Working Conditions Research Articles

Digital Intermediation in Paid Domestic Work in Argentina: An Analysis of Ambivalent Effects on Working Conditions

Recent studies offer ambivalent conclusions on the effect of digital intermediaries in domestic and care work; while some suggest that the digital platforms exacerbate and perpetuate the precariousness of the sector as well as its underlying social inequalities, others contend that the effects of these technologies are not yet clear. Drawing on these perspectives but focusing specifically on the platforms’ organizational structures, this article contributes to a growing body of scholarship on the differential impact of digital intermediaries in this occupation. Based on a study of the digital platform Zolvers in Argentina, the article analyzes the effects on working conditions of three types of working arrangements: regular work managed by the digital intermediary, regular work managed by the employer household, and casual ‘one-time-only’ jobs. This research uses a mixed methods approach, including a survey of 300 domestic workers, 20 semi-directed interviews, and two focus groups with workers using Zolvers.

Psychological Distress and Associated Factors Among Elementary School Teachers: A Cross-Sectional Study.

Teachers can face demanding and stressful working conditions. Classroom environments in elementary schools are dynamic and challenging, which can be mentally and emotionally exhausting for teachers. This study aimed to investigate the prevalence of psychological distress and identify associated factors among elementary school teachers. This is an analytical, observational cross-sectional study. The participants consisted of 450 teachers selected using the cluster sampling method from elementary schools of Tabriz, Iran. Multiple regression analysis was performed to examine the associations between teachers' psychological distress and potential factors. The study found a significant proportion of participants (54.2%) experiencing psychological distress. Multiple regression analysis revealed age, sex, work experience, school type, family income status, teachers' efficacy, emotional labor, and presenteeism were statistically associated with teachers' psychological distress. To address teachers' psychological distress, schools need to adopt policies that promote teacher well-being and mental health support. The high prevalence of psychological distress among elementary school teachers raises concerns and highlights the need for attention. Schools and administrators must provide teachers with the resources and support they need to succeed in their roles. Interventions targeting the identified associated factors must be planned to improve the mental health of elementary school teachers and enhance their overall performance.

Forklift Design Integrated Speed Limiter and Position Tracking Through IoT-Based Website

Forklifts, as lifting and transportation equipment, play a crucial role in logistics. However, forklift operators often chase targets, pushing the forklift to perform at higher speeds. Operating a forklift at high speeds not only poses potential dangers to the working conditions but can also lead to a decrease in forklift performance. Operators do not ensure the forklift is running according to procedures due to a lack of supervision. In response to this issue, the author proposes an innovation in the form of a monitoring device capable of recording speed violations committed by operators. With the planned device, it is expected that forklift operators will exercise more caution and take greater responsibility when operating the forklift. The objective of this research is to reduce the likelihood of accidents and forklift damage due to improper use. The study produces a forklift design equipped with supporting components for the implementation of the device and a website as a monitoring platform for forklift operators and workers, providing real-time access to collected data. This system enhances operational safety in operating forklifts. The research significantly contributes to the development of safer and smarter forklift technology, aligning with strict demands for safety standards and risk management in industrial environments.

Соціальна політика як чинник забезпечення життєстійкості держави

In the conditions when Ukrainian statehood is facing the most serious challenge in its recent history, issues regarding state policy priorities in the social and economic sphere are becoming relevant. The goal of the article is to study the place and role of social policy in the process of ensuring the sustainability of the state. General scientific methods of analysis and synthesis, generalization, classification, system analysis, as well as a graphic method for visualization of the obtained results were used to form the main theses of the study. The work analyzes the modern scientific and theoretical platform and basic definitions of the concept of «sustainability», investigates the specifics and permanent context of the use of terms related to it — viability, stability and resilience, offers a systemic view of the state’s viability and identifies its components. Social policy is considered as an element of the management system of social processes, which directly affects the sustainability of Ukrainian society. At the current stage of development of the global economy, human is the main source of economic growth, and the quality of human potential is the key to the state’s competitiveness. Taking this into account, the importance of social and humanitarian policy is growing many times over. In economic policy, making a profit does not become a self-sufficient activity, instead the policy should be aimed at the person, unlocking the potential of the individual and forming the quality human potential of the state. Therefore, when assessing social policy, one should remember the value of a person, in particular the economic one, and the need for appropriate investments — in safety, health care system, and improving working conditions for the development of this resource. The work highlights the main elements of the state’s sustainability, shows the connection between its higher-level elements, such as the sustainability of the economy and the sustainability of society. It is in society — in the family, community, at the place of study — that the personality is formed and acquires a certain physical condition, education, professional skills and qualifications, and social connections. In this way, human and social capital is formed as a resource for the development of the economy and, accordingly, its stability and sustainability. At the same time, the economy generates material and financial resources that are necessary for both physical existence and development of an individual, as well as for the existence of society as a whole, in particular, social and engineering infrastructure facilities. The conducted analysis clearly demonstrates the importance of social policy as a social institution of sustainability in the state.

