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1.
Ann Acad Med Singap ; 50(3): 203-211, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33855316

RESUMO

INTRODUCTION: Frontline healthcare workers (HCWs) exposed to coronavirus disease 2019 (COVID-19) are at risk of psychological distress. This study evaluates the psychological impact of COVID-19 pandemic on HCWs in a national paediatric referral centre. METHODS: This was a survey-based study that collected demographic, work environment and mental health data from paediatric HCWs in the emergency, intensive care and infectious disease units. Psychological impact was measured using the Depression, Anxiety, Stress Scale-21. Multivariate regression analysis was performed to identify risk factors associated with psychological distress. RESULTS: The survey achieved a response rate of 93.9% (430 of 458). Of the 430 respondents, symptoms of depression, anxiety and stress were reported in 168 (39.1%), 205 (47.7%) and 106 (24.7%), respectively. Depression was reported in the mild (47, 10.9%), moderate (76, 17.7%), severe (23, 5.3%) and extremely severe (22, 5.1%) categories. Anxiety (205, 47.7%) and stress (106, 24.7%) were reported in the mild category only. Collectively, regression analysis identified female sex, a perceived lack of choice in work scope/environment, lack of protection from COVID-19, lack of access to physical activities and rest, the need to perform additional tasks, and the experience of stigma from the community as risk factors for poor psychological outcome. CONCLUSION: A high prevalence of depression, anxiety and stress was reported among frontline paediatric HCWs during the COVID-19 pandemic. Personal psychoneuroimmunity and organisational prevention measures can be implemented to lessen psychiatric symptoms. At the national level, involving mental health professionals to plan and coordinate psychological intervention for the country should be considered.


Assuntos
Ansiedade/etiologia , Depressão/etiologia , Hospitais Pediátricos , Doenças Profissionais/etiologia , Recursos Humanos em Hospital/psicologia , Estresse Psicológico/etiologia , Adulto , Ansiedade/diagnóstico , Ansiedade/epidemiologia , /prevenção & controle , Depressão/diagnóstico , Depressão/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Doenças Profissionais/diagnóstico , Doenças Profissionais/epidemiologia , Pandemias , Prevalência , Fatores de Risco , Autorrelato , Índice de Gravidade de Doença , Singapura/epidemiologia , Estresse Psicológico/diagnóstico , Estresse Psicológico/epidemiologia
2.
Medicine (Baltimore) ; 100(16): e25425, 2021 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-33879672

RESUMO

BACKGROUND: The American Heart Association guidelines recommend switching chest compression providers at least every 2 min depending on their fatigue during cardiopulmonary resuscitation (CPR). Although the provider's heart rate is widely used as an objective indicator for detecting fatigue, the accuracy of this measure is debatable. OBJECTIVES: This study was designed to determine whether real-time heart rate is a measure of fatigue in compression providers. STUDY DESIGN: A simulation-based prospective interventional study including 110 participants. METHODS: Participants performed chest compressions in pairs for four cycles using advanced cardiovascular life support simulation. Each participant's heart rate was measured using wearable healthcare devices, and qualitative variables regarding individual compressions were obtained from computerized devices. The primary outcome was correct depth of chest compressions. The main exposure was the change in heart rate, defined as the difference between the participant's heart rate during individual compressions and that before the simulation was initiated. RESULTS: With a constant compression duration for one cycle, the overall accuracy of compression depth significantly decreased with increasing heart rate. Female participants displayed significantly decreased accuracy of compression depth with increasing heart rate (odds ratio [OR]: 0.97; 95% confidence interval [CI]: 0.95-0.98; P < .001). Conversely, male participants displayed significantly improved accuracy with increasing heart rate (OR: 1.03; 95% CI: 1.02-1.04; P < .001). CONCLUSION: Increasing heart rate could reflect fatigue in providers performing chest compressions with a constant duration for one cycle. Thus, provider rotation should be considered according to objectively measured fatigue during CPR.


