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1.
MMWR Morb Mortal Wkly Rep ; 70(13): 495-500, 2021 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-33793460

RESUMO

Messenger RNA (mRNA) BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) COVID-19 vaccines have been shown to be effective in preventing symptomatic COVID-19 in randomized placebo-controlled Phase III trials (1,2); however, the benefits of these vaccines for preventing asymptomatic and symptomatic SARS-CoV-2 (the virus that causes COVID-19) infection, particularly when administered in real-world conditions, is less well understood. Using prospective cohorts of health care personnel, first responders, and other essential and frontline workers* in eight U.S. locations during December 14, 2020-March 13, 2021, CDC routinely tested for SARS-CoV-2 infections every week regardless of symptom status and at the onset of symptoms consistent with COVID-19-associated illness. Among 3,950 participants with no previous laboratory documentation of SARS-CoV-2 infection, 2,479 (62.8%) received both recommended mRNA doses and 477 (12.1%) received only one dose of mRNA vaccine.† Among unvaccinated participants, 1.38 SARS-CoV-2 infections were confirmed by reverse transcription-polymerase chain reaction (RT-PCR) per 1,000 person-days.§ In contrast, among fully immunized (≥14 days after second dose) persons, 0.04 infections per 1,000 person-days were reported, and among partially immunized (≥14 days after first dose and before second dose) persons, 0.19 infections per 1,000 person-days were reported. Estimated mRNA vaccine effectiveness for prevention of infection, adjusted for study site, was 90% for full immunization and 80% for partial immunization. These findings indicate that authorized mRNA COVID-19 vaccines are effective for preventing SARS-CoV-2 infection, regardless of symptom status, among working-age adults in real-world conditions. COVID-19 vaccination is recommended for all eligible persons.


Assuntos
/imunologia , Socorristas , Pessoal de Saúde , Doenças Profissionais/prevenção & controle , Ocupações/classificação , Adolescente , Adulto , /administração & dosagem , Socorristas/estatística & dados numéricos , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Estados Unidos/epidemiologia , Vacinas Sintéticas/imunologia , Adulto Jovem
3.
Ann Agric Environ Med ; 28(1): 27-43, 2021 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-33775065

RESUMO

INTRODUCTION AND OBJECTIVE: The course of COVID-19 caused by the SARS-CoV-2 may be aggravated by bioaerosols containing other viruses, bacteria, and fungi, occurring mainly in the occupational environment. Hence, the diagnostics and treatment of COVID-19 should address such a possibility in the anamnesis, treatment and final recommendations for avoiding of adverse exposure. ABBREVIATED DESCRIPTION OF THE STATE OF KNOWLEDGE: As SARS-CoV-2 attacks primarily the respiratory system and the severe manifestation of COVID-19 is interstitial pneumonia, diagnostics should include the following clinical and laboratory examinations: chest X-ray; high resolution computed tomography (HRCT); pulmonary function tests; arterial-blood gas test; genetic tests for the presence of SARS-CoV-2, in the future with the use of highly specific and sensitive nano-based biosensors; tests for the presence of specific immunity against the antigens of microorganisms causing other infectious or allergic pulmonary diseases (in the case of anamnestic indications). Because an universally accepted treatment for COVID-19 does not exist, the hitherto prescribed antiviral and immune-modulating drugs should be used be with caution. In many cases, a better alternative could be a safe supportive therapy, such as supplementation of the diet with probiotics, prebiotics, vitamins and microelements. SUMMARY: The most important preventive measures against COVID-19 should include: vaccination; the use of filter or surgical masks; disinfection and sterilization; maintaining of well-functioning ventilation and air conditioning systems; reduction of the community air pollution which has been identified as an important factor increasing the COVID-19 severity. In the choice of preventive measures, the above should be considered for their potential efficacy against other bioaerosols as potential disease-aggravating agents.


