Polish medical students facing the pandemic-Assessment of resilience, well-being and burnout in the COVID-19 era

INTRODUCTION

Recent reports indicate that COVID-19 pandemic has significant influence on medical professionals' mental health. Strict limitations in clinical practice and social interactions within academic community, which had to be introduced, could lead to significant psychological distress in medical students. The aim of the study was to assess resilience, well-being and burnout among Polish medical students in the COVID-19 era.

METHODS

The online survey consisting of validated questionnaires assessing resilience (Resilience Scale 14; RS-14), well-being (Medical Student Well-Being Index) and burnout (Maslach Burnout Inventory) as well as self-created survey concerning mental health problems, use of stimulants, SARS-CoV-2 infection, work in COVID-19 units, medical education and social attitude towards health care professionals in the pandemic era was distributed via Facebook and other online students' platforms. 1858 MSs from all polish medical schools agreed to fill in the survey.

RESULTS

'Very low', 'low' and 'on the low end' levels of resilience were found in 26%, 19.1% and 26.9% of the study group, respectively. Students with higher resilience level presented better attitude towards online and hybrid classes. 16.8% of respondents stated that they worked, currently work or plan to work voluntarily at the pandemic frontline. In terms of burnout, these respondents presented lower exhaustion (p = 0.003) and cynicism (p = 0.02), and higher academic efficacy (p = 0.002). That group also showed greater resilience (p = 0.046). The SARS-CoV-2 infection among respondents, their relatives and friends did not influence the results. 39.1% of respondents declared the need of the psychological or psychiatric consultation in relation to pandemic challenges. 231 (26.4%) participants previously diagnosed with mental health disorders noticed worsening of their symptoms. Increased intake of alcohol, cigarettes or other stimulants was noticed by 340 (28.6%) respondents. 80.2% of respondents thought that social aversion and mistrust towards doctors increased during the pandemic and part of them claimed it affected their enthusiasm toward medical career.

CONCLUSIONS

The majority of medical students presented low levels of resilience and high burnout at the time of pandemic. Providing necessary support especially in terms of mental health and building up the resilience of this vulnerable group seems crucial to minimize harm of current pandemic and similar future challenges.

Validation and measurement invariance of the Occupational Depression Inventory in South Africa

This study aimed to validate the recently developed Occupational Depression Inventory (ODI) in South Africa. A total of 327 employees (60% female) participated in the study. Bifactor exploratory structural equation modeling analysis indicated that the ODI can be considered essentially unidimensional. The ODI displayed strong scalability (e.g., scale-level H = 0.657). No monotonicity violation was detected. The reliability of the instrument, as indexed by Cronbach's alpha, McDonald's omega-total, Guttman's λ2, and the Molenaar-Sijtsma statistic, was highly satisfactory. Measurement invariance was observed across age groups, sexes, and ethnicities, as well as between our sample and the ODI's original validation sample. As expected, the ODI showed both a degree of convergent validity and a degree of discriminant validity vis-à-vis a measure of "cause-neutral" depressive symptoms. Moreover, the ODI manifested substantial associations, in the anticipated directions, with measures of work engagement, job satisfaction, and life satisfaction. Overall, the ODI exhibited excellent structural and psychometric properties within the South African context. Consistent with previous research, this study suggests that occupational health specialists can confidently rely on the ODI to investigate job-related distress.

Modelling long-term COVID-19 impacts on the U.S. workforce of 2029

While ensuring employment opportunities is critical for global progress and stability, workers are now subject to several disruptive trends, including automation, rapid changes in technology and skill requirements, and transitions to low-carbon energy production. Yet, these trends seem almost insignificant compared to labor impact of the COVID-19 pandemic. While much has been written about the pandemic's short-term impacts, this study analyzes anticipated long-term impacts on the labor force of 2029 by comparing original 2029 labor projections to special COVID-adjusted projections recently published by the US Bureau of Labor Statistics. Results show that future demand for nearly every type of labor skill and knowledge will increase, while the nature of work shifts from physical to more cognitive activities. Of the nearly three million jobs projected to disappear by 2029 due to COVID, over 91% are among workers without a bachelor's degree. Among workers with a degree demand shifts primarily from business-related degrees to computer and STEM degrees. Results further show that the socialness of labor, which is important for both innovation and productivity, increases in many more industries than it decreases. Finally, COVID will likely accelerate the adoption of teleworking and slightly decrease the rate of workforce automation. These impacts, combined with a shift to more cognitive worker activities, will likely impact the nature of workforce health and safety with less focus on physical injuries and more on illnesses related to sedentary lifestyles. Overall, results suggest that future workers will need to engage more often in training and skill acquisition, requiring life-long learning and skill maintenance strategies.

Employee psychological well-being during the COVID-19 pandemic in Germany: A longitudinal study of demands, resources, and exhaustion

Many governments react to the current coronavirus/COVID-19 pandemic by restricting daily (work) life. On the basis of theories from occupational health, we propose that the duration of the pandemic, its demands (e.g., having to work from home, closing of childcare facilities, job insecurity, work-privacy conflicts, privacy-work conflicts) and personal- and job-related resources (co-worker social support, job autonomy, partner support and corona self-efficacy) interact in their effect on employee exhaustion. We test the hypotheses with a three-wave sample of German employees during the pandemic from April to June 2020 (N_w1  = 2900, N_w12  = 1237, N_w123  = 789). Our findings show a curvilinear effect of pandemic duration on working women's exhaustion. The data also show that the introduction and the easing of lockdown measures affect exhaustion, and that women with children who work from home while childcare is unavailable are especially exhausted. Job autonomy and partner support mitigated some of these effects. In sum, women's psychological health was more strongly affected by the pandemic than men's. We discuss implications for occupational health theories and that interventions targeted at mitigating the psychological consequences of the COVID-19 pandemic should target women specifically.

