TElewoRk-RelAted Stress (TERRA), Psychological and Physical Strain of Working From Home During the COVID-19 Pandemic: A Systematic Review.

BACKGROUND: Many workers shifted to working from home due to the COVID-19 pandemic. This review aims to investigate if this sudden change caused an increase in TElewoRk-RelAted stress (TERRA) which is defined as physical and mental stress caused by telework. METHODS: A systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was performed of three scientific databases (PubMed, ISI Web of Knowledge, and Scopus), which also included a quality assessment. Articles measuring stress, psychological or physical, in remote workers, published from December 2019 through August 2021 were included in the review. Results were extracted by reporting: authors, country, study design, type of workers, sample, questionnaires and measurements, and outcomes. Data were synthesized quantitatively for country, type of workers, and outcomes. RESULTS: Out of the 518 articles found in the three databases, 19 articles were included in the systematic review (10,012 participants overall), and 78.9% of these highlighted an increase in TERRA levels in remote workers. Among 85.7% of the studies considering gender as a variable, TERRA levels were higher in female workers. Twelve (63.2%) of the studies investigated psychological well-being, two (10.5%) focused on the physical well-being of remote workers, three (15.8%) investigated both, and two studies had other outcomes (10.5%). CONCLUSIONS: Considering the redefinition of workplaces dictated by the COVID-19 pandemic, this review highlights the emerging issue of remote work and the use of technology in working from home, emphasizing a rapidly growing occupational health problem. Remote workers need to be provided with emotional and technical support to prevent TERRA in remote workers.

Alcohol Consumption in the Workplace: A Comparison between European Union Countries' Policies.

BACKGROUND: Alcohol use is an ever-growing phenomenon in the population, consumption data indicate that 5-20% of the European working population have serious problems related to alcohol. The use of alcohol constitutes a risk to the health and safety of workers as well as to the safety of the general population. The present work aims to address the problem of alcohol intake in occupational settings by comparatively analyzing alcohol consumption behavior within the 27 countries of the European Union. METHODS: The purpose of this research is to analyze the differences between the 27 countries of the European Union in the application of measures to assess and manage the risk of alcohol intake in occupational settings. RESULTS: An examination of the legislation and guidelines of the different countries reveals profound differences in the management of the problem of alcohol in the workplace. The discrepancy is very wide that it ranges from the complete absence of legislative restrictions on a national level in some countries to highly restrictive measures with severe sanctions in others. CONCLUSIONS: It would be appropriate-also for the purpose of ease of movement of workers within the European Community-to find shared management models useful for protecting the health and safety of workers and the general population.

Employee Participation in Workplace Vaccination Campaigns: A Systematic Review and Meta-Analysis.

To reduce vaccine-preventable diseases in workers, workplace vaccination campaigns can be implemented on-site. The aim of this systematic review was to evaluate adherence to workplace vaccination campaigns. Three databases, PubMed, ISI Web of Science, and Scopus, were screened systematically for articles in English or Italian addressing participation in an on-site vaccination program by employees. The following data was extracted: authors, year, country, type of vaccine, type of workplace, sample size, vaccination rate. Data on the prevalence of flu vaccination were calculated and pooled using a random-effects model. Thirteen articles were included in the review, ten in the meta-analysis. Most studies were conducted in the USA (30.7%) and most vaccination campaigns were against influenza (69.2%), with a pooled estimate of 42% (95% CI: 0.25-0.60%); participation rate was highly variable, ranging from 88.9% for an influenza vaccination campaign to 5.7% for a Lyme disease vaccination campaign. Offering free on-site vaccination can be a successful tool to ensure adherence to vaccination campaigns and administration of all required doses according to the vaccine administration scheme. The occupational physician can play a key role in implementing workplace campaigns for employee mandatory vaccinations.

COVID-19 Vaccination and Medical Liability: An International Perspective in 18 Countries.

