A Cohort Study of Occupational Fatalities among Paramedicine Clinicians: 2003 through 2020.

INTRODUCTION/STUDY OBJECTIVES: Emergency medical technicians (EMTs) and paramedics respond to 40 million calls for assistance every year in the United States; these paramedicine clinicians are a critical component of the nation's health care, disaster response, public safety, and public health systems. The study objective is to identify the risks of occupational fatalities among paramedicine clinicians working in the United States. METHODS: To determine fatality rates and relative risks, this cohort study focused on 2003 through 2020 data of individuals classified as EMTs and paramedics by the United States Department of Labor (DOL). Data provided by the DOL and accessed through its website were used for the analyses. The DOL classifies EMTs and paramedics who have the job title of fire fighter as fire fighters and so they were not included in this analysis. It is unknown how many paramedicine clinicians employed by hospitals, police departments, or other agencies are classified as health workers, police officers, or other and were not included in this analysis. RESULTS: An average of 206,000 paramedicine clinicians per year were employed in the United States during the study period; approximately one-third were women. Thirty percent (30%) were employed by local governments. Of the 204 total fatalities, 153 (75%) were transportation-related incidents. Over one-half of the 204 cases were classified as "multiple traumatic injuries and disorders." The fatality rate for men was three-times higher than for women (95% confidence interval [CI], 1.4 to 6.3). The fatality rate for paramedicine clinicians was eight-times higher than the rate for other health care practitioners (95% CI, 5.8 to 10.1) and 60% higher than the rate for all United States workers (95% CI, 1.24 to 2.04). CONCLUSIONS: Approximately 11 paramedicine clinicians are documented as dying every year. The highest risk is from transportation-related events. However, the methods used by the DOL for tracking occupational fatalities means that many cases among paramedicine clinicians are not included. A better data system, and paramedicine clinician-specific research, are needed to inform the development and implementation of evidence-based interventions to prevent occupational fatalities. Research, and the resulting evidence-based interventions, are needed to meet what should be the ultimate goal of zero occupational fatalities for paramedicine clinicians in the United States and internationally.

Smart-working policies during COVID-19 pandemic: a way to reduce work-related traumas?

Eighth of March 2020, the Italian government introduced a national lockdown to counter the exponential increase in the number of COVID-19 cases; this decision avoided putting a strain on the health system. During the lockdown all non-essential services were stopped and a "stay at home" order was imposed. The purpose is to evaluate the impact of COVID-19 lockdown on Emergency Department (ED) visits due to work-related traumas in the Lombardy region. We performed a retrospective analysis on trauma admissions to the ED registered through the regional portal (EUOL), from 1st January 2019 to 31st December 2019 and from 1st January 2020 to 31st December 2020. The number of ED admissions for traumatic injury and work-related traumas dropped by 32% between 2019 and 2020. A remarkable reduction of work-related traumas was recorded during the two pandemic waves, from March to June and in October and November. The percentage of patient in critical condition in ED slightly raised. These results are probably a consequence of the unprecedented measures imposed by the Italian government to cope with the spread of COVID-19, with important implications for work contexts. This analysis should be considered to optimise the organisation of the emergency system in other critical scenarios. We speculate that the different epidemiology of occupational injuries during the lockdown period is a consequence of smart-working policies that can be held responsible for the drastic reduction of work-related traumas.

