Special Issue "Proceedings of ICOH Occupational Health for Health Worker (OHHW2019) Conference"

Special Issue Editors

Prof. Dr. Nienhaus Albert
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Guest Editor
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
Dr. Gwen Brachman
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Guest Editor
Dr. Brachman graduated from Boston University School of Medicine, completed a residency in Internal Medicine (Pacific Medical Center), a fellowship in Rheumatology (UMDNJ-Rutgers) and a residency in Occupational Medicine (UMDNJ-Rutgers). She was an Assistant Clinical Professor of Medicine and worked in the Occupational Medicine Service at UMDNJ-Rutgers University – New Jersey Medical School in Newark, NJ for 20 years. She is currently retired but remains active in ACOEM (American College of Occupational and Environmental Medicine) and ICOH (International Commission on Occupational Health) where she is the Chair of the Scientific Committee on Occupational Health for Health Workers.
Dr. Antoon De Schryver
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Guest Editor
Dr. De Schryver received an MD and a PhD with a doctoral thesis in Medical Sciences from Ghent University, Belgium. Dr. De Schryver is a certified specialist in Occupational Medicine and in Epidemiology and is a Professor in the Department of Epidemiology and Social Medicine at the University of Antwerp, since 2005. He has been an occupational physician with IDEWE Occupational Health Services since 1997. Occupational Health Memberships: ICOH since 1993, Belgian Association of occupational physicians since 1995 Publications: In total 100 publications in listed journals. Most publications concern studies on epidemiology and infectious diseases in healthcare and non-health care workers.
Interests: epidemiology; particularly occupational and infectious diseases epidemiology; Hepatitis B; vaccinations

Special Issue Information

Dear Colleagues,

You are invited to submit papers to be presented at the ICOH Occupational Health for Health Workers (OHHW2019) Conference (https://www.ohhw2019.org), for publication in IJERPH (Impact Factor 2.145). This Special Issue will be guest edited by Dr. Albert Nienhaus, Dr. Gwen Brachman, and Dr. Antoon De Schryver. Manuscripts should be submitted by 31 March 2020. See the Special Issue website for further details and submission instructions. Participants of this conference will receive a 20% discount on the Article Processing Charges.

Papers submitted to this Special Issue of IJERPH will undergo the standard peer-review procedure. Published papers will be indexed by the SCIE (Web of Science) and PubMed.

Prof. Dr. Nienhaus Albert
Dr. Gwen Brachman
Dr. Antoon De Schryver
Guest Editors

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Published Papers (9 papers)

