Long-Term Effects of COVID-19 on Workers in Health and Social Services in Germany.

Health workers are at increased risk for SARS-CoV-2 infections. What follows the acute infection is rarely reported in the occupational context. This study examines the employees' consequences of COVID-19 infection, the risk factors and the impact on quality of life over time. In this baseline survey, respondents were asked about their COVID-19 infection in 2020 and their current health situation. Out of 2053 participants, almost 73% experienced persistent symptoms for more than three months, with fatigue/exhaustion, concentration/memory problems and shortness of breath being most frequently reported. Risk factors were older age, female gender, previous illness, many and severe symptoms during the acute infection, and outpatient medical care. An impaired health-related quality of life was found in participants suffering from persistent symptoms. Overall, a high need for rehabilitation to improve health and work ability is evident. Further follow-up surveys will observe the changes and the impact of vaccination on the consequences of COVID-19 among health workers.

Risk of Burnout among Emergency Department Staff as a Result of Violence and Aggression from Patients and Their Relatives.

Emergency department staff are often affected by incidents of violence. The aim of the study was to generate data on the frequency of violence by patients and accompanying relatives and the correlation between experienced aggression, a possible risk of burnout and a high sense of stress. Additionally, the buffering effect of good preventive preparation of care staff by the facility on aggressive visitors and patients was examined. In this cross-sectional study, members of the German Society for Interdisciplinary Emergency and Acute Medicine were surveyed. The investigation of risk factors, particularly experiences of verbal and physical violence, as well as exhaustion and stress, was carried out using ordinal regression models. A total of 349 staff from German emergency departments took part in the survey, 87% of whom had experienced physical violence by patients and 64% by relatives. 97% had been confronted with verbal violence by patients and 94% by relatives. Violence by relatives had a negative effect on perceived stress. High resilience or effective preparation of employees for potential attacks was shown to have a protective effect with regard to the burnout risk and perceived stress. Therefore, management staff play a major role in preventing violence and its impact on employees.

COVID-19 infections in staff of an emergency care hospital after the first wave of the pandemic in Germany.

Background: Hospital staff have an increased risk of SARS-CoV-2 infection. It is thus necessary to monitor the situation because infected staff may in turn infect patients and their family members. Following the first wave of infection in the summer of 2020, the Rhine-Maas Hospital (RMK) provided all staff the opportunity to be tested for SARS-COV-2 via antibody testing. Methods: The tests were carried out from 19.6.2020 to 17.7.2020. The IgG antibody test qualitatively tested for SARS-CoV-2 antibodies via enzyme-linked immunosorbent assay (ELISA). An IgG titre of 0.8 IU/mL or more was considered positive. All staff who tested positive for SARS-CoV-2 by PCR testing after February 2020 were also included in the study. Occupational and non-occupational risk factors for infection were determined. Staff in the intensive care ward, the emergency depart-ment, or a SARS-CoV-2 ward ("corona ward") were predefined as having increased exposure. Odds ratios (OR) were calculated using logistical regression for occupational and private infection risk. Results: 903 staff members (58.9%) with complete data took part in the cross-sectional study. 52 staff members (5.8%) had a positive PCR test result in their medical history or tested positive in the IgG test. Around half of the infections (55%) were only detected by serological testing during the study. Staff with tasks classified as at-risk had an OR of 1.9 (95% CI 1.04-3.5) for infection. Risk factors also included private contacts to people infected with SARS-CoV-2 and holidays in risk areas. At the time of data collection, 11.5% of those with the disease reported that they had not yet fully recovered from COVID-19. Discussion: Following the first COVID-19 wave, 5.3% of staff at the RMK were infected. An increase in occupational infection risk was found even after controlling for non-occupational infection risks. This should be taken into account with regard to the recognition of COVID-19 as an occupational disease. Methods to improve protection against nosocomial transmissions should be considered.

[Persistent fatigue symptoms following COVID-19 infection in healthcare workers: risk factors and impact on quality of life]. / Anhaltende Fatigue als Folge einer COVID-19-Infektion bei Beschäftigten im Gesundheitswesen: Risikofaktoren und Auswirkungen auf die Lebensqualität.

