Migrant workers, essential work, and COVID-19.

Globally, migrant and immigrant workers have borne the brunt of the COVID-19 pandemic as essential workers. They might be a Bulgarian worker at a meat processing plant in Germany, a Central American farmworker in the fields of California, or a Filipino worker at an aged-care facility in Australia. What they have in common is they are all essential workers who have worked throughout the coronavirus pandemic and have been infected with coronavirus at work. COVID-19 has highlighted the inequitable working conditions of these workers. In many instances, they are employed precariously, and so are ineligible for sick leave or social security, or COVID-19 special payments. If these are essential workers, they should get at least the same health and safety benefits of all nonessential workers. Improving the working and living conditions of migrant workers can and should be a positive outcome of the coronavirus pandemic.

[Cross-sectional study of the variability of work-related stress among post-graduate medical residents at the main University Polyclinic of Sicily]. / Studio trasversale sulle variabili di stress lavoro-correlato nei medici in formazione specialistica del maggiore Policlinico Universitario della Sicilia.

BACKGROUND: Among health care workers (HCWs), work-related stress is one of the main topics in risk assessment and prevention at the workplace. Post-graduate medical residents (MRs) are a group of HCWs comparable to medical doctors in terms of occupational exposure and occurrence of work-related stress syndromes. OBJECTIVES: Risk assessment of work-related stress among MRs attending the major University Hospital of Sicily. METHODS: A cross-sectional survey via an anonymous and self-administered questionnaire. RESULTS: 45% of clinical MRs and 37% of surgical MRs had access to compensatory rest days against 92% of MRs of the services area (p<0.001). A work attendance recording system for MRs was available in 80% of the postgraduate medical schools of the services area, in 60% of the clinical postgraduate schools and in 50% of the surgical postgraduate schools (p<0.001). MRs of the postgraduate surgical schools reported having access to work breaks (41%) with less frequency compared to clinical (60%) and services MRs (74%) (p<0.001). Both clinical (47%) and surgical MRs (47%) were more exposed to work-related stress than MRs of the services area (27%) (p<0.001). CONCLUSIONS: The survey demonstrated excess exposure to work-related stress for all the considered variables in MRs of the surgical area, compared with MRs of clinical and services areas. It is strongly recommended to provide specific training programmes aimed at managing the MRs' risk of exposure to work-related stress, focusing both on the workers and the work environment.

Police suicide in small departments: a comparative analysis.

The majority of police suicide research has focused on larger police departments. Very little research has been done within small departments. The present study compared suicide rates between small and larger police departments. Two Hundred ninty-eight departments were drawn from the U.S. Public Safety Officer Benefits database totaling 119,624 officers. Annual suicide rates were calculated per 100,000 for each of four category (by size of department) and p-values from Chi-square tests were employed to assess differences in rates across categories. The annual suicide rate varied significantly across departments. Smaller police departments had a significantly higher suicide rate than large departments. Possible reasons include lack of availability for mental health assistance, increased workload and danger and community visibility.

Nursing under the influence: a relational ethics perspective.

When nurses have active and untreated addictions, patient safety may be compromised and nurse-health endangered. Genuine responses are required to fulfil nurses' moral obligations to their patients as well as to their nurse-colleagues. Guided by core elements of relational ethics, the influences of nursing organizational responses along with the practice environment in shaping the situation are contemplated. This approach identifies the importance of consistency with nursing values, acknowledges nurses interdependence, and addresses the role of nursing organization as moral agent. By examining the relational space, the tension between what appears to be opposing moral responsibilities may be healed. Ongoing discourse to identify authentic actions for the professional practice issue of nursing under the influence is called upon.

[Health management in small and medium-sized enterprises: results of a representative survey]. / Gesundheitsmanagement in kleinen und mittleren Unternehmen - Ergebnisse einer repräsentativen Unternehmensbefragung.

PURPOSE: The prevalence of workplace health promotion in small and medium-sized enterprises (SME) in Germany as well as age management were investigated. METHODS: Representative data were collected by computer assisted telephone interviews in 1 441 SME (1-250 employees) in 7 regions of Germany. RESULTS: One-third of the SME have a system of health promotion. Disability management is known only in one third of the enterprises, another third of them knew the legal obligations. About half of the enterprises have a system to collect data about health-related absenteeism in business. Effects caused by the demographic change in Germany are feared by nearly 50% of the enterprises, but only 20% have taken action against it. The implementation of work health promotion is higher in enterprises with more employees. CONCLUSION: The study shows that workplace health promotion (WHP) in German small and medium-sized enterprises is not yet installed to a wide extent. The smaller the enterprises the less WHP is found. The results are verified by similar studies. Small and medium-sized enterprises have a need for consultation in cases of illness or health prevention. But there is not yet an organised structure available for getting advice. The study is the basis for a national project "Gesunde Arbeit", which will establish these consulting structures.

