Reduction of acute respiratory infections in day-care by non-pharmaceutical interventions: a narrative review.

Objective: Children who start in day-care have 2-4 times as many respiratory infections compared to children who are cared for at home, and day-care staff are among the employees with the highest absenteeism. The extensive new knowledge that has been generated in the COVID-19 era should be used in the prevention measures we prioritize. The purpose of this narrative review is to answer the questions: Which respiratory viruses are the most significant in day-care centers and similar indoor environments? What do we know about the transmission route of these viruses? What evidence is there for the effectiveness of different non-pharmaceutical prevention measures? Design: Literature searches with different terms related to respiratory infections in humans, mitigation strategies, viral transmission mechanisms, and with special focus on day-care, kindergarten or child nurseries, were conducted in PubMed database and Web of Science. Searches with each of the main viruses in combination with transmission, infectivity, and infectious spread were conducted separately supplemented through the references of articles that were retrieved. Results: Five viruses were found to be responsible for ≈95% of respiratory infections: rhinovirus, (RV), influenza virus (IV), respiratory syncytial virus (RSV), coronavirus (CoV), and adenovirus (AdV). Novel research, emerged during the COVID-19 pandemic, suggests that most respiratory viruses are primarily transmitted in an airborne manner carried by aerosols (microdroplets). Conclusion: Since airborne transmission is dominant for the most common respiratory viruses, the most important preventive measures consist of better indoor air quality that reduces viral concentrations and viability by appropriate ventilation strategies. Furthermore, control of the relative humidity and temperature, which ensures optimal respiratory functionality and, together with low resident density (or mask use) and increased time outdoors, can reduce the occurrence of respiratory infections.

The labor market costs of work-related stress: A longitudinal study of 52 763 Danish employees using multi-state modeling.

OBJECTIVE: Work-related stress is an important public health concern in all industrialized countries and is linked to reduced labor market affiliation and an increased disease burden. We aimed to quantify the labor market costs of work-related stress for a large sample of Danish employees. METHODS: We linked four consecutive survey waves on occupational health and five national longitudinal registers with date-based information on wage and social benefits payments. From 2012 to 2020, we followed survey participants for two year-periods, yielding 110 559 person-years. We identified work stress by combining three dichotomous stress indicators: (i) self-perceived work stress, (ii) Cohen 4-level perceived stress scale, and (iii) job strain. Using the multi-state expected labor market affiliation (ELMA) method, we estimated the labor market expenses associated with work-related stress. RESULTS: Of the employees, 26-37% had at least one work-stress indicator. Men aged 35-64 years and women aged 18-64 years with work-related stress had up to 81.6 fewer workdays and up to 50.7 more days of sickness absence during follow-up than similarly aged men without work stress. The average annual work absenteeism loss per employee linked to work-related stress was €1903 for men and €3909 for women, corresponding to 3.3% of men's average annual wages and 9.0% of women's average annual wages, respectively. The total annual expenses were €305.2 million for men and €868.5 million for women. CONCLUSION: Work-related stress was associated with significant labor market costs due to increased sickness absence and unemployment. The prevention of work-related stress is an important occupational health concern, and the development of effective interventions should be given high priority.