Application of ISO/IEC Guide 51 to COVID-19 infection control for the occupational safety.

COVID-19 is around the world. We attempt to apply three-step method in ISO/IEC Guide 51: 2014 to COVID-19 infection control in the workplace. The results show that the COVID-19 infection control measures include the eradication of the virus, the destruction of infectivity, the detoxification and weakening and the elimination of opportunities for infection as "Inherently Safe Design Measures", the avoidance of contact as "Safeguarding and Complementary Protective Measures" and the reduction of contact and the avoidance of seriousness as "Information for Use". Among these specific measures, the New Normal, especially in the manufacturing industries, would be "telecommuting" and "unmanned workplaces", which are part of the elimination of opportunities for infection, and "changes in flow lines" and "changes in airflow", which are part of the avoidance of contact. Where "telecommuting" and "unmanned workplaces" are feasible, they should be implemented as much as possible, and where they are not, attempts should be made to minimize human-to-human contact by "changes in flow lines". In addition, in the area of "changes in airflow", there are high expectations for future research on how to establish a ventilation design for COVID-19, in which but also the source would be workers themselves, not only combustible gases and toxic gases.

Original Research: Well-Being and Resilience Among Health Care Workers During the COVID-19 Pandemic: A Cross-Sectional Study.

BACKGROUND: Poor well-being among health care workers, often observed as professional burnout, is a well-documented phenomenon. The coronavirus disease 2019 (COVID-19) pandemic has further stressed the health care workforce, but its specific effects on this workforce remain unknown. This study examined well-being and resilience among health care workers during the COVID-19 pandemic. METHODS: The study used a cross-sectional survey design. Data collection took place through anonymous surveys of nurses (LPNs and RNs), advanced practice providers (NPs, physician assistants, and certified nurse midwives), certified registered nurse anesthetists, respiratory therapists, health care technicians, and therapy service professionals (physical, occupational, and speech therapists). Of the 6,120 health care workers recruited to participate in the study, data from 2,459 participants were analyzed using logistic regression and linear regression. RESULTS: The study found that several factors significantly increased the likelihood of at-risk well-being. These included having a lower level of resilience, using support resources, feeling the organization lacked understanding of the emotional support needs of health care workers during the pandemic, believing the workload had increased, believing there was insufficient personal protective equipment, believing there was inadequate staffing to safely care for patients, and having a lower degree of psychological safety. After controlling for health care workers' role and employment location, several factors were found to be significantly associated with higher levels of resilience. These included having positive perceptions about the organization's understanding of the emotional support needs of health care workers during the pandemic, believing sufficient educational resources were available regarding the care of COVID-19 patients, having positive perceptions of leadership support from direct managers, having positive perceptions of the redeployment policy, and having a higher degree of psychological safety. CONCLUSIONS: This study identified several work environment factors that have significantly affected health care workers' well-being and resilience during the COVID-19 pandemic. This knowledge has practical relevance for health care leaders who aim to better understand and address the well-being and resilience of the health care workforce during this pandemic and beyond.

A review of studies on the COVID-19 epidemic crisis disease with a preventive approach.

BACKGROUND: COVID-19 is a highly contagious acute respiratory syndrome and has been declared a pandemic in more than 209 countries worldwide. At the time of writing, no preventive vaccine has been developed and tested in the community. This study was conducted to review studies aimed at preventing the spread of the coronavirus worldwide. METHODS: This study was a review of the evidence-based literature and was conducted by searching databases, including Google Scholar, PubMed, and ScienceDirect, until April 2020. The search was performed based on keywords including "coronavirus", "COVID-19", and "prevention". The list of references in the final studies has also been re-reviewed to find articles that might not have been obtained through the search. The guidelines published by trustworthy organizations such as the World Health Organization and Center for Disease Control have been used in this study. CONCLUSION: So far, no vaccine or definitive treatment for COVID-19 has been invented, and the disease has become a pandemic. Therefore, observation of hand hygiene, disinfection of high-touch surfaces, observation of social distance, and lack of presence in public places are recommended as preventive measures. Moreover, to control the situation and to reduce the incidence of the virus, some of the measures taken by the decision-making bodies and the guidelines of the deterrent institutions to strengthen telecommuting of employees and reduce the presence of people in the community and prevent unnecessary activities, are very important.

