scholarly journals Occupational risks of COVID-19 in NHS workers in England

2021 ◽  
Author(s):  
DA van der Plaat ◽  
I Madan ◽  
D Coggon ◽  
M van Tongeren ◽  
R Edge ◽  
...  
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Risk Reduction ◽  
Sickness Absence ◽  
Health Professionals ◽  
Healthcare Workers ◽  
Clinical Services ◽  
Occupational Risks ◽  
Reduction Strategies ◽  
Risk Reduction Strategies

AbstractObjectiveTo quantify occupational risks of Covid-19 among healthcare staff during the first wave of the pandemic in EnglandMethodsUsing pseudonymised data on 902,813 individuals continuously employed by 191 National Health Service trusts during 1.1.19 to 31.7.20, we explored demographic and occupational risk factors for sickness absence ascribed to Covid-19 during 9.3.20 to 31.7.20 (n = 92,880). We estimated odds ratios (ORs) by multivariate logistic regression.ResultsWith adjustment for employing trust, demographic characteristics, and previous frequency of sickness absence, risk relative to administrative/clerical occupations was highest in additional clinical services (a group that included care assistants) (OR 2.31), registered nursing and midwifery professionals (OR 2.28) and allied health professionals (OR 1.94), and intermediate in doctors and dentists (OR 1.55). Differences in risk were higher after the employing trust had started to care for documented Covid-19 patients, and were reduced, but not eliminated, following additional adjustment for exposure to infected patients or materials, assessed by a job-exposure matrix. For prolonged Covid-19 sickness absence (episodes lasting >14 days), the variation in risk by staff group was somewhat greater.ConclusionsAfter allowance for possible bias and confounding by non-occupational exposures, we estimated that relative risks for Covid-19 among most patient-facing occupations were between 1.5 and 2.5. The highest risks were in those working in additional clinical services, nursing and midwifery and in allied health professions. Better protective measures for these staff groups should be a priority. Covid-19 may meet criteria for compensation as an occupational disease in some healthcare occupations.Key messagesWhat is already known about this subject?Healthcare workers and other keyworkers (workers whose job was considered essential to societal functioning) had a higher likelihood of testing positive for COVID-19 than other workers during the first lockdown in England. Amongst healthcare workers, those working in inpatient settings had the highest rate of infection.What are the new findings?Between March and July 2000, the overall risk of COVID-19 sickness absence in National Health Service staff in England was lower at older ages, higher in non-white staff, and (in comparison with administrative and clerical staff) more than doubled in registered nurses and among workers such as healthcare assistants providing support to health professionals. Risk in health care scientists was little different from that in administrative and clerical occupationsHow might this impact on policy or clinical practice in the foreseeable future?Our results suggest that the risk reduction strategies that were in place for healthcare scientists were effective. However, the protection for nursing and supporting health professionals was insufficient. In the event of a further ‘wave’ of infections resulting in high hospital admissions, attention should be paid to ensuring that risk reduction strategies for nurses and supporting health professionals are improved.

Global disasters and risk reduction strategies

2016 ◽  
Author(s):  
Virginia Murray ◽  
Amina Aitsi-Selmi ◽  
Alex G. Stewart
Keyword(s):  
Health Service ◽  
Risk Reduction ◽  
Disaster Risk Reduction ◽  
Disaster Risk ◽  
International Perspective ◽  
Population Increase ◽  
Health Issues ◽  
Congenital Rubella ◽  
Reduction Strategies ◽  
Risk Reduction Strategies

As the global population increase, the effects of disasters also increase. However, through improved building codes and other disaster risk reduction interventions, the number of deaths appears to be reducing. International frameworks for reduction and response are being built and an audit of the NHS demonstrated the advantages of an integrated health service. Fact sheets, produced internationally with UK involvement, on several aspects of disaster risk reduction have started to increase awareness of the wide variety of needs, although mental health issues need further research. Not all global disasters with far-reaching consequences are catastrophic in nature. The circumstances of congenital rubella and iodine deficiency show the strengths of international collaboration and the need for high-quality science. This chapter explains disaster risk reduction and sets it in its international perspective, with examples of wide-ranging agreements and frameworks, and their application to the wider UK health service.

scholarly journals Changing patterns of sickness absence among healthcare workers in England during the COVID-19 pandemic

2021 ◽  
Author(s):  
Rhiannon Edge ◽  
Diana A van der Plaat ◽  
Vaughan Parsons ◽  
David Coggon ◽  
Martie van Tongeren ◽  
...  
Keyword(s):  
Mental Illness ◽  
National Health Service ◽  
Health Service ◽  
Sickness Absence ◽  
National Health ◽  
Healthcare Workers ◽  
Disease Occurrence ◽  
Changing Patterns ◽  
Delays In Diagnosis ◽  
Working Populations

Abstract Background Patterns of sickness absence shed useful light on disease occurrence and illness-related behaviours in working populations. Methods We analysed prospectively collected, pseudonymized data on 959 356 employees who were continuously employed by National Health Service trusts in England from 1 January 2019 to 31 July 2020, comparing the frequency of new sickness absence in 2020 with that at corresponding times in 2019. Results After exclusion of episodes directly related to COVID-19, the overall incidence of sickness absence during the initial 10 weeks of the pandemic (March–May 2020) was more than 20% lower than in corresponding weeks of 2019. Trends for specific categories of illness varied substantially, with a fall by 24% for cancer, but an increase for mental illness. A doubling of new absences for pregnancy-related disorders during May–July of 2020 was limited to women with earlier COVID-19 sickness absence. Conclusions Various factors will have contributed to the large and divergent changes that were observed. The findings reinforce concerns regarding delays in diagnosis and treatment of cancers and support a need to plan for a large backlog of treatment for many other diseases. Further research should explore the rise in absence for pregnancy-related disorders among women with earlier COVID-19 sickness absence.

