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Abstract Artificial intelligence (AI) has tremendous potential to improve the cognitive and work burden of clinicians across a range of clinical activities, which could lead to reduced burnout and better clinical care. The recent explosion of generative AI nicely illustrates this potential. Developers and organizations deploying AI have a responsibility to ensure AI is designed and implemented with end-user input, has mechanisms to identify and potentially reduce bias, and that the impact on cognitive and work burden is measured, monitored, and improved. This article focuses specifically on the role AI can play in reducing cognitive and work burden, outlines the critical issues associated with the use of AI, and serves as a call to action for vendors and users to work together to develop functionality that addresses these challenges. Lay Summary Artificial intelligence (AI) has tremendous potential to improve the workload and ability of clinicians to make better decisions across a range of clinical activities, which could lead to reduced burnout and better clinical care. Technology companies and healthcare organizations have a responsibility to ensure AI is designed and implemented with doctors, nurses, and patients in mind. The actual impact on clinical care, patients, and related clinician workload should be consistently measured, monitored, and improved, and this article outlines an approach that companies and organizations can take.

Background Despite increasing attention to nurse fatigue globally, little is known about its prevalence and contributing factors among Egyptian oncology nurses. Work-related fatigue and burden not only affect nurses’ well-being but also compromise patient care quality and healthcare system efficiency. This study aimed to assess the prevalence of work-related fatigue and burden among oncology nurses in Egypt and to identify their associated factors. Methods An observational cross-sectional study was conducted at the Mansoura Oncology Center in Egypt. A convenience sampling method was used to recruit 273 nurses during their work shifts. Data were collected through a structured face-to-face questionnaire, incorporating socio-demographic details and the Arabic version of the “Self-diagnosis Checklist for Assessment of Workers’ Accumulated Fatigue”. Data were analyzed using SPSS version 27, employing descriptive statistics, chi-square tests, and logistic regression to identify significant predictors. Results The mean fatigue score among participants was 16.2 ± 7.5, with 24.5% of nurses experiencing grade IV fatigue. Regarding work burden, 68.1% of nurses reported grade D burden. Multivariate analysis revealed that being married, holding a bachelor’s degree or higher, and having less than 10 years of work experience were independent predictors of grade IV fatigue, with adjusted odds ratios (AOR) of 2.8, 2.2, and 2.4, respectively. Grade D burden was independently associated with being unmarried (AOR = 2.2) and reporting insufficient income (AOR = 2.8). Conclusions The findings highlight a high prevalence of severe work-related fatigue and burden among oncology nurses in Egypt. Addressing these challenges through institutional policies, adequate staffing, financial support, and targeted mental health interventions is essential. Further research should explore causal relationships and implement interventions to mitigate fatigue and burden in oncology nursing practice.

While the health and environmental benefits of adopting clean cooking fuel are widely documented in the literature, the immediate and direct benefit—women’s time-saving for fuel collection/preparation and cooking—has received little or no attention. Using panel data from 6 energy-poor Indian states involving about 9000 households, we test whether liquefied petroleum gas (LPG) adoption enhances women’s welfare by reducing fuel collection/preparation and cooking time and improving the overall cooking experience through a convenient and efficient cooking arrangement. We also explore the association between women’s participation in decision-making and the likelihood of LPG adoption and refill. The findings reveal that LPG adopters save time by collecting firewood less frequently and preparing fewer pieces of dung cake than non-adopters. Additionally, LPG adopters save 15 min of cooking time per day than non-adopters. Finally, LPG adoption makes the cooking experience more convenient and simpler than traditional cooking fuel. Women’s sole or joint decision-making power is positively correlated with LPG adoption and refilling LPG cylinders. These findings imply that the true social benefit of clean cooking fuel adoption is much greater than the welfare gain accrued through greenhouse gas mitigation and health benefits from cleaner air. However, these positive externalities are less likely to be internalized in fuel choice decisions in households where women do not participate in important household decision-making.