BACKGROUND AND OBJECTIVES: Employees from medical and nursing professions are at increased risk for a SARS-CoV­2 infection and thus more frequently affected by COVID-19 sequelae. Previous studies have identified post-viral fatigue as the most common sequelae. The aim of this study was to investigate risk factors and effects induced by clinically relevant fatigue symptoms following a COVID-19 infection of healthcare workers. METHODS: In the spring of 2021, 4315 insured members of the Statutory Accident Insurance and Prevention in the Health and Welfare Service were contacted for a written survey on their COVID-19 disease in 2020 and its sequelae. Information on Symptoms of acute infection, disease sequelae, and potential risk factors were collected, as well as the physical and mental health status after SARS-CoV­2 infection. The general fatigue scale of the Multidimensional Fatigue Inventory (MFI) was used as fatigue screening. Regression analyses and multivariate analyses of variance were calculated for data analysis. RESULTS: Of the respondents, 10.7% showed severe fatigue symptoms. Identified risk factors for clinical fatigue symptoms included preexisting mental and respiratory conditions and severity of acute infection. Furthermore, severe long-/post-COVID fatigue was associated with higher psychological distress, lower health-related quality of life, and more frequent incapacity to work. CONCLUSIONS: Severe long-/post-COVID fatigue is associated with a high level of distress, which requires specific rehabilitation approaches and poses a challenge to the social insurance agencies and accident insurers to develop appropriate rehabilitation concepts.

Cumulative Incidence of SARS-CoV-2 in Healthcare Workers at a General Hospital in Germany during the Pandemic-A Longitudinal Analysis.

Health workers (HW) are at increased risk for SARS-CoV-2 infection. In order to monitor the infection dynamic on the basis of contact with patients, HW at the St. Antonius Hospital (SAH) were tested four times in one year by PCR and serology. The cumulative incidence of infection in HW was calculated. Swab and blood tests were simultaneously performed between April 2020 and April 2021. Risk factors and demographic information were assessed at the beginning of the study. The response rate was above 75% in all rounds of testing. The study comprised 1506 HW, 165 (10.6%) of which tested positive for SARS-CoV-2 infection. Working in an ICU or on wards with patient contact were risk factors (OR 4.4, 95% CI 1.73-13.6 and OR 2.9, 95% CI 1.27-8.49). At the end of the study, the majority of HW (810 of 1363 (59.4%)) had been vaccinated at least once. A total of 29.1% of unvaccinated HW and 5.3% of vaccinated HW showed an immune response typical for natural SARS-CoV-2 infection. Of the 73 HW who provided information on the course of the disease, 31.5% reported that their quality of life continued to be impaired. The cumulative incidence of infection was low in these HW, which may be attributed to vaccination and good hygiene. Nevertheless, a work-related infection risk was identified, highlighting the need to improve protection against infection. A high risk of developing long COVID was found after the infection has subsided. Special rehabilitation programs should be provided and HW should be compensated for reduced work capacity in the case that rehabilitation fails or takes a long time.

Interventions for Workplace Violence Prevention in Emergency Departments: A Systematic Review.

Emergency departments (EDs) are high-risk settings for workplace violence, but interventions to prevent violent incidents and to prepare staff are not yet consistently implemented, and their effectiveness is often unclear. This study aims to summarise evidence on workplace violence prevention interventions that were implemented in EDs to reduce violent incidents caused by patients/relatives or to increase the knowledge, skills or feelings of safety of ED staff. A systematic review was conducted. The databases MEDLINE, Web of Science, Cochrane Library, CINAHL and PsycINFO were searched for studies dated between January 2010 and May 2021. Interventional and observational studies reporting on behavioural, organisational or environmental interventions among healthcare workers in hospital EDs were included. Studies were assessed for methodological quality using the Johanna Briggs Institute Tools. Key findings of studies were summarised narratively. Fifteen studies were included, of which eleven examined behavioural interventions (classroom, online or hybrid training programmes) on de-escalation skills, violent person management or self-defence techniques. Four studies included in addition, organisational and environmental interventions. Most studies showed that interventions had a positive effect in the form of a reduction of violent incidents or an improvement in how prepared staff were to deal with violent situations; however, evidence is still sparse. Further studies should consider in particular, environmental and organisational interventions and ensure a high methodological quality.

