In fire evacuations, pre-movement time (PT) is an important part of the total egress time. Data from fire drills is commonly used to investigate occupant behavior, including PT, but these data are often subjected to censoring. This study examines the impact of data censoring on PT analysis during fire evacuation drills, which is important for predicting overall evacuation time. It identifies various types of data censorship and highlights the importance of accounting for censored data in statistical analyses. The research utilizes the Accelerated Failure Time model (AFT), a parametric survival analysis method, to address data censoring issues. Data from two fire evacuation drills in residential buildings with occupants with learning disability were analyzed using two scenarios: one excluding censored data and another incorporating it. The results demonstrate that accounting for censored data significantly alters the interpretation of the causal model, with covariates such as fire incident time emerging as significant only when censored data is considered. The AFT model effectively manages censored data by updating predictions for observed events and extrapolating values for censored observations using the best-fit distribution. This study underscores the importance of incorporating censored data into evacuation models emphasizing that excessive data censoring reduces the validity of AFT model predictions. Although limited by sample size, these findings offer valuable insights into effective covariates influencing PT and provide guidance for future evacuation modeling and simulation tools.
{"title":"The impact of data censorship on pre-movement time prediction in building fire evacuation: focusing on people with learning disabilities","authors":"Naser Kazemi Eilaki , Trond Nordvik , Carolyn Ahmer , Ilona Heldal , Håkan Frantzich , Bjarne Christian Hagen","doi":"10.1016/j.ssci.2025.107103","DOIUrl":"10.1016/j.ssci.2025.107103","url":null,"abstract":"<div><div>In fire evacuations, pre-movement time (PT) is an important part of the total egress time. Data from fire drills is commonly used to investigate occupant behavior, including PT, but these data are often subjected to censoring. This study examines the impact of data censoring on PT analysis during fire evacuation drills, which is important for predicting overall evacuation time. It identifies various types of data censorship and highlights the importance of accounting for censored data in statistical analyses. The research utilizes the Accelerated Failure Time model (AFT), a parametric survival analysis method, to address data censoring issues. Data from two fire evacuation drills in residential buildings with occupants with learning disability were analyzed using two scenarios: one excluding censored data and another incorporating it. The results demonstrate that accounting for censored data significantly alters the interpretation of the causal model, with covariates such as fire incident time emerging as significant only when censored data is considered. The AFT model effectively manages censored data by updating predictions for observed events and extrapolating values for censored observations using the best-fit distribution. This study underscores the importance of incorporating censored data into evacuation models emphasizing that excessive data censoring reduces the validity of AFT model predictions. Although limited by sample size, these findings offer valuable insights into effective covariates influencing PT and provide guidance for future evacuation modeling and simulation tools.</div></div>","PeriodicalId":21375,"journal":{"name":"Safety Science","volume":"196 ","pages":"Article 107103"},"PeriodicalIF":5.4,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-26DOI: 10.1016/j.ssci.2025.107104
Adewoyin A. Osonuga , Ayokunle Osonuga , Deborah Omeni , Gloria C. Okoye , Eghosasere Egbon , David B. Olawade
Hospital falls represent a critical patient safety challenge, affecting millions of patients globally and resulting in substantial morbidity, mortality, and healthcare costs. Traditional fall prevention strategies, whilst beneficial, often lack the precision and real-time responsiveness needed for optimal patient protection. This narrative review with systematic search examines the current applications, effectiveness, and implementation challenges of artificial intelligence (AI) technologies in hospital fall prevention. A comprehensive search was conducted across PubMed, EMBASE, IEEE Xplore, and Google Scholar databases from January 2015 to October 2024. AI technologies demonstrate promise across four primary domains: machine learning predictive models achieving AUROC of 0.85–0.97 (with calibration reported variably), computer vision systems enabling real-time behavioural monitoring (94–97% detection accuracy in controlled settings), sensor-based technologies providing continuous patient surveillance (89–96% accuracy with multi-sensor fusion), and natural language processing enhancing risk factor extraction from clinical documentation (sensitivity 95% CI in selected studies). These metrics represent primarily single-site, retrospective studies with limited external validation and variable baseline fall rates. Successful implementations report fall reduction rates of 0.9–1.2 falls per 1,000 patient-days (15–40% relative reduction) across various healthcare settings, though baseline rates ranged from 2.8 to 5.1 falls per 1,000 patient-days across different care settings, and secular trends and study design heterogeneity limit causal inference. AI-driven systems offer enhanced prediction accuracy, real-time monitoring capabilities, and personalised risk assessment. However, implementation challenges include alarm fatigue (alert rates and positive predictive value rarely reported), algorithmic bias requiring ongoing fairness audits, liability concerns when AI systems fail to prevent falls, data privacy concerns, integration complexities, clinical workflow adaptation, and substantial cost barriers for smaller institutions. Future developments should prioritize explainable AI systems, multisite external validation with standardised metrics (AUROC, AUPRC, calibration), federated learning approaches, and implementation trials examining both fall rates and care process outcomes.
