Redeployment Experiences of Healthcare Workers in the UK during COVID-19: data from the nationwide UK-REACH study (preprint)

Background Increasing demands of COVID-19 on the healthcare system necessitated redeployment of HCWs outside their routine specialties. Previous studies, highlighting ethnic and occupational inequalities in redeployment, are limited by small cohorts with limited ethnic diversity. Aims To assess how ethnicity, migration status, and occupation are associated with HCWs redeployment experiences during COVID-19 in a nationwide ethnically diverse sample. Methods We conducted a cross-sectional analysis using data from the nationwide United Kingdom Research Study into Ethnicity And COVID-19 outcomes in Healthcare workers (UK-REACH) cohort study. We used logistic regression to examine associations of ethnicity, migration status, and occupation with redeployment experiences of HCWs, including provision of training and supervision, patient contact during redeployment and interaction with COVID-19 patients. Results Of the 10,889 HCWs included, 20.4% reported being redeployed during the first UK national lockdown in March 2020. Those in nursing roles (Odds Ratio (OR) 1.22, 95% Confidence Interval (CI) 1.04 to 1.42, p=0.009) (compared to medical roles) had higher likelihood of being redeployed as did migrants compared to those born in the UK (OR 1.26, 95% CI 1.06 to 1.49, p=0.01) (in a subcohort of HCWs on the agenda for change (AfC) pay scales). Asian HCWs were less likely to report receiving training (OR 0.66, 95% CI 0.50 to 0.88, p=0.005) and Black HCWs (OR 2.02, 95% CI 1.14 to 3.57, p=0.02) were more likely to report receiving supervision, compared to White colleagues. Finally, redeployed Black (OR 1.33, 95% CI 1.07 to 1.66, p=0.009) and Asian HCWs (OR 1.30, 95% CI 1.14 to 1.48, p<0.001) were more likely to report face-to-face interaction with COVID-19 patients than White HCWs. Conclusions Our findings highlight disparities in HCWs redeployment experiences by ethnicity, migration, and job role which are potentially related to structural inequities in healthcare. For future emergencies, redeployment should be contingent upon risk assessments, accompanied by training and supervision tailored to individual HCWs experience and skillset.

Gender Differences in Mental Health among Returned Cambodian Migrant Workers During the COVID-19 Pandemic (preprint)

The unexpected deportation of many Cambodian migrant workers to their home regions was precipitated by the COVID-19 outbreak's public health concern. A significant number of Cambodians working abroad or in Cambodian cities return to their home provinces, experience stress and despondency and lose faith. However, little is known about these migrant worker’s living and working conditions, health-related quality of life and occupational mental health. This study identifies factors that influence the mental health of Cambodian migrant workers from various countries. Cross-sectional research was to interview 388 returned Cambodian migrant workers in four provinces. This study using mixed quantitative and qualitative research methods in September 2022. The Patient Health Questionnaire 4 (PHQ-4) was applied to assess depression and anxiety among returned Cambodian migrant workers. Most of the participants were female, and the prevalence of depression has increased for both genders. The logistic regression model was used to examine the associations of the several risk factors and mental health. The confounding effect of socio-economic status (gender, age, income, level of education, marital status, and place of residence) was shown to be associated with the mental health. The probability of mental disease factors (nervousness/ anxious or on the edge, not being able to stop or control worrying, little interest or pleasure in doing thing, and feeling down, depression or hopeless) increased with gender and level of education whereas the probability of inability to control and lack of interest increased with income, regardless of gender. The study concludes that returned migrant workers in Cambodia had high rates of occupational stress.

Comparison of teachers' voice disorders before and during COVID-19 pandemic.

