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Whole-body fatigue (WBF) presents a concerning risk to construction workers, which can impact function and ultimately lead to accidents and diminished productivity. This study proposes a new WBF monitoring technique by applying the Critical Power (CP) model, a bioenergetic model, with a wrist-worn heart rate sensor. The authors modified the CP model to calculate WBF from the percentage of heart rate reserve (%HRR) and generated a personalized model via WBF perception surveys. Data were collected for two days from 33 workers at four construction sites. The results showed that the proposed technique can monitor field workers' perceived WBF with a mean absolute error of 12.8% and Spearman correlation coefficient of 0.83. This study, therefore, demonstrates the viability of wearable WBF monitoring on construction sites to support programs aimed at improving workplace safety and productivity.
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Objectives. Construction worker safety behavior (CWSB) may be affected by a confluence of multilevel and interrelated factors. Cultivating and maintaining CWSB is vital for improving construction safety. Current studies focus on organization-level or individual-level CWSB antecedents. However, few studies have examined the influence of psychological factors on CWSB, thereby reducing the joint effects of multilevel factors on CWSB. Methods. To determine effective strategies for strengthening CWSB, this study adopted the Bayesian network technique to explore the interrelationships between CWSB and its antecedent factors. A Bayesian belief network model was developed and trained with data collected from Chinese construction workers, which connected organizational, individual and psychological factors with CWSB. Results. According to the sensitivity analysis, safety knowledge, safety climate and psychological capital are the three most significant influencing factors for CWSB. A combined strategy that enhances safety knowledge, safety climate and communication competence simultaneously is the most effective option for strengthening CWSB. The validation and robustness of the network showed good accuracy for safety behavior judgment. Conclusion. This study proposes an alternative way to improve safety behavior by identifying its interactive causes and illustrates the importance of initiating systematic safety measures, which may help to mitigate the problem of safety plateau.
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Occupational noise exposure continues to be a prevalent hazard in many industries. While the proliferation of noise dosimeters and wearable devices has made it easier to assess a worker's exposure to noise, many employees exposed to hazardous (i.e., >85 dBA) levels of noise may go their entire career without ever having their personal noise levels measured. In contrast to other occupational exposures, noise is easily perceived by the individual exposed, allowing them to develop subjective judgments regarding its characteristics. To determine whether such self-reported exposures to occupational noise are associated with hearing loss, this analysis used audiometric data and self-reported occupational exposure to loud noise from the National Health and Nutrition Examination Survey (NHANES), which has collected such data from 1999 to May 2020. Linear and logistic regressions models found a statistically significant association between self-reported noise exposure and worsened hearing at the 3, 4, 6, and 8 kHz hearing frequency as well as an elevated odds ratio for the development of hearing loss greater than 25 dB at the 2, 3, and 4 kHz audiometric frequencies. The results of this analysis suggest that in the absence of exposure measurements, workers are likely able to detect exposure to hazardous levels of noise. In these instances, additional measurements should be collected to determine if the workers should be enrolled in a hearing conservation program.
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On pig farms ample opportunity exists for pig-to-human and human-to-pig (cross-species) influenza transmission. The purpose of this study was to assess the risks of cross-species influenza transmission within an indoor pig grower unit in the United States and to prioritize data gaps. Using the World Organization for Animal Health risk assessment framework we evaluated influenza transmission across two risk pathways: 1. What is the likelihood that based on current conditions on a single typical hog grower-finisher facility in the Midwest (US), during a single production cycle, at least one hog becomes infected with an influenza virus associated with swine (either H1N1, H3N2, or H1N2) [step 1a] and that at least one worker becomes infected as a result [step 1b] and that the worker develops symptoms [step 1c]? And 2. What is the likelihood that, based on current conditions on a single typical hog grower-finisher facility in the Midwest (US), during a single production cycle, at least one worker becomes infected with an influenza virus associated with people (either H1N1, H3N2, or H1N2) [step 2a] and that at least one pig becomes infected as a result [step 2b] and that the pig(s) develop(s) symptoms [step 2c]? Semi-quantitative probability and uncertainty assessments were based on literature review including passive and active influenza surveillance data. We assumed a typical pig-grower farm has capacity for 4,000 pigs, two workers, and minimal influenza control measures. Probability and uncertainty categories were assessed for each risk step and the combined risk pathway. The combined risk assessment for risk pathway one was estimated to be Very Low for H1N1 and H1N2 with an overall High level of uncertainty. The combined risk assessment for risk pathway two was estimated to be Extremely Low for H1N1 and H3N2 with a High degree of uncertainty. Scenario analyses in which influenza control measures were assumed to be implemented separately (implementing vaccinating sows, mass vaccinating incoming pigs or improved personal protective equipment adherence) showed no reduction in the combined risk category. When implementing three influenza control methods altogether, the combined risk could be reduced to Extremely Low for risk pathway one and remained Extremely Low for risk pathway two. This work highlights that multiple influenza control methods are needed to reduce the risks of inter-species influenza transmission on swine farms.
