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).

Home office versus ergonomic workstation - is the ergonomic risk increased when working at the dining table? An inertial motion capture based pilot study.

BACKGROUND: In order to reduce the risk of infection with Sars-Cov-2, work practices have been shifted to the home office in many industries. The first surveys concerning this shift indicate an increase in musculoskeletal complaints of many employees. The aim of this study was to compare the ergonomic risk in the upper extremities and trunk of working in a home office with that of working in an ergonomically optimized workplace. METHODS: For this purpose, 20 subjects (13w/7m) aged 18-31 years each performed a 20-minute workplace simulation (10 min writing a text, 10 min editing a questionnaire) in the following set up: on a dining table with dining chair and laptop (home office) and on an ergonomically adjusted workstation (ergonomically optimized workplace). The subjects were investigated using a combined application of a motion capture kinematic analysis and the rapid upper limb assessment (RULA) in order to identify differences in the ergonomic risk. RESULTS: Significantly reduced risk values for both shoulders (left: p < 0.001; right: p = 0.02) were found for the ergonomically optimized workstations. In contrast, the left wrist (p = 0.025) showed a significantly reduced ergonomic risk value for the home office workstation. CONCLUSION: This study is the first study to compare the ergonomic risk between an ergonomically optimized workplace and a home office workstation. The results indicate minor differences in the upper extremities in favor of the ergonomically optimized workstation. Since work-related musculoskeletal complaints of the upper extremities are common among office workers, the use of an ergonomically optimized workstation for home use is recommended based on the results.

A Novel Application of Risk-Risk Tradeoffs in Occupational Health: Nurses' Occupational Asthma and Infection Risk Perceptions Related to Cleaning and Disinfection during COVID-19.

BACKGROUND: Nurses face the risk of new onset occupational asthma (OA) due to exposures to cleaning and disinfection (C&D) agents used to prevent infections in healthcare facilities. The objective of this study was to measure nurses' preferences when presented with simultaneous OA and respiratory viral infection (e.g., COVID-19) risks related to increased/decreased C&D activities. METHODS: Nurses working in healthcare for ≥1 year and without physician-diagnosed asthma were recruited for an online anonymous survey, including four risk-risk tradeoff scenarios between OA and respiratory infection with subsequent recovery (Infect and Recovery) or subsequent death (Infect and Death). Nurses were presented with baseline risks at hypothetical "Hospital 1", and were asked to choose Hospital 2 (increased OA risk to maintain infection risk), Hospital 3 (increased infection risk to maintain OA risk), or indicate that they were equally happy. RESULTS: Over 70% of nurses were willing to increase infection risk to maintain baseline OA risk if they were confident they would recover from the infection. However, even when the risk of infection leading to death was much lower than OA, most nurses were not willing to accept a larger (but still small) risk of death to avoid doubling their OA risk. Age, work experience, and ever having contracted or knowing anyone who has contracted a respiratory viral infection at work influenced choices. CONCLUSIONS: We demonstrate the novel application of a risk-risk tradeoff framework to address an occupational health issue. However, more data are needed to test the generalizability of the risk preferences found in this specific risk-risk tradeoff context.

COVID-19 infections among HCWs exposed to a patient with a delayed diagnosis of COVID-19.

We report on COVID-19 risk among HCWs exposed to a patient diagnosed with COVID-19 on day 13 of hospitalization. There were 44 HCWs exposed to the patient before contact and droplet precautions were implemented: of these, 2 of 44 (5%) developed COVID-19 potentially attributable to the exposure.

Diagnosing occupational COVID-19 in Croatian healthcare workers.

Coronavirus disease 2019 (COVID-19) can be diagnosed as occupational disease by an occupational health physician (OHP), if supported by relevant work-related and medical documentation. The aim of this study was to analyse such documentation submitted by Croatian healthcare workers (HCWs) and discuss its relevance in view of European and Croatian guidelines. The study included 100 Croatian HCWs who were SARS-CoV-2-positive and requested that their infection be diagnosed as occupational disease by their OHPs from 1 May 2020 to 10 March 2021. As participants they were asked to fill out our online Occupational COVID-19 in Healthcare Workers Questionnaire. For the purpose of this study we analysed answers about the type of close contact at the workplace, COVID-19 symptoms, and enclosed work-related (job description, employer statement about exposure to SARS-CoV-2) and medical documentation (positive SARS-CoV-2 polymerase chain reaction test and patient history confirming the diagnosis of COVID-19). Most participants were working in hospitals (N=95), mostly nurses (N=75), who became infected by a patient (N=68) or colleague (N=31), and had at least one COVID-19 symptom (N=87). Eighty participants did not enclose obligatory documents, 41 of whom failed to submit job description and 31 both job description and employer statement. These findings confirm that the major risk of occupational COVID-19 in HCWs is close contact with patients and colleagues, and points out the need for better cooperation between OHPs, occupational safety experts, employers, and diseased workers.

