Musculoskeletal disorders and incongruous postures in workers on ropes: A pilot study.

Background: Occupational hazards believed to cause musculoskeletal disorders in rope workers are traditionally associated with maintaining incongruous postures for prolonged periods of time. Design and methods: A cross-sectional survey was conducted on 132 technical operators in the wind energy and acrobatic construction sectors, who work on ropes, analysing the ergonomic characteristics of the environments, the way in which tasks are carried out, the strain perceived by individual workers, and assessing the presence of any musculoskeletal disorders (MSDs) by means of an objective examination focused on the anatomical districts that were the object of our study. Results: Analysis of the data obtained showed that there were differences in the perception of the level of physical intensity and perceived exertion between the groups of workers. Statistical analysis also revealed a significant association between the frequency of MSDs analysed and perceived exertion. Discussion: The most significant finding to emerge from this study is the high prevalence of MSDs of the cervical spine (52.94%), the upper limbs (29.41%), and the dorso-lumbar spine (17.65%). These values differ from those classically found in those exposed to the risk of conventional manual handling of loads. Conclusions: The high prevalence of disorders of the cervical spine, the scapulo-humeral girdle and the upper limbs, indicates the need to consider the forced position to be assumed for a large part of the work activity, staticity, and the inability to move the lower limbs for long periods as the predominant risk in rope work.

Evaluation of Correlation between Sleep and Psychiatric Disorders in a Population of Night Shift Workers: A Pilot Study.

BACKGROUND: Insomnia is the perception of inadequate, insufficient or non-restorative sleep. Of all sleep-related disorders, insomnia is the most common. It is important to remember that the sleep-wake cycle also plays a central role in the genesis of anxiety and depression. The aim of our study is to evaluate the association between sleep disturbances and anxiety and depression in a group of workers of both sexes who perform night shift work. METHODS: Information on sleep disorders was collected by administering the Insomnia Severity Index (ISI) questionnaire. Statistical analysis was conducted using the Chi-square test to assess whether there were any differences between sex for those who were healthy or who were diagnosed with psychiatric disorders. RESULTS: The results showed that there was a good percentage of subjects with insomnia problems, impairing normal daily activities and promoting the onset of fatigue, daytime sleepiness, cognitive performance deficits and mood disorders. CONCLUSION: We highlighted how anxious and depressive anxiety disorders are more pronounced in people who suffer from altered sleep-wake rhythms. Further research in this direction could prove to be fundamental for understanding the genesis of the onset of other disorders as well.

Work Ability after Breast Cancer: Study of Healthcare Personnel Operating in a Hospital of South Italy.

Breast cancer (BrC) treatment can produce disabilities that often impact the quality of daily life and impact the social and working relationships of the patient. This paper looked into the remaining work ability in a group of female healthcare personnel (HCPs) with BrC in Southern Italy. Each HCP was subjected to a medical check, routine blood tests, and a questionnaire on the work ability index (WAI). Of 980 (100%) HCWs undergoing health control, 6% (n = 54) had experienced BRC, and only 66.6% (n = 36) agreed to take part in the study. A total of 28 (78%) were on night shifts. The WAI score was quite low in 5 (13.8%) cases, moderate in 10 (27.7%) cases, good in 14 (38.8%) cases, and excellent in 7 (19.5%) HCWs. Among all health figures, in nurses as well as technical staff, lower WAI scores were observed. HCWs reported various comorbidities, which affected WAI score, such as limited mobility in the upper limbs, arm/shoulder pain, numbness, and lymphoedema. The main complication that negatively affects any work activity is the morbidity in the upper limbs. This seems to affect the ability to perform tasks, and the re-entry to work is highlighted on sick leave days.

Improving Education and Training to Reduce the Burden of Occupational Cancer. The Riga-European Association of Schools of Occupational Medicine (EASOM) Statement on Work-Related Cancer.

