Symptoms compatible with hypersensitivity reactions after receipt of the first and second dose of COVID-19 vaccine

Background: Until January 2022, 8.975.458 cases of COVID-19 have been reported in Spain. In December of 2020, the European Union authorized the first mRNA vaccines against SARS-COV- 2, developed by Pfizer-BioNTech and Moderna, with two doses separated by 21 and 28 days, respectively. Reports of severe allergic reactions, including anaphylaxis, have prompted concern that the new mRNA vaccine platform has the potential to cause allergic reactions (including anaphylaxis) at a greater rate than other vaccines. Method(s): Immunization process started at Hospital Ramon y Cajal (Madrid, Spain) in January 2021. The hospital provided a form to report any adverse effect after the first or second dose of the vaccine. Until today, in our Allergy Department, we have received more than 500 patients with suspected adverse reaction to the vaccine, although the data in this publication are collected from January 2021 to September 2021. All of them were referred from different services (Occupational Risk Prevention Department, Preventive Medicine Department, General Practitioners and other specialties) by telephone, e-mail or personally at our service. Result(s): Out of the 139 vaccinated patients who reported adverse effects, 131 had a reaction with the first dose, of whom 65% were women. 51% were local reactions and 49% systemic, of which 62% were immediate reactions. We performed diagnostic tests in 55% of the patients: prick test (with macrogol, triamcinolone, dexketoprofen, methylprednisolone acetate, PEG), ID test (with triamcinolone, dexketoprofen, methylprednisolone acetate) with immediate reading and delayed reading in case of delayed reactions, epicutaneous tests (with PEG and polysorbate 80) and blood tests in systemic reactions. All diagnostic tests showed negative results. 82% of patients that reported adverse effects after the first dose tolerated the second dose of the vaccine without incidents. Only one patient had a reaction to the first and second dose despite a negative study, a 58-year- old woman who presented an urticarial rash 24 hours after administration. 8 patients, all of them women, were referred for reaction after the second dose, 87% of whom had tolerated the first dose. Conclusion(s): This single-center experience suggests that most patients who had mild reactions to the first dose of mRNA vaccines have received the second dose uneventfully or with only mild repeat reactions.

Impact of the COVID-19 pandemic on surgical practice in Iraq

Background: The COVID-19 pandemic affects all aspects of life all over the world;general surgeons are highly affected along with other healthcare personnel. A gloomy course of the disease makes it hazardous till now;its impact and ways of protection should be of concern for us so that we can keep on our works. Method(s): A survey was carried out at our hospital among general surgeons and surgeons of other specialties of the course with junior doctors and residents. A questionnaire was answered by them concerning their work with the impact of the virus, collecting data from the statistical unit electronically. Iraq has started lockdown for a period of 24 months from March 2020 to March 2022. Result(s): This study is a cross-sectional study using Google Forms and spread over surgical teams of different specialties at the Imemein Kadhumein Medical City Center. From about 248 responses, 118 responses were taken from the survey. Out of the 50 surgeons, 40 (80%) were infected and out of the 68 residents 62 (91.1%) were infected in our hospital (open and laparoscopic). About 20% of the doctors completely stopped attending outpatient clinics, until vaccination started on March 2021, an overall decrease of 60%. A drop of >75% of income was noticed by 45% of them;and 25% of them feel <75% of the income was received. But others have no change or increase in income as patients shift toward private hospitals because the government ones become loaded with COVID patients. Information about the illness and its sequelae was found through the net to be about 81% and through television to be 16%, whereas others were through national and institutional announcements. Conclusion(s): Standardized measures in detection, treatment, and/or vaccination should be taken into consideration based on the solid scientific facts to have a road map for surgeries during this or subsequent pandemics, getting the best outcome for doctors and patients.Copyright © 2022 Nile, Hamdawi, Khiro, licensee HBKU Press

CITIZENS OF BOLIVIA, COLOMBIA, ECUADOR AND PERU HAVE ADDITIONAL RIGHTS TO THOSE OF THEIR COUNTRY OF BIRTH, WHICH ARE EFFECTIVE THROUGHOUT THE TERRITORY OF THE ANDEAN COMMUNITY. CONCEPT NOT APPLICABLE TO HEALTH PERSONNEL IN THE CASE OF AN OCCUPATIONAL BIOHAZARD EVENT.

