Vitamin D status in active duty Navy military personnel: a systematic review.

OBJECTIVES: Active duty Navy military personnel are prone to vitamin D deficiency due to an occupational environment detrimental to sunlight exposure. The main objective of this systematic review is to provide a worldwide overview of vitamin D status in this population. METHODS: The Condition, Context, Population (CoCoPop) mnemonic was used to define the inclusion criteria (vitamin D status; all contexts; active duty Navy military personnel). Studies with recruits or veterans were excluded. Scopus, Web of Science and PubMed/Medline databases were searched from inception to 30 June 2022. Joanna Briggs Institute and Downs & Black checklists were used for quality assessment and data were synthesised in narrative and tabular formats. RESULTS: Thirteen studies published between 1975 and 2022 and conducted in northern hemisphere Navies, including mainly young and male service members, were included. The prevalence of vitamin D deficiency was globally reported as significant. Nine studies included a total of 305 male submariners who performed 30-92 days submarine patrol and reported the effect of sunlight deprivation in the decrease of vitamin D levels. CONCLUSIONS: This new systematic review underlines the high prevalence of vitamin D deficiency in the Navy, especially in submariners, and the need to implement measures to prevent vitamin D deficiency. Serum 25(OH)D data available and the heterogeneity of the studies limited a pooled analysis. Most studies included only submariners, which may limit generalisability to all active duty Navy military personnel. Further research on this topic should be promoted. PROSPERO REGISTRATION NUMBER: CRD42022287057.

Radiographers' musculoskeletal health in Western Switzerland: WRMSDs symptoms prevalence and risk factors.

BACKGROUND: Work-related musculoskeletal disorders (WRMSDs) are a significant occupational health concern in radiographers. OBJECTIVE: This study aimed to describe radiographers' WRMSDs symptoms prevalence and severity, exploring associations with occupational risk factors. METHODS: A cross-sectional study was conducted to explore WRMSDs symptoms and occupational risk factors in radiographers of Western Switzerland using an online survey, based on the Nordic Musculoskeletal Questionnaire (NMQ). Descriptive statistics were conducted to analyze the collected data, and associative statistics to identify the risk factors related to symptoms. RESULTS: Participants (n = 359) presented a high prevalence of WRMSDs symptoms in the last 12 months (94.7%), with a related absenteeism rate of 15.6%. In the last 7 days, symptoms prevalence was 67.7%. The most affected anatomical regions, over both time periods, were the neck (73.0%, 36.8%) and low back (67.4%, 35.7%). Associative statistics underlined risk factors affecting significantly radiographers' health (OR >2) were the "awkward postures" (OR = 2.86; 95% CI 1.78-4.58) and "feeling anxiety/stress at work" both for low back (OR = 2.38; 95% CI 1.39-4.08), and being a woman for the neck (OR = 2.64; 95% CI 1.51-4.61). CONCLUSIONS: There is a high WRMSDs symptoms prevalence in Western Switzerland radiographers. Radiographers' work demands namely for awkward postures increases the odds for WRMSDs symptoms presence, affecting predominantly neck, upper and lower back. Our data suggest that further research is needed to implement adapted prevention to this specific context.

Vitamin D status in the active duty Navy military personnel: protocol for a systematic review.

INTRODUCTION: Vitamin D is critical for bone health and its deficiency has been linked to increased incidence and severity of multiple diseases. Even so, vitamin D inadequacy is a major public health problem worldwide. The main source of vitamin D is endogenous cutaneous synthesis through exposure to solar ultraviolet B radiation, which is influenced by several factors, including occupational. The active duty Navy military personnel may be prone to vitamin D inadequacy, but a worldwide overview of vitamin D status in this specific population is still lacking. METHODS AND ANALYSIS: The CoCoPop mnemonic will be used for determining the inclusion criteria. Scopus, Web of Science and PubMed/Medline will be searched for all studies including 25-hydroxyvitamin D concentrations of the active duty Navy military personnel. Data extraction and quality assessment (Joanna Briggs Institute's and Downs and Black checklists) will be performed by two reviewers and data will be synthesised in narrative, tabular and map formats. ETHICS AND DISSEMINATION: This study will not involve human or animal subjects and, thus, does not require ethics approval. The outcomes will be disseminated via publication in a peer-reviewed scientific journal and presentation at a scientific conference. PROSPERO REGISTRATION NUMBER: CRD42022287057.

Telework during the COVID-19 epidemic in Portugal and determinants of job satisfaction: a cross-sectional study.

