The impact of international health worker migration and recruitment on health systems in source countries: Stakeholder perspectives from Colombia, Indonesia, and Jordan.

INTRODUCTION: To address domestic shortages, high-income countries are increasingly recruiting health workers from low- and middle-income countries. This practice is much debated. Proponents underline benefits of return migration and remittances. Critics point in particular to the risk of brain drain. Empirical evidence supporting either position is yet rare. This study contributes to filling this gap in knowledge by reporting high-level stakeholders' perspectives on health system impacts of international migration in general, and active recruitment of health workers in specific, in Colombia, Indonesia, and Jordan. METHOD: We used a multiple case study methodology, based on qualitative methods integrated with information available in the published literature. RESULTS: All respondents decried a lack of robust and detailed data as a serious challenge in ascertaining their perspectives on impacts of health worker migration. Stakeholders described current emigration levels as not substantially aggravating existing health workforce availability challenges. This is due to the fact that all three countries are faced with health worker unemployment grounded in unwillingness to work in rural areas and/or overproduction of certain cadres. Respondents, however, pleaded against targeting very experienced and specialised individuals. While observing little harm of health worker migration at present, stakeholders also noted few benefits such as brain gain, describing how various barriers to skill enhancement, return, and reintegration into the health system hamper in practice what may be possible in theory. CONCLUSION: Improved availability of data on health worker migration, including their potential return and reintegration into their country of origin's health system, is urgently necessary to understand and continuously monitor costs and benefits in dynamic national and international health labour markets. Our results imply that potential benefits of migration do not come into being automatically, but need in-country supportive policy and programming, such as favourable reintegration policies or programs targeting engagement of the diaspora.

Factors Associated With University Students' Attitude Toward Euthanasia.

Although euthanasia has been practiced for thousands of years, a wide controversy still exists around it. This study aimed to assess the attitude of university students toward euthanasia and its associated factors. The study included an online self-administered survey. Survey questions consisted of demographic information, psychological condition, and attitude toward euthanasia. A total of 1,188 students participated in the study. Approximately only one-third of the respondents (34.1%) viewed euthanasia as a moral practice, and just one-quarter (25.3%) supported legalizing it. The main reason for not supporting euthanasia was religious considerations (72.2%), followed by moral considerations (46.5%). Factors that predicted a positive attitude toward euthanasia (p < .05) included undefined religion, being male, feeling lonely, or having suicidal thoughts. Conclusively, the negative attitude toward euthanasia is primarily driven by religious beliefs. Furthermore, gender and psychological status play critical roles in students' attitudes toward euthanasia.

Face-to-face versus distance learning of basic suturing skills in novice learners: a quantitative prospective randomized trial.

BACKGROUND AND AIM: Traditionally, practical skills are taught on face-to-face (F-F) basis. COVID-19 pandemic brought distance learning (DL) to the spotlight because of the social distancing mandates. We sought to determine the acceptability and effectiveness of DL of basic suturing in novice learners. METHODS: A prospective randomized controlled trial involving 118 students was conducted. Participants were randomized into two groups for learning simple interrupted suturing: F-F and DL-groups. Evaluation was conducted by two assessors using a performance checklist and a global rating tool. Agreement between the assessors was calculated, and performance scores of the participants were compared. Participants' satisfaction was assessed via a questionnaire. RESULTS: Fifty-nine students were randomized to the F-F group and 59 to the DL-group. Satisfactory agreement between the assessors was demonstrated. All participants were successful in placing three interrupted sutures, with no significant difference in the performance between the groups. 25(44.6%) of the respondents in the DL-group provided negative comments related to the difficulties of remotely learning visuospatial concepts, 16(28.5%) preferred the F-F approach. CONCLUSION: DL of basic suturing is as effective as the F-F approach in novice learners. It is acceptable by the students despite the challenges related to the remote learning of practical skills.

Perceptions of primary healthcare physicians in Jordan of their role in the COVID-19 pandemic: A cross-sectional study.