Assuntos
Reanimação Cardiopulmonar/métodos , Auxiliares de Emergência/estatística & dados numéricos , Fadiga/fisiopatologia , Frequência Cardíaca/fisiologia , Doenças Profissionais/fisiopatologia , Adulto , Reanimação Cardiopulmonar/educação , Auxiliares de Emergência/educação , Fadiga/diagnóstico , Feminino , Humanos , Masculino , Manequins , Doenças Profissionais/diagnóstico , Estudos Prospectivos , Treinamento por Simulação , Trabalho/fisiologia , Adulto Jovem
3.
Pneumologie ; 75(3): 201-205, 2021 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-33728629

RESUMO

The S2k guideline "Diagnostics and assessment of occupational asbestos-related diseases" was updated in November 2020. This article summarizes the most important changes. There is a new reference to the risk of potentially high exposures to asbestos fibers when renovating plaster, fillers and adhesives containing asbestos.Biomarkers such as mesothelin and calretinin should currently only be used in the context of research. The "asbestos airways disease", which can only be diagnosed histologically, is included in the guideline as an early form of asbestosis. Since the UIP pattern is not characteristic of asbestosis, computed tomography cases with UIP patterns alone cannot be assigned reliably to asbestosis without the simultaneous detection of pleural plaques. With regard to the evaluation of the functional damage, attention is drawn to the importance of flow volume curve, whole-body plethysmography, diffusion capacity and exercise testing. If available, the reference values ​​according to GLI are the basis of the assessment. The guideline contains specific recommendations on prevention, medical treatment and, for the first time, on the importance of outpatient rehabilitation and training therapy. There are also references to the assessment of the new occupational disease ovarian cancer after occupational exposure to asbestos.


Assuntos
Asbestos , Asbestose , Doenças Profissionais , Exposição Ocupacional , Doenças Pleurais , Asbestos/toxicidade , Asbestose/diagnóstico , Humanos , Doenças Profissionais/diagnóstico , Exposição Ocupacional/efeitos adversos
4.
FP Essent ; 502: 11-17, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33683849

RESUMO

Occupational lung diseases are caused by workplace inhalation of chemicals, dusts, or fumes. They include asbestosis, silicosis, coal workers' pneumoconiosis (CWP), and occupational asthma. These diseases have nonspecific respiratory symptoms and are only identified if an occupational history is taken. Asbestosis typically is diagnosed 20 to 30 years after peak exposure, often when pleural plaques are noted on chest x-ray (CXR). Asbestosis is associated with an increased cancer risk, which is higher in smokers. Silicosis results from exposure to silica dust from sand, stone, and quartz. It is a fibrotic lung disease with acute, chronic, or accelerated presentations; CXR findings show interstitial fibrosis or nodular opacities. Silicosis increases risk of mycobacterial and fungal infections. In CWP, patients may present with mild symptoms and CXR findings showing small fibrous nodules; progressive massive fibrosis may develop, and there is a risk of mycobacterial and fungal infections. Occupational asthma (OA) can occur de novo from inhaling sensitizers that induce immunoglobulin E-mediated airway reactions, or from inhaling irritants such as smoke, dust, and fumes. OA also can be due to sensitizers/irritants aggravating preexisting asthma. There are no cures for these occupational lung diseases, so prevention, including elimination/control of workplace exposures, and early diagnosis are key.


Assuntos
Asbestose , Minas de Carvão , Doenças Profissionais , Exposição Ocupacional , Pneumoconiose , Silicose , Humanos , Doenças Profissionais/diagnóstico , Doenças Profissionais/epidemiologia , Exposição Ocupacional/efeitos adversos , Pneumoconiose/diagnóstico por imagem , Pneumoconiose/epidemiologia , Silicose/diagnóstico por imagem , Silicose/epidemiologia
5.
Artigo em Inglês | MEDLINE | ID: mdl-33652998

RESUMO

Work-related asthma (WRA) is a very frequent condition in the occupational setting, and refers either to asthma induced (occupational asthma, OA) or worsened (work-exacerbated asthma, WEA) by exposure to allergens (or other sensitizing agents) or to irritant agents at work. Diagnosis of WRA is frequently missed and should take into account clinical features and objective evaluation of lung function. The aim of this overview on pulmonary function testing in the field of WRA is to summarize the different available tests that should be considered in order to accurately diagnose WRA. When WRA is suspected, initial assessment should be carried out with spirometry and bronchodilator responsiveness testing coupled with first-step bronchial provocation testing to assess non-specific bronchial hyper-responsiveness (NSBHR). Further investigations should then refer to specialists with specific functional respiratory tests aiming to consolidate WRA diagnosis and helping to differentiate OA from WEA. Serial peak expiratory flow (PEF) with calculation of the occupation asthma system (OASYS) score as well as serial NSBHR challenge during the working period compared to the off work period are highly informative in the management of WRA. Finally, specific inhalation challenge (SIC) is considered as the reference standard and represents the best way to confirm the specific cause of WRA. Overall, clinicians should be aware that all pulmonary function tests should be standardized in accordance with current guidelines.