Family medicine practitioners' stress during the COVID-19 pandemic: a cross-sectional survey

BACKGROUND

The COVID-19 pandemic has shaken the world in early 2020. In France, General Practitioners (GPs) were not involved in the care organization's decision-making process before and during the first wave of the COVID-19 pandemic. This omission could have generated stress for GPs. We aimed first to estimate the self-perception of stress as defined by the 10-item Perceived Stress Score (PSS-10), at the beginning of the pandemic in France, among GPs from the Auvergne-Rhône-Alpes, a french administrative area severely impacted by COVID-19. Second, we aimed to identify factors associated with a self-perceived stress (PSS-10 ≥ 27) among socio-demographic characteristics of GPs, their access to reliable information and to personal protective equipment during the pandemic, and their exposure to well established psychosocial risk at work.

METHODS

We conducted an online cross-sectional survey between 8th April and 10th May 2020. The self-perception of stress was evaluated using the PSS-10, so to see the proportion of "not stressed" (≤20), "borderline" (21 ≤ PSS-10 ≤ 26), and "stressed" (≥27) GPs. The agreement to 31 positive assertions related to possible sources of stress identified by the scientific study committee was measured using a 10-point numeric scale. In complete cases, factors associated with stress (PSS-10 ≥ 27) were investigated using logistic regression, adjusted on gender, age and practice location. A supplementary analysis of the verbatims was made.

RESULTS

Overall, 898 individual answers were collected, of which 879 were complete. A total of 437 GPs (49%) were stressed (PSS-10 ≥ 27), and 283 GPs (32%) had a very high level of stress (PSS-10 ≥ 30). Self-perceived stress was associated with multiple components, and involved classic psychosocial risk factors such as emotional requirements. However, in this context of health crisis, the primary source of stress was the diversity and quantity of information from diverse sources (614 GPs (69%, OR = 2.21, 95%CI [1.40-3.50], p < 0.001). Analysis of verbatims revealed that GPs felt isolated in a hospital-based model.

CONCLUSION

The first wave of the pandemic was a source of stress for GPs. The diversity and quantity of information received from the health authorities were among the main sources of stress.

Attending to the Emotional Well-Being of the Health Care Workforce in a New York City Health System During the COVID-19 Pandemic

The COVID-19 pandemic has placed an enormous strain on health care workers, and its potential impact has implications for the physical and emotional well-being of the workforce. As hospital systems run well over capacity, facing possible shortages of critical care medical resources and personal protective equipment as well as clinician deaths, the psychological stressors necessitate a strong well-being support model for staff. At the Mount Sinai Health System (MSHS) in New York City, health care workers have been heroically providing frontline care to COVID-19 patients while facing their own appropriate fears for their personal safety in the setting of contagion. This moral obligation cannot be burdened by unacceptable risks; the health system's full support is required to address the needs of its workforce.In this Invited Commentary, the authors describe how an MSHS Employee, Faculty, and Trainee Crisis Support Task Force-created in early March 2020 and composed of behavioral health, human resources, and well-being leaders from across the health system-used a rapid needs assessment model to capture the concerns of the workforce related to the COVID-19 pandemic. The task force identified 3 priority areas central to promoting and maintaining the well-being of the entire MSHS workforce during the pandemic: meeting basic daily needs; enhancing communications for delivery of current, reliable, and reassuring messages; and developing robust psychosocial and mental health support options. Using a work group strategy, the task force operationalized the rollout of support initiatives for each priority area. Attending to the emotional well-being of health care workers has emerged as a central element in the MSHS COVID-19 response, which continues to be committed to the physical and emotional needs of a workforce that courageously faces this crisis.

Injury surveillance trends in career-technical education: New Jersey 1999-2018

INTRODUCTION

Adolescents engaging in school-sponsored work experiences may be at risk of injury due to factors such as inexperience. This article examines trends in 20 years of reported injuries among New Jersey (NJ) adolescents engaging in school-sponsored work experiences, and compares a transition from paper to online reporting format.

METHODS

New Jersey requires reporting of injuries occurring during school-sponsored work experiences to the NJ Department of Education. Injuries reported by NJ schools from 1999 to 2018 (n = 2,119) were examined; incidence rates for 2008 to 2018 (n = 743) were calculated using publicly available NJ Department of Education enrollment data for the denominator, including for specific groups of students: career and technical education; special healthcare needs.

RESULTS

A downward trend in reported injuries in NJ schools was observed. However, the year online reporting became required by code (2013), an increase of nearly 50% was seen from 2012 (59-89), followed by a decline in reported incidents 2014 to 2018 (mean = 65, range 76 down to 47). Injury rate trends over time paralleled those of reported incidents.

