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Special Issue "The Burden of COVID-19 in Workers"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Occupational Safety and Health".

Deadline for manuscript submissions: 31 March 2023 | Viewed by 13603

Special Issue Editors

1. Competence Centre for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Centre Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany
2. Department for Occupational Medicine, Hazardous Substances and Health Science, Institution for Accident Insurance and Prevention in the Health and Welfare Services (BGW), 22089 Hamburg, Germany
Interests: occupational health; tuberculosis in health workers; violence against health workers; leadership and workers’ health; low back pain in health workers; psycho-social exposure in health workers
Special Issues, Collections and Topics in MDPI journals
ICOH Scientific Committee on Occupational Health for Health Workers, 20122 Milano, Italy
Interests: occupational health; vaccination of health workers; tuberculosis in health workers
Special Issues, Collections and Topics in MDPI journals
Occupational and Environmental Medicine, Department of Family Medicine & Population Health, University of Antwerpen, 2610 Antwerp, Belgium
Interests: occupational medicine; infectious diseases; epidemiology; occupational infectious agents; prevention; vaccination
Special Issues, Collections and Topics in MDPI journals
College of Medicine and Science, Mayo Clinic, Rochester, MN 55905, USA
Interests: occupational health; tuberculosis testing of health workers; mandatory influenza vaccination of health workers
Bellevue / NYU Occupational Environmental Medicine Clinic, Department of Population Health, New York University, New York, NY 10016, USA
Interests: ergonomics; migration and workers health; participative health promotion and protection

Special Issue Information

Dear Colleagues,

The number of SARS-CoV-2 infections is still increasing worldwide, and to a certain extent, the infection risk is related to work. Health workers experience the highest work-related infection risk as they have close contact to COVID-19 patients. Many countries do have special insurance and compensation systems for work-related diseases. However, the question of how to separate a work-related risk from a private or background risk in a pandemic arises. COVID-19 is a multi-organ disease with long-lasting negative health effects for those who become infected, including workers. Therefore, it is of paramount importance to assess the effect of work-related COVID-19 on health, quality of life and work ability. Rehabilitation programs are needed to improve recovery from COVID-19. For those with long-lasting disability and reduced work ability as a cause of COVID-19 infection, compensation needs to be discussed, depending on the social security system of the country in question. The severity of COVID-19 symptoms depends on the health status of the patient before the infection. Psychological problems in a patient’s personal history seem to predict fatigue or memory problems after COVID-19 infection. Therefore, potential compensation depends on the assessment of a patient’s health status before and after infection with COVID-19. Tools for this assessment are still to be developed. Return to Work (RTW) after COVID-19 infection and assessment of the fitness for the job is another issue to be addressed.

So far, in the literature, the assessment of work ability and the compensation of workers after COVID-19 infection is rarely discussed. With this Special Issue, we want to encourage researchers and experts to contribute to the questions of which workers are most commonly affected and how can these workers be assessed after COVID-19 infection so that fair compensation for long-term effects on health, quality of life, and workability can be granted. Studies describing work-related infection risks in workers or follow-up studies which describe the infection dynamics in workers are also welcome for this Special Issue.

With this Special Issue, we aim to stimulate the discussion between experts on occupational health and workers’ compensation from different countries with different social security systems facing the same problems concerning work-related COVID-19 infection.

The Special Issue is coordinated by members of the

Scientific committee of Occupational Health for Health Workers (SCOHHW) of the ICOH. Other scientific committees or working groups of the ICOH are invited to join the discussion and the Special Issue.