Assuntos
Asma Ocupacional , Doenças Profissionais , Exposição Ocupacional , Administração por Inalação , Asma Ocupacional/diagnóstico , Testes de Provocação Brônquica , Humanos , Doenças Profissionais/diagnóstico , Exposição Ocupacional/efeitos adversos , Espirometria
6.
Artigo em Chinês | MEDLINE | ID: mdl-33781033

RESUMO

Objective: A Meta-analysis was used to evaluate the high frequency hearing loss detection rate, its area and time distributions in occupational noise exposed workers in China to provide evidence for the prevention and control of occupational noise-induced deafness. Methods: From February to April 2020, the number of hearing tests and the number of binaural high frequency average hearing threshold ≥40 dB of workers exposed to noise in key occupational disease monitoring and occupational health risk assessment project in China was collected from China National Knowledge Infrastructure (CNKI) , VIP database and PubMed database. The retrieval time was set from the establishment of the database to February 28, 2020. The R 3.6.2 software was used to calculate the pooled high frequency hearing loss detection rate. Results: A total of 28 studies, included 34 data and 1259571 occupational noise exposed workers, were enrolled. The articles covered 16 provinces in 2015-2018. The pooled high frequency hearing loss detection rate in occupational noise exposed workers was 9.45% (95%CI: 7.64%-11.64%) . The high frequency hearing loss detection rate (10.54%) was higher in 2018 than other years (2017: 10.17%, 2016: 9.21%, 2015: 7.88%) . The high frequency hearing loss detection rate (12.23%) was higher in central China than in eastern (10.21%) , western (7.91%) and north-eastern (5.21%) China. Conclusion: The overall high frequency hearing loss detection rate in occupational noise exposed workers is generally high in China. It is important to strengthen the hearing protection in occupational noise exposed workers to facilitate the occupational noise-induced deafness prevention and control in China.


Assuntos
Perda Auditiva Provocada por Ruído , Ruído Ocupacional , Doenças Profissionais , Exposição Ocupacional , China/epidemiologia , Perda Auditiva de Alta Frequência , Perda Auditiva Provocada por Ruído/diagnóstico , Perda Auditiva Provocada por Ruído/epidemiologia , Humanos , Ruído Ocupacional/efeitos adversos , Doenças Profissionais/diagnóstico , Doenças Profissionais/epidemiologia
7.
Artigo em Chinês | MEDLINE | ID: mdl-33781038

RESUMO

Objective: To explore the effect of different diagnostic criteria on occupational noise-induced deafness (Onid) , and to provide theoretical basis for the revision of ONID diagnostic criteria. Methods: From January 2016 to January 2018, the physical examination results of noise-exposed workers during occupational health examination in Qingyuan Occupational Disease Prevention and Treatment Hospital were retrospectively investigated in September 2019, with Gbz 49-2014《diagnosis of occupational noise deafness》as the study object, 471 workers suspected of Onid were weighted with different combinations of high frequency hearing threshold, and the better ear weight was calculated, compared with the diagnostic criteria of 2007 and 2014, the degree of hearing loss was evaluated. SPSS 22.0 was used for statistical analysis, χ(2) test was used for counting data, and non-parametric test was used for measuring bias data. Results: The average age of 471 subjects was (40.32±7.01) years, and the average age of exposure to noise was (7.11±3.44) years. On the basis of the 2007 edition diagnostic standard, the suspected ONID diagnostic rate of different high frequency auditory threshold was increased by 16.35% and 30.15% at 3.0 kHz, 6.0 kHz increased by 20.17%, 3.0 kHz+4.0 kHz increased by 22.29%, 3.0 kHz+6.0 kHz increased by 17.20%, 4.0 kHz+6.0 kHz increased by 25.27%, the differences were statistically significant (P<0.05) , the frequency of 3.0 kHz+4.0 kHz+6.0 kHz increased by 22.29%. Using the 2014 edition diagnostic standard, the diagnostic rate of Onid was reduced by 30.15% and 13.80%, 6 kHz is 9.98% lower, 3.0 kHz+4.0 kHz is 7.86% lower, 3.0 kHz+6.0 kHz is 12.95% lower, 4.0 kHz+6.0 is 4.88% lower, the high frequency of 3.0 kHz+4.0 kHz+6.0 kHz decreased by 7.86%, the differences were statistically significant (P<0.05) . Conclusion: The diagnosis rate of suspected Onid is increased by weighting different high frequency hearing threshold, in which the weighted 4kHz high frequency has the greatest influence on the result, and the weighted 3 kHz high frequency has the least.


