Neglected cause of retinal detachment: a hospital-based case-control study on occupational heavy lifting as a risk factor.

BACKGROUND: Heavy lifting may lead to sudden increase in venous, intra-abdominal, and intraocular pressure which in turn may cause retinal detachment (RD). The epidemiological evidence for this association is still inconclusive. This study was carried out to investigate the relationship between occupational heavy lifting and RD. METHODS: A case-control study was carried out on 151 RD cases and 113 controls free of RD attending the ophthalmology outpatient clinic at Ain Shams University. Personal, medical, and occupational data were collected using interview questionnaires in addition to conducting full ophthalmologic examination. RESULTS: The mean age of study participants was 45.8 ± 9.1 years (46.8 ± 8.9, 44.4 ± 9.2 for RD cases and controls respectively). Statistically significant differences were found between cases and controls regarding years of working, occupational categories, frequency of occupational heavy lifting, non-work heavy lifting, history of head trauma, history of eye surgeries, and family history of RD. Multivariate logistic regression analysis showed that lifting (Odds ratio (OR) = 4.8, p < 0.0001), history of head trauma (OR = 3.3, p = 0.013), diabetes mellitus (DM) (OR = 4.96, p < 0.0001), and previous eye surgeries (OR = 3.5, p = 0.003) increased the risk of RD. CONCLUSION: Occupational heavy lifting is associated with RD. Occupational categories, duration of lifting heavy objects during work and family history of RD had a significant effect on RD. An ergonomic approach should be adopted and practiced as it has a significant impact on reducing the risks of lifting and carrying heavy objects. The workplace's design (including having appropriate mechanical aids available) is also of significant importance to reducing the risks. During the patient's visit, ophthalmologists should consider and look for the occupational heavy lifting history as a potential risk factor of the patient's symptoms.

Validity and Reliability of a COVID-19 Stigma Scale Using Exploratory and Confirmatory Factor Analysis in a Sample of Egyptian Physicians: E16-COVID19-S.

INTRODUCTION: To date, a universal validated and specific tool for assessing coronavirus disease 2019 (COVID-19) stigma among healthcare workers is lacking. We adapted a SARS stigma scale that was developed using the Berger HIV scale for use as a COVID-19 stigma scale and evaluated its psychometric properties among Egyptian physicians. METHODS: We administered the 17-item SARS stigma scale in an anonymous online questionnaire among 509 Egyptian physicians recruited via convenience sampling during a cross-sectional study in June 2020. Exploratory factor analysis was performed on half of the sample. Confirmatory factor analysis of the resulting model was done using structural equation modeling on the other half. Scale reliability was examined using Cronbach's alpha for internal consistency. Convergent construct validity was assessed using regression models to examine the association between the adapted COVID-19 stigma scale and relevant factors. RESULTS: Exploratory factor analysis yielded 16 items (E16-COVID19-S) that supported a three-factor structure: personalized stigma (8 items); concerns of disclosure and public attitudes (5 items); and negative experiences (3 items). Cronbach's α was 0.909 for the total scale and 0.907, 0.663, and 0.789 for the three subscales. E16-COVID19-S was confirmed to have good model fit (comparative fit index = 0.964; root mean squared error of approximation = 0.056). E16-COVID19-S was independently associated with physicians' younger age, lower qualification, working in an isolation hospital, and self-stigma, whether the scale was treated as categorical or continuous. CONCLUSIONS: E16-COVID19-S exhibited good internal consistency and construct validity among this sample of Egyptian physicians. These adequate psychometric properties make the E16-COVID19-S scale appropriate for use by researchers and practitioners.

Health Literacy Co-Design in a Low Resource Setting: Harnessing Local Wisdom to Inform Interventions across Fishing Villages in Egypt to Improve Health and Equity.