{"title":"Artificial intelligence in hospital fall Prevention: Current Applications, Challenges, and Future Directions","authors":"Adewoyin A. Osonuga , Ayokunle Osonuga , Deborah Omeni , Gloria C. Okoye , Eghosasere Egbon , David B. Olawade","doi":"10.1016/j.ssci.2025.107104","DOIUrl":"10.1016/j.ssci.2025.107104","url":null,"abstract":"<div><div>Hospital falls represent a critical patient safety challenge, affecting millions of patients globally and resulting in substantial morbidity, mortality, and healthcare costs. Traditional fall prevention strategies, whilst beneficial, often lack the precision and real-time responsiveness needed for optimal patient protection. This narrative review with systematic search examines the current applications, effectiveness, and implementation challenges of artificial intelligence (AI) technologies in hospital fall prevention. A comprehensive search was conducted across PubMed, EMBASE, IEEE Xplore, and Google Scholar databases from January 2015 to October 2024. AI technologies demonstrate promise across four primary domains: machine learning predictive models achieving AUROC of 0.85–0.97 (with calibration reported variably), computer vision systems enabling real-time behavioural monitoring (94–97% detection accuracy in controlled settings), sensor-based technologies providing continuous patient surveillance (89–96% accuracy with multi-sensor fusion), and natural language processing enhancing risk factor extraction from clinical documentation (sensitivity 95% CI in selected studies). These metrics represent primarily single-site, retrospective studies with limited external validation and variable baseline fall rates. Successful implementations report fall reduction rates of 0.9–1.2 falls per 1,000 patient-days (15–40% relative reduction) across various healthcare settings, though baseline rates ranged from 2.8 to 5.1 falls per 1,000 patient-days across different care settings, and secular trends and study design heterogeneity limit causal inference. AI-driven systems offer enhanced prediction accuracy, real-time monitoring capabilities, and personalised risk assessment. However, implementation challenges include alarm fatigue (alert rates and positive predictive value rarely reported), algorithmic bias requiring ongoing fairness audits, liability concerns when AI systems fail to prevent falls, data privacy concerns, integration complexities, clinical workflow adaptation, and substantial cost barriers for smaller institutions. Future developments should prioritize explainable AI systems, multisite external validation with standardised metrics (AUROC, AUPRC, calibration), federated learning approaches, and implementation trials examining both fall rates and care process outcomes.</div></div>","PeriodicalId":21375,"journal":{"name":"Safety Science","volume":"196 ","pages":"Article 107104"},"PeriodicalIF":5.4,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-24DOI: 10.1016/j.ssci.2025.107102
José V. Riera , Carlos Reaño , Verónica Romero , Pedro Morillo , Sergio Casas-Yrurzum
In most developed countries, legislation on personal protective equipment (PPE) requires employers not only to provide PPE to their workers but also to record the process in order to ensure adequate traceability. While employers are obligated to register the delivery of PPE, this process is often conducted manually, leading to mistakes and potential inaccuracies. This paper proposes an Augmented Reality (AR)-based system designed to streamline PPE delivery and registration by integrating marker-based recognition, mobile AR visualization, and interactive training modules. The system allows workers to scan PPE items using QR codes, ensuring automated tracking and digital record-keeping, while also providing on-demand safety training videos linked to each piece of equipment. A user study with 45 participants was conducted to evaluate the system’s usability, cognitive workload, and user satisfaction. The results indicate a high usability rating, with a System Usability Scale (SUS) score of 83.5, placing the system in the “excellent” category. The NASA Task Load Index (NASA-TLX) assessment revealed low mental and physical demand, confirming its accessibility for users with varying experience levels. Despite these positive outcomes, challenges such as technological adoption barriers, hardware ergonomics, and scalability concerns were identified. The findings suggest that AR-based PPE management ensures compliance and provides an efficient digital alternative to conventional PPE tracking in construction environments.