Risk Factors Associated With SARS-CoV-2 Infection Among Farmworkers in Monterey County, California.

Importance: Essential workers in agriculture and food production have been severely affected by the ongoing COVID-19 pandemic. Objective: To identify risk factors associated with SARS-CoV-2 infection among farmworkers in California. Design, Setting, and Participants: This cross-sectional study invited farmworkers in California's Salinas Valley (Monterey County) receiving transcription-mediated amplification (TMA) tests for SARS-CoV-2 infection at federally qualified community clinics and community sites to participate. Individuals were eligible if they were not pregnant, were 18 years or older, had conducted farmwork since the pandemic started, and were proficient in English or Spanish. Survey data were collected and SARS-CoV-2 tests were conducted among participants from July 16 to November 30, 2020. Exposures: Sociodemographic, household, community, and workplace characteristics. Main Outcomes and Measures: TMA- and immunoglobulin G (IgG)-positive SARS-CoV-2 infection. Results: A total of 1107 farmworkers (581 [52.5%] women; mean [SD] age, 39.7 [12.6] years) were included in these analyses. Most participants were born in Mexico (922 [83.3%]), were married or living with a partner (697 [63.0%]), and worked in the fields (825 [74.5%]). Overall, 118 of 911 (13.0%) had a positive result on their TMA test for SARS-CoV-2 infection, whereas 201 of 1058 (19.0%) had antibody evidence of infection. In multivariable analyses accounting for recruitment venue and enrollment period, the incidence of TMA-positive SARS-CoV-2 infection was higher among those with lower than primary school-level education (adjusted relative risk [aRR], 1.32; 95% CI, 0.99-1.76; non-statistically significant finding), who spoke an Indigenous language at home (aRR, 1.30; 95% CI, 0.97-1.73; non-statistically significant finding), who worked in the fields (aRR, 1.60; 95% CI, 1.03-2.50), and who were exposed to a known or suspected COVID-19 case at home (aRR, 2.98; 95% CI, 2.06-4.32) or in the workplace (aRR, 1.59; 95% CI, 1.18-2.14). Positive results on IgG tests for SARS-CoV-2 infection were more common among those who lived in crowded housing (aRR, 1.23; 95% CI, 0.98-1.53; non-statistically significant finding), with children aged 5 years or younger (aRR, 1.40; 95% CI, 1.11-1.76), with unrelated roommates (aRR, 1.40; 95% CI, 1.19-1.64), and with an individual with known or suspected COVID-19 (aRR, 1.59; 95% CI, 1.13-2.24). The risk of IgG positivity was also higher among those with body mass index of 30 or greater (aRR, 1.65; 95% CI, 1.01-2.70) or diabetes (aRR, 1.31; 95% CI, 0.98-1.75; non-statistically significant finding). Conclusions and Relevance: In this cross-sectional study of farmworkers in California, both residential and workplace exposures were associated with SARS-CoV-2 infection. Urgent distribution of COVID-19 vaccines and intervention on modifiable risk factors are warranted given this population's increased risk of infection and the essential nature of their work.

A Physician's Guide for Workers' Return to Work During COVID-19 Pandemic.

OBJECTIVE: Higher probability of developing severe COVID-19 has been associated with health risk factors and medical conditions which are common among workers globally. For at risk workers, return to work may require additional protective policies and procedures. METHODS: A review of the medical literature was conducted on health risk factors and medical conditions associated with increased COVID-19 morbidity and mortality, standardized measures for community COVID transmission, and occupation-specific risk. RESULTS: The relative risk of acquiring and the severity of COVID-19 for workers is associated with three pillars: individual risk, workplace risk, and community risk. Matrices were developed to determine a worker's individual risk based on these three pillars. CONCLUSIONS: A practical decision tool is proposed for physicians evaluating and managing individual worker COVID-19 risk in the context of returning to work.