BACKGROUND: Telework satisfaction is a Public Health concern, intensified by the COVID-19 pandemic, and its determinant factors may be related with the negative health effects of teleworking. However, there is still little research exploring this issue. This study aimed to characterize telework during the first wave of the COVID-19 epidemic in Portugal and to identify the major predictors of telework satisfaction. METHODS: This is a cross-sectional study aimed at all teleworkers working in Portugal, during the first wave of the COVID-19 epidemic. Data were collected through a Google Forms platform online questionnaire distributed by a snowball method on social networks. Descriptive statistics included crude and relative frequency data. The associations between sociodemographic characteristics, self-perceived health, organization of working time, concentration at work, work-life balance, work disconnection, working conditions, and organizational demands (flexibility and organizational trust based on E-work Life Scale) with telework satisfaction were estimated through logistic regression. RESULTS: This study included 1004 participants. Teleworkers satisfaction levels were high (69%). Better concentration at work (OR = 1.54; 95%CI 1.01-2.34); the satisfaction with the balance between work life and extra work when teleworking (OR = 1.79; 95%CI 1.17-2.74); and higher work flexibility (OR = 2.26; 95%CI 1.46-3.49) were good predictors of greater levels of satisfaction with telework. However, its major predictors were the company's trust in teleworkers (OR = 4.50; 95%CI 2.89-7.02) and feeling good in the workspace at home (OR = 3.72; 95%CI 1.46-9.49). CONCLUSIONS: Our findings point that work environment and organizational culture play a crucial role in affecting telework satisfaction. More studies are needed to monitor telework satisfaction and its effects on physical and mental health, so that Public and Occupational Health (and Safety) can be able to identify and implement the best interventions that allow promoting individual health and foster a healthy work environment for teleworkers.

Does working at home compromise mental health? A study on European mature adults in COVID times.

INTRODUCTION: The COVID-19 pandemic has transformed working at home (WAH) into the exclusive mode of working for many European workers. Although WAH will likely remain after COVID-19, its consequences on workers' health are unclear. This study examines the association of WAH and the change of four mental health (MH) domains. METHODS: We used data from the last wave of the Survey on Health, Aging, and Retirement in Europe, collected in June and July 2020 on European people aged 50 and older. We restricted our analysis to people aged 50-65 who were working before COVID-19 (N = 7065). We modeled the risk of worsening of depression and anxiety feelings, sleeping trouble, and feelings of loneliness as a function of the working situation (usual setting, at home and usual setting, at home only), using logistic regressions. A first model adjusted for sociodemographic variables, a second one adding country fixed effects, and the last one adding the stringency of COVID-19-related restrictions. RESULTS: WAH was significantly associated with a worsening of all MH symptoms. Nevertheless, when the stringency index was factored in, no significant association of WAH was found with any of the health outcomes except for anxiety feelings (+4.3% points). However, the increased anxiety feelings among people in WAH were not greater than the one observed among nonworkers. DISCUSSION: Our findings show that WAH was not a major cause of mental health deterioration among European mature adults during the first month of the pandemic. Further evidence is needed on WAH under post-COVID-19 "normal" circumstances.

Occupational Health of Frontline Healthcare Workers in the United Arab Emirates during the COVID-19 Pandemic: A Snapshot of Summer 2020.

The study aim was to understand the availability of personal protective equipment (PPE) and the levels of anxiety, depression, and burnout of healthcare workers (HCWs) in the United Arab Emirates (UAE). This study was an online-based, cross-sectional survey during July and August 2020. Participants were eligible from the entire country, and 1290 agreed to participate. The majority of HCWs were females aged 30-39 years old, working as nurses, and 80% considered PPE to be available. Twelve percent of respondents tested positive for SARS-CoV-2. Half of HCWs considered themselves physically tired (52.2%), reported musculoskeletal pain or discomfort (54.2%), and perceived moderate-to-high levels of burnout on at least one of three burnout domains (52.8%). A quarter of HCWs reported anxiety (26.3%) or depression (28.1%). HCWs reporting not having musculoskeletal pain, having performed physical activity, and higher scores of available PPE reported lower scores of anxiety, depression, and burnout. UAE HCWs experienced more access to PPE and less anxiety, depression, and burnout compared with HCWs in other countries. Study findings can be used by healthcare organizations and policymakers to ensure adequate measures are implemented to maximize the health and wellbeing of HCWs during the current COVID-19 and future pandemics.

Prevalence of COVID-19 in health professionals and occupational psychosocial risks.

INTRODUCTION: Health professionals who provide clinical care are exposed to patients potentially infected by the severe acute respiratory syndrome coronavirus 2 SARS-CoV-2), namely physicians and nurses; consequently, these professionals face higher risks of infection. OBJECTIVES: This study aimed to describe the prevalence of coronavirus disease 19 (COVID-19) cases among health professionals and the frequencies of risk factors and psychosocial risk. METHODS: This is a cross-sectional study targeted at health professionals working in Portugal during the current COVID-19 pandemic. Data were obtained through a self-administered questionnaire available online at the websites of medical and nursing boards, among other sources. We performed a univariate analysis, calculating absolute and relative frequencies, and a bivariate analysis with a Pearson's chi-squared test. RESULTS: We studied 4,212 health professionals, of which 36.7% (n = 1,514) worked in areas dedicated to the treatment of sick or suspected COVID-19 patients. Of these, 2.11% tested positive for SARS-CoV-2. Among all participants, 76.7% and 79.1% presented moderate to severe levels of fatigue and anxiety, respectively. Fatigue levels were significantly higher in professionals working in areas dedicated to the treatment of patients with COVID-19 (80.5% p = 0.01), but this difference was not observed regarding anxiety (79.5% p = 0.681). CONCLUSIONS: The percentage of health professionals who tested positive for SARS-CoV-2 was 2.11%. The reported high levels of fatigue and anxiety should determine a better protection of the health and safety of those who provide health care in the current pandemic.

Working time and upper limb musculoskeletal symptoms: a longitudinal study among assembly line workers.

