Occupational medicine (Oxford, England)最新文献

{"title":"Evaluation of the Warrior Programme intervention among UK ex-service personnel.","authors":"G Thandi,&nbsp;A Phillips,&nbsp;N Greenberg,&nbsp;N Maguire,&nbsp;N T Fear","doi":"10.1093/occmed/kqab153","DOIUrl":"https://doi.org/10.1093/occmed/kqab153","url":null,"abstract":"<p><strong>Background: </strong>Research has shown that of the myriad services available to veterans in the UK, very few have been independently evaluated. This report presents the results of a randomized controlled trial assessing the impact of Time Line Therapy™ delivered by the Warrior Programme (a third-sector organization).</p><p><strong>Aims: </strong>This study was aimed to determine if the intervention is effective in reducing emotional and functional difficulties in ex-service personnel.</p><p><strong>Methods: </strong>A mixed-design analysis of variance model was used to investigate whether the Warrior Programme had a statistically significant impact on self-reported scores. The intervention and control group provided data on measures prior to and immediately after the intervention, and at 3-month follow-up.</p><p><strong>Results: </strong>Those in the intervention group (n = 23) reported statistically significant improvements in self-reported scores immediately following intervention: the Clinical Outcomes in Routine Evaluation (CORE) scores (CORE global distress mean difference [MD] = 45.0, 95% confidence interval [CI] 31-60) (CORE subjective well-being MD = 5.9, 95% CI 3.5-8.3) (CORE functioning MD = 16.7, 95% CI 11.4-21.9) (CORE problems/symptoms MD = 19.4, 95% CI 13.1-25.7), general self-efficacy (MD = -9.8, 95% CI -13.6 to -6.8), anxiety (MD = 8.6, 95% CI 5.2-12.1), depression (MD = 10, 95% CI 6.6-13.5), post-traumatic stress disorder (MD = 26.3, 95% CI 17-25) and functional impairment (MD = 11.1, 95% CI 5.3-16.8) over time, compared to the control group (n = 29). However, score improvement was not sustained over time or statistically significant at follow-up.</p><p><strong>Conclusions: </strong>The Warrior Programme was effective in reducing emotional and functional difficulties in ex-service personnel immediately after the intervention, but the effect was not sustained at 3-month follow-up.</p>","PeriodicalId":520727,"journal":{"name":"Occupational medicine (Oxford, England)","volume":" ","pages":"91-98"},"PeriodicalIF":5.1,"publicationDate":"2022-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39621523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Firefighting and melanoma, epidemiological and toxicological associations: a case report.","authors":"Bendik C Brinchmann,&nbsp;Merete D Bugge,&nbsp;Karl-Christian Nordby,&nbsp;Jose Hernán Alfonso","doi":"10.1093/occmed/kqab183","DOIUrl":"https://doi.org/10.1093/occmed/kqab183","url":null,"abstract":"<p><p>The International Agency for Research on Cancer (IARC) classifies firefighting as possibly carcinogenic to humans, and polychlorinated biphenyls (PCBs) as carcinogens with sufficient evidence for development of melanoma in humans. We present a case report of a firefighter with melanoma and history of 33 years of occupational exposure. Based on the available epidemiological and toxicological evidence of association between being a firefighter and developing melanoma, melanoma was recognized by the Norwegian Labour and Welfare Service as an occupational disease in our patient. In 2017, melanoma was acknowledged as an occupational disease in only 8 out of 28 surveyed European countries. Melanoma should be considered as a possible occupational disease among firefighters with a history of relevant exposure. Further recognition of the occupational exposures leading to increased risk of melanoma is still needed for preventive purposes.</p>","PeriodicalId":520727,"journal":{"name":"Occupational medicine (Oxford, England)","volume":" ","pages":"142-144"},"PeriodicalIF":5.1,"publicationDate":"2022-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c9/12/kqab183.PMC8863077.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39937830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of BAME is controversial-occupational risk from COVID-19 and supporting ethnic minority workers.","authors":"Sheetal Chavda","doi":"10.1093/occmed/kqab067","DOIUrl":"https://doi.org/10.1093/occmed/kqab067","url":null,"abstract":"","PeriodicalId":520727,"journal":{"name":"Occupational medicine (Oxford, England)","volume":" ","pages":"65-66"},"PeriodicalIF":5.1,"publicationDate":"2022-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8500020/pdf/kqab067.