{"title":"Enhancing PPE delivery and registration through augmented reality technology","authors":"José V. Riera , Carlos Reaño , Verónica Romero , Pedro Morillo , Sergio Casas-Yrurzum","doi":"10.1016/j.ssci.2025.107102","DOIUrl":"10.1016/j.ssci.2025.107102","url":null,"abstract":"<div><div>In most developed countries, legislation on personal protective equipment (PPE) requires employers not only to provide PPE to their workers but also to record the process in order to ensure adequate traceability. While employers are obligated to register the delivery of PPE, this process is often conducted manually, leading to mistakes and potential inaccuracies. This paper proposes an Augmented Reality (AR)-based system designed to streamline PPE delivery and registration by integrating marker-based recognition, mobile AR visualization, and interactive training modules. The system allows workers to scan PPE items using QR codes, ensuring automated tracking and digital record-keeping, while also providing on-demand safety training videos linked to each piece of equipment. A user study with 45 participants was conducted to evaluate the system’s usability, cognitive workload, and user satisfaction. The results indicate a high usability rating, with a System Usability Scale (SUS) score of 83.5, placing the system in the “excellent” category. The NASA Task Load Index (NASA-TLX) assessment revealed low mental and physical demand, confirming its accessibility for users with varying experience levels. Despite these positive outcomes, challenges such as technological adoption barriers, hardware ergonomics, and scalability concerns were identified. The findings suggest that AR-based PPE management ensures compliance and provides an efficient digital alternative to conventional PPE tracking in construction environments.</div></div>","PeriodicalId":21375,"journal":{"name":"Safety Science","volume":"196 ","pages":"Article 107102"},"PeriodicalIF":5.4,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Long working hours and overtime among healthcare workers (HCWs) have become a global occupational health concern. Evidence on dose–response thresholds and subgroup vulnerabilities remains limited, particularly in middle-income settings. This study examined associations between weekly working hours and mental health outcomes in a Chinese medical consortium.
Methods
A cross-sectional survey was conducted among 983 HCWs from four hospitals in Southern China (June–July 2023; response rate 92.1 %). Weekly working hours were classified using WHO/ILO cut-points (35–40, 41–48, 49–54, ≥55 h/week). Burnout, depression, sleep troubles, stress, somatic stress, and cognitive stress were measured using the COPSOQ III. Multivariable regression estimated associations, with subgroup analyses by gender, shift status, and exposure duration.
Results
A clear dose–response pattern was observed, with risk thresholds at 49 and 55 h/week. Compared with 35–40 h/week, working ≥ 55 h/week was associated with higher burnout (β = 4.23, 95 %CI 0.17–8.30), stress (β = 4.25, 95 %CI 0.24–8.26), and somatic stress (β = 5.30, 95 %CI 1.22–9.38) after adjustment. Female HCWs showed elevated risks at 49–54 h/week, whereas male HCWs mainly deteriorated ≥ 55 h/week. Shift workers demonstrated increased somatic stress from 49–54 h/week, with widespread adverse effects ≥ 55 h/week. Longer exposure duration further lowered tolerance thresholds. Work pace emerged as a robust independent correlate across outcomes.
Conclusions
Long working hours were linked to poorer mental health, with 49 and 55 h/week as warning thresholds. A triple burden of prolonged hours, high work pace, and heavy demands magnifies risk. Vulnerabilities varied by gender, shift status, and exposure duration, underscoring the need for tailored protections.
背景保健工作者（HCWs）的长时间工作和加班已成为一个全球性的职业健康问题。关于剂量反应阈值和亚组脆弱性的证据仍然有限，特别是在中等收入环境中。本研究考察了一个中国医疗联合体的每周工作时间与心理健康结果之间的关系。方法对华南地区4家医院983名卫生保健员（2023年6 - 7月，回复率92.1%）进行横断面调查。每周工作时间按照WHO/ILO的临界值（35-40、41-48、49-54、≥55小时/周）进行分类。使用COPSOQ III测量倦怠、抑郁、睡眠问题、压力、躯体压力和认知压力。多变量回归估计相关性，并根据性别、轮班状态和暴露时间进行亚组分析。结果观察到明显的剂量-反应模式，风险阈值分别为49和55 h/周。与35-40 h/周相比，≥55 h/周调整后的倦怠（β = 4.23, 95% CI 0.17-8.30）、应激（β = 4.25, 95% CI 0.24-8.26）和躯体应激（β = 5.30, 95% CI 1.22-9.38）较高。女性HCWs在49 ~ 54 h/周时风险升高，而男性HCWs主要在≥55 h/周时恶化。倒班工人在49-54小时/周期间表现出增加的躯体应激，≥55小时/周的不良反应广泛存在。较长的暴露时间进一步降低了耐受阈值。工作速度在结果之间表现出强大的独立相关性。结论：长时间工作与较差的心理健康有关，每周49和55小时是预警阈值。长时间工作、高节奏工作和高要求的三重负担放大了风险。脆弱性因性别、轮班状态和暴露时间长短而异，因此需要量身定制保护措施。
{"title":"The dose-response relationship between work hours and mental health in healthcare workers: a cross-sectional study in a Chinese medical consortium","authors":"Yuting Tang, Min Zhang, Yiming Huang, Fuyuan Wang, Chuning He, Xinxin Fang, Xuechun Wang, Yiran Zhang","doi":"10.1016/j.ssci.2025.107093","DOIUrl":"10.1016/j.ssci.2025.107093","url":null,"abstract":"<div><h3>Background</h3><div>Long working hours and overtime among healthcare workers (HCWs) have become a global occupational health concern. Evidence on dose–response thresholds and subgroup vulnerabilities remains limited, particularly in middle-income settings. This study examined associations between weekly working hours and mental health outcomes in a Chinese medical consortium.