Medicina Del Lavoro最新文献

Background: Like other European systems, the Spanish national health system (NHS) is reaching a critical point. This article analyses sickness absence (SA) trends, as a direct indicator of this crisis, among healthcare workers (HCWs) in Spain, comparing the pre-pandemic, pandemic, and post-pandemic periods.

Methods: This study was based on a retrospective cohort of HCWs (n=7.918) hired at Hospital del Mar in Barcelona for at least three months during 2018-2023. The primary outcome was incident SA episodes. Incidence rates (IR) per 1,000 persons-day and 95% confidence intervals (95% CI) were calculated by sex, period, and occupational variables. Longitudinal entropy regression models were estimated to identify the factors influencing the frequency of transitions between the different HCWs' employment states (active or on SA).

Results: Increasing trends in IR (95%CI) were observed, rising from 1.77 (1.71; 1.83) episodes of SA per 1,000 workers-day during the pre-pandemic period to 5.04 (4.93; 5.15) during the post-pandemic among women, and from 1.23 (1.14; 1.31) to 3.79 (3.64; 3.95), respectively, among men. Nurses, nurse aides, orderlies/technicians, workers under 30, and those in intensive care units and emergency rooms showed the highest IR during and after the pandemic, with longitudinal entropy analysis revealing increased state changes, primarily affecting these groups.

Conclusions: This study demonstrates a significant rise in SA incidence among HCWs during and after the pandemic and identifies vulnerable groups with higher incidence. Several hypotheses, such as poor working conditions, burnout, and patient complexity, have been suggested to explain these results. Urgent interventions are needed to safeguard HCWs' health, thus maintaining the sustainability and safety of the NHS.

Background: The COVID-19 pandemic compelled changes to the structure and organization of many occupational sectors that may impact workers' well-being and work-related symptoms.

Objective: Evaluate the effects of working modifications related to the COVID-19 pandemic on occupational health outcomes and work ability (WA) among a large group of Italian banking employees.

Methods: 2,859 employees visited during health surveillance in 2021 were divided into two job groups: front-office (FO) and back-office workers (BO). Data on conditions associated with office work, psychological distress, WA, and fitness-to-work judgment were analyzed and compared with available data from the pre-pandemic period (2018-2019).

Results: The prevalence of analyzed outcomes was lower than in pre- and post-COVID evaluation literature. After COVID-19, a 28% increase in asthenopin was found in BO, while musculoskeletal symptoms increased about 22% in BO and 9% in FO. Post-COVID showed a 28% rise in stress-related symptoms and a 17% increase in psychotropic drug consumption in both groups. After the lockdown, the prevalence of moderate/poor scores decreased by 13% in each group. Fitness-to-work judgment without limitations prevalence was unchanged.

Conclusion: The slight worsening in all examined outcomes at post-lockdown evaluation and the outcomes' prevalence consistently lower than the literature data could be linked to the measures the Institute took to support employees during the COVID-19 pandemic. In this context, a comprehensive integration between occupational safety and health promotion practices is recommended to ensure the highest level of safeguarding for workers' well-being.

Background: The Work-Related Questionnaire for Upper Extremity Disorders (WORQ-UP) serves as a patient-reported outcome measure to identify work-related limitations in individuals with upper extremity musculoskeletal disorders. This study aims to adapt the WORQ-UP into Turkish and subsequently evaluate its validity and reliability.

Methods: The Turkish WORQ-UP, along with the previously validated Turkish Quick DASH, were administered to 136 patients. The Turkish WORQ-UP was applied twice within a 7-14 day interval to assess test-retest reliability. Reliability was assessed using measures of internal consistency and intraclass correlation coefficient (ICC). For validity assessment, Spearman correlation coefficients were calculated between the Turkish WORQ-UP and Quick DASH, and Explanatory (EFA) and Confirmatory factor analysis (CFA) were conducted.

Results:  In the reliability analysis, items 11, 12, 13, 15, and 16, which did not meet the criterion of item total score correlation >30, were excluded, resulting in a 12-item Turkish WORQ-UP with satisfactory validity and reliability outcomes. The Cronbach's alpha and ICC were calculated as 0.895 and 0.879, respectively, while the SEM and MDC were determined to be 0.93 and 1.85. In the EFA, the Kaiser-Meyer-Olkin measure (0.895) and Bartlett's tests were both significant (p < 0.001). Additionally, the CFA indicated an acceptable fit with two factors. The goodness of fit indices, including χ2/df = 2.09, CFI = 0.934, TLI = 0.918, and RMSEA = 0.08, confirmed the adequacy of the model. The 12-item Turkish WORQ-UP showed a significant and strong correlation (r = 0.754; p < 0.001) with Quick DASH.