BACKGROUND: Following the remarkable spread of coronavirus disease 2019 (COVID-19), worldwide, it quickly became apparent that many public health systems worldwide were not prepared to manage such a pandemic. We aimed to assess the perceptions of primary care physicians (PCPs) in Jordan towards their role during COVID-19. METHODS: A cross-sectional study using a self-administered questionnaire was performed. The study participants included PCPs from the Ministry of Health, academic institutions, and the private sector in Jordan. RESULTS: A total of 221 PCPs participated in the study. Most participants reported not having received any training on infection control (59.7%) or COVID-19 (81%). More than half PCPs (53.4%) felt positive about the way patients received and/or complied with their instructions. More than half PCPs (55.7%) educated their patients on protective measures against COVID-19 infection and considered this as part of their role and responsibility. Over 80% of the participants would apply social distancing, hand sanitation, facial masks, and patient education, but only half (51.1%) reported planning to order COVID-19 test kits. CONCLUSIONS: PCPs had a positive attitude towards controlling COVID-19 infection and showed a willingness to educate patients on how to protect themselves. However, PCPs should be provided special training on COVID-19.

The relationship of atrial fibrillation with left atrial size in patients with essential hypertension.

Atrial fibrillation (AF) is the most common sustained arrhythmia and it is a major public health problem worldwide. Hypertension is one of the major risk factors for the development of AF. This study is carried out to determine the prevalence and independent risk factors for atrial fibrillation (AF) in hypertensive patients and to evaluate the relationship of AF with left atrial size. This is a retrospective observational cross - sectional study that used a retrospective electronic chart review of all admitted patients to cardiology department at King Abdullah university hospital (KAUH) in Irbid, Jordan, with a diagnosis of hypertension along with various acute cardiac admissions, including AF during 1-year period (January 1st to December 31 of 2021). Risk factors for AF (age, sex, DM, coronary artery disease, valvular heart disease, Cor-pulmonale, obstructive sleep apnea, and congestive cardiac failure) were retrieved from electronic charts of the patients. A total of 958 patients were admitted to the coronary care unit (CCU) and intermediate care unit (IMCU) during a 1-year period. Among them, 276 had 2 or 3 admissions. The main reason of admission was acute coronary syndrome (n = 491), heart failure (n = 180), and AF (n = 144), indicating AF prevalence of 15%. However, there were 40 patients with combined causes. All patients in the study (n = 958) were diagnosed with hypertension, including patients with atrial fibrillation (n = 144). The mean age of patients was 61.4 (± 11.46) years, and approximately two thirds of them were males (65.4%). The binary logistic regression model demonstrated a significant statistical relationship of age, left atrial size, coronary artery disease, left ventricular ejection fraction, left ventricular dimensions in systole and diastole, and heart failure with the occurrence of AF after controlling for gender, smoking, and diabetes. Findings indicate that left atrial size plays a significant role in the development of AF in patients with hypertension. However, the prevalence of AF significantly increased with advancing age in both sexes because of increased left ventricular hypertrophy, which leads to increased left atrial size.

The Impact of COVID-19 Pandemic on Patients Receiving Orthodontic Treatment.

OBJECTIVE: The coronavirus disease 2019 (COVID-19) pandemic impacted the provision of dental treatment in a timely manner including orthodontic treatment. The objective of this study was to assess challenges encountered by patients undergoing orthodontic treatment during the pandemic and their attitude toward managing these challenges. MATERIAL AND METHODS: A cross-sectional sample of orthodontic patients at Prince Rashid Hospital in the north of Jordan was recruited to participate in a self-administered questionnaire that included questions related to orthodontic problems encountered during the lockdown, ways to overcome these problems, and concerns about their treatment. RESULTS: A total of 120 patients participated, 40 males and 80 females. Most participants (n = 86) had a fixed orthodontic appliance, who reported various orthodontic problems (82%), but the most common problems reported were exposed wire endings and loosening of brackets. Likewise, the most commonly reported problem among those with removable appliances (n = 34) was a broken or loose appliance (60%). However, patients of both types of appliances ignored the problem and waited until the re-opening of dental offices. Further, most patients missed at least one appointment for different reasons and three-quarters of them (76.6%) did not communicate with their orthodontists during the lockdown. Patients expressed their disagreement with the closure of dental offices during the pandemic because of their concern of a prolonged waiting to receive another appointment. CONCLUSION: The COVID-19 pandemic had a significant impact on orthodontic care and the maintenance of appointments during the lockdown periods. Patients varied in ways they managed their orthodontic problems, including their commitment to communicate with the dentists or maintain their appointments. Hence, patients should be trained on how to manage the appliance problems when they need and encourage them to accept distant communication during the emergencies.

