The hierarchy of preventive measures to protect workers against the COVID-19 pandemic: A review

Biosecurity in the workplace and a QMS during the COVID-19 pandemic: a survey for Peruvian goods companies

Objectives. This study analyzes the differences between goods companies with a Standard No. ISO 9001:2015 quality management system (QMS) and those without, in terms of implementation of biosecurity measures during the COVID-19 pandemic. The study shows whether having a QMS helped companies to implement the biosecurity measures required to continue operating during a pandemic. Methods. The sample was composed of 145 Peruvian goods companies. The empirical data were collected through a questionnaire sent to company presidents, general managers and department heads. The questionnaire focused on four biosecurity dimensions in the workplace: protocols, preventive actions, biosecurity processes and risk management. Results. The study found that companies with a QMS (Standard No. ISO 9001:2015) significantly differed from companies without in the implementation of three of the four biosecurity dimensions. Conclusions. This study is useful for academia and companies because it identifies the main differences between certified and non-certified companies, in terms of adoption of biosecurity measures. This study highlights the importance of a QMS to respond to hazardous situations like a global health crisis, but also provides useful information for the strategic decision-making process of companies.

Healthcare-acquired Sars-Cov-2 infection: A viable legal category?

In the context of the Sars-Cov-2 pandemic, according to the various periods of emergency and the rate of infections, hospitalized subjects also contracted the infection within the ward, sometimes with the development of disease (COVID-19) and sometimes with permanent damage. The authors wondered if Sars-Cov-2 infection should be considered on a par with other infections acquired in the healthcare setting. The non-diversified diffusion between the health and non-health sectors, the ubiquity of the virus and the high contagiousness, together with the factual inability to prevent it by the health structures, despite the adoption of entry control, practices of isolation of positive subjects, and staff surveillance, lead to consider COVID-19 in a different way, in order to otherwise burden health structures in the face of unmanageable risks, clearly also dependent on exogenous and uncontrollable factors. The guarantee of care safety must, in the pandemic, be able to compare with the real capacity for intervention according to the asset of the current health service, requesting State intervention with alternative instruments, such as una tantum compensation, for COVID-19 damage reparation occurred in the health sector.

Burnout and psychological symptoms in healthcare workers during the COVID-19 pandemic: Comparisons of different medical professions in a regional hospital in Turkey

BACKGROUND: Early studies have revealed the psychological effects of the COVID-19 outbreak on healthcare workers (HCWs). Burnout and psychological outcomes of different medical professions during the pandemic have not yet been addressed. OBJECTIVE: The study aimed to investigate the burnout, depression, anxiety, and psychological distress levels of HCWs, and to determine the predictive factors of burnout in different professions of frontline HCWs during the pandemic. METHODS: This cross-sectional study included 253 HCWs (79 physicians, 95 nurses, and 79 other-HCWs). The Maslach Burnout Inventory, Beck Depression Inventory, Beck Anxiety Inventory, and Impact of Event Scale-Revised, and Sociodemographic Form were used. RESULTS: Emotional exhaustion was significantly higher in physicians and nurses than in other frontline HCWs. While depersonalization was significantly higher in physicians than nurses / other HCWs, levels of avoidance, hyperarousal and intrusion were found to be higher in other HCWs / nurses than physicians. Depression was the most effective predicting variable for burnout, following age, quarantine, supervisor’s/team leader’s attitude, hyperarousal and avoidance. CONCLUSIONS: It has been observed that depending on the uncertainty and life risk of the pandemic in HCWs involved in the treatment of COVID-19, physicians who are the decision-making authorities in the treatment process used more depersonalization than nurses and other HCWs. Nurses and other-HCWs had significantly higher distress symptoms than physicians. Both future research and psychosocial services should address those with high depressive symptoms as a potentially fragile subgroup for burnout among HCWs, and investigate and develop evidence-based interventions that can provide mental well-being, and prevent burnout.