Assuntos
Surdez , Perda Auditiva Provocada por Ruído , Ruído Ocupacional , Doenças Profissionais , Exposição Ocupacional , Limiar Auditivo , Criança , Pré-Escolar , Surdez/diagnóstico , Perda Auditiva Provocada por Ruído/diagnóstico , Perda Auditiva Provocada por Ruído/etiologia , Humanos , Ruído Ocupacional/efeitos adversos , Doenças Profissionais/diagnóstico , Padrões de Referência , Estudos Retrospectivos
8.
Aten Primaria ; 53(3): 101956, 2021 03.
Artigo em Espanhol | MEDLINE | ID: mdl-33592533

RESUMO

OBJECTIVE: To identify the sociodemographic, clinical and epidemiological characteristics associated with the presence of infection by the SARS-CoV-2 virus in family physicians who carry out their work in Primary Care (PC) or in Hospital Emergencies. DESING: Observational analytical case-control study. SITE: Primary care. PARTICIPANTS: 969 Primare Care Physicians, Hospital Emergency physicians and other extrahospitalry centers that had PCR for the detection of the SARS-CoV-2. Of these, 133 participated as cases (PCR positive) and 836 as controls (PCR negative). INTERVENTIONS: No. MAIN MEASUREMENTS: Sociodemographic and work, contact with a COVID-19 patient, symptoms present during the process, first manifested symptom, previous chronic pathologies, and tobacco use. RESULTS: 13.7% (95% CI: 11.6-16.0) were cases infected with SARS-CoV-2. The most frequently declared symptoms by those infected were a feeling of fatigue/tiredness (69.2%; 95% CI: 60.9-77.4%), cough (56.4%; 95% CI: 47.6-65.2%) and headache (55.6%; 95% CI: 46.8-64.4%).Using logistic regression, the variables independently associated with SARS-CoV-2 virus infection in Family Physicians were: previous contact with a COVID-19 patient (OR: 2.3; 95% CI: 1.2-4.2), present fatigue / tiredness (OR: 2.2; 95% CI: 1.2-3.9), smell alteration (4.6; 95% CI: 1.7-12.5), taste alteration (OR: 32.0; 95% CI: 9.6-106.8), cough (OR: 3.0; 95% CI: 1.7-5.3) and fever (OR: 6.1; 95% CI: 3.2-11.4). CONCLUSIONS: Symptoms independently related to SARS-CoV-2 virus infection in Family Physicians were fatigue, fever, cough, and altered taste and smell. The presence of these symptoms could facilitate the diagnosis of suspected COVID-19 disease and the earlier selection of those that require confirmatory tests.


Assuntos
/diagnóstico , Doenças Profissionais/diagnóstico , Doenças Profissionais/epidemiologia , Médicos de Família , Atenção Primária à Saúde , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/etiologia , Espanha/epidemiologia
10.
Semin Speech Lang ; 42(1): 73-84, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33596606

RESUMO

Many speech-language pathologists (SLPs) recently adopted a live, synchronous online distribution of clinical services due to physical distancing measures aimed at bringing the coronavirus disease 2019 (COVID-19) outbreak under control. Few SLPs had received training in telepractice to prepare them for changes from an in-person service delivery model to synchronous telepractice. The new telepractice environment may alter vocal behaviors and communication interactions in such a way that negatively impacts voice production. Thus, delivering synchronous online clinical services may require that SLPs adopt novel prevention strategies for avoiding phonogenic voice problems. Guided by two complementary injury frameworks, the Haddon Matrix and the Haddon Countermeasures, this article provides an overview of potential factors associated with phonogenic voice problems among SLPs in telepractice and proposes possible prevention strategies to maintain optimal vocal health and function with synchronous modes of online clinical practice.