Original Mixed Methods Research Experiences, Service Needs, and Impacts of Workplace Safety and Insurance Board (WSIB) processes on injured and ill workers: evidence from the city and district of Thunder Bay (Ontario, Canada)

Introduction: Individuals experience negative physical, social and psychological ramifications when they are hurt or become ill at work. Ontarios Workplace Safety and Insurance Board (WSIB) is intended to mitigate these effects, yet the WSIB process can be difficult. Supports for injured workers can be fragmented and scarce, especially in underserved areas. We describe the experiences and mental health needs of injured and ill Northwestern Ontario workers in the WSIB process, in order to promote system improvements. Methods: Community-recruited injured and ill workers (n=40) from Thunder Bay and District completed an online survey about their mental health, social service and legal system needs while involved with WSIB. Additional Northwestern Ontario injured and ill workers (n=16) and community service providers experienced with WSIB processes (n=8) completed interviews addressing similar themes. Results: Northwestern Ontario workers described the impacts of workplace injury and illness on their professional, family, financial and social functioning, and on their physical and mental health. Many also reported incremental negative impacts of the WSIB processes themselves, including regional issues such as "small town" privacy concerns and the cost burden of travel required by the WSIB, especially during COVID-19. Workers and service providers suggested streamlining and explicating WSIB processes, increasing WSIB continuity of care, and region-specific actions such as improving access to regional support services through arms-length navigators. Conclusion: Northwestern Ontario workers experienced negative effects from workplace injuries and illness and the WSIB process itself. Stakeholders can use these findings to improve processes and outcomes for injured and ill workers, with special considerations for the North.

Experiences, impacts and service needs of injured and ill workers in the WSIB process: evidence from Thunder Bay and District (Ontario, Canada). / Expériences, besoins en services et répercussions des processus de la Commission de la sécurité professionnelle et de l'assurance contre les accidents du travail (WSIB) chez les travailleurs blessés et malades : données probantes de la ville et du district de Thunder Bay (Ontario, Canada).

INTRODUCTION: Individuals experience negative physical, social and psychological ramifications when they are hurt or become ill at work. Ontario's Workplace Safety and Insurance Board (WSIB) is intended to mitigate these effects, yet the WSIB process can be difficult. Supports for injured workers can be fragmented and scarce, especially in underserved areas. We describe the experiences and mental health needs of injured and ill Northwestern Ontario workers in the WSIB process, in order to promote system improvements. METHODS: Community-recruited injured and ill workers (n = 40) from Thunder Bay and District completed an online survey about their mental health, social service and legal system needs while involved with WSIB. Additional Northwestern Ontario injured and ill workers (n = 16) and community service providers experienced with WSIB processes (n = 8) completed interviews addressing similar themes. RESULTS: Northwestern Ontario workers described the impacts of workplace injury and illness on their professional, family, financial and social functioning, and on their physical and mental health. Many also reported incremental negative impacts of the WSIB processes themselves, including regional issues such as "small town" privacy concerns and the cost burden of travel required by the WSIB, especially during COVID-19. Workers and service providers suggested streamlining and explicating WSIB processes, increasing WSIB continuity of care, and region-specific actions such as improving access to regional support services through arm's-length navigators. CONCLUSION: Northwestern Ontario workers experienced negative effects from workplace injuries and illness and the WSIB process itself. Stakeholders can use these findings to improve processes and outcomes for injured and ill workers, with special considerations for the North.

Workers' Perception Heat Stress: Results from a Pilot Study Conducted in Italy during the COVID-19 Pandemic in 2020.

Many workers are exposed to the effects of heat and often to extreme temperatures. Heat stress has been further aggravated during the COVID-19 pandemic by the use of personal protective equipment to prevent SARS-CoV-2 infection. However, workers' risk perception of heat stress is often low, with negative effects on their health and productivity. The study aims to identify workers' needs and gaps in knowledge, suggesting the adaptation of measures that best comply with the needs of both workers and employers. A cross-sectional online questionnaire survey was conducted in Italy in the hottest months of 2020 (June-October) through different multimedia channels. The data collected were analyzed using descriptive statistics; analytical tests and analysis of variance were used to evaluate differences between groups of workers. In total, 345 questionnaires were collected and analyzed. The whole sample of respondents declared that heat is an important contributor to productivity loss and 83% of workers did not receive heat warnings from their employer. In this context, the internet is considered as the main source of information about heat-related illness in the workplace. Results highlight the need to increase workers' perception of heat stress in the workplace to safeguard their health and productivity. About two-thirds of the sample stated that working in the sun without access to shaded areas, working indoors without adequate ventilation, and nearby fire, steam, and hot surfaces, represent the main injuries' risk factors.

