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This article focuses on the number of accidents at work in enterprises in the steel industry. Accidents have a significant effect on the operations of enterprises due to the social and economic costs they generate. This article presents the dependence between the number of accidents at work, demographic characteristics (sex, age) and work experience of injured persons, which allows for the identification of risk groups based on to the tested feature. The scope of the analysis covers the structure of accidents at work in the steel industry in the years 2009-2015. The aim of this article is to present the dependence between the number of accidents at work and the demographic characteristics and work experience of workers employed in the industry under examination. The conducted analysis led to the conclusion that there is a relation between the number of accidents at work and the demographic characteristics of persons sustaining an accident at work. In the period between 2009-2015, male workers aged 30-39 were involved in accidents at work the most frequently. The research methodology applied in this article consists of: absolute and generic analysis of work accidents, ratio analysis and statistical analysis of the relation between the number of accidents at work and the demographic characteristics of workers injured in accidents. The applied methodology of analysis of accidents at work may be used for a benchmark analysis of various industry sectors in any country or the same sectors in various countries.

Depression symptoms are one of the most common psychiatric disorders and affect all aspects of life. The impact of depression symptoms on sick leave in the working population is a major issue that requires a more comprehensive examination. This systematic review used the PRISMA method to identify eligible studies (n = 15). Subsequently, the association between depression symptoms and sick leave was examined and several important subgroup analyses were performed. Depression symptoms were associated with sick leave, with an overall risk ratio (RR) of 1.52 [95% confidence interval (95% CI) 1.34–1.73]. In men, the result displayed RR 2.19 (95% CI 1.17–4.09) and in women, the result showed RR 1.54 (95% CI 1.35–1.76). Additional subgroup analyses that account for methodological differences across studies based on the method of assessing depression symptoms and sick leave showed that this association was consistent. Depression symptoms are associated with sick leave. Given that sick leave can have an economic and social burden, more attention to depression symptoms is necessary.

Utilizing emergency department admissions to estimate and describe agricultural injuries in the United States (U.S.) provides a unique view of one of the country's most dangerous occupations. This study characterizes and provides nationally representative estimates of persons with non-fatal agricultural-related injuries treated in emergency departments in the U.S.We conducted a cross-sectional study using U.S. Consumer Product Safety Commission, National Electronic Injury Surveillance System (NEISS) data for patients treated in emergency departments from January 1, 2015 to December 31, 2019. We queried all cases in the NEISS database using the location code "farm" and with a narrative search using relevant key words.An estimated 62,079 people were treated in an emergency department for agricultural related injuries. The mean age estimate in this population was 39 years-old, with ages ranging from 1 to 95. Almost two-thirds of patients were male, and almost 80% were white. Approximately 30% and 22% of those injured were youth and elderly patients, respectively. The majority of injuries occurred from April through September. The most common injury was fracture, followed by open wound or amputation. There were significant differences between the body parts injured in youth versus adult patients. The primary source of injury was in the vehicles category, with tractors being the dominant vehicle type.Agricultural vehicles remain a major source of injuries that require treatment in emergency departments. Previous methods of quantifying severe ag-related injuries were limited; our research utilized NEISS data to portray injury statistics more accurately.

Agricultural work involves ergonomic and psychosocial strain, which contribute to musculoskeletal conditions. The aim of this study was to assess if specific ergonomic, psychosocial, and preventive factors are linked to musculoskeletal pain or discomfort symptoms (MSS) in farmers and ranchers. We analyzed data from the Central States Center for Agricultural Safety and Health survey that was conducted in 2018 in a seven-state region of the central United States. MSS were assessed with questions from the Standardized Nordic Questionnaire. The survey included questions on demographic, ergonomic, psychosocial and preventive factors. Farm production variables were added from the Farm Market iD database. We analyzed the data using Generalized Estimating Equations. The overall prevalence of MSS for all body sites combined was 59% among 4,354 farmers and ranchers who responded (19% response rate). After controlling for age, sex, and operator status, three factors (high stress level, sleep deprivation, and exhaustion/fatigue) showed the strongest associations with MSS in any body site, with adjusted odds ratios (OR) ranging from 4.8 to 5.6. Forceful exertions, repetitive tasks, awkward postures, frequent manual labor, and vibration were also significantly associated with MSS, with adjusted ORs ranging from 1.8 to 3.3. Recommended preventive techniques were not protective for MSS. New effective strategies are needed to reduce the high burden of musculoskeletal outcomes among farmers and agricultural workers.

PurposeThe aim of the study is to determine the prevalence of absenteeism and presenteeism and explore their association with work performance among support workers in a medical school hospital in Thailand.Design/methodology/approachA cross-sectional study was conducted among 1,102 support workers in the Faculty of Medicine Ramathibodi Hospital, Mahidol University, in June–August 2020. The World Health Organization Health and Work Performance Questionnaire (HPQ) was used to assess absenteeism, presenteeism, work performance and related factors. Multiple logistic regression was used to examine the association between current work performance and absenteeism and presenteeism in the past year.FindingsA total of 505 (45.8%) support workers completed the self-report questionnaire. Prevalence of sickness absence, non-sickness absence and presenteeism in the past year was 54.2%, 81.4% and 48.1%, respectively. Sickness absence and presenteeism in the past year were significantly associated with increased odds of poor work performance: (OR 3.05, 95% CI: 1.24–7.49) and (OR 5.12, 95% CI: 2.25–11.64), respectively. Support workers with high levels of stress and burnout were 3.89 (95% CI: 1.56–9.68) and 2.66 (95% CI: 1.50–4.72) times more likely to report poor work performance.Originality/valueSickness absence and presenteeism are associated with poor work performance in hospital support workers. Other factors such as stress and burnout also contribute to poor work performance, and interaction among these factors needs further research. To improve productivity, hospital administrators might consider intervention programs to enhance work performance among workers with sickness absence and presenteeism.

Polymer processing belongs to the category of hazardous industries and requires a deep and comprehensive analysis of the production environment from a hygienic point of view in order to minimize the negative impact on human health and components of the biosphere. The purpose of the study. It is important to study a set of adverse factors that affect employees in the process of processing polymer waste, to establish the relationship with the development of general and occupational diseases. Results and discussion. It has been established that the working conditions of the process of processing polymer waste have a combined effect on the body caused by a set of adverse production factors of different actions. The main ones are: dust in the air of the working area with polymer dust with mixed and unstable composition over time, noise, cooling microclimate, difficulty of work. The excess of maximum permissible concentration for dust load on the body of workers in the process of mechanical processing of PPV is from 1.35 times to 1.74 times, at the workplaces of the baler and shredder and unloading-packing operator (working conditions class 3.1). Exceedance of the sound pressure level in the range from 2 dBA to 15 dBA was recorded at all workplaces (working conditions class 3.2). The parameters of the microclimate at all workplaces, except for the forklift operator, belong to the harmful class of working conditions 3.1. According to the severity of the labor process, the working conditions of employees vary from allowable 2 (operator of the technological process) to harmful 3.2 (baler and shredder operator). In terms of intensity, the working conditions of all employees belong to harmful class 3.2, due to the significant noise load, which prevents the capture and transmission of information between participants in the processing process, as well as timely receipt of audio signals from the process operator and equipment. Mostly working conditions of employees in the process of processing PPV mixtures belong to class 3.2, except for the forklift operator (class 3.4). As for the integrated assessment, according to the hygienic classification, working conditions of operators of unloading-packing, crushing, technological process and baler are evaluated according to class 3.2, and the truck operator - 3.4 according to state sanitary rules and regulations "Hygienic classification of labor according to the indicators of harmfulness and danger and the intensity of the labor process" (order of the Ministry of Health dated 08.04.2014 No.248,), which can lead to the development of work-related diseases