Frequency of Workplace Controls and Associations With Safety Perceptions Among a National Sample of US Food Retail Workers During the COVID-19 Pandemic.

OBJECTIVES: Explore workplace control frequencies and factors associated with US food retail workers' safety perceptions during COVID-19. METHODS: An online, cross-sectional survey captured working conditions and safety perceptions among a large, national sample of US food retail workers from July to October 2020. RESULTS: Overall, 40.3% reported feeling "not so" or "not protected" by COVID-19 controls. Administrative controls were more commonly reported (56.8% reported ≥5 controls) than engineering (19.5% reported ≥3). Fomite-related controls were more common than those reducing interpersonal contact. After adjustment, organizational safety climate (prevalence ratio (PR): 1.53, 95% CI: 1.24, 1.89), and perceived strict prevention measure enforcement (PR: 0.60, 95% CI: 0.46, 0.78) were associated with safety perceptions. CONCLUSIONS: Many workers do not feel well-protected by COVID-19 controls. Safety climate and control enforcement are associated with workers' COVID-19 safety perceptions.

A national survey of the impact of COVID-19 on personal, academic, and work environments of nursing students.

BACKGROUND: Nursing students are experiencing life changing events in their personal, academic, and work environments since the onset of the pandemic. PURPOSE: The purpose of this study was to describe and explore the effects of COVID-19 on personal, workforce, and academic experiences of nursing students (N = 620). METHOD: A 68-item survey with three areas of focus surrounding academic, workforce and personal experiences was distributed to multiple schools across the United States. The analysis compares student responses from the five regions of the US. FINDINGS: Significant differences were found in the pairwise comparisons. The analysis revealed the academic changes were generally viewed as negative. Fear/anxiety and political influences impacted the outcomes of the pandemic. DISCUSSION: Understanding the effects of the pandemic on the personal, work and academic experiences of nursing students will assist academia and healthcare in adapting existing policies to meet student needs in the various regions of the United States.

Transport of Aerosols in Underground Mine Workings in Terms of SARS-CoV-2 Virus Threat.

This paper presents a method of implementation and the results of aerosol dispersion tests in underground mine workings. Numerous tests were carried out to determine the potential risk of SARS-CoV-2 coronavirus infection in the underground environment of the mines. The influence of selected parameters of mine air on the possibility and method of aerosol transmission through ventilation routes was experimentally determined in real conditions. The concentration of additional aerosols in the class of ultrafine and fine aerosols increased with the distance from the generator, while the concentration of coarse particles decreased. Assuming the consumption of the solution with which aerosols were generated, even at a small level of 1 cm3/min., the number of additional aerosols was several hundred particles in one cubic centimeter of air at a distance of 50-70 m from the generator. The concentration of ultrafine particles in the range of 40-20,000 nm increased from 122 particles/cm3 to 209 particles/cm3 at air temperature of 12 °C and relative humidity of 95-96%, and from 90 particles/cm3 to 243 particles/cm3 at air temperature of 17 °C and relative humidity of 76-82%, with the increasing distance from the generator (10 m to 50 m).

Menopausal symptoms and work: a narrative review of women's experiences in casual, informal, or precarious jobs.

Governments, employers, and trade unions are increasingly developing "menopause at work" policies for female staff. Many of the world's most marginalised women work, however, in more informal or insecure jobs, beyond the scope of such employment protections. This narrative review focuses upon the health impact of such casual work upon menopausal women, and specifically upon the menopausal symptoms they experience. Casual work, even in less-then-ideal conditions, is not inherently detrimental to the wellbeing of menopausal women; for many, work helps manage the social and emotional challenges of the menopause transition. Whereas women in higher status work tend to regard vasomotor symptoms as their main physical symptom, women in casual work report musculoskeletal pain as more problematic. Menopausal women in casual work describe high levels of anxiety, though tend to attribute this not to their work as much as their broader life stresses of lifelong poverty and ill-health, increasing caring responsibilities, and the intersectionally gendered ageism of the social gaze. Health and wellbeing at menopause is determined less by current working conditions than by the early life experiences (adverse childhood experiences, poor educational opportunities) predisposing women to poverty and casual work in adulthood. Approaches to supporting menopausal women in casual work must therefore also address the lifelong structural and systemic inequalities such women will have faced. In the era of COVID-19, with its devastating economic, social and health effects upon women and vulnerable groups, menopausal women in casual work are likely to face increased marginalisation and stress. Further research is need.