CONCLUSIONS

This study suggested worker safety and public health benefits of improvements from State of NJ code required training programs and online injury surveillance report form. Practical Applications: One potential method to address the safety and health of adolescents engaging in work experiences is the use of online reporting forms, to aid in surveillance efforts, coupled with occupational safety and health training specifically geared toward teachers and administrators who both supervise young, relatively inexperienced and vulnerable workers and who make relatively frequent worksite visits. Incorporation of specific details of the instructions on the use of a reporting form into required trainings, in addition to providing a clear, accessible guidance manual online, could further help improve youth worker safety surveillance efforts.

Standing Meetings Are Feasible and Effective in Reducing Sitting Time among Office Workers-Walking Meetings Are Not: Mixed-Methods Results on the Feasibility and Effectiveness of Active Meetings Based on Data from the "Take a Stand!" Study

Active meetings (standing or walking) have the potential to reduce sitting time among office workers. The aim of the present study was to explore the feasibility and effectiveness of standing and walking meetings. The “Take a Stand!” study was a cluster-randomized trial, consisting of multiple components including the possibility of active meetings. Analyses were based on the 173 participants in the intervention group. Feasibility was evaluated by questionnaire and interview data from participants, ambassadors and leaders. Effectiveness was assessed as the change in objectively measured sitting time from baseline to 3 months follow-up. Regular standing meetings were implemented at all offices and were generally popular, as they were perceived as more effective and focused. In contrast, only a few walking meetings were completed, and these were generally associated with several barriers and perceived as ineffective. Participants who participated in standing meetings on a regular basis had 59 min less sitting per 8 h workday (95%CI −101;−17) compared to participants who did not participate in standing meetings at all. Walking meeting participation was not significantly associated with changes in sitting time, likely due to the low number of employees who used this option. This explorative study concludes that standing meetings in office workplaces were feasible and well-liked by the employees, and having frequent standing meetings was associated with reduced sitting time. In contrast, walking meetings were unfeasible and less liked, and thus had no effect on sitting time.

The role of Mexican immigration to the United States in improved workplace safety for natives from 1980 to 2015

Between 1980 and 2015, Mexican immigration to the United States and the share of Mexican immigrants in the labor force quintupled. We provide the first evidence examining whether this impacted one element of the work environment for native workers: workplace safety. To account for endogeneity and ensure that the change in Mexican immigration arose from supply shifts, we use 2SLS and instrumental variables. We show Mexican immigration over this period led natives to work in safer jobs; resulted in fewer workplace injuries for natives; and reduced WC benefit claims overall, which had a meaningful impact on employer costs for WC.

Smoking prevalence in the area of responsibility of the German Ministry of Defense - results of the employee survey in the context of occupational health management

BACKGROUND

Tobacco use, correlated with reduced physical fitness, is one of the leading causes of avoidable death worldwide. It increases the risk of dementia and can shorten the lifespan by 10 years. For the German Armed Forces (Bundeswehr), figures on smoking behavior have not been comprehensively captured. This study analyzes current data in a large sample from this population.

METHODS

Based on an employee survey as part of the Occupational Health Management System, data on smoking behavior from 13,326 participants were analyzed in relation to age, gender, professional status, education level and membership in military operational units versus other agencies.

RESULTS

Smoking behavior varied significantly (P < 0.001) by age group (younger > older), gender, professional status, military agency membership status, and education level (the lower the education level, the higher the smoking rates). With the exception of the downward trend in smoking behavior with increasing age among civilian employees, these results were all significant (P < 0.005).

CONCLUSIONS

This data analysis shows that smoking prevalence among personnel in the area of responsibility of the Federal Ministry of Defense is comparable to the current data from corresponding surveys of the German population. Depending on gender, they generally show values that are slightly above those of the German population. The well-known trend in the general population of decreasing smoking prevalence with increasing age is also seen in this analysis. However, there are considerable differences in the smoking prevalence among individual subgroups (professional status, agency, gender, education level). The data show that particular young soldiers in the armed forces should be the target group for further preventive measures.

Cross-National Comparisons and Correlates of Harms From the Drinking of People With Whom You Work

BACKGROUND

While research in high-income countries (HICs) has established high costs associated with alcohol's harm to others (AHTO) in the workplace, scant attention has been paid to AHTO in the workplace in lower- or middle-income countries (LMICs).

AIM

To compare estimates and predictors of alcohol's impacts upon coworkers among workers in 12 countries.

METHODS

Cross-sectional surveys from 9,693 men and 8,606 women employed in Switzerland, Australia, the United States, Ireland, New Zealand, Chile, Nigeria, Lao PDR, Thailand, Vietnam, India, and Sri Lanka. Five questions were asked about harms in the past year because of coworkers' drinking: Had they (i) covered for another worker; (ii) worked extra hours; (iii) been involved in an accident or close call; or had their (iv) own productivity been reduced; or (v) ability to do their job been affected? Logistic regression and meta-analyses were estimated with 1 or more harms (vs. none) as the dependent variable, adjusting for age, sex, rurality of location, and the respondent worker's own drinking.

RESULTS

Between 1% (New Zealand) and 16% (Thailand) of workers reported that they had been adversely affected by a coworker's drinking in the previous year (with most countries in the 6 to 13% range). Smaller percentages (<1% to 12%) reported being in an accident or close call due to others' drinking. Employed men were more likely to report harm from coworkers' drinking than employed women in all countries apart from the United States, New Zealand, and Vietnam, and own drinking pattern was associated with increased harm in 5 countries. Harms were distributed fairly equally across age and geographic regions. Harm from coworkers' drinking was less prevalent among men in HICs compared with LMICs.