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Research

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Open AccessArticle
(Un)bounded Social Work?—Analysis of Working Conditions in Refugee and Homeless Aid in Relation to Perceived Job Stress and Job Satisfaction
Int. J. Environ. Res. Public Health 2020, 17(2), 601; https://doi.org/10.3390/ijerph17020601 - 17 Jan 2020
Abstract
Little is known about working conditions of social workers providing help in homeless and refugee aid. Therefore, the present study examined their work-related demands, job and personal resources as well as workplace violence, domain-specific demands, and gender-related differences. Job demands and resources were [...] Read more.
Little is known about working conditions of social workers providing help in homeless and refugee aid. Therefore, the present study examined their work-related demands, job and personal resources as well as workplace violence, domain-specific demands, and gender-related differences. Job demands and resources were analyzed with regard to their association with job stress and job satisfaction. Two hundred and fifty-three social workers (69.2% female, 30.8% male) from four federal states in Germany (Berlin, Hamburg, Schleswig-Holstein, and Mecklenburg-Western Pomerania) took part in the cross-sectional quantitative online survey that included validated scales and exploratory items especially developed for the target group. Multiple regression analysis showed that resilience as a personal resource was a significant negative predictor of perceived job stress. Emotional demands were positively related with perceived job stress. Meaning of work and social support were strongly associated with job satisfaction. Language and bureaucratic barriers as well as being affected by clients’ experiences were the domain-specific demands named most often. The study offers insights into the work-related demands and resources and their respective impact on perceived job stress and job satisfaction experienced by social workers in refugee and homeless aid. In order to ensure health and safety for this occupational group, health promotion measures focusing on structural aspects are recommended. Full article
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Open AccessArticle
Surgical Smoke—Hazard Perceptions and Protective Measures in German Operating Rooms
Int. J. Environ. Res. Public Health 2020, 17(2), 515; https://doi.org/10.3390/ijerph17020515 - 14 Jan 2020
Abstract
(1) Background: Hazardous substances in surgical smoke that is generated during laser or electrosurgery pose a potential health hazard. In Germany, the Technical Rules for Hazardous Substances (TRGS 525) have included recommendations for appropriate protective measures since 2014. Up to now, no empirical [...] Read more.
(1) Background: Hazardous substances in surgical smoke that is generated during laser or electrosurgery pose a potential health hazard. In Germany, the Technical Rules for Hazardous Substances (TRGS 525) have included recommendations for appropriate protective measures since 2014. Up to now, no empirical data has been available on the extent to which recommendations have been implemented in practice. (2) Methods: In 2018, 7089 surgeons in hospitals and outpatient practices were invited by email to participate in an online survey. In addition, 219 technical assistants were interviewed. The questionnaire dealt with knowledge of, and attitudes toward, the hazard potential of surgical smoke, as well as the availability and actual use of protective measures. Furthermore, manufacturers and distributors of smoke extraction devices were asked to give their assessment of the development of prevention in recent years. (3) Results: The survey response rate was 5% (surgeons) and 65% (technical assistant staff). Half of all surgeons assumed that there were high health hazards of surgical smoke without taking protective measures. Operating room nurses were more often concerned (88%). Only a few felt properly informed about the topic. The TRGS recommendations had been read by a minority of the respondents. In total, 52% of hospital respondents and 65% of the respondents in outpatient facilities reported any type of special suction system to capture surgical smoke. One-fifth of respondents from hospitals reported that technical measures had improved since the introduction of the TRGS 525. Fifty-one percent of the surgeons in hospitals and 70% of the surgeons in outpatient facilities “mostly” or “always” paid attention to avoiding surgical smoke. The most important reason for non-compliance with recommendations was a lack of problem awareness or thoughtlessness. Twelve industrial interviewees who assessed the situation and the development of prevention in practice largely confirmed the prevention gaps observed; only slight developments were observed in recent years. (4) Conclusions: The low response rate among surgeons and the survey results both indicate a major lack of interest and knowledge. Among other measures, team interventions with advanced training are needed in the future. Full article
Open AccessArticle
Cost-Effectiveness Analysis of Direct-Acting Antiviral Agents for Occupational Hepatitis C Infections in Germany
Int. J. Environ. Res. Public Health 2020, 17(2), 440; https://doi.org/10.3390/ijerph17020440 - 09 Jan 2020
Abstract
Around 1% of the world’s population is infected with hepatitis C. The introduction of new direct-acting antiviral agents (DAAs) in 2014 has substantially improved hepatitis C treatment outcomes. Our objective was to evaluate the long-term cost effectiveness of DAAs in health care personnel [...] Read more.
Around 1% of the world’s population is infected with hepatitis C. The introduction of new direct-acting antiviral agents (DAAs) in 2014 has substantially improved hepatitis C treatment outcomes. Our objective was to evaluate the long-term cost effectiveness of DAAs in health care personnel (HP) with confirmed occupational diseases in Germany. A standardised database from a German statutory accident insurance was used to analyse the cost-effectiveness ratio for the DAA regimen in comparison with interferon-based triple therapies. Taking account of the clinical progression of the disease, a Markov model was applied to perform a base case analysis for a period of 20 years. The robustness of the results was determined using a univariate deterministic sensitivity analysis. The results show that treatment with DAAs is more expensive, but also more effective than triple therapies. The model also revealed that the loss of 3.23 life years can be averted per patient over the 20 years. Compared to triple therapies, DAA treatment leads to a higher sustained virologic response (SVR). Although this results in a decrease of costs in the long term, e.g., pension payments, DAA therapy will cause greater expense in the future due to the high costs of the drugs. Full article
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Open AccessArticle
Culture of Blame—An Ongoing Burden for Doctors and Patient Safety
Int. J. Environ. Res. Public Health 2019, 16(23), 4826; https://doi.org/10.3390/ijerph16234826 - 01 Dec 2019
Abstract
Introduction: Every procedure in healthcare carries a certain degree of inherent unsafety resulting from problems in practice, which might lead to a healthcare adverse event (HAE). It is very important, and even mandatory, to report HAE. The point of HAE reporting is not [...] Read more.
Introduction: Every procedure in healthcare carries a certain degree of inherent unsafety resulting from problems in practice, which might lead to a healthcare adverse event (HAE). It is very important, and even mandatory, to report HAE. The point of HAE reporting is not to blame the person, but to learn from the HAE in order to prevent future HAEs. Study question: Our aim was to examine the prevalence and the impact of culture of blame on health workers’ health. Methods: A cross-sectional study on healthcare workers at two Croatian hospitals was conducted using the Hospital Survey on Patient Safety Culture (PSC). Results: The majority of PSC dimensions in both hospitals were high. Among the dimensions, Hospital Handoffs and Transitions and Overall Perceptions of Safety had the highest values. The Nonpunitive Response to Error dimension had low values, indicating the ongoing culture of blame. The Staffing dimension had low values, indicating the ongoing shortage of doctors and nurses. Discussion: We found inconsistencies between a single-item measure and PSC dimensions. It was expected that Frequency of Events Reported (PSC dimension) relates to Number of Events Reported (single-item measure). However, in our study, the relations between these pairs of measures were different between hospitals. Our results indicate the ongoing culture of blame. Healthcare workers do not report HAE because they fear they will be punished by management or by law. Full article