Objective To study the association between breast cancer and work burden over 25 years. Methods The study was based on the Kuopio Osteoporosis Risk Factor and Prevention (OSTPRE) cohort (n = 14,220) and included women who had answered the questionnaire from the year 1994 and had no previous breast cancer. Breast cancer cases were recorded from the Finnish Cancer Registry during the study period: from 1st June 1994 till December 31, 2019. Using questionnaires, we collected information on work burden, body mass index (BMI), menopausal hormone therapy (MHT), alcohol consumption, parity, and family history of breast cancer. Work burden was categorized as low or high. Variables were used both in the univariate and multivariate Cox regression analyses to explore their associations with breast cancer. Results Altogether 825 women (6.9%) were diagnosed with breast cancer during the study period with a mean follow-up of 13.3 ± 7.2 years. Women with breast cancer were compared to those without breast cancer during the follow-up period (n = 11,117). A low work burden was associated with a 1.3-fold higher incidence of breast cancer (95% confidence interval 1.2–1.6) than a high work burden. Low work burden was associated with an increased breast cancer risk. Conclusion Low work burden is associated with elevated postmenopausal breast cancer risk in the 25-year follow-up period.

Objectives: “Karoshi” (death due to overwork) of doctors occurred frequently and attracted increasing attention in recent years in China. This study aimed to determine the prevalence of work-related accumulated fatigue of doctors and its associated factors in tertiary hospitals of China. Methods: A cross-sectional questionnaire survey was conducted on 1729 full-time doctors employed by 24 tertiary hospitals across eastern developed, central developing, and western underdeveloped regions of China. Accumulated fatigue was categorized into four levels using the “Self-diagnosis Checklist for Assessment of Workers’ Accumulated Fatigue” rated on a scale matrix considering both overwork and fatigue symptoms. Ordinal logistic regression analyses were performed to identify factors associated with work-related accumulated fatigue. Results: About 78.8% of respondents reported a “high level” of work-related accumulated fatigue, including 42.0% at a “very high” level. Male doctors and those aged between 30 and 45 years and who had a professional title were found to have higher levels of accumulative fatigue than others. Low salary and poor working conditions (in the western region) were also significantly associated with high levels of work-related accumulated fatigue (p < 0.05). Conclusion: High levels of work-related accumulated fatigue are prevalent in doctors working in tertiary hospitals in China. Male doctors establishing their early- and mid-careers are the high-risk group. Poor working conditions are associated with work-related accumulated fatigue.

We provide a brief introduction to the objectives, data, methods and results of the World Health Organization (WHO)/International Labor Organization (ILO) Joint Estimates of the Work-related Burden of Disease and Injury (WHO/ILO Joint Estimates), which estimated the burden attributable to 19 selected occupational risk factors. The WHO/ILO Joint Estimates were produced within the global Comparative Risk Assessment framework, which attributes the burden of one specific health outcome (ie, disease/injury) to a specific occupational risk factor. For 39 established occupational risk factor-health outcome pairs, estimates are produced using population attributable fractions (PAF) from recent burden of disease estimates. For two additional pairs, PAF are calculated from new databases of exposure and risk ratios produced in WHO/ILO systematic reviews. Attributable disease burdens were estimated by applying the PAF to total disease burdens. Globally in 2016, it is estimated that 1.88 [95% uncertainty range (UR) 1.84-1.92] million deaths and 89.72 (95% UR 88.61-90.83) million disability-adjusted life years were attributable to the 19 selected occupational risk factors and their health outcomes. A disproportionately large work-related burden of disease is observed in the WHO African Region (for disability-adjusted life years), South-East Asia Region, and Western Pacific Region (for deaths), males and older age groups. The WHO/ILO Joint Estimates can be used for global monitoring of exposure to occupational risk factors and work-related burden of disease and to identify, plan, cost, implement and evaluate policies, programs and actions to prevent exposure to occupational risk factors and their associated burden.