Introduction: The studies of comparative law are used as a methodology of legal analysis based on the comparison of different applications and interpretations for similar cases, the interest in comparative law lies in that it nourishes and broadens the vision for international understanding, which makes us understand the rationale of the rules in different states, Of our interest is the concept of the Andean citizen and the migratory statute that defines that migrant workers from Bolivia, Colombia, Peru and Ecuador have additional rights, guarantees and duties to those of their country of birth, these new social rights are those granted since August 11, 2021 by decision 878 of the Andean migratory statute. When analyzing whether the health workers who attended the COVID-19, exposure to occupational biological risk was considered in each of their countries as of occupational origin, since the objective of the community is to standardize and normalize concepts and regulations and thus allow inferring whether they are entitled to the assistance and economic benefits covered to the worker Objective:To compare the legislation issued by the health authorities of the member countries of the Andean Community of Nations on COVID-19, and if this was configured as an Occupational Disease in health workers who attended the Pandemic. Material(s) and Method(s): An exhaustive review was carried out in the official communication channels of the health authorities of Colombia, Ecuador, Peru and Bolivia, CAN member countries, filtering the information on how they developed COVID-19 as an Occupational Disease in their internal regulations, identifying guarantees and protections provided by the countries to the health workers who have been in charge of the integral attention of this contingency. Descriptive study that included a search from April to December 2021. Result(s):After the review,COVID-19 was recognized as an Occupational Disease in health workers, in 3 of the 4 Countries, 1 of the Countries determined it as a Public Health problem, likewise it was found that each Country, approaches Occupational Risks differently, translating into the fact that Health Workers of the CAN, did not have guarantees and protections proper to the Occupational Risks system. Conclusion(s): There is a lack of development on the part of all the Countries that make up the CAN, with regard to aligning their regulations on labor risks, in such a way that they guarantee access to the Andean Citizen to enjoy the guarantees provided by social security in accordance with the supra-national regulation, Decision 584 which approves an instrument that establishes the fundamental rules on occupational safety and health, as a basis for the gradual and progressive harmonization of the laws and regulations governing the particular situations of the labor activities developed in each of the Member Countries, which are not fully developed by all the member countries, generating legal insecurity and uncertainty for the migrant worker.Copyright © 2022, Accion Medica S.A.. All rights reserved.

Difficulties Faced By Dentists During COVID Pandemic-A Survey

Aim: To assess the hardships faced by dentists during covid pandemic. Introduction: COVID-19 was declared a pandemic by the World Health Organisation (WHO). The primary clinical appearances are respiratory in nature. Dental practitioners are among the most elevated hazard categories for transmission of covid since numerous dental methods have the potential to transmit the disease. Material(s) and Method(s): A cross sectional survey via an online questionnaire of 11 close ended questions was done. It was circulated via Google forms. The questionnaire contains questions on demographic details also. Data was collected and tabulated in excel sheet and statistical analysis was done using SPSS version 23. A total of 133 dentists responded to the study. Result(s): Most of the dentists reported that they were worried about operational and financial challenges to run their practice during Covid-19 pandemic. 53.4% of the dentists were male while 46.6% of the participants were female. Most of the dentists agreed that they are at higher risk of contracting covid-19 than other medical professionals. Most of the dentists agreed that they may be the major cause of transmitting the infection to their patients. Conclusion(s): During Covid-19, dentists had to face a lot of ethical and moral dilemmas along with facing operational challenges. This led to a negative impact on their lives, the present study draws our attention towards the hardships they faced.Copyright © 2022 Ubiquity Press. All rights reserved.