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted among 983 HCWs from four hospitals in Southern China (June–July 2023; response rate 92.1 %). Weekly working hours were classified using WHO/ILO cut-points (35–40, 41–48, 49–54, ≥55 h/week). Burnout, depression, sleep troubles, stress, somatic stress, and cognitive stress were measured using the COPSOQ III. Multivariable regression estimated associations, with subgroup analyses by gender, shift status, and exposure duration.</div></div><div><h3>Results</h3><div>A clear dose–response pattern was observed, with risk thresholds at 49 and 55 h/week. Compared with 35–40 h/week, working ≥ 55 h/week was associated with higher burnout (<em>β</em> = 4.23, 95 %CI 0.17–8.30), stress (<em>β</em> = 4.25, 95 %CI 0.24–8.26), and somatic stress (<em>β</em> = 5.30, 95 %CI 1.22–9.38) after adjustment. Female HCWs showed elevated risks at 49–54 h/week, whereas male HCWs mainly deteriorated ≥ 55 h/week. Shift workers demonstrated increased somatic stress from 49–54 h/week, with widespread adverse effects ≥ 55 h/week. Longer exposure duration further lowered tolerance thresholds. Work pace emerged as a robust independent correlate across outcomes.</div></div><div><h3>Conclusions</h3><div>Long working hours were linked to poorer mental health, with 49 and 55 h/week as warning thresholds. A triple burden of prolonged hours, high work pace, and heavy demands magnifies risk. Vulnerabilities varied by gender, shift status, and exposure duration, underscoring the need for tailored protections.</div></div>","PeriodicalId":21375,"journal":{"name":"Safety Science","volume":"196 ","pages":"Article 107093"},"PeriodicalIF":5.4,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Despite symptom fluctuations being a key aspect of living with a musculoskeletal condition, previous research has largely treated MSDs as stable over time, implicitly assuming a static course of symptom development. Guided by the Dynamic Equilibrium Model and the Job Demands-Resources model, this study aims to fill this gap by examining the stability and variability of MSD symptoms over a short-to-medium time frame (i.e., three months). We also investigate whether, and to what extent, temporary job demands and resources influence MSD symptoms beyond the effects of chronic work conditions. A shortitudinal design with three measurement points was conducted with 795 Italian employees (60.5 % females; mean age = 39.8), using Doubly Latent Multilevel Structural Equation Modelling. Results indicate that MSD symptoms are relatively stable, with approximately two-thirds of the reliable variance attributable to trait-like factors. Nevertheless, meaningful within-person fluctuations were also observed, partly driven by variations in work characteristics. Notably, while chronic stressful conditions (e.g., consistently high workload) had the strongest impact on MSDs, higher-than-usual workload had notable, situation-dependent effects on MSDs (both directly and indirectly via reduced psychological health). In contrast, control and support from colleagues functioned as protective factors only when consistently available. Overall, the present study highlights the need for comprehensive occupational health interventions addressing both situational and chronic work factors to reduce the risk of MSDs.
{"title":"Stability and fluctuations in musculoskeletal disorder symptoms: the roles of chronic and acute job demands and resources","authors":"Ivan Marzocchi , Valerio Ghezzi , Luigi Fusco , Francesca Spinella , Ilaria Olivo , Stefano Isolani , Matteo Ronchetti , Monica Ghelli , Benedetta Persechino , Claudio Barbaranelli","doi":"10.1016/j.ssci.2025.107100","DOIUrl":"10.1016/j.ssci.2025.107100","url":null,"abstract":"<div><div>Despite symptom fluctuations being a key aspect of living with a musculoskeletal condition, previous research has largely treated MSDs as stable over time, implicitly assuming a static course of symptom development. Guided by the Dynamic Equilibrium Model and the Job Demands-Resources model, this study aims to fill this gap by examining the stability and variability of MSD symptoms over a short-to-medium time frame (i.e., three months). We also investigate whether, and to what extent, temporary job demands and resources influence MSD symptoms beyond the effects of chronic work conditions. A shortitudinal design with three measurement points was conducted with 795 Italian employees (60.5 % females; mean age = 39.8), using Doubly Latent Multilevel Structural Equation Modelling. Results indicate that MSD symptoms are relatively stable, with approximately two-thirds of the reliable variance attributable to trait-like factors. Nevertheless, meaningful within-person fluctuations were also observed, partly driven by variations in work characteristics. Notably, while chronic stressful conditions (e.g., consistently high workload) had the strongest impact on MSDs, higher-than-usual workload had notable, situation-dependent effects on MSDs (both directly and indirectly via reduced psychological health). In contrast, control and support from colleagues functioned as protective factors only when consistently available. Overall, the present study highlights the need for comprehensive occupational health interventions addressing both situational and chronic work factors to reduce the risk of MSDs.