Conclusion: The Turkish version of WORQ-UP with 12 items had proper psychometric properties to identify work-related limitations in individuals with upper extremity musculoskeletal disorders.

Background: The assessment of work-related stress is mandatory in Italy, according to Legislative Decree 81/2008. The Academic Teacher Stress Indicator Tool (ATS-IT) was developed to address stress in academic teaching staff by adapting the Health and Safety Executive Management Standards Indicator Tool (HSE-MS IT).

Methods: An online ATS-IT survey was administered to all teaching staff at the University of Trieste, yielding 334 valid responses. The survey also included a measure of psychosomatic complaints and demographic questions. Confirmatory factor analysis (CFA) was performed to test the six-factor structure, and reliability was assessed using Cronbach's alpha.

Results: CFA confirmed an excellent fit for the six-factor structure (CFI = .99; TLI = .99; RMSEA = .034). Reliability analysis mainly showed acceptable values (Cronbach's α ranging from .66 to .91). Significant gender differences were found in the Demands and Control scales, with additional differences based on age and academic role across multiple scales. The ATIS-IT scales were significantly intercorrelated and negatively correlated with psychosomatic complaints.

Conclusions: The ATS-IT demonstrates good potential as a valid and reliable instrument for assessing work-related stress among Italian academic teaching staff. Its use can facilitate better stress management and intervention strategies in educational institutions.

The discovery of the detrimental effects of asbestos on human health came long after its widespread use, with the first scientific evidence of asbestos-related diseases emerging in the late 19th and early 20th centuries. Despite efforts to ban its use, asbestos continues to be mined and used in Central Asia (as well as in Russia, China, and other countries). To gain a deeper understanding of the situation in Central Asia, we have conducted a systematic review of scientific literature on the use of asbestos, exposure assessment, and health consequences of asbestos exposure in this geographic area. This review encompasses studies about exposure assessments, epidemiological data, and biochemical or clinical surveys conducted in Kazakhstan, Uzbekistan, Tajikistan, Turkmenistan, and Kyrgyzstan. A total of 18 articles met the inclusion criteria, and their content is summarised in this review, which represents the first attempt to systematically examine research on asbestos and its impact on the health of workers and the general population in Central Asia countries, including literature published in Russian and English. The findings here highlighted the substantial limitations of the currently available knowledge about the impact of asbestos on health in this geographical area.

Background: There is limited information on the immediate effects of whole-body vibration (WBV) on the upper limb. This study aims to determine the immediate effects of WBV on reaction speed and proprioception in young adult students' upper extremities.

Methods: In total, 62 students participated in the study. WBV was applied to the participants, and its immediate effects on proprioception and upper extremity reaction speed were examined. Participants' proprioception and perception of joint position at 30-60 degrees of shoulder flexion, shoulder abduction, and elbow flexion angles were measured with absolute error degrees. Reaction rates were evaluated with the Ruler-Drop Test and the mobile application SWAY.

Results: A decrease was observed in the absolute error level of the participants' joint position perception at 30-60 elbow and shoulder position degrees, measured after immediate WBV application (p <0.05). After the RDT application, a decrease in the length of catching the target was observed (p <0.05). The SWAY test determined that they moved the smartphone in a shorter time (p <0.05). Right and left RDT scores showed that the distance to catch the ruler was significantly lower in male individuals before the application. In comparison, the distance to catch the ruler was lower after the application (right/left p<0.05).

Conclusions: The study found that applying WBV improved upper extremity proprioception perception and reaction speed in young adults. This information can guide clinicians in applying WBV to healthy individuals and those with symptoms.

Background: PFASs, synthetic chemicals, can be encountered by humans through occupational or environmental exposure, and some reports suggest that they can disrupt endocrine and hormonal activities. In this comprehensive review and meta-analysis, we explored the connection between exposure to PFASs and the risks of breast and female genital cancers.