Prof. Dr. Albert Nienhaus
Dr. Gwen Brachman
Dr. Antoon De Schryver
Dr. William Buchta
Dr. Acran Salmen-Navarro
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • occupational health
  • COVID-19
  • COVID-19 infection
  • work-related diseases
  • psychological problems

Published Papers (11 papers)

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Research

Article
Impact of Rehabilitation on Physical and Neuropsychological Health of Patients Who Acquired COVID-19 in the Workplace
Int. J. Environ. Res. Public Health 2023, 20(2), 1468; https://doi.org/10.3390/ijerph20021468 - 13 Jan 2023
Viewed by 788
Abstract
Workers, especially healthcare workers, are exposed to an increased risk for SARS-CoV-2 infection. However, less is known about the impact of rehabilitation on health outcomes associated with post-COVID. This longitudinal observational study examined the changes in physical and neuropsychological health and work ability [...] Read more.
Workers, especially healthcare workers, are exposed to an increased risk for SARS-CoV-2 infection. However, less is known about the impact of rehabilitation on health outcomes associated with post-COVID. This longitudinal observational study examined the changes in physical and neuropsychological health and work ability after inpatient rehabilitation of 127 patients (97 females/30 males; age 21–69 years; Mean = 50.62) who acquired COVID-19 in the workplace. Post-COVID symptoms, functional status, physical performance, neuropsychological health, employment, and work ability were assessed before and after rehabilitation. Group differences relating to sex, professions, and acute COVID status were also analyzed. Except for fatigue, the prevalence of all post-COVID symptoms decreased after rehabilitation. Significant improvements in physical performance and neuropsychological health outcomes were determined. Moreover, healthcare workers showed a significantly greater reduction in depressive symptoms compared to non-healthcare workers. Nevertheless, participants reported poor work ability, and 72.5% of them were still unable to work after discharge from rehabilitation. As most participants were still suffering from the impact of COVID-19 at rehabilitation discharge, ongoing strategies in aftercare are necessary to improve their work ability. Further investigations of this study population at 6 and 12 months after rehabilitation should examine the further course of post-COVID regarding health and work ability status. Full article
(This article belongs to the Special Issue The Burden of COVID-19 in Workers)
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Article
Healthcare Workers after Two Years of COVID-19: The Consequences of the Pandemic on Psychological Health and Sleep among Nurses and Physicians
Int. J. Environ. Res. Public Health 2023, 20(2), 1410; https://doi.org/10.3390/ijerph20021410 - 12 Jan 2023
Cited by 2 | Viewed by 1026
Abstract
COVID-19 has challenged the health workforce worldwide. In this cross-sectional study with a retrospective assessment, we explored the impact of the pandemic on mental health and sleep among a sample of Italian nurses and medical doctors. A total of 287 healthcare workers (212 [...] Read more.
COVID-19 has challenged the health workforce worldwide. In this cross-sectional study with a retrospective assessment, we explored the impact of the pandemic on mental health and sleep among a sample of Italian nurses and medical doctors. A total of 287 healthcare workers (212 nurses and 75 physicians) completed a web survey on socio-demographic, psychological, and sleep-related aspects referring to the period before the pandemic and to the present period of February to June 2022. Comparisons between nurses and physicians revealed that the former had greater distress in response to the pandemic. Consistently, the multivariate analysis of covariance showed that even if both groups were negatively impacted by the pandemic, nurses presented a greater worsening over time regarding several psychological and sleep symptoms. Furthermore, we observed that working on the frontline represented an additional risk factor for nurses. In line with previous evidence, we also found that personal experiences with COVID-19 are significant predictors of the current health status. Our results underscore the urgent need for preventive programs among healthcare operators to increase their coping skills and prevent the long-term consequences of chronic stress, especially for high-risk professionals. Specific attention should also be devoted to programs to improve sleep quality and reduce sleep-related traumatic symptoms. Full article
(This article belongs to the Special Issue The Burden of COVID-19 in Workers)
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Article
COVID-19 as an Occupational Disease—Temporal Trends in the Number and Severity of Claims in Germany