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Animal Husbandry , Orthomyxoviridae Infections , Swine Diseases , Animals , Orthomyxoviridae Infections/veterinary , Orthomyxoviridae Infections/transmission , Orthomyxoviridae Infections/epidemiology , Orthomyxoviridae Infections/virology , Swine Diseases/transmission , Swine Diseases/virology , Swine Diseases/epidemiology , Swine , Risk Assessment , Humans , Animal Husbandry/methods , Influenza A Virus, H3N2 Subtype , Midwestern United States/epidemiology , Influenza A Virus, H1N1 Subtype , United States/epidemiology , Influenza A virus , Influenza A Virus, H1N2 Subtype , Influenza, Human/transmission , Influenza, Human/epidemiologyABSTRACT
Background: Workers are often exposed to hazardous heat due to their work environment, leading to various injuries. As a result of climate change, heat-related injuries (HRIs) are becoming more problematic. This study aims to identify critical contributing factors to the severity of occupational HRIs. Methods: This study analyzed historical injury reports from the Occupational Safety and Health Administration (OSHA). Contributing factors to the severity of HRIs were identified using text mining and model-free machine learning methods. The Multinomial Logit Model (MNL) was applied to explore the relationship between impact factors and the severity of HRIs. Results: The results indicated a higher risk of fatal HRIs among middle-aged, older, and male workers, particularly in the construction, service, manufacturing, and agriculture industries. In addition, a higher heat index, collapses, heart attacks, and fall accidents increased the severity of HRIs, while symptoms such as dehydration, dizziness, cramps, faintness, and vomiting reduced the likelihood of fatal HRIs. Conclusions: The severity of HRIs was significantly influenced by factors like workers' age, gender, industry type, heat index , symptoms, and secondary injuries. The findings underscore the need for tailored preventive strategies and training across different worker groups to mitigate HRIs risks.
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Objectives: Acknowledging peer support as the cornerstone in mitigating the psychosocial burden arising from the second victim phenomenon, this study assesses the economic benefits of a Peer Support Program (PSP), compared to data of the Resilience In Stressful Events (RISE) program in the US, within the acute inpatient care sector in Germany. Methods: Employing a Markov model, this economic evaluation analyzes the cost benefits, including sick day and dropout costs, over a 1-year period, comparing scenarios with and without the Peer Support Program from a hospital perspective. The costs were calculated as an example based on a hospital with 1,000 employees. The estimations are considered conservative. Results: The anticipated outcomes demonstrate an average cost saving of 6,672 per healthcare worker participating in the Peer Support Program, leading to an annual budgetary impact of approximately 6,67 Mio. for the studied hospital. Conclusion: The integration of a PSP proves economically advantageous for German hospitals, not only preserving financial resources but also reducing absenteeism, and mitigating turnover, thereby enhancing overall patient care.
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Peer Group , Humans , Germany , Cost-Benefit Analysis , Social Support , Markov Chains , AbsenteeismABSTRACT
The adoption of the Internet of Things (IoT) in the mining industry can dramatically enhance the safety of workers while simultaneously decreasing monitoring costs. By implementing an IoT solution consisting of a number of interconnected smart devices and sensors, mining industries can improve response times during emergencies and also reduce the number of accidents, resulting in an overall improvement of the social image of mines. Thus, in this paper, a robust end-to-end IoT system for supporting workers in harsh environments such as in mining industries is presented. The full IoT solution includes both edge devices worn by the workers in the field and a remote cloud IoT platform, which is responsible for storing and efficiently sharing the gathered data in accordance with regulations, ethics, and GDPR rules. Extended experiments conducted to validate the IoT components both in the laboratory and in the field proved the effectiveness of the proposed solution in monitoring the real-time status of workers in mines.
