Underreporting of Work-Related COVID-19 Cases in Norway.

Background: This register-based study provides a profile of work-related Covid-19 cases reported by physicians to the Norwegian Labor Inspection Authority (NLIA). Methods: All the reports of work-related Covid-19 cases reported by a physician to the NLIAs Registry for Work-Related Diseases (RAS) between February 2020 and February 2022 were included. Descriptive statistics and the incidence rate of reported cases were computed for age, gender, and occupation. Results: Two hundred and seventeen work-related Covid-19 cases were reported to RAS during the study period. Sixty-five percent of the cases were females (n = 141), and 35 percent (n = 76) were males. Doctors, nurses, and ambulance personnel yielded higher incidence rates than other healthcare and nonhealthcare occupations. Conclusions: This study indicates that women aged 25-39 and employed in the healthcare sector had the highest reported incidence and number of work-related Covid-19 cases. Physician underreporting of work-related Covid-19 cases is an important finding. Plausibly, underreporting is more substantial for at-risk non-healthcare occupations such as waiters, bartenders, food couriers, and taxi drivers than occupations in healthcare.

Lessons learned from the COVID-19 pandemic-what Occupational Safety and Health can bring to Public Health.

We strive to increase public (PH) and occupational health (OSH) inter-linkages by building a collaborative framework. Besides Covid-19 pandemic, recent approaches such as Human Exposome and Total Worker Health TM, have led to a shift to improving health of working population and consequently the total population. These health objectives can be best realised through primary care actors in specific contexts. Work, school, home and leisure are the four multi-stakeholder contexts in which health and healthcare (goal-oriented care) objectives needs to be set and defined. PH policy makers need to establish a shared decision-making process involving employees, employers and OSH representatives to set PH goals and align with OSH goals. The policy making process in OSH can serve as a potential way forward, as the decisions and policies are being decided centrally in consultation with social partners and governments. This process can then be mirrored on company level to adopt and implement.

Physician Notified Work-Related Diseases Among Farmers in Norway: Data from 2007 - 2016.

Introduction: This study provided a profile of work-related diseases in the farming sector notified by physicians to the Norwegian Labor Inspection Authority's (NLIA) Registry for Work-Related Diseases (RAS) over a 10-year period.Methods: Data for the occupational code "farmers" were extracted from RAS for the period 2007-2016. We performed a descriptive analysis to obtain frequency, percentage, and incidence distribution of the data. We also explored the relationship of the notified diagnosis with gender, age, occupational exposures and the type of reporting physicians.Results: Four hundred and sixty-nine cases of work-related diseases among farmers were notified in the period 2007-2016. Eighty-seven percent of the reported cases were males. The incidence of work-related diseases for the entire study period was computed to be 114/100 000 workers. The incidence and number of cases notified were highest among males and for the age group 55-74 years. Noise was the most frequently reported occupational exposure accounted for 291 cases. Hearing loss constituted for 62% of the notified cases, followed by respiratory diseases that accounted for 20% of the cases. Forty-eight cases of skin diseases, while only a few cases of musculoskeletal (n = 7) and mental disorders (n = 1) were notified. There was a strong association (λ = 0.51) between occupational exposure and notified diagnosis, and a moderate association (λ = 0.32) between type of reporting physician and the notified diagnosis.Conclusion: This profile of the physician notified work-related diseases among farmers in Norway yielded a suppressed estimate of the actual incidence of cases. The biased distribution of nature and number of work-related diseases amongst farmers is primarily attributed to the significant undercount of cases. Physician underreporting of cases to the NLIA coupled with lack of Occupational Health Services coverage of workers in the farming sector contributes to this undercount of cases.

Trends in incidence of occupational asthma, contact dermatitis, noise-induced hearing loss, carpal tunnel syndrome and upper limb musculoskeletal disorders in European countries from 2000 to 2012.

OBJECTIVES: The European Union (EU) strategy for health and safety at work underlines the need to reduce the incidence of occupational diseases (OD), but European statistics to evaluate this common goal are scarce. We aim to estimate and compare changes in incidence over time for occupational asthma, contact dermatitis, noise-induced hearing loss (NIHL), carpal tunnel syndrome (CTS) and upper limb musculoskeletal disorders across 10 European countries. METHODS: OD surveillance systems that potentially reflected nationally representative trends in incidence within Belgium, the Czech Republic, Finland, France, Italy, the Netherlands, Norway, Spain, Switzerland and the UK provided data. Case counts were analysed using a negative binomial regression model with year as the main covariate. Many systems collected data from networks of 'centres', requiring the use of a multilevel negative binomial model. Some models made allowance for changes in compensation or reporting rules. RESULTS: Reports of contact dermatitis and asthma, conditions with shorter time between exposure to causal substances and OD, were consistently declining with only a few exceptions. For OD with physical causal exposures there was more variation between countries. Reported NIHL was increasing in Belgium, Spain, Switzerland and the Netherlands and decreasing elsewhere. Trends in CTS and upper limb musculoskeletal disorders varied widely within and between countries. CONCLUSIONS: This is the first direct comparison of trends in OD within Europe and is consistent with a positive impact of European initiatives addressing exposures relevant to asthma and contact dermatitis. Taking a more flexible approach allowed comparisons of surveillance data between and within countries without harmonisation of data collection methods.