Rethinking the Paradigm and Practice of Occupational Health in a World Without Decent Work: A Perspective From East and Southern Africa.

The global political economy is generating new forms and growing shares of informal, insecure, and precarious labor, adding to histories of insecure work and an externalization of social costs. The COVID-19 pandemic has highlighted the consequences of ignoring such signals in terms of the increased risk and vulnerability of insecure labor. This paper explores how such trends are generating intersecting adverse health outcomes for workers, communities, and environments and the implications for breaking siloes and building links between the paradigms, science, practice, and tools for occupational health, public health, and eco-health. Applying the principle of controlling hazards at the source is argued in this context to call for an understanding of the upstream production and socio-political factors that are jointly affecting the nature of work and employment and their impact on the health of workers, the public, and the planet.

The Dual Epidemics of 2020: Nursing Leaders' Reflections in the Context of Whole Person/Whole Systems.

The Greater Boston Nursing Collective, a consortium composed of university nursing deans and chief nursing officers within academic medical centers and specialty hospitals in Boston, Massachusetts, was formed in 2014. Since the group's inception, our mission has been to create and reinforce whole-person/whole-system healing environments to improve the health of all communities. Through our collaboration in navigating the dual epidemics of COVID-19 and structural racism within our respective organizations, and across the United States and the world, we share experiences and lessons learned. Our common mission is clearer than ever: to create safe and joyful work environments, to protect the dignity of those we are privileged to serve, and to generate policies to advance health equity to rectify societal forces that have shaped this dual epidemic. We are humbled by the many who persist despite limited rest and respite, and whose stories, innovations, and leadership we are honored to witness and share. They have defined our generation, just as nurses in earlier crises have done: leading through service to others as our purpose and privilege.

Characteristics of SARS-CoV-2 Transmission among Meat Processing Workers in Nebraska, USA, and Effectiveness of Risk Mitigation Measures.

The coronavirus disease (COVID-19) pandemic has severely impacted the meat processing industry in the United States. We sought to detail demographics and outcomes of severe acute respiratory syndrome coronavirus 2 infections among workers in Nebraska meat processing facilities and determine the effects of initiating universal mask policies and installing physical barriers at 13 meat processing facilities. During April 1-July 31, 2020, COVID-19 was diagnosed in 5,002 Nebraska meat processing workers (attack rate 19%). After initiating both universal masking and physical barrier interventions, 8/13 facilities showed a statistically significant reduction in COVID-19 incidence in <10 days. Characteristics and incidence of confirmed cases aligned with many nationwide trends becoming apparent during this pandemic: specifically, high attack rates among meat processing industry workers, disproportionately high risk of adverse outcomes among ethnic and racial minority groups and men, and effectiveness of using multiple prevention and control interventions to reduce disease transmission.

Health Professionals of Prevention in Italy: The Value of Expertise During COVID-19 Pandemic.

There are 22 different degree courses related to the Healthcare Professions in the Italian university system, which are divided into four areas. "Healthcare Professions of Prevention" is the fourth area and it is fundamental for the National Health Service. In particular, in this pandemic emergency situation, the contribution of the Prevention Technicians in the Environment and Workplaces (PTEW) is essential in the field and workplace management. The "Core Competence" of the PTEW is to carry out, with professional autonomy, prevention, verification, and control activities in the field of hygiene and safety of living and working environments. In the hospitals, the indications provided by national and/or regional authorities are implemented through procedures on good hygiene practices developed by PTEW (e.g., hand hygiene, "respiratory tract hygiene," environmental hygiene, social distancing, and use of Personal Protective Equipment). One of the activities is the health surveillance on the field by population monitoring. The protocols foreseen for the "in-flow of workers" involve a wider control between social life and work. The PTEW will use a Check List divided into 3 macro phases: Entry, Activity Context, and Exit, defining each behavior of the work phases with a constant presence of verification of the procedures. The PTEW will be a Leader on the topics of education, training, and persuasion, considering a New Principle that "transforms the worker as active part in the application and diffusion of the safety measures".