<b> Aim:</b> The aim of the study was to analyze the impact of the COVID-19 pandemic and the related change of the teaching mode from stationary to distance learning on the severity of voice-related ailments among teachers. </br></br> <b> Materials and methods:</b> A questionnaire survey of teachers was conducted to assess voice disorders during stationary and remote work using the Vocal Tract Discomfort (VTDs) scale and Numeric Rating Scale (NRS), and the respondents' subjective feelings were assessed. Demographic and environmental factors associated with voice work were examined. Data on sickness absence, which were obtained from the "Health Needs Maps 2020" Ministry of Health's, were also analyzed. Responses were subjected to statistical analysis. A P-value level below 0.05 was considered statistically significant. </br></br> <b>Results:</b> 128 teachers participated in the survey. The overall assessment of voice disorders using VTDs and NRS scales showed no statistically significant differences for complaints between stationary and remote work. Detailed analysis revealed more se-vere voice disorders in teachers working more than 6 months remotely (P = 0.049) and having more than 20 lessons per week (P = 0.012). Subjective assessment confirmed a significantly lower percentage of teachers reporting voice disorders when wor-king remotely compared to stationary (P = 0.043). This resulted in less sickness absence and a 40% decrease in sick leave related to voice disorders in 2020 compared to 2019. </br></br> <b>Conclusions:</b> During the remote learning period of the COVID-19 pandemic, teachers reported lower severity of voice disor-ders and this influenced the reduction of sickness absences. There were no statistically significant differences in voice complaints as assessed by VTDs and NRS scales for both teaching modes. Several factors affecting the severity of vocal tract disorders were identified - the number of class hours per week (>20) for stationary teaching and a long period of remote teaching (>6 months).

Frequency and risk factors of musculoskeletal disorders in high risk occupation workers in Urban, Karachi.

OBJECTIVE: To determine the frequency and risk factors of musculoskeletal disorders in high-risk occupation workers in an urban setting. METHODS: The analytical cross-sectional study was conducted in Karachi from July to December 2020, and comprised office workers, operation theatre technicians and coolies. The presence of musculoskeletal disorders was assessed using the Nordic Musculoskeletal Questionnaire to determine factors associated with moderate to severe condition. Data was analysed using SPSS 20. RESULTS: Of the 300 male subjects, 100(33.3%) each were office workers, operation theatre technicians and coolies. The overall mean age was 33.25±6.8 years (range: 18-50 years). The overall prevalence of musculoskeletal disorders was 179(59.7%). Besides, 117(65.4%) patients with musculoskeletal disorders had intermediate stage of the disease. The lower back and neck were the most common site of trouble involved in preceding 12 months 111(43.6%) each. CONCLUSIONS: Prevalence of musculoskeletal disorders was found to be a common problem affecting high-risk occupational workers.

Tropical infections as occupational diseases among young volunteers in social projects.

PURPOSE: The trend of volunteering overseas has increased tremendously over the last decade. Volunteers often go to regions where they are exposed to the risk of tropical infections like malaria, dengue, typhoid fever and schistosomiasis. Health assessments have shown a high occurrence of tropical infections among young volunteers. Such tropical infections are notifiable in Germany, as they are covered by a separate branch of the social insurance system. However, there is still limited data on systematical improvement of medical prevention and health care for volunteers. METHODS: This retrospective study included 457 cases with a diagnosis for a tropical infection or typhoid fever from January 2016 to December 2019. Data sets were anonymised and then analysed with descriptive statistics first. Cases of volunteers sent abroad by "Weltwärts" were compared to cases of aid workers sent to non-industrial countries. RESULTS: A high occurrence of tropical infections as occupational diseases has been shown for volunteers compared to other (mostly older) aid workers being sent to tropical regions. The risk of acquiring a tropical infection was significantly higher in Africa compared to other tropical regions. Cases of malaria were reported significantly more often among the group of volunteers than among aid workers during the period under review. Medical check-ups after travel were rare among volunteers. CONCLUSIONS: Data imply a disproportionate risk for malaria in Africa with a higher risk of acquiring malaria tropica in Sub-Saharan regions. Region-specific risks need to be addressed in training seminars in order to raise awareness among young volunteers before travel. Medical examinations after travel should be mandatory and specific to a particular region.

[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.

Global Trends in Occupational Lung Disease.

