Temperature Screening of Healthcare Personnel Is Ineffective in Controlling COVID-19.

OBJECTIVE: Our aim was to describe the effectiveness of employee temperature screening at a public hospital in San Francisco during the COVID-19 pandemic. METHODS: An estimated 6000 health care personnel (HCP) underwent daily screening before entry to campus. Logs of failed employee entrance temperature screenings from March 2020 through March 2021 were reviewed. RESULTS: From March 2020 through March 2021, only one employee, who reported no symptom that could bar their entry to work, had an elevated temperature on screening. On re-check with an oral thermometer, that individual's temperature was normal. CONCLUSIONS: While the rationale to continue temperature screening may be rooted in beliefs it will increase employee reporting of symptoms or exposures, our results indicates that such screening of HCP at large US hospitals has no utility in detecting COVID-19 or controlling its transmission.

Incidence and Characteristics of Delayed Injection Site Reaction to the mRNA-1273 Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Vaccine (Moderna) in a Cohort of Hospital Employees.

BACKGROUND: mRNA SARS-CoV-2 vaccines are administered to 2 million individuals per day in the United States under US Food and Drug Administration emergency use authorization. METHODS: Observational cohort study of hospital employees who received their first SARS-CoV-2 mRNA vaccination between 14 December 2020 and 8 January 2021, including employees who reported onset of an injection site reaction ≥48 hours after administration of their first or second dose to an employee hotline. RESULTS: Thirteen female employees who received the mRNA-1273 vaccine (Moderna) during the first 3 weeks of the SARS-CoV-2 vaccine rollout at San Francisco General Hospital reported a pruritic rash at the injection site appearing 3 -9 days after receipt of their initial dose. Five had milder or similar reactions with earlier onset after the second dose. One additional female employee reported this delayed reaction only after the second dose. None reported serious adverse events or had symptoms severe enough to seek medical attention. These cases represented 1.1% of the 1275 female employees who received their first mRNA-1273 dose and 2.0% of the 557 who were aged 31 -45 years during this initial vaccine rollout. None of 675 males who initiated mRNA-1273 or 3612 employees of any sex who initiated BNT162b (Pfizer) vaccination during this period reported delayed-onset reactions. CONCLUSIONS: These results suggest that delayed-onset, injection site pruritic rashes after mRNA-1273 SARS-CoV-2 vaccine administration, lasting up to 1 week, occur commonly in females, do not lead to serious sequela, and should not deter receipt of the second vaccine dose.

The Heat Death Line: Proposed Heat Index Alert Threshold for Preventing Heat-Related Fatalities in the Civilian Workforce.

A threshold Heat Index (HI) can serve as the basis for advising the civilian workforce about the risk of heat-related illnesses. We conducted a systematic review and compiled reports of work-related fatalities from heat-related illnesses. We calculated the HI for each fatality. Our objective was to expand upon the military's concept of a "heat death line" and identify an HI alert threshold for the civilian workforce. We identified 14 publications totaling 570 heat-related deaths. In the meta-analysis, the median HI was 101 with a range of 62 to 137. Almost all deaths (96 percent and 99 percent of civilian and military fatalities, respectively) occurred when HI ≥80, which is our proposed heat death line. Some existing HI-based heat advisories are set at a higher temperature value. However, many occupational heat-related illnesses occur below these thresholds, resulting in low sensitivity and a false sense of security. In at-risk outdoor industries, HI ≥80 should trigger hazard awareness and protective actions.

Work related injuries in Qatar: a framework for prevention and control.

