The COVID-19 pandemic reduced the trauma incidence and modified its pattern in Al-Ain City, United Arab Emirates.

AIM: We aimed to study the impact of the COVID-19 pandemic on the pattern of injury and outcome of hospitalized trauma patients in Al-Ain City, United Arab Emirates, to use this information in the preparedness for future pandemics. METHODS: We retrospectively compared the trauma registry data of all hospitalised trauma patients, who were treated at the two main trauma centres in Al-Ain City (Al-Ain Hospital and Tawam Hospital); those who were treated over 1 year before the pandemic (n = 2002) and those who were treated at the first year of the COVID-19 pandemic (n = 1468). RESULTS: There was a 26.7% reduction in the overall incidence of trauma admissions in the COVID-19 pandemic period. The mechanism of injury significantly differed between the two periods (p < 0.0001, Fisher's exact test). There was an absolute increase in the number of injuries, due to machinery and falling objects during the pandemic (39.7% and 54.1% respectively, p < 0.001). In contrast, road traffic collisions and falls were reduced by 33.5% and 31.3%, respectively. Location significantly differed between the two periods (p < 0.0001, Fisher's exact test). There was an absolute increase of 18.4% in workplace injuries and a reduction of 39.3% in home injuries over the study period. In addition, we observed relatively more workplace injuries and fewer home injuries during the pandemic (11.3% and 42.8% compared with 7.1% and 52.4%, respectively). Mortality was similar between the two periods (1.8% compared with 1.2%, p = 0.16, Fisher's exact test). CONCLUSIONS: The COVID-19 pandemic has modified the trauma risk exposure in our population. It reduced trauma hospital admissions by around 27%. Work-related injuries, including falling objects and machinery injuries, were relatively higher during the pandemic. Prevention of work-related injuries should be an important component of preparedness for future pandemics.

Investigation and analysis of occupational physical injuries among healthcare staffs during allopatric medical aid for the fight against COVID-19.

BACKGROUND: Occupational health impairment of medical personnel manifested as a prominent problem in COVID-19. The aim of this study is to investigate the occupational physical injuries of front-line medical staffs in Hubei province during the fight against COVID-19. MATERIAL AND METHODS: questionnaire survey was conducted among 476 medical staffs from 3 regions of Hubei Province, including general characteristics and the physical discomfort/damage suffered in the isolation wards during working hours. RESULTS: A total of 457 valid questionnaires were collected. The common physical discomfort/damage included skin injuries (22.76%), conjunctivitis (15.10%), falls (9.19%), intolerant unwell symptoms (8.53%) and sharp injuries (6.13%). Logistic regression analysis showed that: lack of protective work experience (OR = 2.049, 95% CI: 1.071-3.921), continuous working for 4 h (OR = 3.771, 95% CI: 1.858-7.654), and working >4 h (OR = 7.076, 95% CI: 3.197-15.663) were high-risk factors for skin injuries. Working continuously for 4 h (OR = 3.248, 95% CI: 1.484-7.110) and working >4 h (OR = 3.096, 95% CI: 1.232-7.772) were high-risk factors for conjunctivitis. Lack of protective work experience was a high risk factor for falls (OR = 5.508, 95% CI: 1.299-23.354). The high risk factors for intolerant unwell symptoms were continuous working for 4 h (OR = 5.372, 95% CI: 1.239-23.301) and working >4 h (OR = 8.608, 95% CI: 1.843-40.217). Working in a COVID-19 critical care unit (OR = 3.249, 95% CI: 1.344-7.854) and implementation of nursing (OR = 9.766, 95% CI: 1.307-72.984) were high risk factors for sharp injuries. CONCLUSIONS: Occupational physical injuries are universal in the COVID-19 ward. Those who take up nursing, work in a critical care ward, with no experience in an isolation ward for infectious diseases, and work continuously for ≥4 h on the same day should get more attention. Med Pr. 2022;73(3):209-18.