Lung diseases caused by workplace exposure are too often mis- or underdiagnosed due in part to nonexistent or inadequate health surveillance programs for workers. Many of these diseases are indistinguishable from those that occur in the general population and are not recognized as being caused at least in part by occupational exposures. More than 10% of all lung diseases are estimated to result from workplace exposures. This study reviews recent estimates of the burden of the most important occupational lung diseases using data published by United Nations specialized agencies as well as the Global Burden of Disease studies. We focus on occupational chronic respiratory disease of which chronic obstructive lung disease and asthma are the most significant. Among occupational cancers, lung cancer is the most common, and is associated with more than 10 important workplace carcinogens. Classic occupational interstitial lung diseases such as asbestosis, silicosis, and coal workers' pneumoconiosis still comprise a substantial burden of disease in modern industrial societies, while other occupational causes of pulmonary fibrosis and granulomatous inflammation are frequently misclassified as idiopathic. Occupational respiratory infections gained prominence during the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) pandemic, eclipsing influenza and tuberculosis and other less common workplace infectious agents. The most significant risks are workplace exposures to particulate matter, gases, and fumes as well as occupational carcinogens and asthmagens. We present data on the burden of disease measured by deaths attributable to occupational respiratory disease as well as disability-adjusted years of life lost. Where available, prevalence and incidence data are also presented. These diseases are unique in that they are theoretically 100% preventable if appropriate exposure controls and workplace medical surveillance are implemented. This remains a continuing challenge globally and requires steadfast commitment on the part of government, industry, organized labor, and the medical profession.

Examination of Musculoskeletal System Disorders and Ergonomic Conditions in the Work Environment of Academics Providing Distance Education During the COVID-19 Pandemic: Controlled Study.

BACKGROUND This study aimed to evaluate whether the incidence rate of musculoskeletal system disorders changed owing to the increase in the time spent on the computer by academics who did or did not provide distance education during the COVID-19 pandemic. MATERIAL AND METHODS The Cornell Musculoskeletal Discomfort Questionnaire was used to assess musculoskeletal discomfort experienced in the past 1 week. In addition, the Occupational Safety and Health Administration (OSHA) Computer Workstations Evaluation Checklist was used to assess the ergonomic structure of the work environment. The questionnaire assessed musculoskeletal system disorders and collected demographic characteristics. RESULTS The study group included 184 (101 male, 83 female) academics who provided distance education, whereas the control group included 82 (44 male, 38 female) academics who did not provide distance education. The mean ages of academics in the study group and control group were 37.46±7.34 and 41.26±10.06 years, respectively. Although computer-based work environment ergonomics were similar (P>0.05) in both groups during the pandemic, the incidence rate of musculoskeletal disorders was significantly high in the study group (P<0.001). These disorders were mostly seen in the neck, back, and waist regions (P<0.001). CONCLUSIONS The results suggested that the incidence rate of musculoskeletal disorders increased in academics who provided distance education during the COVID-19 pandemic.

Teleworking and Musculoskeletal Disorders: A Systematic Review.

Teleworking has spread drastically during the COVID-19 pandemic, but its effect on musculo-skeletal disorders (MSD) remains unclear. We aimed to make a qualitative systematic review on the effect of teleworking on MSD. Following the PRISMA guidelines, several databases were searched using strings based on MSD and teleworking keywords. A two-step selection process was used to select relevant studies and a risk of bias assessment was made. Relevant variables were extracted from the articles included, with a focus on study design, population, definition of MSD, confounding factors, and main results. Of 205 studies identified, 25 were included in the final selection. Most studies used validated questionnaires to assess MSD, six considered confounders extensively, and seven had a control group. The most reported MSD were lower back and neck pain. Some studies found increased prevalence or pain intensity, while others did not. Risk of bias was high, with only 5 studies with low/probably low risk of bias. Conflicting results on the effect of teleworking on MSD were found, though an increase in MSD related to organizational and ergonomic factors seems to emerge. Future studies should focus on longitudinal approaches and consider ergonomic and work organization factors as well as socio-economic status.

Occupational Disease and Injury in Malaysia: A Thematic Review of Literature from 2016 to 2021.