A review and research agenda for recent socially and environmentally sustainable practices for warehouse management systems

PurposeThe concept of a sustainable warehouse management system (WMS) is a relevant yet under-researched area within warehousing logistics. The purpose of this research is twofold: first, to review the literature on the topic of socially and environmentally sustainable practices; second, to lay the theoretical base for identifying social and environmental sustainability practices in warehousing operations that can serve as focus areas for WMS operational functions.Design/methodology/approachThis research built knowledge on a systematic literature review and bibliometric analysis in Scopus Elsevier and Web of Science Core Collection databases. After comprehensively filtering English literature from 2016 to 2024, only 43 out of the initial 601 studies comprised relevant warehousing practices that can be incorporated into the scope of WMS activities.FindingsAs a result, retrieved practices were allocated to a specifically designed warehouse model within the main processes, equipment and resources. This model could serve as a baseline for incorporating 48 sustainable WMS practices. The prevailing share of practices focuses on environmental rather than social warehouse sustainability. WMS should adopt sustainable warehousing practices to reduce warehouses' carbon footprint, energy and resource consumption and improve working conditions in a warehouse.Originality/valueThere have not been any existing reviews on warehouses' social and environmental sustainability to synthesize knowledge and serve as a base for WMS sustainability. This research will contribute to developing more sustainable and environmentally responsible warehousing operations, ultimately benefiting society and the environment. By incorporating such practices into WMS, warehouse owners can ensure efforts toward social and environmental sustainability while still maintaining efficient operations.

Differential Degradation of Wooden Cutting Boards and Ergonomic Aspects of Beef and Chevon Marketing in Port Harcourt, Nigeria

Abstract Although wood degradation and ergonomics are critical design issues in the wood product industry worldwide, data on wood as a degradable and culturally important material for cutting meat and the ergonomics of meat marketing in urban Nigerian markets are unavailable. This study investigated the degradation of wooden cutting boards (WCB) caused by meat cutting and marketing ergonomics. Degradation was estimated using eight WCB administered to four participants marketing chevon and four participants marketing beef. Descriptive and anthropometric data were obtained from 129 participants using questionnaires and measurements. The degradation results showed that after three months, cutting meat caused a significant monthly average WCB loss of 19.6 ± 4% and 11.6 ± 4% and a cumulative weight loss of 58.17% and 34.72% for chevon and beef, respectively. A substantial number of meat marketers were found to work in awkward postures, especially in the upper extremity mismatched condition, where they potentially exert more force, resulting in contact between the cutting tools and WCB that degrades the cutting board during meat cutting. Therefore, mismatched working conditions are a feasible and heightened factor contributing to wood degradation during meat cutting and marketing. The results can help people gain a deeper understanding of wood degradation from commercial meat cutting and the ergonomics of meat marketing and provide strategies for ensuring a sustainable supply of high-quality wood and improving ergonomic conditions.

