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Background Choosing cutoff values for nerve conduction studies (NCS) and ultrasound cross-sectional area (CSA) in the diagnosis of carpal tunnel syndrome (CTS) is critical in determining the diagnostic accuracy of the tests. The goals of this study were to: (1) determine the sensitivity and specificity of various electrodiagnostic and ultrasound threshold values for diagnosis of CTS; and (2) determine the number of hands that underwent NCS and ultrasound that were within 10% of threshold values. Methods A total of 309 hands of 235 patients were included in this study. Diagnosis of median neuropathy was made based on NCS by the independent physician performing the NCS. Criteria analyzed included distal motor latency of 4.4+ ms, distal sensory latency of 3.6+ ms, difference in median-ulnar mixed nerve palmar latency of 0.4+ ms, and CSA of the median nerve of 10+ mm2. Results Median neuropathy was diagnosed in 235 hands, whereas 74 hands were found not to have median neuropathy. Overall, 141 hands (46%) had at least 1 of the 3 electrodiagnostic variables within 10% of the diagnostic cutoff values, and 137 hands (44%) had a median nerve CSA within 10% of 10 mm2. By performing ultrasound in addition to NCS for each patient, an additional 65 hands (21%) had a definitive diagnosis on at least 1 of the 2 diagnostic modalities. Conclusions Ultrasound and NCS yielded a similar number of patients within 10% of their diagnostic threshold values. When used together, the number of patients with a nonborderline diagnosis on at least 1 diagnostic modality was increased substantially.

In response to the COVID-19 pandemic, many countries have adopted a broad spectrum of containment measures, from recommendations to stay at home to quarantines of large geographic regions. As part of this response, corporations and governments alike have strongly encouraged workers to telecommute where possible. More than 3.4 billion people in 84 countries have been confined to their homes, as estimated in late March 2020, which potentially translates to many millions of workers temporarily exposed to telecommuting. Since 2000, the emergence of digital and broadband internet has facilitated the development of home telework. Despite limited research interest on its impact on occupational health, several health benefits and risks of telework have been identified in academic or grey literature (table 1) (for a review see Ref. 1). …

The latest technological innovations have considerably increased the field of application for infrasound, and the possible risks that infrasound may present to those exposed to it must be taken into account. The main task of this article is to organize and summarize recent studies on the most common artificial emitting sources and the effects that these non-audible frequencies have on health when absorbed by the body, as well as presenting the existing regulations, a discussion and a series of conclusions that clarify aspects of infrasound. The intention of the authors of this article is that what is exposed in this review can be used to address and determine future lines of research and promote architects to take the spaces of installations within a building very seriously as well as carry out competent administration considering a minimum distance from the road to where habitable buildings are planned.

Introduction Previous studies on occupational health focussed predominately on the occurrence of occupational diseases. Relatively few studies have measured how employment is associated with the use of healthcare services. This study investigates the association between employment and the extent and range of healthcare use, such as medical expenditures, of women in South Korea. Methods We analyze data of the Korean Health Panel, an ongoing longitudinal national representative survey, from 2008 to 2017, to identify the status of economic activity of women by year and age group. We estimate the association between female employment status and medical expenditures by using random effect panel Tobit models. Furthermore, we investigate the association between employment status and the range of healthcare services in biomedicine and traditional Korean medicine (KM) by conducting conditional fixed-effects logistic regression analyses. Results For women aged between 25 and 65 in 2017, the majority of them were employed or self-employed. (The proportion of employment of self-employment equals 64.80%). In addition, working women spent 11.6% less on healthcare than nonworking women, and self-employment lowered the healthcare expenditure by 13.1%. Neither work nor the type of work is related to the types and range of healthcare service use. Being employed or self-employed is negatively associated with women’s expenditure on healthcare. Conclusions The findings show that employment is associated with less spending on healthcare. They imply that employment has a positive impact on women’s health.

Zusammenfassung. Hintergrund: Fortbildungen für Pflegende auf der Intensivstation sind obligat, es fehlt jedoch oft an Kurzfortbildungen von bis zu 15 Minuten innerhalb der Arbeitszeit. Derzeit gibt es keine vergleichende Datenlage zur zeitlichen Verortung von Kurzfortbildungen. Fragestellungen: Welche Auswirkungen haben zeitlich unterschiedlich verortete Kurzfortbildungsveranstaltungen zu Beginn des Spätdienstes gegenüber zum Ende des Frühdienstes auf die Wissensaufnahme von Pflegenden auf der Intensivstation? Ergänzend sollten weitere Rahmenbedingungen und eine abschließende Empfehlung für die Veranstaltungen ermittelt werden. Methode: In einer Beobachtungsstudie mit Pflegenden, die Kurzfortbildungsveranstaltungen vor dem Spätdienst (VS) oder nach dem Frühdienst (VF) besuchten, kam ein Fragebogen zum Einsatz. Als primärer Outcome-Effekt wurde die Odds Ratio (OR) anhand von drei Quizfragen errechnet. Sekundäre Outcome-Parameter, zu denen u.a. eine pünktliche Teilnahme der Pflegenden sowie das Empfehlungsverhalten zählten, wurden mit Methoden deskriptiver Statistik ermittelt. Ergebnisse: Bei einem Rücklauf von 98,59% (n = 420) betrug die OR 1,22 (95%-KI: 0,90; 1,64) zugunsten der Gruppe VS im Vergleich zu VF. Pflegende aus VS konnten zu 96,73% (n = 237) und aus VF zu 80,13% (n = 121) die Veranstaltungen pünktlich besuchen. Weiterhin empfahlen Teilnehmende die Kurzfortbildungen auf einer Skala von 1 (unbedingt hingehen) bis 6 (lass lieber bleiben) in VS im Mittelwert mit 2,27 (SD 1,15) und in VF mit 2,21 (SD 1,07). Schlussfolgerung: Kurzfortbildungen sollten zu Beginn des Spätdienstes angeboten werden.

ObjectivesPrevious studies on the association between psychosocial work factors and blood pressure mainly focused on specific occupations or populations and had limited sample sizes. We, therefore, investigated the associations between psychosocial work factors and blood pressure in a large general working population in the Netherlands.MethodsWe included 63 800 employees from the Netherlands, aged 18–65 years, with blood pressure measurements and a reliable job code at baseline. Psychosocial work factors (job strain, effort–reward imbalance (ERI) and emotional demands) in the current job were estimated with three recently developed psychosocial job exposure matrices. To examine the associations, regression analyses adjusted for covariates (age, sex, body mass index, education, monthly income, pack-years, smoking, alcohol consumption and antihypertensive medication (not included for hypertension)) were performed.ResultsHigher job strain was associated with higher systolic blood pressure (SBP) (B (regression coefficients) (95% CI) 2.14 (1.23 to 3.06)) and diastolic blood pressure (DBP) (B (95% CI) 1.26 (0.65 to 1.86)) and with higher odds of hypertension (OR (95% CI) 1.43 (1.17 to 1.74)). Higher ERI was associated with higher DBP (B (95% CI) 4.37 (3.05 to 5.68)), but not with SBP or hypertension. Higher emotional demands were associated with lower SBP (B (95% CI) −0.90 (−1.14 to −0.66)) and lower odds of hypertension ((OR) (95% CI) 0.91 (0.87 to 0.96)).ConclusionsIn the general working population, employees in jobs with high job strain and ERI have higher blood pressure compared with employees with low job strain and ERI. Emotional demands at work are inversely associated with blood pressure.