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The widespread utilization of personal protective equipment (PPE) during the COVID-19 pandemic has been crucial for reducing transmission risk among healthcare workers (HCWs) and the public. However, the extensive use of PPE has brought about potential adverse reactions, particularly among HCWs. This study aims to investigate the prevalence and characteristics of adverse skin reactions associated with PPE use among different categories of HCWs, including faculty, residents, and nursing officers (NOs), in a dedicated tertiary care COVID-19 hospital. The study design was a hospital-based cross-sectional analytical study conducted over one month, involving a total of 240 participants. The participants were required to complete a pre-tested semi-structured questionnaire that covered demographic information, PPE-related data, preventive measures, observed reactions, and self-management strategies. Results indicated that adverse skin reactions were common among HCWs, with reactions reported by all participants. The most commonly used PPE included N95 masks, goggles, gloves, face shields, isolation gowns, and medical protective clothing. Excessive sweating (60% residents, 21.1% NOs, and 16.25% faculties), facial rash, dry palms (>70% of HCWs), and itching were among the most prevalent adverse reactions. Urticarial lesions (28.5% among NOs), pressure marks and pain (100% on the cheek among all HCWs), fungal infections (18.5% among residents at the web space of fingers), and skin breakdown were also reported. Factors such as age, gender, pre-existing skin problems, and oily/acne-prone skin history were found to be significantly associated with adverse skin reactions. In conclusion, the findings highlight the common adverse reactions reported by HCWs during the use of different PPEs. Certain steps taken by HCWs for the prevention of adverse reactions due to PPE emphasize the importance of tailored preventive measures and strategies to mitigate these adverse reactions, such as proper PPE selection, well-fitting equipment, regular breaks, and appropriate skincare practices. These insights contribute to the development of guidelines for optimal PPE usage and support the well-being of HCWs in their essential roles.
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BACKGROUND AND PURPOSE: Industrial environments present unique challenges in ensuring worker safety and optimizing productivity. The emergence of smart wearable technologies such as smart insoles has provided new opportunities to address these challenges through accurate unobtrusive monitoring and analysis of workers' activities and physical parameters. This systematic review aims to analyze the utilization of smart wearable insoles in industrial environments, focusing on their applications, employed analysis methods, and potential future directions. METHODS: A comprehensive review was conducted, involving the analysis of 27 papers that utilized smart wearable insoles in industrial settings. The reviewed articles were evaluated to determine the trends in application and methodology, explore the implementation of smart insoles across different industries, and identify the prevalent machine learning models and analyzed activities in the relevant literature. RESULTS: The majority of the reviewed articles (67%) primarily focused on human activity recognition and gesture estimation using smart wearable insoles, aiming to enhance safety and productivity in industrial settings. Furthermore, 10% of the studies focused on fatigue identification, 10% on slip, trip, and fall hazard detection, and 13% on biomechanical analyses of workers' body joint loads. The construction industry accounted for approximately 60% of the studies conducted in industrial settings using smart insoles. The most prevalent machine learning models utilized in these studies were neural networks (48%), support vector machines (33%), k-nearest neighbors (30%), decision trees (26%), and random forests (15%). These models achieved median accuracies of 95%, 96%, 91%, 92%, and 95%, respectively. Among the analyzed activities, walking, bending with/without lifting/lowering a load, and carrying a load were the most frequently considered, with frequencies of 10, 10, and 7 out of the 27 studies, respectively. CONCLUSION: The findings of this systematic review demonstrate the growing interest in implementing smart wearable insoles in industrial environments to enhance safety and productivity. However, the effectiveness of these systems is dependent on factors such as accuracy, reliability, and generalizability of the models. The review highlights the need for further research to address these challenges and to explore the potential of these systems for use in other industrial applications such as manufacturing. Overall, this systematic review provides valuable insights for researchers, practitioners, and policymakers in the field of occupational health and safety.
