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"Occupational health practice"
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Fitness for work during the COVID-19 disease: principles and suggested assistive tool for protecting workers during the pandemic era
ObjectiveAmongst the many intricacies engendered by the COVID-19 pandemic was the posed risk of exposure to SARS-COV2 infections among workers and the need to evaluate fitness for work (FFW) of individuals in high exposure groups or those with background morbidity. A designated task force of the Israeli Association of Occupational Medicine has evaluated the relevant literature and published guidelines concerning medical work restrictions for employees in high-risk occupations during the epidemic of novel COVID-19.MethodsThe study depicts a case series of 17 FFW evaluations performed in Maccabi Health Services occupational clinics using the guidelines formulated by the Israeli Occupational Medicine Association.Results17 patients, mainly healthcare workers, whose major health hazards were immunodeficiency, respiratory diseases and pregnancy, were assessed in this case series. We present the essential parameters of these FFW evaluations and discuss decision-making in selected cases.ConclusionsApplying guidelines in various work settings and health risk levels during the SARS-CoV-2 pandemic allows for both patients' health preservation and efficient workforce deployment.
Journal Article
Association between SARS-CoV-2 infection, exposure risk and mental health among a cohort of essential retail workers in the USA
ObjectivesTo investigate SARS-CoV-2 (the virus causing COVID-19) infection and exposure risks among grocery retail workers, and to investigate their mental health state during the pandemic.MethodsThis cross-sectional study was conducted in May 2020 in a single grocery retail store in Massachusetts, USA. We assessed workers’ personal/occupational history and perception of COVID-19 by questionnaire. The health outcomes were measured by nasopharyngeal SARS-CoV-2 reverse transcriptase PCR (RT-PCR) results, General Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9).ResultsAmong 104 workers tested, 21 (20%) had positive viral assays. Seventy-six per cent positive cases were asymptomatic. Employees with direct customer exposure had an odds of 5.1 (95% CI 1.1 to 24.8) being tested positive for SARS-CoV-2 after adjustments. As to mental health, the prevalence of anxiety and depression (ie, GAD-7 score >4 or PHQ-9 score >4) was 24% and 8%, respectively. After adjusting for potential confounders, those able to practice social distancing consistently at work had odds of 0.3 (95% CI 0.1 to 0.9) and 0.2 (95% CI 0.03 to 0.99) screening positive for anxiety and depression, respectively. Workers commuting by foot, bike or private cars were less likely to screen positive for depression (OR 0.1, 95% CI 0.02 to 0.7).ConclusionsIn this single store sample, we found a considerable asymptomatic SARS-CoV-2 infection rate among grocery workers. Employees with direct customer exposure were five times more likely to test positive for SARS-CoV-2. Those able to practice social distancing consistently at work had significantly lower risk of anxiety or depression.
Journal Article
Occupational factors in the COVID-19 pandemic in Italy: compensation claims applications support establishing an occupational surveillance system
IntroductionThe SARS-CoV-2 pandemic is an impacting challenge for occupational health. Epidemiological surveillance of COVID-19 includes systematic tracking and reporting of the total cases and deaths, but suitable experiences of surveillance systems for identifying the occupational risk factors involved in the COVID-19 pandemic are still missing, despite the interest for occupational safety and health.MethodsA methodological approach has been implemented in Italy to estimate the occupational risk of infection, classifying each economic sector as at low, medium-low, medium-high and high risk, based on three parameters: exposure probability, proximity index and aggregation factor. Furthermore, during the epidemic emergency, the Italian Workers’ Compensation Authority introduced the notation of COVID-19 work-related infection as an occupational injury and collected compensation claims of workers from the entire national territory.ResultsAccording to compensation claims applications, COVID-19 infection in Italy has been acquired at the workplace in a substantial portion of the total cases (19.4%). The distribution of the economic sectors involved is coherent with the activities classified at risk in the lockdown period. The economic sectors mostly involved were human health and social work activities, but occupational compensation claims also include cases in meat and poultry processing plants workers, store clerks, postal workers, pharmacists and cleaning workers.ConclusionsThere is a need to go towards an occupational surveillance system for COVID-19 cases, including an individual anamnestic analysis of the circumstances in which the infection is acquired, for the prevention of occupational infectious risk, supporting insurance system effectiveness and managing vaccination policies.
Journal Article
Migrant workers and COVID-19
ObjectivesDaily numbers of COVID-19 in Singapore from March to May 2020, the cause of a surge in cases in April and the national response were examined, and regulations on migrant worker accommodation studied.MethodsInformation was gathered from daily reports provided by the Ministry of Health, Singapore Statues online and a Ministerial statement given at a Parliament sitting on 4 May 2020.ResultsA marked escalation in the daily number of new COVID-19 cases was seen in early April 2020. The majority of cases occurred among an estimated 295 000 low-skilled migrant workers living in foreign worker dormitories. As of 6 May 2020, there were 17 758 confirmed COVID-19 cases among dormitory workers (88% of 20 198 nationally confirmed cases). One dormitory housing approximately 13 000 workers had 19.4% of residents infected. The national response included mobilising several government agencies and public volunteers. There was extensive testing of workers in dormitories, segregation of healthy and infected workers, and daily observation for fever and symptoms. Twenty-four dormitories were declared as ‘isolation areas’, with residents quarantined for 14 days. New housing, for example, vacant public housing flats, military camps, exhibition centres, floating hotels have been provided that will allow for appropriate social distancing.ConclusionThe COVID-19 pandemic has highlighted migrant workers as a vulnerable occupational group. Ideally, matters related to inadequate housing of vulnerable migrant workers need to be addressed before a pandemic.
