Search Results (28)

Workplace psychological safety (PS) has been recognized as crucial in mitigating organizational stressors and enhancing positive workplace outcomes, particularly in high-risk occupations such as healthcare and public safety. This scoping review aims to synthesize the existing literature on psychological safety in high-risk workplaces to identify key antecedents, workplace enhancements, and research gaps. A systematic search of studies published between 2010 and January 2025 was conducted across multiple databases, including CINAHL, Medline, ERIC, JSTOR, PsycInfo, Business Source Ultimate, and Sociological Abstract. Inclusion criteria focused on adult workers in high-risk workplace environments. Following screening and eligibility assessments, 16 studies from six countries were selected for analysis. Data were extracted and thematically analyzed based on leadership styles, organizational structures, and workplace culture related to psychological safety. The review identified three primary antecedents of psychological safety in high-risk workplaces: (1) inclusive and transformational leadership styles, (2) hierarchical structures and power dynamics, and (3) workplace climate and communication culture. Studies consistently found that inclusive leadership, ethical integrity, and transformational leadership were strongly associated with higher psychological safety levels. While hierarchical structures provided the necessary organization, overly rigid hierarchies often suppressed employee voice and innovation. A workplace culture characterized by trust, transparency, and open communication fosters greater psychological safety and improved teamwork and well-being. Full article

Occupational health and safety (OHS) is a critical component of sustainable work practices, guaranteeing employee well-being in parallel with minimizing business operation threats. The integration of ethics in OHS practices, however, poses a major obstacle, given that most businesses prefer complying with regulations rather than adopting proactive, ethically directed risk avoidance. This study employs a systemic process in assessing business ethics integration in practices of OHS, emphasizing leadership, employee engagement, and precautionary safety. This quantitative survey research sought to gauge the utilization of OHS practices among firms in the construction industry. This study examined critical factors such as employee training, absenteeism patterns, wellness programs, and usage of safety practices. Our study outcomes identify a reduction in accidents in workplaces, lower absenteeism, and improved monitoring of employee well-being when a blend of systemic safety programs and ethically directed strategies is utilized. This study emphasizes the imperative of a proactive, ethically comprehensive strategy in practices of OHS, which calls for improved leadership, constant safety learning, and enhanced wellness programs. The findings contribute to the development of sustainable risk management frameworks, offering practical insights for businesses, policymakers, and industry stakeholders to improve workplace safety culture. Full article

AI technologies are becoming increasingly prevalent in industrial workplaces, extending their applications beyond productivity to critical areas such as occupational safety. From our perspective, it is important to consider the safety of these AI systems for users already at the research and development stage, rather than only after deployment. Therefore, in this review, we synthesize publications that propose such AI-based safety systems to assess how potential risks are addressed early in their design and prototype stages. Consequently, we explore current advancements in AI-driven, sensor-based, and human-centered applications designed to enhance occupational safety by monitoring compliance, detecting hazards in real time, or assisting users. These systems leverage wearables and environmental sensing to proactively identify risks, support decision-making, and contribute to creating safer work environments. In this paper, we categorize the technologies according to the sensors used and highlight which features are preventive, reactive, or post-incident. Furthermore, we address potential risks posed by these AI applications, as they may introduce new hazards for workers. Through a critical review of current research and existing regulations, we identify gaps and propose key considerations for the safe and ethical deployment of trustworthy AI systems. Our findings suggest that in AI- and sensor-based research applications for occupational safety, some features and risks are considered notably less than others, from which we deduce that, while AI is being increasingly utilized to improve occupational safety, there is a significant need to address regulatory and ethical challenges for its widespread and safe adoption in industrial domains. Full article

A significant amount of fungicides consumed in European agriculture are used in viticulture, despite vineyards only occupying a very limited percentage of the cultivated area. Cultivation of disease-resistant hybrid grape cultivars can reduce vineyard treatments by half, with a significant decrease in climate-altering emissions, farmer costs, occupational injury risks, and excessive soil compression. The objective of this study is to investigate the motives and barriers that winegrowers in South Tyrol, Italy face when considering the conversion to fungus-resistant grape varieties (PIWI) farming. We conducted a qualitative study using in-depth interviews and participant observation with winegrowers to gain insight into their perspectives on the reasons for and challenges in adopting or practicing PIWI viticulture. The paper tests two hypotheses: the environmental commitment and concerns of producers with their personal values and environmental ethics in adopting PIWI varieties and relational and social influences, leading producers towards the consideration of social sustainability. The results present a picture aligned with the existing literature, emphasizing a stronger commitment to environmental sustainability while also considering economic and legislative constraints in the cultivation of a niche wine variety, which still has a limited market presence and distribution. Full article