An Echo State Network-Based Light Framework for Online Anomaly Detection: An Approach to Using AI at the Edge

Production efficiency is used to determine the best conditions for manufacturing goods at the lowest possible unit cost. When achieved, production efficiency leads to increased revenues for the manufacturer, enhanced employee safety, and a satisfied customer base. Production efficiency not only measures the amount of resources that are needed for production but also considers the productivity levels and the state of the production lines. In this context, online anomaly detection (AD) is an important tool for maintaining the reliability of the production ecosystem. With advancements in artificial intelligence and the growing significance of identifying and mitigating anomalies across different fields, approaches based on artificial neural networks facilitate the recognition of intricate types of anomalies by taking into account both temporal and contextual attributes. In this paper, a lightweight framework based on the Echo State Network (ESN) model running at the edge is introduced for online AD. Compared to other AD methods, such as Long Short-Term Memory (LSTM), it achieves superior precision, accuracy, and recall metrics while reducing training time, CO2 emissions, and the need for high computational resources. The preliminary evaluation of the proposed solution was conducted using a low-resource computing device at the edge of the real production machine through an Industrial Internet of Things (IIoT) smart meter module. The machine used to test the proposed solution was provided by the Italian company SIFIM Srl, which manufactures filter mats for industrial kitchens. Experimental results demonstrate the feasibility of developing an AD method that achieves high accuracy, with the ESN-based framework reaching 85% compared to 80.88% for the LSTM-based model. Furthermore, this method requires minimal hardware resources, with a training time of 9.5 s compared to 2.100 s for the other model.

Nanofluid Minimum Quantity Lubrication (NMQL): Overview of Nanoparticle Toxicity and Safer-Design Guidelines

Minimum Quantity Lubrication (MQL) has received much attention from the research community as a potential lubricating system to reduce environmental hazards and health issues that can be commonly found in flood cooling/lubricating systems based on metalworking fluids. The addition of nanoparticles in MQL systems (NMQL) has led to improved machining performance, increasing the cooling capability and reducing friction and tool wear, and some researchers have proved the applicability of this type of system for difficult-to-cut materials. However, the mist generated by MQL systems due to both the MQL system itself and the machining operation may pose an additional hazard to operators which is being overlooked by the research community. These hazards become more severe when using nanoparticles, but unfortunately very few works have paid attention to nanoparticle toxicity as applied in MQL systems, and this issue should be clearly understood before encouraging its implementation in industry. Furthermore, current legislation does not help since regulation of permissible exposure limits when dealing with nanoparticles is still ongoing in most cases. In this work, the toxicity of nanoparticles applied in MQL systems is analyzed, and recent research on studies of nanoparticle toxicity both in vitro and in vivo is presented. A relative comparison of toxicity is provided for those nanoparticles that have been reported in the literature as potential additives for MQL. The review is focused on analyzing the main factors of toxicity of nanoparticles which are identified as size, shape, surface properties, agglomeration and solubility. This review presents guidelines for safer nanolubricant formulations, guiding practitioners towards proper NMQL implementations in industry. Furthermore, current occupational exposure limits and recommendations are provided for all the nanoparticles potentially used in MQL systems, which is of interest in terms of work safety.

Impact of COVID-19 Pandemic on the Migrant Workers and Public Policy in Case of Malaysia & Indonesia

B The COVID-19 (Corona Virus Disease 2019) pandemic has changed the world altogether to a different plane. It has disrupted economy, health, family, society, etc. and there is no one left who has not been affected by it. Public Policy in case of migrant workers finds important place in this calculation. For, they play an important role in many of the economies, and still are the most vulnerable section of people who has been affected by the COVID-19 pandemic. Their problem emanates from various angles like that of being a legal or illegal (unaccounted) migrant worker, vulnerabilities emanating from lack of bargaining power with their employers and host nations, lack of safety working and hygienic living conditions, access to proper affordable health care facilities, etc. For the international migrant workers (who crosses border from home state to another state for purpose of employment or better economic aspirations), things have been really difficult in these pandemic times in terms of how they were treated by the authorities in the host countries and what kind of national public policy measures was taken to assure their physical health and mental wellbeing, engaging with them to assuage their psychological trauma caused due to various pressures and stress, economic condition, etc. Women migrant workers were more affected in way of losing their jobs, livelihood, family pressures and responsibilities. This paper looks into the effect of COVID-19 pandemic on the migrant workers, particularly with a focus on public policy measures taken in Malaysia and Indonesia, as these two nations contributes major chunk of migrant workers (inward and outward respectively) in the south-East Asian region. Apart from detailing the problems faced by the migrant workers during the pandemic times, this paper will dwell deep into the kinds of national public policy measures implemented towards the migrant workers as a response to the pandemic condition and its impact. In addition, this paper will also look into the role and policy of international organisations and NGOs towards the same. Apart from analyzing the problems and identifying the gaps in the approach of the respective governments, recommendations are also made to the public policy makers to improve the effect of their public policies and actions towards the migrant workers, on the basis of highlighting some good practices that are followed in other states.

