Prevalence of SARS-CoV-2 among Belgian workers in long-term care facilities.

BACKGROUND: Healthcare workers (HCWs) can be a source of SARS-CoV-2 within long-term care facilities (LTCFs); therefore, we analysed the data from a testing programme among LTCF employees. AIMS: The aim of this study was to investigate the prevalence of SARS-CoV-2 and its determinants among employees of LTCFs and the risk for fellow workers and residents. METHODS: Testing started at week 15, the first wave's peak, using nasopharyngeal swabs for PCR up to week 23. At the start of the second wave (week 32), testing resumed. RESULTS: A total of 32 457 test results were available from 446 LTCFs: 2% were positive: 1% in men, 2% in women, 2% in HCWs (=having patient contact), 1% in non-HCWs, higher in younger age groups. In total, 30 729 employees were tested once, 823 twice, 66 thrice and 4 four times. Prevalence was 13% during the first week of testing (week 15) and declined to 7% (week 16) to stay at around 1% (from week 17 until week 23). At the start of the second wave (week 31-33), the prevalence was around 3%. In 70% of positive tests, the employee was asymptomatic. CONCLUSIONS: Our study confirms the presence of HCWs with SARS-CoV-2 as a possible source of infection in LTCFs even when the incidence in the general population was low; 70% were asymptomatic. To control the spread of SARS-CoV-2 in LTCFs vaccination, infection prevention and control measures are necessary as well as testing of all LTCF HCWs during possible outbreaks, even if asymptomatic.

Prevalence of high cardiovascular risk by economic sector.

PURPOSE: The aim of this study was to assess the prevalence of high cardiovascular risk and the trend of cardiovascular risk factors in a large sample of Belgian workers. METHODS: A cross-sectional study was performed on the data of workers under medical surveillance by the non-profit occupational health service IDEWE in 2018. The prevalence of poor health for smoking, physical activity, body mass index (BMI), and blood pressure according to the American Heart Association (AHA) definition was investigated. The presence of three or more poor cardiovascular health metrics was considered high cardiovascular risk. A log-binomial regression model was used to compare the prevalence of high cardiovascular risk between economic sectors taking into account age and gender and to calculate predicted probabilities of high cardiovascular risk. RESULTS: Data about 212,792 workers were available. In 2018, overall, 7% of workers had high cardiovascular risk. Transport and construction had the highest prevalence of high cardiovascular risk, 14% and 12%, respectively. The lowest prevalence, 3%, was observed in education. Differences between sectors remained statistically significant after adjustment for age and gender. In men, workers in transport and storage and in construction had the highest predicted probability of high cardiovascular risk that increased with age. In women, highest predicted probability was observed in transport and storage. CONCLUSIONS: When implementing health promotion initiatives, priority should be given to sectors and professions where risk factors are most prevalent or are increasing rapidly. Measures should be tailored to the special needs of the occupational groups at high risk.

Data warehouse for detection of occupational diseases in OHS data.

BACKGROUND: Occupational health and safety (OHS) services collect a wide range of data during health surveillance. AIMS: To build a 'data warehouse' to make OHS data available for research and to investigate sector-specific health problems. METHODS: Medical data were extracted, transformed and loaded into the data warehouse. After validation, data on lifestyle, categorized medication use, ICD-9-CM encoded sickness absences and health complaints, collected between 2010 and 2014, were analysed with logistic regression to compare proportions between employment sectors, taking into account age, gender, body mass index (BMI) and year of examination. RESULTS: The data set comprised 585000 employees. Average age and employment seniority were 39 ± 12 and 8 ± 9 years, respectively. BMI was 26 ± 5 kg/m(2). Health complaints, medication use and sickness absence significantly increased with BMI and age. The proportion of employees with health problems was highest in health care (64%), government (61%) and manufacturing (60%) and lowest in the service sector. In all sectors, 10% of workers reported locomotor health problems, apart from the service sector (8%) with similar results for medication consumption. Neuropsychological drugs were more frequently used by health care workers (8%). The transport sector contained the highest proportion of cardiological medication users (12%). Finally, 30-59% of employees reported at least one sickness absence episode. Sickness absence due to locomotor issues was highest in manufacturing (11%) and health care (10%), followed by government (9%) and construction (9%). CONCLUSIONS: Significant differences in indices of workers' health were observed between sectors. This information is now being used in the implementation of a sector-oriented health surveillance programme.

Genetic susceptibility in solvent induced neurobehavioral effects.

The aim of this investigation was to study the influence of genetic polymorphisms of biotransformation enzymes and dopamine receptors on neurobehavioral effects in referents (n = 53), solvent-workers (n = 144), and chronic toxic encephalopathy (CTE) patients (n = 33). All participants were interviewed for exposure data and confounding factors and underwent a clinical examination. Neurobehavioral complaints (neurotoxicity symptom checklist-60) and effects [simple reaction time (SRT), symbol digit substitution (SDS), hand-eye coordination (HEC), and digit span backwards (DSB)] were evaluated with a computer assisted test battery. The following genotypes were determined: GSTM1, GSTT1, GSTP1, DRD2 Taq1A, DRD2 Taq1B, and DRD2-141Cdel. Neurotoxic effects and complaints were significantly higher in CTE patients and were related to both duration and level of exposure. An equal distribution of genotypes was found between all groups. Logistic regression analysis revealed that GSTT1 was negatively associated with sleep and sensorimotor complaints. GSTM1 had a protecting influence on the relationship between logDSB and the cumulative exposure index and between logSRT and cumulative exposure index and degree of exposure, respectively. This effect was also found when correcting for age, education level, alcohol consumption, and smoking. DRD2-141Cdel polymorphisms had a negative influence on the relationship between logSDS and the total exposure time. GSTT1 might be protective against sleep and sensorimotor complaints, whereas GSTM1 seems to decrease sustained attention and short-term memory problems in relation to solvent exposure. Individuals possessing DRD2-141Cdel variant experienced more visuomotor problems.

Does enhanced information exchange between social insurance physicians and occupational physicians improve patient work resumption? A controlled intervention study.

BACKGROUND: Patient work resumption after sickness absence varies even among patients with similar pathologies and characteristics. Explanations remain uncertain. One newly investigated field is "information asymmetry", a situation in which critical information is not appropriately exchanged between stakeholders in disability management. It is hypothesised that information asymmetry between social insurance physicians and occupational physicians prolongs sickness absence. OBJECTIVES: To assess the influence of enhanced information exchange between these physicians on patient outcome. METHODS: Non-randomised controlled intervention study. The setting was the work inability assessment consultation of social insurance physicians in Belgium. Inclusion criteria were: employee, age 18-50, and subacute (more than one month) sickness absence. The intervention was a structured information exchange (through the use of a communication form) between the patient's social insurance physician and occupational physician. The intervention started when the patient's sickness absence reached the subacute stage, and ended when the sickness absence benefit was ceased or the duration exceeded one year. The primary outcome measure was the sickness absence benefit status of the patient assessed one year after benefit onset. RESULTS: Of the 1883 patients asked to enroll in the study, 1564 (84%) participated; 505 (32%) of 1564 patients were assigned to the intervention group and 1059 (68%) to the control group; 1553 (99%) of 1564 patients completed the study. In the intervention group, 86% received no sickness absence benefit at the end of the study, versus 84% in the control group (95% CI 0.91-1.15). No significant differences in other outcome parameters were obtained. CONCLUSIONS: Information exchange between physicians may not be enough to influence work resumption among patients on sickness absence. Further research on stakeholders' information asymmetry and its effect on the outcome of patients are necessary. The complexity of information asymmetry in disability management cannot be underestimated.