Hypothermia is a situation in which the internal body temperature drops below 35 degrees Celsius. The article presents the relevance, theoretical aspects and features of the action of general hypothermia on the heart in general and cardiomyocytes in particular. The purpose of the study was to study the changes in the myocardium under the action of general hypothermia at different levels of structural organization. The object of the study were the hearts of laboratory adult rats. The study involved 20 animals. The longitudinal section shows that the right ventricle is much thinner than the left and its cavity is presented in the form of a crescent. The interventricular septum is thicker than the wall of the right ventricle and goes into its cavity. Results. To establish the shape of the heart and track the dynamic changes at the organ level, we calculated an index showing the ratio of the width of the heart to its length. In 80% of cases, the heart shape of intact rats was conical, the index averaged 55%, only 20% elliptical, the index was more than 65%. We did not observe other forms of heart in the group of intact rats. In the experimental groups, a spherical heart shape appeared. The thickness of the anterior wall of the left ventricle for 10 days from the beginning of the experiment was 3.15±0.11 mm, the side wall 3.1±0.11 mm, the posterior wall 2.45±0.04 mm, interventricular septum 2.95±0.09 mm. In the right ventricle, the thickness of the anterior wall is 1.04±0.03 mm, the posterior wall is 1.36±0.04 mm. On the 30th day from the beginning of the experiment, the thickness of the anterior wall of the left ventricle was 3.21±0.11 mm, the side wall 2.65±0.06 mm, the posterior wall 3.27±0.09 mm, the interventricular septum 3.14±0.13 mm. In the right ventricle, the thickness of the anterior wall is 1.09±0.04 mm, the posterior wall is 1.38±0.03 mm. Conclusions. The increase in heart mass, change in its shape due to changes in the middle third of the heart wall of both the left and right ventricles. The highest rates were in the middle third of the heart (zone "B"): In all layers of the myocardium there is an increase in the diameter of cardiomyocytes, a decrease in the distance between individual cardiomyocytes and their groups. The distance between adjacent cardiomyocytes in the left ventricle is: in the outer layer 1/8 of the diameter of the cardiomyocyte, between groups of cardiomyocytes 1/4 of the diameter of the cardiomyocyt

BACKGROUND: Law enforcement agencies often include fitness testing as part of the hiring process. However, it can be months from this testing to when a recruit starts academy. OBJECTIVE: To determine fitness changes from hiring to academy in recruits who graduate (GRAD) or separate (SEP; do not complete) from academy. METHODS: Analysis on recruits from one agency, split into GRAD (n = 436) and SEP (n = 78) groups, was conducted. These tests were conducted during initial hiring and academy: push-ups, sit-ups, and arm ergometer revolutions in 60 s; 75-yard pursuit run (75PR); and 2.4 km run. Data were analyzed via a two-way repeated measures ANOVA. Change scores were derived between hiring and academy data for both groups, and analyzed via independent samples t-tests. RESULTS: Push-ups, 75PR, arm ergometer, and 2.4 km run generally improved (p≤0.001). There were no significant between-group interactions or differences in performance changes for GRAD and SEP recruits. SEP recruits tended to have lesser fitness test performance compared to GRAD recruits. CONCLUSIONS: GRAD and SEP recruits showed some fitness improvements between initial hiring through to academy. However, SEP recruits with lesser muscular endurance, running speed, and aerobic capacity during hiring did not substantially improve by academy, which likely impacted their academy survivability.

Bakers are at high risk of rhinitis and asthma, but the prevalence of these occupational diseases is not well known in Sub-Saharan Africa. We investigated the prevalence of occupational rhinitis and asthma among industrial bakers in the former province of Katanga. In a cross-sectional study conducted in eight towns from October 2018 to September 2019, we included 276 male workers from 18 industrial bakeries and 113 male controls (35 butchers and 78 bread sellers), all nonsmokers. Participants replied to a validated questionnaire (European Community of Respiratory Health Survey II), administered face to face, and performed spirometry at the work place. In 15 bakers with symptoms of work-related asthma, records of self-measured peak expiratory flow (PEF) 4 times per day during 4 weeks were analyzed by the OASYS (Occupational Asthma System) protocol. The bakers and controls did not differ by age (32.2 ± 7.3 y vs 32.8 ± 10.3 y). According to the questionnaire, work-related rhinitis and asthma were significantly more prevalent among bakers (31% and 5%, respectively) than among controls (2% and 0%, respectively). However, the groups did not differ significantly with regard to spirometric parameters. Based on PEF records, 10 out of 15 were positive for occupational asthma (OASYS score > 2.5), so the rate of occupational asthma was 3.6% in this study. This first study in DR Congo demonstrates the existence of occupational rhinitis and asthma among industrial bakers in Katanga. Further epidemiological studies are needed to clarify the extent and risk factors of baker’s asthma in the area. In the meantime, advocacy and implementation of appropriate occupational hygiene measures are warranted to protect bakery workers in DR Congo.

BACKGROUND: Worksite wellness programs have the ability to activate health promotion and stimulate behavior change. OBJECTIVE: To measure longitudinal associations between visits with a Registered Dietitian Nutritionist (RDN), as part of worksite wellness programs, on dietary and lifestyle behavior changes. METHODS: The study sample included 1,123 employees with 77 different worksite wellness programs across the United States from March to December 2017. Hierarchical linear modeling was used to evaluate the associations of RDN visits with behavior changes. RESULTS: The mean BMI at baseline was 33.48, indicating over half of all employees are considered obese. Employees who attended more than one visit showed an increase in whole grain consumption and corresponding weight loss (t-ratio = 2.41, p = 0.02). Age played a significant factor in the rise of systolic blood pressure; employees who attended more visits showed an increase in whole grain consumption and corresponding blood pressure (t-ratio = –2.11, p = 0.04). CONCLUSIONS: RDNs as part of worksite wellness programs, can contribute to improvements in lifestyle behavior changes. These data highlight the need for nutrition intervention at the workplace. Research on nutrition-focused worksite wellness programs is needed to assess the long-term health outcomes related to dietary and lifestyle behavior changes.

Introduction. Compensation programs for radiation-induced diseases in some foreign countries. The data presented in UN documents. The linkage between irradiation and certain diseases in the Russian Federation. Conclusion.

BACKGROUND: Work-related fatigue can cause disruption in mental and physical activities of the workers. Considering the importance of recovery from fatigue in emergency services, as seen in firefighting duties, the preparation and validation of the Need For Recovery Scale (NFRS) questionnaire can be useful and effective. OBJECTIVE: This study assessed the reliability and validity of the Persian version of Need For Recovery Scale among industrial firefighters. METHODS: Need for recovery scale contains 11 questions. First, a questionnaire was translated using backward-forward method. Then, for measuring validity of the questionnaire, the opinions of 10 experts in related fields were obtained. Content Validity Index (CVI) and Content Validity Ratio (CVR) were calculated. The reliability was determined through 107 questionnaires completed by the industrial firefighters. RESULTS: The average age of the firefighters in this study was 37.5 years and they had an average of 10 years of work experience. The mean Need For Recovery Index from fatigue was 33.03 for the study population. Of the first 11 questions, 9 questions in the original NFRS showed a satisfactory level of CVR. The Content Validity Index and Cronbach’s α were 0.89 and 0.77 respectively. CONCLUSION: Based on the results, the Need For Recovery Scale is a reliable tool for assessing fatigue and revealed an acceptable level of validity and reliability that makes it usable for fatigue assessment in the industrial firefighters.

Diurnal temperature range (DTR) is a meteorological indicator closely associated with global climate change. Thus, we aim to explore the effects of DTR on the outpatient and emergency room (O&ER) admissions for cardiovascular diseases (CVDs), and related predictive research. The O&ER admissions data for CVDs from three general hospitals in Jinchang of Gansu Province were collected from 2013 to 2016. A generalized additive model (GAM) with Poisson regression was employed to analyze the effect of DTR on the O&ER admissions for all cardiovascular diseases, hypertension, ischemic heart disease (IHD) and stoke. GAM was also used to preform predictive research of the effect of DTR on the O&ER admissions for CVDs. There were similar positive linear relationships between DTR and the O&ER visits with the four cardiovascular diseases. And the cumulative lag effects were higher than the single lag effects. A 1 °C increase in DTR corresponded to a 1.30% (0.99–1.62%) increase in O&ER admissions for all cardiovascular diseases. Males and elderly were more sensitivity to DTR. The estimates in non-heating season were higher than in heating season. The trial prediction accuracy rate of CVDs based on DTR was between 59.32 and 74.40%. DTR has significantly positive association with O&ER admissions for CVDs, which can be used as a prediction index of the admissions of O&ER with CVDs.