Employment status of referrals to a regional Long COVID service in the United Kingdom

Introduction: Long COVID is a new phenomenon characterised by multiple physical and psychological symptoms, all of which can affect a person's ability to work. There has been evidence that Long COVID disproportionately affects healthcare professionals (HCPs). Aim(s): We analysed the employment status of referrals to the Cheshire and Merseyside Long Covid assessment service. Method(s): Retrospective case note review of referrals received between 01/03/21-30/09/21. Result(s): 1285 referrals analysed, of which: 59.2% (761) currently working 19.7% (253) long term sick leave . 10.3% (111) retired 0.7% (9) students, of these 33.3% (3) were on placement within hospitals. . 8.6% (132) were unemployed, of these 15.2% (20) contributed this to Long COVID syndrome 1.48% (19) had no record of employment 20.2% (259) worked for the National Health Service (NHS). Table 1 shows the breakdown by sector. Conclusion(s): The results show the ongoing socio-economic impact of COVID-19. Almost 1/3 of the cohort were unemployed or on long-term sick leave. Furthermore, NHS HCP made up the largest proportion of the long-term sick group. Further work could evaluate the occupational risk associated with Long COVID syndrome, especially in healthcare settings.

High anti-SARS-CoV-2 IgG antibody seroprevalence among long-distance trucking crews in Kenya within one year of the COVID-19 pandemic

Introduction/ Background: The first case of COVID-19 in Kenya was confirmed in March 2020. Given their key role, long-distance trucking crews (drivers, assistants and others) were exempted from local COVID-19 travel restrictions. Long-distance trucking crews also interact with many contacts over large geographical areas, placing them at increased risk of SARS-CoV-2 infection. Methods: We conducted two cross-sectional serosurveys to estimate cumulative SARS-CoV-2 incidence among trucking crews in Kenya. The surveys were conducted in Kilifi County and Busia County, the first in September - October 2020 and the second in January - April 2021. Up to 5mL of blood was collected from participants and plasma extracted. Plasma samples were tested using a validated in-house anti-spike IgG ELISA with 93% sensitivity and 99% specificity. Overall crude and test performance adjusted seroprevalence were estimated. Results: A total of 830 and 527 participants were sampled in the first and second cross-sectional serosurveys, respectively. Overall crude SARS-CoV-2 IgG antibody seroprevalence was 39.6% (95% CI 36.3-43.1) and 61.9% (57.6-66.0) in the September-October 2020 survey and the January-April 2021 survey, respectively. Overall SARS-CoV-2 IgG antibody seroprevalence adjusted for test performance was 42.3% (95% credible interval 38.4-46.3) in the September- October 2020 survey and 66.6% (61.7-72.2) in the January-April 2021 survey. Impact: This research generates empirical evidence on the risk of SARS-CoV-2 infection among long-distance trucking crews. The findings demonstrate the challenge of infection prevention within a group at increased occupational risk during pandemics yet exempt from stringent pandemic control measures given a critical role in sustaining supply chains during pandemics. Conclusion: Two-thirds of trucking crews were infected with SARSCoV- 2 within one year of the pandemic. Seroprevalence was higher compared to Kenyan healthcare workers (20.8% [17.5-24.4], July- December 2020) and blood donors (48.5% [45.2-52.1], January-March 2021), indicating higher infection risk. Preparedness planning for the safe continuation of haulage remains important for future pandemics.

Threats to operating room personnel's occupational safety and health: a qualitative study

Background & Objective: Every operating room has been associated with a variety of occupational hazards, but not many studies have been conducted to assess and address these hazards. We used a qualitative approach to explore operating room personnel's experiences of workplace hazards and how these hazards threaten their occupational safety and health (OSH). Methodology: This qualitative study was conducted in five teaching hospitals in the south-west of Iran from February 2019 to March 2021. The sample was 24 operating room personnel who were selected under convenient sampling technique. Data were collected using semi-structured, individual interviews, document review and non-participant observation. The collected data were analyzed according to the qualitative content analysis method using MAXQDA v. 2020. Results: After prolonged analysis of the data, the researchers extracted 644 codes, 13 subcategories, 4 categories, and 1 main theme. The main theme of the study was working in a context of occupational hazards. Conclusions: Operating rooms are full of potential dangers, which, when combined with the personnel's negligence and management inefficiencies, increase the risk of occupational health and safety. Therefore, making working conditions safe by providing adequate personal protective equipment (PPE), in-service training, and identifying and managing the causes of personnel negligence are recommended. Moreover, strategies should be introduced to manage stress and conflicts among the healthcare personnel, thus controlling psychological hazards.