Agility and Sustainability: A Qualitative Evaluation of COVID-19 Non-pharmaceutical Interventions in the UK Logistics Sector

Background

The emergence of SARS-CoV-2 triggered a chain of public health responses that radically changed our way of living and working. Non-healthcare sectors, such as the logistics sector, play a key role in such responses. This research aims to qualitatively evaluate the non-pharmaceutical interventions (NPIs) implemented in the UK logistics sector during the COVID-19 pandemic.

Methods

We conducted nine semi-structured interviews in July-August 2020 and May-June 2021. In total 11 interviewees represented six companies occupying a range of positions in the UK's logistics sector, including takeaway food delivery, large and small goods delivery and home appliance installation, and logistics technology providers. Thematic analysis was completed using NVivo12. Codes relevant to NPIs were grouped into themes and mapped deductively onto an adapted Hierarchy of Control (HoC) framework, focusing on delivery workers. Codes relevant to the implementation process of NPIs were grouped into themes/subthemes to identify key characteristics of rapid responses, and barriers and facilitators.

Results

HoC analysis suggests the sector has implemented a wide range of risk mitigation measures, with each company developing their own portfolio of measures. Contact-free delivery was the most commonly implemented measure and perceived effective. The other implemented measures included social distancing, internal contact tracing, communication and collaboration with other key stakeholders of the sector. Process evaluation identified facilitators of rapid responses including capacity to develop interventions internally, localized government support, strong external mandates, effective communication, leadership support and financial support for self-isolation, while barriers included unclear government guidance, shortage of testing capacity and supply, high costs and diversified language and cultural backgrounds. Main sustainability issues included compliance fatigue, and the possible mental health impacts of a prolonged rapid response.

Conclusions

This research identified drivers and obstacles of rapid implementation of NPIs in response to a respiratory infection pandemic. Existing implementation process models do not consider speed to respond and the absence or lack of guidance in emergency situations such as the COVID-19. We recommend the development of a rapid response model to inform the design of effective and sustainable infection prevention and control policies and to focus future research priorities.

Early Nurse Management Experiences from Finnish COVID-19 Hubs: An In-Action Review

Primary healthcare (PHC) clinics are the point of access for many COVID-19 patients; however, the focus of crisis response work has been in securing hospital capacities. The purpose of this study was to describe the early nurse management experiences from PHC clinics within Greater Helsinki dedicated to caring for all ambulatory patients with possible COVID-19 symptoms. The study objectives were to make PHC crisis response contributions known and to provide an in-action review (IAR) of crisis response efforts. Nurse managers from the four COVID-19 hubs in Greater Helsinki were interviewed using thematic pair interviews. The data were analyzed inductively using thematic analysis, by which four main themes emerged: (1) capacity development led to a state of flux, (2) infection prevention control (IPC) was critical, (3) management of staff was essential in facilitating crisis response, and (4) respondents’ personal experiences. The state of flux stressed the provision of PHC services, but quick developments in telemedicine eased that burden. Conversation surrounding IPC was extensive, though discrepancies suggest that global efforts to standardize IPC practices must begin locally. Leadership was adjusted to accommodate for the crisis, especially regarding the motivation of staff. A vision to aspire toward in crisis recovery is needed.

Safety Management and Wellbeing during COVID-19: A Pilot Study in the Manufactory Sector

BACKGROUND

The rapid spread of COVID-19 has generated anxiety and concerns among the whole population, by also affecting people's working life quality. Although several studies underlined the impact of the COVID-19 pandemic in the healthcare sector, very few studies investigated the consequences in the occupational sectors with low risk of contagion.

METHOD

220 full-time in-presence workers of the manufacturing sector agreed to participate in a study of cross-sectional design during September and October 2020. Data were collected by means of a self-reported questionnaire conceived to investigate the constructs of the COVID-19 concerns, both the personal contribution and the supervisor support to workplace safety, the organizational commitment to safety, and finally, the level of workers' exhaustion.