Objectives Diisocyanates are a chemical group that are widely used at workplaces in many sectors. They are also potent skin- and respiratory sensitizers. Exposure to diisocyanates is a main cause of occupational asthma in the European Union. To reduce occupational exposure to diisocyanates and consequently the cases of diisocyanate-induced asthma, a restriction on diisocyanates was recently adopted under the REACH Regulation in the European Union. Methods A comprehensive evaluation of the data on occupational exposure to the most important diisocyanates at workplaces was made and is reported here. The diisocyanates considered are methylene diphenyl diisocyanate (MDI), toluene diisocyanate (TDI), and hexamethylene diisocyanate (HDI), accounting for more than 95% of the market volume in the EU. The exposure assessment is based on data from Chemical Safety Reports (CSRs) of REACH Registration Dossiers, workplace air monitoring data from Germany, from the UK Health and Safety Executive (HSE), and literature data relevant for the EU, and the USA. Results Occupational exposure to diisocyanates is particularly relevant in: (i) C.A.S.E. applications (Coatings, Adhesives, Sealants, Elastomers), (ii) production of polyurethanes (PUs) (e.g. slab-stock foam), (iii) handling of partly uncured PU products (e.g. cutting, demoulding, spray application of foam), and (iv) when diisocyanates/PUs are heated (e.g. hot lamination, foundry applications/casting forms). Ranking of the reported data on inhalation to diisocyanate exposure at workplaces (maximum values) leads to following order: (i) HDI and its oligomers in coatings, (ii) MDI in spray foam applications, (iii) TDI in manufacture of foam, (iv) TDI in manufacture of PUs and PU composite materials, (v) TDI in adhesives, (vi) MDI in adhesives, (vii) MDI in manufacture of PUs and PU composite materials, (viii) TDI in coatings, (ix) MDI in manufacture of foam, and (x) HDI in adhesives.

International audience; Aims: We conducted a cross-sectional study on healthcare workers from the University Hospital in Clermont-Ferrand. They received a self-report questionnaire consisting of the Maslach Burnout Inventory, Job Demand Control Support, Effort-Reward Imbalance model, and questions about ethical conflict in order to investigate on burnout.Results: We included 1774 workers. Overinvestment was the only factor explaining the increase in emotional exhaustion, depersonalization, and the decrease in personal accomplishment. Taking into account the absence of burnout as a reference, overinvestment multiplied the risk of high burnout by 22.0 (5.10 to 94.7).Conclusion: Some “forgotten” occupations among healthcare workers are at risk of burnout. Overinvestment was the main factor explaining the increase in the tree dimensions of burnout. Moreover, the two main models of stress at work were highly predictive of burnout.

The Covid-19 pandemic has upended the way we work, raising challenges but also rapidly accelerating the adoption of digital technologies to facilitate remote work. Although remote work poses certai...

Introduction When it is not possible to capture direct measures of occupational exposure or conduct biomonitoring, retrospective exposure assessment methods are often used. Among the common retrospective assessment methods, assigning exposure estimates by multiple expert rater review of detailed job descriptions is typically the most valid, but also the most time-consuming and expensive. Development of screening protocols to prioritize a subset of jobs for expert rater review can reduce the exposure assessment cost and time requirement, but there is often little data with which to evaluate different screening approaches. We used existing job-by-job exposure assessment data (assigned by consensus between multiple expert raters) from a large, population-based study of women to create and test screening algorithms for polycyclic aromatic hydrocarbons (PAHs) that would be suitable for use in other population-based studies. Methods We evaluated three approaches to creating a screening algorithm: a machine-learning algorithm, a set of a priori decision rules created by experts based on features (such as keywords) found in the job description, and a hybrid algorithm incorporating both sets of criteria. All coded jobs held by mothers of infants participating in National Birth Defects Prevention Study (NBDPS) (n = 35,424) were used in developing or testing the screening algorithms. The job narrative fields considered for all approaches included job title, type of product made by the company, main activities or duties, and chemicals or substances handled. Each screening approach was evaluated against the consensus rating of two or more expert raters. Results The machine-learning algorithm considered over 30,000 keywords and industry/occupation codes (separate and in combination). Overall, the hybrid method had a similar sensitivity (87.1%) as the expert decision rules (85.5%) but was higher than the machine-learning algorithm (67.7%). Specificity was best in the machine-learning algorithm (98.1%), compared to the expert decision rules (89.2%) and hybrid approach (89.1%). Using different probability cutoffs in the hybrid approach resulted in improvements in sensitivity (24–30%), without the loss of much specificity (7–18%). Conclusion Both expert decision rules and the machine-learning algorithm performed reasonably well in identifying the majority of jobs with potential exposure to PAHs. The hybrid screening approach demonstrated that by reviewing approximately 20% of the total jobs, it could identify 87% of all jobs exposed to PAHs; sensitivity could be further increased, albeit with a decrease in specificity, by adjusting the algorithm. The resulting screening algorithm could be applied to other population-based studies of women. The process of developing the algorithm also provides a useful illustration of the strengths and potential pitfalls of these approaches to developing exposure assessment algorithms.

Zusammenfassung Ziel der Studie Menschen mit geistiger Behinderung weisen eine geringere Lebenserwartung und häufigere Komorbidität als die Allgemeinbevölkerung sowie ungedeckte Gesundheitsbedarfe auf. Als ein Grund wird eine unzureichende medizinische Versorgung vermutet, wozu in Deutschland wenige Daten vorliegen. Die Studie widmet sich deshalb der Frage, wie Menschen mit geistiger Behinderung die medizinische Versorgung einschließlich Vorsorge und präventive Angebote in Anspruch nehmen. Methodik Querschnittstudie in 3 Werkstätten für Menschen mit geistiger Behinderung. Von Angehörigen wurde die Inanspruchnahme der Gesundheitsversorgung per Fragebogen erhoben. Die Auswertung erfolgte deskriptiv und inferenzstatistisch im Vergleich zur Allgemeinbevölkerung sowie innerhalb der Teilnehmenden auf soziodemografische Unterschiede. Ergebnisse Fast alle 181 Teilnehmer (Teilnahmequote 19,3%) haben einen Hausarzt. Im Vergleich zur Allgemeinbevölkerung nehmen die Teilnehmer die hausärztliche und die Versorgung durch zahlreiche andere Facharztgebiete häufiger in Anspruch. Die Krebsvorsorge für Dickdarm, Brust, Gebärmutterhals und Prostata nehmen sie seltener, für Haut und den Check-up öfter in Anspruch. Bei Zahnarztkontrollen und Maßnahmen der Gesundheitsförderung zeigt sich kein Unterschied. Teilnehmer aus Wohnheimen nehmen die Regelangebote mehr in Anspruch als die bei Angehörigen oder alleine Lebenden. Teilnehmer mit Migrationshintergrund kennen die Versorgungsangebote weniger gut. Schlussfolgerung Hinweise auf eine generelle gesundheitliche Unterversorgung zeigen die Ergebnisse nicht. Die Teilnahme an der Krebsvorsorge mit aufwändigeren Untersuchungen sollte gefördert werden, insbesondere für die allein oder bei Angehörigen lebenden Menschen mit geistiger Behinderung; Menschen mit Migrationshintergrund und ihre Angehörigen sollten gezielt informiert werden.

Objective. To study the causes of death from common diseases at the workplace and to develop the scientifically grounded programs aimed at their prevention and decrease. A sudden death of a person at workplace is a global issue of occupational medicine in all the countries. About 85 % of sudden deaths occur due to health status of workers, first of all, circulatory system diseases and only 15 % are caused by occupational accidents. Materials and methods. To reach the aim, there were investigated the materials of investigation of the cases of death form common diseases at the workplace for 5 years (20142018) presented by the State Labor Inspection in the Republic of Bashkortostan. Results. According to the analyzed data of medicolegal report of accidents with lethal outcome resulting from common diseases it was established that men aged 5660 years, workers, mostly of manufacturing industry, died more often (92.5 %). Program of preventive measures was worked out on the basis of the obtained results. Conclusions. High death rate from circulatory system diseases at workplace needs a complex of treatment and preventive measures to be developed, which will decrease the risk of a sudden cardiac death among workers of industrial enterprises.

Purpose We conducted a systematic review to understand the impact that return-to-work coordinators (RTWCs) have on return to work (RTW) outcomes for sick/injured workers. Methods MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science, and ABI Inform were searched from January 1, 2000 to September 16, 2020. Of 2,927 retrieved and screened citations, 14 quantitative articles fulfilled the eligibility and quality criteria. Quality assessment, data extraction, and evidence synthesis followed article screening. Results We focused on the impact of RTWCs for outcomes of work absence, RTW rates, quality of life, and cost–benefit. Our final synthesis included 14 articles. We found strong evidence that work absence duration was reduced when workers had face-to-face contact with a RTWC. As well, there was strong evidence linking face-to-face RTWC interventions with higher RTW rates and moderate evidence that this reduced intervention costs. RTWC interventions involving the identification of barriers and facilitators to RTW also showed promising results. However, only limited evidence was found that RTWCs improved quality of life for workers. Conclusions Our synthesis identifies key features of RTW interventions that improve RTW outcomes. Future high-quality research should measure long-term outcomes of RTWC interventions to evaluate sustainability and consider the nature of work. They should also focus on RTWC impact on worker quality of life assessments and for older workers and workers with chronic health conditions.