Metal exposure of workers during recycling of electronic waste: a cross-sectional study in sheltered workshops in Germany.

OBJECTIVES: In Germany, the initial step of electronic waste (e-waste) recycling frequently takes place in sheltered workshops for physically and mentally handicapped workers (Werkstätten für behinderte Menschen (WfbM), in german language). E-waste recycling involves a potential risk of exposure to toxic metals. Therefore, we assessed the occupational exposure of recycling workers to toxic metals to identify potential health risks and insufficient protective measures. METHODS: We used a combined air- and bio-monitoring approach to determine exposure of recycling workers to toxic metals. Air and urine samples were collected in five sheltered workshops in Germany and were analysed for their content of aluminium, antimony, arsenic, beryllium, cadmium, chromium, cobalt, mercury and nickel. Results were compared to German and international occupational limit values and to metal exposures of workers in conventional e-waste recycling firms. RESULTS: Exposure of recycling workers in five German sheltered workshops to the studied metals and their compounds was below German and international occupational limit values across all facilities studied considering both air and urine samples. Workers in the present study were not exposed to higher amounts of toxic metals than workers in conventional e-waste recycling firms. CONCLUSION: This is the first study on toxic metal exposure of recycling workers in sheltered workshops. The results of this study revealed a low occupational exposure of e-waste recycling workers to toxic metals in this type of enterprises. Current work methods and safety measures provide the workers with adequate protection.

[Prevalence of SARS-CoV-2 in employees of a general hospital in Northrhine-Westphalia, Germany]. / Prävalenz von SARS-CoV-2 bei Mitarbeitern eines Krankenhauses der Regel-/Schwerpunktversorgung in Nordrhein-Westfalen.

BACKGROUND: We assessed the prevalence of SARS-CoV-2 in the staff of a general hospital in North-Rhine-Westphalia in a cross-sectional study. METHOD: Employees (n = 1363) were offered a nasopharyngeal swab and serology for SARS-CoV-2. Additionally, employees completed a questionnaire about preexisting conditions, contacts with SARS-CoV-2-positive individuals and COVID-19-specific symptoms. RESULTS: 1212 employees participated. 19 of 1363 (1.4 %) employees tested positive by PCR (3 within and 16 before the study). 40 (3.3 %) and 105 (8.6 %) had IgG and IgA, respectively, 32 (2.6 %) both IgG and IgA. Overall, 47 employees tested positive. In this group, most frequently reported symptoms were headache (56 %), fatigue (49 %), sore throat (49 %), and cough (46 %); fever was reported by 33 %. SARS-CoV-2-positive employees reported more frequently contact with COVID-19 cases (60.5 % vs. 37.3 %, p = 0.006). Employees testing positive only for IgA reported less symptoms. CONCLUSION: Between 27.04. and 20.05.2020, 3.9 % of the employees working in a general hospital were tested positive for SARS-CoV-2. This proportion was lower than expected; possible explanations are the low level of endemic infection and the extensive, uniform in-house preventative measures.

Risk of Occupational Latent Tuberculosis Infection among Health Personnel Measured by Interferon-Gamma Release Assays in Low Incidence Countries-A Systematic Review and Meta-Analysis.

Healthcare workers (HCWs) have increased risk for latent tuberculosis infection (LTBI) and tuberculosis (TB) disease due to their occupational exposure. For some years now, interferon-γ release assays (IGRAs) have replaced the tuberculin skin test for the diagnosis of LTBI in many countries. This review examined the occupational risk of LTBI in HCWs with IGRA testing in low incidence countries. A systematic review and meta-analysis of studies from 2005 onwards provide data regarding the prevalence of LTBI in HCWs. In addition, the pooled effect estimates were calculated for individual regions and occupational groups. 57 studies with 31,431 HCWs from four regions and a total of 25 countries were analysed. The prevalence of LTBI varied from 0.9 to 85.5%. The pooled estimation found the lowest prevalence of LTBI for North American and West Pacific countries (<5%), and the highest prevalence for Eastern Mediterranean countries (19.4%). An increased risk for LTBI was found only for administrative employees. Studies on the occupational risk of LTBI continue to show increased prevalence of HCWs, even in low-incidence countries. Good quality studies will continue to be needed to describe occupational exposure.