</div></div>","PeriodicalId":21375,"journal":{"name":"Safety Science","volume":"196 ","pages":"Article 107100"},"PeriodicalIF":5.4,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Earplugs are essential for hearing protection in noisy workplaces, but their effectiveness depends heavily on user comfort, which influences proper and consistent use. This study explores functional and acoustical comfort experienced by 173 workers across Canadian companies, each testing different ’disposable or reusable’ earplug models over seven weeks. Comfort is assessed using detailed questionnaires covering six subdimensions: ease of insertion and removal, noise protection, impact on work, and discomfort related to internal and external noise perception. Linear mixed-effects models are applied within a triad framework encompassing person-, earplug-, and environment-related characteristics in order to identify those with a significant influence on functional and acoustical comfort. Results show that person-related variables are the most influential. Handedness, hearing loss, and prior HPD experience significantly impact comfort, with left-handed participants reporting greater insertion and removal discomfort—possibly due to earcanal asymmetry and dexterity differences. Several earcanal morphological features also play a role, including isoperimetric ratios, circumference at multiple cross-sections, conicity, and length. Only a few earplug-specific characteristics influence comfort outcomes. Foam expansion time is linked to reduced acoustical discomfort associated with the perception of internal sounds, while stem presence improves insertion ease. Environmental factors do not have significant effects. In the longer term, these findings call for a rethinking of the design and selection of ’disposable or reusable’ earplugs, primarily based on earcanal morphology and users’ past experience. The study also underscores the need for improved objective metrics to assess comfort and supports the development of more personalized hearing protection solutions.
{"title":"Analysis of the functional and acoustical comfort of earplugs experienced by a group of workers in Canadian companies and identification of the influencing variables","authors":"Bastien Poissenot-Arrigoni , Olivier Doutres , Alessia Negrini , Djamal Berbiche , Franck Sgard","doi":"10.1016/j.ssci.2025.107098","DOIUrl":"10.1016/j.ssci.2025.107098","url":null,"abstract":"<div><div>Earplugs are essential for hearing protection in noisy workplaces, but their effectiveness depends heavily on user comfort, which influences proper and consistent use. This study explores functional and acoustical comfort experienced by 173 workers across Canadian companies, each testing different ’disposable or reusable’ earplug models over seven weeks. Comfort is assessed using detailed questionnaires covering six subdimensions: ease of insertion and removal, noise protection, impact on work, and discomfort related to internal and external noise perception. Linear mixed-effects models are applied within a triad framework encompassing person-, earplug-, and environment-related characteristics in order to identify those with a significant influence on functional and acoustical comfort. Results show that person-related variables are the most influential. Handedness, hearing loss, and prior HPD experience significantly impact comfort, with left-handed participants reporting greater insertion and removal discomfort—possibly due to earcanal asymmetry and dexterity differences. Several earcanal morphological features also play a role, including isoperimetric ratios, circumference at multiple cross-sections, conicity, and length. Only a few earplug-specific characteristics influence comfort outcomes. Foam expansion time is linked to reduced acoustical discomfort associated with the perception of internal sounds, while stem presence improves insertion ease. Environmental factors do not have significant effects. In the longer term, these findings call for a rethinking of the design and selection of ’disposable or reusable’ earplugs, primarily based on earcanal morphology and users’ past experience. The study also underscores the need for improved objective metrics to assess comfort and supports the development of more personalized hearing protection solutions.</div></div>","PeriodicalId":21375,"journal":{"name":"Safety Science","volume":"196 ","pages":"Article 107098"},"PeriodicalIF":5.4,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-22DOI: 10.1016/j.ssci.2025.107096
Riccardo Tartaglia , Chiara Parretti , Giuseppe Candido , Micaela La Regina , Franco Scaldaferri , Gabriele Rumi , Daniele Napolitano , Giuseppe Vetrugno , Paul Barach
The World Health Organization (WHO) emphasizes the importance of digital solutions such as telemedicine for improving care quality and safety. Recent surveys reveal the limited adoption in many countries including Italy, particularly in regions with mature healthcare systems. The aim of our study was to identify the critical barriers to the implementation of telemedicine visits and propose robust solutions to mitigate the risks associated with the successful rollout and utilization of sustainable telemedicine.