Association of vitamin D levels and polymorphisms in vitamin D receptor with type 2 diabetes mellitus.

Type 2 diabetes mellitus (T2DM) is a leading cause of death. The prevalence of T2DM in countries of the Middle East and North Africa (MENA) region, including Jordan, is among the highest worldwide. The reason(s) behind the epidemic nature of T2DM in Jordan are unknown but warrant further exploration. Studies have indicated that T2DM could be influenced by diet and/or genetic background. Evidence suggests that numerous patients with T2DM are deficient in vitamin D. The activity of vitamin D on its target tissues may be influenced by single nucleotide polymorphisms (SNPs) in the vitamin D receptor (VDR) gene. It was therefore hypothesized that SNPs in VDR could modify the risk of T2DM. To test this hypothesis, 125 patients with T2DM were recruited along with 125 controls. The study subjects were genotyped for variations in rs2228570, rs1544410, rs7975232, and rs731236 SNPs in the VDR. The levels of 25-hydroxyvitamin D [25(OH)D] were measured from the serum. The analysis revealed that reduced 25(OH)D and age were associated with the risk of T2DM (P<0.05). Moreover, under a dominant inheritance model, the GG genotype of rs2228570 was revealed to increase the risk of T2DM in univariate and multivariate analysis (P<0.05). Additionally, a chromosomal block containing the GAAG haplotype of VDR SNPs increased the risk of T2DM (OR=1.909; CI: 1.260-2.891; P=0.0021). Collectively, the present study revealed that low levels of serum 25(OH)D and rs2228570 of the VDR gene are associated with the risk of T2DM.

Quality of care for type 2 diabetes in Jordan: A national study.

The present study aimed to describe the quality of healthcare delivered to patients with type 2 diabetes in Jordan in 2017. Another objective was to identify the factors related to glycemic control and hospital admission due to type 2 diabetes. This was a national population-based household study. Aspects of care quality were evaluated in relation to outcomes, such as glycemic control [hemoglobin A1c; glycated hemoglobin (HbA1c) level <7%] and hospital admission owing to diabetes. A total of 754 patients previously diagnosed with type 2 diabetes and aged ≥25 years were recruited. The number of annual visits was >10 for 48.5% and 1-4 for 38.2% of patients. The proportion of patients achieving glycemic control was 33.0%. In total, 4 of 5 patients reported easy access to health facilities and good health team support. Foot and eye examinations were performed for 24.9 and 55.0% of the patients, respectively. Dietary advice was delivered to 87.5% of the patients. Glycemic control exhibited a significant inverse association with the duration of diabetes and the number of annual visits. Following a specific diet for managing diabetes and the cessation of medication after an improved well-being were independently associated with a higher likelihood of glycemic control (HbA1c <7%). On the whole, the present study demonstrates that a number of indicators for the quality of diabetes care in Jordan were relatively satisfactory; however, others require improvement. The findings demonstrate that numerous patients with diabetes in Jordan require education about the treatment and management of, and complications associated with diabetes, especially those who are recently diagnosed.

Communicating the Risks of Air Pollution to the Public: A Perspective from Jordan and Lebanon.

Background: Communicating air pollution to the public is essential in reducing exposure to air pollutants through increasing awareness and promoting precautionary actions. However, one way to approach the public is through healthcare professionals who are considered public health leaders and could influence the public's opinion. The current study aimed to investigate the perception of health experts about communicating air pollution to the public. Methods: Personal interviews of 32 health professionals were conducted to report their opinions about communication of air pollution through an open-ended questionnaire. Interview questions were focused on 5 themes: common air pollutants and health risks, goals and barriers of communication, types of information to disseminate, target groups, and vehicles of communication. Results: Interviewees agreed that air pollution should be communicated to the public. Major barriers to achieving effective communication were people's poor comprehension and lack of interest of policymakers. The levels of pollution, associated health risks, and ways to protect one's self were the most frequently reported types of information to distribute. Most interviewees focused on patients with pre-existing conditions and children as the main target groups. Further, social media and text messages were preferred as vehicles of communication. Conclusion: Although not all interviewees had a clear idea of how to develop and implement a communication system, most of them agreed on its importance in protecting the public. More emphasis on this topic and further investigations are expected to increase the interest of health care professionals in communicating the risks of air pollution and advocating for public health policies regarding air pollution.

Water, Sanitation, and Hygiene and Infection Prevention and Control in Jordanian Hospitals in the Context of COVID-19: A National Assessment.