Assuntos
/diagnóstico , /terapia , Aerossóis/efeitos adversos , Humanos , Doenças Profissionais/complicações , Doenças Profissionais/prevenção & controle , Exposição Ocupacional/efeitos adversos , Exposição Ocupacional/prevenção & controle , Doenças Respiratórias/complicações , /isolamento & purificação
5.
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
6.
BMJ Open ; 11(2): e043837, 2021 02 22.
Artigo em Inglês | MEDLINE | ID: mdl-33619195

RESUMO

OBJECTIVES: Healthcare personnel (HCP) are at an increased risk of acquiring COVID-19 infection especially in resource-restricted healthcare settings, and return to homes unfit for self-isolation, making them apprehensive about COVID-19 duty and transmission risk to their families. We aimed at implementing a novel multidimensional HCP-centric evidence-based, dynamic policy with the objectives to reduce risk of HCP infection, ensure welfare and safety of the HCP and to improve willingness to accept and return to duty. SETTING: Our tertiary care university hospital, with 12 600 HCP, was divided into high-risk, medium-risk and low-risk zones. In the high-risk and medium-risk zones, we organised training, logistic support, postduty HCP welfare and collected feedback, and sent them home after they tested negative for COVID-19. We supervised use of appropriate personal protective equipment (PPE) and kept communication paperless. PARTICIPANTS: We recruited willing low-risk HCP, aged <50 years, with no comorbidities to work in COVID-19 zones. Social distancing, hand hygiene and universal masking were advocated in the low-risk zone. RESULTS: Between 31 March and 20 July 2020, we clinically screened 5553 outpatients, of whom 3012 (54.2%) were COVID-19 suspects managed in the medium-risk zone. Among them, 346 (11.4%) tested COVID-19 positive (57.2% male) and were managed in the high-risk zone with 19 (5.4%) deaths. One (0.08%) of the 1224 HCP in high-risk zone, 6 (0.62%) of 960 HCP in medium-risk zone and 23 (0.18%) of the 12 600 HCP in the low-risk zone tested positive at the end of shift. All the 30 COVID-19-positive HCP have since recovered. This HCP-centric policy resulted in low transmission rates (<1%), ensured satisfaction with training (92%), PPE (90.8%), medical and psychosocial support (79%) and improved acceptance of COVID-19 duty with 54.7% volunteering for re-deployment. CONCLUSION: A multidimensional HCP-centric policy was effective in ensuring safety, satisfaction and welfare of HCP in a resource-poor setting and resulted in a willing workforce to fight the pandemic.


Assuntos
Transmissão de Doença Infecciosa do Paciente para o Profissional , Corpo Clínico Hospitalar , Doenças Profissionais , Adulto , /prevenção & controle , /transmissão , Países em Desenvolvimento , Feminino , Hospitais Universitários/organização & administração , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Masculino , Corpo Clínico Hospitalar/estatística & dados numéricos , Modelos Organizacionais , Doenças Profissionais/epidemiologia , Doenças Profissionais/prevenção & controle , Política Organizacional , Equipamento de Proteção Individual , Estudos Prospectivos , Medição de Risco , Centros de Atenção Terciária/organização & administração
7.
MMWR Morb Mortal Wkly Rep ; 70(7): 250-253, 2021 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-33600383

RESUMO

Certain hazard controls, including physical barriers, cloth face masks, and other personal protective equipment (PPE), are recommended to reduce coronavirus 2019 (COVID-19) transmission in the workplace (1). Evaluation of occupational hazard control use for COVID-19 prevention can identify inadequately protected workers and opportunities to improve use. CDC's National Institute for Occupational Safety and Health used data from the June 2020 SummerStyles survey to characterize required and voluntary use of COVID-19-related occupational hazard controls among U.S. non-health care workers. A survey-weighted regression model was used to estimate the association between employer provision of hazard controls and voluntary use, and stratum-specific adjusted risk differences (aRDs) among workers reporting household incomes <250% and ≥250% of national poverty thresholds were estimated to assess effect modification by income. Approximately one half (45.6%; 95% confidence interval [CI] = 41.0%-50.3%) of non-health care workers reported use of hazard controls in the workplace, 55.5% (95% CI = 48.8%-62.2%) of whom reported employer requirements to use them. After adjustment for occupational group and proximity to others at work, voluntary use was approximately double, or 22.3 absolute percentage points higher, among workers who were provided hazard controls than among those who were not. This effect was more apparent among lower-income (aRD = 31.0%) than among higher-income workers (aRD = 16.3%). Employers can help protect workers from COVID-19 by requiring and encouraging use of occupational hazard controls and providing hazard controls to employees (1).