Relationship between occupational injury and gig work experience in Japanese workers during the COVID-19 pandemic: a cross-sectional internet survey.

This study evaluated the relationship between occupational injury risk and gig work, which included the exchange of labor for money between individuals or companies via digital platforms. As Japan has experienced a severe economic decline during the coronavirus disease 2019 (COVID-19) pandemic, an increasing number of individuals have engaged in gig work. While few studies have evaluated occupational risks in gig work, several traffic accidents associated with food delivery gig work have been reported in the mass media. In this study, 18,317 individuals completed an internet survey that collected information pertaining to their involvement in gig work and experience of related occupational injuries; data regarding several confounding factors were also recorded. Multiple logistic regression analysis showed that workers involved in gig work had a greater risk of any minor occupational injuries (odds ratio, 3.68; 95% confidence interval, 3.02-4.49) and activity-limiting injuries (odds ratio, 9.11; 95% confidence interval, 7.03-11.8) than those not involved in gig work, after adjusting for age, sex, household income, lifestyle factors, and work-related factors. The results of this study indicate that gig workers are exposed to greater occupational hazards during the COVID-19 pandemic. Additional studies are warranted to clarify the causal mechanism for this relationship.

The Abysmal Organization of Work and Work Safety Culture Experienced by North Carolina Latinx Women in Farmworker Families.

The occupational health of immigrant workers in the United States is a major concern. This analysis describes two domains, organization of work and work safety culture, important to the occupational health of Latinx women in farmworker families. Sixty-seven Latinx women in North Carolina farmworker families completed a baseline and five follow-up questionnaires in 2019 through 2021. Fifty-nine of the women were employed in the year prior to the Follow-Up 5 Questionnaire. These women experienced an abysmal organization of work and work safety culture. They experienced significant job churn, with most changing employment several times during the 18-month period. Most of their jobs were seasonal, paid less than $10.00 per hour, piece-rate, and almost all without benefits. The women's jobs had little skill variety (mean 1.5) or decision latitude (mean 1.1), but had high psychological demands (mean 2.0). Work safety climate was very low (mean 13.7), with 76.3% of women noting that their supervisors were "only interested in doing the job fast and cheaply" rather than safely. Women employed as farmworkers versus those in other jobs had few differences. Further research and intervention are needed on the organization of work and work safety culture of Latinx women manual workers.

Collective Occupational Trauma, Health Care Quality, and Trauma-Informed Leadership: Intersections and Implications.

Managing stress, burnout, and vicarious trauma is a long-standing issue for the health and behavioral health workforce, including those in case management. Yet, the recent novel coronavirus pandemic has amplified routine burnout to record levels. Practitioners and patients are amid a new dynamic of collective occupational trauma (COT). In this realm, health and behavioral health workers (HBWs) experience the same reality as their patients, families, and support systems; professional boundaries become blurred, leading to heightened levels of emotional vulnerability that can prompt the development of more pervasive psychopathology. This reality has put the Quadruple Aim in peril, with increased workforce turnover, staff shortages, costs, and quality challenges. This article: Applicable to all health and behavioral health settings where case management is practiced. Organizational cultures must shift from a "process and roll" mindset to one that is trauma-informed. Implementation of TIC has yielded successful outcomes for the workforce via enhanced patient engagement, treatment adherence, and successful outcomes. In tandem, TIC leadership and supervision models have had promising results and should be more readily utilized; they acknowledge and address workforce trauma while prioritizing staff health, mental health, and wellness. Failure to shift the culture will result in an ongoing exodus of practitioners, leaving insufficient numbers to render safe, cost-effective, efficient, and patient-centered care. The case management workforce comprises professional disciplines across health and behavioral health, employed in every setting. The expanding workforce presence has put them at risk of COT. Leadership strategies must shift to acknowledge workforce exposure to occupational trauma, address mental health and wellness, and address professional self-care. This shift is key to mitigating retention, sustainability, and quality challenges.