NONINVASIVE VENTILATION IN A COVID-19 PATIENT RESULTING IN PNEUMOTHORAX

CASE: A 57-year-old man with a history of hypertension presented with shortness of breath, dry cough, and subjective fever. He tested positive for SARS-CoV-2 upon presentation. He denied tobacco use or occupational hazards. He had an initial respiratory rate of 31 and oxygen saturation of 84% on room air. On exam, he was tachycardiac, and his lungs revealed bibasilar rales. His blood work revealed elevated inflammatory markers. His CTA was negative for pulmonary embolism but revealed bilateral groundglass infiltrates. He was admitted and started on dexamethasone, remdesivir, and enoxaparin. He developed worsening oxygen requirements during his stay and was transitioned to high flow nasal cannula and subsequently to BiPAP with IPAP of 20 cm H2O and EPAP of 10 cm H2O with FiO2 100%. His chest x-ray revealed a right-sided pneumothorax and pneumo-mediastinum with extensive subcutaneous emphysema [Fig 1]. Subsequently, he developed worsening acidosis, lethargy, hypotension, and tachycardia, prompting a chest tube placement and intubation [Fig 2]. While in the intensive care unit, he developed another right-sided pneumothorax, prompting a 2nd chest tube placement. IMPACT/DISCUSSION: The COVID-19 pandemic has created uncertainty about patient care, especially respiratory management. The increasing need for ventilators led to a nationwide shortage, and noninvasive ventilation (NIV) techniques needed to be employed despite the potential for aerosolization of the virus associated with their use. Barotrauma is a dreaded complication when using invasive ventilation. Increased volume can result in hyperinflated alveoli and air leaks into the surrounding tissues and spaces. There has been a limited number of cases reported of pneumothorax in COVID-19 infection from NIV. NIV can also produce high tidal volumes, high transpulmonary pressure, and high intrinsic positive expiratory pressure. Consider pneumothorax as a differential when a COVID-19 patient is clinically deteriorating on NIV. Radiographic imaging and ultrasound are cost-effective tools for the diagnosis of pneumothorax. CONCLUSION: Barotrauma-induced pneumothorax is a well-known complication of invasive ventilation. In an attempt to decrease invasive ventilation complications and save limited resources, our focus has shifted to NIV. We should, however, be mindful that COVID-19 patients managed with NIV are also at risk of pneumothorax from increased tidal volumes, the risk of which is compounded by severe lung injury. The best practice to prevent barotrauma is to ensure the patient's tidal volume does not exceed 6mL/kg ideal body weight. This application is an easy and effective prophylactic approach that should be taught to all providers to prevent iatrogenic injuries in these patients who are already at increased risk of lung injury.

Infection-Control knowledge, attitude, practice and risk perception of occupational exposure to COVID-19 among dentists: A cross-sectional survey.

Background: COVID-19 is a potentially fatal disease that was announced as a global pandemic at the beginning of the year 2020. Aim: The purpose of our cross-sectional study was to evaluate the infection-control knowledge, attitude, practice, and risk perception of occupational exposure to COVID-19 among multinational dentists. Patients and Methods: A self-designed, 33-item, English questionnaire was created and distributed through social media and digital communication platforms. The questionnaire covered the demographic data, knowledge and perception of the occupational risk of the COVID-19 infections, and compared some infection control measures taken before and after this global pandemic. The results were analyzed, and four scores were used to assess the aforementioned parameters. Results: A total of 300 multinational dentists answered our survey, with the majority being females (59%) and aging from 25 to 44 years old (68%). We found that a statistically significant relationship exists between attitude and nationality, country of practice, medical condition, and the practicing specialty (P < 0.05). In addition, risk perception had a statistically significant correlation with nationality, smoking habits, education level, and specialty (P < 0.05). Furthermore, there was a statistically significant correlation between the practice score and the gender, age, smoking habits, education level, nature of the practice (private or governmental), and academia affiliation (P < 0.05). Conclusions: The study sample had good compliance with the instructions and guidelines of the World Health Organization (WHO) and the Centre for Disease Control (CDC), with most of them improving their infection control precautions after the virus's emergence according to the said guidelines. Furthermore, our participants were fearful of the COVID-19 virus and the fact of being potential transmitters. Despite saying that, the significant majority of them reported being confident in treating COVID-19-positive patients.