Introduction: Working people are exposed to occupational hazards and are at risk of having occupational disease or injury in a rapidly industrializing country like Malaysia. This study aims to review and summarize the occupational disease and injury in Malaysia from 2016 to 2021. Methods: This study used PubMed and Scopus databases to conduct a systematic literature search using a set of keywords. The selected records dated from 1 January 2016 to 8 September 2021 were extracted into the Mendeley Desktop and ATLAS.ti 8 software. Systematic screening was conducted by two independent researchers and finalized by the third researcher. Data were coded and grouped according to the themes. The results were presented as the table for descriptive analysis and cross-tabulation between the themes. Results: A total of 120 records were included in this study. Under the theme of main health problems, the findings showed that mental health, infectious disease, and work-related musculoskeletal disorders are the top three problems being discussed in the literature for the working people in Malaysia. The findings also showed an increasing trend of mental health problems during pandemic COVID-19 years. In addition, hospital was the highest workplace where the occupational health problems were reported.Discussion/Conclusion. There was substantial work on the mental health problem, infectious diseases, and work-related musculoskeletal disorders as the main health problem among workers in Malaysia in the past five years. The employers must report any occupational health and injury case to the authority and prompt intervention can be initiated.

Lessons on the COVID-19 pandemic: who are the most affected (preprint)

Epidemic prevention policies during COVID-19 are considered effective ways to protect lives, but the dramatically changing work and lifestyle under those policies significantly impact occupational stress. Based on the panel data of job stress checks from 2018 to 2021, this study explores the time and individual heterogeneity in the impacts of the pandemic on occupational stress. Following the job demand-resource theory, we further identified the most affected group of employees, given their workplace factors. Our findings show that, on average, occupational stress was alleviated initially in 2020 but deteriorated again in 2021. By examining the heterogeneity effects, we found that less motivated employees are more likely to experience a significant fluctuation in high-stress risk due to the pandemic. Providing adequate workplace support is expected to mitigate the high-stress risk, especially interpersonal relationships, support from managers, job meaning, job control, and work-life balance. Motivated employees experienced higher occupational stress in the early phase of the pandemic, while less motivated employees tended to have higher occupational stress in the following years of the pandemic. The most effective workplace factors to mitigate the negative pandemic impacts on occupational stress vary across the years, requiring continuing studies to understand and provide person-centered coping solutions.

Ergonomics of E-Learning Workstations and the Prevalence of Musculoskeletal Disorders-Study among University Students.

The prevalence of musculoskeletal disorders (MSD) has increased significantly in recent years. The COVID-19 pandemic has led to a fundamental change in the lifestyles, ways of learning and working patterns of the general population, which in turn, might lead to health consequences. The aim of this study was to evaluate the conditions of e-learning and the impact of the learning modality on the occurrence of musculoskeletal symptoms among university students in Poland. This cross-sectional study included 914 students who completed an anonymous questionnaire. The questions covered two time periods (before and during the COVID-19 pandemic) and were aimed at obtaining information about lifestyle (including physical activity using the modified International Physical Activity Questionnaire, 2007 (IPAQ), perceived stress and sleep patterns), the ergonomics of computer workstations (by Rapid Office Strain Assessment, 2012 (ROSA) method), the incidence and severity of musculoskeletal symptoms (by the Nordic Musculoskeletal Questionnaire, 2018 (NMQ)) and headaches. The main differences between the two periods were statistically significant according to the Wilcoxon test in terms of physical activity, computer use time, and severity of headaches. During the COVID-19 pandemic, there was a significant increase in MSD (68.2% vs. 74.6%) and their intensity (2.83 ± 2.36 vs. 3.50 ± 2.79 points) among the student population (p < 0.001). In the group of students with MSD, there was a high musculoskeletal load, due to the lack of ergonomic remote learning workstations. In future, a thorough study should be carried out, and there is an urgent need to raise students' awareness of arranging learning workstations according to ergonomic principles in order to prevent the occurrence of musculoskeletal problems.