This study followed assembly line workers during 7 months, comprising a 4-wk season holidays. The main purposes were to determine the potential effect of working time on the presence and intensity of upper limb musculoskeletal symptoms, as to verify the effect of 4 wk of job interruption in the upper limb musculoskeletal symptoms presence and intensity. Data was collected during 6 moments. Generalized estimating equations analyses were used. For the effect estimates, odds ratio with corresponding 95% confidence intervals were reported for each outcome/model. The upper limb musculoskeletal symptoms showed a significant increase (p=0.001), especially after the 4 wk off. In all data collection points there was a significant positive association between the upper limb musculoskeletal symptoms and general health status (p<0.001). Considering symptoms' intensity, significant relations were found (p<0.001). Work time had a negative effect on the work-related upper limb musculoskeletal symptoms over 7 months (OR 0.909, 95% CI 0.861-0.960, p=0.001). For the intensity of upper limb symptoms, the effect of time was also statistical significant (OR 0.115, 95% CI 1.031-1.220, p=0.008). A 4-wk job interruption did not show an immediately positive effect on upper limb musculoskeletal symptoms presence.

Self-Reported Variables as Determinants of Upper Limb Musculoskeletal Symptoms in Assembly Line Workers.

BACKGROUND: Assembly lines work is frequently associated to work-related upper limb musculoskeletal disorders. The related disability and absenteeism make it important to implement efficient health surveillance systems. The main objective of this study was to identify self-reported variables that can determine work-related upper limb musculoskeletal symptoms-discomfort/pain-during a 6-month follow-up. METHODS: This was a prospective study with a 6-month follow-up period, performed in an assembly line. Upper limb musculoskeletal discomfort/pain was assessed through the presence of self-reported symptoms. Uni- and multivariate logistic regression analyses were used to evaluate which self-reported variables were associated to upper limb symptoms after 6 months at the present and to upper limbs symptoms in the past month. RESULTS: Of the 200 workers at baseline, 145 replied to the survey after 6 months. For both outcomes, "having upper limb symptoms during the previous 6 months" and "education" were possible predictors. CONCLUSION: Our results suggest that having previous upper limb symptoms was related to its maintenance after 6 months, sustaining it as a specific determinant. It can be a hypothesis that this population had mainly workers with chronic symptoms, although our results give only limited support to self-reported indicators as determinants for upper limb symptoms. Nevertheless, the development of an efficient health surveillance system for high demanding jobs should implicate self-reported indicators, but also clinical and work conditions assessment should be accounted on the future.

Workplace Violence in Healthcare: A Single-Center Study on Causes, Consequences and Prevention Strategies.

INTRODUCTION: Workplace violence is one of the main risk factors in the professional world. Healthcare workers are at higher risk when compared to other sectors. Our study aimed to characterize physical and verbal violence in a public hospital and to define occupational health prevention and surveillance strategies. MATERIAL AND METHODS: Single center observational cross-sectional study, carried amongst healthcare workers in a public hospital in Lisbon. A qualitative survey was carried out through six in-depth interviews. A quantitative survey was carried through questionnaires delivered to 32 workers. A significance level of 5% was accepted in the assessment of statistical differences. The Mann-Whitney test and the Fisher's exact test were used to calculate p values. RESULTS: The main results are: (1) 41 violence incidents were reported in the quantitative phase; (2) 5/21 [23.81%] victims notified the incident to the occupational health department; (3) 18/21 [85.71%] victims reported a permanent state of hypervigilance; (4) 22/28 [78.57%] participants self-reported poor or no familiarity with internal reporting procedures; (5) 24/28 [85.71%] participants believed it is possible to minimize workplace violence. DISCUSSION: Workplace violence is favored by unrestricted access to working areas, absence of security guards and police officers or scarce intervention. The low notification rate contributes to organizational lack of action. The state of hypervigilance reported in our study reflects the negative effects of threatening occupational stressors on mental health. CONCLUSION: Our results show that workplace violence is a relevant risk factor that significantly impacts workers' health in a noxious manner, deserving a tailored occupational health approach whose priority areas and strategies have been determined.

Introdução: A violência no local de trabalho é um dos principais fatores de risco no mundo do trabalho. Os trabalhadores da saúde apresentam um risco superior. O nosso estudo teve como objetivo caracterizar a violência física e verbal num hospital público e definir estratégias de prevenção e vigilância em saúde ocupacional. Material e Métodos: Estudo observacional transversal monocêntrico, conduzido num hospital público em Lisboa com trabalhadores da saúde. Foi realizado um inquérito qualitativo com entrevistas em profundidade a seis trabalhadores e um inquérito quantitativo com questionários a 32 trabalhadores. Aceitou-se um nível de significância de 5% na avaliação das diferenças estatísticas. O teste de Mann-Whitney e o teste exato de Fisher foram usados para calcular os valores de p. Resultados: Os principais resultados são: (1) 41 episódios reportados na fase quantitativa; (2) 5/21 [23,81%] vítimas notificaram o incidente; (3) 18/21 [85.71%] vítimas reportaram estados de hipervigilância permanente; (4) 22/28 [78,57%] participantes não conheciam ou conheciam mal os procedimentos de notificação; (5) 24/28 [85,71%] consideravam possível minimizar o problema. Discussão: A violência é favorecida pelo acesso livre às zonas de trabalho, ausência de agentes de segurança e polícia ou falta da respetiva intervenção. A baixa notificação contribui para a ausência de medidas organizacionais. O estado de hipervigilância relatado reflete o efeito prejudicial da exposição a fontes de stress e ameaça. Conclusão: A violência no local de trabalho é um fator de risco relevante, com impacto negativo na saúde dos trabalhadores e merece uma abordagem individualizada no âmbito da saúde ocupacional, cujas áreas e estratégias prioritárias foram definidas neste estudo.