Effects of vr-based interactive interior design on the emotional and mental health of office worker

ABSTRACT From the perspective of the evolution of the concept of health, the purpose of mental health is to achieve better living conditions, higher adaptability and development level, and also the best combination of physical and mental well-being and social well-being. According to the literature, the region and privacy of office interior design, the comfort and convenience of office furniture, the charm of office environment and individuation all have an impact on the mental health of office workers. Interactive interior design based on virtual reality can improve the office environment, thus improving the work efficiency and productivity of employees. A comfortable office environment has a positive impact on physical factors for office workers, which is beneficial for improving their mental health. This paper aimed to study how to analyze and study the impact of interactive interior design based on virtual reality (VR) on the emotional and psychological health of office workers. In this paper, the impact of VR interior design was evaluated by fuzzy comprehensive evaluation method, and the analytic hierarchy process (AHP) was used to quantify the weight. In the experiment part of this paper, through the analysis of the questionnaire of the office workers in Chengdu, Sichuan Province, and the comparison of the experimental data, it can be known that before the experiment, the control group and the experimental group were both very healthy, and after the experiment, the psychological health of the two groups was very healthy, which was 0 and 4 people. It can be seen that the psychological health of the workers in the experimental group has changed significantly. This paper studied the influence of VR interaction design on worker’s emotion from the experimental point of view and proved its influence on employee’s emotion from the empirical point of view, which had certain reference significance for future research.

Occupational health risk assessment of exposure to major hazardous chemicals in copper and nickel smelting enterprises

Objective: To evaluate the risk of major chemical exposure positions in copper and nickel smelting enterprises, and provide a basis for risk assessment and prevention control measures. Methods: From September to October 2023, two copper nickel ore smelting enterprises in Xinjiang Uygur Autonomous Region were selected as the research objects. Relevant information on chemicals was collected through occupational hazard field investigations. Qualitative analysis and exposure index methods were used in GBZ/T 298-2017 "Technical Guidelines for Occupational Health Risk Assessment of Chemical Hazardous Factors in the Workplace" to conduct risk assessments on the main chemical exposure positions. The qualitative risk assessment results were checked for consistency using the Weighted Kappa coefficient. Results: The positions with high risk of exposure to hazardous chemicals in copper nickel smelting enterprises are saponification positions exposed to hydrochloric acid in refining processes, black nickel positions exposed to sodium hydroxide, and tail suction positions. The consistency between the two occupational health risk assessment results is poor (Kappa=0.14) . Conclusion: The amount of major hazardous chemicals in copper-nickel smelting enterprises is large, and the occupational health risks caused by exposure are complex and diverse, so the effects of chronic occupational health should be strengthened.

The occupational exposure prevention and control system for hazardous drugs in the United States

Hazardous drugs represented by antineoplastic drugs have clear health hazards to occupational exposed populations, and this issue has received widespread attention all over the world in recent years. This article reviewed the laws, regulations, guidelines, and industry guidance documents for the prevention and control of occupational exposure to hazardous drugs issued by relevant departments and associations in the United States. It could provide a reference basis for the development of occupational environmental health standards and protection guidelines, with the aim of reducing the risk of occupational exposure to hazardous drugs and promoting the healthy development of healthcare services in China.