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Wearable Electronic Devices , Humans , Biomechanical Phenomena , Industry , Machine Learning , Occupational Health , ShoesABSTRACT
The agriculture industry lacks novel techniques for analyzing risks facing its workers. Although injuries are common in this field, existing datasets and tools are insufficient for risk assessment and mitigation for two primary reasons: they provide neither immediate nor long-term risk mitigation advice, and they do not account for hazards which fluctuate daily. The purpose of Demeter is to collect safety data about hazards on farms and produce risk analysis and mitigation reports. This application uses a combination of formula-based risk calculations and state-of-the-art graph neural networks (GNNs) to perform risk analysis and reduction. The formula-based risk calculations had a mean absolute error (MAE) of 0.2110, and the GNN had an accuracy of 94.9%, a precision of 0.3521, and a recall of 0.8333. Demeter has the potential to reduce the number of injuries and fatalities among agriculture workers by alerting them to risks present in their daily workflow and suggesting safety precautions.
Subject(s)
Agriculture , Farmers , Humans , Farmers/statistics & numerical data , Risk Assessment/methods , Agriculture/instrumentation , Accidents, Occupational/prevention & control , Occupational Health/standards , Neural Networks, Computer , Occupational Injuries/prevention & control , Occupational Injuries/epidemiologyABSTRACT
BACKGROUND: The second victim phenomenon and moral injury are acknowledged entities of psychological harm for healthcare providers. Both pose risks to patients, healthcare workers, and medical institutions, leading to further adverse events, economic burden, and dysfunctionality. Preceding studies in Germany and Austria showed a prevalence of second victim phenomena exceeding 53 percent among physicians, nurses, emergency physicians, and pediatricians. Using two German instruments for assessing moral injury and second victim phenomena, this study aimed to evaluate their feasibility for general practitioners and healthcare assistants. METHODS: We conducted a nationwide anonymous online survey in Germany among general practitioners and healthcare assistants utilizing the SeViD (Second Victims in Deutschland) questionnaire, the German version of the Second Victim Experience and Support Tool Revised Version (G-SVESTR), and the German version of the Moral Injury Symptom and Support Scale for Health Professionals (G-MISS-HP). RESULTS: Out of 108 participants, 67 completed the survey. In G-SVESTR, the collegial support items exhibited lower internal consistency than in prior studies, while all other scales showed good-quality properties. Personality traits, especially neuroticism, negatively correlated to age, seem to play a significant role in symptom count and warrant further evaluation. Multiple linear regression indicated that neuroticism, agreeableness, G-SVESTR, and G-MISS-HP were significant predictors of symptom count. Furthermore, moral injury partially mediated the relationship between second victim experience and symptom count. DISCUSSION: The results demonstrate the feasible use of the questionnaires, except for collegial support. With respect to selection bias and the cross-sectional design of the study, moral injury may be subsequent to the second victim phenomenon, strongly influencing symptom count in retrospect. This aspect should be thoroughly evaluated in future studies.
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BACKGROUND: Globally, close to one-third of all workplace violence (WV) occurs in the health sector. Exposure to WV among healthcare professionals in Ghana has been widely speculated, but there is limited evidence on the problem. This study therefore investigated WV, its risk factors, and the psychological consequences experienced by health workers in Ghana. METHODS: An analytic cross-sectional study was conducted in the Greater Accra region from January 30 to May 31, 2023, involving selected health facilities. The participants for the study were selected using a simple random sampling technique based on probability proportional-to-size. The data analyses were performed using STATA 15 software. Logistic regression analyses were employed to identify the factors associated with WV, considering a significance level of p-value < 0.05. RESULTS: The study was conducted among 607 healthcare providers and support personnel across 10 public and private hospitals. The lifetime career, and one-year exposure to any form of WV was 414 (68.2%) [95% CI: (64.3-71.9%)] and 363 (59.8%) [95% CI: (55.8-63.7%)], respectively. Compared to other forms of WV, the majority of healthcare workers, 324 (53.4%) experienced verbal abuse within the past year, and a greater proportion, 85 (26.2%) became 'super alert' or vigilant and watchful following incidents of verbal abuse. Factors significantly linked to experiencing any form of WV in the previous 12 months were identified as follows: older age [AOR = 1.11 (1.06, 1.17)], working experience [AOR = 0.91 (0.86, 0.96)], having on-call responsibilities [AOR = 1.75 (1.17, 2.61)], and feeling adequately secure within health facility [AOR = 0.45 (0.26, 0.76)]. CONCLUSION: There was high occurrence of WV, and verbal abuse was the most experienced form of WV. Age, work experience, on-call duties, and security within workplace were associated with exposure to WV. Facility-based interventions are urgently needed to curb the incidence of WV, especially verbal abuse.