Occupational Infection Risk with Multidrug-Resistant Organisms in Health Personnel-A Systematic Review.

The increase in multi-drug-resistant organisms (MDROs) in the last years has become a public health problem. MDROs are partially responsible for numerous nosocomial infections, extended hospital stays, high costs, and high mortality. In addition to methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE), Gram-negative bacteria are also a key area of focus. The knowledge of MDROs among the medical staff in the occupational context is limited, with the exception of MRSA. Therefore, a systematic review was carried out to determine the occupational risk for employees posed by MDROs. The search included studies from the year 2000 onwards among personnel who had contact with MDROs. A total of 22 primarily cross-sectional studies in hospital or geriatric care settings were found, with large differences regarding number of participants, examination method, inclusion of a control group, and study quality. The most frequently examined pathogens were extended-spectrum ß-lactamase (ESBL)-producing bacteria with a prevalence of 2.6-48.5%, VRE (0-9.6%), and MRSA (0.9-14.5%). There are only few qualitatively good studies available on MDROs' risk infection for employees in the health service. Any comparison of the results was limited by data heterogeneity. More research is required to describe the occupational risk of infection with MDROs.

MRSA Point Prevalence among Health Care Workers in German Rehabilitation Centers: A Multi-Center, Cross-Sectional Study in a Non-Outbreak Setting.

People working in health care services have an increased risk of being infected with methicillin-resistant Staphylococcus aureus (MRSA), though little is known about the prevalence in rehabilitation centers. This cross-sectional study investigated the MRSA prevalence in employees from different rehabilitation centers and aimed to identify risk factors for MRSA transmission. We invited all staff (i.e., with and without patient contact from 22 participating rehabilitation centers; n = 2499) to participate. Study participation included a questionnaire on personal characteristics, lifestyle, personal and occupational risk factors for MRSA and nasal swabs taken by the study team. In total, 1005 persons participated in the study (response: 40.2%). Only four participants carried MRSA (0.40 (95% CI 0.00-1.00) per 100). MRSA carriage did not seem to be occupationally related, as it was found in different occupations with and without direct contact with MRSA patients, as well as in different clinics with different indications and patient clientele. We could not find a clear association between MRSA carriage and potential risk factors due to the low number of cases found. Genotyping revealed the spa types t032 (Barnim epidemic strain) and t1223. Our results suggest a low point prevalence of nasal MRSA colonization in a non-outbreak setting in employees from rehabilitation centers.

Prevalence and risk factors of MRSA colonisations: a cross-sectional study among personnel in outpatient care settings in Hamburg, Germany.

OBJECTIVES: Healthcare workers frequently come into contact with infected individuals and are at a greater risk of infection than the general population due to their occupation. Multidrug-resistant organisms (MDROs) also pose a significant challenge for personnel and medical facilities. Currently, little is known about the occupational risk of methicillin-resistant Staphylococcus aureus (MRSA) in outpatient care settings. Therefore, a cross-sectional study was conducted in Hamburg to investigate MRSA colonisation among outpatient nursing staff. METHODS: MRSA screening with nasal swabs was carried out, the known risk factors for colonisation were determined and information on infection control was inquired. Where tests were positive, a control swab was taken; if this confirmed a positive result, decolonisation was offered. A molecular biological examination of the MRSA samples was performed. The occupational MRSA exposure and risk factors were compared with the situation for personnel in inpatient geriatric care. RESULTS: A total of 39 outpatient services participated in the study and 579 employees were tested. The MRSA prevalence was 1.2% in all and 1.7% in nursing staff. Most of the employees that tested positive had close or known contact with MRSA patients. Health personnel frequently reported personal protective measures and their application. Compared with inpatient care staff, outpatient staff were older and had worked in their profession for a longer time. CONCLUSION: This study marks the first time that data has been made available on the occupational MRSA risk of outpatient care personnel in Hamburg. The MRSA prevalence is low and provides a good basis for describing the MRSA risk of occupational exposure by health personnel in outpatient care.