Fishermen in low resource settings have limited access to health services and may have a range of health literacy-related difficulties that may lead to poor health outcomes. To provide solutions and interventions based on their needs, co-design is considered best practice in such settings. This study aimed to implement a co-design process as a step towards developing health literacy interventions to improve health and equity in the Borollos Lake region of northern Egypt, a low resource setting with a high prevalence of chronic diseases. This study was guided by the Ophelia (Optimising Health Literacy and Access) process, a widely used and flexible co-design process that seeks to create local and fit-for-purpose health literacy solutions through genuine engagement and participation of community members and relevant stakeholders. Following a health literacy survey using the Health Literacy Questionnaire (HLQ), cluster analysis was conducted to identify the diverse health literacy profiles among the fishing communities. Seven health literacy profiles were identified. Vignettes, representing these profiles, were presented and discussed in ideas generation/co-design workshops with fishermen and health workers to develop intervention ideas. Seventeen fishermen, 22 wives of fishermen, and 20 nurses participated in four workshops. Fifteen key strategies across five themes, including 'Enhancing education among fishing communities', 'Provide good quality health services', 'Financial support for health', 'Social support for health', and 'Promote better health-related quality of life among fishermen', were generated. The ideas did not only target the individuals but also required actions from the government, non-government organizations, and fishermen syndicates. By harnessing local wisdom, the Ophelia process has created meaningful engagement with the local communities, leading to a wide range of practical and feasible solutions that match the special needs and environment of a low resource setting.

COVID-19-related stigmatization among a sample of Egyptian healthcare workers.

OBJECTIVES: To explore coronavirus disease 2019 (COVID-19)-related stigma and its associated factors among Egyptian physicians. METHODS: A cross-sectional study using an anonymous online questionnaire was conducted from 7 to 21 June 2020. The survey was distributed via social media and email to physicians working in Egypt through convenience sampling. RESULTS: 509 physicians participated in the study (mean age: 41.5±10.2). 138 (27.1%) participants were directly involved in the care of COVID-19 patients. 159 (31.2%) participants reported severe level of COVID-19-related stigma. Participants' mean overall COVID-19-related stigma score was 40.6±8.0. The mean subscale scores were: personalized stigma 26.0±5.7, disclosure concerns 9.3±2.2, negative self-image 6.9±1.6, and concern with public attitudes 24.4±4.9. In the multivariable regression analyses, the overall COVID-19-related stigma score was higher in participants with lower qualifications (ß = -0.19, 95% CI: 2.32, -0.64, p = 0.001), and in those working in a quarantine hospital (ß = 0.08, 95% CI: 0.01, 7.14, p = 0.050). CONCLUSIONS: A considerable proportion of Egyptian physicians in this exploratory study experienced COVID-19-related stigmatization. These preliminary findings highlight the need for specific research and targeted interventions particularly addressing COVID-19-related stigmatization among healthcare workers.

Health literacy strengths and limitations among rural fishing communities in Egypt using the Health Literacy Questionnaire (HLQ).

INTRODUCTION: Health literacy is an important determinant of health. The aim of this study was to use a multi-dimensional measurement tool to describe the health literacy of people living in a fishing community in northern Egypt. METHODS AND ANALYSIS: Data were collected from 436 people (fisherman and their families), using the Health Literacy Questionnaire (HLQ), which includes 9 scales. Effect sizes (ES) for standardized mean differences estimated the magnitude of difference between demographic groups. RESULTS: The mean age of participants was 42 years, 50% were male, 42% were working in the fishing sector, 17.9% had access to the Internet and 36.8% were illiterate. Male participants showed higher capabilities in scales 3. Actively managing my health and 4. Social support for health (ES = 0.21 and 0.27, respectively). In comparison to other occupations, fishing occupation had a negative impact on scale 7. Navigating the healthcare system (ES -0.23). Also, higher educational level was associated with higher HLQ indicators. Across all scales, scale 2. Having sufficient information to manage my health showed the lowest mean (SD) score; 2.23 (0.76) indicating that most people reported they didn't have enough information. CONCLUSIONS: This study has revealed that fishermen and their families have a wide range of health literacy difficulties which are likely to have profound negative effects on health behavior and health outcomes.

Nutritional status and parasitic infestation among working children in a village in Egypt: a comparative study.