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39438237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of an occupational medicine patient consultation note assessment tool.","authors":"V Spilchuk,&nbsp;R House,&nbsp;R Nisenbaum,&nbsp;D L Holness","doi":"10.1093/occmed/kqab154","DOIUrl":"https://doi.org/10.1093/occmed/kqab154","url":null,"abstract":"<p><strong>Background: </strong>Medical education focuses on assessment, diagnosis and management of various clinical entities. The communication of this information, particularly in the written form, is rarely emphasized. Though there have been assessment tools developed to support medical learner improvement in this regard, none are oriented to occupational medicine (OM) practice.</p><p><strong>Aims: </strong>This study was aimed to develop and evaluate an assessment tool for consultation letters, by modifying a previously validated assessment tool to suit practice in OM.</p><p><strong>Methods: </strong>Using an iterative process, OM specialists added to the Consultation Letter Rating Scale (CLRS) of the Royal College of Physicians and Surgeons of Canada (henceforth abbreviated as RC) additional questions relevant to communication in the OM context. The tool was then used by two OM specialists to rate 40 anonymized OM clinical consultation letters. Inter-rater agreement was measured by percent agreement, kappa statistic and intraclass correlation.</p><p><strong>Results: </strong>There was generally good percent agreement (>80% for the majority of the RC and OM questions). Intraclass correlation for the five OM questions total scores was slightly higher than the intraclass correlations for the five RC questions (0.59 versus 0.46, respectively), suggesting that our modifications performed at least as well as the original tool.</p><p><strong>Conclusions: </strong>This new tool designed specifically for evaluation of patient consultation notes in OM provides a good option for medical educators in a variety of practice areas in providing non-summative, low-stakes assessment and/or feedback to nurture increased competency in written communication skills for postgraduate trainees in OM.</p>","PeriodicalId":520727,"journal":{"name":"Occupational medicine (Oxford, England)","volume":" ","pages":"99-104"},"PeriodicalIF":5.1,"publicationDate":"2022-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39641100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resident physicians physical activity during on-call shifts: smartphone-based assessment.","authors":"R Ben-David,&nbsp;Z Savin,&nbsp;H Herzberg,&nbsp;Y Shulman,&nbsp;N Bar-Yakkov,&nbsp;A Haham,&nbsp;O Yossepowitch,&nbsp;M Sofer","doi":"10.1093/occmed/kqab159","DOIUrl":"https://doi.org/10.1093/occmed/kqab159","url":null,"abstract":"<p><strong>Background: </strong>Physical activity of resident physicians (RPs) during on-call shifts is difficult to objectively evaluate. The integration of smartphones in our daily routines may allow quantitative assessment, employing pedometric assessment.</p><p><strong>Aims: </strong>To evaluate the number of steps that RPs walk during on-call shifts as a marker of physical activity by using smartphone-based pedometers.</p><p><strong>Methods: </strong>Step counts were collected from 100 RPs' smartphones who volunteered to participate in the study between January 2018 and May 2019. The conversion rate was 1400 steps = 1 km (application's default). A shift was defined as regular morning work followed by an in-house on-call stay, totalling 26 hours. Statistical analyses included univariate and multivariate linear mixed models, and Fisher exact test. A P-value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>The average walking distance was 12 118 steps (8.6 km/RP/shift). Paediatric intensive care unit and neurosurgery residents recorded the longest walking distances 16 347 and 15 630 steps (11.67 and 11.16 km/shift), respectively. Radiology residents walked the shortest distances 4718 steps (3.37 km/shift). Physically active RPs walked significantly longer distances during their shifts than non-physically active RPs: 12 527 steps versus 11 384 steps (8.95 versus 8.13 km/shift, P < 0.05), respectively. Distances covered during weekday shifts were longer than weekend shifts: 12 092 steps versus 11 570 steps (8.63 versus 8.26 km/shift, P < 0.05), respectively.</p><p><strong>Conclusions: </strong>Smartphone-based pedometers can aid in analysing physical activity and workload during on-call shifts; such information can be valuable for human resource department, occupational health authorities and medical students with impaired physical mobility when choosing a speciality.