Occupational Medicine-Oxford最新文献

Background: Carpal tunnel syndrome (CTS) is a socially relevant condition. Risk factors associated with CTS severity and work have not been explored.

Aims: This case-control study aims to investigate the association between CTS severity and occupational biomechanical overload considering personal anthropometric risk factors.

Methods: We consecutively enrolled one CTS case for two controls. CTS cases were grouped into three classes of progressive clinical and electrophysiological severity according to two validated scales. Job titles were coded according to the International Standard Classification of Occupations (ISCO 88) and grouped into two broad socio-occupational categories: blue-collar and white-collar workers.The associations between CTS (or CTS severity) and blue-collar status were assessed using unconditional (or multinomial) logistic regression models adjusted for age, gender, centre and two anthropometric indexes: wrist-palm ratio and waist-stature ratio. Odds ratios (OR) or relative risk ratio and 95% confidence intervals (95% CI) were calculated, as appropriate.

Results: We included 183 cases and 445 controls. Blue-collar status was a risk factor for CTS (OR 2.4; 95% CI 1.5-3.8). Among job titles, vine and/or olive tree growers (OR 6.0; 95% CI 2.0-17.9) and food processing workers (OR 4.8; 95% CI 1.5-15.2) were at higher risk. At multinomial logistic regression analysis, blue-collar status and the two anthropometric indexes were associated with moderate/severe CTS, after mutual adjustment.

Conclusions: Blue-collar workers showed a higher risk of CTS than white-collar workers, adjusting for anthropometric and body measures as well. Preventive interventions should be addressed to decrease the biomechanical overload of the upper limbs and limit the overweight.

Background: Understanding of hazardous alcohol drinking and insomnia among Australian ambulance personnel is limited. Australian ambulance organizations have strengthened their organizational human resource management (HRM) to promote their employees' healthy lifestyles, health and well-being.

Aims: To describe the prevalence of hazardous alcohol consumption and insomnia among Australian ambulance personnel and to explore their associations with the organizational HRM strength.

Methods: This cross-sectional study was conducted on 492 ambulance personnel randomly selected from three Australian states. The Alcohol Use Disorders tool, The Insomnia Severity Index and the Perceived HRM System Strength instrument measured alcohol consumption, insomnia and HRM strength. Descriptive analyses, bivariate association analyses and general linear models were used for data analysis.

Results: Twenty per cent of Australian ambulance personnel consumed alcohol at a hazardous level and 68% experienced clinically significant insomnia. There was no significant association between organizational HRM strength and ambulance personnel's hazardous alcohol consumption. There was a significant association between organizational HRM strength (consensus) and ambulance personnel's insomnia experience.

Conclusions: Hazardous alcohol consumption and insomnia were concerns among Australian ambulance personnel. Even though strengthening the HRM system might reduce their experience of insomnia, simply strengthening the HRM system could not reduce their hazardous alcohol consumption.

Background: Sleep of inadequate quality, duration or regularity has potential negative physical and mental health outcomes. The impacts of poor sleep within the paramedic occupation are not well understood.

Aims: This review aimed to determine the prevalence of insomnia, excessive daytime sleepiness and poor sleep quality amongst paramedics, and to identify any relationships between insomnia, excessive daytime sleepiness, poor sleep quality and other health-related outcomes.

Methods: A systematic search identified studies that measured excessive sleepiness, insomnia or poor sleep quality using validated measures. The population was limited to paramedics in Australia, New Zealand or the UK owing to the similar nature of the workload, education standards, shift patterns and scope of practice.

Results: Four studies were included. All used the Pittsburgh Sleep Quality Index, two used the Epworth Sleepiness Scale and one used the Insomnia Severity Index. Sample sizes ranged between 60 and 342. The weighted mean prevalence of excessive daytime sleepiness was 30 %, and poor sleep quality reported as 71%. Only one study measured the association between sleep and other health-related outcomes; this study reported an association between sleep quality and multiple measures of mental health.

Conclusions: The findings of this review suggest that paramedics experience both poor-quality sleep and excessive daytime sleepiness, and further suggest that there may be an association between poor sleep quality and mental health. Given sleep impacts a variety of health outcomes, as well as impacts work performance, research on the specific components of sleep is important.

Background: Call-handlers and dispatchers (CHDs) working in specialized emergency and urgent communication centres are essential in supporting public safety and health. Evidence suggests that these professionals are at increased risk of mental health conditions, including post-traumatic stress disorder (PTSD), depression, anxiety and alcohol abuse among other conditions; however, reliable prevalence estimates remain undetermined.

Aims: We provide the estimated pooled prevalence for PTSD, depression, anxiety and hazardous drinking among emergency and urgent CHDs globally.

Methods: We searched 10 electronic databases, grey literature and the Annals of Emergency Dispatch and Response. Eligible studies reported original quantitative data and used validated self-reported measures on the prevalence of mental health conditions of interest (i.e. PTSD, depression, anxiety and alcohol use) within CHD professionals. Three reviewers independently screened results for eligibility. Prevalence estimates were pooled using random-effects meta-analyses.