Lombalgias em auxiliares de enfermagem hospitalares / Low back pain among hospital nursing assistants

Introdução: Os auxiliares de enfermagem (AE) hospitalares constituem um grupo profissional para o qual a lombalgia ocupacional é relevante. Objetivo: Caracterizar os contextos da lombalgia num grupo de AE que, por esse motivo, solicitaram exame médico ocasional. Métodos: Utilizou-se uma entrevista estruturada para a caracterização sociodemográfica, do estado de saúde e do episódio mais relevante de lombalgia e seu enquadramento, seguida de exame objetivo sumário e de consulta do processo individual do Serviço de Saúde Ocupacional (SSO). Resultados: Foram entrevistados 30 AE: predomínio de mulheres de meia-idade, com excesso de peso e sedentárias. Os episódios mais relevantes de lombalgia caracterizaram-se por dor intensa (93,3%), tendo condicionado limitação funcional em 63,3% dos AE. As atividades mais relacionadas com o episódio de lombalgia foram a transferência de doentes (23,3%) e a movimentação/o transporte de cargas >12 kg (20%). Todos eles recorreram a serviços médicos, mas, à data da entrevista, 80% mantinham lombalgia ativa. Ao exame objetivo, oito apresentavam dismetria dos membros inferiores, e 11, escoliose. Os sinais de Lasègue e de Bragard estiveram presentes simultaneamente em 11 casos. Identificaram-se associações significativas (p<0,05) entre a presença de sinais clínicos, a presença de lombalgia atual e a incapacidade para o trabalho. Conclusões: A maioria dos AE afirmou que o episódio agudo de lombalgia ocorreu durante a realização de tarefas exigentes, como transferência de doentes e movimentação/transporte de cargas >12 kg. Assim, apesar da influência dos fatores individuais, a prevenção e o tratamento da lombalgia em AE passam por uma intervenção integrada do SSO, minimizando o seu impacto na saúde e no absentismo.

Background: Occupational low back pain (LBP) is a relevant condition among hospital nursing assistants (NA). Objective: To characterize the context of LBP among NA who sought medical care for this reason. Methods: We conducted structured interviews to characterize the participants' sociodemographic profile, state of health and most relevant LBP episode. Next we subjected the participants to brief objective physical examination and reviewed their occupational health records. Results: We interviewed 30 NA, most of whom were middle-aged women with excess weight and sedentary lifestyle. The most relevant LBP episodes were characterized by severe pain (93.3%) and resulted in functional restrictions for 63.3% of the sample. Job tasks most frequently associated with LBP were patient transfer (23.3%) and lifting/carrying loads >12 kg (20%). Although all the participants had sought medical care, 80% still complained of pain at the time of the interviews. On physical examination, the Lasègue and Bragard signs were found in 11 participants. We found significant association (p<0.05) between clinical signs, ongoing pain and incapacity for work. Conclusions: According to most participants, LBP episodes occurred while performing tasks involving high physical demands, such as patient transfer and lifting/carrying loads >12 kg. The influence of individual factors notwithstanding, prevention and treatment of LBP among NA requires integrated occupational health interventions to minimize its impact on health and absenteeism.

Low back pain among hospital nursing assistants.

BACKGROUND: Occupational low back pain (LBP) is a relevant condition among hospital nursing assistants (NA). OBJECTIVE: To characterize the context of LBP among NA who sought medical care for this reason. METHODS: We conducted structured interviews to characterize the participants' sociodemographic profile, state of health and most relevant LBP episode. Next we subjected the participants to brief objective physical examination and reviewed their occupational health records. RESULTS: We interviewed 30 NA, most of whom were middle-aged women with excess weight and sedentary lifestyle. The most relevant LBP episodes were characterized by severe pain (93.3%) and resulted in functional restrictions for 63.3% of the sample. Job tasks most frequently associated with LBP were patient transfer (23.3%) and lifting/carrying loads >12 kg (20%). Although all the participants had sought medical care, 80% still complained of pain at the time of the interviews. On physical examination, the Lasègue and Bragard signs were found in 11 participants. We found significant association (p<0.05) between clinical signs, ongoing pain and incapacity for work. CONCLUSIONS: According to most participants, LBP episodes occurred while performing tasks involving high physical demands, such as patient transfer and lifting/carrying loads >12 kg. The influence of individual factors notwithstanding, prevention and treatment of LBP among NA requires integrated occupational health interventions to minimize its impact on health and absenteeism.