MRSA prevalence among patient transport staff in Hamburg.

Introduction: Patient transport employees frequently come into contact with multidrug-resistant organisms (MDROs) and therefore are at a greater risk of infection than the general population. These pathogens pose a significant challenge for employees of patient transport services since they can spread over long distances through patient transfers. To date, little is known about the occupational risk of MRSA infection in patient transport settings. Methods: A cross-sectional study was conducted to investigate the prevalence of MRSA in patient transport personnel, including taxi drivers, as well as the potential risk factors for MRSA colonization. For screening, nasal swabs were taken. When an individual was tested positive, a control swab was taken; if this confirmed a positive result, decolonization measures were offered. A molecular biological examination of the MRSA samples was performed. Results: A total of 222 patient transport employees were screened and 7 employees tested positive, putting the MRSA prevalence at 3.2% (95% CI 1.4-6.5). Significant risk factors among patient transport staff (PTS) for testing positive were the use of antibiotics (OR 11.9; 95% CI 1.8-78.4) and hospital admission (OR 6.9; 95% CI 1.1-45.9). MRSA swabs were also performed on a total of 102 taxi drivers who provide patient transport services. The MRSA prevalence was 0.98 (95% CI <0.01-5.9). Significant group differences between PTS and taxi drivers, with respect to potential risk factors for MRSA colonization, were identified as inpatient treatment (p=0.09), chronic respiratory illnesses (p=0.01), and knowingly transporting patients/passengers with MRSA (p=0.03). Conclusion: This study is the first to make data on the MRSA risk of patient transport employees in Hamburg available. The prevalence data are low in all areas and indicate a somewhat low risk of infection. A good infection control at the facilities is highly recommendable and the employees should acquire in-depth knowledge of infection prevention to improve compliance with personal protective measures.

MRSA Prevalence and Risk Factors among Health Personnel and Residents in Nursing Homes in Hamburg, Germany - A Cross-Sectional Study.

INTRODUCTION: The increase of multidrug-resistant organisms in hospitals causes problems in nursing homes. Staff in geriatric nursing homes are at greater risk of MRSA colonisation. The aim of the study was to describe the occupational exposure to MRSA among health personnel in geriatric nursing. METHODS: A point prevalence survey was conducted among health personnel and residents of geriatric nursing homes within the greater Hamburg district. Nasal swabs and, where relevant, wound swabs were collected for the screening survey. Risk factors for MRSA colonisation were identified by means of a questionnaire and using the files held on the residents. Where tests on nursing staff were positive, a control swab was taken; when the results were confirmed positive, decolonisation was performed. The responsible general practitioners were notified of positive MRSA findings among residents. A molecular biological examination of the MRSA samples was performed. RESULTS: A total of 19 institutions participated in the study. Nasal swabs were taken from 759 nursing staff and 422 residents. Prevalence of MRSA was 1.6% among staff and 5.5% among residents. MRSA colonisation among health personnel indicated a correlation with male gender (OR 4.5, 95% CI 1.4-14.1). Among the residents, chronic skin diseases (OR 3.2, 95% CI 1.0-10.3) and indwelling devices (OR 3.2, 95% CI 1.2-8.1) were identified as risk factors. No link between MRSA in residents and in health personnel could be established. CONCLUSION: The number of MRSA colonisations among nursing staff and residents of geriatric nursing homes in Hamburg was rather low at 1.6% and 5.5% respectively and equates to the results of other surveys in non-outbreak scenarios.

The prevalence of hepatitis C among healthcare workers: a systematic review and meta-analysis.