Reducing the burden of occupational cancers (OCs) is currently one of the most challenging Occupational Health (OH) issues. The European Union (EU) has made efforts to improve the existing legal framework and developed specific legislation aimed at reducing the burden of OC. However, available data suggest that OC are underreported. In August 2019, the European Association of Schools of Occupational Medicine (EASOM) adopted a statement that highlighted the importance of improving the education and training of Medical Doctors (MDs) to facilitate improvements in recognizing and reporting OC. To achieve this, EASOM proposes to promote OH education and training of MDs at undergraduate and postgraduate levels, foster harmonization of OH education and teaching standards and programs across EU countries, and enhance cooperation between universities and international scientific associations. Finally, we suggest that occupational data should be recorded in cancer and medical registers. By engaging MDs more fully in the debate about OCs, they will become more aware of the Occupational Physician's role in reducing the burden of OCs and, furthermore, embed consideration of occupation as a potential cause of cancer into their own practice. These interventions will help promote the implementation of policies and interventions aimed to reduce OC in the workplace.

Sickness Presence among Health Care Professionals: A Cross Sectional Study of Health Care Professionals in Slovenia.

BACKGROUND AND OBJECTIVES: Presenteeism is a relatively new phenomenon that people, despite complaints and ill health that should prompt them to rest and take sick leave, go to work in any case. The highest sickness presence is largely to be found in the care and welfare and educational sectors. The aim of the study is to investigate the relations between different factors and sickness presence among health care professionals. MATERIALS AND METHODS: A cross-sectional study was conducted at the largest hospital in Slovenia involving 5865 health care professionals employed at the University Medical Centre Ljubljana in the period between 1 January 2010 and 31 December 2010. Logistic regression methods were used to assess the associations between risk factors and their interactions and sickness presence. RESULTS: Besides high odds for sickness presence in multivariate modelling for acute (OR = 359.7; 95%CI = 89.1-1452.8) and chronic disease (OR = 722.5; 95%CI = 178.5-2924.5) the highest odds were calculated for poor self-related health (OR = 3.0; 95%CI = 1.9-4.8), no possibility of replacement (OR = 1.9; 95%CI = 1.5-2.3), sickness absence > two times a year (OR = 1.6; 95%CI = 1.2-2.1), disabled workers (OR = 1.6; 95%CI = 1.0-2.5), and lower salary when on sick leave (OR = 1.5; 95%CI = 120-1.9). Risk factors interactions were not found to be associated with sickness presence among health care workers. CONCLUSIONS: The pre-requisite for higher sickness presence is workers' bad health. The results indicate that sickness presence was associated with psycho social risk factors at work and their economic consequences. Continued sickness presence might have negative rather than positive consequences on work and health care professionals' health in the future. Sickness presence needs to be taken into account for health care organizers.

Alcohol, drugs and psychotropic medication at work: guidelines for medical fitness.

Alcohol and illicit drug use in the workplace is a relatively widespread but still insufficiently recognised phenomenon. The reliability of judgement and performance of workers especially undertaking safety-critical tasks must not be influenced by physical, mental and/or behavioural disturbances. It is the responsibility of a company to define and implement proper policy for managing safety risks related to the influence of alcohol, drugs and/or psychotropic medication. Occupational physicians are already involved in the process of prevention in these matters. Authors describe basic recommendations of two biggest international associations of occupational physicians in this field because workers may not perform safety-critical tasks under the influence of psychotropic substances such as alcohol, illicit drugs and psychotropic medication.

Cystic fibrosis and career counselling.

OBJECTIVE: Cystic fibrosis is a genetic disorder that affects mostly lungs but also other organs. Modern treatment has transformed once fatal disease of childhood into the chronic disease of adulthood. Hence more patients enter the job market. Very few adolescents with cystic fibrosis receive some formal career guidance. There is still no professional career guidance for them in Slovenia. METHODS: Literature on workability of patients with cystic fibrosis was reviewed. Following the articles and Slovenian and foreign manuals the guidelines on career counselling of young patients with cystic fibrosis is proposed, as well as the suggestions for professional qualification of these patients. RESULTS: The results of the studies present that workability of patients with cystic fibrosis is associated to forced expiratory volume in 1 second (FEV1) (p < 0.05), the achieved educational level more than 3 years of faculty study (p < 0.001-p < 0.013), self-assessment of quality of life (p = 0.005), age (p = 0.01), and the number of admissions to the hospital (p = 0.001). CONCLUSIONS: The interactions among work, quality of life and survival require that healthcare workers strive to help their patients with cystic fibrosis to succeed in their professional lives. The young patients should achieve the highest level of education possible and follow their wishes in line with the realistic possibilities.