An Overview of Cleaning Agents' Health Hazards and Occupational Injuries and Diseases Attributed to Them in Sweden.

Using data from the Swedish Products Register, hosted by the Swedish Chemicals Agency (KemI), national occupational injury and disease statistics, and call records from the Swedish Poisons Information Centre (PIC) we characterize health hazards of marketed cleaning products and recorded injuries, disease, and incidents linked to cleaning or disinfection agents. The results show that cleaning agents pose many kinds of health hazards, although corrosion and irritation hazards dominate, in particular for the eyes (54% of all included products). Few products were recognized as inhalation hazards. The nature of the health hazards is reflected in the occupational disease and injury statistics and PIC records for eyes and skin but not for the respiratory tract. Among occupational disease cases attributed to cleaning or disinfection agents, 61% concern skin and 26% the respiratory tract. Among occupational injury cases 64% concern chemical burns. However, only a small part (<0.5%) of all reported diseases and injuries were explicitly attributed to cleaning or disinfection agents. On average, there were 11 cases of disease attributed to cleaning or disinfection agents per million workers and year. For occupational injuries the corresponding number was 8. The data concern a broad range of sectors and occupations, but notable sectors were healthcare, accommodation and food service, and manufacturing. Women were more likely to suffer from disease, men and women equally likely to suffer from injury. PIC cases were evenly distributed between men and women, but the clear risk cases more frequently involved men. Occupational diseases increased many-fold in 2020 while injuries decreased, which could be due to COVID-19 changing use patterns of cleaning and disinfection agents at work. We conclude that cleaning agents pose a variety of risks to a large part of the workforce, although particular attention for preventive efforts may need to be directed to the healthcare, accommodation and food service, and manufacturing sectors.

Occupational impact in COVID-19 pandemic according to one year of compensation claims in Italy.

OBJECTIVES: to evaluate the patterns of occupational COVID-19 cases, based on compensation claims applied to the Italian National Institute for Insurance against Accidents at Work (Inail). DESIGN: descriptive analyses of daily time series of compensation claims applications, geographical distributions, and occupations involved. Multivariate analyses have been performed for identifying significant epidemiological pattern. SETTING AND PARTICIPANTS: compensation claims for COVID-19 injuries received by Inail from March 2020 to February 2021 have been analysed. MAIN OUTCOME MEASURES: daily time series of compensation claims applications in the first year of pandemic and comparatively with population data, patterns of occupations majorly involved in time, territorial clusters. RESULTS: in the observed period, Inail has received 155,684 workers' compensation claims with a first peak (more than 1,000 daily compensation claims) in March 2020 and a second peak (more than 1,500) in November 2020. A time dependent geographical pattern was identified, with the Northern regions formerly affected in the first phase, followed by a diffusion in the Central and Southern regions during the summer period. Health technicians (32% and 42% in male and female, respectively) and physicians (15%and 6%) were the most involved workers. The timing of infection was found to depend by job, with physicians, nurses, and health technicians firstly involved with a spread of about 2 weeks with respect to other jobs. Trend in health workers' vaccination has been found in a clear inverse relationship with the decreasing number of compensation claims, remaining, since February 2021, under one hundred daily cases of occupational COVID-19 compensation claims. CONCLUSIONS: different intensities, timing, and characteristics were found among application claims, which address for different pandemic diffusion paths. Health workers are the firstly and most involved impacted by the pandemic. The use of application claims could be useful and effective in monitoring the occupational component of COVID-19 and his trend in time and space. There is a need to establish an epidemiological surveillance system that includes the assessment of work related risk, supporting the effectiveness of public insurance and welfare system, and to harmonize occupational data collection among countries.

Eye Health, COVID-19, and the Occupational Health Professional: Round Table.