INTRODUÇÃO: Os auxiliares de enfermagem (AE) hospitalares constituem um grupo profissional para o qual a lombalgia ocupacional é relevante. OBJETIVO: Caracterizar os contextos da lombalgia num grupo de AE que, por esse motivo, solicitaram exame médico ocasional. MÉTODOS: Utilizou-se uma entrevista estruturada para a caracterização sociodemográfica, do estado de saúde e do episódio mais relevante de lombalgia e seu enquadramento, seguida de exame objetivo sumário e de consulta do processo individual do Serviço de Saúde Ocupacional (SSO). RESULTADOS: Foram entrevistados 30 AE: predomínio de mulheres de meia-idade, com excesso de peso e sedentárias. Os episódios mais relevantes de lombalgia caracterizaram-se por dor intensa (93,3%), tendo condicionado limitação funcional em 63,3% dos AE. As atividades mais relacionadas com o episódio de lombalgia foram a transferência de doentes (23,3%) e a movimentação/o transporte de cargas >12 kg (20%). Todos eles recorreram a serviços médicos, mas, à data da entrevista, 80% mantinham lombalgia ativa. Ao exame objetivo, oito apresentavam dismetria dos membros inferiores, e 11, escoliose. Os sinais de Lasègue e de Bragard estiveram presentes simultaneamente em 11 casos. Identificaram-se associações significativas (p<0,05) entre a presença de sinais clínicos, a presença de lombalgia atual e a incapacidade para o trabalho. CONCLUSÕES: A maioria dos AE afirmou que o episódio agudo de lombalgia ocorreu durante a realização de tarefas exigentes, como transferência de doentes e movimentação/transporte de cargas >12 kg. Assim, apesar da influência dos fatores individuais, a prevenção e o tratamento da lombalgia em AE passam por uma intervenção integrada do SSO, minimizando o seu impacto na saúde e no absentismo.

Percepção dos riscos profissionais em trabalhadores de transporte de valores / Perceived occupational hazards among cash-in-transit guards

Introdução: Realizou-se um estudo no setor de vigilância privada com vigilantes de transporte de valores (VTVA) diante da presença de queixas de saúde a uma organização sindical do setor. Objetivos: Diagnosticar a situação de trabalho desses profissionais, do ponto de vista da saúde e segurança, caracterizando as condições de trabalho e as tarefas desses trabalhadores, identificando elementos da atividade de trabalho com influência em sua saúde e segurança e apontando os principais problemas de saúde autorreportados em três empresas que operam em Portugal. Métodos: Efetivou-se um estudo exploratório, de natureza descritiva, recorrendo a um questionário dirigido a trabalhadores com três dimensões, de acordo com os objetivos no contexto da saúde e segurança do trabalho (SST). O questionário foi aplicado nas empresas pelos representantes do sindicato e sem qualquer participação das direções das empresas. Resultados: A atividade desses funcionários apresenta exigências diversas, nomeadamente de concentração e precisão, carga física elevada, horários atípicos, exposição a situações emocionalmente fortes e ainda violência. Evidencia­se, por parte dos trabalhadores, influência negativa do trabalho em sua saúde e segurança, tanto no nível físico como no psicológico. Conclusão: Identifica-se uma importante variabilidade de condições e exigências do trabalho nas empresas observadas, que determina a necessidade de intervenção no contexto da SST, designadamente por meio de sensibilização sobre a legislação existente no sentido da prevenção das doenças ligadas ao trabalho e também dos acidentes de trabalho

Background: Given reports of health complaints by cash-in-transit (CIT) guards to their trade union, we conducted a study at private security companies. Objectives: To establish the health and safety at work (HSW) conditions to which employees from three companies in Portugal were subjected, characterize their working conditions and tasks, and identify aspects of their activity with influence on their health and safety, as well as self-reported health problems. Methods: We performed an exploratory and descriptive study based on a questionnaire with three dimensions corresponding to the study aims. The questionnaire was applied by workers' representatives in the workplace without any participation of employers. Results: The job of CIT guards poses several demands as concentration and precision, involves high physical load, atypical schedules, and exposure to emotionally disturbing situations and violence. The workers rated negative the influence of work on their physical and mental health and safety. Conclusion: We found considerable variability in working conditions and work demands between the analyzed companies. Such diversity points to the need to intervention on HSW through sensitization toward the legislation in force for the prevention of work related diseases and accidents

Patient and hospital characteristics that influence incidence of adverse events in acute public hospitals in Portugal: a retrospective cohort study.

OBJECTIVE: To analyse the variation in the rate of adverse events (AEs) between acute hospitals and explore the extent to which some patients and hospital characteristics influence the differences in the rates of AEs. DESIGN: Retrospective cohort study. Chi-square test for independence and binary logistic regression models were used to identify the potential association of some patients and hospital characteristics with AEs. SETTING: Nine acute Portuguese public hospital centres. PARTICIPANTS: A random sample of 4250 charts, representative of around 180 000 hospital admissions in 2013, was analysed. INTERVENTION: To measure adverse events based on chart review. MAIN OUTCOME MEASURE: Rate of AEs. RESULTS: Main results: (i) AE incidence was 12.5%; (ii) 66.4% of all AEs were related to Hospital-Acquired Infection and surgical procedures; (iii) patient characteristics such as sex (female 11%; male 14.4%), age (≥65 y 16.4%; <65 y 8.5%), admission coded as elective vs. urgent (8.6% vs. 14.6%) and medical vs. surgical Diagnosis Related Group code (13.4% vs. 11.7%), all with p < 0.001, were associated with a greater occurrence of AEs. (iv) hospital characteristics such as use of reporting system (13.2% vs. 7.1%), being accredited (13.7% vs. non-accredited 11.2%), university status (15.9% vs. non-university 10.9%) and hospital size (small 12.9%; medium 9.3%; large 14.3%), all with p < 0.001, seem to be associated with a higher rate of AEs. CONCLUSIONS: We identified some patient and hospital characteristics that might influence the rate of AEs. Based on these results, more adequate solutions to improve patient safety can be defined.