Zusammenfassung Hintergrund Die Studienzeit ist eine Phase, in der die jungen Erwachsenen mit spezifischen Anforderungen konfrontiert werden. Studierende der Medizin gelten als besonders psychisch belastet. Untersuchungen, in denen sie diesbezüglich mit Studienfächern der gleichen Branche verglichen werden, sind jedoch rar. Fragestellung Ziel der Untersuchung war es, die psychische Gesundheit von Medizinstudierenden sowie von Gesundheits- und Pflegemanagementstudierenden zu untersuchen und zu vergleichen. Material und Methoden Untersucht wurden Studierende der Studiengänge Gesundheits- sowie Pflegemanagement (WHZ) und Medizinstudierende der (TU Dresden). Verschiedene Aspekte psychischer Gesundheit wurden mithilfe eines Online-Fragebogens erhoben. Dieser beinhaltete die Instrumente zur Erfassung der Prüfungsängstlichkeit (TAI-G-Kurzskala) und psychischen Belastung (BSI-18), sowie ein Item zur Ermittlung der subjektiv wahrgenommenen Studienbelastung. 258 Studierende nahmen an der Befragung teil. Ergebnisse Es konnten keine signifikanten Unterschiede hinsichtlich des Gesamtscores der Prüfungsängstlichkeit und der psychischen Belastung zwischen den Studierenden beider Studienfächer festgestellt werden. Dahingegen gaben Medizinstudierende an, dass sie im Vergleich zu Studierenden der anderen beiden Studienfächer eine signifikant höhere Studienbelastung wahrnehmen. Schlussfolgerung Die ermittelten Gesamtscores lagen teilweise über den Werten in vergleichbaren Studien. Die Studierenden sollten bereits präventiv unterstützt werden, um eigene Bewältigungsstrategien zu entwickeln. Nicht nur die Bereitstellung von Hilfen ist notwendig, sondern vielmehr das aktive Eingreifen mithilfe von gesundheitsfördernden Maßnahmen durch die Institution Hochschule, in die die Studierenden frühzeitig integriert werden sollten.

Zusammenfassung Hintergrund Trotz einer hohen Zahl an Abschlüssen in der Humanmedizin ist in Deutschland immer häufiger von einem Ärztemangel die Rede. Ein Grund ist die schwierige Vereinbarkeit von Kliniktätigkeit und Familienleben, die vor allem Ärztinnen als Hauptgrund für die spätere Arbeit im nicht-kurativen Bereich nennen. Ziel der Arbeit Die vorliegende Arbeit befasst sich mit dem Einfluss des Elternstatus von Ärztinnen und Ärzten auf ihre Karriereentwicklung und das Belastungserleben am Ende der Weiterbildung. Darüber hinaus betrachtet werden die Auswirkungen von befristeten Arbeitsverträgen und erlebter Unterstützung durch den Partner auf das Belastungserleben. Material und Methoden Es wurden die Daten der KarMed-Studie, welche sich mit Karriereverläufen von Ärztinnen und Ärzten während der fachärztlichen Weiterbildung beschäftigt, ausgewertet. Die vorliegende Arbeit befasst sich mit der querschnittlichen Analyse des Erhebungszeitraums von Oktober 2015 bis Mai 2016. Zu diesem befanden sich 433 StudienteilnehmerInnen am Ende ihrer Weiterbildung. Eingesetzt wurden u. a. die Fragebögen Work-Family Conflict und Family-Work Conflict Skalen. Ergebnisse Ärztinnen mit Kind unterbrechen die Weiterbildung fünfmal häufiger als ihre Kolleginnen ohne Kind und achtzehnmal häufiger als Ärzte mit Kind. Ärztinnen mit Kind sowie Ärzte mit Kind weisen signifikant höhere Werte auf der Family-Work Conflict Skala auf, Ärztinnen ohne Kind hingegen höhere Werte auf der Work-Conflict Skala. Bei Ärzten zeigt sich kein signifikanter Unterschied auf der Work-Family Skala. Weder ein befristeter Arbeitsvertrag noch die Verteilung von Kinderbetreuung zwischen Ärztinnen/Ärzten und ihren Partnern/-rinnen haben einen signifikanten Einfluss auf das Belastungserleben zur Folge. Schlußfolgerung Es besteht ein Bedarf die Konflikte, die aus dem Familienleben auf das Arbeitsleben wirken insbesondere für Ärztinnen in Weiterbildung zu reduzieren.

Zusammenfassung Ziel der Studie U-Vorsorgeuntersuchungen und Impfungen sind zentrale Vorsorgemaßnahmen des Kindesalters, wobei bisher keine quantitativen Angaben zu deren wechselseitiger Akzeptanz vorlagen. Ziel dieser Studie war die Quantifizierung dieser Verteilungsmuster und Identifikation von Assoziationen zwischen Vorsorgeuntersuchungen und definierten Routineimpfungen bei Einschulungskindern unter Berücksichtigung des sozialen Umfeldes. Methodik Im Rahmen der Schuleingangsuntersuchungen 2015 wurden unter anderem die dokumentierte U-Vorsorgeuntersuchungen und Routineimpfungen auf Stadtebene erfasst. Begleitend wurde ein freiwillig auszufüllender Proxy-Fragebogen an die Fürsorgeberechtigten der Einschulungskinder ausgegeben, um ergänzend Merkmale der familiären Lebensverhältnisse zu erfassen. Unter Verwendung von SPSS 25.0 wurden die Teilnahmequoten aller U-Vorsorgeuntersuchungen und definierter Routineimpfungen nebst spezifischer Kreuzprävalenzen und Risikoschätzer errechnet. Ergebnisse Von den 407 Einschulungskindern wurden bei 76,8% der Vorschulkinder beide Präventionsmaßnahmen vollständig durchgeführt, wobei innerhalb der gesamten Studienkohorte von 280 (68,8%) ein Zusatzfragebogen abgegeben wurde. Am häufigsten hatten in Deutschland geborene Kinder zu 70,3% und zu 69,7% mit deutscher Nationalität komplette Vorsorgeuntersuchungen mit zugleich vollständigem Impfstatus. Hinsichtlich des familiären Umfeldes hatten Kinder mit Geschwistern (17,5%), Kinder mit getrenntlebenden Elternteilen (13,3%) und Familien mit bis zu 4 näheren Angehörigen (7,1%) deutlich seltener alle Vorbeugemaßnahmen komplett als andere. Die stärksten Assoziationen in Hinblick auf unvollständige Vorsorgeuntersuchungen waren für ein nichtdeutsches Geburtsland des Kindes (OR=7,95) und für eine nichtdeutsche Nationalität mindestens eines Elternteiles (OR=4,52) vorzufinden. Schlussfolgerungen Die identifizierten Verteilungsmuster und Assoziationen lieferten neue Erkenntnisse für die Etablierung von risikogruppenspezifischen Maßnahmen zur Steigerung der Akzeptanz sowohl bei U-Vorsorgeuntersuchungen als auch in Hinblick auf definierte Routineimpfungen. Dadurch kann eine bedarfsoptimierte Gesundheitsversorgung bei Kindern im Sinne eines sozialkompensatorischen Ansatzes ermöglicht werden.

The main mission of the International Agency for Research on Cancer (IARC/WHO) is to conduct research for cancer prevention worldwide. The strategies of the IARC to reduce the occupational cancer burden include enhancing cancer surveillance, evaluating and classifying potential human carcinogens, and conducting epidemiological research to fill gaps in knowledge on occupationally related cancers. Beyond the IARC work, it is essential to systematically monitor occupational exposures in workplaces, in order to effectively protect workers. There are multiple sources of information about occupational exposures in workplaces, but they are often not used for hazard surveillance or for research. The Russian Federation has great potential to advance research and worker protection due to their strong tradition to monitor and record exposure concentrations in workplaces. Currently most evidence regarding occupational cancer burden comes from Western Europe and North America. Estimation of the burden of occupational cancer requires accurate data from local settings as extrapolating data from other settings may be misleading due to major differences in exposures, exposure pathways and baseline cancer risks. To fill this knowledge gap, it is important to conduct exposure surveillance and epidemiological studies on occupational cancer in the Russian Federation.