Purpose: To identify areas that need improvement in Jordanian health centers regarding infection prevention and control (IPC) programs; water, sanitation, and hygiene (WASH) services; and other protective measures, especially in the context of coronavirus disease (COVID-19). Methods: This is a national assessment study that comprised hospitals of different sectors in Jordan, including, Ministry of Health (MoH), private, and military hospitals. The study included 23 Jordanian hospitals. Assessment tools were developed and adapted mainly from the WASH Facility Improvement Tool (WASH FIT) and other tools. Hospitals were assessed to meet targets based on whether indicators were fully met, partially met, or not met. Results: The mean percentage of the 150 indicators that met the standards was 83.2% (72.6% for MoH, 84.5% for private, and 90.4% for military hospitals). The percentage of indicators, both WASH/IPC and training and education indicators, that met the targets were higher in military hospitals than in MoH and private hospitals. However, in context of COVID-19, only 64.7% of indicators related to precautionary measures were met by all hospitals. Conclusion: The data available on WASH/IPC in Jordan are scarce, and the study findings will help in preventing severe consequences of the COVID-19 pandemic. There is scope for improvement in many WASH/IPC aspects, and urgent actions should be taken, especially to fill the gaps in COVID-19 precautionary measures.

Air pollutants and attention deficit hyperactivity disorder medication administration in elementary schools.

Air pollution is considered a risk factor for several diseases, particularly respiratory and cardiovascular diseases. However, the effects of air pollution on neurobehavioral disorders have not been confirmed as of yet. Thus, the aim of this study was to determine whether there was an association between seven air pollutants and ADHD medication administration (ADHD-MA) in Pennsylvania-located elementary schools over a 3-year period. An ecological study design involving records of 168,825 children from elementary schools in 49 Pennsylvania counties was used. The number of children with ADHD-MA was extracted from an online software specifically designed for allowing nurses to record health conditions in schools. Daily measurements of air pollutants were obtained from the U.S Environmental Protection Agency. The differences in the number of ADHD-MA among the four seasons, for all years, were statistically significant (P<0.001). Three air pollutants (SO2, CO, and PM2.5) were significantly associated with ADHD-MA; no interactions among air pollutants were significant. Air pollution was thus likely associated with ADHD-MA. Prospective epidemiological and biomedical studies should next examine the molecular relationship between air pollution and ADHD symptoms.

Daytime Sleepiness among Medical Colleges' Students in Jordan: Impact on Academic Performance.

Introduction: Sleep disorders are extremely prevalent in the general population. College students are more susceptible to sleep problems. This is due to the increased competition in getting a job position and the current alterations in the labor market. Poor sleep is prevalent and has deleterious effects on college students, but its frequency among college students has not been documented in Jordan. So, the aims of this study are to assess the prevalence of daytime sleepiness among medical college students in Jordan and to look for any links between daytime sleepiness and academic performance. Methods: A cross-sectional study performed on medical and paramedical specialties students and Epworth sleepiness Sscale (ESS) was used. To assess the students' academic performance, the cumulative grade point average was utilized. Results: 977 students from five medical colleges participated in the study. ESS scores were abnormal in 34.4% of students and were considered to have daytime sleepiness. Significant lower ESS scores were associated with students who reported good sleep quality than students who reported poor sleep quality. Significant lower ESS scores were reported by students who slept more than 7 hours compared with students who slept less than 6 hours. The ESS scores were not significantly associated with students' CPGA. Conclusion: Daytime sleepiness is highly prevalent among medical students in Jordan. The data of this study might be very helpful to assess the academic policy makers to develop intervention strategies that resolve the sleep disturbances in college students and reduce its impact on the academic achievements.

Osteoporosis among Postmenopausal Women in Jordan: A National Cross-Sectional Study.