OCCUPATIONAL ACCIDENT DUE TO COVID-19 INFECTION IN HEALTH AND SOCIAL-HEALTH WORKERS IN THE FIFTH SANITARY AREA OF ASTURIAS

Introduction: In Spain, COVID-19 infection in the health and socialhealth workers is considered as an occupational accident (OA) if the Occupational Risk Prevention Services (ORPS) certificate it.The aim of our study was to verify it in our area and to correct deficiencies. Material and Method: Descriptive study from May 28, 2020 to January 27, 2021.The health Inspection Unit of our area required OA certificate to the ORPS, and the assessment by the National Institute of Social Security (NISS) when the private insurance fund denied OA. Results: Total of 204 cases (55.4% healthcare workers, 52.5% from public centres (33.3% in our area). ORPS OA certificate: 61.8%. NISS recognised OA: 41.2%. OA recognition was greater in socio-health and private workers than in sanitary and public workers.The medical inspection Unit intervention partially improve the results. Conclusions: Despite complying with legal requirements there were no OA recognition in all cases of COVID-19 infection in these workers. The medical inspection Unit was not guarantor enough.

University of Chicago Pathology Novel SARS-CoV-2 Autopsy Protocol

Background: While all autopsies pose a potential risk of exposure to infectious agents, the recent emerging SARS-CoV-2 (COVID) pandemic reminds us of this elevated potential. During this outbreak there are still few detailed protocol recommendations, limited data, and much uncertainty about how exactly to handle such a case. Furthermore, it has been estimated that SARS-CoV-2 autopsies take at least three times longer than a standard autopsy. We designed an institutional autopsy protocol to mitigate occupational risk, increase efficiency, limit exposure, and maximize educational value. Design: The personal protective equipment (PPE) for the evisceration component of the autopsy consisted of Powered Air Purifying Respirator (PAPR), two layers of long cuff disposal gloves, plastic apron, fluid proof gown, and fluid resistant leg covers. All SARS-CoV-2 autopsies were conducted by a limited number of trained personnel including an attending pathologist, resident and pathologist assistant using the Virchow evisceration method. The cranium was opened using a bone saw with an integrated vacuum. Organ retrieval, weight, and photographing of the cut surface were performed on the day of evisceration and could be completed within one hour, including cleaning of the autopsy suite. Sectioning was performed after fixation for 48-72 hours in 10% neutral buffered formalin. On the day of sectioning, a PAPR was replaced with a N95 respirator. Results: Over 10 members of our department have contributed to performing 40 COVID autopsies since 2019. No personnel became infected with SARS-CoV-2. Our complete protocol has provided our institution with resources to further study the pathogenesis of COVID in humans. It also differs from other modifications by for example, having multiple body cavities open at a time and not having autopsy rooms dedicated only to infected cadavers. Using these methods we have been able to supply numerous institutional labs with organ sections for various research protocols. Conclusions: Although post-mortem examination of COVID-infected decedents has inherent risk, only complete autopsies are a source of invaluable and irreplaceable information. This protocol was originally designed for SARS-CoV-2, but we recognize the potential application for other high-risk infectious cases. It is our hope that as more practical evidence-based biosafety guidance is disseminated the need for limited autopsies and partially or completely suspended autopsy services will be obviated.