BACKGROUND: A validated method to assess sitting and standing posture in a clinical setting is needed to guide diagnosis, treatment and evaluation of these postures. At present, no systematic overview of assessment methods, their clinimetric properties, and usability is available. OBJECTIVE: The objective of this study was to provide such an overview and to interpret the results for clinical practice. METHODS: A systematic literature review was performed according to international guidelines. Two independent reviewers assessed risk of bias, clinimetric values of the assessment methods, and their usability. Quality of evidence and strength of recommendations were determined according to the Grading of Recommendations Assessment, Development and Evaluation working group (GRADE). RESULTS: Out of 27,680 records, 41 eligible studies were included. Thirty-two assessment instruments were identified, clustered into five categories. The methodological quality of 27 (66%) of the articles was moderate to good. Reliability was most frequently studied. Little information was found about validity and none about responsiveness. CONCLUSIONS: Based on a moderate level of evidence, a tentative recommendation can be made to use a direct visual observation method with global posture recorded by a trained observer applying a rating scale.

Purpose The purpose is to report on the mental health response to the Grenfell incident within the London Fire Brigade (LFB). Design/methodology/approach The LFB implemented screening for the symptoms of posttraumatic stress disorder (PTSD) at 28 days, 3 months and 6 months for all personnel directly involved in the incident. Findings The prevalence of PTSD within frontline personnel was 13.4% at 28 days, falling to 7.6% at 6 months. The LFB's internal Counselling and Wellbeing Service offered treatment to those scoring above the cut-off for PTSD along with accepting self-referral and referrals from line managers and occupational health. There were 139 referrals within the 12-month period following the incident. Research limitations/implications The outcomes for those who engaged in treatment are broadly in line with other studies evaluating post-disaster interventions. Issues for consideration within national guidelines are discussed. Practical implications The screen and treat approach adopted by LFB was shown to be a feasible approach to use within such a scenario. Originality/value The current study reports on a screen and treat approach to one of the largest single incidents in the UK in recent years.

Objectives The aim of this study was to assess the validity and reliability of the Serbian versions of the Copenhagen Burnout Inventory (CBI) and the Study Burnout Inventory (SBI) among fifth-year medical students at 5 universities in Serbia. Material and methods The study included 573 fifthyear medical students at 5 universities in Serbia. The research instrument consisted of SBI and CBI. The reliability of these instruments was assessed using an internal consistency measure (Cronbach's α), an intra-class coefficient (ICC) and factor analysis. Results Cronbach's α for SBI was 0.83, including for exhaustion 0.73, for cynicism 0.70, and for inadequacy 0.48. The test-retest reliability (ICC) was 0.75. Cronbach's α for personal burnout on CBI was 0.89, for the faculty-related burnout 0.86, and for the faculty-members-related burnout 0.92. Cronbach's α for CBI was 0.93. The factor analysis for SBI showed 2 factors and for CBI 3 factors. Conclusions This study revealed that the Serbian versions of both SBI and CBI could be used for the assessment of burnout in this population.

Men extend their employment beyond pensionable age more often than women, but the factors that contribute to this sex difference are unknown. This study aimed to examine sex differences in extending employment and the contribution of sociodemographic, work- and health-related factors to these differences. Participants of this prospective cohort study were 4,263 public sector employees from Finland who reached their individual pensionable date between 2014 and 2019 and responded to a survey on work- and non-work-related issues before that date. Extended employment was defined as continuing working for over six months beyond the individual pensionable date. We used mediation analysis to examine the contribution of explanatory factors to the association between sex and extended employment. Of the participants, 29% extended employment beyond the pensionable date. Men had a 1.29-fold (95% confidence interval 1.11-1.49) higher probability of extending employment compared with women. Men had a higher prevalence of factors that increase the likelihood of extended employment than women (such as spouse working full-time, no part-time retirement, low job strain, high work time control, and lack of pain) and this mediated the association of sex with extended employment by up to 83%. In conclusion, men were more likely to extend their employment beyond pensionable age than women. This difference was largely explained by men being more likely to have a full-time working spouse, low job strain, high work time control, no pain, and not being on part-time retirement.The online version contains supplementary material available at 10.1007/s10433-021-00663-1.

Background To examine the association of job strain with cognitive ability and the influence of life-course job strain on later life cognitive decline. Methods Data were derived from six waves of the Survey of Health, Aging, and Retirement in Europe. The study sample consists of 13349 participants aged 50 to 98 years at wave 2 and has been followed up for 12-years. Job strain status across working life was assessed using a short demand-control job strain model containing two core dimensions: job demands and job control collected in wave 3. Cognitive abilities concerning episodic memory was assessed by immediate recall and delayed recall tests, executive function was evaluated by verbal fluency test collected in all waves (waves 2–7) except wave 3. Mixed-effects model was used to estimate working life job strain and its cumulative effect on cognitive decline. Results Both passive and high strain jobs were associated with lower levels of cognitive ability (episodic memory and verbal fluency) in comparison with active job. Long exposure to active- or low strain-job was associated with higher cognitive ability whereas long exposure to passive job or moderate duration of high strain job was associated with lower cognitive ability. The rate of memory decline was positively related to moderate duration of passive job and negatively related to long-term exposure to low strain job. Limitations Information on working conditions was based on self-reported recollections. Conclusions Working life variation in job strain status and their duration may explain individual differences in cognitive ability in later life.

The effectiveness of vibration-reducing (VR) gloves is conventionally assessed based on the vibration transmissibility of the gloves. This study proposed a method for analyzing and assessing the effectiveness of VR gloves based on how gloves affect the vibration power absorption (VPA) of the hand&ndash, arm system and its distribution. A model of the entire tool&ndash, handle&ndash, glove&ndash, hand&ndash, arm system was used to predict the VPA distributed in the glove and across the substructures of the hand&ndash, arm system. The ratio of the gloved-VPA and ungloved-VPA in each group of system substructures was calculated and used to quantify VR glove effectiveness, which was termed the VPA-based glove vibration transmissibility in this study. The VPA-based transmissibility values were compared with those determined using to-the-hand and on-the-hand methods. Three types of gloves (ordinary work glove, gel VR glove, and air bubble VR glove) were considered in the modeling analyses. This study made the following findings: the total VPA-based transmissibility spectrum exhibits some similarities with those determined using the other two methods, the VPA-based transmissibility for the wrist&ndash, forearm&ndash, elbow substructures is identical to that for the upper&ndash, arm&ndash, shoulder substructures in the model used in this study, each of them is equal to the square of the glove vibration transmissibility determined using the on-the-wrist method or on-the-upper-arm method, the other substructure-specific VPA-based transmissibility spectra exhibit some unique features, the effectiveness of a glove for reducing the overall VPA in the hand&ndash, arm system depends on the glove effectiveness for absorbing the vibration energy, which seems to be associated primarily with the glove cushioning materials, the glove may also help protect the fingers or hand by redistributing the VPA across the hand substructures, this redistribution seems to be primarily associated with the glove structural properties, especially the tightness of fit for the glove.