Assuntos
Comunicação , Doenças Profissionais/diagnóstico , Doenças Profissionais/prevenção & controle , Transtorno Fonológico/diagnóstico , Transtorno Fonológico/prevenção & controle , Patologia da Fala e Linguagem , Telerreabilitação , /complicações , Humanos , Intervenção Baseada em Internet , Fatores de Risco , Qualidade da Voz
11.
Artigo em Chinês | MEDLINE | ID: mdl-33535343

RESUMO

Objective: To analyze the diagnosis of 3 cases of leukemia applying for the diagnosis of occupational radiogenic neoplasms. Methods: Retrospective analysis the occupational history, the disease history and the probability of causation (PC value) information of 3 radiological workers. Results: Two cases' PC value of 95% confidence limit of were >50%, and they were diagnosed as radiogenic neoplasms. One case was <50% and diagnosed as nonoccupational radiogenic neoplasms. Conclusion: The probability of causation analysis has important guiding significance for the diagnosis of occupational radiogenic neoplasms. Radiological workers should improve their awareness of self-protection and reduce the occurrence of occupational diseases.


Assuntos
Leucemia , Doenças Profissionais , Exposição Ocupacional , Humanos , Leucemia/diagnóstico , Leucemia/epidemiologia , Doenças Profissionais/diagnóstico , Doenças Profissionais/epidemiologia , Probabilidade , Radiografia , Estudos Retrospectivos
13.
Ann Surg ; 273(4): 625-629, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33491977

RESUMO

OBJECTIVE: To investigate the relationship between surgeon gender and stress during the Covid-19 pandemic. BACKGROUND: Although female surgeons face difficulties integrating work and home in the best of times, the Covid-19 pandemic has presented new challenges. The implications for the female surgical workforce are unknown. METHODS: This cross-sectional, multi-center telephone survey study of surgeons was conducted across 5 academic institutions (May 15-June 5, 2020). The primary outcome was maximum stress level, measured using the validated Stress Numerical Rating Scale-11. Mixed-effects generalized linear models were used to estimate the relationship between surgeon stress level and gender. RESULTS: Of 529 surgeons contacted, 337 surgeons responded and 335 surveys were complete (response rate 63.7%). The majority of female respondents were housestaff (58.1%), and the majority of male respondents were faculty (56.8%) (P = 0.008). A greater proportion of male surgeons (50.3%) than female surgeons (36.8%) had children ≤18 years (P = 0.015). The mean maximum stress level for female surgeons was 7.51 (SD 1.49) and for male surgeons was 6.71 (SD 2.15) (P < 0.001). After adjusting for the presence of children and training status, female gender was associated with a significantly higher maximum stress level (P < 0.001). CONCLUSIONS: Our findings that women experienced more stress than men during the Covid-19 pandemic, regardless of parental status, suggest that there is more to the gendered differences in the stress experience of the pandemic than the added demands of childcare. Deliberate interventions are needed to promote and support the female surgical workforce during the pandemic.


Assuntos
/psicologia , Doenças Profissionais/etiologia , Médicas/psicologia , Estresse Psicológico/etiologia , Cirurgiões/psicologia , Adulto , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/diagnóstico , Doenças Profissionais/epidemiologia , Pandemias , Fatores de Risco , Fatores Sexuais , Estresse Psicológico/diagnóstico , Estresse Psicológico/epidemiologia , Estados Unidos/epidemiologia
15.
Am J Ind Med ; 64(4): 227-237, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33491195

RESUMO

The impact of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 permeates all aspects of society worldwide. Initial medical reports and media coverage have increased awareness of the risk imposed on healthcare workers in particular, during this pandemic. However, the health implications of COVID-19 for the global workforce are multifaceted and complex, warranting careful reflection and consideration to mitigate the adverse effects on workers worldwide. Accordingly, our review offers a framework for considering this topic, highlighting key issues, with the aim to prompt and inform action, including research, to minimize the occupational hazards imposed by this ongoing challenge. We address respiratory disease as a primary concern, while recognizing the multisystem spectrum of COVID-19-related disease and how clinical aspects are interwoven with broader socioeconomic forces.