Int. J. Environ. Res. Public Health 2023, 20(2), 1182; https://doi.org/10.3390/ijerph20021182 - 09 Jan 2023
Viewed by 1036
Abstract
COVID-19 is considered an occupational disease (OD), when infection occurs at the workplace for health workers (HW). Because of the increased infection risk of these workers, they were deemed to be a priority group when the vaccination campaign started in Germany in December [...] Read more.
COVID-19 is considered an occupational disease (OD), when infection occurs at the workplace for health workers (HW). Because of the increased infection risk of these workers, they were deemed to be a priority group when the vaccination campaign started in Germany in December 2020. By December 2021, more than 90% of HW had been vaccinated twice. We studied the number and the time trend concerning the severity of OD claims related to COVID-19. Workers’ compensation claims for OD are recorded in a standardized database of the Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW). We analyzed all notifiable COVID-19 related claims filed between 1 March 2020 and 30 September 2022. The proportion of severe cases was estimated by inpatient stays, injury benefit payments, rehabilitation measures, and deaths. The data analysis was descriptive. Due to COVID-19, 317,403 notifiable cases were reported to the BGW. Of these, 200,505 (63.2%) had thus far been recognized as OD. The number of notifiable cases was highest in 2022 and lowest in 2020. In total, 3289 insured individuals were admitted to rehabilitation management. This represented 1.6% of all recognized ODs due to COVID-19 at the BGW. The proportion of cases admitted to rehabilitation management decreased from 4.5% of all recognized ODs in 2020 to 3.2% in 2021 and to 0.1% of all recognized cases in 2022. For inpatient stays, injury benefit payment, and death, a similar trend was observed. Therefore, it might be concluded that the successful vaccination campaign mitigated the negative health effects of COVID-19 on HW. Even with vaccination, severe cases can occur. Therefore, infection prevention at the workplace remains paramount. Full article
(This article belongs to the Special Issue The Burden of COVID-19 in Workers)
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Article
Are We Prepared for the Next Pandemic? Management, Systematic Evaluation and Lessons Learned from an In-Hospital COVID-19 Vaccination Centre for Healthcare Workers
Int. J. Environ. Res. Public Health 2022, 19(23), 16326; https://doi.org/10.3390/ijerph192316326 - 06 Dec 2022
Viewed by 548
Abstract
Background: the organisation of a COVID-19 vaccination campaign for healthcare workers (HCWs) within a university hospital presents a challenge of a particularly large scale and urgency. Here, we evaluate the in-hospital vaccination process and centre for HCWs at LMU University Hospital in Munich, [...] Read more.
Background: the organisation of a COVID-19 vaccination campaign for healthcare workers (HCWs) within a university hospital presents a challenge of a particularly large scale and urgency. Here, we evaluate the in-hospital vaccination process and centre for HCWs at LMU University Hospital in Munich, Germany. Methods: We executed a mixed-method process evaluation of the vaccination centre at LMU University Hospital during the first COVID-19 vaccination campaign. In a programme monitoring, we continuously assessed the implementation of the centre’s operational management including personnel resources. In evaluating the outreach to and satisfaction of the target group with the centre and process, we executed two anonymous surveys aimed at the HCWs vaccinated at the in-hospital centre (1) as well as centre staff members (2). Results: staff numbers and process time per person were reduced several times during the first vaccination campaign. Lessons concerning appointment scheduling were learned. HCWs vaccinated at the in-hospital centre were satisfied with the process. A longer waiting time between admission and inoculation, perceived dissatisfying accessibility as well as an increased frequency of observed adverse events were linked to a reduced satisfaction. Comparatively subpar willingness to adhere to non-pharmaceutical measures was observed. Centre staff reported high satisfaction and a workload relatively equal to that of their regular jobs. Our outcomes provide references for the implementation of an in-hospital vaccination centre in similar settings. Full article
(This article belongs to the Special Issue The Burden of COVID-19 in Workers)
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Article
Prevalence of Adverse Skin Reactions in Nursing Staff Due to Personal Protective Equipment during the COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2022, 19(19), 12530; https://doi.org/10.3390/ijerph191912530 - 01 Oct 2022
Cited by 2 | Viewed by 824
Abstract