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Open AccessArticle
To Be or Not to Be Vaccinated? The Ethical Aspects of Influenza Vaccination among Healthcare Workers
Int. J. Environ. Res. Public Health 2019, 16(20), 3981; https://doi.org/10.3390/ijerph16203981 - 18 Oct 2019
Abstract
Influenza is a highly contagious airborne disease with a significant morbidity and mortality burden. Seasonal influenza (SI) vaccination has been recommended for healthcare workers (HCWs) for many years. Despite many efforts to encourage HCWs to be immunized against influenza, vaccination uptake remains suboptimal. [...] Read more.
Influenza is a highly contagious airborne disease with a significant morbidity and mortality burden. Seasonal influenza (SI) vaccination has been recommended for healthcare workers (HCWs) for many years. Despite many efforts to encourage HCWs to be immunized against influenza, vaccination uptake remains suboptimal. Sometimes there is a significant sign of improvement, only if numerous measures are taken. Is ‘the evidence’ and ‘rationale’ sufficient enough to support mandatory influenza vaccination policies? Most voluntary policies to increase vaccination rates among HCWs have not been very effective. How to close the gap between desired and current vaccination rates? Whether (semi)mandatory policies are justified is an ethical issue. By means of a MEDLINE search, we synthesized the most relevant publications to try to answer these questions. Neither the ‘clinical’ Hippocratic ethics (the Georgetown Mantra: autonomy, beneficence, non-maleficence, and justice), nor the ‘public health’ ethics frameworks resolve the question completely. Therefore, recently the ‘components of justice’ framework was added to the ethical debate. Most options to increase the uptake arouse little ethical controversy, except mandatory policies. The success of vaccination will largely depend upon the way the ethical challenges like professional duty and ethics (deontology), self-determination, vaccine hesitance, and refusal (‘conscientious objector’) are dealt with. Full article
Open AccessArticle
Quality of Life and Work Ability among Healthcare Personnel with Chronic Viral Hepatitis. Evaluation of the Inpatient Rehabilitation Program of the Wartenberg Clinic
Int. J. Environ. Res. Public Health 2019, 16(20), 3874; https://doi.org/10.3390/ijerph16203874 - 12 Oct 2019
Cited by 1
Abstract
The aim of this study was to research the impact of inpatient rehabilitation on work ability and health-related quality of life factors for healthcare personnel (HP) with chronic hepatitis B and C virus (HBV and HCV) infection. A prospective evaluation study with three [...] Read more.
The aim of this study was to research the impact of inpatient rehabilitation on work ability and health-related quality of life factors for healthcare personnel (HP) with chronic hepatitis B and C virus (HBV and HCV) infection. A prospective evaluation study with three data collection times without an external control group was conducted. HP (n = 163) with an occupational acquired chronic hepatitis B/C infection who participated in an inpatient rehabilitation program were surveyed. Information was collected on work ability (WAI—Work Ability Index), quality of life (SF-36—Short Form-36 Health Survey), and anxiety and depression-related symptoms (HADS-D—Hospital Anxiety and Depression Scale). The majority of participants had HCV infection. Work ability was poor, improved significantly until the end of treatment, and remained at a moderate level six months later. The SF-36 showed no change in physical health over the study period, the results regarding mental health were in the average range with a significant improvement directly after intervention. The HADS-D results indicate noteworthy anxiety and depression symptoms during the study period. The inpatient rehabilitation program proved to be effective in the short term regarding mental health (SF-36) and WAI. To ensure long lasting positive results, services aimed at enhancing physical and mental health should be provided as early as possible and on a recurring basis. Full article
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Open AccessArticle
Radiation Dose to the Eye Lens through Radiological Imaging Procedures at the Surgical Workplace during Trauma Surgery
Int. J. Environ. Res. Public Health 2019, 16(20), 3850; https://doi.org/10.3390/ijerph16203850 - 11 Oct 2019
Abstract
Background: Due to the drastic reduction of the eye lens dose limit from 150 mSv per year to 20 mSv per year since 2018, the prospective investigation of the estimated dose of the eye lens by radiological imaging procedures at the surgical [...] Read more.
Background: Due to the drastic reduction of the eye lens dose limit from 150 mSv per year to 20 mSv per year since 2018, the prospective investigation of the estimated dose of the eye lens by radiological imaging procedures at the surgical site during trauma surgery in the daily work process was carried out. This was also necessary because, as experience shows, with changes in surgical techniques, there are also changes in the use of radiological procedures, and thus an up-to-date inventory can provide valuable information for the assessment of occupationally induced radiation exposure of surgical personnel under the current conditions. Methods: The eye lens radiation exposure was measured over three months for five trauma surgeons, four hand surgeons and four surgical assistants with personalized LPS-TLD-TD 07 partial body dosimeters Hp (0.07). A reference dosimeter was deposited at the surgery changing room. The dosimeters were sent to the LPS (Landesanstalt für Personendosimetrie und Strahlenschutzausbildung) measuring institute (National Institute for Personal Dosimetry and Radiation Protection Training, Berlin) for evaluation after 3 months. The duration of the operation, occupation (assistant, surgeon, etc.), type of surgery (procedure, diagnosis), designation of the X-ray unit, total duration of radiation exposure per operation and dose area product per operation were recorded. Results: Both the evaluation of the dosimeters by the trauma surgeons and the evaluation of the dosimeters by the hand surgeons and the surgical assistants revealed no significant radiation exposure of the eye lens in comparison to the respective measured reference dosimeters. Conclusions: Despite the drastic reduction of the eye lens dose limit from 150 mSv per year to 20 mSv per year, the limit for orthopedic, trauma and hand surgery operations is well below the limit in this setting. Full article
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Open AccessArticle
MRSA Point Prevalence among Health Care Workers in German Rehabilitation Centers: A Multi-Center, Cross-Sectional Study in a Non-Outbreak Setting
Int. J. Environ. Res. Public Health 2019, 16(9), 1660; https://doi.org/10.3390/ijerph16091660 - 13 May 2019
Abstract
People working in health care services have an increased risk of being infected with methicillin-resistant Staphylococcus aureus (MRSA), though little is known about the prevalence in rehabilitation centers. This cross-sectional study investigated the MRSA prevalence in employees from different rehabilitation centers and aimed [...] Read more.
People working in health care services have an increased risk of being infected with methicillin-resistant Staphylococcus aureus (MRSA), though little is known about the prevalence in rehabilitation centers. This cross-sectional study investigated the MRSA prevalence in employees from different rehabilitation centers and aimed to identify risk factors for MRSA transmission. We invited all staff (i.e., with and without patient contact from 22 participating rehabilitation centers; n = 2499) to participate. Study participation included a questionnaire on personal characteristics, lifestyle, personal and occupational risk factors for MRSA and nasal swabs taken by the study team. In total, 1005 persons participated in the study (response: 40.2%). Only four participants carried MRSA (0.40 (95% CI 0.00–1.00) per 100). MRSA carriage did not seem to be occupationally related, as it was found in different occupations with and without direct contact with MRSA patients, as well as in different clinics with different indications and patient clientele. We could not find a clear association between MRSA carriage and potential risk factors due to the low number of cases found. Genotyping revealed the spa types t032 (Barnim epidemic strain) and t1223. Our results suggest a low point prevalence of nasal MRSA colonization in a non-outbreak setting in employees from rehabilitation centers. Full article