Assuntos
Saúde Global , Doenças Profissionais , Pandemias , /diagnóstico , /epidemiologia , /métodos , Saúde Global/economia , Saúde Global/estatística & dados numéricos , Humanos , Controle de Infecções/métodos , Doenças Profissionais/diagnóstico , Doenças Profissionais/economia , Doenças Profissionais/epidemiologia , Doenças Profissionais/terapia , Exposição Ocupacional/efeitos adversos , Exposição Ocupacional/prevenção & controle , Saúde do Trabalhador , Pandemias/economia , Pandemias/prevenção & controle , Pandemias/estatística & dados numéricos , Vigilância em Saúde Pública
17.
Ter Arkh ; 92(6): 89-92, 2020 Jul 09.
Artigo em Russo | MEDLINE | ID: mdl-33346500

RESUMO

Osteoarthritis is a common pathology, which indicates the great medical and social significance of this disease. The article discusses the issues of pathogenesis, risk factors and diagnosis of professional and professionally caused osteoarthritis: the age of onset of the disease, the specifics of work, the localization of joint damage. Differential diagnosis issues are discussed.


Assuntos
Doenças Profissionais , Osteoartrite , Humanos , Articulação do Joelho , Doenças Profissionais/diagnóstico , Doenças Profissionais/epidemiologia , Doenças Profissionais/etiologia , Osteoartrite/diagnóstico , Osteoartrite/epidemiologia , Fatores de Risco
18.
Klin Lab Diagn ; 65(12): 750-756, 2020 Dec 29.
Artigo em Inglês | MEDLINE | ID: mdl-33373506

RESUMO

The production of synthetic materials - fiberglass and rubber-technical products, as well as products derived from oil refining wastes continues to grow. A characteristic feature of the working conditions of these enterprises is the content of chemicals of hazard class 1-4, which may be potentially hazardous to workers. It imperative to justify prenosological laboratory criteria for health problems of manufacturing workers. The results of the hematological, biochemical, immunological and cytochemical parameters among manufacturing workers are presented. Significant changes in the processes of oxidative metabolism, lipid metabolism, impaired immune status, and intracellular enzyme activity were found in a significant proportion of the workers. Changes were detected in workers even with a short work experience (5 years) and of young age (20-30 years). With an increase in the occupational length of service, the frequency of these disorders increased. Based on the results obtained, early diagnostic and prognostic criteria for health disorders in workers of diverse chemical industries are substantiated. Based on the results obtained, early diagnostic and prognostic criteria for health disorders in workers of diverse chemical industries are substantiated. For rubber manufacturing workers: increased malonic dialdehyde, reduced catalase activity, the activity of catalase is lowering; increased enzymes activity (AST, ALT, GGT), protein abnormalities, erythropenia, decreased hemoglobin levels, increased reticulocyte. For fiber glass manufacturing workers: indicators of the oxidative antioxidant system, hemograms - increased lymphocytes, erythrocytosis, leukocytosis, increased CD3 +, increased CD4 +, CD 16+, CD 20 +, FAL, IgG, increased total protein, hyperfermentemia (GGT, ALT), changes in the intracellular enzymes activity - acid phosphatase of neutrophils and lymphocytes, decreased myeloperoxidase, increased glycogen levels. For olefin oxides manufacturing workers - this is hyperfermentemia (ALT, alkaline phosphatase), protein metabolism changes, increased red blood cells, reticulocytes, neutrophils, lymphocytes, eosinophils, platelets, leucopenia, decreased FAL, increased IgM, decreased IgA, IgG, changes in the intracellular enzymes activity - decrease myeloperoxidase, increase acid phosphatase of neutrophils and lymphocytes.