Are health professionals vulnerable to workrelated musculoskeletal disorders

Introduction: Work-related musculoskeletal disorders (MSDs) are a group of disorders confined basicly to muscles, tendons, ligaments, nerves, joints, and bones and occur in relation to occupational activities. These disorders are reported to be common in health professionals and affect their quality of life. Carpal tunnel syndrome, tendinitis, degenerative spine disease, thoracic outlet syndrome, and strained neck syndrome are common in health workers. These problems often arise due to nonneutral postures, unsuitable instruments, nonergonomic working conditions. In addition, repetitive challenging activities are common risk factors. Medical students: MSDs can begin in medical students at even educational stage, especially during laboratory studies. Researches showed that the most common sites of problems are;lower back, neck, and upper back. Lower back, neck, and upper back prevented daily activities in the majority of cases. Strategies are suggested to address ergonomic and postural training, as part of university curriculums, including the identification of problems for early intervention to facilitate sustainable workforces. Health professionals: Work-related MSDs were found to be relatively highly prevalent among health care and hospital workers in general and nurses in particular. Both disorders were reported to be largely workrelated and stress-related. Moreover, they were found to be a result of both psychological stress and physical strain from work. Surgeons: Compared with disease estimates in the general population, surgeons have a higher prevalence of MSDs. Surgeons, hospital administrations, surgical material designers, and health insurance schemes have a role to play in taking action to protect surgeons from this potential burden and occupational health hazard. Dentistry: Professional practice and dental training have many risk factors, and the dental team should be able to recognize these factors to protect themselves. The most common sites for MSDs are neck, lower back, and shoulders. Women show a higher frequency of intense pain involving the cervical, lumbar, dorsal, and wrist areas placing them at a higher risk of injury. Nurses: Because of the specificity of their work tasks and the long duration of tasks in health institutions, nurses are quite vulnerable to various occupational risk factors. In addition to the physical risk factors connected to the work tasks, there are also individual risk factors, related to each individual's susceptibility and organizational/psychosocial risk factors (although these occupational risk factors are often addressed separately), whose control is critical. During the pandemic: Physicians and nurses can be considered to have MSDs because of: (1) the difficulties they experience, especially while using Personal Protective Equipment for Covid-19 in Intensive Care Unit/Settings. (2) the difficulties they experience by having to spend a long time at the computer to provide telemedicine services to the patients they monitor. Long and intensive studies leading up to these periods may have also caused MSDs. Conclusion: Areas of action can be ergonomic equipment, training, and consulting for workplaces at home and ergonomic risk assessments. In cases where protection is not provided and early treatment is not performed, they can cause temporary or permanent work disability.

Diagnosis of Covid-19 by RTPCR and Correlation with Radiological and Immunological Parameters among Health Care Workers at a Tertiary Care Hospital in Hyderabad

Background:Detection of Covid-19 among Health Care Workers (HCWs) is crucial for hospital infection prevalence and containment of the disease. According to current diagnosis criteria, laboratory diagnosis by RTPCR has become standard and formative assessment of Covid-19 infection. Present study aims to diagnose Covid-19 infection by RTPCR and corre- lating the results with clinical, immunological and radiological parameters in HCWs at Sir Ronald Ross Institute of Tropi- cal And Communicable Diseases (SRRIT&CD), HyderabadA. Methods:All HCWs of SRRIT&CD tested by RTPCR for Covid-19 were included in the study. HCWs positive by RTPCR were advised quarantine and investigated for CBP, Chest X-Ray, HRCT Chest (radiological investigations) CRP and IL-6 (Immunological investigations). Results:Since SRRIT&CD is an isolation centre all HCW were exposed to Covid-19 cases and were tested regularly for Covid-19 by RTPCR. 53(12.6%) of HCWs were positive for Covid-19, out of which 22( 41.5%) were doctors, 6(11.3%) were nursing staff, 13(24.5%) were technical staff,8 (15%) were sanitation and house-keeping staff and 4 (7.5%) were office staff. 88.7% of 53 Covid positive cases were symptomatic presenting with fever as the common symptom an 11.3% were asymptomatic. Significant chest X-ray, HRCT Chest and immunological findings were reported in 11.3%, 9.4% and 9.4% respectively. 2 (3.7%) HCW with co-morbidities succumbed to the disease. Re-infection was seen in 1 HCW (1.9%). Conclusions:In the present study RTPCR is the main stay in the diagnosis of Covid -19 which is a potential occupational risk among health care individuals. Hence early diagnosis by RTPCR and effective isolation can minimize the spread of the disease in the institute