Cabin crew health and fitness-to-fly: Opportunities for re-evaluation amid COVID-19.

Aircrew fitness-to-fly is among the elements that make aviation the safest form of long-distance transport. The health of cabin crew is a crucial determinant in carrying out safety-related duties. 'Fitness-to-fly' is associated with defined workplace conditions, for which airlines have a legal duty to ensure fitness for employment. We explored the literature on fitness-to-fly to obtain a pragmatic assessment of the challenges for aeromedical examinations. Regulations promulgated by aviation regulatory authorities and airline-internal policies have similar status and meaning, yet there is no harmonised approach internationally, and an inability to conform periodic medical assessments to actual operational fitness. The COVID-19 pandemic has highlighted the need to better understand fitness-to-fly criteria. Fitness-to-fly measures are mainly based on self-reported data and there is a need for a 'safety' factor for self-reports. Aeromedical evaluations should evolve from meeting medical standards to include pandemics as an element of the overall risk of aircraft operations. Re-evaluating criteria for fitness-to-fly assessment will further the goal of linking research to the actual needs of public health decisionmakers. If airlines are to resume operations at pre-pandemic levels, they must demonstrate to the public and public health agencies that fitness-to-fly assessment is appropriate and effective.

Reflections on the lived experience of working with limited personal protective equipment during the COVID-19 crisis.

Coronavirus disease 2019 (COVID-19) has placed significant strain on United States' health care and health care providers. While most Americans were sheltering in place, nurses headed to work. Many lacked adequate personal protective equipment (PPE), increasing the risk of becoming infected or infecting others. Some health care organizations were not transparent with their nurses; many nurses were gagged from speaking up about the conditions in their workplaces. This study used a descriptive phenomenological design to describe the lived experience of acute care nurses working with limited access to PPE during the COVID-19 pandemic. Unstructured interviews were conducted with 28 acute care nurses via telephone, WebEx, and Zoom. Data were analyzed using thematic analysis. The major theme, emotional roller coaster, describes the varied intense emotions the nurses experienced during the early weeks of the pandemic, encompassing eight subthemes: scared and afraid, sense of isolation, anger, betrayal, overwhelmed and exhausted, grief, helpless and at a loss, and denial. Other themes include: self-care, 'hoping for the best', 'nurses are not invincible', and 'I feel lucky'. The high levels of stress and mental assault resulting from the COVID-19 crisis call for early stress assessment of nurses and provision of psychological intervention to mitigate lasting psychological trauma.

Review of hygiene adaptations among UK doctors in controlling the spread of SARS-CoV-2 infection.

BACKGROUND: A significant number of healthcare workers around the world have contracted COVID-19 from their workplace, thus there is a need to investigate common hygiene practices. AIM: We aimed to describe the common hygiene adaptations of doctors in the hospital and at home. METHODS: A survey of 110 doctors in UK was carried out to determine their hygiene adaptations and practices. Data were collected on demographics and personal protective equipment compliance. RESULTS: The key findings were frequent hand washing (51%), change of clothing entering and leaving hospital (88% and 92%, respectively), taking a shower upon returning home (85%) and washing work attire at temperatures of 60-80°C (50%). A higher proportion of junior doctors washed their scrubs (p=0.004) and stethoscopes (p=0.014) compared with consultants and seniors. Female doctors cleaned their mobile phones (p=0.022) and work belongings (p=0.01) more frequently. CONCLUSION: This study signified that junior doctors were more meticulous in hygiene adaptations and female doctors were more fastidious in personal hygiene. The observations of this study may be beneficial in preventing transmission of infection to families of healthcare professionals and are important to implement in the case of a second wave of COVID-19.