Occupational Stress in Healthcare During Covid 19

Several studies dedicated to the risk of work-related stress have already shown for some time that healthcare workers are subjected to multiple sources of stress. Recent literature has shown that the SARS CoV 2 pandemic has subjected healthcare workers in emergency/urgent departments and Covid −19 departments to work-related stress risk. In a Sicilian hospital, a sample of 50 health workers (25 men/25 women) was given the "INAIL questionnaire work-related stress risk” structured in 35 items to investigate 7 dimensions of occupational stress (1) Question, (2) Control, (3) Management support, (4) Support from colleagues, (5) Relationships, (6) Role, (7) Change. The results show in 27% of the sample a high level of occupational stress and in 62% an average level of occupational stress with little control and emotional exhaustion, especially in women. In conclusion, to avoid the chronicization of dysfunctional pictures, health institutions must provide staff with psychosocial support services to protect them from the risk of work-related stress. AD -, Messina, Italy ;, Messina, Italy

Occupational risk factors and preventative practice reflections during COVID pandemic

Occupational therapy within community mental health teams (CMHT) has a unique potential for upstream preventative practice [Letts, L. (2004). In B. C. Crepeau E. & B. B. Schell (Eds.) Health promotion in Willard & Spackman's occupational therapy (18th edn., pp. 160-177). Lippincott Williams & Wilkins]. Practicing preventatively, was an opportunity posed by the COVID pandemic, we saw an opportunity to realise our professional potential here and preventative practice as a professional strength. However, working in a fast paced, medically driven environment, has historically been a barrier to authentically accessing the service user [Letts, L. (2004). In B. C. Crepeau E. & B. B. Schell (Eds.) Health promotion in Willard & Spackman's occupational therapy (18th edn., pp. 160-177). Lippincott Williams & Wilkins]. Further, in the light of the pandemic, we had lost our usual ways of working. In place of face-to-face contact, we were left with the medium of the telephone. We decided to become our own occupational therapists, to reconsider our professional roles by reflecting on the body of knowledge which informs our clinical reasoning, in an ethically driven light, to include the values of occupation, sustainability and client centred practice.

Emergency physician risk of occupational mortality: A scoping review.

BACKGROUND: Occupational hazards for emergency physicians are widely known, but the risk of work-related mortality is not clear. The COVID-19 pandemic generated new concerns about the risk of occupational mortality, particularly in the setting of inadequate personal protective equipment. The perception of increased risk generated ethical concerns regarding emergency physicians' duty to treat and employers' duty to protect their employees. We performed this scoping review to define prepandemic emergency physician occupational mortality. METHODS: We performed a scoping review of peer-reviewed publications from PubMed, EMBASE, and Cochrane databases in September 2020. RESULTS: Of the 747 unique articles identified in the 3 databases, 1 article met inclusion criteria and was included in the final analysis. CONCLUSION: The baseline risk of occupational mortality for emergency physicians is not established in the scientific literature. Further study is needed to quantify risk, as this information would be useful to shape policy and ethical considerations.

Risk of occupational infection in forensic workers: a review.

The occupational risk of infection in forensic workers is a cause for concern, furthermore in the current context of the coronavirus disease-19 (COVID-19) pandemic. In order to characterize this risk, we performed an extended review of the literature on occupational infections occurring in forensic workers. Seventeen articles were included. Direct contamination by aerosolization was the main mode of transmission reported, with 17 cases of tuberculosis. Indirect contamination was described as the mode of transmission in 10 cases (five cases of blastomycosis, two cases of tuberculosis, two Streptococcus pyogenes, and one case of human immunodeficiency virus). In all the other included cases, the mode of transmission was unknown. For two of them, the information provided was sufficient to link them to occupational exposure (one case of toxoplasmosis, one case of tuberculosis). For the remaining 10 cases, the link was uncertain (six cases of tuberculosis, three of hepatitis B, and one of COVID-19). Even if there is probably significant under-declaration, the number of infections linked to an occupational risk in forensic workers is not alarming, thanks to effective preventive measures.

The price of COVID-19 risk in a public university.