Review

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Open AccessReview
Occupational Infection Risk with Multidrug-Resistant Organisms in Health Personnel—A Systematic Review
Int. J. Environ. Res. Public Health 2019, 16(11), 1983; https://doi.org/10.3390/ijerph16111983 - 04 Jun 2019
Abstract
The increase in multi-drug-resistant organisms (MDROs) in the last years has become a public health problem. MDROs are partially responsible for numerous nosocomial infections, extended hospital stays, high costs, and high mortality. In addition to methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE), [...] Read more.
The increase in multi-drug-resistant organisms (MDROs) in the last years has become a public health problem. MDROs are partially responsible for numerous nosocomial infections, extended hospital stays, high costs, and high mortality. In addition to methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE), Gram-negative bacteria are also a key area of focus. The knowledge of MDROs among the medical staff in the occupational context is limited, with the exception of MRSA. Therefore, a systematic review was carried out to determine the occupational risk for employees posed by MDROs. The search included studies from the year 2000 onwards among personnel who had contact with MDROs. A total of 22 primarily cross-sectional studies in hospital or geriatric care settings were found, with large differences regarding number of participants, examination method, inclusion of a control group, and study quality. The most frequently examined pathogens were extended-spectrum ß-lactamase (ESBL)-producing bacteria with a prevalence of 2.6–48.5%, VRE (0–9.6%), and MRSA (0.9–14.5%). There are only few qualitatively good studies available on MDROs’ risk infection for employees in the health service. Any comparison of the results was limited by data heterogeneity. More research is required to describe the occupational risk of infection with MDROs. Full article
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