Osteoporosis is considered a widespread health problem that affects senior citizens, particularly older women, after the menopause. This national study aimed to estimate the prevalence of osteoporosis among Jordanian postmenopausal women and to determine the association of demographic and nutritional factors, such as calcium and vitamin D supplement intake, with osteoporosis in postmenopausal women. A cross-sectional study was conducted among 884 postmenopausal women aged ≥50 years. A multistage sampling technique was used to select participants from three geographic regions of Jordan (north, middle, and south). The data were collected from the participants by a team of field researchers comprising men and women through a standard questionnaire. The prevalence of osteoporosis was 19.8% among postmenopausal Jordanian women. The study results showed that age (p ˂ 0.001), geographic region (p = 0.019), occupation (p = 0.002), and educational level (p = 0.001) were significantly associated with osteoporosis. Moreover, osteoporosis was significantly associated with calcium and vitamin D supplement intake (p < 0.05). There is a high prevalence of osteoporosis among postmenopausal Jordanian women. Therefore, there is a need to educate women at this age, and probably at an earlier age, to prevent or reduce the development of osteoporosis.

The Knowledge of Sleep Medicine among Dental Interns in Northern Jordan.

OBJECTIVES: The diagnosis and treatment of patients with sleep disorders are the most challenging issues in dentistry. The aim of this study was to assess the knowledge among dental interns in Northern Jordan about sleep medicine and sleep disorders. MATERIALS AND METHODS: This cross-sectional study was performed using the Assessment of Sleep Knowledge in Medical Education (ASKME) questionnaire. The questionnaire was given to 88 dental interns (52 females and 36 males) in Northern Jordan. Chi-squared test was utilized for data analysis. RESULTS: The mean score of the ASKME questionnaire was 12 out of 30 (40%). The majority of dental interns (88.6%) correctly answered ≤ 50% of the questions. No association was found between gender and score results. CONCLUSIONS: Dental interns in Northern Jordan have a low level of knowledge about sleep medicine and sleep disorders. Dental faculties should provide courses related to sleep medicine throughout undergraduate education.

Knowledge, attitude, and practice of healthy eating among public school teachers in Kuwait.

BACKGROUND: Healthy food is essential for strengthening the body and protecting it from diseases. Conversely, unhealthy food can cause severe diseases in children and adolescents. The present study aimed to assess the level of knowledge, attitude, and practice among teachers about healthy food and to examine the associated factors. DESIGN AND METHODS: A cross-sectional study was conducted using a questionnaire distributed to 300 teachers in the Hawalli and Al-Jahra educational areas in Kuwait over approximately six months in 2019. RESULTS: Those who participated in a course had significantly greater knowledge than those who did not (p=0.005). The respondents in Hawalli had a significantly lower mean attitude than Al-Jahrah teachers (7.9±1.5 vs 8.2±1.5, respectively; p=0.03). CONCLUSIONS: Limited knowledge combined with a low level of positive attitude suggests an ongoing educational workshop should be established to promote healthy nutrition.

Attitudes of Medical and Health Sciences Students towards Abortion in Jordan.

BACKGROUND: Jordan laws on permitting abortion are considered moderate. Religion is one of the key determinants of people's attitudes towards abortion and plays a crucial role in people's readiness to accept or refute this practice. In this study, we examined the attitudes of medical and health sciences students towards abortion. METHODS: In this cross-sectional study, a self-administered questionnaire survey was distributed to students at Jordan University of Science and Technology. Attitudes towards abortion were tested using 16 items that were included in the survey. Descriptive statistics and logistic regression models were used in the analysis. RESULTS: A total of 1324 students in the medicine and dentistry colleges participated in the study. Two-thirds of the participants were women. Most participants were 20-25 years old, and they grew up in a family of 6-8 members. The overall attitude towards abortion was negative, except if the pregnancy was a threat to the mother's life (91.5%) or if the conception occurred from rape (54.2%). Otherwise, the students indicated that every conceived child has the right to be born (76.8%) and that abortion is considered murder (53.1%). Furthermore, the students who were more likely to support abortion were those attending the medical college, living in a city, and/or raised in smaller families (p = 0.04). CONCLUSIONS: Compared with other students, medical students were more supportive of abortion. This implied the necessity to include training on safe abortion in the medical curriculum and increase public awareness of the importance of safe abortion.

Leptin and the GA genotype of rs2167270 of the LEP gene increase the risk of prediabetes.