We study the allocation of and compensation for occupational COVID-19 risk at Auburn University, a large public university in the U.S. In Spring 2021, approximately half of the face-to-face classes had enrollments above the legal capacity allowed by a public health order, which followed CDC's social distancing guidelines. We find lower-ranked graduate student teaching assistants and adjunct instructors were more likely to deliver riskier classes. Using an IV strategy in which teaching risk is shifted by classroom features (geometry and furniture), we show instructors who taught at least one risky class earned $7,400 more than those who did not.

Risky business: Understanding the association between objective COVID-19 occupational risk features and worker subjective risk perceptions

Many workers are at risk of contracting COVID-19 through work, and subjective perceptions of COVID-19 risk are important predictors of worker attitudes and behaviours. However, little to no research provides comprehensive examination of objective COVID-19 occupational risk factors and how, or under what conditions, these factors relate to subjective risk perceptions. Using two wave survey data matched with archival data from the Occupational Information Network (O*Net) and county-level COVID-19 case data (N = 295), we examine how objective COVID-19 occupational risk relates to workers' subjective risk of contracting COVID-19 at work. We also examine the moderating roles of financial frailty, adherence to governmental workplace safety recommendations, and local COVID-19 threat. Results indicate that objective COVID-19 occupational risk significantly predicts subjective risk of contracting COVID-19 at work. Moreover, factors representing in-person work conducted in close proximity to others accounted for a large proportion of explained variance in subjective risk. There was no support for moderation;however, financial frailty and workplace safety had independent main effects on subjective risk perceptions. Our results have theoretical implications for the Economic Stress and COVID-19 Occupational Risk model (Sinclair et al., Appl. Psychol., 70, 2021, 85), individual models of subjective risk perceptions, and practical implications for mitigating occupational risk at work. © 2023 The Authors. Journal of Occupational and Organizational Psychology published by John Wiley & Sons Ltd on behalf of The British Psychological Society.

The Relative Contributions of Occupational and Community Risk Factors for COVID-19 among Hospital Workers: The HOP-COVID Cohort Study.

The relative contributions of occupational and community sources of COVID-19 among health-care workers (HCWs) are still subject to debate. In a cohort study at a 2814-bed tertiary medical center (five hospitals) in the Paris area of France, we assessed the proportion of hospital-acquired cases among staff and identified risk factors. Between May 2020 and June 2021, HCWs were invited to complete a questionnaire on their COVID-19 risk factors. RT-PCR and serology test results were retrieved from the virology department. Mixed-effects logistic regression was used to account for clustering by hospital. The prevalence of COVID-19 was 15.6% (n = 213/1369 respondents) overall, 29.7% in the geriatric hospitals, and 56.8% of the infections were hospital-acquired. On multivariable analyses adjusted for COVID-19 incidence and contact in the community, a significantly higher risk was identified for staff providing patient care (especially nursing assistants), staff from radiology/functional assessment units and stretcher services, and staff working on wards with COVID-19 clusters among patients or HCWs. The likelihood of infection was greater in geriatric wards than in intensive care units. The presence of significant occupational risk factors after adjustment for community exposure is suggestive of a high in-hospital risk and emphasizes the need for stronger preventive measures-especially in geriatric settings. Clinicaltrials.gov NCT04386759.

Epidemiological and Genomic Analysis of a Large SARS-CoV-2 Outbreak in a Long-Term Care Facility in Catalonia, Spain.

Limiting outbreaks in long-term care facilities (LTCFs) is a cornerstone strategy to avoid an excess of COVID-19-related morbidity and mortality and to reduce its burden on the health system. We studied a large outbreak that occurred at an LTCF, combining methods of classical and genomic epidemiology analysis. The outbreak lasted for 31 days among residents, with an attack rate of 98% and 57% among residents and staff, respectively. The case fatality rate among residents was 16% (n = 15). Phylogenetic analysis of 59 SARS-CoV-2 isolates revealed the presence of two closely related viral variants in all cases (B.1.177 lineage), revealing a far more complex outbreak than initially thought and suggesting an initial spread driven by staff members. In turn, our results suggest that resident relocations to mitigate viral spread might have increased the risk of infection for staff members, creating secondary chains of transmission that were responsible for prolonging the outbreak. Our results highlight the importance of considering unnoticed chains of transmission early during an outbreak and making an adequate use and interpretation of diagnostic tests. Outbreak containment measures should be carefully tailored to each LTCF. IMPORTANCE The impact of COVID-19 on long-term care facilities (LTCFs) has been disproportionately large due to the high frailty of the residents. Here, we report epidemiological and genomic findings of a large outbreak that occurred at an LTCF, which ultimately affected almost all residents and nearly half of staff members. We found that the outbreak was initially driven by staff members; however, later resident relocation to limit the outbreak resulted in transmission from residents to staff members, evidencing the complexity and different phases of the outbreak. The phylogenetic analysis of SARS-CoV-2 isolates indicated that two closely related variants were responsible for the large outbreak. Our study highlights the importance of combining methods of classical and genomic epidemiology to take appropriate outbreak containment measures in LTCFs.