A national survey of support and counselling after maternal death.

The 2000-2002 Confidential Enquiry into Maternal and Child Health report highlighted several cases of maternal death where the staff who had been involved, were not offered support. The report recommended that 'Trusts must make provision for the prompt offer of support and/or counselling for all staff who have cared for a woman who has died.' We conducted a postal survey to firstly establish whether Trusts had implemented this, and also to ascertain the experience of consultant obstetric anaesthetists. Of 706 respondents (response rate 64%), 60% involved in a maternal death or other traumatic event received no offer of support, 65% were unaware of potential sources of support and only 5% received details of further help available. Furthermore, 69% were unaware of policies within their own Trusts for the provision of support services. We suggest that a formal structure should exist within all units that offers confidential support services and/or debriefing facilities to all staff involved in a maternal death or other traumatic event.

Offshore industry: medical emergency response in the offshore oil and gas industry.

BACKGROUND: The hunt for oil and gas has taken workers into new more distant locations including those offshore. The remoteness of the offshore platforms and vessels coupled with the potential risk of being cut off by bad weather presents particular challenges for medical emergency response (MER). AIMS: Firstly to define the challenges for MER in terms of locations, population and epidemiology of injuries and illnesses in the offshore environment. Secondly to give examples of legal requirements and industry standards to manage MER. Thirdly to look at existing and emerging practice to manage these challenges. METHODS: A review of published literature was supplemented with a summary of current practice in the industry. RESULTS AND DISCUSSION: Medical professionals (medics) working offshore on installations and vessels are primarily responsible for the medical care of the workers. The medics have clinics with suitable medical equipment for managing emergencies as well as providing limited primary care. Some countries have legislation that stipulate minimum requirements. Where there is no national legislation, industry and company guidance is used to define the MER standards. Supervision of the offshore medics is often provided by doctors on shore via radio and phone links. These methods of communication are now being augmented with more sophisticated telemedicine solutions such as the Internet and live video links. These newer solutions allow for prompt high-quality care and provide the scope for a variety of new treatment options to be available for the offshore workforce.

Criminal investigator stress: symptoms, syndromes, and practical coping strategies.

Without the skill and dedication of criminal investigators, there could literally be no criminal justice system. This group of law enforcement professionals has its own special needs and requires its own special kind of support. The present article describes the special stresses and challenges of homicide and sex crime investigators, and the range of responses shown by these officers. Recommendations are provided for the proper selection and training of investigators, and the personal and professional characteristics of successful investigators are outlined. A variety of stress-coping strategies are then described, some developed by the officers themselves, others with the aid of mental health consultants. The importance of professionalism as a key feature of high-quality investigative work is highlighted, and the ways in which criminal investigators can best access the services of mental health clinicians for their own psychological well-being are discussed.

[Humanization in nursing assistance: perception of nurses in municipal health services]. / Humanização da assistência de enfermagem: percepção de enfermeiros nos serviços de saúde de um município.

The following paper aims to identify the perception of nurses regarding humanization in nursing assistance in a municipality, pointing out difficulties for users and nurses while rendering these services. This is an exploratory-descriptive study, with a qualitative approach involving thirty-seven nurses who answered an open survey The content of the surveys was analyzed through theme analysis. Categories led nurses to a more accurate perception of assistance humanization, like, for example, how to look after others as one would like to be taken care of and also how to have a whole view of the users. Regarding difficulties, the study displayed shortcomings in humanized service (lack of time; inappropriate facilities; and lack of material and human resources). Concerning humanization in health care provided by nurses, the necessity for a better support by the administrator and the promotion of workers' health have been highlighted. The nurses recommend the use of services taking into account the qualification and commitment of the worker with the user

[Occupational health in China, an emerging issue]. / La santé au travail en Chine, une préoccupation naissante.

In Chinese factories, the prevention of occupational illness is inadequate. Public authorities have only recently started to pay attention to the issue. Individual and collective protection measures need to be developed, employees made aware of the issues and controls improved.

Occupational health needs of universities: a review with an emphasis on the United Kingdom.

This study describes the needs of universities in relation to planning the provision of occupational health services, by detailing their occupational hazards and risks and other relevant factors. The paper presents the results of (1) an enquiry into publicly available data relevant to occupational health in the university sector in the United Kingdom, (2) a literature review on occupational health provision in universities, and (3) selected results from a survey of university occupational health services in the UK. Although the enquiry and survey, but not the literature review, were restricted to the UK, the authors consider that the results are relevant to other countries because of the broad similarities of the university sector between countries. These three approaches showed that the university sector is large, with a notably wide range of occupational hazards, and other significant factors which must be considered in planning occupational health provision for individual universities or for the sector as a whole.

Intervention development in occupational research: an example from the printing industry.