Prediabetes is a precursor stage that frequently develops to definitive type 2 diabetes mellitus (T2DM). Therefore, identifying individuals with prediabetes can allow for early intervention measures that delay or prevent disease progression to T2DM. Several biochemical changes appear to be associated with prediabetes, including an increase in the serum levels of leptin. In Jordan, this association has not been previously investigated. In the present study, the serum levels of leptin were measured in 122 prediabetes subjects and 122 controls. Furthermore, the genotypes of three single nucleotide polymorphisms in the LEP gene (rs7799039, rs2167270 and rs791620) were investigated for their association with prediabetes using PCR-restriction fragment length polymorphism. The results revealed a significant increase in serum leptin levels in the prediabetes group. It was also shown that the GA genotype and the A allele of rs2167270 were significantly associated with an increased risk of prediabetes (P<0.05). These findings were shown to be independent of body mass index, waist circumference and serum glucose levels. To the best of our knowledge, the present study is the first in Jordan to have reported an association between serum leptin levels and the GA genotype of rs2167270 with an increased risk of prediabetes, identified both in the univariate and multivariate models.

Attitude of Jordanian Health Care Workers Toward Surrogacy.

Objective: To assess the attitude of Jordanian health care workers toward surrogacy. Materials and methods: Three municipalities in Jordan were randomly selected, one from each region: north, south and central of Jordan. A total of: four public hospitals, three private hospitals, one university hospital, 40 health centers and 40 private clinics were included in the study. Healthcare workers in the selected facilities were randomly approached using a self- administered questionnaire to collect data. Distributions of attitude by gender, job title, and physician's specialty were used to describe participants' attitude toward surrogacy. Results: Responses of 382 participants were reported, of whom, 230 (60.2%) were females. Three in every four participants didn't support legalizing surrogacy in Jordan. Majority reported negative attitude toward commercial surrogacy (85.1%) and noncommercial surrogacy (76.4%). Religious considerations were the main reason (71.1%) for the attitude toward surrogacy. Most items describing attitude toward surrogacy were significantly distributed across different job titles: nurses, medical doctors, and other healthcare workers (p < 0.05). Conclusion: Negative attitude among health care workers toward surrogacy was mainly driven by religious beliefs. However, there are core cultural changes in the community which might alter the attitude toward surrogacy in the future.

Exercise Counseling by Primary Care Physicians in Jordan-A Preliminary Study.

Despite the value of physical activity and exercise to patients, little is known about the perception and practices of Jordanian primary care physicians (PCPs) regarding counseling patients about exercise. This study was aimed at assessing counseling about exercise by PCPs in Jordan. A cross-sectional study targeting a random sample of physicians from family medicine, internal medicine and general practice in academic, public, and private sectors. Chi-square test of independence was used to assess the association of perceptions and practices of physicians regarding exercise counseling with their specialty. Logistic regression models were used to examine the association of demographic information with selected items of perception and practice. A total of 218 physicians participated in the study. They were mainly males (67%), family medicine physicians (42.2%), and had a mean age of 33.7 (±9.87) years. Most physicians believed that less than half of patients will start exercising (91.3%) or will continue exercising if they were repeatedly counseled at follow-up visits (85.4%). Family medicine physicians counseled more patients, more frequently, and their desire to counsel more patients was significantly higher than other physicians (P = .002).The Perceptions and practices of Jordanian PCPs toward exercise counseling for their patients were found positive; however the desire to counsel more patients was low. Lack of patients' motivation to practice exercise, time constraint and limited resources were the most frequently reported barriers to counseling. Further investigation on how to overcome such barriers is recommended.

Needle Stick and Sharp Injuries Among Healthcare Workers: A retrospective six-year study.

OBJECTIVES: This study aimed to examine the proportion of needle stick and sharp injuries (NSSIs) among healthcare workers at King Hussein Medical Center (KHMC), Amman, Jordan. METHODS: All NSSI reports referred from departments at KHMC to the Preventive Medicine Department between 2013-2018 were retrospectively reviewed. Proportion of NSSIs were calculated and stratified according to age, gender, job title, place and site of injury and the procedure/task during which the injury occurred. RESULTS: There were a total of 393 NSSIs. A significant association was found between the proportion of NSSIs and all tested variables (P <0.001). The reported proportion of NSSIs was highest among nurses (39.7%) followed by cleaners (36.3%), physicians (10.4%), other workers (7.4%) and lab technicians (5.9%) during the study's six-year period. Hospital wards were the most common locations (46.1%) where injuries took place. Injuries also occurred most frequently during medical waste collection (38.2%). CONCLUSION: The proportion of NSSIs was highest among nurses and cleaners. Safety policies and training among high-risk groups should be reviewed to reduce the risk of NSSIs. Multicentre studies at a national level should be conducted to examine whether this study's findings reflect national trends.