Burnout is a factor that affects organizational performance. Researchers have not determined whether an ethical climate and adequate work autonomy provide sufficient emotional stability to dampen burnout or, conversely, increase it. In addition, the abundant literature analyzing the relationship between work autonomy and burnout does not sufficiently establish whether it acts as a stress-reducing resource or a stress-increasing demand. It is also unknown to what extent work autonomy contributes to explaining the relationship between ethical climate and burnout. Therefore, the main aim of this study is to examine the relationship between an ethical climate based on principles and norms and burnout using the moderating effect of work autonomy. We approached this question using a multivariate moderation analysis. The sample consists of 448 employees in the Colombian electric sector. The results show that an ethical climate of principles and work autonomy are positively related to burnout, measured by the dimensions of emotional exhaustion and depersonalization. However, the relationship between an ethical climate of principles and burnout shifts from positive to negative when a rule-demanding work environment is associated with a high perception of work autonomy. In conclusion, when employees have considerable control over their usual tasks, they develop a pattern of behavior that incorporates both the organization’s internal standards and the principles that shape individual morality. In this case, employees are able to balance the workload with the high psychological demands of an ethical climate of principles, without it being a disturbance to their emotional well-being. The results of this research are particularly relevant because they show for the first time that an ethical climate of principles can have opposite effects on employee burnout, both positive and negative, depending on the degree of work autonomy. This opens the door to new strategies for organizations to prevent certain psychosocial occupational risks, such as burnout, which often have a serious impact on employees’ mental health. Moreover, the model of moderation proposed in this article can be replicated in other Latin American countries with similar characteristics to those of Colombia or even transferred to rich countries. Full article

(1) Background: Exposure to blood carries the risk of transmission of many infectious diseases. Healthcare workers (HCWs), including hospital-based medical students, face high and often under-reported rates of exposure to needlestick and sharps injuries. Previous studies have shown that students’ knowledge of infection control varies, highlighting the importance of pre-placement training. This study aims to assess knowledge, attitudes and practices regarding these risks in a population of medical students from Albania. (2) Methods: A validated questionnaire was administered to 134 medical students in an Italian hospital in May 2023. It assessed HBV vaccination status, adherence to infection control practices, knowledge of pathogen transmission, exposure incidents and attitudes towards infected patients. Three additional questions addressed air-borne transmission of tuberculosis and vaccination recommendations for healthcare workers. (3) Results: Most students (64%) reported being aware of occupational exposure risks. While 93% and 87%, respectively, recognised HIV and HBV as blood-borne pathogens, fewer recognised Treponema pallidum (44%). Awareness of post-exposure prophylaxis for HIV was high (85%), but although 75% reported having received training, only 45% felt it was adequate. Statistical analysis revealed an association between knowledge of infection control, awareness of pathogen transmission and understanding of the importance of vaccination. (4) Conclusions: Our study highlights gaps in medical students’ knowledge of occupational infections and highlights the need for improved pre-clerkship education. Improved education could reduce anxiety, ethical issues and misconceptions and promote safer healthcare practices. Full article

Dermatologic care within the military faces unique ethical challenges. Service members are stationed across nationally and globally diverse settings, and therefore, dermatologic care rendered ranges from within resource-rich, advanced military medical treatment facilities to austere, resource-limited, deployed field environments. Additionally, military service members are often at unique risk for dermatologic disease, given occupational, environmental, and geographic exposures not commonly faced by their civilian counterparts. This review explores topics in dermatoethics via case analyses of ethical considerations within the scope of dermatologic care for military service members. Full article

The construction industry has been slow to implement safe working conditions, even though it could reduce the risks and dangers that the industry’s operations pose to human health and safety. More research and development in this area is clearly needed to increase the acceptance of safety in the execution of engineering projects, as previous study has demonstrated. Therefore, this study will analyse safe working conditions in construction-related professions in order to determine the focal area of previous studies. However, there has not been much effort put into mapping international studies on safe working environments in the construction industry. This research evaluates safety for the construction industry in order to discover new research trends. This indicates the ongoing challenges in the sector. For this study, comprehensive bibliometric methodology was applied, and data were extracted from the Scopus database. Using keywords like “safe”, “working condition”, “construction industry” or “built environment”, “health and safety”, and “technology”, publications from the database were extracted. Based on the collected bibliographic information, a co-authorship and co-occurrence map was created using VOSviewer. Research on occupational health and safety in the building industry, safety management and risk factors in the construction industry, ethical considerations in human experimentation, and safety and work environment revealed an emerging trend in safe working conditions in the construction industry. Full article