Assuntos
/prevenção & controle , Programas Obrigatórios/estatística & dados numéricos , Doenças Profissionais/prevenção & controle , Saúde do Trabalhador/estatística & dados numéricos , Programas Voluntários/estatística & dados numéricos , Adolescente , Adulto , Acessibilidade Arquitetônica/estatística & dados numéricos , Feminino , Humanos , Masculino , Máscaras/estatística & dados numéricos , Pessoa de Meia-Idade , Equipamento de Proteção Individual/estatística & dados numéricos , Inquéritos e Questionários , Estados Unidos/epidemiologia , Local de Trabalho/estatística & dados numéricos , Adulto Jovem
9.
Blood Transfus ; 19(2): 158-167, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33539280

RESUMO

BACKGROUND: The COVID-19 pandemic is placing blood and tissue establishments under unprecedented stress, putting its capacity to provide the adequate care needed at risk. Here we reflect on how our integrated organisational model has faced the first impact of the pandemic and describe what challenges, opportunities and lessons have emerged. MATERIALS AND METHODS: The organisational model of the Catalan Blood and Tissue Bank (Banc de Sang i Teixits, BST) is described. The new scenario was managed by following international recommendations and considering the pandemic in a context of volatility, uncertainty, complexity, and ambiguity (VUCA), allowing rapid measures to be taken. These aimed to: ensure donor safety, promote proper responses to patients' needs, ensure the health and well-being of personnel, and prepare for future scenarios. RESULTS: The BST has adapted its activities to the changes in demand. No shortage of any product or service occurred. Donor acceptance, safety and wellbeing were maintained except for tissue donation, which almost completely stopped. To support the health system, several activities have been promoted: large-scale convalescent plasma (CP) production, clinical trials with CP and mesenchymal stromal cells, massive COVID-19 diagnoses, and participation in co-operative research and publications. Haemovigilance is running smoothly and no adverse effects have been detected among donors or patients. DISCUSSION: Several elements have proven to be critical when addressing the pandemic scenario: a) the early creation of a crisis committee in combination with technical recommendations and the recognition of a VUCA scenario; b) identification of the strategies described; c) the integrated donor-to-patient organisational model; d) active Research and Development (R&D); and e) the flexibility of the staff. It is essential to underline the importance of the need for centralised management, effective contingency strategies, and early collaboration with peers.


Assuntos
Bancos de Sangue/organização & administração , Pandemias , Bancos de Tecidos/organização & administração , Bancos de Sangue/provisão & distribução , Transfusão de Componentes Sanguíneos/estatística & dados numéricos , Doadores de Sangue , Transplante de Medula Óssea , /terapia , Humanos , Imunização Passiva , Modelos Organizacionais , Doenças Profissionais/prevenção & controle , Segurança , Espanha , Obtenção de Tecidos e Órgãos
10.
J Laryngol Otol ; 135(1): 83-85, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33413719

RESUMO

OBJECTIVE: Microlaryngoscopy is an aerosol-generating procedure. This paper presents a novel approach for better protecting staff during microlaryngoscopy. METHODS: A clear plastic microscope drape is attached to the objective lens. Instead of using the drape to cover the microscope, it is pulled down to cover the patient's head and torso. The holes designated for the binoculars of the microscope are used for the surgeon hands, forming protective clear plastic sleeves. CONCLUSION: The proposed technique, which is simple, relatively inexpensive and technically feasible for any hospital to perform during microlaryngoscopy procedures, can increase safety and minimise droplet and aerosol exposure in the operating theatre.


Assuntos
Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Laringoscopia/métodos , Doenças Profissionais/microbiologia , Doenças Profissionais/prevenção & controle , Otolaringologia , Humanos , Microscopia
11.
Public Health ; 191: 11-16, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33465515