The COVID-19 vaccination has proven to be the most effective prevention measure, reducing deaths and hospitalizations and allowing, in combination with non-pharmacological interventions, the pandemic to be tackled. Although most of the adverse reactions to vaccination present mild symptoms and serious effects are very rare, they can be the cause of legal action against the healthcare workers (HCWs) who administered it. To highlight differences in the medical liability systems, we performed a search for the three most populous countries in each continent on vaccine injury compensation programs, new laws or policies to protect HCWs administering vaccinations introduced during the COVID-19 pandemic, and policies on mandatory vaccinations, on literature databases and institutional sites. We found that in seven countries the medical liability system is based on Common Law, while in eleven it is mainly based on Civil Law. Considering the application of specific laws to protect HCWs who vaccinate during the pandemic, only the USA and Canada provided immunity from liability. Among the countries we analyzed, fourteen have adopted compensation funds. From an international perspective, our results highlight that in eleven (61.1%) countries medical liability is mainly based on Civil Law, whilst in seven (38.9%) it is based on Common Law.

Returning to work and the impact of post COVID-19 condition: A systematic review.

BACKGROUND: The COVID-19 pandemic is still ongoing, with rapidly increasing cases all over the world, and the emerging issue of post COVID-19 (or Long COVID-19) condition is impacting the occupational world. OBJECTIVE: The aim of this systematic review was to evaluate the impact of lasting COVID-19 symptoms or disability on the working population upon their return to employment. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statements we performed a systematic review in December 2021, screening three databases (PubMed, ISI Web of Knowledge, Scopus), for articles investigating return to work in patients that were previously hospitalized due to COVID-19. A hand-searched was then performed through the references of the included systematic review. A quality assessment was performed on the included studies. RESULTS: Out of the 263 articles found through the initial search, 11 studies were included in this systematic review. The selected studies were divided based on follow-up time, in two months follow-up, follow-up between two and six months, and six months follow-up. All the studies highlighted an important impact of post COVID-19 condition in returning to work after being hospitalized, with differences based on follow-up time, home Country and mean/median age of the sample considered. CONCLUSIONS: This review highlighted post COVID-19 condition as a rising problem in occupational medicine, with consequences on workers' quality of life and productivity. The role of occupational physicians could be essential in applying limitations to work duties or hours and facilitating the return to employment in workers with a post COVID-19 condition.

Medical Liability of the Vaccinating Doctor: Comparing Policies in European Union Countries during the COVID-19 Pandemic.

In 2020, the COVID-19 pandemic exhausted healthcare systems around the world, including European Union countries, with healthcare workers at the frontline. Therefore, new health laws and policies have been introduced at the national level in order to offer greater legal protection for health workers. Since the introduction of COVID-19 vaccination, it has led to the development of specific laws to define the compulsoriness for particular categories. This review aimed to evaluate the system of medical liability, focusing on the ten countries of the European Union with the highest rate of vaccination coverage against SARS-CoV-2. A country-by-country analysis was conducted on the different medical liability systems of individual professionals, in general, and with specific focus on the vaccinating doctors. Additional search was conducted to investigate which European states have introduced specific policies in this field, to identify the implementation of any new laws alongside the COVID-19 vaccination campaigns, and to assess which countries have adopted the European Digital COVID Certificate and funded specific compensation programs for COVID-19 vaccination. Our results highlight an extremely fragmented European scenario; therefore, this work could be a starting point to define a common approach for medical liability and related policies in the COVID-19 pandemic.

Public Health Regulations and Policies Dealing with Preparedness and Emergency Management: The Experience of the COVID-19 Pandemic in Italy.

Worldwide, the management of health emergencies requires a high degree of preparedness and resilience on the part of governments and health systems. Indeed, disasters are becoming increasingly common, with significant health, social, and economic impacts. Living in a globalized world also means that emergencies that occur in one country often have an international, in some cases global, spread: the COVID-19 pandemic is a cogent example. The key elements in emergency management are central governance, coordination, investment of resources before the emergency occurs, and preparedness to deal with it at all levels. However, several factors might condition the response to the emergency, highlighting, as for Italy, strengths and weaknesses. In this context, policies and regulation of actions to be implemented at international and national level must be up-to-date, clear, transparent and, above all, feasible and implementable. Likewise, the allocation of resources to develop adequate preparedness plans is critical. Due to COVID-19 pandemic, the European Commission proposed the temporary recovery instrument NextGenerationEU, as well as a targeted reinforcement of the European Union's long-term budget for the period 2021-2027. The pandemic highlighted that it is necessary to interrupt the continuous defunding of the health sector, allocating funds especially in prevention, training and information activities: indeed, a greater and more aware public attention on health risks and on the impacts of emergencies can help to promote virtuous changes, sharing contents and information that act as a guide for the population.

