Correlation between unproven therapies and delayed return-to-work for COVID-19-infected healthcare workers.

The objective of this study is to investigate factors influencing the time to return to work (RTW) of HealthCare Workers (HCW) infected with COVID-19 during the initial wave of the pandemic in a southern French university hospital. Data collection of 170 HCW (between March 16 to June 1, 2020) included demographic and professional information, clinical profiles, comorbidities, medical management, therapies and RT-PCR results. The mean time to RTW was 15.6 days. Multivariate analyses revealed that the time to RTW was shorter among laboratory and emergency workers, while it was longer for HCW aged 40 to 49 years, at higher risk of severe illness, with a delayed negative SARS-CoV-2 PCR or those treated with azithromycin and/or hydroxychloroquine. This study highlights diverse factors affecting HCW RTW post-COVID-19 infection, underscoring the importance of exercising caution in administering unproven therapies to HCW during the early stages of a novel infectious pandemic.

Permanent unfitness for work and mental disorders: a multicentric cross-sectional study of 2,788 unfit employees.

In France, Mental Disorders (MD) are the second most common medical cause of unfitness-for-work notices. The main objective is to describe the MD causing permanent medically unfitness at the workstation. A cross-sectional multicenter survey was conducted among employees followed by 323 physicians from occupational health services of the South of France in 2017. The MD responsible for unfitness for the job were coded according to the ICD-10 nomenclature and their occupational origin was estimated by each physician. On 359,966 employees screened, 2,788 were unfitted. Among the 2,779 unfitness cases which were analysed, 985 were unfitted for MD. The incidence rate of unfitness for MD was 2.78 unfit per 1,000 employees followed. Representing 36.8% (985 cases) of all grounds for unfitness, MD were estimated to be work-related in 614 (63.6%) of cases. The main MD were 449 (45.6%) cases of major depressive episodes, 227 (23.0%) anxiety disorders and 131 (13.3%) recurrent depressive disorders. Their occupational origin was mentioned in 296 (67.3%), 168 (74.7%), 62 (49.6%) cases and the link with a Burnout (BO) in 166 (38.3%), 61 (27.9%) and 41 (34.2%) cases respectively among 364 all pathologies reported to a BO. Unfitness for MD was more common among women (ORa = 1.79 95% CI [1.50-2.13]), working in trade, transport, accommodation and catering (ORa = 1.47 95% CI [1.04-2.09]) and increase with age (ORa = 4.24 95% CI [2.73-6.60] for over 55). Major depressive episodes represent the MD most frequently responsible for unfitness and the most related to occupational origin.

Factors associated with internal contamination of nurses by antineoplastic drugs based on biomonitoring data from a previous study.

Internal contamination of healthcare professionals by antineoplastic drugs (ADs) remains a current occupational health issue, particularly because these compounds are classified as dangerous to handle by the NIOSH. In order to improve preventive actions, a study of the factors associated with this internal contamination was conducted among nursing staff in health care institutions. This study is a statistical analysis of metadata from a cross-sectional observational study conducted among nurses in two French hospitals. The internal contamination of each nurse was assessed in a previous study and was defined by whether or not at least one studied AD was detected in at least one urine sample. Three urine samples and a self-questionnaire were collected for each participant. Analysis of five ADs (cyclophosphamide, ifosfamide, metabolite of 5-fluorouracil, methotrexate, doxorubicin) were performed by liquid chromatography coupled to tandem mass spectrometry. A multivariate stepwise descending regression model was used to determine factors associated with internal contamination by coupling data from a self-questionnaire with internal contamination data. A total of 74 nurses participated to the study and 68 were included for this work: 39 nurses with and 29 without detectable internal ADs contamination. Two protective factors of internal contamination could be identified: a high "glove wearing score" (OR: 0.957; 95%CI: 0.93-0.98; p < 0.01) and a high "total number of years handling ADs and/or caring for patients treated with ADs" (OR: 0.797; 95%CI: 0.67-0.91; p < 0.01). In addition, three factors contributing to internal contamination were identified, namely "feeling sufficiently informed about tasks exposing to ADs" (OR: 9.585; 95%CI: 2.23-57.05; p < 0.01), "disposal of a waste bin containing equipment used for administration of the ADs studied" (OR: 8.04; 95%CI: 1.87-46.08; p < 0.01) and "changing sheets and/or making bed of a patient treated by one of the ADs studied" (OR: 10.479; 95%CI: 1.43-133.30; p < 0.05). Thus, the use of gloves when handling ADs directly or indirectly and the contaminating nature of certain tasks should be taken into account when (1) implementing preventive actions in health care services and (2) training and informing exposed staff. Further studies would be desirable to confirm these results and extend them to other professional categories.