BACKGROUND: Intervention development research is an essential prerequisite of any study that attempts to determine whether specific interventions work to prevent work related injury and illness. METHODS: Focus groups (n = 5) and direct observational studies (n = 21) of printers were used to elicit key issues that would aid the development of subsequent interventions. Transcripts from these were analysed by standard qualitative methods to identify common and related themes. RESULTS: The views of managers differed significantly from those of print workers in a number of areas, and working practices did not always follow policy. The majority of printers did not perceive dermatitis to be a major problem, although many complained of dry hands. Other key results included: the lack of skin care policy in most companies; poor understanding of the nature, causes, and treatment of dermatitis; low priority of dermatitis within health and safety concerns; little or no provision of occupational health services, particularly skin checks; variability in provision of and access to appropriate skin protection; and lack of accessible washing facilities. CONCLUSIONS: As a result it was decided to evaluate the implementation of four INTERVENTIONS: provision of (1) skin checks and treatment advice; (2) gloves of the correct type and size, and use of an after-work cream; (3) information on dermatitis within the printing industry; and (4) development of best practice skin care policy.

Prevalence and factors related to Canadian workplace health programs.

BACKGROUND: This study documented the prevalence and factors related to workplace health programs in Canada, including Employee Assistance Programs (EAPs), drug testing programs, and Health Promotion Programs (HPPs). METHODS: A representative sample of 565 Human Resources Managers at worksites with 100 or more employees across Canada completed a questionnaire on the worksite characteristics and the types of programs at their workplace (response rate = 79.8%). RESULTS: EAPs were established in 67.8% of sampled worksites (95% CI: 63.9%-71.7%). The proportion of worksites with EAPs varied significantly across work sectors (p<0.001) but not across regions of Canada. Worksites with EAPs had significantly (p<0.001) fewer visible minorities and had more unionized employees (p<0.001) than worksites without EAPs. For drug-testing programs, about 10.3% of Canadian worksites have them (95% CI: 7.8%-12.8%). Significant differences were noted across regions (p<0.001) with Alberta most likely to have such programs (25.4%) and Ontario least likely (4.6%). Also, safety-sensitive worksites and those with United States ownership were significantly (p<0.05) more likely to have drug testing. The most common type of HPP was fitness programs (29.4%) and the least common was day/elder care programs (5.5%). Fitness programs were most common in the Eastern provinces and least common in Quebec. CONCLUSIONS: Overall, Canadian worksites favour a health promotion and treatment approach over a deterrence approach for addressing health and substance use issues in the workplace. Workplace health programs were related to several factors that have created an uneven system of health promotion, treatment and deterrence in Canadian worksites.

Is there a duty for private employers to provide emergency mental health care services?

This article presents a discussion of whether employers in private companies have a duty to provide an emergency action plan with a mental health component for its employees. It discusses basic negligence concepts and focuses mainly on the "duty of care" component of negligence. It then applies the negligence concepts to private employers and discusses how private companies arguably might have a duty under the laws of negligence to provide employees with an emergency action plan, specifically a plan including mental health provisions.

Prevention and treatment of infectious diseases in healthcare workers.

OBJECTIVES: To study the prevention and treatment of infectious diseases offered to healthcare workers (HCWs) in Thailand. MATERIAL AND METHOD: Data were collected by interviewing in 2002. RESULTS: A total 1,218 HCWs in 33 hospitals were interviewed. Nurses and doctors were the majority group, accounting for 31.5% and 30.5% respectively. Pre-employement health screenings were done by physical examination in 56.0% and chest X-ray in 55.7% and immunization against hepatitis B and tubuculosis were offered in 17.7% and 11.4% respectively. Annual physical examination and chest x-ray were done in 66.3% and 76.9%. Reported infection with hepatitis A hepatitis B, tuberculosis in HCWs were as high as 16.8%, 4.0% and 2.6% respectively. Only 3.5% to 24.3% of HCWs ever read guidelines on the prevention of infection. Existing laws allowed the implementation of prevention, treatment and compensation in case of occupationally acquired infection in HCWs. CONCLUSION: Prevention of infection in HCWs was implemented far below the ideal level. They should be better protected under existing laws.

[Tuberculosis as an occupational disease]. / Tuberculosis como enfermedad ocupacional.

Health workers are exposed to numerous infectious diseases from which the patients they attend are suffering and that have been recognised as occupational infectious diseases. Those most frequently reported are acquired by the haematogenous path, especially hepatitis due to virus B. Numerous infectious diseases are transmitted through airways and until the coming of acute severe respiratory syndrome caused by a coronavirus, tuberculosis was one of the most dreaded. In this paper we analyse the reasons why tuberculosis is considered to be an occupational disease in health personnel; which activities entail most risk and the measures that should be adopted to reduce nosocomial transmission.