The association between visual display terminal use and dry eye: a review.

BACKGROUND: Dry eye disease (DED) is a multifactorial disease of the tear film and ocular surface. It causes ocular symptoms, reduced quality of life and a considerable economic burden on society. Prolonged use of visual display terminals (VDTs) has been suggested as an important risk factor for DED. PURPOSE: This review aims to study the association between DED and VDT use with an emphasis on the prevalence of DED among VDT users and harmful daily duration of VDT use. METHODS: A PubMed search was conducted and yielded 57 relevant articles based on a set of inclusion and exclusion criteria. The studies were subclassified according to study design. RESULTS: The far majority of the studies showed an association between VDT use and DED or DED-related signs and symptoms. The prevalence of definite or probable DED in VDT and office workers ranged from 26% to 70%, with as few as 1-2 hr of VDT exposure per day being associated with DED. CONCLUSION: VDT use is strongly associated with DED. VDT-associated DED is prevalent, but the exact prevalence needs to be further elucidated using standardized DED diagnosis criteria. Furthermore, a safe lower limit of daily VDT use has yet to be established. More research is needed on the effect of digitalization and digital transformation, which are particularly high during the time of the COVID-19 pandemic.

Mental health care of health workers during Covid-19: Recommendations based on evidence and expert consensus.

INTRODUCTION: The crisis situation generated by COVID-19 and the measures adopted have generated social changes in the normal dynamics of the general population and especially for health workers, who find themselves caring for patients with suspected or confirmed infection. Recent studies have detected in them depression and anxiety symptoms and burnout syndrome, with personal and social conditions impacting their response capacity during the health emergency. Our aim was to generate recommendations for the promotion and protection of the mental health of health workers and teams in the first line of care in the health emergency due to COVID-19. METHODS: A rapid literature search was carried out in PubMed and Google Scholar, and an iterative expert consensus and through electronic consultation, with 13 participants from the areas of psychology, psychiatry and medicine; the grading of its strength and directionality was carried out according to the international standards of the Joanna Briggs Institute. RESULTS: Thirty-one recommendations were generated on self-care of health workers, community care among health teams, screening for alarm signs in mental health and for health institutions. CONCLUSIONS: The promotion and protection activities in mental health to face the health emergency generated by COVID-19 worldwide can include coordinated actions between workers, health teams and health institutions as part of a comprehensive, community care, co-responsible and sustained over time.

[Occupational diseases of the airways and the lungs]. / Berufskrankheiten der Atemwege und der Lunge.

The attributable proportion of occupation-related influences on airway and lung diseases is 10-30%. In patients with obstructive airway diseases it is extremely important to sufficiently document findings during the period of activities burdening the airway as compared to periods off work. Chronic obstructive pulmonary disease (COPD) can have a work-related (partial) cause even in smokers. Regarding occupational infectious diseases, the main cause up to 2019 was tuberculosis but the corona pandemic has led to coronavirus disease 2019 (COVID-19) being the most frequent occupational disease. For the occupational medical assessment of interstitial and malignant pulmonary diseases, checklists can be helpful to support the medical history.

Influence of the characteristics of home office work on self-perceived vocal fatigue during the COVID-19 pandemic.

PURPOSE: To verify the influence of work characteristics and the occupational voice use on the self-perception of vocal fatigue symptoms in individuals working in the home office during the COVID-19 pandemic. METHODS: This was a cross-sectional, observational, and descriptive study. The sample consisted of 206 individuals (123 women and 83 men), with an average age of 34 years, working exclusively in a home office mode due to the pandemic. Through an online form, all participants responded to the Vocal Fatigue Index (VFI) protocol and the questionnaire on the characterization of work and the occupational voice use during the pandemic, developed by the authors of this study. Multiple linear regression using the backward elimination technique was performed. RESULTS: The variables the interlocutor does "not listen to me in home office work," "noise in the home office work environment," "the daily workload in home office," "vocal quality worsened in home office work," "increased vocal loudness in home office work" and "lack of training about voice use in home office work" are predictors of the dependent variable vocal fatigue symptoms. CONCLUSION: The characteristics of work and occupational voice use influence the self-perception of vocal fatigue symptoms in individuals working in the home office mode during the COVID-19 pandemic.

Factors associated with psychiatric adverse effects in healthcare personnel during the COVID-19 pandemic in Ecuador.