Doctors' reports of work-related hearing loss.

BACKGROUND: Noise-induced hearing loss is the diagnosis that is most frequently reported to the Norwegian Labour Inspection Authority. The objective of this study was to describe the doctors' reports on noise-induced hearing loss and assess the quality of the information. MATERIAL AND METHOD: The study is based on reports to the Labour Inspection Authority for the years 2005-09. We grouped the reporting incidence according to industry, gender and age on the basis of Statistics Norway's employment statistics. The reports were compared to data from Statistics Norway's living conditions survey from 2009. RESULTS: A total of 7,888 reports had been submitted in the study period (2005-2009), 96% of which concerned men. The annual reporting incidence amounted to 66 per 100,000 employees; six and 120 for women and men respectively. The reporting incidence was highest in the age group 55-74 years and for the construction and manufacturing industries. Altogether 52% of the reports pertained to employees who were no longer working in the enterprise where they had been exposed to noise. The proportion of reports pertaining to employees aged under 40 years was lower than the corresponding proportion of those who reported work-related hearing loss in Statistics Norway's living conditions survey from 2009. Occupational health physicians submitted 85% of the reports. INTERPRETATION: Of those exposed to noise, only a small proportion of women, younger employees and employees in enterprises with no access to occupational health services are captured by the reporting system. The same may apply to employees in industries such as transport and retail trade, but this will require further investigation.

Estimating work-related amputations in the Norwegian manufacturing sector: a 10-year retrospective study based on two-source capture-recapture method.

BACKGROUND: Work-related amputations are serious yet preventable injuries. Workers in the manufacturing sector in particular are vulnerable to amputation injuries compared to workers in other sectors. METHODS: In this study, we used a two-source capture recapture method to estimate the true number of annual work-related amputations in the Norwegian manufacturing sector for a 10-year study period (1998-2007). The two-sources utilized in this study were the Norwegian Labor Inspection Authorities Registry of Work-Related Injuries (RWI) and the Association of Norwegian Private Insurance Companies registry for occupational injuries (ANPIC). RESULTS: We estimated an annual incidence rate that ranged from 21/100 000 to 62/100 000 workers during the study period. Our findings indicate an undercount of amputations reported to the Norwegian Labour Inspection Authority's registry ranging from 16% to 58% during the study period. CONCLUSIONS: Work-related amputations remain a challenge in the Norwegian manufacturing sector. This study underscores the need of robust epidemiological surveillance infrastructure and effective interventions to prevent amputations at work.

A randomized, controlled intervention of machine guarding and related safety programs in small metal-fabrication businesses.

OBJECTIVES: Metal fabrication employs an estimated 3.1 million workers in the United States. The absence of machine guarding and related programs such as lockout/tagout may result in serious injury or death. The purpose of this study was to improve machine-related safety in small metal-fabrication businesses. METHODS: We used a randomized trial with two groups: management only and management-employee. We evaluated businesses for the adequacy of machine guarding (machine scorecard) and related safety programs (safety audit). We provided all businesses with a report outlining deficiencies and prioritizing their remediation. In addition, the management-employee group received four one-hour interactive training sessions from a peer educator. RESULTS: We evaluated 40 metal-fabrication businesses at baseline and 37 (93%) one year later. Of the three nonparticipants, two had gone out of business. More than 40% of devices required for adequate guarding were missing or inadequate, and 35% of required safety programs and practices were absent at baseline. Both measures improved significantly during the course of the intervention. No significant differences in changes occurred between the two intervention groups. Machine-guarding practices and programs improved by up to 13% and safety audit scores by up to 23%. Businesses that added safety committees or those that started with the lowest baseline measures showed the greatest improvements. CONCLUSIONS: Simple and easy-to-use assessment tools allowed businesses to significantly improve their safety practices, and safety committees facilitated this process.

The Norwegian Labour Inspectorate's Registry for Work-Related Diseases: data from 2006.

The Norwegian Labour Inspectorates (NLI's) Registry for Work-Related Diseases was established in 1920. Based on the principle of sentinel health events (SHE), its central purpose is to provide information to the NLI to enable workplace interventions and the prevention of hazardous exposures. Although physicians are required to report work-related diseases to the NLI, only 3% did so in 2006. There were 3392 cases of work-related diseases reported to the NLI by 561 physicians in 2006. Diseases of the ear (noise-induced hearing loss) comprised 59% (n=1987) of the cases, while 12% (n=398) of the cases were attributed to the diseases of the respiratory system and 7% (n =239) were diseases of the skin and subcutaneous tissue. Despite limitations, the registry continues to inform NLI's prevention strategies, supplements data concerning work-environment surveillance, and provides impetus for epidemiological studies.

A comparison of the perceptions and beliefs of workers and owners with regard to workplace safety in small metal fabrication businesses.