We assessed the introduction of telemedicine services for remote follow-up care for chronic gastrointestinal inflammatory bowel disease (IBD) and measured its impact on the risks of patient hospitalizations. We used the Failure Mode and Effects Analysis (FMEA) method to measure the clinical process and identify potential failures and assigned a Risk Priority Number (RPN) to each step. FMEA is a systematic process that involves selecting defined processes, assembling a multidisciplinary team, and analyzing potential failures by establishing links between failure modes, their effects, and causes. The team included medical and nursing leaders and coordinators, and human factors methodology experts, who mapped the care processes and identified potential failure modes for each process. We ranked the failure modes based on severity, frequency, and detectability, and proposed clinical process redesigns to mitigate or prevent failures that could lead to patient harm.
We identified 6 main process phases for introducing a televisiting service for patients with chronic inflammatory bowel disease (IBD). The FMEA risk analysis highlighted the criticalities as steps with the highest priority: failure to conduct the visit due to programming error (RPN 450), failure to send the final report (RPN 390), privacy issues during the visit (RPN 350), and appointment booking problems (RPN 340) at the central booking center.
Implementing a telemedicine program requires a comprehensive approach that includes identifying key clinical and organizational issues impacting system usability; targeted training of healthcare staff; developing clear policies and procedures; enhancing digital skills and addressing access concerns among citizens using the system; prioritizing patient care and integrating seamlessly with existing systems within the hospital. The disparities between hospital managers and physicians in evaluating the failure risks highlight the key differences in their risk perceptions. Comparisons with similar cases in the literature are necessary.
{"title":"Implementing a televisiting program in a tertiary university hospital: Failure modes and effect analysis (FMEA) and solutions for improving patient safety and sustainable care","authors":"Riccardo Tartaglia , Chiara Parretti , Giuseppe Candido , Micaela La Regina , Franco Scaldaferri , Gabriele Rumi , Daniele Napolitano , Giuseppe Vetrugno , Paul Barach","doi":"10.1016/j.ssci.2025.107096","DOIUrl":"10.1016/j.ssci.2025.107096","url":null,"abstract":"<div><div>The World Health Organization (WHO) emphasizes the importance of digital solutions such as telemedicine for improving care quality and safety. Recent surveys reveal the limited adoption in many countries including Italy, particularly in regions with mature healthcare systems. The aim of our study was to identify the critical barriers to the implementation of telemedicine visits and propose robust solutions to mitigate the risks associated with the successful rollout and utilization of sustainable telemedicine.</div><div>We assessed the introduction of telemedicine services for remote follow-up care for chronic gastrointestinal inflammatory bowel disease (IBD) and measured its impact on the risks of patient hospitalizations. We used the Failure Mode and Effects Analysis (FMEA) method to measure the clinical process and identify potential failures and assigned a Risk Priority Number (RPN) to each step. FMEA is a systematic process that involves selecting defined processes, assembling a multidisciplinary team, and analyzing potential failures by establishing links between failure modes, their effects, and causes. The team included medical and nursing leaders and coordinators, and human factors methodology experts, who mapped the care processes and identified potential failure modes for each process. We ranked the failure modes based on severity, frequency, and detectability, and proposed clinical process redesigns to mitigate or prevent failures that could lead to patient harm.</div><div>We identified 6 main process phases for introducing a televisiting service for patients with chronic inflammatory bowel disease (IBD). The FMEA risk analysis highlighted the criticalities as steps with the highest priority: failure to conduct the visit due to programming error (RPN 450), failure to send the final report (RPN 390), privacy issues during the visit (RPN 350), and appointment booking problems (RPN 340) at the central booking center.</div><div>Implementing a telemedicine program requires a comprehensive approach that includes identifying key clinical and organizational issues impacting system usability; targeted training of healthcare staff; developing clear policies and procedures; enhancing digital skills and addressing access concerns among citizens using the system; prioritizing patient care and integrating seamlessly with existing systems within the hospital. The disparities between hospital managers and physicians in evaluating the failure risks highlight the key differences in their risk perceptions. Comparisons with similar cases in the literature are necessary.</div></div>","PeriodicalId":21375,"journal":{"name":"Safety Science","volume":"196 ","pages":"Article 107096"},"PeriodicalIF":5.4,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-20DOI: 10.1016/j.ssci.2025.107091
Carmen Anaya-Aguilar , Eva Rosel , Alberto Rodríguez-Archilla , Rosa Anaya-Aguilar , Manuel Bravo , Yolanda Martínez-Beneyto
Despite technological advancements in dentistry, professionals remain exposed to numerous occupational hazards that compromise their health and well-being. These include chronic exposure to hazardous chemicals, aerosols, ionizing radiation, excessive noise, and significant ergonomic and psychosocial stressors.
A review of current scientific literature reveals persistent challenges for dental professionals, such as daily contact with harmful substances, invasive procedures, contaminated aerosols, radiation, noise, and a high prevalence of musculoskeletal and psychosocial disorders. These risks persist despite technological improvements and continue to hinder the development of a strong culture of occupational health and safety within the profession.