The aim of this study was to estimate the prevalence of viral hepatitis C (HCV) infection among healthcare workers (HCWs) compared to the general population. A systematic search for the years 1989-2014 was conducted in the Medline, Embase and Cochrane databases. Studies on hepatitis C in HCWs were included if they incorporated either a control group or reference data for the general population. The study quality was classified as high, moderate or low. Pooled effect estimates were calculated to determine the odds of occupational infection. Heterogeneity between studies was analysed using the χ(2) test (p<0.10) and quantified using the I(2) test. 57 studies met our criteria for inclusion and 44 were included in the meta-analysis. Analysis of high and moderate quality studies showed a significantly increased OR for HCV infection in HCWs relative to control populations, with a value of 1.6 (95% CI 1.03 to 2.42). Stratification by study region gave an OR of 2.1 in low prevalence countries; while stratification by occupational groups gave an increased prevalence for medical (OR 2.2) and for laboratory staff (OR 2.2). The OR for professionals at high risk of blood contact was 2.7. The pooled analysis indicates that the prevalence of infection is significantly higher in HCWs than in the general population. The highest prevalence was observed among medical and laboratory staff. Prospective studies that focus on HCW-specific activity and personal risk factors for HCV infection are needed.

What do healthcare workers in elderly care know about occupational health and safety? An explorative survey.

BACKGROUND: Demographic changes will lead to a growing demand for healthy, motivated healthcare workers (HCW) in the years ahead. Along with well-targeted prevention, knowledge of occupational health and safety and infection precaution is essential for a healthy working life. In this context back-friendly working methods and protection from infectious diseases are necessary in elderly care. METHODS: In 2012, a survey was conducted in nine residential and two semi-residential nursing homes, as well as in one home care service in the Schwerin area of northeast Germany. Four hundred and seventy three HCWs were asked to fill in a questionnaire on what they knew about aspects of occupational health and safety such as vaccinations and preventative measures administered by occupational physicians, hygiene, back-friendly working methods and infection prevention. The statistical evaluation was descriptive, with a comparison between job title. Differences were examined with chi square or Fisher's exact test. RESULTS: The response rate was 28 % (n = 132). The largest group of respondents (36 %) were qualified geriatric HCWs. More than 74 % of employees felt well informed about opportunities for precautionary checks and vaccination by occupational physician, and 93 % utilized these opportunities. When it came to assigning modes of transmission to specific infectious diseases, only 23 % of participants were well informed, and one in three (31 %) care assistants was inadequately informed. Fewer than half of participants could correctly name the indications for hand disinfection. Only 66 % of the HCWs said they were aware of training offers for the management of multidrug-resistant organisms in their institution. They did know about possible aids to back-friendly working, although gaps in knowledge were apparent. Only 59 % of respondents knew that care utensils should preferably be stored at working height so as to reduce awkward body postures. CONCLUSIONS: Employees in elderly care are well informed about the range of precautionary occupational medical examinations and take advantage of this offering. Questions in the survey regarding hygiene management were answered in a competent manner. On the other hand some gaps in the knowledge about infection prevention and occupational safety became apparent. Differences between qualified and unqualified participating professionals occurred only in the knowledge of infectious diseases and pathogens and the associated path of infection. The extent to which training can help to improve infection prevention and occupational health and safety should be investigated.

Framing of feedback impacts student's satisfaction, self-efficacy and performance.

Feedback is considered important to acquire clinical skills. Research evidence shows that feedback does not always improve learning and its effects may be small. In many studies, a variety of variables involved in feedback provision may mask either one of their effects. E.g., there is reason to believe that the way oral feedback is framed may affect its effect if other variables are held constant. In a randomised controlled trial we investigated the effect of positively and negatively framed feedback messages on satisfaction, self-efficacy, and performance. A single blind randomised controlled between-subject design was used, with framing of the feedback message (positively-negatively) as independent variable and examination of hearing abilities as the task. First year medical students' (n = 59) satisfaction, self-efficacy, and performance were the dependent variables and were measured both directly after the intervention and after a 2 weeks delay. Students in the positively framed feedback condition were significantly more satisfied and showed significantly higher self-efficacy measured directly after the performance. Effect sizes found were large, i.e., partial η (2) = 0.43 and η (2) = 0.32 respectively. They showed a better performance throughout the whole study. Significant performance differences were found both at the initial performance and when measured 2 weeks after the intervention: effects were of medium size, respectively r = -.31 and r = -.32. Over time in both conditions performance and self-efficacy decreased. Framing the feedback message in either a positive or negative manner affects students' satisfaction and self-efficacy directly after the intervention be it that these effects seem to fade out over time. Performance may be enhanced by positive framing, but additional studies need to confirm this. We recommend using a positive frame when giving feedback on clinical skills.