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Workplace Violence , Humans , Workplace Violence/psychology , Cross-Sectional Studies , Ghana/epidemiology , Prevalence , Surveys and Questionnaires , Health Personnel/psychology , Workplace/psychology , Risk FactorsABSTRACT
Serotonergic psychedelics, such as lysergic acid diethylamide (LSD), psilocybin, dimethyltryptamine (DMT), and 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT), are currently being investigated for the treatment of psychiatric disorders such as depression and anxiety. Clinical trials with psilocybin and LSD have shown improvement in emotional and psychological scores. Although these drugs are reported to be safe in a controlled environment (such as clinical trials), exposure to low doses of these drugs can result in psychedelic effects, and therefore, occupational safety is an important consideration to prevent adverse effects in the workplace from low daily exposure. This article will discuss the factors involved in the derivation of occupational exposure limits (OELs) and risk assessment of these psychedelic drugs. To support the OEL derivations of psychedelic drugs, information regarding their mechanism of action, adverse effect profiles, pharmacokinetics, clinical effects, and nonclinical toxicity were considered. Additionally, psilocybin and LSD, which are the most extensively researched psychedelic substances, are employed as illustrative examples in case studies. The OELs derived for psilocybin and for LSD are 0.05 and 0.002 µg/m3 , respectively, which indicates that these are highly hazardous compounds, and it is important to take into account suitable safety measures and risk-management strategies in order to minimize workplace exposure.
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Hallucinogens , Humans , Hallucinogens/toxicity , Hallucinogens/therapeutic use , Psilocybin/toxicity , Psilocybin/therapeutic use , Lysergic Acid Diethylamide/toxicity , Lysergic Acid Diethylamide/therapeutic use , N,N-Dimethyltryptamine , Risk AssessmentABSTRACT
This article explores the usability and user experience challenges of ARROWS, a novel augmented reality (AR) and wearable technology (WT) safety system for roadway work zones, an area with limited existing usability research. We utilized a mixed-method approach with two complementary experiments in indoor and outdoor settings, using the Wizard of Oz methodology and a high-fidelity prototype. We focused on identifying usability challenges, factors contributing to user experience and the distinct needs of highway workers, documenting results using the system usability scale (SUS), the rating scale mental effort (RSME) and a trust score. Participants rated the usability of ARROWS above average in both settings, while making a reasonable level of mental effort. The findings also indicate a significant correlation between perceived trust and usability, highlighting the importance of trust in user experience.