Perceived occupational hazards among cash-in-transit guards.

BACKGROUND: Given reports of health complaints by cash-in-transit (CIT) guards to their trade union, we conducted a study at private security companies. OBJECTIVES: To establish the health and safety at work (HSW) conditions to which employees from three companies in Portugal were subjected, characterize their working conditions and tasks, and identify aspects of their activity with influence on their health and safety, as well as self-reported health problems. METHODS: We performed an exploratory and descriptive study based on a questionnaire with three dimensions corresponding to the study aims. The questionnaire was applied by workers' representatives in the workplace without any participation of employers. RESULTS: The job of CIT guards poses several demands as concentration and precision, involves high physical load, atypical schedules, and exposure to emotionally disturbing situations and violence. The workers rated negative the influence of work on their physical and mental health and safety. CONCLUSION: We found considerable variability in working conditions and work demands between the analyzed companies. Such diversity points to the need to intervention on HSW through sensitization toward the legislation in force for the prevention of work-related diseases and accidents.

INTRODUÇÃO: Realizou-se um estudo no setor de vigilância privada com vigilantes de transporte de valores (VTVA) diante da presença de queixas de saúde a uma organização sindical do setor. OBJETIVOS: Diagnosticar a situação de trabalho desses profissionais, do ponto de vista da saúde e segurança, caracterizando as condições de trabalho e as tarefas desses trabalhadores, identificando elementos da atividade de trabalho com influência em sua saúde e segurança e apontando os principais problemas de saúde autorreportados em três empresas que operam em Portugal. MÉTODOS: Efetivou-se um estudo exploratório, de natureza descritiva, recorrendo a um questionário dirigido a trabalhadores com três dimensões, de acordo com os objetivos no contexto da saúde e segurança do trabalho (SST). O questionário foi aplicado nas empresas pelos representantes do sindicato e sem qualquer participação das direções das empresas. RESULTADOS: A atividade desses funcionários apresenta exigências diversas, nomeadamente de concentração e precisão, carga física elevada, horários atípicos, exposição a situações emocionalmente fortes e ainda violência. Evidencia-se, por parte dos trabalhadores, influência negativa do trabalho em sua saúde e segurança, tanto no nível físico como no psicológico. CONCLUSÃO: Identifica-se uma importante variabilidade de condições e exigências do trabalho nas empresas observadas, que determina a necessidade de intervenção no contexto da SST, designadamente por meio de sensibilização sobre a legislação existente no sentido da prevenção das doenças ligadas ao trabalho e também dos acidentes de trabalho.

Exigências visuais e fadiga visual em médicos oftalmologistas / Visual demands and visual fatigue among ophthalmologists

Contexto: As exigências visuais, designadamente da visão ao perto, são cada vez mais frequentes no mundo do trabalho, podendo causar fadiga visual ou astenopia. Os médicos oftalmologistas exercem atividades que exigem esforço visual, o que determina o interesse no seu estudo pela saúde ocupacional. Objetivos: Identificar a prevalência das queixas visuais e a sua relação com as exigências do trabalho nos médicos oftalmologistas em um hospital universitário de Lisboa. Métodos: Avaliou-se a ocorrência de sintomas de fadiga visual por meio de um questionário de sintomas ­ Inventário de Eficiência Visual (IEV) ­ e pela determinação dos pontos próximos de acomodação e de convergência. Utilizou-se o teste de Schirmer para a avaliação da secreção lacrimal. Os resultados foram analisados com o auxílio da estatística descritiva, do coeficiente de Spearman e do teste de Wilcoxon para p<0,05. Resultados: Dos 27 médicos respondentes, a maioria refere fadiga visual (n=25), assim como a presença de olhos secos e o piscar frequentemente (n=27). Os resultados do teste de Shirmer evidenciam diferenças no final do dia de trabalho e os pontos próximos de acomodação e convergência evidenciam a presença de fadiga visual. Conclusões: Os resultados revelaram diferenças significativas entre o início e o final do dia de atividade profissional dos médicos oftalmologistas, indiciando a existência de fadiga visual ao final do dia de trabalho. Tal situação determina a necessidade de implementar um programa de vigilância da saúde para prevenir alterações visuais de natureza profissional.