Permanent Unfitness for Work and Musculoskeletal Diseases: A Multicentric Cross-sectional Study of 2788 Unfit Employees.

OBJECTIVE: To describe the various musculoskeletal diseases resulting in work-related permanent unfitness for work. Methods: In 2017, a multicenter cross-sectional employee survey in the South of France was conducted by 323 occupational physicians. Results: Of the 359,966 employees monitored, 2788 had permanent unfitness for work. This number included 1078 for musculoskeletal diseases, which was more frequent in women (odds ratio, 1.42; confidence interval, 1.20 to 1.68) and showed an increase in women older than 55 years (odds ratio, 6.42; confidence interval, 4.4 to 6.60). Back disorder was the most common work-related disorder reported (n = 488 [45.4%]), with soft tissue conditions being (n = 237 [22.0%]). Arthropathy (n = 157 [14.6%]) had occupational origins in 282 (44.3%), 169 (26.6%), and 55 (8.6%) cases, respectively. Conclusions: Musculoskeletal disability prevention should be encouraged to avoid resultant employment attrition.

Job retention for people with bipolar disorder: A qualitative analysis.

At least half of people with bipolar disorder, whose global prevalence is greater than 1% of the general population, do not have a stable occupation. The objective of this study is to identify the factors perceived by bipolar people as having an impact on retention in employment. Semi-directed individual interviews were offered to subjects with bipolar disorder, of working age, who had been seen by three different hospital departments in the south of France. These people had to be medically stable and have at least one occupational experience. Each interview was recorded and transcribed manually and then analyzed according to a thematic classification of verbatims. Nineteen people participated in the interviews. Three major themes identified were classified into intrinsic (working routine and working environment) and extrinsic (external aids) factors for the bipolar person. The majority believe that working regular hours is a balancing factor. For everyone, night work and stress factors can lead to relapses. All stressed the need to destigmatize the disease. Most believe that it is necessary to develop employment support organizations specific to mental illnesses. This research helps to inform people with bipolar disorder about the occupational factors that help balance their condition. Personalized multidisciplinary care pathways involving occupational medicine must be developed in order to promote the balance of the disease and job retention.

Burnout prevalence among European physicians: a systematic review and meta-analysis.

PURPOSE: Our objective was to assess burnout prevalence rates among physicians practicing in Europe (regardless of their specialty) taking into account the main approaches used to define burnout with the Maslach Burnout Inventory (MBI) tool. METHODS: A systematic review was carried out from 2006 to 2018. A keyword request was obtained using the PubMed/Medline, Web of Science and Banque de Données en Santé Publique search engine. Studies written in English measuring burnout with the MBI tool among a population of practicing European physicians were selected. Data were extracted and classified according to burnout's definition provided by the authors. Three definitions using the MBI dimensions were considered: tri-, bi- and unidimensional definition. A meta-analysis was then performed on burnout prevalence rates according to the dimensional definition of burnout. RESULTS: From 2378 search results, we selected 56 studies including from up to 41 European countries. Depending upon the study, physicians' burnout prevalence rates ranged from 2.5% to 72.0%. The pooled prevalence rate of burnout was estimated at 7.7% [5.3-10.4%] with the tridimensional definition, 19.7% [13.5-26.3%] with the bidimensional definition and 43.2% [29.0-57.6%] with the unidimensional definition. CONCLUSION: Burnout pooled prevalence among physicians varies from single to fivefold depending on the method employed to assess burnout with the MBI tool. Medical community should determine a standardized method to assess burnout prevalence rates to best evaluate this phenomenon.

Screening of health workers exposed to SARS-CoV-2 in a university hospital in the south of France.

INTRODUCTION: SARS-CoV-2, which causes COVID-19, is a virus that has caused a global pandemic. Health workers (HWs) are major players in the fight against this infection and are occupationally exposed to the virus in the course of their work. In this context, this study presents surveillance data on 1714 workers in a hospital center in the south of France for the period from March 17 to April 20, 2020. MATERIALS AND METHODS: Symptomatic HWs, contact cases and those with high anxiety were tested. Diagnosis of COVID-19 was performed by RT-PCR after nasopharyngeal sampling. RESULTS: During this period, 30.4% of hospital staff received 3028 nasal swabs. Of these, 8.0% were infected with SARS-CoV-2. Among the SARS-CoV-2 positive HWs, 24.3% were asymptomatic. Among COVID unit and non COVID unit, the positive HWs for SARS-CoV-2 were, respectively, 5.8% and 8.2% (p = 0.2). HWs over 50 years of age were less likely to be positive for SARS-CoV-2 (3.8%) than other younger HWs (9.1%) (p < 0.001). No serious cases of COVID-19 were reported in our population during this period. DISCUSSION: Our study suggests that HWs who tested positive for COVID-19 are often asymptomatic. Therefore, PPE is pivotal to prevent HWs to patients and HWs to HWs transmission during workshifts. Contact tracing and screening is essential to limit the spread of the virus within the hospital. On the other hand, HWs working in COVID-19 units are not more often infected probably because they have a higher risk awareness than other HWs.