BACKGROUND: Eye health has garnered increased attention since the COVID-19 pandemic. This Round Table explored the impact mask wearing, delays in eye examinations, and increased screen time have on vision and ultimately the worker. METHODS: Leading experts in the areas of occupational health, risk management, eye health, and communication were identified and invited to participate in a Round Table discussion. Questions posed to experts were based on literature that addressed eye health, such as mask wearing, communication and managing expectations when accessing professional eye health appointments, and increased screen time. FINDINGS: Experts agreed that eye health considerations must be in place. These considerations should address not only clinical care of the patient but ways to protect workers from occupational injury associated with the eye. CONCLUSION/APPLICATION TO PRACTICE: The occupational health professional is a key resource for assessment and training that pertains to eye health.

Injury epidemiology in professional ballet: a five-season prospective study of 1596 medical attention injuries and 543 time-loss injuries.

OBJECTIVES: To describe the incidence rate, severity, burden and aetiology of medical attention and time-loss injuries across five consecutive seasons at a professional ballet company. METHODS: Medical attention injuries, time-loss injuries and dance exposure hours of 123 professional ballet dancers (women: n=66, age: 28.0±8.3 years; men: n=57, age: 27.9±8.5 years) were prospectively recorded between the 2015/2016 and 2019/2020 seasons. RESULTS: The incidence rate (per 1000 hours) of medical attention injury was 3.9 (95% CI 3.3 to 4.4) for women and 3.1 (95% CI 2.6 to 3.5) for men. The incidence rate (per 1000 hours) of time-loss injury was 1.2 (95% CI 1.0 to 1.5) for women and 1.1 (95% CI 0.9 to 1.3) for men. First Soloists and Principals experienced between 2.0-2.2 additional medical attention injuries per 1000 hours and 0.9-1.1 additional time-loss injuries per 1000 hours compared with Apprentices (p≤0.025). Further, intraseason differences were observed in medical attention, but not time-loss, injury incidence rates with the highest incidence rates in early (August and September) and late (June) season months. Thirty-five per cent of time-loss injuries resulted in over 28 days of modified dance training. A greater percentage of time-loss injuries were classified as overuse (women: 50%; men: 51%) compared with traumatic (women: 40%; men: 41%). CONCLUSION: This is the first study to report the incidence rate of medical attention and time-loss injuries in professional ballet dancers. Incidence rates differed across company ranks and months, which may inform targeted injury prevention strategies.

Prevention and occupational hazards for the skin during COVID-19 pandemic.

The life of medical specialists worldwide has dramatically changed due to the spread of the coronavirus disease 2019 (COVID-19) pandemic. Health care professionals (HCPs) have personally faced the outbreak by being on the first line of the battlefield with the disease and, as such, compose a significant number of people who have contracted COVID-19. We propose a classification and discuss the pathophysiology, clinical findings, and treatments and prevention of the occupational skin hazards COVID-19 poses to HCPs. The multivariate pattern of occupational skin diseases during the COVID-19 pandemic can be classified into four subgroups: mechanical skin injury, moisture-associated skin damage, contact reactions, and exacerbation of preexisting dermatoses. The clinical pattern is versatile, and the most affected skin sites were the ones in contact with the protective equipment. Dermatologists should recognize the plethora of HCPs' occupational skin reactions that are occurring during the COVID-19 pandemic and implement treatment and preventive strategies.

Medical Device-Related Pressure Injury to the Ear from a Mask.

ABSTRACT: Mask wearing is now ubiquitous because of the COVID-19 pandemic and has given rise to medical device-related pressure injuries in persons at risk of skin breakdown. The ear has unique anatomy that is particularly susceptible to injury from pressure. In this time of mandatory personal protective equipment requirements in healthcare facilities, protection and assessment of skin in the vulnerable postauricular area are needed. This article presents a case report of a pressure injury on the ear, reviews the anatomy of the ear, and provides strategies for assessment and treatment of pressure injuries in this often overlooked anatomic region.

Association Between Skin Injuries in Medical Staff and Protective Masks Combined with Goggles During the COVID-19 Pandemic.