</p>","PeriodicalId":520727,"journal":{"name":"Occupational medicine (Oxford, England)","volume":" ","pages":"105-109"},"PeriodicalIF":5.1,"publicationDate":"2022-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39691927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic evaluations of interventions against influenza at workplaces: systematic review.","authors":"S K Ofori,&nbsp;Y W Hung,&nbsp;J S Schwind,&nbsp;K Diallo,&nbsp;D Babatunde,&nbsp;S O Nwaobi,&nbsp;X Hua,&nbsp;K L Sullivan,&nbsp;B J Cowling,&nbsp;G Chowell,&nbsp;I C H Fung","doi":"10.1093/occmed/kqab163","DOIUrl":"https://doi.org/10.1093/occmed/kqab163","url":null,"abstract":"<p><strong>Background: </strong>The burden of influenza is mostly felt by employees and employers because of increased absenteeism rates, loss of productivity and associated direct costs. Even though interventions against influenza among working adults are effective, patronage and compliance to these measures especially vaccination are low compared to other risk groups.</p><p><strong>Aims: </strong>This study was aimed to assess evidence of economic evaluations of interventions against influenza virus infection among workers or in the workplace setting.</p><p><strong>Methods: </strong>The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) reporting guideline for systematic reviews was followed. Three databases, PubMed, Web of Science and EconLit, were searched using keywords to identify relevant articles from inception till 25 October 2020. Original peer-reviewed papers that conducted economic evaluations of influenza interventions using cost-benefit, cost-effectiveness or cost-utility analysis methods focused on working-age adults or work settings were eligible for inclusion. Two independent teams of co-authors extracted and synthesized data from identified studies.</p><p><strong>Results: </strong>Twenty-four articles were included: 21 were cost-benefit analyses and 3 examined cost-effectiveness analyses. Two papers also presented additional cost-utility analysis. Most of the studies were pharmaceutical interventions (n = 23) primarily focused on vaccination programs while one study was a non-pharmaceutical intervention examining the benefit of paid sick leave. All but two studies reported that interventions against influenza virus infection at the workplace were cost-saving and cost-effective regardless of the analytic approach.</p><p><strong>Conclusions: </strong>Further cost-effectiveness research in non-pharmaceutical interventions against influenza in workplace settings is warranted. There is a need to develop standardized methods for reporting economic evaluation methods to ensure comparability and applicability of future research findings.</p>","PeriodicalId":520727,"journal":{"name":"Occupational medicine (Oxford, England)","volume":" ","pages":"70-80"},"PeriodicalIF":5.1,"publicationDate":"2022-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39745083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment and outcomes of firefighter applicants with possible asthma.","authors":"T Kabir,&nbsp;S Schofield,&nbsp;B Fitzgerald,&nbsp;J Cannon,&nbsp;J Szram,&nbsp;J Feary","doi":"10.1093/occmed/kqab162","DOIUrl":"https://doi.org/10.1093/occmed/kqab162","url":null,"abstract":"<p><strong>Background: </strong>Firefighter applicants (FFAs) with a history of asthma may be refused entry to the fire service because of potentially putting themselves and others at risk.</p><p><strong>Aims: </strong>We undertook a service evaluation to identify respiratory and employment outcomes of FFAs with a history of asthma who had undergone additional respiratory assessment at our specialist occupational lung disease clinic during 2005-19.</p><p><strong>Methods: </strong>We reviewed FFA medical records and categorized them as having either no current asthma or definite/probable asthma at the time of clinic assessment. 'No current asthma' was defined as negative non-specific bronchial hyper-responsiveness (BHR) to histamine/methacholine, and no symptoms or treatment within the 2 years before clinic. 'Definite/probable current asthma' was defined as either positive BHR, or negative BHR with symptoms and/or treatment within the previous 2 years. Around 1 year later, we contacted FFAs to enquire about their application outcome and current respiratory symptoms.</p><p><strong>Results: </strong>Data were available on 116 applicants; of whom, 45% (n = 52) had definite/probable current asthma and were significantly more likely to be older, atopic to common aeroallergens, report atopic disease and have a lower forced expiratory volume in one second/forced vital capacity ratio compared with applicants with no current asthma. Only two individuals' applications were rejected due to asthma. At follow-up, just 2 (2%) of the 90 operational firefighters reported any recent trouble with asthma.