Face mask use and disposal behaviour of frontline young doctors during the COVID-19 pandemic: a two-year study.

INTRODUCTION: The COVID-19 pandemic has severely affected India in spite of an ongoing vaccination campaign. The doctors are at greater risk of COVID-19 and face masks are a protective measure against this threat. We assessed the use and disposal of face masks among postgraduate trainees (PGTs) working on the COVID-19 frontline in an Indian medical college. METHODOLOGY: Data was collected from all PGTs who agreed to participate during the first, second and third wave of the pandemic in India. A pre-tested questionnaire to assess and compare face mask use and disposal behaviour across the three phases was used. RESULTS: All participants used face masks regularly; a significant uptrend in N-95 mask users and double mask users was observed as the pandemic progressed. Use of face shields peaked during the second wave. Most participants preferred keeping the mask on always at work and avoided donning and doffing of masks in between usage. Many of them practiced 'extended use' of face masks and nearly a third re-used a mask for ≥ 6 days, which is against the standard recommendations; however, such behavior among participants showed a downward trend. Proper disposal practices were not followed by many participants, leaving scope for environmental contamination. CONCLUSIONS: There is an imminent need to make the young frontline doctors aware regarding appropriate mask usage and disposal for better preparedness before any health exigencies of the future.

Are Healthcare Workers Infected with SARS-CoV-2 at Home or at Work? A Comparative Prevalence Study.

Prior to the widespread use of vaccinations, healthcare workers (HCWs) faced the double burden of caring for unprecedented numbers of critically ill COVID-19 patients while also facing the risk of becoming infected themselves either in healthcare facilities or at home. In order to assess whether SARS-CoV-2-positivity rates in HCWs reflected or differed from those in their residential areas, we compared the SARS-CoV-2-positivity rates during 2020 among HCWs in Hadassah Hebrew University Medical Centers (HHUMC), a tertiary medical center in Jerusalem, Israel, to those of the general population in Jerusalem, stratified by neighborhood. Additionally, we compared the demographic and professional parameters in every group. Four percent of the adult population (>18 years) in Jerusalem tested positive for SARS-CoV-2 during 2020 (24,529/605,426) compared to 7.1% of HHUMC HCWs (317/4470), rate ratio 1.75 (95% CI 1.57-1.95), with wide variability (range 0.38-25.0) among different neighborhoods. Of the 30 neighborhoods with more than 50 infected HCWs, 25 showed a higher positivity rate for HCWs compared to the general population. The higher risk of HCWs compared to residents representing the general population in most neighborhoods in Jerusalem may be explained by their behavior in and out of the hospital.

[Factors associated with the risk of COVID-19 in health-care workers]

BACKGROUND: Although healthcare personnel are considered a high-risk group for SARS-CoV-2 infection due to their exposure, research on the factors associated with their infection is limited. The objective was to identify factors associated with the acquisition of COVID-19 in healthcare personnel. METHODS: a multicenter, cross-sectional study with nested cases and controls was carried out in 23 hospitals in Argentina. A structured survey was used to collect demographic, institutional and behavioral variables from healthcare personnel with positive RT-PCR for SARS-CoV2 (cases) and healthcare personnel with negative test results (controls). Those variables significantly associated with the condition of having had COVID-19 in the bivariate analysis were included in a multivariate analysis. RESULTS: A total of 2088 workers participated in the study, with an incidence of 1.41 cases per 10 000 worker-hours (95%CI 1.35-1.48). Being male, (OR 1.60;95%CI 1.32-1.95), working in social security, (OR 1.53;95%CI 1.13-2.07), being nursing staff, (OR 1.46;95%CI 1.22-1.74), having personal protective equipment, (OR 0.33;95%CI 0.18-0.62), sharing unprotected common spaces with other workers, (OR 1.98;95%CI 1. 60-2.44), living with people confirmed or suspected of COVID-19 (OR 1.69;95%CI 1.37-2.09), sharing infusions or other drinks and/or food with people in the community (OR 1.31;95%CI 1.02-1.70), feeling distressed (OR 1.85;95%CI 1.55-2.21) and were independently associated with the risk of acquiring COVID-19. DISCUSSION: This study allowed us to identify different potentially modifiable factors on which action should be taken to reduce the risk of acquiring COVID-19 by the healthcare personnel.