CONCLUSIONS

Workforce impairment because of drinking extends beyond the drinker in a range of countries and impacts productivity and economic development, particularly affecting men in LMICs.

Flexible employment policies, temporal control and health promoting practices: A qualitative study in two Australian worksites

For four decades, theories of job demand-control have proposed that higher occupational status groups have lower health risks due to the stress accompanying jobs featuring high demands but high control. This research examines whether Flexible Work Arrangements (FWAs) can improve the health prospects of a range of workers by giving greater control over work time arrangements. Our setting is Australia, where FWAs were introduced in 2009. In line with these early studies alongside studies of work-life balance, we expected to observe that workers with access to control over daily work times could better control the activities outside of work that influence chronic disease. Using a practice sociology approach, we compared the accounts of twenty-eight workers in blue and white collar industries with differing degrees of work time flexibility. The findings do not contradict early theories describing occupational differences of job demand-control dynamics and their relationship to health risks. However, this study suggests that a) time demands and strains have increased for a broad sweep of workers since the 1980s, b) the greater control of higher occupational status groups has been eroded by the high performance movement, which has attracted less scrutiny than FWAs, and c) more workers are forced to adapt their daily lives, including their approach to health, to accommodate their job demands. Job insecurity further impedes preventative health practices adoption. What might appear to be worker-controlled flexibility can-under the pressures of job insecurity and performance expectations without time limits-transform into health-eroding unpredictability. The answer however is not greater flexibility in the absence of limits on the well-documented precursors of work stress: long hours, job insecurity and intensity-related exhaustion. While there have been welcome developments in job demand-control-health conceptualizations, they typically ignore the out-of-work temporal demands that workers face and which compound on-the-job demands. Redesign of the temporalities of working life within worksites need to be accompanied by society-level policies which address caring responsibilities, gender equality as well as broad labour market conditions.

Toward an Expanded Focus for Occupational Safety and Health: A Commentary

Powerful and ongoing changes in how people work, the workforce, and the workplace require a more holistic view of each of these. We argue that an expanded focus for occupational safety and health (OSH) is necessary to prepare for and respond rapidly to future changes in the world of work that will certainly challenge traditional OSH systems. The WHO Model for Action, various European efforts at well-being, and the Total Worker Health concept provide a foundation for addressing changes in the world of work. However, a paradigm expansion to include the recognition of worker and workforce well-being as an important outcome of OSH will be needed. It will also be vital to stimulate transdisciplinary efforts and find innovative ways to attract and train students into OSH professions as the paradigm expands. This will require active marketing of the OSH field as vibrant career choice, as a profession filled with meaningful, engaging responsibilities, and as a well-placed investment for industry and society. An expanded paradigm will result in the need for new disciplines and specialties in OSH, which may be useful in new market efforts to attract new professionals. Ultimately, to achieve worker and workforce well-being we must consider how to implement this expanded focus.

Changes of 30 years in the recognized occupational diseases of Korea: Lessons from the system change perspective

Thirty years ago, in 1988 of Korea, street demonstrations for the recognition of a 15-year-old boy's death as occupational mercury poisoning had shattered the taboo against occupational disease, and since then, the volume and contents of recognized diseases had changed a lot. Here we tried to ascertain and explain the changes from the system viewpoint. The system of risk management at work was analyzed in narrative terms of what, how, who, and why of the occupational disease managements, then and now, and we conclude the system of last 30 years was to manage the benevolent benefit to the victims for politico-economic purposes. Despite a big shift in outer appearance, the changes in the inner operation were small, and we propose to adopt newer approaches of more health and safety oriented together with human rights.

Change in subjective well-being over 20 years at two Norwegian medical schools and factors linked to well-being today: a survey

BACKGROUND

There is a lack of studies on factors in the curriculum, study environment and individual differences that can promote well-being among medical students as a response to the frequent reports on the negative health effects of study demands among medical students worldwide.

OBJECTIVE

This study investigates differences in well-being among today's Norwegian medical students compared with students 20 years ago, the most important predictors of well-being today, and whether there have been any changes in the levels of some of these factors since the period analysed.

METHODS

We analysed cross-sectional survey data among all medical students (63.9%, N = 1044/1635) at two medical faculties with different curriculums (traditional and integrated) in Norway in 2015 (STUDMED 2015). We used comparison data from a longitudinal survey among medical students from the same medical faculties in 1993 to 1999: the NORDOC project (T1 = 89%, T2 = 72% and T3 = 68%). Differences in subjective well-being and correlates by demographic, curriculum, and study environment factors among the present students were tested by t-tests and stepwise linear regression analysis.

RESULTS

Students today scored lower on their levels of subjective well-being than students 20 years ago. The difference was found among female and males in different study stages. The final model showed that subjective well-being today was associated with self-esteem (β = .98, p < .001) and social support from medical school friends (β = .22, p < .001), a partner (β = .08, p = .020) or other family members (β = .04, p = .041), as well as perception of medical curriculum and environment (β = -.38, p < .001), personal competence (β = -.40, p < .001), finance/accommodation (β = -.22, p < .001) and perceived exam stress (β = -.26, p < .001).

CONCLUSIONS

The results show a decrease in subjective well-being among medical students and, in particular, among female students. The faculties should pay attention to the factors identified in the study environment and curriculum associated with subjective well-being in order to promote their student's well-being and stimulate health and academic performance.