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Augmented Reality , Occupational Health , Wearable Electronic Devices , Humans , TransportationABSTRACT
BACKGROUND: The study aimed to evaluate the effectiveness of filtering facepiece respirators (FFRs) in reducing odour nuisances in agricultural work environment. Additionally, an assessment was conducted on the microbiological contamination of FFRs and the functionality of Time4Mask application in enhancing workplace safety. MATERIAL AND METHODS: Two types of FFRs were used for the study: with absorbing properties and reference ones. The research was carried out in 6 livestock rooms during a 1-week period in early spring (February-March 2021) on a farm in central Poland. The microclimate conditions (thermoanemometer), and particulate matter concentrations (laser photometer) were assessed. Additionally, the odour content in the studied rooms and the breathing zone of FFR users (gas chromatography with mass spectrometry) were evaluated. The number of microorganisms on the respirators was determined (cultivation method), followed by their identification (biochemical tests, taxonomic keys). Breakthrough curves were determined for both FFR types to assess absorption capabilities. RESULTS: The average temperature in the livestock rooms was about 13°C, relative humidity - 53%, air flow velocity - 0.21 m/s, and particulate matter concentration - 0.216 mg/m3. A significant variety of odorants was found in the environment and the breathing zone under the FFRs. Bacterial counts ranged between 2.4 × 101 and 2.6 × 102 CFU/cm2, fungi between 3.2 × 100 and 5.4 × 101 CFU/cm2, xerophilic fungi from 4.4 × 100 to 4.0 × 101 CFU/cm2, mannitol-positive staphylococci between 1.6 × 101 and 1.0 × 102 CFU/cm2, and haemolytic staphylococci from 2.2 × 101 to 4.5 × 101 CFU/cm2, depending on the respirator type. Respirators were colonized by bacteria from the genera: Bacillus, Staphylococcus, actinobacteria Streptomyces sp., and fungi: Candida, Absidia, Aspergillus, Mucor, and Penicillium. Respirators with absorbing properties had over 8-times longer breakthrough time than reference ones. CONCLUSIONS: Respirators with activated carbon effectively improved work comfort when exposed to odours. Due to growth of microorganisms in the respirator materials, periodic replacement is necessary. It is crucial to provide workers with information about the safe-use time of respirators, considering environmental conditions. This is achievable using modern IT tools like Time4Mask application. Med Pr Work Health Saf. 2023;76(5):363-75.
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Air Pollutants, Occupational , Occupational Exposure , Respiratory Protective Devices , Humans , Air Pollutants, Occupational/analysis , Occupational Exposure/prevention & control , Occupational Exposure/analysis , Odorants/analysis , Gas Chromatography-Mass Spectrometry , Particulate Matter/analysis , Ventilators, Mechanical , Fungi , BacteriaABSTRACT
Methyl bromide (MB) is worldwide the only effective fumigant heavily used for quarantine pre-shipment treatment and has a critical use exemption for soil fumigations due to its excellent permeability and insecticidal effect. However, MB should be replaced as it is an an ozone-depleting substance and also highly toxic to humans. Recently, MB has been shown to be hazardous even for asymptomatic workers, affecting their central and autonomic nervous systems. However, the effects of MB exposure on vascular health have not been explored. This study aimed to determine whether MB affects the arterial system of asymptomatic workers. We measured the second derivative of the photoplethysmogram (SDPTG) indices, which are indicators of vascular load and aging, and urinary bromide ion (Br-) concentrations in 44 fumigators (study group) and 20 inspectors (control group) before and after fumigation. In fumigators, the mean values of post-work SDPTG indices (b/a, c/a, d/a, e/a, and SDPTG aging index) and Br- levels were significantly changed compared to their pre-work values (p < 0.05), indicating a negative effect on their cardiovascular health. In contrast, SDPTG indices and Br- levels in inspectors did not show any differences before and after work. All SDPTG indices except c/a showed significant correlations with Br- levels in all individuals (p < 0.05). In conclusion, the Br- levels and SDPTG indices of fumigators varied after MB work, and they experienced negative effects on their health despite being asymptomatic.
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Hydrocarbons, Brominated , Insecticides , Humans , Photoplethysmography , Aging/physiologyABSTRACT
(1) Background: The second victim phenomenon (SVP) plays a critical role in workplace and patient safety. So far, there are limited epidemiological data on the SVP in German-speaking countries. Some studies have been carried out in Germany, but so far, no quantitative studies have been carried out in Austria examining the prevalence, symptom load and preferred support measures for second victims (SVs). This study therefore examines the SVP among Austrian pediatricians. (2) Methods: A nationwide, cross-sectional and anonymous online study was conducted using the SeViD questionnaire (Second Victims in Deutschland) including the Big Five Inventory-10 (BFI-10). Statistical analysis included binary-logistic and multiple linear regression with the bootstrapping, bias-corrected and accelerated (BCa) method based on 1000 bootstrap samples. (3) Results: Of 414 Austrian pediatricians, 89% self-identified as SVs. The main cause of becoming an SV was the unexpected death or suicide of a patient. High neuroticism and extraversion values as well as working in outpatient care positively correlated with having experienced the SVP. A preferred support strategy was access to legal counseling. (4) Conclusions: Austrian pediatricians have the highest SVP prevalence measured with the SeViD questionnaire. Further research should focus on prevention strategies and intervention programs.