Work related injuries (WRIs) are a growing public health concern that remains under-recognized, inadequately addressed and largely unmeasured in low and middle-income countries (LMIC's). However, even in high-income countries, such as those in Gulf Cooperating Council (GCC) like Qatar, there are challenges in assuring the health and safety of its labor population. Countries in the GCC have been rapidly developing as a result of the economic boom from the petrochemical industry during the early seventies. Economic prosperity has propelled the migration of workers from less developed countries to make up for the human resource deficiency to develop its infrastructure, service and hospitality industries. Although these countries have gradually made huge gains in health, economy and human development index, including improvements in life expectancy, education, and standard of living, there remains a high incidence of work-related injuries especially in jobs in the construction and petrochemical sector. Currently, there is scarcity of literature on work-related injuries, especially empirical studies documenting the burden, characteristics and risk factors of work injuries and the work injured population, which includes large numbers of migrant workers in many GCC countries. This paper will focus on the current understanding of WRIs in those countries and identify the gaps in current approaches to workplace injury prevention, outlining current status of WRI prevention efforts in Qatar, and propose a framework of concerted action by multi-sectoral engagement.

Using the CDC Worksite Health ScoreCard to Assess Employer Health Promotion Efforts: A Case Study at Johns Hopkins Medicine.

OBJECTIVES: The aim of this study was to determine whether the Centers for Disease Control and Prevention Worksite Health ScoreCard (ScoreCard) is an effective vehicle for measuring workplace health promotion programs and causing change in a large employer with multiple entities defined by different physical environments and types of workers. METHODS: Johns Hopkins Medicine (JHM) representatives completed a baseline ScoreCard for each of their entities. In the subsequent year, improvement of the ScoreCard was tied to leadership performance evaluation. JHM year over year scores were analyzed, along with comparisons to national benchmarks. RESULTS: Eleven of the 12 JHM entities improved their overall score from year one to year two and the JHM enterprise surpassed national benchmarks in year two. CONCLUSION: Organizations can use the ScoreCard as an effective measurement tool and as a method to improve the number of evidenced-based health promotion strategies provided to their employees.

Incidence of non-tunnelled central venous catheter-related infections in oncologic patients receiving chemotherapy in an outpatient setting.

INTRODUCTION: Central venous catheters (CVCs) are becoming more popular for delivery of outpatient courses of intravenous therapy such as chemotherapy and long-term antibiotics. The incidence of non-tunnelled type CVC-related infections in patients with solid tumours receiving chemotherapy in an ambulatory setting has not been well studied. We aimed to determine the baseline data on CVC-related infections in this retrospective study conducted from January 2005 to December 2007. METHODS: Data on cancer patients with CVCs inserted as outpatients at National Cancer Centre Singapore over a three-year period were collected and analysed retrospectively. Data retrieved from medical records included patients' demographics, the number of catheter days, cancer type and other medical illnesses. Definitions from the Centre for Disease Control and Prevention for CVC-related infections were used. For data analysis, graphical and quantitative techniques were employed. RESULTS: A total of 88 CVCs were inserted during the study period, with a total of 11,541 catheter days (median 114; range 2-510 days). Infection rate was 0.87 per 1,000 catheter days. The risk of infection was higher when catheters were left in situ for longer periods of time and in patients with solid tumours. CONCLUSION: The infection rate for non-tunnelled type CVCs is low in our centre. Hence, its use for chemotherapy on an outpatient basis is relatively safe and convenient in oncologic patients.

A Drosophila model for alcohol reward.

The rewarding properties of drugs contribute to the development of abuse and addiction. We developed a new assay for investigating the motivational properties of ethanol in the genetically tractable model Drosophila melanogaster. Flies learned to associate cues with ethanol intoxication and, although transiently aversive, the experience led to a long-lasting attraction for the ethanol-paired cue, implying that intoxication is rewarding. Temporally blocking transmission in dopaminergic neurons revealed that flies require activation of these neurons to express, but not develop, conditioned preference for ethanol-associated cues. Moreover, flies acquired, consolidated and retrieved these rewarding memories using distinct sets of neurons in the mushroom body. Finally, mutations in scabrous, encoding a fibrinogen-related peptide that regulates Notch signaling, disrupted the formation of memories for ethanol reward. Our results thus establish that Drosophila can be useful for understanding the molecular, genetic and neural mechanisms underling the rewarding properties of ethanol.