Background The prevailing global work scenario and deteriorating health facilities in economies indulge the risk perspective in the labor market model. This is the reason that the risk factor is cautiously attributed to wages and labor market efficiencies specifically in developing and emerging economies. In this respect, Occupational Injuries of Workers (OIW) is considered essential to demonstrate the risk and Occupational Health and Safety (OHS) setups given the constraints of the labor. Intuitively, the prime objective of this study is to make an assessment of the labor market considering the OIW through the indicators of industry division, employment status, occupational distribution, adopted treatment, gender and regionality. Methods The assessment strategy of the study has been categorized into trend analysis and Index Value Calculation (IVC) segments employing the data from 2001 to 2018. Results The pattern of the selected indicators of the OIW has been observed in the available data while the IVC estimations are considered through time and reference categories. The findings of both exercises revealed absolute and relative heterogeneities at both industry and occupational levels. Conclusion The consistency for gender and regional distribution of both assessments points out the need for effective policy initiatives. The study suggests separate analyses of industry and occupations for a better understanding of the OHS setups and up-gradation in Pakistan.

Objectives: Our aim was to validate the “Wulira App” a mHealth application against gold standard audiometry as a pragmatic audiometry solution for under-served and vulnerable groups of patients at risk of hearing loss. The specific objectives were as follows: To compare hearing thresholds determined using the Wulira app to standard pure tone audiometry among patients on MDR-TB treatment. To determine the correlation between the measured hearing loss with the Wulira app and standard audiometry with patient reported hearing loss. To determine the proportion of patients on MDR-TB treatment that experience hearing loss? Materials and Methods: We consecutively recruited patients ≥18 years old and receiving kanamycin in their treatment regimen between February and June 2019 for this study. Clinical and demographic data were obtained from each participant and documented in a secure database. Participants had hearing assessment performed once at enrolment with paired standard audiometry and the Wulira mobile phone app in a soundproof room. Results: A total of 120 MDR-TB patients with a mean age of 34.0 (±9.6) years were recruited for this study and 69 (57.5%) were male. When compared to pure tone audiometry, the Wulira app was able to correctly detect 91.4% hearing loss in right ear and 88.4% in the left ear. The specificity of the Wulira app was equally high, reaching 93.2% in the right ear and 91.5% in the left ear. Conclusion: The Wulira app may be a useful alternative home-based tool for hearing assessment in MDR-TB patients, essentially for early detection of hearing loss following commencement of second-line injectable drugs.

Objective To identify latent components from among 13 work and non-work stressors and to examine whether the accumulation of stress factors within these components was associated with sleep problems. Methods A cohort of older employees (n = 2771 individuals, n = 3921 person-observations) responded to at least two surveys. Principal Component Analysis (PCA) was used to identify latent components. Analysis of variance was used to examine their associations with sleep. Results The components were: 'Physical workload and shift work', 'Psychosocial workload', 'Social and environmental non-work adversity' and 'Life event- and health-related non-work adversity'. They were consistently associated with sleep problems, except for 'Physical workload and shift work'. 'Social and environmental non-work adversity' was associated with sleep problems at follow-up. Conclusions Clusters of work- and non-work-related stressors were identified, and their accumulation was associated with sleep problems among older employees.

Objectives Previous studies on the effect of low social support at work on blood pressure showed mixed results. Few previous studies have used ambulatory blood pressure and examined whether the effect of low social support at work vary among men and women. The aim of this study was to examine the association between low social support at work, ambulatory blood pressure means and hypertension prevalence, in a sample of white-collar workers men and women. Methods A repeated cross-sectional design was used. Data were collected three times during a 5-year period, among 3919 white-collar women and men. At each time, coworker and supervisor social support at work were measured using validated scales. Ambulatory blood pressure was measured every 15 min during a working day. General estimating equations were used. Results In adjusted models, women exposed to low coworker (+0.6 mmHg) and low supervisor social support at work (+0.7 mmHg) had slightly higher diastolic blood pressure means when compared to unexposed women. In men, those with low coworker social support at work had higher diastolic (+0.7 mmHg) blood pressure while those with low supervisor social support had a higher prevalence of hypertension (prevalence ratio = 1.14, 95% CI: 1.04–1.24). Conclusions Men with low supervisor social support at work had a higher prevalence of hypertension. Low social support at work was associated with modest increases in diastolic blood pressure among men and women. Workplace prevention strategies aiming to increase social support at work could lead to beneficial effects on worker’s cardiovascular health.

BACKGROUND: Environmental hazards in healthcare institutions affect the quality of patient care as well as personnel and patient safety. OBJECTIVE: The aim of this study was to develop and apply a semi-quantitative risk assessment method to calculate occupational health risk levels with regard to the sensitivities of healthcare institutions. METHODS: The present research was conducted in three phases. In phases 1 and 2, the model was developed using a review of different risk assessment methods, extracting expert opinions (N = 10) through semi-structured interviews, and using the fuzzy analytical hierarchy process (FAHP). In phase 3, in order to validate the proposed method, one of the five public hospitals was randomly selected and a case study comprising 6 sections was performed. RESULTS: A total of 43 health risks were identified and evaluated using the present method, 41.86% of which were at very high levels, 16.27% at high levels, 30.23% at substantial ones, 9.3% at medium and 2.32% at low levels. The highest health risks were found in paraclinical and operating room wards. CONCLUSION: To overcome the shortcomings of the proposed health risk assessment methods, a semi-quantitative method was used in the present study to more accurately calculate the risk levels in the healthcare institutions and also calculate the risk level of each hospital unit. The proposed semi-quantitative method can be used as a tool for assessing occupational health risks as a key element of risk management. In addition, by focusing on an appropriate framework for occupational health risk assessment, specialists in the organization will be able to take significant and effective steps to implement an efficient risk management system.

Workers who experience language barriers are more likely to get injured or sick because of their work and have poorer claim and return-to-work outcomes compared to other workers. To better understand the systemic factors that shape access to compensation in contexts of language barriers, we compared language accommodation policies and practices in the Quebec and Ontario workers’ compensation systems. We uncovered gaps limiting access to professional interpreters in both provinces, although gaps were more pronounced in Quebec where workers were responsible for the cost of interpreters. We argue that simply improving the linguistic competence of workers’ compensation systems is not sufficient to tackle access barriers and must be accompanied by efforts to address the root causes of social and economic inequities for workers who experience language barriers.

Publisher Copyright: © 2021 The Author(s). Published with license by Taylor & Francis Group, LLC. Physicians often work long hours and on-call shifts, which may expose them to circadian misalignment and negative health outcomes. However, few studies have examined whether these working hour characteristics, ascertained using objective working hour records, are associated with the physicians’ risk of sickness absence. We investigated the associations of 14 characteristics of payroll-based working hours and on-call work with the risk of short sickness absence among hospital physicians. In this cohort study, 2845 physicians from six Finnish hospital districts were linked to electronic payroll-based records of daily working hours, on-call duty and short (1–3 days) sickness absence between 2005 and 2019. A case-crossover design was applied using conditional logistic regression with the 28 day case and control windows to estimate odds ratios (ORs) and 95% confidence intervals (CI) for short sickness absence. After controlling for weekly working hours and the number of normal (≤12 h) shifts, a higher number of long (>12 h) shifts (ORs for ≥5 versus none: 2.54, 95% CI 1.68–3.84), very long (>24 h) shifts (ORs for ≥5 versus none: 2.62, 95%CI 1.61–4.27), and on-call shifts (OR for ≥5 versus none: 2.15, 95% CI 1.44–3.21) and a higher number of short (