This study aimed to assess occupational risks in dental clinics by analyzing expert opinion through the Delphi method. A panel of 18 experts, each with over ten years of experience, participated. Results indicated that “rotary dental instruments (e.g., turbines, contra-angle handpieces)” were consistently rated as the highest risk (mean score: 3.50). In the deviation category, the “risk of SARS-CoV-2 transmission due to inappropriate PPE use” received the highest scores (3.83 and 3.61). In the contact category, “exposure to sharp, cutting, or abrasive instruments/materials” was rated highest (3.94 and 3.78).
The study concludes that rotary instruments and sharp tools contribute significantly to the generation of potentially pathogenic bioaerosols and elevate the risk of infection. While strict safety protocols are essential, they may impair working conditions by reducing visibility, fogging protective eyewear, limiting breathability, and increasing humidity factors associated with decreased efficiency and increased stress among dental professionals.
{"title":"Delphi assessment of occupational hazards in Spanish dentists","authors":"Carmen Anaya-Aguilar , Eva Rosel , Alberto Rodríguez-Archilla , Rosa Anaya-Aguilar , Manuel Bravo , Yolanda Martínez-Beneyto","doi":"10.1016/j.ssci.2025.107091","DOIUrl":"10.1016/j.ssci.2025.107091","url":null,"abstract":"<div><div>Despite technological advancements in dentistry, professionals remain exposed to numerous occupational hazards that compromise their health and well-being. These include chronic exposure to hazardous chemicals, aerosols, ionizing radiation, excessive noise, and significant ergonomic and psychosocial stressors.</div><div>A review of current scientific literature reveals persistent challenges for dental professionals, such as daily contact with harmful substances, invasive procedures, contaminated aerosols, radiation, noise, and a high prevalence of musculoskeletal and psychosocial disorders. These risks persist despite technological improvements and continue to hinder the development of a strong culture of occupational health and safety within the profession.</div><div>This study aimed to assess occupational risks in dental clinics by analyzing expert opinion through the Delphi method. A panel of 18 experts, each with over ten years of experience, participated. Results indicated that “rotary dental instruments (e.g., turbines, contra-angle handpieces)” were consistently rated as the highest risk (mean score: 3.50). In the deviation category, the “risk of SARS-CoV-2 transmission due to inappropriate PPE use” received the highest scores (3.83 and 3.61). In the contact category, “exposure to sharp, cutting, or abrasive instruments/materials” was rated highest (3.94 and 3.78).</div><div>The study concludes that rotary instruments and sharp tools contribute significantly to the generation of potentially pathogenic bioaerosols and elevate the risk of infection. While strict safety protocols are essential, they may impair working conditions by reducing visibility, fogging protective eyewear, limiting breathability, and increasing humidity factors associated with decreased efficiency and increased stress among dental professionals.</div></div>","PeriodicalId":21375,"journal":{"name":"Safety Science","volume":"196 ","pages":"Article 107091"},"PeriodicalIF":5.4,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-20DOI: 10.1016/j.ssci.2025.107097
Ruihang Yang , Chao Li , Dachuan Wang , Tiejun Zhou , Haibin Zhang , Yin Huang
The great vertical upwards evacuation distance of deep subway stations leads to longer evacuation times from incident sites to ground safety zones, while the sub-safety zones within these stations serve essential roles in evacuation buffering and safety assurance. To study the movement patterns and evacuation behaviors of pedestrians in sub-safety zones, a series of on-site controlled experiments for pedestrian evacuation were conducted at the Wulichong subway station in Guiyang, China. Video analyzing techniques were employed to extract the trajectories of pedestrians, and the self-organization phenomena, choice behavior, and elevator evacuation time under various experimental situations were investigated in detail. The results of the study show that: (a) Over 81 % of pedestrians would prefer to utilize the elevator to evacuate in the deep subway station after education; (b)There is a threshold that when the number of pedestrians in the elevator lobby exceeds 10 (0.42p/m2), everyone gives up waiting and chooses stairs; (c) The longest elevator waiting time for pedestrians is 88 s, and the evacuation efficiency of a single elevator in a 39.7 m buried-depth subway station is 12.9 ped/min. This study advances the understanding of pedestrian evacuation dynamics in deep subway sub-safety zones, providing a scientific basis for the update of evacuation norms in subway stations, such as putting forward suggestions for improvement in elevator use standards and sub-safety zone design.