Background: The SOUND study demonstrated that an axillary de-escalation may be sufficient in locoregional and distant disease control in selected early breast cancer (EBC) patients. To establish any preoperative variables that may drive sentinel lymph node biopsy (SLNB) omission, a study named sentinel omission risk factor (SOFT) 1.23 was planned. Methods: A single-center retrospective study from a prospectively maintained database was designed, aiming at underlying preoperative prognostic factors involved in sentinel lymph node (SLN) metastasis (lymph node involvement (LN+) vs. negative lymph node (LN−) group). Secondary outcomes included surgical room occupancy analysis for SLNB in patients fulfilling the SOUND study inclusion criteria. The institutional ethical committee Area Territoriale Lazio 2 approved the study (n° 122/23). Results: Between 1 January 2022 and 30 June 2023, 160 patients were included in the study and 26 (%) were included in the LN+ group. Multifocality, higher cT stage, and larger tumor diameter were reported in the LN+ group (p = 0.020, p = 0.014, and 0.016, respectively). Tumor biology, including estrogen and progesterone receptors, and molecular subtypes showed association with the LN+ group (p < 0.001; p = 0.001; and p = 0.001, respectively). A total of 117 (73.6%) patients were eligible for the SOUND study and the potential operating room time saved was 2696.81 min. Conclusions: De-escalating strategies may rationalize healthcare activities. Multifactorial risk stratification may further refine the selection of patients who could benefit from SLNB omission. Full article

This study was carried out in the district of Taquaral de Minas, in the municipality of Itinga, located in Jequitinhonha Valley, state of Minas Gerais, which is considered one of the largest yolk-producing regions in Brazil. Miners in gem extraction areas are prone to severe oxidative damage due to their increased exposure to toxic metals, as well as chemical, physical, and biological agents, resulting in diseases such as silicosis. Thus, this work aimed to evaluate occupational exposure in prospectors through biomonitoring techniques using a variety of biomarkers for oxidative stress, genotoxicity, and mutagenicity. Twenty-two miners and seventeen workers who were not occupationally exposed were recruited, totaling thirty-nine participants. The study was approved by the Research Ethics Committee of the Federal University of the Jequitinhonha and Mucuri Valleys. In this study, the levels of total peroxides, catalase activity, and microelements in plasma were evaluated. Additionally, environmental analysis was carried out through the Ames and Allium cepa tests. The results of the lipoperoxidation assessment were significant, with increased frequencies in exposed individuals compared to controls (p < 0.05), as determined by the Mann–Whitney test. Micronutrients in the blood showed lower concentrations in the group exposed to Fe and Se than in individuals not exposed to these elements. The results of the Ames test and Allium cepa test were statistically significant compared to the controls (p < 0.05), as determined by the Mann–Whitney test for genotoxicity and cytotoxicity. Thus, the results of the present study indicate possible environmental contamination and a potential risk to the health of miners, which suggests that further studies are important in the region. Full article

Airborne pollutants pose a significant threat in the occupational workplace resulting in adverse health effects. Within the Industry 4.0 environment, new systems and technologies have been investigated for risk management and as health and safety smart tools. The use of predictive algorithms via artificial intelligence (AI) and machine learning (ML) tools, real-time data exchange via the Internet of Things (IoT), cloud computing, and digital twin (DT) simulation provide innovative solutions for accident prevention and risk mitigation. Additionally, the use of smart sensors, wearable devices and virtual (VR) and augmented reality (AR) platforms can support the training of employees in safety practices and signal the alarming concentrations of airborne hazards, providing support in designing safety strategies and hazard control options. Current reviews outline the drawbacks and challenges of these technologies, including the elevated stress levels of employees, cyber-security, data handling, and privacy concerns, while highlighting limitations. Future research should focus on the ethics, policies, and regulatory aspects of these technologies. This perspective puts together the advances and challenges of Industry 4.0 innovations in terms of occupational safety and exposure assessment, aiding in understanding the full potential of these technologies and supporting their application in industrial manufacturing environments. Full article

Background: Defensive medicine is characterized by medical decisions made primarily as a precaution against potential malpractice claims. For psychiatrists, professional responsibility encompasses not only the appropriateness of diagnosis and treatment but also the effects of their interventions on patients and their behaviors. Objective: To investigate the socio-demographic, educational, and occupational characteristics and work-related attitudes that may serve as predictors of defensive medicine among Italian psychiatrists. This research extends the results of a previous analysis based on a national survey. Methods: A secondary analysis of the database of a national survey on attitudes and behaviors of Italian psychiatrists regarding defensive medicine and professional liability was performed for this study. Results: Among 254 surveyed psychiatrists, 153 admitted to practicing defensive medicine, while 101 had this attitude with less than half of their patients. The first group was predominantly comprised of women (p = 0.014), who were younger in age (43.34 y 9.89 vs. 48.81 y 11.66, p < 0.001) and had fewer years of professional experience (12.09 y ± 9.8 vs. 17.46 y ± 11.2, p < 0.001). There were no significant differences in prior involvement in complaints (p = 0.876) or the usual place of work (p = 0.818). The most prominent predictors for practicing defensive medicine were (1) considering guidelines and good clinical practices not only for their clinical efficacy but also or exclusively for reducing the risk of legal complaints for professional liability (OR = 3.62; 95%CI, 1.75–7.49), and (2) hospitalizing patients with violent intentions even if not warranted according to their mental state (OR = 2.28; 95%CI, 1.50–3.46, p < 0.001). Prioritizing protection from professional liability over patients’ actual needs in prescribing or adjusting drug dosages and in involuntary hospitalization, as well as prescribing lower dosages than recommended for pregnant patients, were identified as additional predictors. Finally, years of professional experience exhibited a protective function against defensive practices. Conclusions: Psychiatrists advocate the need to implement a ‘risk management culture’ and the provision of more balanced duties in order to ensure ethical and evidence-based care to their patients. A particular source of concern stems from their professional responsibility towards not only the health of patients but also their behavior. However, these aspects conflict with a limited potential for assessment and intervention based on effective clinical tools. A reform of professional liability that considers the specificities of patients cared for by mental health services could contribute to reducing the risk of defensive medicine. Full article