Methods: We systematically reviewed the literature from IARC Monographs, ATSDR documents, and PubMed (as of January 2024) for cohort, case-control, and ecological studies on PFAS exposure and breast or female genital cancers. Four reviewers independently screened studies, and data extraction included study design, patient characteristics, and effect size measures. The quality of studies was assessed using the modified version of the Newcastle-Ottawa Scale (NOS). Forest plots of relative risks (RR) were constructed for breast and female genital cancer. Meta-analyses were conducted using random-effects models, stratified analyses, dose-response assessments, and publication bias evaluation.

Results: The meta-analysis included 24 studies, comprising 10 cohort, 13 case-control, and one ecological study. The summary relative risk (RR) of breast cancer for PFOA exposure was 1.08 (95% CI = 0.97-1.20; n=21), and for PFOS was 1.00 (95% CI = 0.85-1.18; n=12). The RR for ovarian cancer and PFAS was 1.07 (95% CI = 1.04-1.09; n=12). The stratification by quality score, year of publication, and exposure source did not reveal any differences. However, analysis by geographical region (p=0.01) and study design (p=0.03) did show differences, particularly in terms of incidence. Stratified analyses of the dose-response relationship did not reveal a trend in the risk of breast cancer or female genital cancers, and no publication bias was found for either cancer type. No results were available for cervical and endometrial cancers.

Conclusion: In summary, we have found an association between PFAS exposure and ovarian cancer and a possible effect on breast cancer incidence in some specific groups. Although potential bias and confounding prevent conclusions regarding causality, these findings may hold significance for females who encounter such pollutants in their occupational or daily environments.

Introduction: Benzene is a recognized carcinogen; however, its association with breast cancer is not well established. Hence, a meta-analysis of cohort and case-control studies was performed to determine the association between occupational benzene exposure and the risk of breast cancer.

Methods: A systematic literature review identified 7573 publications from which 23 cohort and case-control studies were retained and evaluated using meta-analyses (fixed effects model). PRISMA guidelines were followed. Our protocol was registered in the PROSPERO database (Registration No. CRD42022379720). Study quality was assessed using a modified Newcastle-Ottawa scale (NOS).

Results: The summary relative risk (RR) for ever-benzene exposure was 1.08 (95% CI=1.03-1.14, I2=38.6%, n=23 risk estimates); corresponding RR for cancer incidence and mortality were 1.08 (95% CI=1.02-1.14, I2=56.1%, n=16) and 1.10 (95% CI=0.87-1.37, I2<0.001%, n=10). However, heterogeneity was detected for sex (p-het=0.002), publication year (p-het<0.001), study design (p-het<0.001), study quality (p-het<0.001), and industry of employment (p-het=0.03). The RR for high level of exposure showed positive association with breast cancer 1.35 (95% CI=1.06-1.72, I2 =<0.001%, n=3) and (P-het=0.64). Publication bias was detected (p=0.03).

Conclusions: The results of our meta-analysis indicate a positive association between occupational benzene exposure and an increased risk of breast cancer, particularly when exposed to higher levels of benzene. However, bias and confounding could not be excluded.

Background: The rapid growth of the digital economy has transformed various labor markets, including the food sector. The transient nature and the peculiar work environments of food delivery workers raise concerns about occupational safety and health (OSH). This study aims to better understand these issues by conducting a comprehensive exploratory survey on OSH among food delivery riders in Milan, Italy.

Methods:  The study employed structured interviews based on a validated questionnaire developed through a literature review, expert interviews, and input from riders and health and safety professionals. The survey was performed from July to November 2022 by interviewing riders at their main gathering points.

Results: We interviewed 240 riders, 97% males, 81% less than 35 years old, and 83% with extra-European origin. Delivery was performed mainly by traditional bicycles (40%) and e-bikes (46%), with 44% working seven days per week and 23% working more than 8 hours daily. Road accidents were reported by 39% of riders, influenced by type of vehicle, fatigue, and number of daily deliveries. Physical and verbal assaults (12% and 28%, respectively) were reported, as well as health-related issues, particularly musculoskeletal disorders.

Conclusions: The findings underscore food delivery riders' complex challenges, emphasizing the need for targeted interventions. The study calls for collaborative efforts between policymakers, employers, OSH professionals, and stakeholders to enhance OSH standards and promote decent working conditions, aligning with the 2030 Agenda for Sustainable Development.