Results: In total, 16 857 references were retrieved. From these, 183 full-text articles were assessed for eligibility, of which 37 articles were included in this systematic review, and 13 articles provided necessary quantitative information for meta-analyses. In total, 7759 CHDs were considered across nine different countries. The overall pooled prevalence for PTSD was 17.8% (95% confidence interval [CI] 12.4-24.0%), depression was 28.2% (95% CI 20.7-36.2%), anxiety was 17.2% (95% CI 6.6-31.5%) and hazardous drinking was 17.8% (95% CI 6.9-32.2%).

Conclusions: These findings indicate CHDs are at significant risk of mental health problems. Further quantitative and qualitative research is warranted to help understand the psychological risks of working as a CHD and guide appropriate psychological support.

Background: Academic researchers experience high levels of stress, isolation and loneliness, which compromise their well-being. There is a particular need to address these issues amongst early career and postgraduate research staff. 'Spaces for Listening' is an initiative to increase active listening and provide peer support.

Aims: To assess the feasibility, acceptability and potential impacts of Spaces for Listening in an academic setting.

Methods: Early career and postgraduate researchers from a large university in the UK were invited to attend 'Academic Spaces for Listening' (ASfL). Five ASfL sessions (including in-person and Chinese language) were held. A mixed-methods study using online survey and in-depth interviews was conducted. Quantitative data were analysed using descriptive statistics, and qualitative data were analysed using principles of thematic analysis. The qualitative and quantitative findings were integrated at the interpretation phase.

Results: A total of 25 participants attended an ASfL session, 22 of them completed the survey and 6 participants participated in semi-structured interviews. Participants were very satisfied with the session content (68%, n = 15), organization (68%, n = 15) and delivery (68%, n = 15). Four themes were identified from qualitative analysis: (i) the 'Academic Spaces for Listening' (ASfL) experience; (2) impact of ASfL; (3) potential challenges of ASfL and (4) ASfL in the future. Interpersonal connectedness was an important outcome for participants during the session. Participants showed interest in the future of ASfL.

Conclusions: Implementing Spaces for Listening in an academic setting is feasible and was well received by participants. The initiative may fill a gap in the social interactions amongst academic researchers.

Background: Working from home (WFH) is becoming more common, but little is known about how it specifically affects neuro-divergent workers' psychological and occupational well-being.

Aims: This review aimed to explore the experiences of neuro-divergent staff WFH, including the challenges they face; the potential benefits of homeworking for this specific population and the support systems they require.

Methods: We searched six electronic databases, as well as reference lists of included papers, one preprint server and Google, for literature on neuro-divergent workers' experiences of WFH. Results were synthesized using thematic analysis.

Results: We reviewed 25 studies (mostly based on data collected during the coronavirus disease 2019 pandemic), finding very little research statistically analysing the impact of WFH on well-being or productivity, or comparing the impact of WFH across neuro-divergent and neuro-typical populations. The (mostly qualitative) findings showed that neuro-divergent participants described various benefits and challenges of the sensory environment at home; the reduction of commuting; increased flexibility and lack of routine when homeworking; the reduction of 'masking' behaviours; lack of in-person social contact and increased use of technology.

Conclusions: The findings emphasize the importance of not assuming a one-size-fits-all approach to homeworking and suggest managers should be mindful of workers' individual preferences for working whilst ensuring that all employees are appropriately supported. The results can inform future research and provide insights for employers to help them create more inclusive work environments.

Background: Physicians in certain specialities are routinely exposed to procedural ionizing radiation. Their risk of cancer is unknown, including by cancer sub-types.

Aims: To assess cancer risk among exposed physicians.

Methods: This population-based case-control study was completed in Ontario, Canada, where healthcare is universal, using linkage of physician billing claims to a province-wide cancer registry. Up to five cancer-free physician controls were matched to each cancer-affected physician, by sex, and both age at and year of, entry into practice. Cumulative exposure to procedural ionizing radiation was captured by physician billing claims. Conditional logistic regression generated an odds ratio (OR) of cancer per 1000 procedures performed and as a binary exposure comparing physicians above the upper 95th percentile cumulative number of procedures (≥200) to those below this cut point.

Results: Mean (standard deviation) age of the 1265 cases and 5772 non-cancer controls was 39.7 (10.7) and 37.7 (9.0) years, and 45% and 49% were female, respectively. After a median (interquartile ranges) of 13.0 (6.9-20.4) and 12.5 (6.5-20.1) years of lookback among cases and controls, the OR of cancer was 1.02 (95% confidence interval 0.99-1.05; P = NS) per 1000 additional procedures performed. Modelling the cumulative exposure to procedures nonlinearly did not change the observed association (P > 0.40 for each). Comparing physicians above versus below the upper 95th percentile cumulative number of procedures, the OR of cancer was 1.23 (95% confidence interval 0.75-2.01, P = NS).

Conclusions: Physician exposure to procedural ionizing radiation was not associated with a higher risk of cancer. Measures that minimize radiation exposure should continue.