Background Caregivers in healthcare settings are exposed to a risk of antineoplastic drug contamination which can lead to adverse health effects. Biological monitoring is necessary to estimate the actual level of exposure of these workers. This study was conducted with the aim of assessing blood contamination levels by irinotecan and its metabolites of pharmaceutical staff operating inside and outside a compounding unit. Methods The study took place within the pharmaceutical unit of a French comprehensive cancer centre. Blood samples were collected from the pharmacy workers operating inside and outside the compounding unit, and analysed by UHPLC-MS/MS. Plasma and red blood cell irinotecan and its metabolites (SN-38; APC) were determined with a validated analytical method detection test. Results A total of 17/78 (21.8%) plasma and red blood cell-based assays were found to be contaminated among staff. Overall, the total number of positive assays was significantly higher for staff members working outside the compounding unit than for workers working inside it ( P = 0.022), with respectively 5/42 (11.9%) and 12/36 (33.3%) positive assays. For plasma dosages, the “outside” group had a significantly higher number of positive assays ( P = 0.014). For red blood cell-based assays, no significant difference was found ( P = 0.309). Conclusions This study reveals that pharmaceutical staff serving in health care settings are exposed to a risk of antineoplastic drug contamination, not only inside the compounding room but also in adjacent rooms. The results would help to raise awareness and potentially establish protective measures for caregivers working in areas close to the compounding room as well.

Introduction. In current conditions, the preservation of the health of the able-bodied population is of particular relevance and is an essential task of occupational health and ensuring social guarantees for employees. The study aims to scientifically substantiate the main requirements of the standards aimed at preserving employees' health. Materials and methods. The materials of harmful production factors, occupational morbidity at mining and coal industry enterprises, ferrous metallurgy, aluminum production plants are analyzed. We perform Cross-sectional epidemiological studies to assess the risk of developing chronic general somatic diseases. Results. We present the justification of the platform of standards based on the risk assessment of violation of worker's health in the extraction and processing of ore and coal minerals. The share of jobs with harmful working conditions at these enterprises ranges from 73 to 90%. We have the indicators of occupational morbidity and quantitative assessment of the occupational risk of developing chronic general somatic diseases. Conclusions. We give a comprehensive assessment of the current state of working conditions, the levels of occupational morbidity, the prevalence of production-related diseases in workers associated with the impact of production factors at enterprises of the leading sectors of the economy. It served as a justification for developing a platform of standards that include measures to reduce the risk of employee health disorders.

Zusammenfassung Hintergrund MERCED ist eine randomisierte kontrollierte Versorgungsstudie zu Wirksamkeit und Nutzen einer medizinischen Rehabilitation (MR) bei sozialversicherten Erwerbstätigen mit einer chronisch entzündlichen Darmerkrankung. Im Vergleich zur fortgesetzten Routineversorgung („usual care“) zeigte sich für die Interventionsgruppe (IG) im Mittel 8 Monate nach MR ein moderater, aber klinisch relevanter Zusatznutzen für verschiedene Teilhabe-, klinische und psychologische Parameter. Für die Entwicklung des Erwerbsstatus, der Arbeitsunfähigkeitstage und die subjektive Erwerbsprognose ergaben sich jedoch keine Vorteile gegenüber der Kontrollbedingung. Methodik Wir nutzten mit Fragebögen erfasste Berichte und Bewertungen der 211 Mitglieder der IG zu ihrem Zugang zur MR, den Reha-Prozessen und deren subjektiven Erfolgen sowie Effekten im prä-post-Vergleich. Ergebnisse Drei Leistungsangebote der Reha-Kliniken mit Bezug zur Erwerbsfähigkeit und Berufstätigkeit (Beratungen zum Arbeitsplatz, Sozialrecht, Nachsorge) erreichten 33, 48 bzw. 23% der Rehabilitanden. Versicherte mit besonderen beruflichen Belastungen zeigen gleiche Teilnahmehäufigkeit wie solche ohne. Die 3 Angebote erhalten im Vergleich zu 12 anderen auf einer 5-stufigen Skala (1=sehr gut bis 5=sehr schlecht) die schlechteren Beurteilungen (2,3 – 2,5 – 3,0). Schlussfolgerung Die relative Vernachlässigung des Problemfelds Arbeit und Beruf in der MR kann die beobachtete, i.e.S. ‚sozialmedizinische‘ Ineffektivität der Rehamaßnahmen wenigstens teilweise erklären. Aus den Erfahrungen und Daten von MERCED leiten wir Empfehlungen zur Intensivierung des Zugangs, zu den Prozessen und zur Evaluation einer beruflich stärker orientierten MR ab.

Traffic accidents are considered a major public health problem in many countries. The aim of this study was to explore the relationships between traffic climate factors (i.e., external affective demands, functionality and internal requirements), driver behaviours, dangerous driving behaviours and traffic accident involvement among taxi drivers. A total of 450 male taxi drivers participated in the study. The traffic climate scale (TCS), the driver behaviour questionnaire (DBQ), the positive driver behaviours scale (PDBS) and the Dula dangerous driving index (DDDI) were used to measure driving behaviours and traffic conditions. The results showed that there was a significant negative correlation between functionality (of the TCS) and the number of accident involvement. Further analysis demonstrated that the effect of risky driving (of the DDDI) on accident involvement was significant. Taken together, these findings suggest that functional traffic systems and driving environments play important roles in traffic accident involvement.

The study objective is to create a scale specifically for measuring driver fatigue and to analyze the scale's psychometric properties. The participants were 518 Spanish drivers. We carried out an exploratory factor analysis (EFA) and the first subsample obtained a single-item solution (eight items). We then performed a confirmatory factor analysis (CFA) with a second subsample. The results were root mean square error of approximation (rmsea) = 0.05, comparative fit index (CFI) = 0.94 and Tucker-Lewis index (TLI) = 0.92, which corroborates the previous results and maintains the same number of elements. The resulting dimension shows good reliability. The scale scores were then related to several external correlates and other scales, and showed good convergence and criteria validity. The results indicate that the scale for assessing work fatigue specifically in professional drivers - driver fatigue (DF-8) - is a reliable and valid instrument.

In the decade since the last published comprehensive report of occupational exposures in the glass wool insulation industry, many process and regulatory changes have occurred in the glass wool manufacturing sector. This paper assesses whether any significant changes in worker exposures to glass wool fibers have resulted from these process and regulatory changes. The analysis compares worker exposures to glass wool overall and across different product and job categories in the manufacturing sector prior to and after 2007, the data cutoff period for the last comprehensive update of occupational exposures in this industry. The exposure data were downloaded from the North American Insulation Manufacturers Association's synthetic vitreous fiber (SVF) exposure database, which has been continually updated with all new available SVF exposure data for the past two decades. This analysis finds no major changes in worker exposures in the glass wool manufacturing industry over the past decade, with exposures remaining well below the 1 f/cc voluntary permissible exposure limit.

Introduction. The article presents results of the study of the impact of the personal protective equipment EP-4 (0) in various assembly (overalls, jacket and trousers, jacket and semi-overall) from power frequency electric field and electrical shock on the thermal state of workers in a heating environment at air temperature 34.8 ○C and relative humidity 48%. Materials and methods. The study involved three men aged 35.3±4.6 years. They did the physical exercise for 40 minutes, had comfortable relaxation for 30 minutes after work. Recorded indices included skin temperature and moisture sensation score on 11 parts of the body, body temperature in the ear canal, heart rate, clothes temperature, heat sensation score, moisture loss, moisture evaporation efficiency. Results. Overalls using had the highest values of heat content, moisture score, heart rate changes, and body temperature increment. Heat content index in the body reached maximum permissible value using overalls earlier than other configurations. Conclusion. The research data showed overalls have the most significant impact on the human thermal state, jacket and trousers have the least impact, jacket and semi-overall take an intermediate place. The configuration including jacket and trousers, jacket and semi-overall under specific operating conditions is the most optimal. Such PPE assembly can be recommended for use in the open area in the summer season at an air temperature of 35 ○C and above, subject to protective requirements.

This study examined the shift parameters that contribute to sleep loss and on-duty fatigue in British Columbia Wildfire Service (BCWS) firefighters using sleep–wake data, work–rest data and alertness and fatigue predictions from a biomathematical model (BMM) of fatigue. A total of 40 firefighters (age: 30.4 ± 11.6 years; 13 F, 26 M) volunteered over a 14-day consecutive fireline deployment, followed by a 3-day rest period, at two separate fires in British Columbia (during the 2015 fire season). Sleep–wake data were obtained using a wrist-worn accelerometer and self-reported sleep logs. Shift start and end times were provided by the BCWS at the completion of the study. Sleep and shift data were manually entered into a validated BMM (Circadian Alertness Simulator) to generate fatigue scores and shift work patterns. Shift duration was the major contributor to fatigue, as 46% (n = 274) of shifts were ≥14 h in length and the average shift length was 13.0 ± 0.62 h. However, none of the firefighters had a high-risk fatigue score (>60). The findings from this study indicated that using a BMM of fatigue can provide important insights into shift-work parameters that contribute to workplace fatigue and sleep loss in wildland firefighters.

