Presence and use of automated external defibrillators in occupational setting, Belgium.

OBJECTIVES: Few studies focus on out-of-hospital cardiac arrests in the occupational setting. Therefore, this study describes the presence and use of an automated external defibrillator (AED) at Belgian workplaces during the period 2012-2014. MATERIAL AND METHODS: A self-constructed questionnaire was developed and sent to internal prevention counselors. RESULTS: In total, 767 companies filled out the questionnaire. An AED was available in 48.8% of the companies. Presence mainly depended on the number of persons present in the company (both workers and non-workers (e.g., visitors, clients)) and on some occupational cardiovascular risks but was often not based on a well-conducted risk analysis. Training of workers and AED maintenance were provided appropriately. An AED was used for shocking 23 times of which 10 persons survived. CONCLUSIONS: Acquiring an AED in the occupational setting is seldom based on a well-conducted risk analysis. Therefore, instructions and criteria are needed to come to a rational decision. Furthermore, a registry on AED utilization in the workplace (e.g., with data on long-term survival) should be set up. Int J Occup Med Environ Health 2018;31(5):603-611.

Assessing factors associated with long-term work disability after cancer in Belgium: a population-based cohort study using competing risks analysis with a 7-year follow-up.

OBJECTIVES: The number of workers with cancer has dramatically increasing worldwide. One of the main priorities is to preserve their quality of life and the sustainability of social security systems. We have carried out this study to assess factors associated with the ability to work after cancer. Such insight should help with the planning of rehabilitation needs and tailored programmes. PARTICIPANTS: We conducted this register-based cohort study using individual data from the Belgian Disability Insurance. Data on 15 543 socially insured Belgian people who entered into the long-term work disability between 2007 and 2011 due to cancer were used. PRIMARY AND SECONDARY OUTCOME MEASURES: We estimated the duration of work disability using Kaplan-Meier and the cause-specific cumulative incidence of ability to work stratified by age, gender, occupational class and year of entering the work disability system for 11 cancer sites using the Fine and Gray model allowing for competing risks. RESULTS: The overall median time of work disability was 1.59 years (95% CI 1.52 to 1.66), ranging from 0.75 to 4.98 years. By the end of follow-up, more than one-third of the disabled cancer survivors were able to work (35%). While a large proportion of the women were able to work at the end of follow-up, the men who were able to work could do so sooner. Being women, white collar, young and having haematological, male genital or breast cancers were factors with the bestlikelihood to be able to return to work. CONCLUSION: Good prognostic factors for the ability to work were youth, woman, white collar and having breast, male genital or haematological cancers. Reviewing our results together with the cancer incidence predictions up to 2025 offers a high value for social security and rehabilitation planning and for ascertaining patients' perspectives.

Sustainable employability for older workers: an explorative survey of belgian companies.

BACKGROUND: The European Agency for Safety and Health at Work (EU-OSHA) is developing an online e-guide, which will provide tips and practical information for each EU country (in their national language(s)) on ageing and occupational health and safety. The e-guide will be launched in 2016 as part of the EU-OSHA campaign on Healthy Workplaces for all ages. The e-guide will present evidence, tools and practical examples of how companies can take action and effectively promote sustainable employability. METHODS: As part of the development of the e-guide, a cross-sectional study was conducted to survey Belgian employers in April 2015 to determine their specific needs concerning older workers' occupational health and safety issues. Researchers from Milieu Ltd. (Brussels, Belgium), the consultancy company coordinating the e-guide project, and Mensura Occupational Health Services (Brussels, Belgium) developed a 13-item questionnaire. The survey addressed the needs and importance given to sustainable employability of older workers in Belgian companies and evaluated corporate knowledge regarding relevant national policies. The questionnaire was distributed electronically to the management of 22,084 private-sector companies affiliated with Mensura. RESULTS: Ten percent (n = 2133) of recipients opened the e-mail, and 37 % (n = 790) of these completed the questionnaire. In 89 % of the responding companies, sustainable employability of workers aged ≥55 years plays an important role; 70 % have no active sustainable employability policy/initiative; 18 % experience difficulties promoting sustainable employability; and 86 % indicate no need for support to promote sustainable employability. Respondents noted the following health complaints among workers aged ≥55 years: work-related health problems (31 %), stress (26 %), work agreements/type of work (17 %), work/life balance (15 %), and career development and/or training (9 %). Topics concerning health and well-being of workers aged ≥55 years requiring the most attention include motivation (30 %) and adaptation of the workplace to their health requirements (26 %). CONCLUSIONS: The e-guide should raise further awareness among employers about the importance of implementing an active sustainable employability policy to prolong working life in a healthy and productive way. The e-guide should also include tools to address work-related health problems and stress, motivation, and adaptation of the workplace to the health requirements of workers aged ≥55 years.

