[The problem of long/post-COVID in expert assessments]. / Problematik von Long­/Post-COVID in der Begutachtung.

Assessing long/post-COVID syndrome (PCS) following an infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a multidisciplinary challenge due to the diverse and complex symptoms. Besides discipline-specific evaluation of infection-related organ damage, the main issue is expert objectivity and causality assessment regarding subjective symptoms. The consequences of long/PCS raise questions of insurance rights in all fields of law. In cases of persistent impairment of performance, determining reduction in earning capacity is crucial for those affected. Recognition as an occupational disease (BK no. 3101) is vital for employees in healthcare and welfare sectors, along with occupational accident recognition and assessing the illness's consequences, including the reduction in earning capacity (MdE) in other sectors or work areas. Therefore, expert assessments of illness consequences and differentiation from previous illnesses or damage disposition are necessary in all areas of law, individually based on corresponding organ manifestations in medical fields and interdisciplinarily for complex late sequelae, for instance, by internists with appropriate qualifications for pulmonary or cardiac manifestations and neurologists, psychiatrists, and neuropsychologists for neurological and psychiatric manifestations, etc.

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.

Trends in Occupational Infectious Diseases in South Korea and Classification of Industries According to the Risk of Biological Hazards Using K-Means Clustering.

Against the backdrop of the COVID-19 pandemic, it is necessary to identify these risks and determine whether the current level of management is appropriate to respond to the risk of biological hazards depending on the occupation. In this study, the incidence and fatality rates of occupational diseases were calculated using industrial accident statistics of South Korea, and trends by year using joinpoint regression and relative risk by industry using k-means clustering were evaluated for infectious diseases. We found that infectious diseases had the third highest incidence and fourth highest fatalities among all occupational diseases. In the incidence rate, joinpoints appeared in 2009 and 2018, and the annual percent change changed to 7.79, -16.63, and 82.11. The fatality rate showed a consistent increase with an annual percent change of 4.37, but it was not significant. Industries were classified into five groups according to risk, and the legal control measures of certain industries were not sufficient. Follow-up studies are needed to rectify the structural limitations of industrial accident statistics.

Risk Factors Identification of Unsafe Acts in Deep Coal Mine Workers Based on Grounded Theory and HFACS.

The risk factors affecting workers' unsafe acts were comprehensively identified by Human Factors Analysis and Classification System (HFACS) and grounded theory based on interview data and accident reports from deep coal mines. Firstly, we collected accident case and field interview data from deep coal mines issued by authoritative institutions. Then, the data were coded according to grounded theory to obtain relevant concepts and types. The HFACS model was used to classify the concepts and categories. Finally, the relationship between core and secondary categories was sorted out by applying a story plot. The results show that risk factors of unsafe acts of deep coal mine workers include environmental factors, organizational influence, unsafe supervision and unsafe state of miners, and the main manifestations of unsafe acts are errors and violations. Among them, the unsafe state of miners is the intermediate variable, and other factors indirectly affect risky actions of coal miners through unsafe sates. Resource management, organizational processes and failure to correct problems are the top three risk factors that occur more frequently in unsafe acts. The three most common types of unsafe act are unreasonable labor organization, failure to enforce rules, and inadequate technical specifications. By combining grounded theory and the HFACS framework to analyze data, risk factors for deep coal miners can be quickly identified, and more precise and comprehensive conceptual models of risk factors in unsafe acts of deep coal miners can be obtained.

During COVID-19, which is more effective in work accident prevention behavior of healthcare professionals: Safety awareness or fatalism perception?

BACKGROUND: As the pandemic process, COVID-19 has a serious occupational safety risk for healthcare professionals. Therefore, determining their health and safety perceptions and attitudes in the pandemic process is very important. This study aims to determine which is more effective in work accident prevention behavior: safety awareness and competencies of healthcare professionals or perception of fatalism. METHOD: For this purpose, a questionnaire was applied to 326 healthcare professionals. The questionnaire consists of four parts: (1) demographic information of the employees, (2) scale of preventing occupational accidents, (3) fatalism perception scale in occupational health and safety, and (4) security awareness and competency scale. Descriptive statistical methods, multiple regression and correlation analysis were used in the analysis of the data. RESULTS: It was determined that the participants' safety awareness and competencies were at the high level and their fatalism perceptions were at the low level. The average of the responses given by the participants to the scale of preventing work accidents was above the middle level. According to the study, the safety awareness and competencies of health workers were found to be about three times more effective on the behavior of preventing work accidents than the perception of fatalism. CONCLUSION: In conclusion, it is important to recommend managers to take the step to increase the safety awareness and competencies of those working in their institutions.

Construction Safety during Pandemics: Learning from the Xinjia Express Hotel Collapse during COVID-19 in China.

Many construction accidents occur in China each year, leading to a large number of deaths, injures, and property losses. Due to the outbreak of COVID-19, little attention is paid to construction safety, resulting in severe accidents. To prevent construction accidents and learn to how address safety issues in future pandemics, this study proposed an improved STAMP (Systems Theoretic Accident Modeling and Processes) model to analyze the collapse accident of the Xinjia Express Hotel used for COVID-19 quarantine in China. Through the application of the STAMP approach, the causes of the construction accident and the relationship between various causal factors are analyzed from a systematic perspective. The identified causes are divided into five categories: contractors, management of organizations, technical methods, participants, and interactive feedback. Finally, safety recommendations are drawn from this study to improve construction safety and safety management in pandemics.