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Adverse events can occur at any time during medical treatment of patients. These adverse events not only negatively impact patients but also the medical personnel involved. The impairment of medical personnel after an adverse event is known as the second victim phenomenon (SVP). Although the concept of second victims is relatively unknown, the chances to become a second victim during the course of one's professional carrier are high. Effective measures to support second victims are peer support programs within medical institutions, which also benefit economically from the implementation of these programs. Supporting second victims is also beneficial to future patients and finally healthcare systems as a whole.
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Anesthesiology , Humans , Medical Errors , Health PersonnelABSTRACT
Background Periodic outbreaks of SARS-CoV-2 in hospital settings amidst the recent pandemic are well known. However, the timely control of such outbreaks was key to preventing morbidity among vulnerable patients as well as reducing sickness absenteeism among healthcare workers. This is the first study of its kind in India. Methods An outbreak investigation was conducted between June 12 and July 18, 2020, at the All India Institute of Medical Sciences, New Delhi, India, during the first wave of COVID-19. Results A total of 27 individuals were infected during this time, including people visiting the hospital and healthcare workers. A thorough investigation led us to the epidemiological link between cases and allowed us to bring reforms to the existing hospital policy of screening and admission of COVID-19 patients and those suspected to have the infection. This experience helped us avoid future outbreaks during the second wave of COVID-19 in our hospital. Conclusion The SARS-CoV-2 virus is highly transmissible, especially in hospital settings due to the high burden of patients and close proximity between patients. Timely intervention is the key to effective control of hospital outbreaks, as it can avoid morbidity in patients and reduce sickness absenteeism among healthcare workers.
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INTRODUCTION: The costs of global warming are substantial. These include expenses from occupational illnesses and injuries (OIIs), which have been associated with increases during heatwaves. This study estimated retrospective and projected future heatwave-attributable OIIs and their costs in Australia. MATERIALS AND METHODS: Climate and workers' compensation claims data were extracted from seven Australian capital cities representing OIIs from July 2005 to June 2018. Heatwaves were defined using the Excess Heat Factor. OIIs and associated costs were estimated separately per city and pooled to derive national estimates. Results were projected to 2030 (2016-2045) and 2050 (2036-2065). RESULTS: The risk of OIIs and associated costs increased during heatwaves, with the risk increasing during severe and particularly extreme heatwaves. Of all OIIs, 0.13% (95% empirical confidence interval [eCI]: 0.11-0.16%) were heatwave-attributable, equivalent to 120 (95%eCI:70-181) OIIs annually. 0.25% of costs were heatwave-attributable (95%eCI: 0.18-0.34%), equal to $AU4.3 (95%eCI: 1.4-7.4) million annually. Estimates of heatwave-attributable OIIs by 2050, under Representative Concentration Pathway [RCP]4.5 and RCP8.5, were 0.17% (95%eCI: 0.10-0.27%) and 0.23% (95%eCI: 0.13-0.37%), respectively. National costs estimates for 2030 under RCP4.5 and RCP8.5 were 0.13% (95%eCI: 0.27-0.46%) and 0.04% (95%eCI: 0.66-0.60), respectively. These estimates for extreme heatwaves were 0.04% (95%eCI: 0.02-0.06%) and 0.04% (95%eCI: 0.01-0.07), respectively. Cost-AFs in 2050 were, under RCP4.5, 0.127% (95%eCI: 0.27-0.46) for all heatwaves and 0.04% (95%eCI: 0.01-0.09%) for extreme heatwaves. Attributable fractions were approximately similar to baseline when assuming theoretical climate adaptation. DISCUSSION: Heatwaves represent notable and preventable portions of preventable OIIs and economic burden. OIIs are likely to increase in the future, and costs during extreme heatwaves in 2030. Workplace and public health policies aimed at heat adaptation can reduce heat-attributable morbidity and costs.