In order to prevent the nosocomial transmission of the SARS-CoV-2 virus, it has become necessary for health workers to increase their use of personal protective equipment (PPE). The aim of the study was to investigate the prevalence and influencing factors for adverse skin [...] Read more.
In order to prevent the nosocomial transmission of the SARS-CoV-2 virus, it has become necessary for health workers to increase their use of personal protective equipment (PPE). The aim of the study was to investigate the prevalence and influencing factors for adverse skin reactions (ASR) due to occupational PPE use among nursing staff in Germany during the COVID-19 pandemic. The study uses a mixed methods design. A focus group was created with experts from the field of healthcare, and an online survey was then carried out among nursing staff. Influencing factors were identified using multivariate logistic regression via odds ratios (ORs) with 95% confidence intervals (CIs). A total of 2274 nursing staff took part in the survey, with 1967 included in the analysis. The prevalence of ASR was 61%, with 94% affecting at least one area of the face. Statistically significant factors of influence were Filtering Face Peace (FFP) mask wearing duration of ≥4 h, a history of contact allergies, and being female and young. A pre-existing skin disease had a protective effect. The prevalence of PPE-related ASR underlines the necessity for targeted preventive measures for nursing staff during pandemic situation. Full article
(This article belongs to the Special Issue The Burden of COVID-19 in Workers)
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Article
Incidence, Prevalence, and Sources of COVID-19 Infection among Healthcare Workers in Hospitals in Malaysia
Int. J. Environ. Res. Public Health 2022, 19(19), 12485; https://doi.org/10.3390/ijerph191912485 - 30 Sep 2022
Cited by 2 | Viewed by 1054
Abstract
The COVID-19 pandemic introduced significant novel risks for healthcare workers and healthcare services. This study aimed to determine the prevalence, trends, characteristics, and sources of COVID-19 infection among healthcare workers during the early COVID-19 pandemic in Malaysian hospitals. A cross-sectional study used secondary [...] Read more.
The COVID-19 pandemic introduced significant novel risks for healthcare workers and healthcare services. This study aimed to determine the prevalence, trends, characteristics, and sources of COVID-19 infection among healthcare workers during the early COVID-19 pandemic in Malaysian hospitals. A cross-sectional study used secondary data collected from a COVID-19 surveillance system for healthcare workers between January and December 2020. Two surges in COVID-19 cases among healthcare workers in Malaysia were epidemiologically correlated to a similarly intense COVID-19 pattern of transmission in the community. The period prevalence of COVID-19 infection and the mortality rate among healthcare workers in Malaysia were 1.03% and 0.0019%, respectively. The majority of infections originated from the workplace (53.3%); a total of 36.3% occurred among staff; a total of 17.0% occurred between patients and staff; and 43.2% originated from the community. Healthcare workers had a 2.9 times higher incidence risk ratio for the acquisition of COVID-19 infection than the general population. Nursing professionals were the most highly infected occupational group (40.5%), followed by medical doctors and specialists (24.1%), and healthcare assistants (9.7%). The top three departments registering COVID-19 infections were the medical department (23.3%), the emergency department (17.7%), and hospital administration and governance (9.1%). Occupational safety and health units need to be vigilant for the early detection of a disease outbreak to prevent the avoidable spread of disease in high-risk settings. The transformation of some tertiary hospitals to dedicated COVID-19 care, the monitoring of new procedures for the management of COVID-19 patients, and appropriate resource allocation are key to successful risk mitigation strategies. Full article
(This article belongs to the Special Issue The Burden of COVID-19 in Workers)
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Article
Coronavirus Vaccination: Spike Antibody Levels in Health Workers after Six Months—A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2022, 19(18), 11422; https://doi.org/10.3390/ijerph191811422 - 10 Sep 2022
Cited by 1 | Viewed by 1063
Abstract
Healthcare workers bear a high risk of infection during epidemics and pandemics such as the current SARS-CoV-2 pandemic. Various new vaccines have been approved. We investigated the influence of the time elapsed since vaccination, as well as of vaccination schema, on health workers’ [...] Read more.