Cancer survivors' efforts to facilitate return to work.

This study assesses individual factors that influence return to work (RTW) and in particular on the cancer survivors' ability to prepare his/her job resumption. A self-administered questionnaire was completed by 105 cancer survivors after at least 4 weeks after the time of their RTW. Various methods of returning to work were compared between occupational and medical characteristics with multivariate statistical tests. Regular contact by a cancer survivor with the company during sick leave is associated with RTW within 1 year of diagnosis (ORaj = 5.78). Optional pre-reinstatement visit with the occupational physician is associated with the absence of employee activity's change (ORaj = 2.30). The cancer survivors who during treatment period ask for an adaption of treatment are more likely to have a change in working conditions (ORaj = 14.5). The adaptation to recovery conditions appears to be associated with survivors' effort to RTW. It should be confirmed with new studies.

The quality of life and the future of young adults with Asperger syndrome.

Purpose: This pilot study describes the socio-professional development and quality of life of young adults with Asperger syndrome in France.Methods: Those young adults, between 18 and 30 years old, receiving care in a child psychiatry department for autistic spectrum disorder, were requested to respond to the Ad Hoc, World Health Organization Quality Of Life - Bref and Copenhagen psychosocial questionnaires regarding their socio-professional background and feelings about their future.Results: Of the 79 eligible subjects, 24 were selected to participate in our study. Their average age at the time of the pilot study was 22.2 years (standard deviation 3.4 years), and their average age when they were diagnosed was 17.5 years (standard deviation 3.7 years.). There were 54% who reported a psychiatric comorbidity anxiety disorder. Half stated they had completed secondary school and benefitted from being professionally employed. During this study, only six were employed, while the others remained financially dependent on their parents. The group's quality of life self-assessment scores were significantly lower compared to the French general population in overall psychology (43.6 versus 68.7) and social relationships (48.9 versus 76.5). However, the study's participants perceived work as an important means to their personal development. Hence, in order to cope with their difficulties, they hoped to benefit from customized support adapted to their autistic disorder and for their workplace colleagues to be better informed about Asperger syndrome.Conclusions: Our results are in line with international data. Additional studies need to be done in order to determine socio-professional integration factors and, in particular, the integration of potential contributions by occupational health departments with those social and medical teams supporting these young adults.Implications for rehabilitationYoung adults with Asperger syndrome benefit from the support of their family in determining their professional goals.Support may be required to enhance social and communicative abilities to help integration.Employees would benefit from information on the syndrome and how best to support.

[Qualitative study on young hospital physicians: They remain satisfied ]. / Qualité de vie au travail de jeunes médecins hospitaliers : satisfaits malgré tout .

INTRODUCTION: Prevalence of depression, suicidal ideation and burnout are higher among physicians than in general population. Young physicians seem more concerned and the beginning of career seems to be a period of greater risks for hospital practitioners. While this may be the case, in France, few studies have specifically evaluated the quality of the working conditions of this population. The objective of this study is to identify stress factors related to the organization of work and to social relationships at work, as they are perceived by the young hospital physicians. METHODS: A qualitative study through semi-structured interviews was conducted with hospital practitioners with less than 10 years of practice. Manual analysis of the interviews was carried out by three interviewers and supplemented by a computerized lexical analysis. RESULTS: Eighteen physicians were interviewed. Five categories of psychosocial and organizational factors have been identified. Teamwork and communication are generally associated with positive feelings. The pace of work, professional status, organizational factors and material conditions are considered unsatisfactory. Young physicians, however, are satisfied with the content of their work, particularly because of scientific emulation and skills development. CONCLUSION: The results of this study should help to better target prevention actions in order to improve the working conditions of young doctors. It seems a priority to reduce their workload or to regulate their working time, to offer greater stability to their work and to provide them with better material work conditions.

Meta-Analysis Reveals the Association Between Male Occupational Exposure to Solvents and Impairment of Semen Parameters.