ABSTRACT BACKGROUND The use of electronic health records (EHR) is widely recommended as a means to improve the quality, safety and efficiency of US healthcare. Relatively little is known, however, about how implementation and use of this technology affects the work of clinicians and support staff who provide primary health care in small, independent practices. OBJECTIVE To study the impact of EHR use on clinician and staff work burden in small, community-based primary care practices. DESIGN We conducted in-depth field research in seven community-based primary care practices. A team of field researchers spent 9–14 days over a 4–8 week period observing work in each practice, following patients through the practices, conducting interviews with key informants, and collecting documents and photographs. Field research data were coded and analyzed by a multidisciplinary research team, using a grounded theory approach. PARTICIPANTS All practice members and selected patients in seven community-based primary care practices in the Northeastern US. KEY RESULTS The impact of EHR use on work burden differed for clinicians compared to support staff. EHR use reduced both clerical and clinical staff work burden by improving how they check in and room patients, how they chart their work, and how they communicate with both patients and providers. In contrast, EHR use reduced some clinician work (i.e., prescribing, some lab-related tasks, and communication within the office), while increasing other work (i.e., charting, chronic disease and preventive care tasks, and some lab-related tasks). Thoughtful implementation and strategic workflow redesign can mitigate the disproportionate EHR-related work burden for clinicians, as well as facilitate population-based care. CONCLUSIONS The complex needs of the primary care clinician should be understood and considered as the next iteration of EHR systems are developed and implemented.

Many mainstream schools of economics argue that work is a burden, while nonmainstream schools argue that this might not be entirely true. This paper aims to reconcile this difference by suggesting that individuals will balance income and leisure only after the fixed expense for their current living standard is met. Three applications show that the above explanation can reconcile different historical perspectives, explain various discrepancies about labor supply between neoclassical theory predictions and empirical findings, and reconcile the different interpretations about lottery winners’ labor supply.

OBJECTIVE: This study provides the global-, regional- and country-level estimates on the work-related burden of diseases and accidents for 2019, including deaths, disability adjusted life years (DALY) and economic losses. METHODS: Data on occupational illnesses and injuries from international organizations, institutions, and public websites were used. Risk ratios (RR) and population attributable fractions (PAF) for the risk factor-outcome pairs were derived from the literature. Estimated mortality and DALY for a group of seven major diseases covering 120 risk-outcome pairs attributable to work were calculated for 181 countries. RESULTS: Globally, 2.9 million deaths were attributed to work, with 2.58 million deaths due to work-related diseases and 0.32 million related to occupational injuries. Globally, work-related diseases with a long latency period are increasing, while the number of occupational injuries has decreased. Work-related circulatory diseases were the major cause of 912 000 deaths globally, followed by 843 000 work-related malignant neoplasms. In high-income, American, Eastern European and Western Pacific World Health Organization (WHO) regions, however, work-related malignant neoplasms comprised the biggest disease group. DALY attributable to work were estimated to be 180 million in 2019, with an associated economic loss of 5.8% of global GDP. New estimates of psychosocial factors increased the global loss. CONCLUSIONS: The burden of work-related diseases and injuries increased by 26% from 2.3 million annual deaths in 2014 to 2.9 million in 2019. The DALY attributable to work have also substantially increased from 123 million in 2014 to 180 million in 2019 (47% increase). We found large regional and country variations.

Introduction We aim to characterize the magnitude of the work burden (weeks off from work) associated with prostate cancer (PCa) treatment over a 10‐year period after PCa diagnosis and identify those at greatest risk. Materials and Methods We identified men diagnosed with PCa treated with radical prostatectomy, radiation therapy, or active surveillance/watchful waiting within CaPSURE. Patients self‐reported work burden and SF36 general health scores via surveys before and 1,3,5, and 10 years after treatment. Using multivariate repeated measures generalized estimating equation modeling we examined the association between primary treatment with risk of any work weeks lost due to care. Results In total, 6693 men were included. The majority were White (81%, 5% Black, and 14% Other) with CAPRA low‐ (60%) or intermediate‐risk (32%) disease and underwent surgery (62%) compared to 29% radiation and 9% active surveillance. Compared to other treatments, surgical patients were more likely to report greater than 7 days off work in the first year, with relatively less time off over time. Black men (RR 0.64, 95% CI 0.54–0.77) and those undergoing radiation (vs. surgery, RR 0.46, 95% CI 0.41–0.51) were less likely to report time off from work over time. Mean baseline GH score (73 [SD 18]) was similar between race and treatment groups, and stable over time. Conclusions The work burden of cancer care continued up to 10 years after treatment and varied across racial groups and primary treatment groups, highlighting the multifactorial nature of this issue and the call to leverage greater resources for those at greatest risk. Within this longitudinal study of 6693 men treated for prostate cancer, time take off from work due to PCa treatment persisted up to 10 years after primary treatment. The long‐term impact of PCa treatment was not limited only to those with paid jobs and was found to also effect one's usual activities/responsibilities and general health of all men with PCa.