The "Healthwise” Approach In Togo, From Pilot Centers To The National Strategy For The Promotion Of Safety And Health At Work For Health Workers (2016-2021)

Introduction: In the majority of African countries and particularly in Togo, the safety and health conditions in their workplaces in the health sector are insufficient. Since 2016, the HealthWISE-WHO/ILO approach has been an effective tool for promoting occupational safety and health (OSH) in experimentation in the health sector in Togo. The objective of this analysis is to highlight the first positive impacts of this approach. Materials and Methods: Analysis of the reports of the Health Centres Pilot Health Centres project by the HealthWISE-ILO/WHO approach and the implementation documents of the OSH Strategic Plan for Health Workers in Togo Results: The promotion of the improvement of occupational safety and health through the HealthWISE approach in the thirteen (13) pilot health centres had led to a clear advance in the field. Indeed, of the thirteen pilot centres, eight (8) had carried out a summary assessment of occupational risks and all the centres appointed HealthWISE focal points. Ten (10) health centres were able to carry out improvement action plans. Improvement actions are illustrated by improvements made in maternity wards, offices and intensive care units in some hospitals. Since 2020, the achievements of the implementation of the HealthWISE action plans have enabled a rapid response by integrating the strategy into the national response to the emergency response to the covid-19 pandemic with a view to protecting health workers. Conclusion : the ILO/WHO HealhWISE approach and the implementation of the national strategy have led to a significant improvement in OSH in the health sector in Togo.

Unfree and at high risk: Understanding child labour and occupational risks from the viewpoint of those involved

Why do young workers suffer many times the injury rate of adults? We cannot answer this question without first understanding how children of poor families, such as those making bricks, become child laborers. We are learning that the process of transitioning into work starts early in life, at the same time as children are learning language, culture, religion, and morality. This lead to the development of a worldview that legitimizes child labor in the eyes of its victims, also tends to overlook or accept the health risks it entails. Yet emerging data indicate that, in addition to the excessive physical loads the children are expected to carry, there is the heavy psychological load of responsibility towards younger siblings and disabled family members. This load is not diminishing as child labour rates overall are increasing. Current research being undertaken with underprivileged communities in Pakistan is exploring potential points of intervention, for example, determining to what extent children are ‘socialized into work’ by their parents and siblings or alternatively by their own experiences and mistakes, as well as the factors which provide positive reinforcement. It seeks points of intervention from the regulatory angle as well. Why are basic health and safety laws so widely ignored? The upheaval of COVID 19 on top of a steady trend toward increased global production and communication are putting pressure on both young workers and those who employ them. Health professionals must document the effects of these changes on young workers’ health and design counter-measures that are adapted to local social environment.

Ergo@Home Guideline – a Tool for Working from Home Using Information Technology, in Pandemic

Introduction: For most people, Covid-19 pandemic was a challenge regarding work. It "accelerated” the transition to online activities in many fields, where teleworking and telestudy concepts were applied, based on nowadays information technology. The aim of this work is to elaborate a guideline for teleworking and telestudy in Romania. Material and methods: A multidisciplinary team of ergonomists, architects, different health care specialists was involved. They studied and systematized the legal framework of working from home, the common and emerging risk factors identified in computing activities, their effects on health and prophylactic recommendations. Results: The guideline is structured in three parts: the first is dedicated to ergonomics principles in office work, the second describes solutions for organizing home space for work using the green concept and the third approaches occupational risks, their health effects and some medical advice. The multidisciplinary approach concerning the prophylactic recommendations to teleworking is the key to maintain wellbeing and health. To prolonged sitting posture, visual and neuropsychological overload, there are added the emerging risks in the context of teleworking: lack of direct relationship, home office organization, confusion between working and personal time, internet quality, increase of sedentary lifestyle and implicitly the risk of cardiovascular, metabolic and musculoskeletal diseases. Conclusions: The elaboration of a teleworking and telestudy ergonomic guideline will be useful to employees and employers, students and organizations, in order to maintain one’s health