RESUMO

OBJECTIVES: To investigate the changes in personal attitudes and behaviour before and after negative serological test results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies. STUDY DESIGN: Cross-sectional questionnaire survey. METHODS: A survey questionnaire was conducted with 200 industry workers (68% males and 32% females) who had previously tested negative for SARS-CoV-2 antibodies. The survey examined participants' self-reported general attitudes towards coronavirus disease 2019 (COVID-19), their sense of fear, as well as their behaviour towards protective measures before and after the testing. RESULTS: Participants perceived the disease as a severe health threat and acknowledged that the protective measures were appropriate. Respondents reported a high level of adherence to measures and low level of fear, both before and after the testing. Although these indicators were statistically significantly reduced after the test (P < 0.004), they did not result in irresponsible non-adherence behaviours. Almost all respondents attributed their application of personal protection measures to factors other than the results of serological screening. CONCLUSIONS: Serological tests do not contribute to irresponsible non-adherence behaviours in an environment where protective measures are efficient. However, they may help reduce fear within society and working environments.


Assuntos
/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Indústrias , Doenças Profissionais/prevenção & controle , Adulto , Anticorpos Antivirais/sangue , Croácia/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
13.
J Vasc Interv Radiol ; 32(2): 220-225.e2, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33461874

RESUMO

PURPOSE: To evaluate the impact of a versatile flexible ceiling-mounted C-arm on active table and gantry repositioning during interventions and its effect on operator discomfort, system usability, and patient safety compared with a traditional ceiling-mounted system. MATERIALS AND METHODS: There were 100 IR procedures studied: 50 in a traditional IR system (standard group) and 50 with a novel multiaxis ceiling-mounted system (test group). FlexArm was capable of multiple gantry rotation points allowing increased access to the patient in addition to 236 cm of lateral x-ray detector travel. For each procedure, both the table and the gantry repositioning were measured. Patient safety, patient/equipment repositioning effort, and physical discomfort were evaluated through an operator survey. RESULTS: Table repositioning was reduced from 42 to 16 instances per procedure (P < .001) in the test group compared with the standard group. The operators perceived less table and gantry repositioning effort (P < .0001) and decreased risks of equipment collisions, displacement of vascular access, and dislodgment of tubes/lines with the test group (P < .0001). Operator discomfort was reduced for all body areas in the test group over the standard group (P < .0001). CONCLUSIONS: The FlexArm system geometry enhances operator ergonomics, as there was a decrease need to move the table, leading to a perceived decrease in patient risk and decrease operator physical discomfort when compared to a traditional imaging system.


Assuntos
Angiografia/instrumentação , Ergonomia , Radiografia Intervencionista/instrumentação , Radiologistas , Angiografia/efeitos adversos , Desenho de Equipamento , Humanos , Doenças Musculoesqueléticas/etiologia , Doenças Musculoesqueléticas/prevenção & controle , Doenças Profissionais/etiologia , Doenças Profissionais/prevenção & controle , Saúde do Trabalhador , Posicionamento do Paciente , Segurança do Paciente , Estudos Prospectivos , Radiografia Intervencionista/efeitos adversos , Fluxo de Trabalho
14.
J Am Geriatr Soc ; 69(3): 593-599, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33370448

RESUMO

OBJECTIVES: To plan for coronavirus infectious disease 2019 (COVID-19) vaccine distribution, the Indiana Department of Health surveyed nursing home and assisted living facility staff. DESIGN: Cross-sectional analysis of an anonymous survey sent via text message link to personal cell phones and emails. SETTING AND PARTICIPANTS: Nursing home and assisted living facility staff in Indiana. MEASURES: Staff characteristics including age, gender, race, ethnicity, role in the facility, experience in long-term care, and geographic location of facility were self-reported along with prior infection and willingness to receive an approved vaccine as soon as it is available. Responses were weighted to represent staff statewide. Weighted frequencies and logit regression estimated characteristics associated with vaccine willingness. RESULTS: There were 8,243 responses to the survey. For nursing home staff (survey delivered via 23,232 working phone numbers), there was a 33% response rate). There were 2,372 (29%) in nurse aide or similar roles and 1,602 nurses providing direct clinical care (19%). Overall, 45% of respondents indicated they would receive an approved COVID-19 vaccine as soon as available. Of those unwilling to take the vaccine when first available, 44% would consider in the future. Concerns about side effects was the primary reason for vaccine hesitancy (70%). Characteristics associated with increased willingness were age over 60, male, and white race (P < .0001). No statistically significant differences were observed among staff self-reporting prior SARS-CoV-2 infection. CONCLUSIONS AND IMPLICATIONS: The willingness to receive the COVID-19 vaccine immediately or in the future may be as high as 69%, but varies among subgroups of nursing home staff which has implications for distribution. Educating staff on the vaccine may be critical for increasing uptake. Widespread vaccination holds the promise of protection against serious illness and death and a return of visitors and activities that support improved quality of life. This promise will not be realized without strong uptake of the vaccines.