Background Airway obstruction is a key feature of asthma and chronic obstructive pulmonary diseases (COPD). Smoking habits and workplace exposures to vapors, gas, dusts, and fumes (VGDF) could cause or exacerbate airway obstruction. The aim of this study is to evaluate the risk of airway obstruction due to smoking and workplace exposure, and their interaction, in a large population-based study. Methods In this cross-sectional study, a sample (n = 6153) of the Swedish population aged between 24 and 76 years underwent a questionnaire, clinical examination, blood test, and spirometry to gather information on airway obstruction classified by Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria or American Thoracic Society (ATS)/European Respiratory Society (ERS) criteria, risk factors, and confounders. Occupational exposures to VGDF were rated according to a specific job-exposure matrix. Adjusted logistic regression models were used to evaluate risk factors for airway obstruction in smokers and nonsmokers. Results In total, 9.8% had airway obstruction by GOLD criteria and 10.3% by ATS/ERS. Smokers with a high likelihood of exposure to VGDF had a higher risk of airway obstruction than those not exposed (odds ratio [OR]: 1.74, 95% confidence interval [CI]: 1.15-2.65 by GOLD; OR: 1.58, 95% CI: 1.06-2.37 by ATS/ERS) especially those >50 years of age. In smokers highly exposed to VGDF, risk estimates were higher than in the whole population, and the interaction between high exposure to VGDF and smoking further increased the risk of airway obstruction. Conclusions This study suggests a possible role for interaction between cigarette smoking and VGDF exposure on the risk of airway obstruction.

Introduction. Healthcare practitioners are at increased risk of infection with infectious diseases, including the inhalation route. Healthcare practitioners use respirators of various designs providing different efficiency of protection. The purpose of the study was to improve efficiency of the respiratory protection of the healthcare practitioners in Russian Federation. There were analyzed available NIOSH publications, articles in journals Taylor & Francis, Oxford University Press, published materials of Federal Service for Supervision of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), and western training manuals. Differences in the requirements of the legislation were identified that increase the risk of infection in healthcare practitioners. There are no methods for assessing the risk level, and there are no specific requirements for selecting the respirator’s type that corresponds to the risk level. The employer is not obliged to provide the fit test for all employees. The respirator must be used timely, so it should not negatively affect the worker. But the average carbon dioxide concentration can exceed the STEL by more than two times. The certification requirements for respirators do not correspond to the conditions of their use in the hospitals. Respirators were not certified as means of protection against bioaerosols. Conclusions. Identified shortcomings in the respiratory safety of health care workers show possible ways to improve their protection by harmonizing national legislation with the best of existing Western requirements.

ZusammenfassungIm Jahr 2009 wurde in Folge eines neuen Berufsgenossenschaftlichen Grundsatzes G 46 „Belastungen des Muskel-Skelett-Systems“ von der Deutschen Gesetzlichen Unfallversicherung (DGUV) erstmalig eine Handlungsanleitung für zielgerichtete arbeitsmedizinische Vorsorge bei physischen Belastungen zusammengestellt (BGI/GUV‑I 504-46). Diese enthielt eine Checkliste zur Prüfung des Angebots arbeitsmedizinischer Vorsorge bei körperlichen Belastungen des Muskel-Skelett-Systems. Im Jahr 2013 wurden neue Anlässe für die Angebotsvorsorge bei Tätigkeiten mit wesentlich erhöhten körperlichen Belastungen eingeführt und durch eine Arbeitsmedizinische Regel (AMR 13.2) konkretisiert.Im Forschungsprojekt MEGAPHYS der Bundesanstalt für Arbeitsschutz und Arbeitsmedizin (BAuA) und der DGUV wurden Methoden zur Beurteilung physischer Belastungen verschiedener Komplexitätsstufen bearbeitet. Leitmerkmalmethoden als spezielle Screeningverfahren wurden für 6 Belastungsarten weiter- und neuentwickelt.Betriebliche Praktiker stehen bei der Gefährdungsbeurteilung vor der Frage, ob die Arbeitsbedingungen tatsächlich „wesentlich erhöhte körperliche Belastungen“ beinhalten könnten und daher eingehender zu prüfen sind.Mit dieser Checkliste soll der betrieblichen Praxis eine Hilfe zur Verfügung stehen, um zu klären, ob die konkreten Arbeitsbedingungen überhaupt wesentlich erhöhte Belastungen darstellen könnten. Sie orientiert sich am Risikokonzept für die Erkennung der Wahrscheinlichkeit körperlicher Überbeanspruchungen im Projekt MEGAPHYS. Ein Verdacht auf eine wesentlich erhöhte Belastung (Risikobereich 3) kann bereits bestehen, wenn die Ausprägung der mittels Checkliste eingeschätzten Merkmale im mittleren Risikobereich 2 („mäßig erhöhte körperliche Belastungen“) liegt.

Neela Thotha (Copper sulphate) is a mineral origin drug in Unani system of medicine (USM). Chemically, it is known as copper sulphate that formulated as CuSO4. It is used by various Unani scholars to manage different ailments in effective and safe manner as Mufrad (single) and Murakkab (compound) form viz. Amrad Jild (skin disease), Amrad Chashm (eyes diseases), Amrad Nizam Hadm (GIT diseases), Amrad Tansuliya (sexually transmit diseases), Amrad Dimag (brain diseases), Amrad Tanffus (respiratory disease) and Poisoning of certain substances. A review was done by bibliographic database from ScienceDirect, Medline, PubMed, Embase, Scopus, Ebsco Publishing's Electronic Databases, and Scirus. Search was done by using key words viz. ‘Neela Thotha’, ‘Copper sulphate ’, ‘Tootiya’, and ‘CuSO4’, literature of Neela Thotha was also collected from the renowned Unani text book viz. Khazain-ul-Advia, Mohit-e-Aazam, Makhzan-ul-Mufradat, and Mufradat-e-Azizi and also from standard conventional books viz. Indian Medicinal Plants, and Parikh’s Textbook of Medical Jurisprudence Forensic Medicine and Toxicology. In conventional medicine Neela Thotha considered as poisonous substance characterized by colicky abdominal pain, vomiting, diarrhoea, severe headache, albuminuria, dyspnoea, circulatory failure, coma and death and avoids its use in human being. While in USM after proper detoxification of Neela Thotha is used in various ailments. Neela Thotha and its formulations have been claimed by Unani scholars to be useful in the management of various ailments. In this article authors have an attempt to explore properties and used of Neela Thotha in several ailments. Keywords: Neela Thotha; Tootiya; CuSO4; Copper sulphate; Copper