Healthcare workers bear a high risk of infection during epidemics and pandemics such as the current SARS-CoV-2 pandemic. Various new vaccines have been approved. We investigated the influence of the time elapsed since vaccination, as well as of vaccination schema, on health workers’ spike antibody levels following their second vaccination. Blood samples were obtained from employees working at a German hospital between August 2021 and December 2021 on average half a year (range 130–280 days) after their second vaccination. Levels of SARS-CoV-2-IgG antibodies (spike and nucleocapsid protein) were qualitatively detected via chemiluminescent immunoassays (CLIAs). A previous infection with SARS-CoV-2 was an exclusion criterion. In total, 545 persons were included in this cross-sectional study. Most participants (97.8%) showed elevated anti-spike concentrations. Anti-spike levels differed significantly among vaccination schemas. Repeated vector vaccinations resulted in lower protective antibody levels. Higher age levels, immunosuppression and a longer time period since the second vaccination resulted in lower anti-spike levels. Women’s antibody levels were higher, but not significantly. Since anti-spike levels drop after vaccination, further boosters are required to increase immunoreactivity. If two vector vaccines have been administered, it is possible that an mRNA booster might increase the anti-spike level. Full article
(This article belongs to the Special Issue The Burden of COVID-19 in Workers)
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Article
Fear of COVID-19 Impact on Professional Quality of Life among Mental Health Workers
Int. J. Environ. Res. Public Health 2022, 19(16), 9949; https://doi.org/10.3390/ijerph19169949 - 12 Aug 2022
Cited by 2 | Viewed by 1472
Abstract
Several studies have examined the impact of the COVID-19 pandemic on healthcare workers’ mental health, but only a few have investigated its detrimental effect on the mental well-being of mental health workers (MHWs). Background: The current study aimed to explore the effect of [...] Read more.
Several studies have examined the impact of the COVID-19 pandemic on healthcare workers’ mental health, but only a few have investigated its detrimental effect on the mental well-being of mental health workers (MHWs). Background: The current study aimed to explore the effect of the fear of COVID-19 (FCV-19) on professional quality of life dimensions, namely compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS) in MHWs above and beyond sociodemographic and professional factors. Methods: Hierarchical linear regression models were employed to examine the relationship of extreme FCV-19 with CS, BO, and STS in MHWs (n = 224), after considering sociodemographic variables as potential confounding factors. Extreme FCV-19 was operationalized as a binary variable with a cut-off score of ≥16.5 considered as extreme fear. Results: We found that extreme FCV-19 in MHWs is linked with increased compassion fatigue (BO and STS), and this relationship is exacerbated by younger age in regard to BO and by female gender concerning STS. CS remains unaffected by severe FCV-19, and it is higher in older participants. Conclusion: Organizational support is required to protect MHWs’ mental well-being and ensure the quality of care they provide during prolonged crises, such as the COVID-19 pandemic. Measures that intensify a sense of safety, protection, and control against COVID-19 infections in mental health services should be included in the recommendations that may reduce BO and STS among MHWs. Full article
(This article belongs to the Special Issue The Burden of COVID-19 in Workers)
Article
The Association between Working Hours Flexibility and Well-Being Prior to and during COVID-19 in South Korea
Int. J. Environ. Res. Public Health 2022, 19(14), 8438; https://doi.org/10.3390/ijerph19148438 - 11 Jul 2022
Cited by 1 | Viewed by 1111
Abstract
Objective: This study examined the relationship between the flexibility of work schedule arrangements and well-being among full-time workers prior to and after the coronavirus disease (COVID-19) outbreak in South Korea. Methods: Data from the fifth 2017 and sixth 2020–2021 Korean Working Conditions Survey, [...] Read more.