Pregnant women presumably gather information about the coronavirus disease 2019 (COVID-19) from various sources. However, it is difficult for pregnant women who are not medical professionals to source the appropriate information because of the infodemic related to the COVID-19 pandemic. Therefore, the objective of our study was to investigate how pregnant women gathered information about COVID-19 and COVID-19 vaccination. To address this issue, we conducted an online questionnaire survey between 5 October and 22 November 2021, which was approved by the Ethics Committee of Nihon University School of Medicine. We received 4962 responses after excluding 1179 insufficient answers. Our study found that age, occupation, and infection-risk anxiety influenced the selection of media for obtaining information. Pregnant women who were older, medical professionals, public servants, or educators tended to rely on specialized medical websites, whereas housewives tended to use mass media, social media, and sources with uncertain scientific evidence. Additionally, the number of weeks of gestation and the method of conception (natural or assisted reproductive conception) affected the selection of media. The accessibility of COVID-19 information for pregnant women was determined by their social background and pregnancy status. We need to continue making efforts to ensure that appropriate information is readily available to pregnant women and their families. Full article

A complexity of factors, from health and technology innovations to policy redesign to achieve consumer-directed care, are impacting traditional roles for Australian allied health practitioners (AHPs). This pilot study considers roles for AHPs in relation to assistive technology (AT) interventions. Articulating ‘who does what’ may serve a number of purposes including de-professionalization of the discourse; better utilization of support networks and workforces; and alignment with contemporary policy. Yet, a suitable framework to assist with collaborative AT implementation between relevant stakeholders was not identified within the existing literature. This research aimed to develop and pilot an AT collaboration tool which enables AHPs, consumers, their support networks and the support workforce, to navigate policy redesign toward ethical consumer-directed implementation of AT interventions. An AT collaboration tool was developed based upon practice-based knowledge, relevant regulatory and practice evidence and identifies relevant stakeholders, AT service steps and roles, and quality indicators to support competent practice. The tool was piloted in four separate and diverse practice analyses of AT interventions (custom prosthetics, home enteral nutrition, communication devices, and vehicle modifications) considering four allied health professions (prosthetics and orthotics, dietetics, speech pathology, occupational therapy). Pilot testing of the tool supports the feasibility of re-framing AT provision using competency-based and risk-informed approaches and enabling more inclusive roles for consumers and the support workforce. Further testing of the tool is indicated, followed by strategic actions for uptake by individuals, professions and policymakers. The AT collaboration tool has potential to enable AHPs to fulfil ethical obligations for consumer-centered practice, and to facilitate consumer choice, both in Australia and internationally. Full article

Globally, employee burnout (EBO) is a black swan in healthcare management. Previous organizational management literature shows that EBO was often misunderstood by assuming it as a personal issue. However, the new definition by the World Health Organization (WHO) clearly indicates that EBO is an occupational phenomenon that places responsibility on organizations to manage it. Although recent evidence suggests ethical leadership (ELP) style may be important to mitigate EBO, shockingly, such relationships were not tested in healthcare systems, especially in low- and middle-income countries. Filling this knowledge gap in the existing body of knowledge, this study aimed to investigate the ELP–EBO relationship. To explain the underlying mechanism of how ELP reduces EBO, this study included two psychological factors as a mediator and a moderator: altruism (AL) and intrinsic motivation (IM). The data were obtained from hospital employees via a self-administered questionnaire (n = 289, paper-pencil method). A hypothetical framework was designed and tested for empirical validation through structural equation modeling (SEM). Empirical evidence confirmed that ELP reduces the risk of burnout among hospital employees, and AL mediates this relationship. The results also confirmed the conditional indirect role of IM in the above proposed mediated relationship. This study’s outcomes can help hospital administration deal with EBO’s epidemic in an ELP framework. Other, different implications have also been discussed in detail. Full article