Investigation and analysis of occupational physical injuries among healthcare staffs during allopatric medical aid for the fight against COVID-19.

BACKGROUND: Occupational health impairment of medical personnel manifested as a prominent problem in COVID-19. The aim of this study is to investigate the occupational physical injuries of front-line medical staffs in Hubei province during the fight against COVID-19. MATERIAL AND METHODS: questionnaire survey was conducted among 476 medical staffs from 3 regions of Hubei Province, including general characteristics and the physical discomfort/damage suffered in the isolation wards during working hours. RESULTS: A total of 457 valid questionnaires were collected. The common physical discomfort/damage included skin injuries (22.76%), conjunctivitis (15.10%), falls (9.19%), intolerant unwell symptoms (8.53%) and sharp injuries (6.13%). Logistic regression analysis showed that: lack of protective work experience (OR = 2.049, 95% CI: 1.071-3.921), continuous working for 4 h (OR = 3.771, 95% CI: 1.858-7.654), and working >4 h (OR = 7.076, 95% CI: 3.197-15.663) were high-risk factors for skin injuries. Working continuously for 4 h (OR = 3.248, 95% CI: 1.484-7.110) and working >4 h (OR = 3.096, 95% CI: 1.232-7.772) were high-risk factors for conjunctivitis. Lack of protective work experience was a high risk factor for falls (OR = 5.508, 95% CI: 1.299-23.354). The high risk factors for intolerant unwell symptoms were continuous working for 4 h (OR = 5.372, 95% CI: 1.239-23.301) and working >4 h (OR = 8.608, 95% CI: 1.843-40.217). Working in a COVID-19 critical care unit (OR = 3.249, 95% CI: 1.344-7.854) and implementation of nursing (OR = 9.766, 95% CI: 1.307-72.984) were high risk factors for sharp injuries. CONCLUSIONS: Occupational physical injuries are universal in the COVID-19 ward. Those who take up nursing, work in a critical care ward, with no experience in an isolation ward for infectious diseases, and work continuously for ≥4 h on the same day should get more attention. Med Pr. 2022;73(3):209-18.

The impact of lockdowns during the COVID-19 pandemic on work-related accidents in Austria in 2020.

BACKGROUND: This study aims to investigate the impact of the lockdowns during the COVID-19 (Corona-Virus-Disease 19) pandemic in Austria on work-related accidents in the year 2020. Apart from the lockdowns, multiple work-related measures were introduced in 2020, such as the new law on short-term work and regulation on accidents during home-office. Their combined effects on work-related accidents are unknown and a secondary parameter of this study. METHODS: Daily data on the number of accepted and rejected cases of work-related accidents from the Allgemeine Unfallversicherungsanstalt were obtained for the years 2019 and 2020. Based on data provided by the World Health Organization and government publications, the beginning and end dates of national hard and soft lockdown periods were derived. From this database, a difference-in-differences regression analysis on the absolute number of daily work-related accidents was conducted. RESULTS: On average 272.3 work-related accidents per day were registered in 2019 and 199.4 in 2020, a statistically significant reduction of 72.9 accidents per day and total decrease of 26,164 less accidents compared to 2019. Both lockdowns had a statistically highly significant effect on work-related accidents: The hard lockdown reduced the average number of daily registered work-related accidents by 40%. The light lockdown phases reduced this number by an average of 51%. Weekends and holidays had the greatest impact on work-related accidents with a reduction of 69% and 73%, respectively. CONCLUSION: Both lockdown qualities during the COVID-19 pandemic in Austria led to a significant reduction in work-related accidents for their duration. These findings merit further investigation with more detailed data on sectors and injury-quality.