ZusammenfassungZiel der Studie „Real world“-Daten aus der ambulanten Gesundheitsversorgung sind in Deutschland nur schwer systematisch und longitudinal zu erlangen. Unsere Vision ist eine permanente Datenablage mit repräsentativen, de-identifizierten Patienten- und Versorgungsdaten, längsschnittlich, fortwährend aktualisiert und von verschiedenen Versorgern, mit der Möglichkeit zur Verknüpfung mit weiteren Daten, etwa aus Patientenbefragungen oder biologischer Forschung, zugänglich für andere Forscher. Wir berichten methodische Vorgehensweisen und Ergebnisse aus dem RADAR Projekt.Methodik Untersuchung des Rechtsrahmens, Entwicklung prototypischer technischer Abläufe und Lösungen, mit Machbarkeitsstudie zur Evaluation von technischer und inhaltlicher Funktionalität sowie Eignung für Fragestellungen der Versorgungsforschung.Ergebnisse Ab 2016 entwickelte ein interdisziplinäres Wissenschaftlerteam ein Datenschutzkonzept für Exporte von Versorgungsdaten aus elektronischen Praxisverwaltungssystemen. Eine technische und organisatorische Forschungsinfrastruktur im ambulanten Sektor wurden entwickelt und im Anwendungsfall „Orale Antikoagulation“ (OAK) umgesetzt. In 7 niedersächsischen Hausarztpraxen wurden 100 Patienten gewonnen und nach informierter Einwilligung ihre ausgewählten Behandlungsdaten, reduziert auf 40 relevante Datenfelder, über die Behandlungsdatentransfer-Schnittstelle extrahiert, unmittelbar vor Ort in identifizierende bzw. medizinische Daten getrennt und verschlüsselt zur Treuhandstelle (THS) bzw. an den Datenhalter übertragen. 75 Patienten, die die Einschlusskriterien erfüllten (mind. 1 Jahr Behandlung mit OAK), erhielten einen Lebensqualitäts-Fragebogen über die THS per Post. Von 66 Rücksendungen wurden 63 Fragebogenergebnisse mit den Behandlungsdaten in der Datenablage verknüpft.Schlussfolgerung Die rechtskonforme Machbarkeit der Gewinnung von pseudonymisierten hausärztlichen Routinedaten mit expliziter informierter Patienteneinwilligung und deren wissenschaftliche Nutzung einschließlich Re-Kontaktierung und Einbindung von Fragebogendaten konnte nachgewiesen werden. Die Schutzkonzepte Privacy by design und Datenminimierung (Artikel 25 mit Erwägungsgrund 78 DSGVO) wurden systematisch in das RADAR Projekt integriert und begründen wesentlich, dass der Machbarkeitsnachweis rechtskonformer Primärdatengewinnung und sekundärer Nutzung für Forschungszwecke gelang. Eine Nutzung hinreichend anonymisierter, aber noch sinnvoller hausärztlicher Gesundheitsdaten ohne individuelle Einwilligung ist im bestehenden Rechtsrahmen in Deutschland schwerlich umsetzbar.

Resume Introduction L'objectif de cette etude consiste a comparer l'hypothese de vulnerabilite et l'hypothese d'expression pour expliquer la plus grande detresse psychologique des femmes en emploi. Ces deux hypotheses sont contrastees en integrant les stresseurs du travail, de la famille, le conflit travail-famille et les ressources psychosociales. Methode Les modeles conceptuels ont ete testes par des analyses de chemins en multiniveaux aupres de 2026 employes quebecois (Canada) repartis dans 63 etablissements. Resultats Les resultats soutiennent partiellement les deux hypotheses. Dans le cas de l'hypothese de vulnerabilite, la monoparentalite, les problemes avec les enfants et l'estime de soi sont indirectement impliques dans la variation du niveau de la detresse psychologique parmi les femmes par l'intermediaire de l'interference famille-travail. Dans le cas de l'hypothese d'expression, bien que l'interference famille-travail soit associee a plus de detresse psychologique parmi les femmes, ce stresseur est associe a davantage de consommation d'alcool a risque parmi les hommes. Les tensions avec le conjoint et le sentiment de controle participent egalement au mecanisme d'expression a travers l'interference famille-travail. Conclusion Ces resultats soulignent l'importance de considerer les multiples mecanismes par lesquels le genre contribue aux inegalites de sante mentale. Ils invitent egalement a distinguer les deux directions du conflit travail-famille comme mediateurs genres.

PURPOSE To identify predictors of return to work, duration of time off work, and claim closure for first responders experiencing injuries or illnesses, and summarize the claim data. METHODS First responder claims collected between January 2012 and July 2017 were obtained from a disability management company. Known predictors of return to work were extracted from the data including age, sex, diagnosis, years of service, claim lag, medical report lag, and the return-to-work duties. Survival analyses were performed to identify predictors of return to work and claim closure using the Cox proportional regression analysis. Log-rank tests were performed to identify predictors that affected the rate of return to work and claim closure. Summary statistics were performed for the injury and return-to-work data. RESULTS 60 of the 67 (89.6%) identified first responders returned to work within the data collection period. Musculoskeletal injuries predicted an increased likelihood of returning to work (hazard ratio = 2.0, 95%CI = 1.14-3.60) and a shorter duration of time off work (37 days on average) compared to mental health issues. Everyday of claim lag and medical report lag predicted a 2% decrease in likelihood of return to work. Returning to work was the only predictor of claim closure. 45 (67.2%) first responders returned to their pre-absence duties. 22 (32.8%) mental health claims and 45 (67.2%) injury claims were identified. CONCLUSIONS 89.6% of first responders returned to work, although only 67.2% returned to their pre-absence duties. Predictors of return to work included injury type, as first responders with musculoskeletal injuries returned to work sooner, and claim and medical lag delayed the return to work.

L’entree a l’ecole appartient au champ des rites de passage de la petite enfance. De nombreux albums de litterature de jeunesse cherchent a desamorcer l’intensite dramatique qui emaille cet evenement en mettant en scene un premier jour d’ecole. Ces ouvrages s’engagent dans la preparation emotionnelle de l’enfant qui precede l’entree a l’ecole. Ils offrent un repertoire de mises en representation de la gestion de la separation parents-enfants, qui temoigne du statut et de la construction sociale des emotions associees a cette transition. L’analyse de contenu d’un corpus de 158 ouvrages revele que les livres pour enfants autour de la rentree distillent des codes emotionnels socialement clives, a mettre en lien avec l’echelle de legitimite culturelle qui regit le paysage editorial. Le controle des emotions, erige en competence du metier d’eleve, fait l’objet au cœur de ces albums d’un travail emotionnel differemment maitrise selon le destinataire social mais toujours au service d’une incontournable mise en conformite scolaire.

Background: The associations between adverse working conditions and mental disorders are well established. However, associations between adverse working conditions and poor mental health functioning is a less explored area. This study examines these associations among younger public sector employees of the City of Helsinki, Finland. Methods: We use data from the Young Helsinki Health Study with a representative sample of the employees of the City of Helsinki, aged 19–39 years (n=4 217). Mental health functioning was measured with mental composite summary of the Short Form 36. Working conditions included factors related to both the psychosocial (job control and job demands) and the physical work environment (physical workload). To examine the associations, we used logistic regression models with adjustments for socio-demographics, other working conditions and health-related covariates. Results: After adjustment for sociodemographic characteristics, poor health, health behaviours and other occupational exposures, high job demands (OR=1.69; 95% CI=1.45–1.97) and low job control (OR=1.65; 95% CI=1.40–1.94) were associated with poor mental health functioning. High physical workload was not associated with the outcome (OR=0.87; 95% CI=0.72–1.05) after the adjustments. Conclusions: Adverse psychosocial working conditions were associated with mental health functioning, whereas physical working conditions were not. As impaired functioning is likely to cause health-related lost productivity and can lead to work disability, further research and interventions with a balanced approach focusing on both psychosocial working conditions and mental health functioning are recommended.