Systematic review: chronic obstructive pulmonary disease and work-related outcomes

Background

Several studies have assessed the impact of chronic obstructive pulmonary disease (COPD) on work ability and work productivity; however, this relationship is poorly understood.

Aims

To undertake a systematic review to assess the effects of COPD on employment, absenteeism and presenteeism.

Methods

A comprehensive search using CINAHL, Embase, MEDLINE and the Cochrane Library was conducted to include epidemiological studies from 1937 to August 2017. One reviewer screened all citations. Shortlisted full-text articles were independently assessed by a second reviewer. Data were extracted by one reviewer with a random sample of papers (45%) checked by a second reviewer.

Results

Forty-four studies were included; the majority of evidence was from cross-sectional studies, and some cohort studies. COPD patients had lower employment rates than those without COPD. Among those in work, most studies showed patients with COPD took more time off work than those without and reported poorer work performance (presenteeism), although evidence for this association was weaker. The influence of disease severity on these outcomes was unclear; however, it appeared that increasing severity of airflow obstruction was associated with reduced likelihood of being employed. A number of methodological limitations were found among the evidence, including the lack of adjustment for important confounders.

Conclusions

Future studies are required which assess the impact of COPD on presenteeism using validated presenteeism instruments and consistent reporting methods. Robust studies are now needed to identify modifiable factors associated with these poorer working outcomes to inform future interventions aimed at improving work productivity among those with COPD.

Occupational Risk Prevention through Smartwatches: Precision and Uncertainty Effects of the Built-In Accelerometer

Wearable technology has had a significant growth in the last years; this is particularly true of smartwatches, due to their potential advantages and ease of use. These smart devices integrate sensors that can be potentially used within industrial settings and for several applications, such as safety, monitoring, and the identification of occupational risks. The accelerometer is one of the main sensors integrated into these devices. However, several studies have identified that sensors integrated into smart devices may present inaccuracies during data acquisition, which may influence the performance of their potential applications. This article presents an analysis from the metrological point of view to characterize the amplitude and frequency response of the integrated accelerometers in three currently available commercial smartwatches, and it also includes an analysis of the uncertainties associated with these measurements by adapting the procedures described in several International Organization for Standardization (ISO) standards. The results show that despite the technical limitations produced by the factory configuration, these devices can be used in various applications related to occupational risk assessment. Opportunities for improvement have also been identified, which will allow us to take advantage of this technology in several innovative applications within industrial settings and, in particular, for occupational health purposes.

Emerging Ergonomics Issues and Opportunities in Mining

Ergonomics is the scientific discipline that investigates the interactions between humans and systems to optimize both human and system performance for worker safety, health, and productivity. Ergonomics is frequently involved either in the design of emerging technologies or in strategies to alleviate unanticipated human performance problems with emerging technologies. This manuscript explores several such emerging issues and opportunities in the context of the mining sector. In mining, the equipment, tools, and procedures have changed considerably and continue to change. Body-worn technology provides a number of opportunities to advance the safety and health of miners, while teleoperation and autonomous mining equipment stand to benefit significantly from ergonomics applications in other sectors. This manuscript focuses on those issues and opportunities that can impact the safety and health of miners in the near term.

Map Changes and Theme Evolution in Work Hours: A Co-Word Analysis

(1) Background: Work hours are the basic carrier impacting employees' work⁻life experience and organizational performance, and employees have greater anxiety in relation to work hours as new technology requires an increasingly faster work rhythm. However, scientific research on this topic lags far behind the practice, calling to attention the need for research on work hours from the perspective of historical evolution; (2) Methods: The Bibliometric method is used to analyze the 6364 articles and their contained 77 high-frequency keywords related to work hours from the Web of Science published between 1901 and 2017. Additionally, an individual⁻organization⁻society integrative perspective was adopted to describe the map changes and theme evolution of work hours; (3) Results and conclusions: The hot spots of research at the organizational level changed significantly around 1990, with the theme of "long work hours" becoming the core issue in recent years. Studies on the individual level have gradually moved from physiological aspects to the issues of burnout and psychological distress. Research topics related to the social level are somewhat loose, and mainly focused on work⁻life conflict areas. In addition, the cluster analysis based on the high-frequency keywords classifies six research types according to their research themes. Based on these findings, future trends are proposed to provide theoretical and practical reference for future studies.

Changes in respiratory and non-respiratory symptoms in occupants of a large office building over a period of moisture damage remediation attempts

There is limited information on the natural history of building occupants’ health in relation to attempts to remediate moisture damage. We examined changes in respiratory and non-respiratory symptoms in 1,175 office building occupants over seven years with multiple remediation attempts. During each of four surveys, we categorized participants using a severity score: 0 = asymptomatic; 1 = mild, symptomatic in the last 12 months, but not frequently in the last 4 weeks; 2 = severe, symptomatic at least once weekly in the last 4 weeks. Building-related symptoms were defined as improving away from the building. We used random intercept models adjusted for demographics, smoking, building tenure, and microbial exposures to estimate temporal changes in the odds of building-related symptoms or severity scores independent of the effect of microbial exposures. Trend analyses of combined mild/severe symptoms showed no changes in the odds of respiratory symptoms but significant improvement in non-respiratory symptoms over time. Separate analyses showed increases in the odds of severe respiratory symptoms (odds ratio/year = 1.15‒1.16, p-values<0.05) and severity scores (0.02/year, p-values<0.05) for wheezing and shortness of breath on exertion, due to worsening of participants in the mild symptom group. For non-respiratory symptoms, we found no changes in the odds of severe symptoms but improvement in severity scores (-0.04‒-0.01/year, p-values<0.05) and the odds for mild fever and chills, excessive fatigue, headache, and throat symptoms (0.65–0.79/year, p-values<0.05). Our study suggests that after the onset of respiratory and severe non-respiratory symptoms associated with dampness/mold, remediation efforts might not be effective in improving occupants’ health.