Bioaccumulation and Health Risk Assessment of Heavy Metals in Labeo rohita and Mystus seenghala from Jhelum River, Punjab, Pakistan

The bioaccumulation of trace elements and heavy metals in aquatic organisms is a critical environmental concern due to its potential impact on ecosystem health and human safety. This study investigated the level of trace elements and heavy metals bioaccumulation in Labeo rohita and Mystus seenghala from the River Jhelum in the district Khushab, Punjab, Pakistan. The concentration of calcium, magnesium, iron, nickel, copper, arsenic, cadmium, zinc, chromium, manganese, cobalt, and lead in the gills, liver, and muscle tissues of these fish was measured using inductively coupled plasma-mass spectrometry. Then, the extent of contamination and its possible health risks were assayed. Our findings indicate significant variations in the elemental and metal concentrations among different organs and between species, reflecting their diverse feeding habits and habitats. The health risk assessment based on the estimated daily intake, estimated weekly intake, maximum permissible intake, target hazard quotient, hazard index or total target hazard quotient, health risk index, and target cancer risk revealed potential risks to human consumers of these fish. This study emphasizes the need for continuous monitoring, as new data and insights are crucial for understanding and mitigating these risks. Strict regulatory measures are also necessary to safeguard public health and preserve the ecosystem of Jhelum River.

Maternal, Fetal, and Labour Outcomes of Dupilumab Use for Atopic Dermatitis During Pregnancy: A Systematic Review.

Atopic dermatitis is a chronic complex inflammatory disease that significantly impacts maternal well-being and quality of life during pregnancy, warranting effective therapeutic interventions that prioritize maternal health and fetal safety. Dupilumab is approved for moderate-to-severe atopic dermatitis, but limited data exist regarding its safety during pregnancy. We conducted a systematic review to review and analyze maternal, fetal, and labour outcomes in patients receiving dupilumab for atopic dermatitis during pregnancy. Comprehensive searches were conducted using databases including OVID, Scopus, and Web of Science, covering studies published until May 2024. Our search yielded 285 studies, of which 13 met the eligibility criteria. These studies included 68 patients with 69 pregnancies, revealing 58 live births and 11 spontaneous abortions. Dupilumab therapy was administered continuously throughout pregnancy in 22.2% of cases, while 77.8% received intermittent treatment. Maternal atopic dermatitis outcomes showed significant improvement in disease severity. Most pregnancies (86.3%) progressed without complications. Labour-associated outcomes varied, with 82.4% of women undergoing vaginal deliveries. The majority of births occurred at full term (82.5%), with a mean gestational age of 38.4 weeks. Fetal outcomes demonstrated a normal birth weight in 92.3% of cases, with no reported congenital defects. Our review suggests that dupilumab use during pregnancy is associated with improvement of atopic dermatitis and low or minimal risk of major adverse outcomes in treated patients or their newborns. Prospective studies with long-term follow-up are warranted to confirm the safety of dupilumab in this population.

Preliminary survey of three mosquito-borne viruses using a self-established multiplex RT-qPCR assay in Chinese blood donors

BackgroundMosquito-borne pathogens pose a significant threat to both human health and blood safety. The primary mosquito-borne viruses that present this threat are Zika virus, Chikungunya virus, and Dengue virus. At present, there are limited efficacious vaccines or therapeutic drugs for the prevention and treatment of these viral infections. Blood donors can remain asymptomatically infected and unfortunately, screening for these three viruses in Chinese blood donors are not mandatory, leaving the residual risk to transfusion recipients uncertain. Objective: To address this, we developed a single-tube multiplex RT-qPCR assay for ZCD detection and was preliminarily employed to screen a total of 10,566 blood donations in Nanning Blood Center in order to assess the prevalence risk of these pathogens in blood donors. Results: None of the blood samples was reactive for ZCD by nucleic acid test (NAT). One out of 173 donations (1/173, 0.58 %) was IgG positive for ZIKV and 14 (14/173, 8.4 %) were IgG positive for DENV. None of these 173 donations was IgG positive for Chikungunya virus. These findings suggest that the prevalence of ZCD infection in blood donors in Nanning is very low although past DENV infection (IgG positive) was relatively common. Conclusion: A single-tube multiplex RT-qPCR assay for simultaneous detection of ZCD viruses was successfully established and applied for screening in blood donors. The residual risk of ZCD infection through transfusion is currently low in Nanning, China. The NAT assay for ZCD will serve as a technical reserve in response to future epidemic or pandemic of mosquito-borne pathogens.

