A Physician's Guide for Workers' Return to Work During COVID-19 Pandemic.

OBJECTIVE: Higher probability of developing severe COVID-19 has been associated with health risk factors and medical conditions which are common among workers globally. For at risk workers, return to work may require additional protective policies and procedures. METHODS: A review of the medical literature was conducted on health risk factors and medical conditions associated with increased COVID-19 morbidity and mortality, standardized measures for community COVID transmission, and occupation-specific risk. RESULTS: The relative risk of acquiring and the severity of COVID-19 for workers is associated with three pillars: individual risk, workplace risk, and community risk. Matrices were developed to determine a worker's individual risk based on these three pillars. CONCLUSIONS: A practical decision tool is proposed for physicians evaluating and managing individual worker COVID-19 risk in the context of returning to work.

Insomnia symptoms and their association with workplace productivity: cross-sectional and pre-post intervention analyses from a large multinational manufacturing company.

BACKGROUND: Symptoms of insomnia are common and might impact work productivity. We investigated the relationship between insomnia symptoms and workplace productivity in a global manufacturing company. METHODS: Within an uncontrolled, cross-sectional study, employees from a US-based company were invited to participate in an online evaluation comprising the Sleep Condition Indicator (SCI) measuring symptoms of insomnia (high score indicating better sleep), 2 items of the Work Productivity and Impairment Index (WPAI) measuring 'presenteeism' and 'absenteeism' (high score indicating loss of work productivity) and 1 item of the Perceived Stress Scale (PSS) from January 2015 onwards. Pre-post, within-subject data were collected to preliminary test effects of 'sleep tips' and digital cognitive behavioral therapy (dCBT). RESULTS: In 2798 employees [72% male; mean age 46.3(SD11.8) yrs] sleep was poorest in plant staff [SCI = 3.70(2.73)], then retail staff [4.34(3.02)], then office staff [4.95(2.83): overall F(2,2786) = 43.7, P < .0001]. More insomnia symptoms were associated with WPAI presenteeism (r = -.489, P < .0001; R2 = 23.9%). Insomnia symptoms also were the strongest predictor of work-related productivity, with stress only contributing a further 9%. A regression model for 'absenteeism' was statistically significant but of limited predictive value (R2 = 3.4%). In a sample of 214 employees with pre- and post-intervention data, the SCI of those exposed to sleep tips significantly increased from 5.36(3.28) to 6.01(3.22), [t(123) = -3.02, P = .003] and from 3.08(2.24) to 6.03(2.97) for those who accessed dCBT [t(89) = -8.40, P < .001). CONCLUSION: Symptoms of insomnia are associated with poor work productivity. Additionally, targeted insomnia interventions may offer potential to improve sleep and work productivity.

The workforce challenges of end-of-life issues.

Health care organizations, along with non-health-related industries, need to do a better job helping workers who are caring for sick or elderly relatives.