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: Hand-arm vibration syndrome (HAVS) is an occupational disease associated with long-term exposure to power tools leading to hand-transmitted vibration exposure. Prior research has focussed on physical manifestations with little known about the psychological impacts of HAVS.

Aims: To examine if HAVS severity and/or functional impairment is associated with psychological outcomes.

Methods: We conducted a cross-sectional study collecting data through a survey and retrospective chart review of workers being assessed for HAVS at an occupational medicine clinic. We collected information on demographics, work conditions, disease characteristics and physical and psychological outcomes as measured through validated instruments (SF-12, QuickDASH, GAD-2, PHQ-2). Descriptive statistics and bivariate analyses were followed by multivariable models to explore associations between mental health outcomes and predictor variables.

Results: Participants (N = 94; 56% response rate) were male with a mean age of 48.2 years. The majority (62%) worked in the mining sector, and 27% of participants reported feeling depressed and 35% reported showing little interest in or pleasure in doing things, while 28% reported clinically significant anxiety symptoms. In multivariable models, the QuickDASH, a measure of upper-extremity function and disability, was the only significant predictor of psychological outcomes.

Conclusions: Workers with HAVS have poorer mental health and physical functioning outcomes in comparison to the general population. Employers should consider tailored policies and interventions to address the mental health of workers with HAVS.

Background: Many studies have documented exposure to psychosocial factors in healthcare workers (HCWs) during the coronavirus disease 2019 (COVID-19) pandemic. Few have done it prospectively with open-ended questions.

Aims: To describe the evolution of stress factors reported by HCWs during the pandemic.

Methods: A prospective cohort of 4964 HCWs (physicians, nurses, healthcare aides and personal support workers), from four Canadian provinces, received four online questionnaires between the spring 2020 and 2022. Responses to an open-ended question on stressful events were coded into 25 stressors. Multilevel logistic regressions assessed trends in stressors, and the effect of gender, occupation and age.

Results: In 2020, 91% of participants reported at least one stressor compared to 51% in spring 2022. Overall, eight stressors were reported 1000 times or more among 16 786 questionnaires. Five stressors decreased over time: fear of COVID-19, problems with personal protective equipment, changing guidelines, management of difficult cases and changes to work routine. Conversely, an increasing trend was noted for volume of work, and poor behaviour from the public or colleagues. Difficulties managing patients' deaths remained steady. Changes in stressors over time were similar by gender, professional role and age group, although the reporting of some stressors varied within subgroups.

Conclusions: Reporting of most stressors decreased over the pandemic, except for stressors arising from the changing demands on staff and patients as the pandemic progressed. Such changes in workplace psychosocial factors need to be addressed by prevention programmes to ensure an appropriate support response to the needs of HCWs.

Background: Occupational stress among healthcare workers negatively impacts job satisfaction and patient care quality, jeopardizing healthcare system sustainability. Traditional employer-driven approaches often fail to address these challenges comprehensively, leading to persistent gaps in work condition transparency and well-being.

Aims: To elucidate the working conditions of health workers and introduce a worker-centred, technology-based strategy moving beyond traditional practices and entrenched medical culture.

Methods: A nationwide survey of Belgian medical residents evaluated occupational conditions and perceptions of management practices. Additionally, the alpha version of a decentralized mobile application was tested to gather user satisfaction and feedback on its usability. The data were surveyed using Pearson's chi-squared and Kruskal-Wallis rank sum tests to assess associations between categorical and ordinal variables, respectively. Alpha-testing results were evaluated using descriptive statistics.

Results: The nationwide survey, involving 257 participants, revealed significant associations between medical specialty, work choices and compensation. Notably, 91% of participants expressed strong interest in our proposed open, decentralized solution. In the alpha testing phase, 12 testers reported high satisfaction regarding time-tracking accuracy and payroll verification, though challenges related to administrative burden were also identified.

Conclusions: The findings underscore the need for innovative, worker-centred occupational management solutions. The proposed solution shows promise in improving autonomy and transparency, potentially enhancing healthcare delivery and sustainability.

Background: The symptoms of Long coronavirus disease 2019 (Covid-19) are heterogeneous, creating uncertainty for employers regarding the diagnosis. The prevalence of Long Covid-19 in the workforce is also unknown. Furthermore, workers affected by Long Covid-19 encounter considerable difficulties in ensuring work safety and returning to their jobs due to this condition.

Aims: This review is aimed to identify the prevalence of Long Covid-19 in the workplace and to determine the various symptoms of Long Covid-19 experienced by the workers.

Methods: A meta-analysis was conducted to calculate the pooled estimates for the prevalence of Long Covid-19. Heterogeneity among the estimates was evaluated using the I² statistic.

Results: The pooled prevalence of Long Covid-19 among workers across the 11 studies was 38% (95% CI 23-56). A total of 43 symptoms associated with Long Covid-19 were identified in the workplace, with the top five symptoms being dyspnoea at moderate activity (51%, 95% CI 39-62), mental symptoms (38%, 95% CI 6-87), dyspnoea at mild activity (35%, 95% CI 25-47), fatigue (26%, 95% CI 3-78) and effort intolerance (24%, 95% CI 15-35).

Conclusions: The review indicates a significant burden of long-lasting symptoms within the workforce. The top five reported symptoms of Long Covid-19 were dyspnoea during mild and moderate activities, mental symptoms, fatigue and effort intolerance.