Hintergrund Patienten nutzen zunehmend soziale Medien und Bewertungsportale, um sich uber Krankenhauser zu informieren, diese zu bewerten oder einen Erfahrungsbericht uber den Krankenhausaufenthalt zu schreiben. Krankenhauser haben die Moglichkeit, online abgegebene Patientenkritik fur die interne Qualitatssicherung sowie das Online-Reputationsmarketing zu nutzen. Ziel der Studie: Ziel ist es, Zufriedenheitsbewertungen zu vorangegangen Krankenhausaufenthalten von Social Media Nutzern der Plattformen „Google“ sowie Nutzern des Bewertungsportals „Klinikbewertungen.de“ zu analysieren und plattformspezifisch zu vergleichen. Methodik Es wurde eine Extraktion von Nutzerbewertungen (N=16 691) zu allen Krankenhausern (N=180) im Bundesland Niedersachsen (Vollerhebung) auf den Plattformen Google und Klinikbewertungen.de fur die Jahre 2013–2018 vorgenommen. Anschliesend wurden deskriptive und induktive Analysen (Chi²-Test) der Nutzerbewertungen durchgefuhrt und ein plattformspezifischer Vergleich vorgenommen. Ergebnisse Die meisten Nutzer sind mit ihrem Krankenhausaufenthalt zufrieden, wobei Nutzer der Plattform Google ihren Krankenhausaufenthalt schlechter bewerten (n=6 181; 57,6% zufrieden) als Nutzer der Plattform Klinikbewertungen (n=10 509; 65,4% zufrieden). Krankenhauseigenschaften (Bettenzahl, Fachabteilung), Eigenschaften des Nutzers (Verfasser, Versicherungsart) sind mit der Bewertung des Krankenhausaufenthaltes (Sternebewertung) signifikant assoziiert (Google: Bettenzahl p Schlussfolgerung Die Onlinebewertung eines Krankenhausaufenthaltes ist assoziiert mit der Bettenzahl und der Fachabteilung eines Krankenhauses sowie damit, ob der Verfasser Patient oder Angehoriger ist und ob eine private oder gesetzliche Krankenversicherung besteht. Diese Erkenntnisse konnen fur die Interpretation von Onlinebewertung eines Krankenhausaufenthaltes verwendet werden und konnen die Nutzung von Online-Bewertungen fur Krankenhauser fur die interne Qualitatssicherung oder zur Verbesserung der Online-Reputation unterstutzen. Background Patients are increasingly using social media and review sites to get information on hospitals, to rate them or to write a review about their own experiences during hospital stay. Hospitals have the opportunity to use these patient reviews for internal quality assurance as well as online reputation marketing. Objective The objective is to analyze the satisfaction ratings of previous hospitals stays by social media users on platforms such as “Google”, as well as reviews from the German site “Klinikbewertungen.de”, and to compare them. Methods User reviews (n=16,691) for all hospitals (n=180) in the federal state of Lower Saxony (complete survey) for 2013–2018 were extracted from the platforms Google and the German Klinikbewertungen.de. Subsequently, a descriptive and inductive analysis (Chi²-test) of the user reviews and a comparison specific for the platforms were completed. Results Most users are satisfied with their hospital stay, whereby users of the platform Google ratd their hospital stay worse (n=6,181; 57.6% satisfied) than users of the platform Klinikbewertungen.de (n=10,509; 65.4% satisfied). Features of the hospital (number of beds, specialist departments) and features of the users (author, type of insurance) were significantly associated with the rating for the hospital stay (star review). (Google: number of beds p Conclusion The online review of a hospital stay is associated with the number of beds, the specialist departments of hospitals, whether the author is the patient or a relative, and the type of health insurance they have, namely private or statutory. Online reviews and ratings for hospitals may be used for internal quality assurance or improvements of company online reputation.

Background Paid employment has been shown to benefit childless women’s health, while employed mothers experience poorer health, and more pronounced fatigue. This study measures the association between job characteristics and the health and well-being of employed mothers and the differential susceptibility to job characteristics between coupled and single-parent mothers. Methods We used data from the 5th Portuguese National Health Survey from 1649 employed women (aged 25–54) living with a child under 16. We modelled depression (assessed by the Personal Health Questionnaire-8) and self-reported health as a function of job characteristics, adding interaction terms to compare coupled and single-parent mothers, using logistic regressions. Results Working part-time was associated with depression (odds ratio (OR) = 3.39, 95% confidence interval (CI) = 3.31–3.48) and less-than-good health (OR = 1.28, 95%CI = 1.26–1.31), compared to working full time. Compared to high-skill jobs, the likelihood for depression among low-skill occupations was lower among coupled mothers (OR = 0.25, 95%CI = 0.24–0.26), and higher among single-parent mothers (OR = 1.75, 95%CI = 1.54–1.99). Unstable jobs were associated with depression among coupled mothers. Conclusions Part-time jobs are detrimental for mothers’ mental health, but high-skilled jobs are protective for single-parent mothers. Part-time and unstable jobs are linked to poorer self-reported health among coupled mothers. Results question the gendered arrangements that may face employed coupled mothers.

The evidence for styrene’s being a human lung carcinogen has been inconclusive. Occupational cohorts within the reinforced-plastics industry are an ideal population in which to study this association because of their relatively high levels of exposure to styrene and lack of concomitant exposures to other known carcinogens. However, healthy worker survivor bias (HWSB), where healthier workers stay employed longer and thus have higher exposure potential, is a likely source of confounding bias for exposure-response associations, in part due to styrene’s acute effects. Through December 31, 2016, we studied a cohort of 5,163 boatbuilders exposed to styrene in Washington State who were employed between 1959 and 1978; prior regression analyses had demonstrated little evidence for an exposure-response relationship between styrene exposure and lung cancer mortality. Based on estimates of necessary components of HWSB, we found evidence for a potentially large HWSB. Using g-estimation of a structural nested model to account for HWSB, we estimated that 1 year of styrene exposure at more than 30 parts per million accelerated time to lung cancer death by 2.29 years (95% confidence interval: 1.53, 2.94). Our results suggest possibly strong HWSB in our small cohort and indicate that large, influential studies of styrene-exposed workers may suffer from similar biases, warranting a reassessment of the evidence of long-term health effects of styrene exposure.

Background: Excess weight is a public health problem and has a negative impact on health. Objective: To determine the frequency of excess weight and its associated factors among workers of the public transport service in Lima. Methods: This was an observational, cross-sectional, and descriptive study. Workers of public transport service companies were considered as the study population. The study variable was excess body weight, which included overweight and obesity. For its determination, the Body-Mass Index (BMI) was used. Results: A total of 238 workers of both sexes participated in the study. The median age was 39 years (interquartile range: 47-32). Of the sample, 93.7% (n=223) were male, 63.4% (n=151) were between 30 and 49 years of age, 67.6% (n=161) worked in the driver's position, and the rest worked as ticket collectors. According to BMI, 81.1% (n=193) had excess weight, of which 44.1% (n=105) corresponded to the overweight and 37% (n=88) to the obesity category. Only 18.9% (n=45) of the sample were in the normal range. Excess weight occurred in a higher proportion among workers belonging to the age group of 30 to 49 years (p=0.002), in cohabiting and or married people (p=0.006), and in bus drivers (p=0.003). Conclusion: The workers of the public transport service in Lima have a very high prevalence of excess weight. It is higher than the national average. The factors associated with excess weight were the following: age group between 30 and 49 years, marital status, and working as a driver. It requires a sanitary intervention in the family and the workplace.

Objectives Roughly 10% of occupational injuries result in permanent impairment and a permanent partial disability (PPD) award. After initial return to work (RTW) following a work injury, many workers with permanent impairment face RTW interruption (breaks in ongoing employment due to reinjury, poor health, disability, lay-off, etc.). Most RTW and reinjury research has focused on worker-level risk factors, and less is known about contextual factors that may be amenable to workplace or workers’ compensation (WC)-based interventions. The aim of this study was to identify modifiable organizational and psychosocial workplace factors associated with (i) RTW interruption and (ii) reinjury among workers with a permanent impairment. Methods This retrospective cohort study included WC claims data and survey data for 567 injured workers who RTW at least briefly after a work-related injury that resulted in permanent impairment. Workers were interviewed once by phone, 11–15 months after WC claim closure with a PPD award. Logistic regression models were used to estimate associations between each workplace factor of interest and each outcome, controlling for whole body impairment percentage, gender, age, nativity, educational level, State Fund versus self-insured WC coverage, employer size, union membership, industry sector, and employment duration of current/most recent job. Results Twelve percent of workers had been reinjured in their current or most recent job, 12% of workers were no longer working at the time of interview, and Conclusions This study provides evidence that several potentially modifiable organizational and psychosocial factors are associated with safe and sustained RTW among injured workers with work-related permanent impairment. The lack of interaction between any of these workplace factors and degree of impairment suggests that these findings may be generalizable to all workers, and further suggests that workplace interventions based on these findings might be useful for both primary and secondary prevention. Though primary prevention is key, secondary prevention efforts to sustain RTW and prevent reinjury may reduce the considerable health, economic, and social burden of occupational injury and illness.

There are several well-known risk factors for work-related musculoskeletal disorders (MSDs). Despite this knowledge, too many people still work in harmful conditions. The absence of occupational exposure limits (OELs) for physical workload impedes both supervision and preventive work. To prevent myalgia, tendon disorders, and nerve entrapments in the upper musculoskeletal system, we propose action levels concerning work postures, movement velocities and muscular loads recorded by wearable equipment. As an example, we propose that wrist velocity should not exceed 20°/s as a median over a working day. This has the potential to reduce the prevalence of carpal tunnel syndrome (CTS) in highly exposed male occupational groups by 93%. By reducing upper arm velocity in highly exposed female groups to the suggested action level 60°/s, the prevalence of pronounced neck/shoulder myalgia with clinical findings (tension neck syndrome) could be reduced by 22%. Furthermore, we propose several other action levels for the physical workload. Our ambition is to start a discussion concerning limits for physical workload, with the long-term goal that OELs shall be introduced in legislation. Obviously, the specific values of the proposed action levels can, and should, be discussed. We hope that quantitative measurements, combined with action levels, will become an integral part of systematic occupational health efforts, enabling reduction and prevention of work-related MSDs.