OBJECTIVE: To explore the relationship between wearing protective masks and goggles and skin injuries in medical staff during the COVID-19 pandemic. METHODS: Researchers conducted a cross-sectional, multicenter online survey. Respondents voluntarily completed the questionnaire on their smartphones. Ordinal and multinomial logistic regressions were used to identify factors related to skin injuries. RESULTS: In total, 1,611 respondents wore protective masks combined with goggles in 145 hospitals in China; 1,281 skin injuries were reported (overall prevalence, 79.5%). Multiple concomitant skin injuries (68.5%) and injuries in four anatomic locations (24.0%) were the most common, followed by injuries in three (22.8%), two (21.7%), and one location (11.0%). Multinomial logistic regression indicated that sweating increased the risk of injuries in one to four anatomic locations (95% confidence interval for odds ratio 16.23-60.02 for one location and 38.22-239.04 for four locations), and wearing an N95 mask combined with goggles and a daily use longer than 4 hours increased the risk of injuries in four locations (95% confidence interval for odds ratio 1.18-5.31 and 1.14-3.93, respectively). CONCLUSIONS: The prevalence of skin injuries among medical staff wearing protective masks combined with goggles was very high. These were mainly device-related pressure injuries, moisture-associated skin damage, and skin tears. The combination of various factors resulted in skin injuries at multiple sites. Preventing and managing sweating should be a focus for medical staff who wear protective masks combined with goggles for more than 4 hours.

Personal Protective Equipment in COVID-19: Impacts on Health Performance, Work-Related Injuries, and Measures for Prevention.

OBJECTIVE: To assess impact of personal protective equipment (PPE) on healthcare providers (HCPs) in caring for COVID-19 patients. METHODS: A cross-sectional survey was conducted over 50 hospitals in China. Descriptive analyses and Chi-square tests were performed on the collected data. RESULTS: All 104 frontline HCPs report negative impacts of PPE on their clinical performance, 97% of them experienced discomfort and injuries caused by wearing PPE for long hours. Frontline HCPs provided suggestions to alleviate the negative impacts and to enhance communication between healthcare staff and patients. Two hundred eighty two non-frontline HCPs also revealed similar problems; however, we recorded a few discrepancies between answers given by frontline and non-frontline HCPs. CONCLUSIONS: Wearing PPE for long hours degrades health performance. Measures were suggested to improve the design of PPE for protecting HCPs and enhancing their services to COVID patients.

Finding the Edges of Problems: Social Media as an Exploratory Research Tool.

Social media use in public health and other health related research applications has seen a rapid increase in recent years. However, there has been very limited utilization of this growing digital sector in agricultural injury research. Social media offers immense potential in gathering informal data, both text and images, converting them into knowledge, which can open up avenues for research, policy, and practice. There are a number of ways social media data can be utilized in agricultural injury research. This paper touches on the adoption of these data sources in health research and discusses the use of social media as an exploratory research tool that can peer into and identify the edges of potential health and safety problems.

Facial pressure injuries and the COVID-19 pandemic: skin protection care to enhance staff safety in an acute hospital setting.