Analysis of factors affecting health status and abnormal lung function of workers exposed to welding fumes in Tianjin from 2020 to 2022

Objective: To investigate the health status and the influencing factors of abnormal lung function of welding fumes exposure workers in Tianjin from 2020 to 2022, and to provide theoretical basis for the protection and intervention of key occupational diseases. Methods: In October 2023, the relevant data of occupational health examination of welding fumes exposure workers in Tianjin from 2020 to 2022 (10831, 10758 and 21717 in 2020, 2021 and 2022, respectively) were collected from the China Disease Prevention and Control Information Platform. The electrocardiogram, chest radiograph and lung function abnormalities of workers in each year were analyzed, as well as the association between lung function abnormalities and gender, age, working age, region, etc. With gender, age and years of service as independent variables, logistic regression analysis was performed year by year on the influencing factors of abnormal lung function. Results: From 2020 to 2022, electrocardiogram, chest radiograph and lung function abnormality rates of workers exposed to welding fumes had statistical significances (χ(2)=301.79, 7.87, 1614.54, P<0.05), and the lung function abnormality rate showed a downward trend year by year (χ(2)(trend)=1516.19, P<0.001). The abnormal rates of lung function in male workers exposed to welding fumes were higher than those in female workers (χ(2)=61.65, 8.04, 15.22, P<0.05). With the increase of age, the abnormal rate of lung function showed an increasing trend (χ(2)(trend)=6.47, 10.81, 4.72, P<0.05). The abnormal rates of lung function in the four districts around the city in each year were 22.05% (318/1442), 8.91% (171/1919) and 6.48% (273/4212), respectively. Year by year logistic regression analysis showed that females were the protective factors for abnormal lung function (OR=0.369, 0.568, 0.546; 95%CI: 0.298-0.458, 0.367-0.879, 0.388-0.767; P<0.05) . Conclusion: Attention should be paid to the health status of welding fumes workers in Tianjin, focusing on the protection of middle-aged male workers, and effective prevention measures should be taken for key areas and industries such as the four districts around the city.

Analysis of cytogenetic indexes and occupational characteristics of radiation workers with lens opacity

Objective: To analyse the characteristics of micronuclus and chromosomal aberrations and the lens opacity in different working years, ages and work type of radiation workers with lens opacity. Methods: In January 2022, we selected 400 radiation workers with lens opacity who had undergone occupational health examination in Hangzhou Hospital for the Prevention and Treatment of Occupational Disease from March 2014 to December 2021 as research objects. To analyze the differences of micronucleus, chromosome aberration and the lens opacification rates of different length of service, type of work, age radiologic workers. Results: The results showed that radiation the micronucleus abnormality (0.59‰) and chromosome aberration (2.67%) in peripheral blood in workers who served more than 20 years were significantly higher than that of micronucleus abnormality (0.18‰) and chromosome aberration (0.31%) in workers served less than 20 years, the differences were statistically significant (P<0.05). The micronucleus abnormality (0.32‰) and chromosome aberration (0.57%) in the interventionist were higher than oral radiation workers (0.12‰ and 0.19%) and diagnostic radiologist (0.05‰ and 0.12%), the differences were statistically signcficant (χ(2)=23.98, 6.72, P<0.05) . Conclusion: The rates of micronucleus and chromosome aberration of the interventionaist are higher than oral radiation workers and the traditional radiologist. Workers engaged in radiation should improve personal protection and undertake regular occupational health examinations.

Application of Earned Value Analysis Method and Earned Schedule Method to Time and Cost Control In Bank X Building Project

Construction projects are activities that must be completed within limited time and resources. This research aims to identify risky activities and make control efforts to reduce the level of hazard risk in the installation of steel box girder on the bridge. This research used a mixed methods approach, combining quantitative and qualitative methods. Data were collected through surveys and interviews with 60 respondents from 35 bridge projects. The results showed that there were 29 variables of work accident risk factors, including 3 variables with moderate risk levels, 24 variables with high risk levels, and 2 variables with extreme risk levels. The highest risk factors were mobilization that caused congestion and crane overturning during girder lifting that caused operators to fall. To reduce the risk level, efforts are made to ensure all work is done correctly, conduct regular safety inspections, and ensure an effective communication system in the installation of steel box girders on the bridge. The findings can serve as a basis for policy makers to develop better OHS regulations and guidelines, as well as provide valuable information for the development of more effective safety training programs for workers in the construction sector.