Publisher Copyright: © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under CC BY-NC-ND 4.0 license Background: High emotional demands at work can affect employees’ health and there is a need to understand whether such an association might be modified by other working conditions. We aimed to examine emotional demands at work as a risk factor for long-term sickness absence and analyse whether influence, possibilities for development, role conflicts, and physical demands at work might modify this risk. Methods: We did a nationwide, population-based, prospective cohort study in Denmark and included employed individuals who were residing in Denmark in 2000, aged 30–59 years, who had complete data on age, sex, and migration background, with information on emotional demands and possible effect modifiers from job exposure matrices, and covariates and outcome (sickness absence) from population registers. Individuals with long-term sickness absence (≥6 weeks of consecutive sickness absence) between Jan 1, 1998, and Dec 31, 2000, and self-employed individuals were excluded. We assessed long-term sickness absence during a 10-year period from Jan 1, 2001, to Dec 31, 2010. Using Cox regression, we estimated hazard ratios (HRs) and 95% CIs and tested interaction as departure from additivity, estimating relative excess risk due to interaction (RERI). Multivariable adjusted models included sex, age, cohabitation, migration background, and income. Findings: 1 521 352 employed individuals were included and contributed data between Jan 1, 2000, and Dec 31, 2010. During 11 919 021 person-years (mean follow-up 7·8 years), we identified 480 685 new cases of long-term sickness absence. High emotional demands were associated with increased risk of long-term sickness absence compared with low emotional demands, after adjusting for age, sex, cohabitation, migration background, income, and the four possible effect modifiers (adjusted HR 1·55 [95% CI 1·53–1·56]). The association between high emotional demands and risk of long-term sickness absence was stronger in a synergistic way when individuals were also exposed to low possibilities for development (RERI 0·35 [95% CI 0·22–0·47]; 28·9 additional cases per 1000 person-years) and high role conflicts (0·13 [0·11–0·15]; 22·0 additional cases per 1000 person-years). No synergy was observed for influence and physical demands at work. Interpretation: People in occupations with high emotional demands were at increased risk of long-term sickness absence. Our findings on synergistic interactions suggest that, in emotionally demanding occupations, increasing possibilities for development and reducing work-related role conflicts might reduce long-term sickness absence. Further interventional studies are needed to confirm or refute this hypothesis. Funding: Danish Work Environment Research Fund, NordForsk.

Antiphishing aid systems, among other automated systems, are not perfectly reliable. Automated systems can make errors, thereby resulting in false alarms or misses. An automated system's capabilities need to be communicated to the users to maintain proper user trust. System capabilities can be learned through an explicit description or from experience. Using a phishing-detection system as a testbed in this article, we systematically varied automation error type and the method of communicating system reliability in a factorial design and measured their effects on human performance and trust in the automation. Participants were asked to classify emails as legitimate or phishing with assistance from the phishing-detection system. The results from 510 participants suggest that learning through experience with feedback improved trust calibration for both objective and subjective trust measures in most conditions. Moreover, false alarms lowered trust more than misses for both unreliable and reliable systems, and false alarms turned out to be beneficial for proper trust calibration when using unreliable systems. Design implications of the results include using feedback whenever possible and choosing false alarms over misses for unreliable systems.

Purpose Physical work exposures are associated with sickness absence among older employees. We aimed to examine if they similarly contribute to all-cause sickness absence during early and mid-careers. Methods We used questionnaire data on physical work exposures linked to register data on sickness absence from 3542 municipal employees aged 19–39 years. Follow-up for the number of sickness absence days was 12 months. Exposures to physical workload, occupational environmental hazards, and sedentary work were divided into quartiles. In addition, duration of daily exposure to heavy work was included. Negative binomial regression models were used. Results Higher exposure to physical workload or hazardous exposures was associated with a higher number of sickness absence days. The age and gender adjusted rate ratios for sickness absence days among the participants whose exposure to physical workload was in the highest exposure quartile were 2.1 (95% CI 1.8‒2.5) compared with those whose exposure was in the lowest quartile. In addition, rate ratios for sickness absence days among participants who reported that they do heavy physical work 1.1‒2.0 h, 2.1‒4.0 h or over 4 h daily were 1.6 (1.3‒1.9), 1.5 (1.3‒1.8) and 1.7 (1.5‒2.1), respectively, compared with those who reported not doing physical work. Further adjustment for lifestyle factors or health characteristics attenuated the associations only slightly. Conclusion Exposure to physically demanding work is associated with a higher number of sickness absence days among municipal employees below 40 years of age. Physical working conditions should be considered when aiming to support later work ability.

Violence and Violence Prevention in Nursing Homes during the COVID-19 Pandemic - A partial analysis of Interviews with Managers or Team Leaders Abstract. Background: During the first wave of the COVID-19 pandemic, strict infection control measures were in force in long-term residential care in Germany that burdened staff and isolated residents socially. Both are considered risk factors for violence in long-term residential care. Questions: How does violence develop in nursing homes under pandemic conditions from the point of view of managers and how do strategies for preventing violence change? Methods: Semi-structured telephone interviews were conducted with staff in 43 nursing homes: 25 with service managers, 15 with nurse managers, 28 with nursing team leaders and 10 with registered nurses with extended tasks. The interviews were recorded as audio, transcribed and analysed in five steps following the "Thematic Framework Analysis". Results: The infection control measures were partly perceived as deprivation of freedom. Residents, relatives and staff partly reacted most with verbal violence. Nevertheless, the issue of violence was not a major concern for management and preventive measures were not carried out. Conclusions: The results show that strategies to prevent violence might not be sufficiently established in the institutions involved and would have to be adapted to the conditions of the pandemic. Further research is needed to evaluate infection control measures in their potential to increase the incidence of violence.

Resume Objectifs Presenter la methodologie de l’evaluation du risque et les resultats biometrologiques de travailleurs du BTP intervenant sur des sites ou des sols pollues par des substances chimiques. Methodes L’identification des dangers et leur hierarchisation reposent sur l’examen critique des analyses de sols. L’evaluation de l’exposition previsible doit tenir compte de la bioaccessibilite des substances impliquees, liee a leurs proprietes physicochimiques. Celles-ci conditionnent leur comportement dans les milieux et leur toxicocinetique chez l’homme. La biometrologie permet de valider la pertinence de cette evaluation et l’efficacite des mesures preventives, et d’assurer la tracabilite des expositions. Resultats Entre 2012 et 2020, 39 chantiers mobilisant l’intervention de salaries du BTP, le plus souvent pour des travaux de terrassement/excavation de terres polluees, ont fait l’objet d’une evaluation a priori par le groupe Toxicologie medicale de BTP Sante au Travail Rhone-Isere. Dans la majorite des situations, a l’exception notable du mercure, aucun risque toxique, ni meme d’impregnation anormale de l’organisme, n’a ete mis en evidence : substances non bioaccessibles et/ou faiblement concentrees dans les terres et/ou EPI adaptes. Les dosages biometrologiques sont (mercure excepte) soit inferieurs aux limites de detection/quantification du laboratoire, soit non modifies entre le debut et la fin du chantier. Conclusion Une evaluation du risque pour les travailleurs du BTP intervenant sur des sites et sols pollues est possible si on dispose de donnees fiables sur la nature et la concentration des polluants, et si on met en œuvre une reflexion sur la bioaccessibilite des substances impliquees. Cette evaluation, le plus souvent tres rassurante, est confirmee par la biometrologie, ainsi que par l’analyse de la litterature, aucune publication ne faisant etat d’intoxication ni meme d’impregnation de l’organisme par les substances chimiques presentes dans les terres chez les travailleurs du BTP intervenant sur sites et sols pollues.