BACKGROUND: Work poses potential threats to the physical, emotional, economic, and academic health of teenagers. Like their adult coworkers, teenagers face exposure to a variety of health and safety hazards that can lead to injury and illness. Children's increased vulnerability puts them at a high risk of work-related health problems. OBJECTIVES: The aim of this study was to compare growth parameters of working children in contrast to nonworking students, and to compare the frequency of anemia and parasitic infestations among the two groups. PARTICIPANTS AND METHODS: A comparative cross-sectional study among 75 working boys in small industrial workshops in Arab Gohaina village in Qaliuobia governorate and 75 students of the same residence was conducted. All children were interviewed and were subjected to physical examination. Their BMI and hemoglobin were measured, and stool samples were examined for parasites. RESULTS: Only 11 and 15% of the workers working children eat vegetables and fruits on daily basis compared with 25 and 49% of students respectively (P<0.001). Mean BMI of the working group was 21.62±2.56 compared with 23.29±3.09 among the students. Students showed more frequency of obesity and overweight than the working group (13.33 and 29.33% compared with 2.67 and 20%, respectively, P=0.009). The hemoglobin level of working children (10.27±0.53 g/dl) was less than that of students (11.31±0.75 g/dl, P<0.001). The frequency of having parasitic infestations among working children was significantly higher than the students (P<0.001). CONCLUSION AND RECOMMENDATIONS: Labor was a factor that negatively affected the health of children. More working children in this village had anemia and parasitic infestations than nonworking ones. It is recommended to pay more attention to health problems among working children, with controlling child labor, especially in hazardous occupations and performing periodic medical examination to monitor their health and development.

Work-related hand injuries treated at a tertiary care hospital.

BACKGROUND: The hands are known to be the most commonly injured body parts in traumatic occupational injuries. They can be disabling, leading to major adverse social and economic consequences for the worker and for his or her family. AIM: The aim of the study was to describe work-related hand injuries and their potential risk factors and also investigate lines of management in relation to the type of injury. PATIENTS AND METHODS: Patients who presented to the emergency room of a tertiary hospital over a 6-month period with occupational hand injuries were interviewed using a predesigned questionnaire. It included questions pertaining to the sociodemographic, occupational, and medical aspects related to the injury. RESULTS: A total of 163 patients were interviewed. More than 50% had injuries from cuts. Almost 60% of work-related hand injuries occurred in the absence of machines. The most common causes of hand injuries mentioned by workers were lack of concentration (68.7%), wearing no or ill-fitting gloves (63.2%), and a defect in the work place (51.5%). On examination, fingers were the most affected site (66.7%). About half of the cases were managed in the emergency room, 28.8% were managed with minor procedures, and 21.9% were managed with major procedures. CONCLUSION AND RECOMMENDATIONS: Work-related hand injuries have multifactorial causes; lack of concentration was the most common in this study. Injuries from cuts were the most common and fingers were the most affected part. Modifications of the possible risk factors may reduce the incidence of acute hand injury at work.

Prevalence and risk factors of sick building syndrome among office workers.

BACKGROUND: Sick building syndrome (SBS) is a group of symptoms relatively common among office workers; such symptoms could have an impact on the workers' productivity. The aim of this study is to measure the prevalence of SBS symptoms among office workers in the Faculty of Medicine, Ain Shams University, Cairo, Egypt, and to determine the possible risk factors. PARTICIPANTS AND METHODS: A cross-sectional study was carried out at the Ain Shams Faculty of Medicine including 826 workers. Data were collected through a self-administered questionnaire that included sociodemographic and occupational histories, work environment, and symptoms related to SBS. RESULTS: Fatigue and headache were the most prevalent symptoms (76.9 and 74.7%, respectively). Using univariate analysis, poor lighting, poor ventilation, lack of sunlight, absence of air currents, high noise, temperature, humidity, environmental tobacco smoke, use of photocopiers, and inadequate office cleaning were associated statistically with SBS symptoms (P<0.05). High work load and poor job satisfaction were also associated significantly with SBS symptoms (P<0.05). Logistic regression analysis showed that poor ventilation, poor lighting, environmental tobacco smoke, high temperature, poor job satisfaction, and inadequate office cleaning were the risk factors of SBS. CONCLUSION AND RECOMMENDATIONS: SBS was highly prevalent among office workers and was influenced by physical and psychosocial working conditions. Good ventilation, reducing room temperature, effective cleaning routines, providing proper lighting, restricting smoking in the workplace, and improving psychosocial working conditions are important ways to reduce SBS symptoms.