specialties, and there is no excess of ischemic heart disease [1, 17]. In Norway, the life expectancy of male doctors is among the highest of all professions; only priests, college/university teachers and architects beat us by a fewmonths (www.ssb.no). US data also confirm that the life expectancy is higher for physicians than for example lawyers and other examined professionals [3]. But are neurovascular surgeons perhaps special? Although neurovascular surgery is both technically and mentally demanding, dealing with as well as controlling stress is part of the drill. Many neurovascular surgeons thrive on stress and may therefore represent a selection of individuals who are more comfortable with stressful situations. With human responses there is often a response shift with repeated exposures over time. With experience many neurovascular surgeons may therefore become more resistant to the adverse reactions from stress, as also suggested in the current study. This is presumably good for our patients. Among the four experienced neurovascular surgeons included in the present study, recorded hemodynamic responses were quite modest with observed heart rates 180/ 110 mmHg) 28 % of the time during observation. Also, abnormal blood pressure was more common during surgery than during vigorous physical exercise [14]. Even so, based on what we know from these two studies, aneurysm surgery does not seem to trigger extreme hemodynamic responses compared to other procedures or life situations. Similar hemodynamic responses have for example been seen during hallux valgus surgery, but with larger responses in trainees than in trainers [5]. Also in healthy men watching (Scottish!) football hemodynamic responses similar to performing aneurysm * Ole Solheim ole.solheim@ntnu.no