“Mat-O-Covid”: a SARS-CoV-2 (COVID-19) Job Exposure Matrix

While exposure assessment is complex for the occupational risk researcher, the objective of our work is to develop and validate a job-exposure matrix (JEM) for SARS-CoV-2 exposure called “Mat-O-Covid” project (“COVID-Mate” in French). A group of French experts, the JEM was developed for all workers using the 2003 Occupation and Socioprofessional Categories (with a transcoding gateway to the 2008 International Standard Classification of Occupations) and a focus on the health and care sector. The average of the experts' coding was used as estimates for both estimates, exposure "subjects” (colleagues and/or public) and "patients” for the focus on the health and care sector, as well as the probability of prevention for each. Intraclass correlations were considered good to excellent except for health prevention. Compared to the United States O*Net JEM, the evaluation was considered as fair. In conclusion, a "Mat-O-Covid” JEM providing a probability of occupational exposure to SARS-CoV-2 will have implications for research and public health, taking into account that its limitations are known, and its validation is still in progress. NB: Mat-O-Covid is available at

Special Session 54 Biorisk Management in the workplace: beyond the tick box

Session introduction Biorisk management is crucial in preventing transmission of hazardous biological agents (HBAs) across various industries and occupational groups to reduce the burden of disease and will be the focus of the session. The COVID-19 pandemic demonstrated the challenges and complexity of identifying biohazards and establishing causal links, fitness for work post infections and workplace accommodation. This session intends to close existing knowledge gaps and empower delegates with information on current best practice examples as a means of sharing solutions locally and globally. The focus will be on determining effective and appropriate workplace strategies using a risk-based approach to prevent exposure to HBAs which complements the global strategy on occupational risk management.

Protecting the Unprotected – Occupational health and safety among informal workers in Southern Africa

The International Labour Organisation (ILO) estimates that approximately 2 billion people, about 61% of all globally employed people, are in the informal economy. This statistic is substantially higher for continental Africa (approximately 86%), and varies across the continent: 31.5% in South Africa, and exceeding 95% in Mozambique, Democratic Republic of Congo and Chad. The informal sector is characterised by vulnerabilities in income, job security, occupational risks and access to healthcare. The ILO, in addressing these challenges, developed Recommendation 204, the “Transition from the Informal to the Formal Economy Recommendation, 2015”. This provides a policy framework that requires a transition that provides adequate social and labour protection, extends legal coverage and protection and ensures compliance with laws. While this transition is necessary, its character particularly with regard to occupational health and safety, needs to be shaped in accordance with needs of workers, harnessing resources from the formal economy and structuring legal frameworks that prioritise health and social protection. Informal work environments vary from extractive, manufacturing, food preparation, commercial, social and retail. Hazardous exposures vary, with workers having little or no resources to introduce controls or to protect their health. Most lack the knowledge about the risks posed by their exposures. Access to medical surveillance is non-existent. While workplace exposures are important factors, social contexts further drive health outcomes: lack of health facilities close to working environments reduce primary health care access, lack of childcare facilities result in child exposures and precarious conditions increase gender and xenophobic violence. Numerous interventions have been piloted and proposed for protecting the health of workers in this sector, including the ILO initiatives such as Work Improvements in Small Enterprises (WISE). However, the success of any intervention is dependent on the multi-stakeholder context. The SARS-CoV-2 pandemic brought into sharp focus the vulnerability of the informal sector – both in terms of economic stability as well as health protection. In South Africa alone, approximately 1.5 million informal sector jobs were lost in the first quarter of 2020. The nature of work has meant that the risk for transmission of infection is extremely high, thus return to work is likely to have resulted in disproportionately higher rates of hospitalisation and death compared to formal workers – but few countries have collected data to better understand the epidemic-related risk of informal work. The growth in the informal economy is a direct result of neo-liberal economic policies championed by government and big-business. The policy infrastructure that encourages the growth in this sector excludes the protection of the health of these workers. All tiers of government should be obliged to commit to policy frameworks, local infrastructure for informal work activity and provision of resources for hazard control and medical surveillance. It is the responsibility of the state to ensure that these workers enjoy the rights to safe and healthy workplaces.