Background: Visual demands, especially for near vision, are becoming increasingly more frequent at the workplace, and might cause visual fatigue or asthenopia. The tasks performed by ophthalmologists involve visual effort, raising interest in their study within the context of occupational health. Objectives: To estimate the prevalence of visual complaints and its relationship to work demands among ophthalmologists at a university hospital in Lisbon. Methods: Occurrence of visual fatigue symptoms was assessed by means of a symptom questionnaire ­ College of Optometrists in Vision Development Quality of Life (COVD-QoL) ­ and through the identification of near points of accommodation and convergence. Schirmer's test was used to assess tear production. The results were analyzed by means of descriptive statistics, Spearman's coefficient and the Wilcoxon test for p<0.05. Results: Most among the 27 analyzed physicians reported visual fatigue (n=25), dry eyes and frequent blinking (n=27). Schirmer's test evidenced differences at the end of the working day and the near points of accommodation and convergence indicated occurrence of visual fatigue. Conclusions: The results showed significant differences between the beginning and the end of the working day among ophthalmologists, with occurrence of visual fatigue at the end of the working day. These findings point to the need to implement a health surveillance program to prevent occupational visual disorders.

Ergonomic strategies to improve radiographers' posture during mammography activities.

OBJECTIVES: To identify alternatives for radiographers' postures while performing mammography that can contribute to reduce the risk of work-related musculoskeletal disorders (WRMSDs). METHODS: Radiographers' postures to positioning craniocaudal (CC) and mediolateral oblique (MLO) views were simulated without any intervention for three scenarios: radiographer/patient with similar statures, radiographer smaller than patient and radiographer taller than patient. Actions were taken to modify the postures: seated radiographer; patient on a step; seated patient; radiographer on a step. All the postures were analysed using kinovea 0.8.15 software and the angles were measured twice and classified according to European standard EN1005-4: 2005. RESULTS: The non-acceptable angles were measured mainly during MLO positioning when radiographer was taller than the patient: 139° and 120° for arm-flexion and abduction, 72° for trunk and -24° for head/neck-flexion. The introduction of alternative postures (radiographer seated), allowed improvements in posture (60° and 99° for arm flexion and abduction, 14° for trunk and 0° for head/neck flexion), being classified as acceptable. CONCLUSIONS: The alternative postures simulated have the potential to reduce the risk of developing WRMSDs when radiographers and patients have different statures. MAIN MESSAGES: • Radiographers' postures in mammography can contribute to work-related musculoskeletal disorders • Non-acceptable posture was identified for MLO breast positioning (radiographer taller than patient) • Adapting posture to patient biotype reduces the WRMSD risk for radiographers.

Tendinite do manguito rotador em operadores de caixa de supermercado: contributos para a vigilância de saúde / Rotator cuff tendinitis in supermarket cashiers: contributions to health surveillance

Contexto: A tendinite do manguito rotador (TMR) é frequente em operadores de caixa de supermercado devido às exigências do trabalho. É, de facto, frequente a realização de movimentos repetitivos de abdução e flexão dos membros superiores, muitas vezes em carga, que podem causar inflamação dos tecidos periarticulares do ombro, desencadeando sinais e sintomas de TMR. Objetivos: Conhecer a prevalência de TMR em operadores de caixa de supermercado por meio da avaliação de sintomas, sinais e ecografia. Métodos: Participaram 44 trabalhadores com idades entre 28 e 47 anos. Eles preencheram um questionário de queixas autorreferidas aos ombros e realizaram exame objetivo (manobras do arco doloroso, do conflito subacromial e abdução resistida do ombro) e ecografia de tecidos moles. Resultados: Identificaram-se queixas de dor no ombro em 26 operadores à direita (59,1%) e em 16 (36,4%) à esquerda. Ao exame objetivo, 15 e 11 trabalhadores (34,1% à direita e 25,0% à esquerda, respetivamente) apresentaram positividade nas três manobras. Na ultrassonografia foram encontradas alterações no ombro direito e esquerdo em 16 e 17 operadores (36,4 e 38,6%, respetivamente). Não foi encontrada concordância estatística entre as três abordagens. A "manobra de abdução resistida do ombro" revelou boa relação com as queixas de dor no ombro (χ2 Wald (1)=7,260; p=0,007). Obtiveram-se resultados semelhantes de associação entre essa manobra e a avaliação ecográfica (χ2 Wald (1)=6,854; p=0,009; ROC=0,714, sensibilidade 75%; especificidade 67,9%). Conclusões: Os resultados obtidos sugerem que a "manobra de abdução resistida do ombro" é preditiva de TMR na vigilância médica desses trabalhadores. Tal deverá ser verificado em futuros estudos, designadamente envolvendo amostras de maiores dimensões.

Background: Rotator cuff tendinitis (RCT) is common among supermarket cashiers due to their work demands. Repetitive movements of shoulder abduction and flexion are frequent, which might cause inflammation of the periarticular tissues of the shoulder, triggering signs and symptoms of RCT. Objectives: To investigate the prevalence of RCT in supermarket cashiers by means of assessment of symptoms, signs and ultrasound. Methods: Forty-four workers aged 28 to 47 years old participated in the study. The participants were subjected to a self-report shoulder complaints questionnaire, clinical examinations ("painful arc test", "empty can test" and "Hawkins-Kennedy impingement test") and soft tissue ultrasound. Results: A total of 26 participants reported shoulder pain on the right side (59.1%) and 16 (36.4%) on the left side. During clinical assessment, 15 and 11 workers (34.1% right and 25.0% left, respectively) had positive results on all three tests. Ultrasound showed alterations in the right and left shoulder in 16 and 17 participants (36.4 and 38.6%, respectively). No statistical correlation was found between the three approaches. The "empty can test" exhibited strong correlation with shoulder pain (χ2 Wald (1)=7.260, p=0.007). Similar results were obtained for the association between this test and ultrasound (χ2 Wald (1)=6.854, p=0.009, ROC=0.714, sensitivity 75%, specificity 67.9%). Conclusions: The results suggest that the "empty can test" is predictive of RCT in the medical surveillance of supermarket cashiers. This finding should be verified in future studies, especially with larger samples.