OBJECTIVES: Solvent exposure is among the most common occupational exposures to chemical toxicants; data about the impact of such exposure on semen parameters are contradictory. We conducted the first meta-analysis to evaluate the risk of alteration in semen parameters related to occupational exposure to solvents. METHODS: From the PubMed database, we selected studies analyzing the semen of subjects occupationally exposed to solvents, compared with unexposed controls. The meta-analysis was performed on the various semen parameters analyzed in both populations. RESULTS: Seven studies were included in the study. The meta-analysis revealed a significant decrease in ejaculate volume [standardized mean difference (SMD) = -0.35 (-0.63 to -0.07)] and sperm concentration [SMD = -0.36 (-0.64 to -0.08)] in workers exposed to solvents compared with unexposed controls. CONCLUSION: Our results highlight the importance of preventing reprotoxic risks to male fertility in the workplace.

Psychosocial risks assessment at hospital: development of a French questionnaire.

BACKGROUND: In order to improve the well-being, health, and performance of hospital workers, it should be important to focus on the psychosocial risk (PSR) factors in the work environment and on job satisfaction. Although many epidemiological questionnaires are used to measure PSR among healthcare workers, no specific existing model can be applied to all categories of hospital workers. OBJECTIVE: To develop a short French self-administered instrument for measuring the PSR for hospital workers: the PSRH questionnaire. METHODS: The content of the PSRH questionnaire was partly derived from the well-known and standardized questionnaires (Karasek Job Content and Siegriest effort-reward imbalance questionnaires). The validation process was carried out in all the departments of a large public university hospital (Marseille, France). Eligible workers were adult employees present on the day of the assessment: healthcare, administrative, and technical workers. A total of 2203 subjects were included from September 2012 to October 2013. RESULTS: The PSRH contains 24 items describing 6 dimensions (Management, cooperation and hierarchical support; Requirements, constraints and autonomy related to work; Support and relationship with the team; Complexity of the work and unforeseen factors; Meaning of work and recognition; and Conciliation work - work out). The six-factor structure presented satisfactory internal consistency and scalability. All the scores showed significant correlations with a well-being score. Acceptability was high. CONCLUSION: The PSRH is a self-administered instrument assessing PSR at hospital that presents satisfactory psychometric properties. Future studies should identify factors that determine low- and high-risk workers in order to implement appropriate preventing strategies.

Employment in French young adult survivors of childhood leukemia: an LEA study (for Leucemies de l'Enfant et de l'Adolescent-childhood and adolescent leukemia).

PURPOSE: Our principal aim was to assess the occupational outcomes of French survivors of childhood leukemia, compared to national population. The secondary objective was to identify determinants linked with employment stability after childhood leukemia. METHODS: All survivors aged 15 and over enrolled in the French LEA Cohort (Childhood and Adolescent Leukemia) were included. Occupational data were self-reported. The occupational distributions expected in the cohort for each age range were established based on the distribution in France as reference, and comparisons between observed and expected distributions were performed. Logistic regression model was used to explore determinants of stability of survivors' employment. RESULTS: The questionnaire was completed by 845 eligible survivors (response rate 87.8 %), with a mean age of 22.3 ± 5.4 years and a mean follow-up duration of 14.3 ± 6.3 years. Among the 361 survivors currently in the labor market, 36 (10.0 %) were seeking a job, which is significantly lower than expected (19.3 %) compared to French population. Conversely, among those currently employed, the number of survivors in unstable employment (43.9 %) was significantly higher than expected (33.5 %). Younger age and higher number of late effects were risk factors for unstable employment. CONCLUSIONS: While the employment rate of the young French adult population of childhood leukemia survivors seems rather positive, access to a steady job appears to be compromised for some survivors. IMPLICATIONS FOR CANCER SURVIVORS: A strategy to better identify particular subgroups of survivors at greatest risk for difficulties in their professional achievement will help ensure the development of specific intervention strategies and support procedures.

The Relocation of a Health Care Department's Impact on Staff: A Cross-Sectional Survey.

OBJECTIVE: This survey compares certain quality of work-life factors between a relocated work group and a control group. METHODS: A self-administered, cross-sectional survey was conducted 12 months after five departments (304 workers) had been relocated between two public health sites. The survey explored the workers' psychosocial job characteristics, their perceived health, and psycho-organizational constraints. The results compared both the relocated and control groups by using univariate and then multivariate statistical analyzes. RESULTS: When compared with the control group (n = 272), the relocated group (n = 180) showed a higher prevalence of psychosocial job characteristic "isostrain." The relocated group showed greater psycho-organizational constraints regarding the organizations favoring communication and team relationships. CONCLUSIONS: It seems that staff relocation can provoke a sense of uncertainty and isolation. Perhaps better communication might have reduced this and deter possible negative health outcomes.