Epidemiology of race day injury in young professional jockeys in Great Britain from 2007 to 2018: a retrospective cohort study.

INTRODUCTION: There are limited injury data in professional horse racing, particularly by sex. OBJECTIVES: To describe injury incidence, characteristics and falls in male and female, flat and jump jockeys in Great Britain. DESIGN AND SETTING: Retrospective cohort study of professional jockeys in Britain. PARTICIPANTS: 245 jockeys licensed between 2007 and 2017. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome measure was injury on a race day. Injury incidence (per 1000 rides; per 1000 falls) was derived. Incidence-rate ratios (IRR) were calculated to compare incidence between flat and jump racing, male and female jockeys, and male flat and male jump jockeys for: (i) injury incidence, (ii) fall incidence and (iii) injuries per fall. RESULTS: 234 British professional jockeys were included. Jockeys were on average 19.5±2.0 years old at licence date, 79.9% male and 58.1% flat. The time of follow-up (racing in the study) was 3.7 (SD=2.3) years. There were 278 injuries, occurring in-race (81.7%), in the stalls (10.8%) or parade ring (6.1%). After one injury was removed to preserve anonymity, 57.2% were soft tissue injuries, 25.3% fractures and 10.5% concussion. There were 1634 falls, with 92% in male jump racing. The injury incidence was higher in jump racing (5.1 vs 1.0/1000 jockey rides). The falls incidence was 1.8/1000 rides in flat and 46.2/1000 rides in jump racing (IRR 0.04, 95% CI 0.03 to 0.04). There were over five times higher injuries/1000 falls in flat than jump racing (IRR 5.56, 95% CI 4.05 to 7.53). Male flat jockeys fell less than female flat (IRR 0.57, 95% CI 0.35 to 0.97). CONCLUSION: Most injuries occurred in-race and were soft tissue injuries. Jump jockeys fell more often than flat, and female flat jockeys fell more often than male flat. Flat jockeys injured more frequently when falling. No sex differences were seen for injuries per fall.

The Impact of COVID-19 Pandemic on Workplace Accidents in Korea.

(1) Background: Although the number of people infected with COVID-19 has increased over time, its effects on workplace accidents are still poorly understood. On the one hand, COVID-19 can reduce workplace accidents through contracted economic activities or changes in work methods. On the other hand, it can increase workplace accidents by spreading in the workplace. The main purpose of this paper is to examine how COVID-19 affected workplace accidents in Korea during the early part of the pandemic. (2) Methods: This paper utilizes the administrative data on workplace accidents in Korea collected by Korea Occupational Safety and Health Agency. In particular, we use monthly data from February 2016 to August 2020. This period was chosen to rule out the effect from the Middle East Respiratory Syndrome outbreak in 2015 and to include COVID-19 effects in 2020, given the available data. To examine the impact of COVID-19 on workplace injury and illness, we estimate fixed effects regression models, allowing us to control for group and time effects. (3) Results: COVID-19 was generally found to reduce workplace accidents in Korea, particularly through a reduction in occupational diseases. However, we also found that COVID-19 increased occupational injuries for males and workers in the transportation industry. We provide some evidence that these workers experienced an increase in workload and were unable to change work methods including working from home during the COVID-19 pandemic. (4) Conclusions: Our results indicate that to reduce workplace accidents, government interventions should be directed at workers who are unable to change work methods and who are likely to suffer an increase in work burden due to COVID-19.

Can Science Help Resolve the Controversy on the Origins of the SARS-CoV-2 Pandemic?

The origins of the calamitous SARS-CoV-2 pandemic are now the subject of vigorous discussion and debate between two competing hypotheses for how it entered the human population: (i) direct infection from a feral source, likely a bat and possibly with an intermediate mammalian host, and (ii) a lab accident whereby bat isolates infected a researcher, who then passed it to others. Here, we ask whether the tools of science can help resolve the origins question and conclude that while such studies can provide important information, these are unlikely to provide a definitive answer. Currently available data combined with historical precedent from other outbreaks and viewed through the prism of Occam's razor favor the feral source hypothesis, but science can provide only probabilities, not certainty.

Hand injuries during COVID-19: Lessons from lockdown.

The two-month nationwide lockdown implemented in Australia in response to COVID-19 involved restrictions on social gatherings and non-essential services, resulting in marked changes to the distribution of time spent at home and in the workplace. Given the likelihood of future lockdowns, this study aimed to investigate whether the lockdown was associated with an alteration in the pattern of acute hand injuries admitted to Sydney Hospital Hand Unit relative to the same period in 2019, and whether target areas for preventative strategies could be identified. During the lockdown period in 2020, 332 acute presentations were noted, and in the same period in 2019, 310 cases were noted. The mean patient age was higher in 2020, largely due to a 327% increase in do-it-yourself (DIY) injuries. Workplace injuries increased in 2020 despite a 9.5% reduction in hours-worked, reflecting a redistribution of workers into manual labour jobs with a higher risk for hand injuries. Patients who suffered low-energy injuries at work were also significantly younger in 2020, suggesting this effect was most pronounced in younger age-groups, probably due to the shutdown of hospitality-based industries. Domestic violence-related injuries increased in 2020, highlighting the need to maintain resources to provide support in such cases at subspecialty hand units, which are often largely outpatient-centred. This study, therefore, identified a number of key areas that could be targeted in the event of future lockdowns, including messages regarding safe DIY activities, and more stringent requirements regarding worksite briefing and safety for people commencing labour-based jobs, especially if transferring from another industry.