Climate change and heat stress resilient outdoor workers: findings from systematic literature review.

PURPOSE: Global warming has led to an increase in the number and intensity of extreme heat events, posing a significant threat to the health and safety of workers, especially those working outdoors, as they often have limited access to cooling strategies. The present systematic literature review (a) summarizes the current knowledge on the impacts of climate change on outdoor workers, (b) provides historical background on this issue, (c) explores factors that reduce and increase thermal stress resilience, (d) discusses the heat mitigation strategies, and (e) provides an overview of existing policy and legal frameworks on occupational heat exposure among outdoor workers. MATERIALS AND METHODS: In this systematic review, we searched scientific databases including Scopus (N = 855), Web of Science (N = 828), and PubMed (N = 202). Additionally, we identified relevant studies on climate change and heat-stress control measures through Google Scholar (N = 116) using specific search terms. In total, we monitored 2001 articles pertaining to worker populations (men = 2921; women = 627) in various outdoor climate conditions across 14 countries. After full-text assessment, 55 studies were selected for inclusion, and finally, 29 eligible papers were included for data extraction. RESULTS: Failure to implement effective control strategies for outdoor workers will result in decreased resilience to thermal stress. The findings underscore a lack of awareness regarding certain adaptation strategies and interventions aimed at preventing and enhancing resilience to the impact of climate change on heat stress prevalence among workers in outdoor tropical and subtropical environments. However, attractive alternative solutions from the aspects of economic and ecological sustainability in the overall assessment of heat stress resilience can be referred to acclimatization, shading, optimized clothing properties and planned breaks. CONCLUSION: The integration of climate change adaptation strategies into occupational health programs can enhance occupational heat resilience among outdoor workers. Conducting cost-benefit evaluations of health and safety measures for thermal stress adaptation strategies among outdoor workers is crucial for professionals and policymakers in low- and middle-income tropical and subtropical countries. In this respect, complementary measures targeting hydration, work-rest regimes, ventilated garments, self-pacing, and mechanization can be adopted to protect outdoor workers. Risk management strategies, adaptive measures, heat risk awareness, practical interventions, training programs, and protective policies should be implemented in hot-dry and hot-humid climates to boost the tolerance and resilience of outdoor workers.

Social vulnerability indicators in pandemics focusing on COVID-19: A systematic literature review.

INTRODUCTION: Social factors can affect the vulnerability of disaster-prone communities. This review aimed to identify and categorize social vulnerability indicators in the COVID-19 pandemic. METHODS: This systematic review was conducted in February 2021. Bibliographies, citation databases, and other available records were investigated based on the aim of the study. The Joanna Briggs Institute (JBI) critical appraisal tools were applied for assessing the included articles retrieved through the comprehensive and systematic literature search. Descriptive and thematic analyses were done to extract the indicators affecting social vulnerability in the COVID-19 pandemic. RESULTS: Thirty-one eligible articles were included and 85 indicators of social vulnerability were extracted. The indicators were categorized in seven main categories, including; Household, community composition; Race, minority status and language; Socioeconomic status; Community health status; Public health infra-structures; Education; Information, technology and communication. CONCLUSION: Regions with higher social vulnerability experienced greater mortality rates during the COVID-19 pandemic. Additional research is needed to measure the social vulnerability index in pandemics to prioritize distribution of scarce resources and ensure effectiveness and equity for all regions of countries.

Towards developing a model for the evaluation of hospital disaster resilience: a systematic review.

BACKGROUND: Hospitals play a vital role in disaster stricken regions. The resilient hospitals will be able to provide essential services to affected people and it can mitigate the risk of injuries during and after disasters. This study aimed to obtain the indicators required for the evaluation of hospital resilience. METHODS: This systematic review was conducted in 2018. Through this systematic review, international electronic databases were investigated for the research studies published in English. The exclusion and inclusion criteria were determined to extract the hospital resilience indicators. These indicators will be used in order to develop a model to keep the system performance at an acceptable level during disasters. RESULTS: Out of 1794 research studies published until September 2018, 89 articles and guidelines with full text were surveyed. Thirty-two articles and guidelines were then selected and analyzed to collect the indicators related to hospital disaster resilience (HDR). The domains and the indicators were extracted from these selected research studies. The authors collected and categorized them into three domains and twenty seven subdomains. The three domains included constructive, infrastructural, and administrative resilience. The relevant indicators were designed for each subdomain to assess HDR. CONCLUSION: Since diverse indicators affect hospital resilience, other studies should be conducted to propose some models or tools to quantify the hospital resilience in different countries and scopes with an all hazards approach.