Nursing Care and Ethical Challenges in the COVID-19 Pandemic: A Review

The COVID-19 pandemic has placed unprecedented pressures on healthcare systems across the globe, with nurses playing a pivotal role in managing patient care during this crisis. As front-line caregivers, nurses were not only responsible for delivering essential medical care but also found themselves navigating a series of ethical challenges that were often fraught with complexity. This review delves into the multifaceted role of nursing during the pandemic, focusing on both the clinical care provided and the significant ethical dilemmas faced by nurses. One of the most pressing ethical challenges was the allocation of scarce medical resources. The surge in COVID-19 cases led to critical shortages of ventilators, ICU beds, personal protective equipment (PPE), and other medical supplies. Nurses, often collaborating with multidisciplinary teams, were forced to make difficult decisions regarding which patients would receive these limited resources, raising profound ethical concerns about fairness and equity in healthcare. The review highlights the need for transparent, consistent decision-making frameworks that prioritize justice and equity. Such frameworks help ensure that resource allocation is guided by ethical principles rather than subjective judgments, thus fostering a fairer and more consistent approach to patient care. Another significant ethical issue addressed in this review is the balance between personal safety and professional duty. Nurses were often placed in situations where they had to weigh their commitment to patient care against the risks posed to their own health, particularly when faced with shortages of adequate PPE. This balancing act between personal safety and professional obligation introduced ethical dilemmas, such as the extent to which nurses were adequately informed of the risks they faced and whether healthcare institutions fulfilled their responsibility to provide a safe working environment. The review underscores the importance of developing robust infection control measures and ensuring the continuous supply of PPE to safeguard the health and well-being of healthcare workers. Patient autonomy and consent were also critical concerns during the pandemic. The urgency of care for critically ill COVID-19 patients, combined with isolation protocols that restricted family involvement, made it challenging to uphold patients' decision-making rights. The review explores how informed consent processes were affected by the rapid progression of illness and the necessity for immediate medical interventions, often with limited patient or family input. This issue further underscores the need for ethical guidelines that protect patient rights while ensuring timely and effective care. The psychological impact of the pandemic on nurses is another key focus of this review. Nurses faced not only physical exhaustion from long hours of work but also significant emotional strain from witnessing high mortality rates and making difficult ethical decisions. The review emphasizes the need for mental health resources, such as counseling and support groups, to help nurses cope with the emotional toll of their work. Addressing issues such as moral injury, compassion fatigue, and burnout is essential to maintaining a resilient nursing workforce. In conclusion, this review provides a comprehensive examination of the ethical challenges faced by nurses during the COVID-19 pandemic. It highlights the critical need for clear ethical guidelines, transparent resource allocation frameworks, protective measures, and mental health support systems. The lessons learned from this pandemic are invaluable for shaping future responses to global health crises, ensuring that nurses and other healthcare professionals are better equipped to navigate the ethical complexities of emergency care.

Musculoskeletal, Pulmonary, and Cardiovascular COVID-19 Sequelae in the Context of Firefighter Occupational Health: A Narrative Review.

For most individuals infected with SARS-CoV-2, the acute illness resolves completely. However, for millions of people, symptoms or sequelae from COVID-19 recur or persist for months to years after infection. Post-COVID-19 sequelae are wide-ranging, often affecting the musculoskeletal, pulmonary, and cardiovascular systems. All who experience post-COVID-19 sequelae face significant challenges navigating home and work life. Occupations such as firefighting, however, are of particular concern given the strenuous nature of a job that relies on a healthy musculoskeletal, pulmonary, and cardiovascular system. Research has documented significant musculoskeletal impairment (including muscle weakness, pain, and fatigue), respiratory dysfunction (including reduced lung function, interstitial disease, and diffusion abnormalities), cardiovascular conditions (including cardiac events, ischemic disease, dysrhythmias, and infectious diseases), and diminished cardiorespiratory fitness that continues for months to years in some individuals. These persistent post-COVID-19 conditions may affect a firefighter's ability to return to work, function at full capacity while at work, and potentially compromise firefighter health and public safety. This review, therefore, explores musculoskeletal, pulmonary, and cardiovascular sequelae post-COVID-19 and the impact of these sequelae on firefighter health and occupational readiness.