Barriers and opportunities for return-to-work of cancer survivors: time for action--rapid review and expert consultation.

BACKGROUND: The spread of early detection and the improvement of cancer treatment have led to an increased prevalence of cancer survivors, including in the working age population. Return-to-work (RTW) of cancer survivors has become a key issue for national cancer control plans. This study aims (1) to identify the factors that have an impact on RTW of cancer survivors and to draw a risk profile supporting health professionals in the screening of those at risk for barriers of RTW and (2) to sharpen these results with input from health, social security and academic Belgian experts and to provide evidence-based recommendations that facilitate RTW of cancer survivors. METHODS: A rapid review was conducted, based on the methodology elaborated by The Knowledge to Action Research Programme and researchers from the University of York, including a quality assessment of retained studies. Next, the Delphi method was used to organize a consultation with experts in order to discuss, validate and complement the results. RESULTS: Forty-three out of 1860 studies were included. We identified nine risk factors grouped into four categories: socio-demographic, disease and treatment-related, work-related, and personal and subjective factors. Experts suggested dividing them into two even groups: factors which are modifiable and those which are not. The awareness of health professionals regarding the identified factors, a better assessment of work capacities, clarity on the rights and obligations of employers and workers alike, and the setup of a positive discrimination employment policy for cancer survivors were acknowledged as factors facilitating RTW of cancer survivors. CONCLUSIONS: The awareness of health professionals regarding barriers of RTW may improve the early identification of cancer survivors at risk for prolonged time to RTW and may allow early supportive intervention. Social and employment policies should be better tailored to support both employers and cancer survivors in the RTW process, providing incentives to positively discriminate cancer survivors on prolonged sick leave.

Searching for consensus among physicians involved in the management of sick-listed workers in the Belgian health care sector: a qualitative study among practitioners and stakeholders.

BACKGROUND: In Belgium, the management of sick leave involves general practitioners (GPs), occupational health physicians (OPs) and social insurance physicians (SIPs). A dysfunctional relationship among these physicians can impede a patient's ability to return to work. The objective of this study was to identify ways to improve these physicians' mutual collaboration. METHODS: Two consensus techniques were successively performed among the three professional groups. Eight nominal groups (NGs) gathered 74 field practitioners, and a two-round Delphi process involved 32 stakeholders. RESULTS: From the results, it appears that two areas (reciprocal knowledge and evolution of the legal and regulatory framework) are objects of consensus among the three medical group that were surveyed. Information transfer, particularly electronic transfer, was stressed as an important way to improve. The consensual proposals regarding interdisciplinary collaboration indicate specific and practical changes to be implemented when professionals are managing workers who are on sick leave. The collaboration process appeared to be currently more problematic, but the participants correctly identified the need for common training. CONCLUSIONS: The three physician groups all agree regarding several inter-physician collaboration proposals. The study also revealed a latent conflict situation among the analysed professionals that can arise from a lack of mutual recognition. Practical changes or improvements must be included in an extended framework that involves the different determinants of interdisciplinary collaboration that are shown by theoretical models. Collaboration is a product of the actions and behaviours of various partners, which requires reciprocal knowledge and trust; collaboration also implies political and economic structures that are led by public health authorities.

Disability management through positive intervention in stakeholders' information asymmetry. A pilot study.

BACKGROUND: One increasingly attractive hypothesis to account for prolonged sickness absence from work is the presence of 'information asymmetry' among stakeholders. Information asymmetry refers to a situation in which critical information is not (appropriately) exchanged, in this case among those involved in disability management. AIM: The purpose of this study was to intervene positively in the information asymmetry that currently exists between social insurance physicians and occupational physicians in Belgium. METHODS: We developed a novel model aimed at improving information exchange, and a pilot study protocol based on the model. Our first objective was to investigate feasibility of implementing the study protocol. Our second and main objective was to obtain preliminary results on whether improving information exchange between physicians would facilitate work resumption of employees out on sickness absence. RESULTS: Of 126 patients recruited, 91 were eligible and assigned to one of two groups: a control group, whose physicians used the standard Belgian evaluation protocol, and an intervention group, whose physicians used our new protocol. Outcome parameters from the 15 patients assigned to the intervention group revealed that enhanced inter-physician information exchange produced favourable work resumption rates (73%), suggesting that both the model and study protocol show promise. CONCLUSIONS: The issue of sharing information among all stakeholders involved in disability management is an important one. Moreover, professional reintegration of employees after a sickness absence is universally important to occupational health practitioners. Our preliminary results suggest that reducing information asymmetry among physicians should be investigated further in larger intervention trials.