Preventive measures for health workers exposed to COVID-19 (SARS-CoV-2).

COVID-19 is a disease caused by a new coronavirus that presented an epidemic focus in China in December 2019 and was declared as a pandemic months later. Consequently, the health systems of most countries implemented preventive measures for their population, thus affecting health personnel, which is the first response force. According to the World Health Organization, 37 million health workers fell ill with COVID-19. In this article, we seek to identify strategies for the prevention of contagion of health personnel by COVID-19 that have obtained favorable results and present measures applicable to the Peruvian reality, focused on the personnel that make up the diagnostic process of COVID-19 and the health centers in operation during the health emergency due to COVID-19. It is concluded that temporary confinement in rotating days of health personnel, traffic control bundling, and adequate supply of personal protective equipment were those that have favored the lower incidence of cases of contagion in health personnel in the countries where they were used.

SARS-CoV-2 Infection in Health Care Workers of Trieste (North-Eastern Italy), 1 October 2020-7 February 2022: Occupational Risk and the Impact of the Omicron Variant.

Vaccination coverage against COVID-19 among health care workers (HCWs) of the University Health Agency Giuliano-Isontina (ASUGI) of Trieste (North-eastern Italy) by 1 January 2022 was 90.4% with at least one vaccine dose, 84.9% with at least 2 doses, and 75.1% with 3 doses, 98.2% with Comirnaty (Pfizer BioNtech, New York, NY, USA) versus 1.8% with Spikevax (Moderna, Cambridge, MA, USA). From 1 October 2020 to 7 February 2022, 1652 SARS-CoV-2 infections were notified in HCWs of ASUGI Trieste. Although the overall risk of SARS-CoV-2 contagion increased over time, the rate of occupational infections progressively declined, from 42.5% during the second COVID-19 wave to 15.6% in the fifth. Between 1 January-7 February 2022 (a period dominated by the Omicron variant), albeit no COVID-19-associated hospitalizations were recorded in HCWs of ASUGI Trieste, 669 SARS-CoV-2 infections were counted against 367 cases observed from 1 October to 31 December 2020, the 3 months preceding the implementation of the vaccination campaign against COVID-19. Job tasks and health care settings turned out to be the most significant risk factors for SARS-CoV-2 infection. However, the effect of workplace prevailed over job task on the biological risk, with greater rates of SARS-CoV-2 infections observed among HCWs operating in areas with higher levels of circulation of the virus, particularly COVID-19 dedicated units.

Developing occupational and health susceptibility personas for wastewater personnel in the United States in the age of COVID-19.

Compared with the public, wastewater personnel, are at an increased risk of infection and illness from wastewater pathogens due to work-related tasks. Unfortunately, current risk assessment approaches do not consider individual personnel factors (e.g., age and health conditions) that may influence their susceptibility to a health effect. The objective of this study is to establish a baseline level of occupational and health factors among the wastewater personnel population, quantify these factors using a susceptibility evaluation scoring system, and examine relevant susceptibility features using the concept of "Personas." Using survey data from 246 respondents and public health risk data on COVID-19 from the CDC, personnel clustered into three persona groups: "low susceptibility," "high occupational susceptibility," and "high health susceptibility." Results highlight the intersectionality between gender, age, underlying health conditions, job tasks, and level of exposure to wastewater and provide context for incorporating individual variables into risk assessment methodologies with the goal of protecting this essential workforce. PRACTITIONER POINTS: A risk assessment framework that combines health and occupational susceptibility factors was developed for wastewater treatment plant personnel. Wastewater personnel clustered into three persona groups: "low susceptibility," "high occupational susceptibility," and "high health susceptibility." The intersectionality between job related activities and individual health provides a holistic approach to risk assessment for wastewater personnel.