Resume L’evaluation de l’exposition est difficile pour le chercheur du domaine des risques professionnels. L’objectif du travail est de developper et de valider une matrice emplois-exposition (MEE) pour l’exposition professionnelle au SARS-CoV-2 appelee « Mat-O-Covid ». Grâce a un groupe d’expert francais, la matrice a ete developpee pour tous les travailleurs sur la profession et les categories socioprofessionnelles de 2003 (avec une passerelle de transcodage vers la Classification internationale type des professions de 2008) et un focus sur le secteur de soin et medicosocial. La moyenne des codages des experts a ete utilisee comme estimation pour l’exposition « sujets » (collegues et/ou public) et « patients » pour le focus secteurs sanitaires, ainsi que la probabilite de prevention pour chaque. Les correlations intraclasses ont ete considerees comme bonnes a excellentes, sauf pour la prevention en sante. Comparees a la matrice americaine O*Net, l’evaluation a ete consideree comme satisfaisante. En conclusion, une MEE « Mat-O-Covid » fournissant une probabilite d’exposition professionnelle au SARS-CoV-2 aura des implications pour la recherche et en sante publique, sous reserve de connaitre ses limites et de poursuivre sa validation.

Background Rodeo is an extreme sport involving powerful forces created by large animals. Objective The objective of this study was to characterize rodeo-related injuries among adolescents treated at United States emergency departments (EDs). Methods Cases were rodeo-related injuries among patients ages 13–19 years reported to the National Electronic Injury Surveillance System during 2000–2019. The distribution of the national injury estimates was determined for selected variables. Results A total of 408 adolescent rodeo-related injuries were identified, resulting in a national estimate of 17,363 injuries. Bulls were involved in 58.4% of the injuries and horses in 28.8%. The patients were 84.7% male and 15.3% female. The most frequently reported mechanisms of injury were: fell or thrown from an animal (41.4%), stepped on by an animal (22.4%), other contact with an animal (7.4%), contact with infrastructure (6.6%), and kicked by an animal (5.9%). The most common diagnoses were contusion or abrasion (29.5%), fracture (22.8%), strain or sprain (15.0%), laceration (8.1%), and concussion (8.0%). The affected body part was 26.9% head and neck, 25.9% upper extremity, 24.6% lower extremity, and 21.6% trunk. Conclusion Most of the injuries involved bulls. The majority of patients were male. Most of the injuries resulted from falling or being thrown by an animal or stepped on by an animal. The most frequently reported injuries were contusion or abrasion, fracture, strain or sprain, laceration, and concussion. The injuries most often affected the head and neck followed by the upper extremity and lower extremity.

Les politiques publiques incitent les Etablissements et services d’aide par le travail (ESAT) a devenir des passerelles vers le milieu ordinaire de travail. Or, les passages du milieu protege en milieu ordinaire relevent d’exceptions. L’article explore ce paradoxe a partir de methodes qualitatives et quantitatives. L’etude montre que la majorite des personnes interrogees ne souhaite pas travailler en milieu ordinaire, percu comme trop violent. Cette vision du milieu ordinaire est renforcee par le discours des salarie·e·s des ESAT, qui faconnent les perspectives des personnes handicapees et effectuent un tri parmi les personnes souhaitant aller vers le milieu ordinaire.

For the first time in Ukraine, phase IV of the International Study of Asthma and Allergies in Childhood (ISAAC) program was realized in Kharkiv region in 2015–2017. 6,330 questionnaires were distributed. 6,146 (97 %) schoolchildren took part in the program. 12.8 % of them had respiratory complaints: 13.2 % of children aged 6 to 7 years, 12.4 % — 13 to 14 years old. These results were compared with the data from ISAAC phase I (V.A. Ognev, 1998) to determine the dynamics of respiratory symptoms prevalence: over the last 19 years, the prevalence of respiratory symptoms has decreased by 1.6 times in children of primary school age and by 2 times — in adolescence. The study was conducted in 8 districts of Kharkiv region (Lozivskyi, Kupianskyi, Vovchanskyi, Bohodukhivskyi, Sakhnovshchynskyi, Barvinkivskyi, Derhachivskyi, Novovodolazkyi) which differ by environmental characteristics. In ecologically contaminated areas, the prevalence of wheezing is 1.4 times higher, exercise-induced asthma symptoms — 1.9 times higher and severe dyspnea attacks disturbing night sleep occur 3.4 times more often. The study is intended to improve the bronchial asthma prevention in children population of Kharkiv region.

ObjectiveThis study investigates if gradual return to work (GRTW) is associated with full sustainable return to work (RTW) for seriously injured workers with a musculoskeletal disorder (MSD), in British Columbia, Canada.MethodsThis is an effectiveness study using a retrospective cohort study design. Accepted workers’ compensation lost-time claims were extracted for workers with an MSD who were on full work disability for at least 30 days, between 2010 and 2015 (n=37 356). Coarsened exact matching yielded a final matched cohort of 12 494 workers who experienced GRTW at any point 30 days post-injury and 12 494 workers without any GRTW. The association between GRTW and sustainable RTW through to end of 12 months was estimated with multivariable quantile regression.ResultsWorkers who were provided with GRTW experienced more time-loss days until sustainable RTW between the 2nd and 5th months after the first time-loss day (ConclusionsFor seriously injured workers with at least 30 days of disability due to a work-acquired MSD, the effect of GRTW becomes apparent at longer disability durations (more than 6 months), with larger beneficial effects for women, workers with soft-tissue injuries and for trade and manufacturing sectors.

Objectives This study aimed to investigate the prevalence of musculoskeletal disorders in the hands and wrists of fishermen working as oyster shuckers, and to identify the risk factors associated with oyster shucking. Material and Methods A total of 590 fishery workers including those working as oyster shuckers in 2015–2017 were included in the study analysis. Hand osteoarthritis (OA), carpal tunnel syndrome (CTS), and ulnar impaction syndrome were diagnosed using X-ray, magnetic resonance imaging, and physical examinations according to each diagnostic criterion. The Rapid Entire Body Assessment was used as a measurement tool for analyzing the occupation-related burden factors. Results The prevalence of hand OA, CTS, and ulnar impaction syndrome was higher in oyster shuckers than in aquaculture/offshore fishery workers. The prevalence of upper limb disease was higher in oyster shuckers than in other fishery workers, even in the prevalence of exposure to occupational burden factors. In oyster shuckers, the incidence of hand and wrist OA was 84%, that of CTS was 72%, and that of ulnar impaction syndrome was 41%. In addition, oyster shuckers were more likely to be exposed to occupational burden factors than were other types of fishermen. Conclusions The prevalence of hand OA, CTS, and ulnar impaction syndrome was higher in oyster shuckers. Therefore, proper stretching or exercises for rest and musculoskeletal relaxation, along with health-care education and promotion, will be needed for the fishermen’s repeated posture and impact work. Int J Occup Med Environ Health. 2021;34(5):603–15

Background Rapid population aging in developed countries has resulted in the working-age population increasingly being tasked with the provision of informal care. Methods An educational intervention was delivered to 21 carer-employees employed at a Canadian University. Work role function, job security, schedule control, work–family conflict, familywork conflict, and supervisor and coworker support were measured as part of an aggregated workplace experience score. This score was used to measure changes pre/post intervention and at a follow-up period approximately 12 months post intervention. Three random intercept models were created via linear mixed modeling to illustrate changes in participants' workplace experience across time. Results All three models reported statistically significant random and fixed effects intercepts, with a positive coefficient of change. Conclusion This suggests that the intervention demonstrated an improvement of the workplace experience score for participants over time, with the association particularly strong immediately after intervention.