Evaluating Effective Leadership and Governance in a Midwestern Agricultural Safety and Health Coalition

Agricultural Centers are a coalition of organizations and individual members with a common purpose: to improve the health and safety of the agricultural community. Successful leadership and governance are essential in accomplishing these goals. This article examined the effectiveness of a midwestern Agricultural Health and Safety Center (Ag Center) leadership and governance structure. The Internal Coalition Outcomes Hierarchy (ICOH) framework and the Internal Coalition Effectiveness (ICE^©) instrument were used, with field visit interviews conducted to gain further insight. Combined comparative findings from both research methods showed that scores in each of the categories increased. Adjustments led to stronger collaborative leadership, vital to successful population health improvement programs. This study showcases coalition qualities in a broader environment, capturing a clearer depiction of leadership and member interaction. Field visit interviews confirmed that this midwestern Ag Center continued to have strong levels of effectiveness in each of the conceptual constructs of a coalition.

Heat exposure and productivity in orchards: Implications for climate change research

Recent studies suggest that heat exposure degrades work productivity, but such studies have not considered individual- and workplace-level factors. Forty-six tree-fruit harvesters (98% Latino/a) from 6 orchards participated in a cross-sectional study in central/eastern Washington in 2015. The association between maximum measured work-shift wet-bulb globe temperature (WBGT_max) and productivity (total weight of fruit bins collected per time worked) was estimated using linear mixed-effects models, adjusting for relevant confounders. The mean (standard deviation) WBGT_max was 27.9°C (3.6°C) in August and 21.2°C (2.0°C) in September. There was a trend of decreasing productivity with increasing WBGT_max, but this association was not statistically significant. When individual- and workplace-level factors were included in the model, the association approached the null. Not considering individual, work, and economic factors that affect rest and recovery in projections of the effects of climate change could result in overestimates of reductions in future productivity and underestimate risk of heat illness.

The need for detailed gender-specific occupational safety analysis

INTRODUCTION

The female work in population is growing in the United States, therefore the occupational health and safety entities must start to analyze gender-specific data related to every industry, especially to nontraditional occupations. Women working in nontraditional jobs are often exposed to extreme workplace hazards. These women have their safety and health threatened because there are no adequate policies to mitigate gender-specific risks such as discrimination and harassment. Employers tend to aggravate this situation because they often fail to provide proper reporting infrastructure and support. According to past studies, women suffered from workplace injuries and illnesses that were less prominent among men. Statistics also confirmed that men and women faced different levels of risks in distinct work environments. For example, the rates of workplace violence and murders by personal acquaintances were significantly higher among women.

METHODS

In this paper, the authors analyze prior public data on fatal and nonfatal injuries to understand why we need to differentiate genders when analyzing occupational safety and health issues.

RESULTS

The analyses confirmed that women dealt with unique workplace hazards compared to men.

CONCLUSIONS

It is urgent that public agencies, such as the U.S. Department of Labor, record gender-specific data in details and by occupations and industries.

PRACTICAL APPLICATION

The reader will become aware of the current lack - and need - of data and knowledge about injuries and illnesses separated by gender and industry. Finally, safety and health researchers are encouraged to investigate the gender-specific data in all industries and occupations, as soon as they become available.

The perspective of European researchers of national occupational safety and health institutes for contributing to a European research agenda: a modified Delphi study

OBJECTIVES

This study, developed within the frame of the Partnership for European Research on Occupational Safety and Health joint research activities and based on the frame designed by the 2013 European Agency for Safety and Health at Work (EU-OSHA) study, is the first example of using the points of view of European occupational safety and health (OSH) researchers.The objective is to identify priorities for OSH research that may contribute to the achievement of present and future sustainable growth objectives set by the European strategies.

METHODS

The study was carried out using a modified Delphi method with a two-round survey. Each round involved a panel of about 110 researchers representing the network member institutes was selected according to specific criteria, including the ownership of research expertise in at least one of the four macroareas identified by the reference report developed by EU-OSHA in 2013.

RESULTS

The study identified some innovative research topics (for example, 'Emerging technological devices' and 'OSH consequences of markets integration') and research priorities (ie, crowdsourcing, e-work, zero-hours contracts) that are not reflected in previous studies of this nature.The absence of any reference to violence and harassment at work among the researchers' proposals is a major difference from previous similar studies, while topics related to gender issues and electromagnetic fields show a lower importance.

CONCLUSIONS

The innovative design of a research priorities identification process, which takes advantage of a large, representative and qualified panel of European researchers allowed the definition of a number of research priorities able to support the inclusion of innovative OSH research issues in the scope of the next European research agenda.