Epidemiological Characteristics, Risk Factors, and Preventive Measures of Occupational Injuries Among Commercial Couriers in China Before and During the COVID-19 Pandemic.

In this study, we focus on the significant upward trend of occupational accidental traffic injuries in commercial couriers during the coronavirus disease (COVID-19) pandemic. This review comments on the characteristics of occupational accidental injuries of commercial couriers in China and then discusses the reasons of the high incidence rate and associated risk factors. Various potential protective measures were also explored to prevent and control the occupational injuries in this vulnerable worker group.

Occupational impact in COVID-19 pandemic according to one year of compensation claims in Italy.

OBJECTIVES: to evaluate the patterns of occupational COVID-19 cases, based on compensation claims applied to the Italian National Institute for Insurance against Accidents at Work (Inail). DESIGN: descriptive analyses of daily time series of compensation claims applications, geographical distributions, and occupations involved. Multivariate analyses have been performed for identifying significant epidemiological pattern. SETTING AND PARTICIPANTS: compensation claims for COVID-19 injuries received by Inail from March 2020 to February 2021 have been analysed. MAIN OUTCOME MEASURES: daily time series of compensation claims applications in the first year of pandemic and comparatively with population data, patterns of occupations majorly involved in time, territorial clusters. RESULTS: in the observed period, Inail has received 155,684 workers' compensation claims with a first peak (more than 1,000 daily compensation claims) in March 2020 and a second peak (more than 1,500) in November 2020. A time dependent geographical pattern was identified, with the Northern regions formerly affected in the first phase, followed by a diffusion in the Central and Southern regions during the summer period. Health technicians (32% and 42% in male and female, respectively) and physicians (15%and 6%) were the most involved workers. The timing of infection was found to depend by job, with physicians, nurses, and health technicians firstly involved with a spread of about 2 weeks with respect to other jobs. Trend in health workers' vaccination has been found in a clear inverse relationship with the decreasing number of compensation claims, remaining, since February 2021, under one hundred daily cases of occupational COVID-19 compensation claims. CONCLUSIONS: different intensities, timing, and characteristics were found among application claims, which address for different pandemic diffusion paths. Health workers are the firstly and most involved impacted by the pandemic. The use of application claims could be useful and effective in monitoring the occupational component of COVID-19 and his trend in time and space. There is a need to establish an epidemiological surveillance system that includes the assessment of work related risk, supporting the effectiveness of public insurance and welfare system, and to harmonize occupational data collection among countries.

Evaluation of Emergency First Response's Competency in Undergraduate College Students: Enhancing Sustainable Medical Education in the Community for Work Occupational Safety.

Worldwide, people's quality of health has been decreasing due to bad eating habits that have generated an increase in diseases such as diabetes, hypertension, overweight, as well as an increase in hours of the daily workday and stress. This situation can generate sudden illness and work accidents where the need to have knowledge in emergency first response (EFR) is necessary for all. Unfortunately, workshops and courses to certify EFR individuals are usually taught only to healthcare professionals. Therefore, to address this need a EFR project has been developed at the Tecnológico de Monterrey (TEC) which consists of a multidisciplinary challenge to train, certify, and evaluate students' competency as "emergency first responders" in medical emergencies and healthcare awareness. This EFR project has been performed for one week, every year since 2015, and constitutes a joint venture among academic departments, faculty, and industrial/government institutions, which work together in multidisciplinary projects, providing a source of innovative proposals. The EFR project at TEC has provided instruction and certification for 966 students between 2015 to 2019 and this study has analyzed results considering a sample size of 197 participants. The combination of exam evaluation, medical emergency skills verification, and project proposal results indicate that most students reach skill levels between 2 and 3 in EFR competency after successfully completing the program, regardless of their year of study or the undergraduate program they are enrolled on. This evaluation emphasizes the compromise of the institution and its students in preparation for new living under sanitary conditions for pandemic conditions such as COVID-19.