COVID-19 in the Czech Republic 2020 and 2021: comparative analysis of probable work-related transmission of the coronavirus SARS-CoV-2.

OBJECTIVES: The aim of the analysis was to determine the probable places of coronavirus transmission in association with the work and compare the situation between 2020 and 2021. METHODS: The work analysed data from the Information System of Infectious Diseases managed by the Institute of Health Information and Statistics of the Czech Republic in the period from March 2020 - December 2021. RESULTS: 2,483,219 COVID-19 cases were officially confirmed (732,202 during 2020 and 1,338,790 in 2021), from them 140,368 (6%) represented work-related disease, 520,830 cases (21%) work-related contact, and 1,822,021 (73%) out-of-work contact. There were identified 13 occupations with the highest incidence of COVID-19 in the observed period (458,341 cases), in descending order - clerk, machinist, teacher, craftsman, worker/agency worker, driver, sales worker/cashier, warehouse worker/expediter, nurse, manager, food worker, paramedic, and social worker. Comparing 2020 and 2021, there was a difference in the ranking of occupations by incidence of disease. In 2021, the risk of infection acquiring increased for the occupations clerk, machinist, craftsman, worker/agency worker, manager, and food worker, while it decreased for the health professions (nurse, other paramedic, physician) and for social worker; 5,514 cases of COVID-19 were recognized as an occupational disease in 2020 and 2021, from them 5,483 cases (99.4%) in the health and social care economic activity sector. CONCLUSION: The available data show probable exposures to an infectious agent (without proof of specific contact with the source of the infection), of which 27% cases of COVID-19 are related to work (cases of work-related disease and work-related contact represented together the closest relationship to work). Different relevant anti-epidemic measures in the workplace have considerable practical importance for epidemic control. The use of personal protection of the mouth and nose with respirators/muffs is essential to reduce the risk of airborne transmission.

COVID-19 as an Occupational Disease-Temporal Trends in the Number and Severity of Claims in Germany.

COVID-19 is considered an occupational disease (OD), when infection occurs at the workplace for health workers (HW). Because of the increased infection risk of these workers, they were deemed to be a priority group when the vaccination campaign started in Germany in December 2020. By December 2021, more than 90% of HW had been vaccinated twice. We studied the number and the time trend concerning the severity of OD claims related to COVID-19. Workers' compensation claims for OD are recorded in a standardized database of the Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW). We analyzed all notifiable COVID-19 related claims filed between 1 March 2020 and 30 September 2022. The proportion of severe cases was estimated by inpatient stays, injury benefit payments, rehabilitation measures, and deaths. The data analysis was descriptive. Due to COVID-19, 317,403 notifiable cases were reported to the BGW. Of these, 200,505 (63.2%) had thus far been recognized as OD. The number of notifiable cases was highest in 2022 and lowest in 2020. In total, 3289 insured individuals were admitted to rehabilitation management. This represented 1.6% of all recognized ODs due to COVID-19 at the BGW. The proportion of cases admitted to rehabilitation management decreased from 4.5% of all recognized ODs in 2020 to 3.2% in 2021 and to 0.1% of all recognized cases in 2022. For inpatient stays, injury benefit payment, and death, a similar trend was observed. Therefore, it might be concluded that the successful vaccination campaign mitigated the negative health effects of COVID-19 on HW. Even with vaccination, severe cases can occur. Therefore, infection prevention at the workplace remains paramount.

Musculoskeletal problems, attitudes and behaviors related to physical activity, and social media addiction in musicians during the COVID-19 pandemic.