Occupational safety and health in construction: a review of applications and trends

Due to the high number of accidents that occur in construction and the consequences this has for workers, organizations, society and countries, occupational safety and health (OSH) has become a very important issue for stakeholders to take care of the human resource. For this reason, and in order to know how OSH research in the construction sector has evolved over time, this article-in which articles published in English were studied-presents an analysis of research conducted from 1930 to 2016. The classification of documents was carried out following the Occupational Safety and Health Cycle which is composed of five steps: regulation, education and training, risk assessment, risk prevention, and accident analysis. With the help of tree diagrams we show that evolution takes place. In addition, risk assessment, risk prevention, and accident analysis were the research topics with the highest number of papers. The main objective of the study was to contribute to knowledge of the subject, showing trends through an exploratory study that may serve as a starting point for further research.

Obscured by administrative data? Racial disparities in occupational injury

Objectives Underreporting of occupational injuries is well documented, but underreporting patterns may vary by worker characteristics, obscuring disparities. We tested for racial and ethnic differences in injury reporting patterns by comparing injuries reported via research survey and administrative injury database in the same group of healthcare workers in the US. Methods We used data from a cohort of 1568 hospital patient-care workers who were asked via survey whether they had been injured at work during the year prior (self-reported injury; N=244). Using the hospital's injury database, we determined whether the same workers had reported injuries to the hospital's occupational health service during that year (administratively reported injury; N=126). We compared data sources to test for racial and ethnic differences in injury reporting practices. Results In logistic regression models adjusted for demographic and occupational characteristics, black workers' odds of injury as measured by self-report data were 1.91 [95% confidence interval (95% CI) 1.04-3.49] compared with white workers. The same black workers' odds of injury as measured by administrative data were 1.22 (95% CI 0.54-2.77) compared with white workers. Conclusions The undercount of occupational injuries in administrative versus self-report data may be greater among black compared to white workers, leading to underestimates of racial disparities in workplace injury.

What should we know about precarious employment and health in 2025? Framing the agenda for the next decade of research

The generalization of flexible labour markets, the declining influence of unions and the degradation of social protection has led to the emergence of new forms of employment at the expense of the Standard Employment Relationship, as well as a considerable amount of research across social and scientific disciplines. Years ago we suggested the urgent need to disentangle the consequences of new types of employment for the health and well-being of workers, contending that the study of precarious employment and health is in its infancy. Today, research challenges include clearer, more precise definitions of the original concepts, a more detailed understanding of the pathways and mechanisms through which precarious employment harms worker health, stronger information systems for monitoring the problem and a complex systems approach to employment conditions and health research. All of these must be guided by the theoretical and policy debates linking precarious employment and health, and be geared towards developing better tools for the design, implementation and evaluation of policies intended to minimize precariousness in the labour market and its effects on public health and health inequalities. Our aim in this paper is to outline an agenda for the next decade of research on precarious employment and health, establishing a compelling programme that expands our understanding of complex causes and links.

Advancing the framework for considering the effects of climate change on worker safety and health

In 2009, a preliminary framework for how climate change could affect worker safety and health was described. That framework was based on a literature search from 1988-2008 that supported seven categories of climate-related occupational hazards: (1) increased ambient temperature; (2) air pollution; (3) ultraviolet radiation exposure; (4) extreme weather; (5) vector-borne diseases and expanded habitats; (6) industrial transitions and emerging industries; and (7) changes in the built environment. This article reviews the published literature from 2008-2014 in each of the seven categories. Additionally, three new topics related to occupational safety and health are considered: mental health effects, economic burden, and potential worker safety and health impacts associated with the nascent field of climate intervention (geoengineering). Beyond updating the literature, this article also identifies key priorities for action to better characterize and understand how occupational safety and health may be associated with climate change events and ensure that worker health and safety issues are anticipated, recognized, evaluated, and mitigated. These key priorities include research, surveillance, risk assessment, risk management, and policy development. Strong evidence indicates that climate change will continue to present occupational safety and health hazards, and this framework may be a useful tool for preventing adverse effects to workers.

Influence of occupational risk factors on health of tire plant workers

Analysis of health state in connection with work conditions for workers of Voronezh tire plant was based on evaluation of occupational and general morbidity according to medical examination data, hygienic characteristics of occupational factors and working process. Findings are high level of general morbidity among the workers, related to combined influence of physical and chemical occupational hazards. First rank places are occupied by locomotory system diseases (32.3%) and cardiovascular diseases (29.3%). Recommendations cover decrease of unfavorable effects of occupational hazards, minimization of occupational risks, including further improvement of work conditions and implementation of laboratory biochemical methods diagnosing premorbid conditions.

Features of work conditions on small and medium business enterprises

Physiologic and hygienic evaluation covered work conditions on small business enterprises of retail and minor wholesale trade. Major unfavorable occupational factor for minor retail seller of foods is work process hardiness (up to 85% of <<standing>>). This work affects the workers' state, with 100% reports of the health state changes by the end of the working day. Physiologic parameter <<work process hardiness>> in the trade workers generally was assigned to allowable (2 grade) criterion, but such parameters as work contents (work covers solving complicated problems), work in tight time conditions, responsibility and long working hours are assigned to first jeopardy degree (3.1). Minor retail trade enterprises appeared to have no work and rest schedule, that is an additional risk factor. Microclimate parameters inside the rooms are the same as outdoors, therefore necessity is to provide artificial sanitary technical systems of ventilation and heating in projects of minor retail trade networks.