Occupational screening for tuberculosis and the use of a borderline zone for interpretation of the IGRA in German healthcare workers.

INTRODUCTION: Healthcare workers (HCWs) in low incidence countries with contact to patients with tuberculosis (TB) are considered a high-risk group for latent TB infection (LTBI) and therefore are routinely screened for LTBI. The German Occupational TB Network data is analyzed in order to estimate the prevalence and incidence of LTBI and to evaluate putative risk factors for a positive IGRA and the performance of IGRA in serial testing. METHODS: 3,823 HCWs were screened with the Quantiferon Gold in Tube (QFT) at least once; a second QFT was performed on 817 HCWs either in the course of contact tracing or serial examination. Risk factors for a positive QFT were assessed by a questionnaire. RESULTS: We observed a prevalence of LTBI of 8.3%. Putative risk factors for a positive QFT result were age >55 years (OR 6.89), foreign country of birth(OR 2.39), personal history of TB (OR 6.25) and workplace, e.g. infection ward (OR 1.76) or geriatric care (OR 1.99). Of those repeatedly tested, 88.2% (721/817) tested consistently QFT negative and 47 were consistently QFT-positive (5.8%). A conversion was observed in 2.8%(n = 21 of 742 with a negative first QFT) and a reversion occurred in 37.3% (n = 28 of 75 with a positive first QFT). Defining a conversion as an increase of the specific interferon concentration from <0.2 to >0.7 IU/ml, the conversion rate decreased to 1.2% (n = 8). Analogous to this, the reversion rate decreased to 18.8% (n = 9) [corrected]. DISCUSSION: In countries with a low incidence of TB and high hygiene standards, the LTBI infection risk for HCWs seems low. Introducing a borderline zone from 0.2 to ≤ 0.7 IU/ml may help to avoid unnecessary X-rays and preventive chemotherapy. No case of active TB was detected. Therefore, it might be reasonable to further restrict TB screening to HCWs who had unprotected contact with infectious patients or materials.

Occupational accident and disease claims, work-related stress and job satisfaction of physiotherapists.

INTRODUCTION: Physiotherapists are exposed to diverse occupational demands. Until now, little has been known about the interaction between occupational stress and the job satisfaction of physiotherapists. This paper aims to examine their work-related stress and job satisfaction. It will analyse accidents at work and occupational diseases of physiotherapists along with work-related physical and psychosocial stress and job satisfaction. METHOD: We analysed routine data of the German Institute for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW) on accidents at work and occurring en route to/from work as well as occupational diseases of physiotherapists. Work-related stress and job satisfaction were examined in a cross-sectional survey using a standard questionnaire to be completed by subjects themselves. RESULTS: Between 2007 and 2011, 1,229 cases of occupational disease were reported to the BGW. The majority of reports involved skin diseases (73%). Stumbles and falls were the most frequent causes of accidents at work (42.9%). Eighty-five physiotherapists all over Germany took part in the survey. They experience high quantitative demands at work. The main physical demands consist of a torso posture between 45° and 90° and high hand activity. Of the 85 subjects, 51% suffer from complaints of the musculoskeletal system in the neck and thoracic spine area and 24% have skin diseases. Most physiotherapists (88%) are satisfied with their work overall. This is aided by a high degree of influence on their work and breaks, by practical application of skills and expert knowledge, high regard for their profession, varied work and a good atmosphere at work. Reservations tend to be about statutory regulations and the social benefits provided by the German healthcare system. CONCLUSION: Overall, despite high demands and stress relating to the adequacy of resources, the majority of physiotherapists surveyed seem to be satisfied with their job. The main focus of action to promote the health of physiotherapists should be on preventing skin disease, problems of the musculoskeletal system and accidents caused by stumbles and falls.