OBJECTIVES: The aim of this study was to determine the impact of a specially designed care bundle on the development of facial pressure injuries (PI) among frontline healthcare workers wearing personal protective equipment (PPE) during the COVID-19 pandemic. The primary outcome of interest was the incidence of facial PIs. The secondary outcomes of interest were facial pain while wearing PPE and ease of use of the care bundle. METHODS: This study used a voluntary survey by questionnaire, supplemented by a qualitative analysis of interviews from a small purposive sample that took place in one large Irish hospital over a two-month period in 2020. The hospital was a city-based public university teaching hospital with 800 inpatient beds. The intervention was a care bundle consisting of skin protection, face mask selection, material use, skin inspection, cleansing and hydration developed in line with international best practice guidelines. All staff working in COVID-19 wards, intensive care units and the emergency department in the hospital were given a kitbag containing the elements of the care bundle plus an information pamphlet. Data were collected via a survey and interviews. RESULTS: A total of 114 staff provided feedback on the use of the care bundle. Before using the care bundle 29% (n=33) of the respondents reported developing a facial PI, whereas after using the care bundle only 8% (n=9) of the respondents reported developing a facial PI. The odds ratio (OR) of skin injury development was 4.75 (95% confidence interval (CI): 2.15-10.49; p=0.0001), suggesting that after the care bundle was issued, those who responded to the survey were almost five times less likely to develop a skin injury. Interviews with 14 staff determined that the bundle was easy to use and safe. CONCLUSION: Among those who responded to the survey, the use of the bundle was associated with a reduction in the incidence of skin injury from 29% to 8%, and respondents found the bundle easy to use, safe and effective. As with evidence from the international literature, this study has identified that when skincare is prioritised, and a systematic preventative care bundle approach is adopted, there are clear benefits for the individuals involved.

Association between N95 respirator wearing and device-related pressure injury in the fight against COVID-19: a multicentre cross-sectional survey in China.

OBJECTIVES: To explore the association between N95 respirator wearing and device-related pressure injury (DRPI) and to provide a basis for protecting medical staff from skin injuries. DESIGN: A cross-sectional, multicentre study. SETTING AND PARTICIPANTS: Medical staff of 60 hospitals were selected from 145 designated medical institutions located in the epidemic area where the patients with COVID-19 were treated in China. RESULTS: In total, 1761 respondents wore N95 respirators (use alone 20.8%; combination use 79.2%), and the prevalence of DRPI was 59.2% (95% CI 56.93 to 61.53). A daily wearing time of >4 hours (OR 1.62, 95% CI 1.11 to 2.35), wearing a N95 respirator in combination with goggles both with the presence of sweating (OR 13.40, 95% CI 7.34 to 23.16) and without the presence of sweating (OR 0.80, 95% CI 0.56 to 1.14) and wearing only a N95 respirator with the presence of sweating (OR 9.60, 95% CI 7.00 to 13.16) were associated with DRPI. A correspondence analysis indicated that if there was no sweating, regardless of whether the N95 respirator was worn by itself or in combination with goggles, single-site DRPI mainly occurred on the nose bridge, cheek and auricle. If there was sweating present, regardless of whether the N95 was worn by itself or in combination with goggles, multiple DRPI sites occurred more often on the face. CONCLUSIONS: The prevalence of DRPI among medical staff caused by N95 respirators was very high, which was mainly associated with a longer daily wearing time and interaction with sweating. The nasal bridge, cheeks and auricles were the primary protection locations found.

Taking care of healthcare workers during COVID-19 pandemic: does plastic surgery have a role?

BACKGROUND: The massive use of personal protective equipment is required by the medical and paramedical staff of the COVID-19 dedicated departments. This often causes painful pressure injuries. The aim of this study is to value the use of anesthetic cream and collagen veil masks for the treatment of pain. We also evaluated the possible psychological impact on healthcare workers involved in the emergency, which is currently a hot topic in the worldwide literature. MATERIALS AND METHODS: We applied lidocaine idrochloride 5% cream and a collagen veil mask respectively  before and after each work shift. We evaluated the improvement of pain symptoms through VAS assessments. We used a modified Maslach burnout inventory as well to evaluate the psychological impact of our treatments on  healthcare workers. RESULTS: A significant reduction of pain was detected within the first 3 days, but this was not significant over the long period (10 days). Otherwise, we saw a significant improvement of the psychological assessment (p<0,05). CONCLUSIONS: Parameters such as pain or psychological stress are not objective, but, anyway, our data show a  reduction of pain due to continuative PPE wearing and a significant improvement of psychological wellness of healthcare workers from two different countries, a finding which should not be undervalued by all the health caregivers not directly involved in COVID-19 pandemic.