BACKGROUND: Problems of improving safety in small business establishments may include a lack of resources, limited unionization, and an informal management structure. METHODS: We evaluated worker and manager perceptions of worksite health and safety using Social Cognitive Theory. We used a business safety scorecard to audit the safety conditions, policies and programs, and work practices. Comparisons were made between the different measures. RESULTS: Businesses with safety committees had 1.7-2.1 times higher proportion of positive safety scorecard items than businesses without committees. Union status and business size were not associated with business safety audit results. Non-English-speaking and less educated employees reported higher levels of knowledge about safety than did their more educated and/or English-speaking peers. CONCLUSIONS: The presence of a safety committee is the single most important indicator of workplace safety. Self-reported understanding of workplace safety is greater among employees who do not speak English or have lower levels of formal education. Future worksite interventions should consider the need for participatory worksite safety committees. Multilingual training programs would help reach a greater proportion of workers.

Organizational characteristics of small metal-fabricating businesses in Minnesota.

Small U.S. businesses are underserved in terms of occupational health and safety (OHS) services. Little is known about organizational factors influencing OHS in these establishments. Machine guarding was quantitatively evaluated in 40 small businesses. Checklists were used to develop safety scores. Organizational information such as number of employees, unionization, and number of machines was obtained. Experience modification rates, annual sales, and credit ratings were also obtained. Safety scores were divided into terciles. Businesses with safety scores in the top third were unionized, had effective safety committees, and had been operational for more than 30 years. Interventions and policies targeted toward development and implementation of safety committees are needed to improve OHS in this cohort. Financial capability had no bearing on ability of a small business to mount an OHS programs. Non-unionized small businesses may be more vulnerable to occupational injuries.

Mapping safety interventions in metalworking shops.

OBJECTIVE: This paper describes the selection of intervention activities designed to lower machine-related hazards and amputations in small metal fabrication businesses. METHODS: Methods included an advisory board, employee discussions, and pilot tests. We used a stepwise intervention mapping process to identify performance objectives, behavioral determinants, and change objectives for two target populations (business owners and employees). RESULTS: Intervention activities for owners were designed to increase knowledge about machine safety, encourage adoption of safety procedures, and motivate improvements in machine guarding. Intervention activities aimed at employees focused on building knowledge and skills of health and safety committee members. CONCLUSIONS: The intervention mapping approach led to important insights about program goals and intervention activities. Intervention mapping also ensured a systematic and thorough review of each target population in the context of our research goals.

Profile of machine safety in small metal fabrication businesses.

BACKGROUND: Metal working has been identified as an industry with one of the highest rates of non-fatal injury in the United States. However, the systematic evaluation of machine-related hazards is lacking. METHODS: The Minnesota Machine Guarding Study evaluates the effectiveness of a peer-based technical and educational intervention designed to reduce exposure to amputation hazards among workers in small machining/metal working businesses. The data presented here provide a profile of machine guarding in small (5-100 employees) metal fabrication businesses in Minnesota. A set of checklists to quantify machine-guarding practices were developed. Up to 25 randomly selected machines were evaluated in each facility. In addition, walk-through surveys were conducted to assess machine-related safety practices and programs (e.g., lock out-tag out). RESULTS: A total of 824 machines were evaluated. Overall, 55% (SD 11%) of items addressing machine guarding were present. No single machine complied with all critical safety requirements. Shops with safety committees tended to have better scores than did shops without safety committees. Thirty-five percent of all businesses had established machine guarding procedures and 17% provided training in machine guarding (e.g., use of machine guards and devices in daily operations) to their employees. CONCLUSIONS: These data indicate that machine guarding and related safety programs in small metal fabrication businesses were inadequate. The data also suggest that safety committees are an important component in improving machine safety and related programs in small businesses.

Machine safety evaluation in small metal working facilities: an evaluation of inter-rater reliability in the quantification of machine-related hazards.

BACKGROUND: Each year there are an estimated 4.2-6.7 amputations per 10,000 workers in the metal fabrication trades in the United States. The Minnesota Machine Guarding Study evaluates the effectiveness of a peer-based technical and educational intervention designed to reduce exposure to amputation hazards among workers in small machining/metal working shops. The study reported here involved the development and evaluation of methods for measuring machine safety, which will be used in the intervention study. METHODS: Using OSHA regulations, ANSI standards, and industry best practices, we developed 23 machine-safety scorecards. The safety scores were dependent on the presence or absence of guards, other safety devices and implements, and the presence or absence of acceptable administrative programs. Inter-rater reliability was assessed for the evaluation of eight types of commonly used metal fabrication machines. RESULTS: Of the 23 most common types of machines, there were a sufficient number of machines to evaluate inter-rater reliability for eight types. Three raters in four shops assessed fifty-nine machines. Overall, the kappa statistic ranged from 0.57 to 0.84, indicating good to very good concordance between raters. In general, machines did not fare well with regard to compliance with current standards. DISCUSSION: The ability to assess machine-related hazards is important in industries where it is difficult to identify and count injuries in a timely fashion. Machinists and safety professionals may use this scoring system as a means of reproducible assessment of machine safety.