INTRODUCTION: Since the emergence of the novel coronavirus disease (COVID-19), the world has faced a pandemic with consequences at all levels. In many countries, the health systems collapsed and healthcare professionals had to be on the front line of this crisis. The adverse effects on the mental health of healthcare professionals have been widely reported. This research focuses on identifying the main factors associated with adverse psychological outcomes. METHODS: Descriptive, cross-sectional study based on surveys, applying the PHQ-9, GAD-7, ISI and EIE-R tests to healthcare professionals from Ecuador during the COVID-19 pandemic. RESULTS: 1028 participants, distributed in: 557 physicians (54.18%), 349 nurses (33.94%), 29 laboratory workers (2.82%), 27 paramedics (2.62%), 52 psychologists (5.05%) and 14 respiratory therapists (1.36%), from 16 of the 24 provinces of Ecuador. Of these, 27.3% presented symptoms of depression, 39.2% anxiety symptoms, 16.3% insomnia and 43.8% symptoms of PTSD, with the 4 types of symptoms ranging from moderate to severe. The most relevant associated factors were: working in Guayas (the most affected province) (OR = 2.18 for depressive symptoms and OR = 2.59 for PTSD symptoms); being a postgraduate doctor (OR = 1.52 for depressive symptoms and OR = 1.57 for insomnia), perception of not having the proper protective equipment (OR = 1.71 for symptoms of depression and OR = 1.57 for symptoms of anxiety) and being a woman (OR = 1.39 for anxiety). CONCLUSIONS: Healthcare professionals can suffer a significant mental condition that may require psychiatric and psychological intervention. The main associated factors are primarily related to living and working in cities with a higher number of cases and the characteristics of the job, such as being a postgraduate doctor, as well as the perception of security. The main risk factors are primarily related to geographical distribution and job characteristics, such as being a resident physician and self-perception of safety. Further studies are required as the pandemic evolves.

To assess the efficacy of safety measures adopted during endoscopy in the Corona Virus Disease-19 era for health care professionals-A single-centre tertiary care hospital experience.

BACKGROUND AND OBJECTIVES: During Corona Virus Disease-19 (COVID-19) pandemic, it has been estimated that approximately 10% of health care professionals (HCPs) have been diagnosed contacting  COVID-19. Aerosol-generating procedures have led to change in safety practices among HCPs. We thus evaluated the efficacy of the endoscopic safety measures among HCPs posted in the endoscopy unit. METHODS: In this retrospective analysis, all endoscopic procedures performed over a period of 4 months, from 1 April to 31 July 2020 were included. We noted indications and number of COVID-positive procedures as well as comprehensive screening of HCPs posted in our endoscopy unit. The aim of the study was to evaluate the incidence and outcome of COVID-19 among HCPs. RESULTS: Three thousand four hundred and sixty procedures were included in the analysis. Indications were divided as urgent (n = 190, 5.49%), semi-urgent (n = 553, 16%) and non-urgent group (n = 2717, 78.52%). Thirty-four procedures (0.98%) were done on diagnosed COVID-19 patients. The most common indications were gastrointestinal bleed (n = 12/34, 35.30%) followed by biliary sepsis (n = 9/34, 26.5%). Among the HCPs, the incidence of symptomatic COVID-19 was 6.58% (n = 5/76). All HCPs recovered with excellent outcomes. A comprehensive screening showed 7.90% (n = 6/76) HCPs having Immunoglobulin G (IgG) antibody in their sera. CONCLUSION: Addition of safety measures in endoscopy leads to low risk of transmission among HCPs.

The Relationship Between Surgeon Gender and Stress During the Covid-19 Pandemic.

OBJECTIVE: To investigate the relationship between surgeon gender and stress during the Covid-19 pandemic. BACKGROUND: Although female surgeons face difficulties integrating work and home in the best of times, the Covid-19 pandemic has presented new challenges. The implications for the female surgical workforce are unknown. METHODS: This cross-sectional, multi-center telephone survey study of surgeons was conducted across 5 academic institutions (May 15-June 5, 2020). The primary outcome was maximum stress level, measured using the validated Stress Numerical Rating Scale-11. Mixed-effects generalized linear models were used to estimate the relationship between surgeon stress level and gender. RESULTS: Of 529 surgeons contacted, 337 surgeons responded and 335 surveys were complete (response rate 63.7%). The majority of female respondents were housestaff (58.1%), and the majority of male respondents were faculty (56.8%) (P = 0.008). A greater proportion of male surgeons (50.3%) than female surgeons (36.8%) had children ≤18 years (P = 0.015). The mean maximum stress level for female surgeons was 7.51 (SD 1.49) and for male surgeons was 6.71 (SD 2.15) (P < 0.001). After adjusting for the presence of children and training status, female gender was associated with a significantly higher maximum stress level (P < 0.001). CONCLUSIONS: Our findings that women experienced more stress than men during the Covid-19 pandemic, regardless of parental status, suggest that there is more to the gendered differences in the stress experience of the pandemic than the added demands of childcare. Deliberate interventions are needed to promote and support the female surgical workforce during the pandemic.