Assuntos
Indústria Química , Doenças Profissionais/diagnóstico , Exposição Ocupacional/efeitos adversos , Diagnóstico Precoce , Humanos , Contagem de Leucócitos , Prognóstico
19.
MMWR Morb Mortal Wkly Rep ; 69(43): 1569-1570, 2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33119564

RESUMO

On August 11, 2020, a confirmed case of coronavirus disease 2019 (COVID-19) in a male correctional facility employee (correctional officer) aged 20 years was reported to the Vermont Department of Health (VDH). On July 28, the correctional officer had multiple brief encounters with six incarcerated or detained persons (IDPs)* while their SARS-CoV-2 test results were pending. The six asymptomatic IDPs arrived from an out-of-state correctional facility on July 28 and were housed in a quarantine unit. In accordance with Vermont Department of Corrections (VDOC) policy for state prisons, nasopharyngeal swabs were collected from the six IDPs on their arrival date and tested for SARS-CoV-2, the virus that causes COVID-19, at the Vermont Department of Health Laboratory, using real-time reverse transcription-polymerase chain reaction (RT-PCR). On July 29, all six IDPs received positive test results. VDH and VDOC conducted a contact tracing investigation† and used video surveillance footage to determine that the correctional officer did not meet VDH's definition of close contact (i.e., being within 6 feet of infectious persons for ≥15 consecutive minutes)§,¶; therefore, he continued to work. At the end of his shift on August 4, he experienced loss of smell and taste, myalgia, runny nose, cough, shortness of breath, headache, loss of appetite, and gastrointestinal symptoms; beginning August 5, he stayed home from work. An August 5 nasopharyngeal specimen tested for SARS-CoV-2 by real-time RT-PCR at a commercial laboratory was reported as positive on August 11; the correctional officer identified two contacts outside of work, neither of whom developed COVID-19. On July 28, seven days preceding his illness onset, the correctional officer had multiple brief exposures to six IDPs who later tested positive for SARS-CoV-2; available data suggests that at least one of the asymptomatic IDPs transmitted SARS-CoV-2 during these brief encounters.


Assuntos
Infecções por Coronavirus/diagnóstico , Doenças Profissionais/diagnóstico , Exposição Ocupacional/efeitos adversos , Pneumonia Viral/diagnóstico , Prisões , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Humanos , Masculino , Exposição Ocupacional/estatística & dados numéricos , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Vermont/epidemiologia , Adulto Jovem
20.
Occup Med (Lond) ; 70(7): 515-522, 2020 10 27.
Artigo em Inglês | MEDLINE | ID: mdl-32954421

RESUMO

BACKGROUND: By law, covid-19 disease and deaths in workers may lead to coroners' inquests and/or Health and Safety Executive (HSE) investigations. AIMS: This study assesses the adequacy of these statutory means to yield recommendations for prevention of acquiring covid-19 infection from work. METHODS: Covid-19 guidance from the chief coroner and the HSE was appraised, including using Office for National Statistics (ONS) data. Practitioners were asked to estimate the likelihood that covid-19 disease may have arisen from 'near-miss' scenarios. Data from the judiciary and the HSE were analysed. RESULTS: The coroners' guidance allowed a wider range of reports of death than did the HSE and conformed better with ONS data on covid-19 mortality by occupation. In the practitioner survey, 62 respondents considered a higher likelihood that reported covid-19 cases would have arisen from the scenario deemed unreportable as a 'dangerous occurrence' by HSE than the reportable scenario (P < 0.001). On average there was only one coroner's report to prevent future death from occupational disease every year in England and Wales. The HSE dealt with a yearly average of 1611 reports of work-related disease including 104 on biological agents, but has received about 9000 covid-19 reports. CONCLUSIONS: Current HSE guidance for reporting work-related covid-19 may miss many thousands of cases and needs further iteration. Coroners have very limited experience of inquiry into occupational disease caused by biological agents compared with the HSE. Concerns regarding national policy such as on protective equipment warrant a full public inquiry.


Assuntos
Betacoronavirus , Causas de Morte , Infecções por Coronavirus/mortalidade , Doenças Profissionais/mortalidade , Exposição Ocupacional/análise , Saúde do Trabalhador , Pneumonia Viral/mortalidade , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/prevenção & controle , Médicos Legistas , Notificação de Doenças , Humanos , Doenças Profissionais/diagnóstico , Doenças Profissionais/prevenção & controle , Exposição Ocupacional/efeitos adversos , Exposição Ocupacional/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/diagnóstico , Pneumonia Viral/prevenção & controle , Reino Unido/epidemiologia
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