{"title":"Investigating the performance of sub-safety zones and occupant evacuation elevators in deep subway stations: An experimental study","authors":"Ruihang Yang , Chao Li , Dachuan Wang , Tiejun Zhou , Haibin Zhang , Yin Huang","doi":"10.1016/j.ssci.2025.107097","DOIUrl":"10.1016/j.ssci.2025.107097","url":null,"abstract":"<div><div>The great vertical upwards evacuation distance of deep subway stations leads to longer evacuation times from incident sites to ground safety zones, while the sub-safety zones within these stations serve essential roles in evacuation buffering and safety assurance. To study the movement patterns and evacuation behaviors of pedestrians in sub-safety zones, a series of on-site controlled experiments for pedestrian evacuation were conducted at the Wulichong subway station in Guiyang, China. Video analyzing techniques were employed to extract the trajectories of pedestrians, and the self-organization phenomena, choice behavior, and elevator evacuation time under various experimental situations were investigated in detail. The results of the study show that: (a) Over 81 % of pedestrians would prefer to utilize the elevator to evacuate in the deep subway station after education; (b)There is a threshold that when the number of pedestrians in the elevator lobby exceeds 10 (0.42p/m<sup>2</sup>), everyone gives up waiting and chooses stairs; (c) The longest elevator waiting time for pedestrians is 88 s, and the evacuation efficiency of a single elevator in a 39.7 m buried-depth subway station is 12.9 ped/min. This study advances the understanding of pedestrian evacuation dynamics in deep subway sub-safety zones, providing a scientific basis for the update of evacuation norms in subway stations, such as putting forward suggestions for improvement in elevator use standards and sub-safety zone design.</div></div>","PeriodicalId":21375,"journal":{"name":"Safety Science","volume":"196 ","pages":"Article 107097"},"PeriodicalIF":5.4,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-20DOI: 10.1016/j.ssci.2025.107095
Allana Santiago , Bernadette Matthews , Won Sun Chen , Therese Keane , Jordy Kaufman
Drowning is a leading cause of injury-related death among children worldwide, prompting calls for effective water safety education. While innovative technologies have shown pedagogical potential in safety education, their application in beach safety remains underexplored. This study compared two digital platforms, an immersive virtual reality (VR) experience and a non-immersive digital game, Swim City (SC), to improve beach safety knowledge among Australian children. The platforms were tested with 101 students aged 8–11 years, assigned to either the VR group (N = 52) or the SC group (N = 49). Students completed a pre-test, a learning session, and a post-test one week later. Outcome measures included knowledge of safety preparation, safe beach practices, recognition of signage and flags, rip current identification, and selecting the safest swimming area. Intrinsic motivation (IM) was also assessed. Interviews with eight teachers explored feasibility, usability, and educational value. VR was more effective than SC in improving signage and flag recognition and rip current identification from aerial-view media. Safety preparation knowledge declined in the VR group, but did not change significantly in the SC group. Both platforms were equally effective for improving safe beach practices, rip current identification from ground-level view media, and selecting the safest swimming area. IM did not differ significantly between groups. Teachers found both platforms engaging and educationally valuable, though VR’s feasibility was affected by setup time, equipment, and health concerns. This study highlights specific strengths of VR and SC for beach safety education. Platform choice can be guided by educational goals, resources, and classroom context.
{"title":"Comparing the effectiveness of an interactive immersive virtual reality experience and a desktop game for beach safety education with children in Australia","authors":"Allana Santiago , Bernadette Matthews , Won Sun Chen , Therese Keane , Jordy Kaufman","doi":"10.1016/j.ssci.2025.107095","DOIUrl":"10.1016/j.ssci.2025.107095","url":null,"abstract":"<div><div>Drowning is a leading cause of injury-related death among children worldwide, prompting calls for effective water safety education. While innovative technologies have shown pedagogical potential in safety education, their application in beach safety remains underexplored. This study compared two digital platforms, an immersive virtual reality (VR) experience and a non-immersive digital game, Swim City (SC), to improve beach safety knowledge among Australian children. The platforms were tested with 101 students aged 8–11 years, assigned to either the VR group (<em>N</em> = 52) or the SC group (<em>N</em> = 49). Students completed a pre-test, a learning session, and a post-test one week later. Outcome measures included knowledge of safety preparation, safe beach practices, recognition of signage and flags, rip current identification, and selecting the safest swimming area. Intrinsic motivation (IM) was also assessed. Interviews with eight teachers explored feasibility, usability, and educational value. VR was more effective than SC in improving signage and flag recognition and rip current identification from aerial-view media. Safety preparation knowledge declined in the VR group, but did not change significantly in the SC group. Both platforms were equally effective for improving safe beach practices, rip current identification from ground-level view media, and selecting the safest swimming area. IM did not differ significantly between groups. Teachers found both platforms engaging and educationally valuable, though VR’s feasibility was affected by setup time, equipment, and health concerns. This study highlights specific strengths of VR and SC for beach safety education. Platform choice can be guided by educational goals, resources, and classroom context.</div></div>","PeriodicalId":21375,"journal":{"name":"Safety Science","volume":"196 ","pages":"Article 107095"},"PeriodicalIF":5.4,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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