BACKGROUND: Musculoskeletal problems are common in musicians. Coronavirus 2019 (COVID-19) has brought with it lockdowns and quarantine periods, and as a result, caused physical and psychological problems. OBJECTIVE: To evaluate musculoskeletal problems, attitudes and behaviors related to physical activity, and social media addiction in musicians during the COVID-19 pandemic. METHODS: This cross-sectional study was conducted on a total of 137 musicians (string, keyboard, wind, percussion instrument players, and vocalists) online. Musculoskeletal problems with Cornell Musculoskeletal Discomfort Questionnaire (CMDQ), attitudes and behaviors related to physical activity with Cognitive Behavioral Physical Activity Questionnaire (CBPAQ), social media addiction with Bergen Social Media Addiction Scale (BSMAS) were evaluated. RESULTS: In CMDQ, it was found that upper back, lower back, and neck problems were more common in all musicians. There were no differences between instrument groups in terms of CBPAQ sub-dimensions, total CBPAQ, and total BSMAS (p > 0.05). CONCLUSION: Considering the dramatic effects of COVID-19, it may be important not to ignore musicians' musculoskeletal problems. It is recommended to design future studies investigating the effects of social media platforms on physical activity awareness by turning the opportunities of COVID-19 into advantages for challenges in musicians.

Social Interactions and Vaccine Hesitancy: Evidence from a Full Population Study in Sweden (preprint)

We investigate individuals’ information milieu and their decision to get the COVID-19 vaccine. The decision to accept or refuse a vaccine is intensely personal and involves the processing of information about phenomena likely to be unfamiliar to most individuals. We thus expect an interplay between an individual’s education and skills level and the information processing of others with whom she can interact and whose decision she can probe and observe. Using individual-level data for adults in Sweden, we can identify the proportion of an individual’s neighborhood and workplace who are unvaccinated as indicators of possible peer effects. We find that individuals with low levels of educational attainment and occupational skills are more likely to be unvaccinated when exposed to other unvaccinated individuals. The peer effects in each of these information milieus further increase the likelihood of not getting vaccinated—with the two acting as information channels that amplify each other.

Protective Strategies of Nurses encountering Covid 19: A Qualitative Study (preprint)

Background: Since nurses have a critical role in managing infectious diseases outbreaks, it is necessary to conduct more research to find the factors and risks leading to occupational injuries, as well as their individual action on protective measures in the event of epidemics. The aim of this study was to explain the protective strategies adopted by nurses during the Covid-19 pandemic. Methods: This qualitative study was performed with the participation of 13 nurses caring for patients infected with Covid-19 in five medical centre in north-western Iran. Data were collected using non-structured qualitative and face-to-face interviews, and analysed by Graneheim and Lundman's content analysis method. Results: Three main categories emerged: Normalization; Avoidance; and logical encounter. Conclusion: Participants were using a wide range of strategies to protect themselves that each one leads to various individual and organizational consequences. By knowing these strategies, nursing managers can maintain the workforce and contribute to the productivity of the organization.

[Occupational diseases in Poland in 2020]. / Choroby zawodowe w Polsce w 2020 roku.

BACKGROUND: The aim of the study is to analyze the epidemiological situation regarding the occurrence of occupational diseases in Poland in 2020 and to define possible directions for recommendations regarding preventive actions. MATERIAL AND METHODS: The cases of occupational diseases identified in accordance with the Polish judicial system and reported to the Central Register of Occupational Diseases in 2020 were analyzed. The analysis took into account disease entities, causal factors, gender, age of patients, exposure period, NACE section and territorial differentiation. Data are presented in absolute numbers and incidence rates per 100 000 employed and 100 000 employed persons. RESULTS: In 2020, 1850 cases of occupational diseases were diagnosed in Poland (11.5 cases per 100 000 employees). The disease entities with the highest incidence were infectious or parasitic diseases, pneumoconiosis, chronic diseases of the voice organ, diseases of the peripheral nervous system, diseases of the locomotor system and hearing loss. Over 90% of the statements concerned people >45 years of age. Most of the identified occupational diseases arose after at least 10 years of work in exposure to a harmful factor, and 73.9% of cases concerned people with over 20 years of work experience in exposure. CONCLUSIONS: The epidemiological situation in the field of occupational diseases in our country indicates a disturbing phenomenon, which is the persistence of a high level of pneumoconiosis of hard coal miners. The reflection of the effects of the pandemic in the COVID-19 incidence statistics as an occupational disease in 2020 is small. It is expected that the number of these cases will increase sharply in the coming years. Med Pr. 2022;73(5):427-33.