Objective: This study examined the relationship between the flexibility of work schedule arrangements and well-being among full-time workers prior to and after the coronavirus disease (COVID-19) outbreak in South Korea. Methods: Data from the fifth 2017 and sixth 2020–2021 Korean Working Conditions Survey, including a final sample of 45,137 participants (22,460 males; 22,677 females), were used. Multiple logistic regression was performed to establish the association between schedule arrangement types and the 5-item World Health Organization Well-Being Index. Results: The study found an association between flexible schedule arrangements and good well-being in 2017: “little flexibility” (odds ratio (OR), 1.33; 95% confidence interval (CI), 1.27–1.48), “moderate flexibility” (OR, 1.48; 95% CI, 1.28–1.71), and “high flexibility” (OR, 1.35; 95% CI, 1.06–1.72). During COVID-19, only workers with “high flexibility” were likely to have good well-being (OR, 1.49; 95% CI, 1.18–1.88), while the association between well-being and “low flexibility” (OR, 1.06; 95% CI, 0.96–1.17) and “moderate flexibility” types (OR, 0.66; 95% CI 0.59–0.75) decreased. This study found that flexible working hours may contribute to better well-being among full-time workers. However, the impact of the COVID-19 pandemic on working conditions and employee well-being should be addressed while setting working hours. Full article
(This article belongs to the Special Issue The Burden of COVID-19 in Workers)
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Article
Long-Term Effects of COVID-19 on Workers in Health and Social Services in Germany
Int. J. Environ. Res. Public Health 2022, 19(12), 6983; https://doi.org/10.3390/ijerph19126983 - 07 Jun 2022
Cited by 7 | Viewed by 1581
Abstract
Health workers are at increased risk for SARS-CoV-2 infections. What follows the acute infection is rarely reported in the occupational context. This study examines the employees’ consequences of COVID-19 infection, the risk factors and the impact on quality of life over time. In [...] Read more.
Health workers are at increased risk for SARS-CoV-2 infections. What follows the acute infection is rarely reported in the occupational context. This study examines the employees’ consequences of COVID-19 infection, the risk factors and the impact on quality of life over time. In this baseline survey, respondents were asked about their COVID-19 infection in 2020 and their current health situation. Out of 2053 participants, almost 73% experienced persistent symptoms for more than three months, with fatigue/exhaustion, concentration/memory problems and shortness of breath being most frequently reported. Risk factors were older age, female gender, previous illness, many and severe symptoms during the acute infection, and outpatient medical care. An impaired health-related quality of life was found in participants suffering from persistent symptoms. Overall, a high need for rehabilitation to improve health and work ability is evident. Further follow-up surveys will observe the changes and the impact of vaccination on the consequences of COVID-19 among health workers. Full article
(This article belongs to the Special Issue The Burden of COVID-19 in Workers)
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Article
Cumulative Incidence of SARS-CoV-2 in Healthcare Workers at a General Hospital in Germany during the Pandemic—A Longitudinal Analysis
Int. J. Environ. Res. Public Health 2022, 19(4), 2429; https://doi.org/10.3390/ijerph19042429 - 19 Feb 2022
Cited by 7 | Viewed by 1833
Abstract
Health workers (HW) are at increased risk for SARS-CoV-2 infection. In order to monitor the infection dynamic on the basis of contact with patients, HW at the St. Antonius Hospital (SAH) were tested four times in one year by PCR and serology. The [...] Read more.
Health workers (HW) are at increased risk for SARS-CoV-2 infection. In order to monitor the infection dynamic on the basis of contact with patients, HW at the St. Antonius Hospital (SAH) were tested four times in one year by PCR and serology. The cumulative incidence of infection in HW was calculated. Swab and blood tests were simultaneously performed between April 2020 and April 2021. Risk factors and demographic information were assessed at the beginning of the study. The response rate was above 75% in all rounds of testing. The study comprised 1506 HW, 165 (10.6%) of which tested positive for SARS-CoV-2 infection. Working in an ICU or on wards with patient contact were risk factors (OR 4.4, 95% CI 1.73–13.6 and OR 2.9, 95% CI 1.27–8.49). At the end of the study, the majority of HW (810 of 1363 (59.4%)) had been vaccinated at least once. A total of 29.1% of unvaccinated HW and 5.3% of vaccinated HW showed an immune response typical for natural SARS-CoV-2 infection. Of the 73 HW who provided information on the course of the disease, 31.5% reported that their quality of life continued to be impaired. The cumulative incidence of infection was low in these HW, which may be attributed to vaccination and good hygiene. Nevertheless, a work-related infection risk was identified, highlighting the need to improve protection against infection. A high risk of developing long COVID was found after the infection has subsided. Special rehabilitation programs should be provided and HW should be compensated for reduced work capacity in the case that rehabilitation fails or takes a long time. Full article
(This article belongs to the Special Issue The Burden of COVID-19 in Workers)
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