</p><p><strong>Conclusions: </strong>A history of asthma alone is not sufficient to determine current asthma in FFAs. Even with a diagnosis of current asthma, FFAs are mostly successful in their application to join the fire service.</p>","PeriodicalId":520727,"journal":{"name":"Occupational medicine (Oxford, England)","volume":" ","pages":"118-124"},"PeriodicalIF":5.1,"publicationDate":"2022-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39735696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disadvantaged employees also need Chief Health Officer support.","authors":"Andrew Frank","doi":"10.1093/occmed/kqab167","DOIUrl":"https://doi.org/10.1093/occmed/kqab167","url":null,"abstract":"","PeriodicalId":520727,"journal":{"name":"Occupational medicine (Oxford, England)","volume":" ","pages":"145"},"PeriodicalIF":5.1,"publicationDate":"2022-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39641101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum to: Evaluation of metabolic syndrome and sleep quality in shift workers.","authors":"N Demiralp,&nbsp;F Özel","doi":"10.1093/occmed/kqab190","DOIUrl":"https://doi.org/10.1093/occmed/kqab190","url":null,"abstract":"Occupational Medicine, doi:10.1093/occmed/kqab140 In the originally published version of ‘Evaluation of metabolic syndrome and sleep quality in shift workers’ by N Demiralp and F Özel, a table was included in error which should have been included in the online supplementary material: ‘Table 1. Identification of MetS according to IDF and NCEP-ATP III (Grundy et al., [17])’. The table now appears as supplementary data online and a note has been added to the article to indicate this. As a consequence, the other tables in the paper have been renumbered, and the citation to Grundy removed from the main article.","PeriodicalId":520727,"journal":{"name":"Occupational medicine (Oxford, England)","volume":" ","pages":"148"},"PeriodicalIF":5.1,"publicationDate":"2022-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39934523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 outbreaks in hospital workers during the first COVID-19 wave.","authors":"L Piapan,&nbsp;P De Michieli,&nbsp;F Ronchese,&nbsp;F Rui,&nbsp;M Peresson,&nbsp;L Segat,&nbsp;P D'Agaro,&nbsp;C Negro,&nbsp;M Bovenzi,&nbsp;F Larese Filon","doi":"10.1093/occmed/kqab161","DOIUrl":"https://doi.org/10.1093/occmed/kqab161","url":null,"abstract":"<p><strong>Background: </strong>Health care workers (HCWs) are on the frontline, playing a crucial role in the prevention of infection and treatment of patients.</p><p><strong>Aims: </strong>This study was aimed to evaluate the prevalence of hospital-acquired coronavirus disease 2019 (COVID-19) infection at work and related factors at the University Hospital of Trieste workers exposed to COVID-19 patients.</p><p><strong>Methods: </strong>From March 1 to May 31, of 4216 employees, 963 were in contact with COVID-19 patients or colleagues and were followed up. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in nasopharyngeal swabs was determined every 3 days, by RT-PCR.</p><p><strong>Results: </strong>During the follow-up period, 193 workers were positive for COVID-19 (5%), and 165 of these (86%) were symptomatic. We identified five major cluster outbreaks of COVID-19 infection in Trieste Hospitals, four of which occurred before the implementation of universal masking for HCWs and patients (1-14 March 2020). COVID-19 infection was significantly higher in high-risk ward workers (Infectious Diseases, and Geriatric and Emergency Medicine, odds ratio [OR] 13.4; 95% confidence interval [CI] 5.8-31), in subjects with symptoms (OR 5.4; 95% CI 2.9-10) and in those with contacts with COVID-19 patients and colleagues (OR 2.23; 95% CI 1.01-4.9).</p><p><strong>Conclusions: </strong>Hospital workers were commonly infected due to contact with COVID-19 patients and colleagues, mainly in the first 15 days of the pandemic, before the implementation of universal mask wearing of HCWs and patients. Repetitive testing and follow-up permitted the identification of COVID-19 cases before symptom onset, obtaining better infection prevention and control.</p>","PeriodicalId":520727,"journal":{"name":"Occupational medicine (Oxford, England)","volume":" ","pages":"110-117"},"PeriodicalIF":5.1,"publicationDate":"2022-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8755348/pdf/kqab161.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39734795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}