Background: The present study investigated the association between two domains of physical activity (occupational physical activity [OPA] and leisure-time physical activity [LTPA]) and sleep duration. Methods: We investigated 3,421 paid workers from the Korea National Health and Nutrition Examination Survey, 2014–2015. Sleep duration was categorized into three categories (short for less than 5 h, optimal for 5–9 h, and long for more than 9 h). OPA and LTPA were defined in terms of answers to relevant questions. Odds ratios were calculated for sleep duration according to each physical activity domain using multinomial logistic regression models. Results: There were 464 subjects (13.6%) who showed short sleep duration, and 169 subjects (4.9%) who showed long sleep duration. Prevalence of OPA and LTPA was higher in male workers than in female workers (for OPA: 3.67% and 1.76%, respectively, p = 0.0108; for LTPA: 16.14% and 6.07%, respectively, p

Background This study aimed to assess the possibility of benzene exposure in workers of a Korean semiconductor manufacturing company by reviewing the issued patents. Methods A systematic patent search was conducted with the Google “Advanced Patent Search” engine using the keywords “semiconductor” and “benzene” combined with all of the words accessed on January 24, 2016. Results As a result of the search, we reviewed 75 patent documents filed by a Korean semiconductor manufacturing company from 1994 to 2010. From 22 patents, we found that benzene could have been used as one of the carbon sources in chemical vapor deposition (CVD) for capacitor; as diamond-like carbon for solar cell, graphene formation, or etching for transition metal thin film; and as a solvent for dielectric film, silicon oxide layer, nanomaterials, photoresist, rise for immersion lithography, electrophotography, and quantum dot ink. Conclusion Considering the date of patent filing, it is possible that workers in the CVD, immersion lithography, and graphene formation processes could be exposed to benzene from 1996 to 2010.

Hazardous area classification design is required to reduce the explosion risk in process plants. Among the international design guidelines, only IEC 60079-10-1 proposes a new type of zone, namely zone 2 NE, to prevent explosion hazards. We studied how to meet the zone 2 NE grade for a facility handling hydrogen gas, which is considered as most dangerous among explosive gases. Zone 2 NE can be achieved considering the grade of release, as well as the availability and effectiveness of ventilation, which are factors indicative of the facility condition and its surroundings. In the present study, we demonstrate that zone 2 NE can be achieved when the degree of ventilation is high by accessing temperature, pressure, and size of leak hole. The release characteristic can be derived by substituting the process condition of the hydrogen gas facility. The equations are summarized considering relation of the operating temperature, operating pressure, and size of leak hole. Through this relationship, the non-hazardous condition can be realized from the perspective of inherent safety by the combination of each parameter before the initial design of the hydrogen gas facility.

Resume L’infection COVID-19 est une maladie emergeante qui peut etre grave, voire meme mortelle. Depuis son eclosion, cette maladie a genere de nombreuses situations de l’exercice medical ou la vie du patient ou son integrite physique se trouvent menacees, et pour lesquelles l’intervention salvatrice urgente du medecin est indispensable. Cette intervention en urgence pour porter secours a personne en peril constitue avant tout une obligation morale mais egalement ethique, deontologique et legale. En effet, la non-assistance a personne est consideree penalement comme un delit passible de sanctions graves. Toutefois, dans le contexte de la pandemie COVID-19, il existe un flou entourant cette infraction complexe, notamment en ce qui concerne l’evaluation du peril, et l’appreciation du risque pour soi ou pour autrui. D’ou l’interet de ce travail qui se propose d’analyser les particularites du delit de non-assistance a personne en peril dans le contexte de la pandemie COVID-19, et de detailler les enjeux judiciaires dans le domaine penal qui decoulent de cette infraction.

Backround Working condition surveys are widely recognized as useful tools for monitoring the quality of working life and the improvements introduced by health and safety policy frameworks at the European and national level. The Italian Workers' Compensation Authority carried out a national survey (Insula) to investigate the employer's perceptions related to working conditions and their impact on health. Methods The present study is based on the data collected from the Italian survey on health and safety at work (INSULA) conducted on a representative sample of the Italian workforce (n = 8,000). This focuses on the relationship between psychosocial risk factors and self-reported health using a set of logistic and linear regression models. Results Working conditions such as managerial support, job satisfaction, and role act as protective factors on mental and physical health. On the contrary, workers' risk perceptions related to personal exposure to occupational safety and health risks, concern about health conditions, and work-related stress risk exposure determine a poorer state of health. Conclusions This study highlights the link between working conditions and self-report health, and this aims to provide a contribution in the field of health at work. Findings show that working conditions must be object of specific preventive measures to improve the workers' health and well-being.

Background The surface mining industry has one of the highest fatality rates among private industries in the United States. Despite recent decreases in the fatality rates of comparable industries, the fatality rate in the surface mining industry has increased. Meanwhile, a lack of safety research in surface mining has hindered efforts to improve safety strategies in the surface mining workplace. Method This study examined quarry workers' hazard identification skills by conducting a case study of a surface mining facility in the Mid-Atlantic region of the United States. Semistructured interviews were conducted with eight quarry workers who were employed at the mine facility. In addition to the interviews, data were collected through field notes, notes from an expert meeting with safety managers, and site photographs to explore quarry workers' safety behaviors in the workplace. Results The results showed that quarry workers identified hazards and improved their safety performance by translating safety knowledge learned from training into practice, acquiring hands-on work experience, learning from coworkers, and sharing responsibilities among team members. Conclusion This study contributes to understanding quarry workers' safe performance beyond what they have learned in safety training to include their interaction with other workers and hand-on experience in the workplace. This study informs practitioners in the surface mining industry to build a safe work environment as they design effective safety programs for employees.

Background Law enforcement communications (i.e., 911 dispatch and call takers) is a challenging and stressful occupation. The purpose of this study is to identify the main stressors associated with employment in law enforcement communications, and to identify and provide context to how these stressors affect workers' health and wellbeing. Methods This research study included focus groups with 23 call takers and 911 dispatchers employed by a large, urban law enforcement agency in 2018. Thematic analyses were conducted to identify trends. Results Four themes of stressors emerged (i.e., the high stakes nature of some 911 calls for service, understaffing, supervisor-related stress, and recruiting practice). Two health-related themes emerged as being occupation-related: weight gain and poor sleep patterns/insufficient sleep). Specifically, participants reported negative eating habits resulting in weight gain and obesity, lack of sleep and irregular sleep schedules, and development of hypertension and/or diabetes since beginning their jobs. Conclusion Law enforcement communications professionals experience a number of the same stressors facing law enforcement officers in patrol. These stressors, combined with the sedentary nature of the job, could result in long-term, chronic health problems.