SICKNESS PRESENCE AND STRESSFUL LIFE EVENTS OF HEALTH CARE WORKERS.

AIM: The aim of the study is to investigate the relationship between sickness presence and stressful life events among health care workers. METHODS: Data were gathered from all health care workers at the University Medical Centre Ljubljana employed there in the period between 1 January 2010 and 31 December 2010. Each employee obtained a questionnaire composed of two standardized international questionnaires. RESULTS: There were 57% of sickness present health care workers among the participants. The sickness present reported to have more diseases of family member than the non-sickness present (OR = 1.5; 95% CI = 1.2-2.0), loan (OR = 1.4; 95% CI = 1.1-1.6), their partner lost job (OR = 1.4; 95% CI = 1.0-1.8), or they changed the place of living (OR = 1.4; 95% CI = 1.0-2.0). CONCLUSIONS: The results of the study indicate that stressful life events with economic consequences might have an important influence on sickness presence.

European Working Time Directive and doctors' health: a systematic review of the available epidemiological evidence.

OBJECTIVE: To summarise the available scientific evidence on the health effects of exposure to working beyond the limit number of hours established by the European Working Time Directive (EWTD) on physicians. DESIGN: A systematic literature search was conducted in PubMed and EMBASE. Study selection, quality appraisal and data extraction were carried out by independent pairs of researchers using pre-established criteria. SETTING: Physicians of any medical, surgical or community specialty, working in any possible setting (hospitals, primary healthcare, etc), as well as trainees, residents, junior house officers or postgraduate interns, were included. PARTICIPANTS: The total number of participants was 14 338. PRIMARY AND SECONDARY OUTCOME MEASURES: Health effects classified under the International Classification of Diseases (ICD-10). RESULTS: Over 3000 citations and 110 full articles were reviewed. From these, 11 studies of high or intermediate quality carried out in North America, Europe and Japan met the inclusion criteria. Six studies included medical residents, junior doctors or house officers and the five others included medical specialists or consultants, medical, dental, and general practitioners and hospital physicians. Evidence of an association was found between percutaneous injuries and road traffic accidents with extended long working hours (LWH)/days or very LWH/weeks. The evidence was insufficient for mood disorders and general health. No studies on other health outcomes were identified. CONCLUSIONS: LWH could increase the risk of percutaneous injuries and road traffic accidents, and possibly other incidents at work through the same pathway. While associations are clear, the existing evidence does not allow for an established causal or 'dose-response' relationship between LWH and incidents at work, or for a threshold number of extended hours above which there is a significantly higher risk and the hours physicians could work and remain safe and healthy. Policymakers should consider safety issues when working on relaxing EWTD for doctors.

Sickness Presence among Disabled Workers at the University Medical Centre Ljubljana.

OBJECTIVES: The aim of the article is to investigate the differences in sickness present and non-sickness present in the group of disabled health care professionals. METHODS: Data were gathered from all disabled health care professionals suffering from invalidity of category II or III who were identified in the research among all health care professionals at the University Medical Centre Ljubljana and who were employed there in the period between 1 January 2010 and 31 December 2010. Each employee obtained a questionnaire composed of three standardized international questionnaires. RESULTS: There were 248 disabled workers of the II. and III. category of invalidity among the participants. Disabled sickness present reported to have more chronic diseases than disabled non-sickness present (OR = 57.0; 95% CI = 24.4-133.2), lower salary when on sick leave (OR = 13.1; 95% CI = 5.7-30.2) and poor self-rated health (OR = 5.8; 95% CI = 2.7-12.3). CONCLUSIONS: The prerequisite for sickness presence among disabled workers is their chronic bad health. It is also formally recognized with the degree of disability. Economic factors are among the most important to direct disabled workers towards sickness presence. The results indicate that workplaces are not adapted to disabled workers in regard to their limitations.