Working conditions and stressors data during Covid-19 and mental well-being in Iranian healthcare workers.

The current Covid-19 pandemic has affected the physical and mental stressors of hospital-based healthcare workers, but the extent of such effects are required to be quantified. This survey looked at data on nurses' perception across teaching hospitals to assess the impacts of Covid-19 on working conditions, exposure to stressors, and mental health symptoms. We implemented a population survey with a cross-sectional design in teaching hospitals affiliated with Medical Sciences Universities in Iran from April to November 2021. Participants were about 1200 health care workers, including hospital nursing staff, assistants, and technicians. Final data were assembled from 831 hospital nurses across surgery, dialysis, intensive care, emergency care, cardiac care, internal medicine, gynecology, and pediatric wards. Self-reported data were collected directly from survey participants. We collected information on variables including gender, marital status, employment status, occupational health training, evaluation of work environment stressors, fear of Covid-19, and occupational burnout constructs, specifically reflecting emotional exhaustion, depersonalization, and personal accomplishment. Focus groups of faculties evaluated and edited items to test the content wording and to define the content that are valid measures of the variables. The questionnaires were assessed for their reliability. Manual data entries were double-checked for errors. Data were recorded and categorized consistently to ensure the replicability of the data in the future. Statistical descriptive and analytical analyses were performed on the data. Data reported on the frequencies and mean values of responses and the variations of mental health in terms of worktime schedules. Chi- square, ANOVA, and correlation analyses determined relations between variables. The compiled data shed light on the exposure and response to physical and psychosocial factors and mental health symptoms among nurses during the pandemic. The data files detailed in this article can be further reused to inform workplace determinants of health in hospital settings. The obtained scores and existing dataset on mental health outcomes can help future studies to consider resilience strategies that should be provided among nurses.

Epidemiological and clinical characteristics of COVID-19 mortality among healthcare workers in Saudi Arabia: A nationwide study.

BACKGROUND: Healthcare workers (HCWs) have been highly affected by COVID-19 due to their fundamental duties in diagnosing, caring, and treating the rapidly increasing number of infected patients. Thus, are facing the occupational risk of COVID-19 infection and mortality. PURPOSE: To investigate the COVID-19 disease clinical characteristic and associated factors among HCWs in Saudi Arabia. METHODS: This was a nationwide, retrospective analytical study conducted from 5th of March 2020-21 st of August 2021. All deceased HCWs who were diagnosed with COVID-19 were included in this study. RESULTS: As of August 21, 2021, a total of 305 deaths were recorded due to COVID-19 infection among HCWs in all Saudi healthcare facilities. The case fatality rate was 0.35%. Deaths were highest among physicians (40.0%). Most of deceased HCWs acquired the infection from the community (80%). 71% of deceased HCWs had at least one chronic medical condition. Most of them were admitted to ICU before they passed away (83.6%). Three significant variables predicting ICU admission were presence of one or more comorbidities, hypertension, and chronic respiratory diseases CONCLUSION: HCWs are at higher risk for exposure to COVID-19 due to their occupational risk. Our study encourages future research to provide more comprehensive information regarding COVID-19 morbidity and mortality among HCWs.

Legionella and Air Transport: A Study of Environmental Contamination.

INTRODUCTION: There is growing interest in the public health and transport sectors in research into exposure to biological hazards, considering not only the risks arising from inter-human contagion, but also those related to exposure to the flight environment itself. The aim of this paper is to report data from an investigation into the water and air-conditioning systems of commercial aircraft for the presence of Legionella contamination, with a total of 645 water samples taken during the period 2007-2021. METHODS: The investigation involved 126 aircraft of six different commercial aircraft types: MD80, Airbus A320 F, Embraer 175/190, AIRBUS A330, Boeing 767 and Boeing 777. Water samples were taken from the water systems (toilet taps, galley and boilers). Each sample was preliminarily subjected to an evaluation of the following parameters: temperature, pH and residual chlorine. The ScanVit® Legionella kit was used for bacteria detection and enumeration. RESULTS: Samples were considered positive if the number of colony-forming units/liter (CFU/L) was >100. For the entire observation period, 45% of the investigated aircraft tested positive. Regarding the overall number of samples analyzed, 68.4% (441/645) were below 100 CFU/L, and thus within the limits allowed by the Italian Guidelines. CONCLUSIONS: Water system contamination with Legionella in the air transport field is a real public health issue that should not be underestimated given the heavy passenger traffic. Infection should be considered an occupational risk to which crew members are exposed.