RESULTS

This study highlights that COVID-19 concerns represent a significant source of stress since it is significantly associated to higher levels of exhaustion among workers. Furthermore, the findings show the relevance of resources related to employee's personal contribution to safety management as well as the role of climate variables.

CONCLUSIONS

These results promote knowledge on the role of COVID-19 concerns in affecting psychological wellbeing at work, as well as the impact of both individual and job-related resources that may prevent exhaustion at work. Finally, the present findings also have implications for organizations and the maintenance of their commitment to safety.

Mental Well-Being and Job Satisfaction of Hospital Physicians during COVID-19: Relationships with Efficacy Beliefs, Organizational Support, and Organizational Non-Technical Skills

The COVID-19 outbreak has led worldwide governments to take preventive measures to contain the spread of the virus and its extraordinary demands upon healthcare workers. Consequently, healthcare workers have been under high pressures, putting them at risk of developing adverse outcomes. The present study aims to investigate the psychological and organizational factors that contributed to physicians’ well-being during the pandemic. A total of 78 Italian physicians participated in the study. They completed a self-report questionnaire measuring efficacy beliefs, orientation towards patient engagement, job satisfaction, non-technical skills, organizational support, sense of belonging to the hospital, job satisfaction, and mental well-being. Physicians’ sense of belonging to their hospital, efficacy beliefs about their organizations and communication with patients, as well as non-technical skills related to communication and risk awareness were positively associated with job satisfaction. In addition, the latter and sense of belonging to own hospital were positively associated with mental well-being. These findings may guide policymakers and healthcare organizations managers to consider the potential psychosocial factors related to physicians’ well-being and the required preventive measures that can help in enhancing their human and organizational resources to cope with stressful situations such as the COVID-19 pandemic.

Return to Work during the COVID-19 Outbreak: A Study on the Role of Job Demands, Job Resources, and Personal Resources upon the Administrative Staff of Italian Public Universities

Background: Compared to healthcare workers and teleworkers, occupational wellbeing of employees who continued or suddenly returned to work during the COVID-19 pandemic have received less attention thus far. Using the Job Demand–Resource model as a framework, the present study aimed at evaluating the role of job demands and job and personal resources in affecting emotional exhaustion among university administrative staff. Methods: This cross-sectional study analyzed data collected through an online questionnaire completed by 364 administrative employees that continued working in presence (WP) and 1578 that continued working blended (WB), namely, partly remotely and partly in presence. Results: Among job demands, quantitative job demand overloads and perceived risk of being infected were positively associated with higher levels of emotional exhaustion. Among job resources, colleague support was significantly associated with lower emotional exhaustion for both WB and WP, whereas supervisor support and fatigue management were salient only for WB. Among personal resources, personal contribution in managing COVID-19-related risk at work emerged as a protective factor for emotional exhaustion. Conclusion: Insights for the development of targeted preventive measure for a more psychologically safe and productive return to work can be derived from these results.

Social inequalities in protective behaviour uptake at the start of the COVID-19 pandemic: results from a national survey

OBJECTIVES

We aimed to assess social patterns of handwashing, social distancing, and working from home at the start of the COVID-19 pandemic in Canada, and determine what proportions of the overall prevalence and social inequalities in handwashing and social distancing are related to inequalities in the opportunity to work from home, to guide pandemic preparedness and response.

METHODS

Using cross-sectional data from the Canadian Perspectives Survey Series, collected between March 29 and April 3, 2020, among Canadian adults (N=4455), we assessed prevalence of not working from home, social distancing in public, or practicing frequent handwashing, according to age, sex, marital status, immigration, education, chronic disease presence, and source of COVID-19 information. Multivariate regression, population attributable fraction estimation, and generalized product mediation analysis were applied.

RESULTS

Absence of frequent handwashing and distancing was more common among those working outside than within the home (prevalence differences of 7% (95% CI: 4, 10) and 7% (95% CI: 3, 10), respectively). Inequalities in handwashing and distancing were observed across education and immigration status. Over 40% of the prevalence of non-uptake of handwashing and distancing was attributable to populations not being able to work from home. If all worked from home, over 40% (95% CI: 8, 70) of education-based inequalities in handwashing and distancing could be eliminated, but differences by immigration status would likely remain.