Journal Article
Identification of early-stage silicosis through health screening of stone benchtop industry workers in Victoria, Australia
ObjectivesThe popularity of high silica content artificial stone has been associated with emergence of severe, progressive silicosis as a major health issue affecting workers in the stone benchtop industry. This population-based health assessment programme has been implemented with the aim of identifcation of silica-associated disease at a preclinical stage.MethodsAll current and former workers from the stone benchtop industry in the State of Victoria are offered free health assessments. Primary evaluations include a standardised questionnaire, physical examination, spirometry and gas transfer assessment and International Labour Organisation-categorised chest X-ray. Secondary evaluations include high-resolution CT chest, blood tests and a respiratory physician evaluation.ResultsAt the end of the first 12 months, 86/239 (36%) workers who had completed secondary evaluation were diagnosed with silicosis (65 simple silicosis and 21 complicated silicosis). 22 had worked in the industry for less than 10 years at the time of diagnosis. Of those with simple silicosis, 80% of workers reported breathlessness only with strenuous exercise (modified Medical Research Council score of 0), and lung function was well preserved (prebronchodilator forced vital capacity mean 99.8% predicted (SD 13.6), diffusion capacity of the lung for carbon monoxide mean 96.2% predicted (SD 18.0)). Antinuclear antibodies were detected in 37% with silicosis and 24% without silicosis.ConclusionEarly results from this comprehensive health assessment programme have indicated a high proportion of referred artificial stone benchtop workers have silicosis, including many with early-stage disease. The common finding of antinuclear antibodies suggest significant potential for autoimmune disease in this occupational group.
Journal Article
Effects of office workstation type on physical activity and stress
ObjectiveOffice environments have been causally linked to workplace-related illnesses and stress, yet little is known about how office workstation type is linked to objective metrics of physical activity and stress. We aimed to explore these associations among office workers in US federal office buildings.MethodsWe conducted a wearable, sensor-based, observational study of 231 workers in four office buildings. Outcome variables included workers’ physiological stress response, physical activity and perceived stress. Relationships between office workstation type and these variables were assessed using structural equation modelling.ResultsWorkers in open bench seating were more active at the office than those in private offices and cubicles (open bench seating vs private office=225.52 mG (31.83% higher on average) (95% CI 136.57 to 314.46); open bench seating vs cubicle=185.13 mG (20.16% higher on average) (95% CI 66.53 to 303.72)). Furthermore, workers in open bench seating experienced lower perceived stress at the office than those in cubicles (−0.27 (9.10% lower on average) (95% CI −0.54 to −0.02)). Finally, higher physical activity at the office was related to lower physiological stress (higher heart rate variability in the time domain) outside the office (−26.12 ms/mG (14.18% higher on average) (95% CI −40.48 to −4.16)).ConclusionsOffice workstation type was related to enhanced physical activity and reduced physiological and perceived stress. This research highlights how office design, driven by office workstation type, could be a health-promoting factor.
Journal Article
Mask-associated ‘de novo’ headache in healthcare workers during the COVID-19 pandemic
ObjectivesThe pandemic caused by the new coronavirus (COVID-19) has changed care activities of health professionals. We analysed the possible association between the appearance of ‘de novo’ headache according to the type of mask used, the related factors and the impact of the cephalalgia on health professionals.MethodsCross-sectional study in a tertiary hospital in Extremadura, Spain. We provided an online questionnaire to healthcare workers during the period of maximum incidence of COVID-19 in our setting.ResultsThe subjects are n=306, 244 women (79.7%), with an average age of 43 years (range 23–65). Of the total, 129 (42.2%) were physicians, 112 (36.6%) nurses and 65 (21.2%) other health workers. 208 (79.7%) used surgical masks and 53 (20.3%) used filter masks. Of all those surveyed, 158 (51.6%) presented ‘de novo’ headache. The occurrence of a headache was independently associated with the use of a filter mask, OR 2.14 (95% CI 1.07 to 4.32); being a nurse, OR 2.09 (95% CI 1.18 to 3.72) or another health worker, OR 6.94 (95% CI 3.01 to 16.04); or having a history of asthma, OR 0.29 (95% CI 0.09 to 0.89). According to the type of mask used, there were differences in headache intensity, and the impact of a headache in the subjects who used a filter mask was worse in all the aspects evaluated.ConclusionThe appearance of ‘de novo’ headache is associated with the use of filter masks and is more frequent in certain healthcare workers, causing a greater occupational, family, personal and social impact.
Journal Article