Key Features in Designing an Integrated Recall System for Dispatch in Mass Casualty Incidents; a Systematic Review.

Introduction: Following Mass Casualty Incidents (MCIs), the sudden surge in demand for essential services disrupts the balance between available and required resources. This study aimed to systematically identify and categorize existing systems employed for dispatching professional or lay rescuers during emergencies. Methods: Adhering to the PRISMA 2020 Checklist, the research scrutinized international databases (PubMed, Scopus, and Web of Science) using formulated search strategies. Additionally, a manual search was conducted on Google Scholar and prominent journals employing specific keywords. Original articles introducing systems for dispatching rescuers to incident sites were included. Results: Thirty-one of the 23051 initially identified documents were included for data extraction and quality assessment. The comprehensive analysis revealed twenty-two dispatch systems worldwide, contributing to life-saving efforts in emergencies. Additionally, an evaluation of the articles' quality using the Mixed Methods Appraisal Tool (MMAT) with five scores, indicated that more than two-thirds of the identified articles scored four or higher. Summarizing the data extracted from these systems, four distinct categories of recall system characteristics were identified: general, dispatcher, responder, and other features. Conclusion: Technology has the potential to revolutionize the delivery of healthcare services. This study highlights four key elements necessary for the development of dispatch systems that can effectively mobilize healthcare providers to the incident scene. These elements include general characteristics, dispatcher roles, responder requirements, and additional features, which equip researchers with the knowledge for designing effective systems to recall healthcare providers during MCI.

Investigating the impacts of socio-economic vulnerability indicators on COVID-19: A case study of Yazd, Iran.

Socio-economic vulnerability plays a major role in affected countries by disasters and emergencies. This study aims to identify the most effective socio-economic vulnerability indicators on COVID-19 cases and severity in the Yazd city. This study was conducted in 2022. Regarding purpose of study, different methods were applied during this research. They were including reviewing scientific research, expert panel sessions, weighting the socio-economic vulnerability indicators by Analytic Hierarchy Process (AHP) and examining the spatially relationships between vulnerability indicators and COVID-19. Excel and GIS software were applied for data analysis using local correlation coefficient. AHP analysis showed that employment, population density, buildings quality and distance from hospitals were obtained the most weight in the related indicators of socio-economic vulnerability. GIS mapping overlying showed that four socio-economic vulnerability sub indicators including percentage of immigrants, age, population density and distance from health centers had spatially relationships with COVID-19 cases and severity. Western, northern and some central regions of Yazd were identified as the COVID-19 hot spots. Local officials and health authorities should pay immediate attention to the most influential socio-econimic vulnerability indicators that are dominant in the Yazd city. They incorporate measures to the regions identified as hot spots because people who located in these areas are more vulnerable to COVID-19 and the other future natual or man-made disasters.

Analysis of Hospital Costs in Road Traffic Injuries.

OBJECTIVE: To investigate the factors affecting the hospital costs in the road traffic injuries. METHODS: This applied study examined the information of patients presenting to Yazd Trauma Center in 2018. The data were extracted from Comprehensive Traffic Injuries System affiliated to the center, which were described with frequency, percentage, mean, and SD, and then analyzed using independent t-test and one-way ANOVA. RESULTS: Most injuries (%66.4) are caused by motorcycle and pertained to head region (%61.8). Some significant correlations were found among gender, type of injury, patient's final status, site of road accident, patient's nationality, type of vehicle used at the time of accident, length of stay (hospital stay), patient's age, and hospital costs (p<0.05). Moreover, the costs were higher in men, and in those with head and neck injuries, dead casualties, suburban high-way accidents, motor cyclists, hospital stay longer than three days, and older patients. CONCLUSION: Given the significant correlations between demographic and social variables under study, the results may be used in planning and designing strategies for controlling road traffic injuries and reducing the related hospitalization costs.