Evaluation of work conditions and transitory disablement morbidity among paramedical personnel

The studies revealed that work of paramedical personnel can be assigned to 2 jeopardy class in chemical factor, noise, vibration, illumination, work hardiness; in unfavorable parameters of microclimate in summer period and work intensity - to 3.1 class, in biologic factor - to 3.1-3.3 class. According to totality of factors, the work of paramedical personnel corresponds to 3.2-3.3 class of work conditions. Morbidity level of medical nurses is <<very low>> with minimal level of occupational risk. With that, more detailed analysis in 4 length of service groups revealed that in a group with over 15 years of service the morbidity level reaches high and extremely high (from 104.0 to 244.4 cases per 100 medical staffers). This evidence could be explained by exposure to occupational risk factors and worse health state with longer length of service and ageing.

Preservation of work potential - basis of governmental policy in Siberian region

The authors accentuate the problem of preserving work potential of Russian population, most notable in industrial cities of Siberian federal district. Based on experience of Russian Federation outstanding scientists in industrial medicine and environmental hygiene (Izmerov N.F., Prokopenko L.V., At'kov O.Yu., Belyaev E.N., Bukhtiyarov IV., BushmanovAYu., Vereshagin A.I., Golovkova N.P., Kouz'mina L.P., Matiukhin VV., Tikhonova G.I., Ushakov I.B., et al), in accordance with Russian President's Orders and under support of Siberian Medical academic society, professionals in Research Institute of complex problems in hygiene and occupational diseases (Director - professor Zakharenkov V.) carry out scientific basis for priority'directions of governmental policy in Siberian region up to the level of complex special-purpose programs that are supposed to include present aims and facilities of various departments for implementation. The article covers conceptual points and main principles of program solutions, and one out of mechanisms for practical implementation.

Towards a greener labour market: occupational health and safety implications

BACKGROUND

Climate change and environmental degradation are seriously jeopardizing the future environmental and economic sustainability at the global level prompting urgent calls for a shift towards more sustainable development and greener economies. The use of the so called green jobs is a key strategy to overcome economic and ecological crisis.

AIM

The present study discusses the implications for employment and decent work of green jobs in order to identify information/training measures to enhance skills of employees protecting their working conditions.

RESULTS

Despite all the emphasis laid today on the green economy, occupational health and safety (OHS) issues have still been talked only limited, as already noted in previous studies and literature reviews.

CONCLUSION

It is needed to assess traditional and new OHS risks within green jobs in order to facilitate the transfer of OHS knowledge to green technologies as well as identifying OHS training needs.

An aftermath analysis of the 2014 coal mine accident in Soma, Turkey: Use of risk performance indicators based on historical experience

On the 13th of May 2014 a fire related incident in the Soma coal mine in Turkey caused 301 fatalities and more than 80 injuries. This has been the largest coal mine accident in Turkey, and in the OECD country group, so far. This study investigated if such a disastrous event should be expected, in a statistical sense, based on historical observations. For this purpose, PSI's ENSAD database is used to extract accident data for the period 1970-2014. Four different cases are analyzed, i.e., OECD, OECD w/o Turkey, Turkey and USA. Analysis of temporal trends for annual numbers of accidents and fatalities indicated a non-significant decreasing tendency for OECD and OECD w/o Turkey and a significant one for USA, whereas for Turkey both measures showed an increase over time. The expectation analysis revealed clearly that an event with the consequences of the Soma accident is rather unlikely for OECD, OECD w/o Turkey and USA. In contrast, such a severe accident has a substantially higher expectation for Turkey, i.e. it cannot be considered an extremely rare event, based on historical experience. This indicates a need for improved safety measures and stricter regulations in the Turkish coal mining sector in order to get closer to the rest of OECD.

[Comparison of morbidity among working population in Russian regions with different modernization levels]

Based on complex of parameters characterizing social economic level, innovation activity and morbidity among able-bodied population, the authors suggested a typology of RF regions different in potential, urgency and risk value of modernization. Claster analysis helped to identify 4 types of territories - moderately modernizing regions with high modernization potential (12 RF subjects), well modernizing regions with moderate modernization potential (26 RF subjects), moderately modernizing regions with moderate modernization potential (28 RF subjects), poorly modernizing regions with low modernization potential (5 RF subjects). Findings are that special attention is required not only by RF subjects with the workers' low health level and poorly modernization processes, but also highly modernized regions with the workers' health problems can result from risky character of modernization. The article is prepared with financial support from RGNF (project N 16-16-59007).

Do immigrants improve the health of natives?

This paper studies the effects of immigration on health. Specifically, we merge information on individual characteristics from the German Socio-Economic Panel (1984-2009) with detailed local labour market characteristics, and we then exploit the longitudinal component of the data to determine how immigration affects the health of both immigrants and natives over time. We find that immigrants to Germany are healthier than natives upon their arrival (the healthy immigrant effect) but that immigrants' health deteriorates over time. We show that the convergence in health is heterogeneous across immigrants and occurs more rapidly among those working in more physically demanding jobs. Because immigrants are significantly more likely to work in strenuous occupations, we investigate whether changes in the spatial concentration of immigrants affect the health of the native population. Our results suggest that immigration reduces the likelihood that residents will report negative health outcomes. We show that these effects are concentrated in blue-collar occupations and are stronger among low-educated natives. Improvements in natives' average working conditions and workloads help explain the positive effects of immigration on the health of the native population.