Work related musculoskeletal disorders in primary health care nurses.

BACKGROUND: Work related musculoskeletal disorders (WRMSDs) constitute a serious occupational health problem among registered nurses (RN) all around the world. Its prevalence is mainly associated with nurses' high physical demands that still remain poorly studied in primary health care (PHC). PURPOSE: To describe nurses' self-reported symptoms of WRMSDs (mainly discomfort and pain) in PHC, featuring the main work tasks that may have risk factors for its development. METHODS: A cross-sectional study was developed to identify self-reported WRMSD symptoms by nurses that worked on PHC in Portugal. Nurses answered an online Portuguese version of the Nordic Musculoskeletal Questionnaire (NMQ) (surveymonkey platform). Data was analyzed using the Statistical Package for the Social Science (SPSS17) program. Statistical analysis was based on descriptive statistics and associations with the χ2 test, Cramér's V, Mann-Whitney and Kruskal-Wallis test, with a significance level of 5%. RESULTS: A sample (n=409), mostly female (84.0%), showed a high prevalence of WRMSDs symptoms in the last 12months (89.0%). The lower back was the most affected body region (63.1%), followed by cervical, dorsal, shoulders and the wrist/hand. In the same period, absenteeism related to these complaints was high (51.4%) and strongly connected with standing work (48.8%), bending the trunk (42.3%), rotating the trunk (40.6%), applying force with hands or fingers (37.3%), sitting work (36.6%) and repetitive arm movement (34.3%). This study showed associations between the prevalence of WRMSDs symptoms in different body regions and some individual characteristics such as: gender, age, BMI, presence of other pathologies and regular physical exercise. CONCLUSIONS: This study indicates that, as in other areas of nursing practice, in PHC nurses are also exposed to risk factors that are linked with a high prevalence of WRMSDs symptoms. "Inadequate" and extreme postures sustained for prolonged periods and their repetitiveness will contribute to this occurrence. This shows the need to develop occupational prevention programs to curb this occupational health issue among PHC nurses.

Visual demands and visual fatigue among ophthalmologists.

BACKGROUND: Visual demands, especially for near vision, are becoming increasingly more frequent at the workplace, and might cause visual fatigue or asthenopia. The tasks performed by ophthalmologists involve visual effort, raising interest in their study within the context of occupational health. OBJECTIVES: To estimate the prevalence of visual complaints and its relationship to work demands among ophthalmologists at a university hospital in Lisbon. METHODS: Occurrence of visual fatigue symptoms was assessed by means of a symptom questionnaire - College of Optometrists in Vision Development Quality of Life (COVD-QoL) - and through the identification of near points of accommodation and convergence. Schirmer's test was used to assess tear production. The results were analyzed by means of descriptive statistics, Spearman's coefficient and the Wilcoxon test for p<0.05. RESULTS: Most among the 27 analyzed physicians reported visual fatigue (n=25), dry eyes and frequent blinking (n=27). Schirmer's test evidenced differences at the end of the working day and the near points of accommodation and convergence indicated occurrence of visual fatigue. CONCLUSIONS: The results showed significant differences between the beginning and the end of the working day among ophthalmologists, with occurrence of visual fatigue at the end of the working day. These findings point to the need to implement a health surveillance program to prevent occupational visual disorders.

CONTEXTO: As exigências visuais, designadamente da visão ao perto, são cada vez mais frequentes no mundo do trabalho, podendo causar fadiga visual ou astenopia. Os médicos oftalmologistas exercem atividades que exigem esforço visual, o que determina o interesse no seu estudo pela saúde ocupacional. OBJETIVOS: Identificar a prevalência das queixas visuais e a sua relação com as exigências do trabalho nos médicos oftalmologistas em um hospital universitário de Lisboa. MÉTODOS: Avaliou-se a ocorrência de sintomas de fadiga visual por meio de um questionário de sintomas - Inventário de Eficiência Visual (IEV) - e pela determinação dos pontos próximos de acomodação e de convergência. Utilizou-se o teste de Schirmer para a avaliação da secreção lacrimal. Os resultados foram analisados com o auxílio da estatística descritiva, do coeficiente de Spearman e do teste de Wilcoxon para p<0,05. RESULTADOS: Dos 27 médicos respondentes, a maioria refere fadiga visual (n=25), assim como a presença de olhos secos e o piscar frequentemente (n=27). Os resultados do teste de Shirmer evidenciam diferenças no final do dia de trabalho e os pontos próximos de acomodação e convergência evidenciam a presença de fadiga visual. CONCLUSÕES: Os resultados revelaram diferenças significativas entre o início e o final do dia de atividade profissional dos médicos oftalmologistas, indiciando a existência de fadiga visual ao final do dia de trabalho. Tal situação determina a necessidade de implementar um programa de vigilância da saúde para prevenir alterações visuais de natureza profissional.