STUDY QUESTION Are physical activity (PA) and body mass index (BMI) associated with irregular periods and heavy menstrual bleeding (HMB) in Australian women? SUMMARY ANSWER Overweight and obese women have higher odds of both irregular periods and HMB than underweight/normal-weight women, but high levels of PA reduce the odds of HMB. WHAT IS KNOWN ALREADY Most studies on relationships between PA and menstrual problems have focused on female athletes, but there have been few population-based studies. STUDY DESIGN, SIZE, DURATION Prospective cohort study, 10618 participants in the Australian Longitudinal Study of Women’s Health (ALSWH) who completed mailed surveys in 1996, with follow-ups in 2000, 2003, 2006, 2009, 2012, and 2015. PARTICIPANTS/MATERIALS, SETTING, METHODS Participants were aged 22 to 27 in 2000. They were asked to report their PA levels and the frequency of irregular periods and HMB in each survey. BMI was calculated at every survey from self-reported weight and height. Generalised estimating equation population-averaged model analyses were conducted to calculate odds ratios (OR) and 95% confidence intervals (95% CIs). MAIN RESULTS AND THE ROLE OF CHANCE At age 22 to 27 years, the prevalence of irregular periods was 19.4%. This remained stable over 15 years. There were no associations between PA and irregular periods. Overweight and obese women had higher odds of irregular periods [overweight: OR 1.08, (95% CI 1.00–1.17); obese: OR 1.29, (95%CI 1.18–1.41)] than women who were underweight/normal weight. The prevalence of HMB at age 22–27 years was 15.9%; this doubled over 15 years. Women who were highly active had 10% lower odds of HMB than women who reported no PA [OR 0.90, (95%CI 0.82–0.98)]. Overweight and obese women had higher odds of HMB [overweight: OR 1.15, (95%CI 1.07–1.23); obese: OR 1.37, (95%CI 1.26–1.49)] than women who were underweight/normal weight. Among obese women, high levels of PA were associated with 19% [OR 0.81, (95%CI 0.68–0.97)] reduction in the odds of HMB. LIMITATIONS, REASONS FOR CAUTION Data collected in the ALSWH are self-reported, which may be subject to recall bias. Reverse causation, due to menstrual problems impacting PA, is possible although sensitivity analyses suggest this is unlikely to have affected the results. Other conditions, e.g., polycystic ovary syndrome, for which no or incomplete data were available, could have affected the results. WIDER IMPLICATIONS OF THE FINDINGS Intervention studies are needed to assess the effect of increasing PA in women with HMB, but these preliminary findings suggest that promoting PA could be an affordable and feasible strategy for reducing HMB in young adult women. STUDY FUNDING/COMPETING INTEREST(S) The ALSWH is funded by the Australian Government. Funding for these analyses was provided by a University of Queensland (UQ) International Postgraduate Research Scholarship and a UQ International Development Fellowship. The authors declare no conflicts of interest. TRIAL REGISTRATION NUMBER N/A

The construction sector has been hit hard by the opioid crisis. We describe CPWR—The Center for Construction Research and Training’s recent efforts to address the challenges of opioid use in the construction industry. With support and guidance from the North America's Building Trades Unions Opioid Task Force, CPWR undertook three projects to promote prevention and best practices for struggling construction workers. The first project focused on recommendations for communications that reframe stigmatizing narratives into effective messages about prevention solutions. The second project refined and distributed a one-hour construction worker opioid hazard awareness training module. The third project assessed opportunities and barriers for the expansion and improvement of existing union peer support programs to support workers through treatment and recovery. Additional resources, such as opioid hazard tool box talks, to help reverse the impact on the sector are also described.

This article focuses on methods and tools to measure worker satisfaction with reference to industrial automation. Despite technological advances in automation, the role of human workers on industrial shop floors remains crucial. To promote humans' roles, production systems should be designed and organized so workers are valued and get satisfactory jobs. The article presents a novel holistic model of worker satisfaction with adaptive automation and working conditions. The model takes into account psychosocial and physical working conditions and the characteristics of the automation system the worker interacts with and its user interface. We propose a questionnaire to be used as a practical tool to assess worker satisfaction with industrial automation, considering also the case of adaptive automation. The proposed version of the questionnaire is the result of pilot testing carried out among shop floor operators and takes into account adjustments derived from end-user feedback.

Objectives. The purpose of this study was to determine the factors that university music students and professional musicians believe caused their musculoskeletal symptoms (MSSs). Methods. Data were collected using a questionnaire distributed to university music students and professional musicians. Using a musician-driven data collection approach, musicians with MSSs were asked to nominate their top three perceived causes of their symptoms. Responses were categorized, and percentages reported for the main categories. Results. Of the 213 musicians, 37.6% reported biological factors, 21.1% reported external, physical factors, 93.9% reported behavioural factors, 18.8% reported psychosocial factors and 9.9% reported ‘other’ factors (e.g., accidents) as the perceived causes of their MSSs. Conclusion. This study is the first to investigate perceived causes of musicians’ MSSs across a diverse range of musicians, using musician-driven methods. By using open response data collection strategies, a comprehensive, unbiased list of perceived causes of MSSs was compiled. Perceived causes not identified in previous research included manual handling, physical activity and sleep problems. Future research should consider the association between perceived causes and MSSs, and barriers and enablers of behaviour changes that may prevent MSSs. This research may guide the development of new strategies to reduce the burden of MSSs in musicians.

Job demands are viewed as the physical, psychological and social effects of the physical and mental efforts required by the job on the employee, while job resources refer to the gains and opportunities that reduce these effects, support employee development and help him/her achieve successful results. The aim of this study is to explain the effects of job demands and job resources perceived by cabin crew members on their safety behavior. To this end, using the qualitative research method, the data were obtained through semi-structured interviews with 14 cabin crew members in a medium-sized airline business in Turkey. The findings were presented under four themes: 'working conditions', 'factors related to cabin crew members', 'passenger behaviors' and 'purser attitudes'. In conclusion, various recommendations are made for airline management by comparing the findings with those reported in the related literature.

Objectives. Although a focus on safety communication between managers and employees has been prevalent, research around coworker influence in this communication has been fragmented in the literature. Methods. To examine these issues, researchers gathered survey data from 1955 mine employees from surface stone, sand and gravel (SSG) and industrial mineral operations across the USA between 2016 and 2018, and studied the effects of relationships between justice perceptions, supervisor communication and coworker communication on behavioral safety compliance. Results. Using structural equation modeling, coworker communication partially mediated the direct effects of supervisor communication and justice perceptions on behavioral safety compliance - where the indirect effects were greater for justice perceptions. Conclusion. The results demonstrate the value in formal and informal communication paths to facilitate employee safety compliance; and that enhanced perceptions of job fairness and adaptability enhances coworker communication, further improving compliance in an interdependent environment.

The petroleum industry is a high-risk industry and operates under the social technical system. Therefore, the safety behavior of employees needs to be paid high attention. Thus, six dimensions of safety management practices are identified as independent variables to predict a special component of common safety behavior-mindful safety practices in the Chinese petroleum industry. High-reliability organization theory is adopted as the underpinning theory. A total 255 first-line workers from a Chinese petroleum company participated in this survey. The results reveal that safety training and safety communication and feedback are positively related to safety motivation. Moreover, workers' involvement and safety promotion policy have direct and positive impacts on mindful safety practices. Further, safety motivation is found to play a mediating role in the prediction of mindful safety practices in the Chinese petroleum industry. These findings give new insights for petroleum companies into how to promote mindful safety practices in the workplace.

The characteristics of transformation of the psychophysiological state of servicemen during a long stay in the combat zone have been studied. The psychophysiological status of servicemen, muscular strength and endurance of right and left arms were assessed. The obtained results indicate that the studied contingent was heterogeneous in its psychophysiological status and was divided into two subgroups «better» and «worse». It was found that the studied psychophysiological parameters are described by two orthogonal factors (65%) - the «activation and stress of the body» factor (38%) and the «quality of cognitive processes» factor (27%). The first factor is the most powerful, this indicates a significant role of a serviceman’s stress-resistance in the conditions of long stay in the combat zone. It was found that this factor is also the leading one in the «worse» subgroup, this to a lesser extent can prevent disorder and unpredictability of behavioral reactions of combatants. In the «better» subgroup «quality of cognitive processes» was the leading factor. It plays a significant role in the balanced activity of functional systems of the body responsible for formation of adaptive behavioral responses during long-term action of high-level stressors. The decisive rules for selection of servicemen best suited for carrying out official duties in conditions of high-risk activities have been developed.