CONCLUSION

For pandemic response, both workplace safety initiatives and mechanisms to address the inequitable distribution of health risks across socio-economic groups are needed to reduce broader inequalities in transmission risk.

Relationship between work-related ocular events, facial injuries and associated factors amongst dental professionals during COVID-19

BACKGROUND

In dental settings, COVID-19 can be transmitted directly from patients to dentists through small droplets, saliva splashes, blood, and other body fluids liberated as a result of dental procedures.

OBJECTIVE

To determine the prevalence of ocular and facial injuries in dental professionals and to investigate factors in dental practice contributing to ocular injuries.

METHODS

An analytical cross-sectional study was performed in public and private sector universities. The study had 301 participants including final year undergraduate students, interns, postgraduate trainees, general practitioners, and dental specialists. Data were gathered online using Google forms. Information on sociodemographic, practice details, history of ocular and facial encounters during the clinical experience, and protective measures adopted by the dentists were collected. Means and standard deviations were calculated for continuous variables whereas frequencies and percentages were calculated for categorical variables. A Chi-square test was applied for association between variables.

RESULTS

Ocular events and facial injuries occurred more in females 204 (67.8%) than in males 97(32.2%). Final year students reported more incidence of ocular encounters than specialists (40.9%, 3.3%). Dentists working in the government sector underwent more ocular encounters than those in private sectors 185(61.4%) and 96 (31.8%). Majority of participants reported that scaling was the procedure in which dentists experienced an ocular event. A significant association was found between ocular events, qualification, years of experience in clinical practice, number of patients treated per day, improper posture, and proper armamentarium (p < 0.05). However, no association was found between ocular events, gender, working sector, and dental procedures.

CONCLUSION

Occurrence of ocular injuries were high compared to facial injuries and these outcomes were dependent on dental expertise and experiences. Appropriate measures should be adopted to minimize the risk of disease transmission and COVID-19 through the eyes among practicing dentists.

Working during a Pandemic between the Risk of Being Infected and/or the Risks Related to Social Distancing: First Validation of the SAPH@W Questionnaire

BACKGROUND

The COVID-19 pandemic led the worldwide healthcare system to a severe crisis in which personnel paid the major costs. Many studies were promptly dedicated to the physical and psychological consequences of the COVID-19 exposure among healthcare employees, whereas the research on the other working populations has been substantially ignored. To bridge the current lack of knowledge about safe behaviors related to the risk of COVID-19 contagion at work, the aim of the study was to validate a new tool, the SAPH@W (Safety at Work), to assess workers' perceptions of safety.

METHODS

A total of 1085 participants, employed in several organizations sited across areas with different levels of risk of contagion, completed an online questionnaire. To test the SAPH@W validity and measurement invariance, the research sample was randomly divided in two.

RESULTS

In the first sub-sample, Confirmatory Factor Analysis demonstrated the adequacy of the SAPH@W factorial structure. In the second sub-sample, multi-group Confirmatory Factor Analysis revealed that the SAPH@W was invariant across gender, ecological risk level, and type of occupation (in-person vs. remote working).

CONCLUSIONS

The study evidenced the psychometric properties of the SAPH@W, a brief tool to monitor workers' experiences and safety perceptions regarding the COVID-19 risk in any organisational setting.

Contribution of Occupational Health to multidisciplinary team work for COVID-19 prevention and management

Introduction: The SARS-CoV-2/Covid-19 pandemic is a challenge for public health and occupational medicine and developing prevention and protection strategies needs expertise from many disciplines. To make prevention successful, individuals have to be motivated to participate and, in turn, motivation depends on understanding how and why prevention measures are implemented. We present a structured approach (the Cycle of prevention) which involves different stakeholders and perspectives to develop, and monitor, prevention strategies in transparent and effective ways.