[Legal resposability of vaccinating doctor]. / Responsabilità medico-legale del medico vaccinatore.

SUMMARY: The legal responsibility of the vaccinating doctor is one of the central issues in the current setting of the Covid-19 pandemic. The aim of this statement is to outline the profiles of the medical legal liability, with a focus on the figure of the vaccinating physician, in criminal, civil, and disciplinary terms, based on the Italian legislation in force. The vaccinating doctor responds for his work in the field of vaccination in the same way as any other health service should perform (diagnostic, therapeutic, etc.). Helpful in this context is the adoption of the L. 76/2021; it was developed to find a balance between safeguarding the person privacy and greater guarantees for the doctor. This law introduces a criminal shield that can put a limit to litigation, curbing the phenomenon of so-called defensive medicine. The climate of uncertainty and fear of legal repercussions for the doctors, and the constant updating and redefinition of the indications of operability in the vaccination campaigns, underline the need to focus on the knowledge of the responsibilities and the safeguard of the vaccinating doctors. In addition to the regulatory cornerstones, the statement also addresses the issue of informed consent and the role of the occupational doctor as a central figure in the vaccination campaign in the workplace.

The Dermatological Effects and Occupational Impacts of Personal Protective Equipment on a Large Sample of Healthcare Workers During the COVID-19 Pandemic.

INTRODUCTION: Working during the Sars-CoV-2 pandemic healthcare workers (HCWs) had to wear Personal Protective Equipment (PPEs) for extended periods of time, leading to an increase in dermatological reactions. The study evaluates the prevalence of adverse skin reactions to PPEs among Italian healthcare workers during the COVID-19 pandemic, and aims to determine whether prolonged PPEs usage poses a significant occupational health risk, by measuring the loss of work days and the eligibility of workers that requested health surveillance due to dermatological PPEs reactions. MATERIALS AND METHODS: An online ad hoc questionnaire was administered to a sample of Italian HCWs. Questions verted on sociodemographic characteristics, PPEs usage, and occupational well-being. Descriptive analyses and logistic regressions were performed to explore possible associations between variables. RESULTS: Two types of PPEs, Gloves and Masks, were tested. The sample included 1,223 interviewed HCWs, 1,184 gave their consent for participation. A total of 90 medical surveillance visits were requested due to PPEs related dermatological issues: in 30 cases were recognized limitations in working duties and in one case the worker was deemed not fit to keep working. Furthermore, 25 workers had a loss of occupational days due to dermatological issues. A statistically significant correlation was observed with being a nurse or midwife (OR = 1.91, IC = 1.38-2.63, p < 0.001), and being female (OR = 2.04, IC = 1.49-2.78, p < 0.001), which acted as risk factors. DISCUSSION: The enhanced protection measures put in place during the COVID-19 pandemic, highlight the importance of occupational dermatology. This study could contribute to assess the issue, aiming to develop better prevention strategies in the workplace in order to improve well-being of HCWs and reduce the impact of dermatological adverse reactions to PPEs.

Atypical koebner phenomenon on a tattoo.

Tattooing is more and more popular in developed countries in recent years and many side effects are associated with this practice, including psoriatic lesions and Koebner phenomenon. We report the case of a lichenoid reaction to red pigment in a patient affected by psoriasis.

Feasibility of home exercises to enhance the benefits of tango dancing in people with Parkinson's disease.

BACKGROUND: A style of dance called tango translates clinical practice into a new philosophy and rehabilitative approach for individuals with Parkinson's disease (PD). The style of dance mixes music, self-generated and external cued strategies and social and emotional recovery. In recent years, there has been an increase in the number of studies reporting health benefits for people diagnosed with PD who dance tango. However, there are some organisational limitations to people participating in dance classes, including having trained Tango teachers, an appropriate space for dancing, and schedule that allows for participants with motor inabilities. METHODS: This pilot study involved the observation of PD patients who completed four days of home exercise plus a tango dance lesson each week for five weeks. RESULTS: Ten PD patients improved their quality of life, their motor score on the Unified Parkinson's Disease Rating Scale and their kinematic performances. CONCLUSIONS: We propose a protocol of exercises that has been derived from the tango dance and that can be performed in a patient's home.