Seroprevalence Survey of Anti-SARS-CoV-2 Antibodies in a Population of Emilia-Romagna Region, Northern Italy.

Italy was the first Western European country to be severely hit by the COVID-19 pandemic. Variations in seroprevalence rates were reported according to geographical and temporal differences of previous surveys, as well as depending on demographic and occupational factors. In this cross-sectional study, we evaluated the prevalence of anti-SARS-CoV-2 antibodies in a population of the Emilia-Romagna region in Northern Italy after the first wave in the period from 26 September 2020-26 March 2021. We included 5128 subjects who voluntarily underwent serological tests to determine anti-SARS-CoV-2 antibody positivity, including both self-referred individuals (24.2%) and workers adhering to company screening programs (76.8%). Overall, seroprevalence was 11.3%, higher in self-referred (13.8%) than employed-referred (10.5%) individuals. A slightly higher seroprevalence emerged in women compared to men (12.3% and 10.7%), as well as in the extreme age categories (18.6% for 60-69 years, 18.0% for ≥70 years, and 17.1% for <20 years compared to 7.6% for 20-39 years). Healthcare professionals showed the highest prevalence of seropositivity (22.9%), followed by workers in direct contact with customers, such as the communication, finance, and tourism sectors (15.7%). Overall subgroups seroprevalence increased compared to the first wave data but the trends agreed between the first and subsequent waves, except for an increase in the younger age group and in the sector in direct contact with customers. Among the occupational categories, our study confirms that healthcare workers and workers in the sports sector were at high risk of exposure to SARS-CoV-2.

COVID-19-Related Mortality amongst Physicians in Italy: Trend Pre- and Post-SARS-CoV-2 Vaccination Campaign.

Globally, there has been a high burden of COVID-19-related mortality amongst physicians and other healthcare workers during the ongoing SARS-CoV-2 pandemic. Fortunately, anti-COVID-19 vaccination campaigns have helped to protect frontline workers and reduce COVID-19-related mortality amongst this occupational group. We analyzed COVID-19-related mortality data for doctors in Italy and compared the crude mortality rate between March-May 2020 (i.e., the beginning of the pandemic in Italy, with the highest rates of COVID-19-related deaths) and the same time period in March-May 2021 (high vaccination coverage amongst Italian physicians). The mortality rate was 12 times higher in March-May 2020 compared to the same time period after the start of the Italian vaccination campaign. Moreover, there was a strong inverse correlation between the number of deaths and the cumulative number of vaccine doses administered in the Italian population. Although non-pharmaceutical interventions, virus evolution and environmental factors probably had an effect, our analysis clearly supports the hypothesis that the vaccination campaign helped to protect Italian physicians and reduce COVID-19-related mortality. The latest available death trends from September to October 2021 for both physicians and the general population are also in favor of the need for the third vaccine dose, currently underway for the majority of the population at risk.

RISK OF SARS-COV-2 INFECTION IN HIGHLY EXPOSED HEALTH WORKERS

Objectives: The present study makes it possible to establish the profile of the worker most susceptible to SARS-CoV-2 infection, describe seroprevalence and determine the presence of anosmia and / or dysgeusia. Material and Methods:A descriptive, cross-sectional, and retrospective epidemiological study was carried out for 263 days in an ICU of a tertiary hospital. One hundred forty-six workers from 11 different categories were included. The results of the diagnostic tests for infection were consulted, and a telephone interview was carried out. Results: Fifty-six workers were infected (39.4%).The risk of infection in healthcare workers was higher (OR 3.38). Nursing staff and shift workers had a higher infection rate (p = 0, 000). Anti SARS-CoV-2 (AntiN) IgG antibodies were detected for more than four months. 38.1% developed anosmia and/or dysgeusia with a recovery of 117.41 days on average. Conclusions: The data obtained may be of interest for assessing occupational risk against SARS-CoV-2 in the health field. © 2022, Accion Medica S.A.. All rights reserved.