Introduction Current Brazilian legislation requires that all workers exposed to noise are to be given an audiogram upon hiring, after 6 months of employment (first periodic test), and annually after the first periodic test. In other countries, the regulations of hearing conservation programs do not include the requirement for audiometric testing at 6 months of employment, but only annually. There is no evidence that the periodicity adopted by Brazilian legislation is the most appropriate. Objective The present study aimed to evaluate the first 3 occupational audiometric tests of workers exposed to noise. Methods Historical cohort study with cross-sectional analysis. Participants were all male metallurgy workers aged up to 40 years. The first 3 audiograms of each worker were analyzed: pre-employment audiometric test, periodic audiometric test 1, and periodic audiometric test 2. For each worker, mean frequency thresholds were calculated at 3, 4, and 6 kHz in the left and right ears for each test. Statistical analysis was performed using the nonparametric Wilcoxon test. Results A total of 988 workers were included. There was a significant difference in auditory thresholds between the pre-employment test and the 2 subsequent periodic tests for the right and left ears. There was no significant difference between Test1 and Test2 in either ear. Conclusion Given the lack of difference between the first 2 periodic tests, we believe that they could be merged into a single test, i.e., first periodic audiometric testing could be performed at 12 months of employment without compromising workers’ health.

There is growing interest in the use of systems-based risk assessment methods in Human Factors and Ergonomics (HFE). The purpose of this study was to test the intra-rater reliability and criterion-referenced concurrent validity of three systems-based risk assessment approaches: (i) the Systems-Theoretic Process Analysis (STPA) method; (ii) the Event Analysis of Systemic Teamwork Broken Links (EAST-BL) method; and, (iii) the Network Hazard Analysis and Risk Management System (Net-HARMS) method. Reliability and validity measures were obtained using the Signal Detection Theory (SDT) paradigm. Whilst STPA identified the highest number of risks, the findings indicate a weak to moderate level of reliability and validity for STPA, EAST-BL and Net-HARMS. There were no statistically significant differences between the methods across analyses. The results suggest that there is merit to the continued use of systems-based risk assessment methods following a series of methodological extensions that aim to enhance the reliability and validity of future applications. Practitioner summary The three risk assessment methods produced weak to moderate levels of stability and accuracy regarding their capability to predict risks. There is a pressing need to further test the reliability and validity of safety methods in Human Factors and Ergonomics.

Zusammenfassung Corona-Pandemie, Digitalisierung, Green Deal – die mittelständischen Unternehmen stehen in den kommenden Jahren neben ihren branchen- und größenspezifischen Aufgaben vor großen Herausforderungen. Diese können sie nur bewältigen, wenn die Politik ihnen einen verlässlichen Rahmen bietet, innerhalb dessen sie wirtschaftlich agieren können. Friederike Welter und Britta Levering zeigen in ihrem Beitrag, worauf die Mittelstandspolitik in Gesetzgebung und Gestaltung von Unterstützungsmaßnahmen aus Sicht der Mittelstandsforschung achten sollte, damit die Wettbewerbs- und Innovationsfähigkeit der mittelständischen Unternehmen nachhaltig gestärkt wird.

Legionella pneumophila is an opportunistic bacterial respiratory pathogen that is one of the leading causes of drinking water outbreaks in the United States. Dental offices pose a potential risk for inhalation or aspiration of L. pneumophila due to the high surface area to volume ratio of dental unit water lines—a feature that is conducive to biofilm growth. This is coupled with the use of high-pressure water devices (e.g., ultrasonic scalers) that produce fine aerosols within the breathing zone. Prior research confirms that L. pneumophila occurs in dental unit water lines, but the associated human health risks have not been assessed. We aimed to: (1) synthesize the evidence for transmission and management of Legionnaires’ disease in dental offices; (2) create a quantitative modeling framework for predicting associated L. pneumophila infection risk; and (3) highlight influential parameters and research gaps requiring further study. We reviewed outbreaks, management guidance, and exposure studies and used these data to parameterize a quantitative microbial risk assessment (QMRA) model for L. pneumophila in dental applications. Probabilities of infection for dental hygienists and patients were assessed on a per-exposure and annual basis. We also assessed the impact of varying ventilation rates and the use of personal protective equipment (PPE). Following an instrument purge (i.e., flush) and with a ventilation rate of 1.2 air changes per hour, the median per-exposure probability of infection for dental hygienists and patients exceeded a 1-in-10,000 infection risk benchmark. Per-exposure risks for workers during a purge and annual risks for workers wearing N95 masks did not exceed the benchmark. Increasing air change rates in the treatment room from 1.2 to 10 would achieve an ∼85% risk reduction, while utilization of N95 respirators would reduce risks by ∼95%. The concentration of L. pneumophila in dental unit water lines was a dominant parameter in the model and driver of risk. Future risk assessment efforts and refinement of microbiological control protocols would benefit from expanded occurrence datasets for L. pneumophila in dental applications.

Occupational heat exposure is linked to the development of kidney injury and disease in individuals who frequently perform physically demanding work in the heat. For instance, in Central America, an epidemic of chronic kidney disease of nontraditional origin (CKDnt) is occurring among manual laborers, whereas potentially related epidemics have emerged in India and Sri Lanka. There is growing concern that workers in the United States suffer with CKDnt, but reports are limited. One of the leading hypotheses is that repetitive kidney injury caused by physical work in the heat can progress to CKDnt. Whether heat stress is the primary causal agent or accelerates existing underlying pathology remains contested. However, the current evidence supports that heat stress induces tubular kidney injury, which is worsened by higher core temperatures, dehydration, longer work durations, muscle damaging exercise, and consumption of beverages containing high levels of fructose. The purpose of this narrative review is to identify occupations that may place US workers at greater risk of kidney injury and CKDnt. Specifically, we reviewed the scientific literature to characterize the demographics, environmental conditions, physiological strain (i.e., core temperature increase, dehydration, heart rate), and work durations in sectors typically experiencing occupational heat exposure, including farming, wildland firefighting, landscaping, and utilities. Overall, the surprisingly limited available evidence characterizing occupational heat exposure in US workers supports the need for future investigations to understand this risk of CKDnt.

Background Drivers suffering from epilepsy are commonly regarded as a threat to road safety. However, inability to use their own means of transport very often implies specific professional effects and lowers the quality of life. The aim of this study was to analyze the driving status of patients with epilepsy in Poland. Material and methods The prospective study was performed using an independent questionnaire developed by the authors, consisting of 4 parts: 1) socio-demographic information, 2) clinical information, 3) driving information, and 4) opinions about patients with epilepsy as drivers. The study was conducted in November 2018-September 2019. A total of 188 patients completed this study. Results More than one-quarter of the patients have a driving license. Among them, 35 individuals (accounting for 18.62% of the whole study group) said that they had received their driving license after the diagnosis of epilepsy. In 10 cases (5.32%), seizures occurred while the patients were driving and in 72 cases (38.30%) while they were traveling as passengers. Among all socio-clinical factors, having a driving license was conditioned by the marital status (p = 0.008) and education (p = 0.007). Other factors did not affect having a driving license or the time of obtaining the license (p > 0.05 for all cases). A relationship was observed between the occurrence of side effects of antiepileptic drugs and the occurrence of seizures while traveling as a car passenger (p = 0.001). Other factors did not affect the occurrence of epileptic seizures while traveling by car, either as a driver or a passenger (p > 0.05). Conclusions A significant proportion of the respondents were of the opinion that patients with epilepsy should not be allowed to obtain a driving license, which is probably related to concerns about the occurrence of epileptic seizures while driving. It is necessary to conduct a nationwide educational and information campaign on epilepsy in various aspects. Med Pr. 2021;72(4):341-50.