Assuntos
/uso terapêutico , Casas de Saúde , Recursos Humanos de Enfermagem/psicologia , Vacinação/psicologia , Adolescente , Adulto , Estudos Transversais , Feminino , Instituição de Longa Permanência para Idosos , Humanos , Indiana , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/prevenção & controle , Doenças Profissionais/virologia , Adulto Jovem
17.
Work ; 67(4): 771-777, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33337399

RESUMO

BACKGROUND: The high spread rate of coronaviruses, specifically severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has raised concerns about the spread of the disease in crowded occupational environments. The risk of occupational exposure to coronavirus depends on the type of industry and the nature of work. Currently, most countries are working for reactivating their economies and need to improve working conditions for a safe situation during the COVID-19 pandemic. OBJECTIVE: The present work aimed to investigate the current engineering and administrative control measures, which are necessary to protect workers against COVID-19 in workplaces. METHODS: The current strategies, including engineering control, administrative control, personal protective equipment, and their efficiencies, were reviewed and discussed. RESULTS: Reviewing the literature indicated that a collection of control approaches should be implemented for an effective control of the virus. Control measures could be selected based on the risk of exposure to COVID-19. The results also revealed that relying solely on a specific control measure could not effectively control the outbreak. CONCLUSION: In conclusion, employers and health professionals must continually monitor international and local guidelines to identify changes in recommendations to make their workplaces safer. Establishment of an expert team in any workplace for the implementation of more effective control measures is warranted, as well.


Assuntos
/prevenção & controle , Doenças Profissionais/prevenção & controle , Exposição Ocupacional , Local de Trabalho/organização & administração , Filtros de Ar , Acessibilidade Arquitetônica , Humanos , Pandemias , Equipamento de Proteção Individual , Ventilação/métodos
19.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi ; 38(10): 794-796, 2020 Oct 20.
Artigo em Chinês | MEDLINE | ID: mdl-33142392

RESUMO

Low back pain (LBP) is a common occupational disease among naval officers and soldiers. This article reviewed the incidence of LBP in naval personnel in different positions in recent years, and analyzed the causes combined with the operating environment and occupational characteristics of personnel in different positions in order to clarify the causes of LBP in naval officers and soldiers in different positions and improve their awareness of the disease. Moreover, this study aims to help naval officers and soldiers to take protective measures in training life to reduce the incidence of LBP.


Assuntos
Dor Lombar , Militares , Doenças Profissionais , Humanos , Incidência , Dor Lombar/epidemiologia , Dor Lombar/prevenção & controle , Doenças Profissionais/epidemiologia , Doenças Profissionais/prevenção & controle
20.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(11): 1175-1179, 2020 Nov 06.
Artigo em Chinês | MEDLINE | ID: mdl-33147912

RESUMO

Occupational stress is one of the major occupational health problems in industrialized countries. In Europe, the United States, Japan, and other countries, occupational stress has been included in the prevention and control of occupational hazards in the workplace. This problem has also become a major risk factor affecting the physical and mental health of the working population in China. Over the last three decades, China had carried out a lot of research on occupational stress and made significant progress, but there is still a big gap between China and industrialized countries in terms of theoretical research on occupational stress, development of measurement tools, research topics and methods, formulation of regulations and standards, and practice of prevention and control. Articles in this key issue report the research on the core scale of occupational stress measurement for the Chinese working population, the scale scoring norm of manufacturing and medical personnel, the research on the relationship between positive psychology variables, and occupational stress and its role in the relationship between occupational stress and health outcomes.


Assuntos
Doenças Profissionais , Saúde do Trabalhador , Estresse Ocupacional , China , Humanos , Saúde Mental , Doenças Profissionais/prevenção & controle , Estresse Ocupacional/prevenção & controle , Estresse Psicológico/prevenção & controle , Estados Unidos , Local de Trabalho
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