scholarly journals Young Aboriginal people's sexual health risk reduction strategies: a qualitative study in remote Australia

Sexual Health ◽  
2020 ◽  
Vol 17 (4) ◽  
pp. 303
Author(s):  
Stephen Bell ◽  
James Ward ◽  
Peter Aggleton ◽  
Walbira Murray ◽  
Bronwyn Silver ◽  
...  
Keyword(s):  
Young People ◽  
Health Service ◽  
Sexual Health ◽  
Health Risk ◽  
Risk Reduction ◽  
Condom Distribution ◽  
Sti Testing ◽  
Reduction Strategies ◽  
Health Risk Reduction ◽  
Risk Reduction Strategies

Background Surveillance data indicate that Aboriginal and Torres Strait Islander young people are more likely than their non-Indigenous counterparts to experience sexually transmissible infections (STIs) and teenage pregnancy. Despite increasing emphasis on the need for strengths-based approaches to Aboriginal sexual health, limited published data document how young Aboriginal people reduce sexual health risks encountered in their everyday lives. Methods: In-depth interviews with 35 young Aboriginal women and men aged 16–21 years in two remote Australian settings were conducted; inductive thematic analysis examining sexual health risk reduction practices was also conducted. Results: Participants reported individual and collective STI and pregnancy risk reduction strategies. Individual practices included accessing and carrying condoms; having a regular casual sexual partner; being in a long-term trusting relationship; using long-acting reversible contraception; having fewer sexual partners; abstaining from sex; accessing STI testing. More collective strategies included: refusing sex without a condom; accompanied health clinic visits with a trusted individual; encouraging friends to use condoms and go for STI testing; providing friends with condoms. Conclusion: Findings broaden understanding of young Aboriginal people’s sexual health risk reduction strategies in remote Aboriginal communities. Findings signal the need for multisectoral STI prevention and sexual health programs driven by young people’s existing harm minimisation strategies and cultural models of collective support. Specific strategies to enhance young people’s sexual health include: peer condom distribution; accompanied health service visits; peer-led health promotion; continued community-based condom distribution; enhanced access to a fuller range of available contraception in primary care settings; engaging health service-experienced young people as ‘youth health workers’.

scholarly journals Hazards of Risk: Identifying Plausible Community Wildfire Disasters in Low-Frequency Fire Regimes

Forests ◽  
2021 ◽  
Vol 12 (7) ◽  
pp. 934
Author(s):  
Andy McEvoy ◽  
Becky K. Kerns ◽  
John B. Kim
Keyword(s):  
Risk Reduction ◽  
Low Frequency ◽  
Fire Regimes ◽  
Cascade Range ◽  
Private Land ◽  
Wildfire Risk ◽  
Location Data ◽  
Reduction Strategies ◽  
Community Exposure ◽  
Risk Reduction Strategies

Optimized wildfire risk reduction strategies are generally not resilient in the event of unanticipated, or very rare events, presenting a hazard in risk assessments which otherwise rely on actuarial, mean-based statistics to characterize risk. This hazard of actuarial approaches to wildfire risk is perhaps particularly evident for infrequent fire regimes such as those in the temperate forests west of the Cascade Range crest in Oregon and Washington, USA (“Westside”), where fire return intervals often exceed 200 years but where fires can be extremely intense and devastating. In this study, we used wildfire simulations and building location data to evaluate community wildfire exposure and identify plausible disasters that are not based on typical mean-based statistical approaches. We compared the location and magnitude of simulated disasters to historical disasters (1984–2020) in order to characterize plausible surprises which could inform future wildfire risk reduction planning. Results indicate that nearly half of communities are vulnerable to a future disaster, that the magnitude of plausible disasters exceeds any recent historical events, and that ignitions on private land are most likely to result in very high community exposure. Our methods, in combination with more typical actuarial characterizations, provide a way to support investment in and communication with communities exposed to low-probability, high-consequence wildfires.

Prevention of Breast Cancer (Part II): Risk Reduction Strategies

2010 ◽  
Vol 28 (10) ◽  
pp. 1070-1077 ◽  
Author(s):  
Maria Tria Tirona ◽  
Rajesh Sehgal ◽  
Oscar Ballester
Keyword(s):  
Breast Cancer ◽  
Risk Reduction ◽  
Reduction Strategies ◽  
Risk Reduction Strategies ◽  
Prevention Of Breast Cancer

Impact of the New York State Prescription Drug Monitoring Program (IStop) on chronic pain management by primary care providers

2021 ◽  
Vol 17 (1) ◽  
pp. 39-54
Author(s):  
Josiah D. Strawser, MD ◽  
Lauren Block, MD, MPH
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Pain Management ◽  
Risk Reduction ◽  
New York State ◽  
Monitoring Program ◽  
Primary Care Providers ◽  
Care Providers ◽  
Reduction Strategies ◽  
Risk Reduction Strategies

Objective: To explore the impact of the New York State Prescription Drug Monitoring Program (IStop) on the self-reported management of patients with chronic pain by primary care providers.Design: Mixed-methods study with survey collection and semistructured interviews.Setting: Multiple academic hospitals in New York.Participants: One hundred and thirty-six primary care providers (residents, fellows, attendings, and nurse practitioners) for survey collection, and eight primary care clinicians (residents, attending, and pharmacist) for interviews. Interventions: Introduction of IStop.Main outcome measure(s): Change in usage of four risk reduction strategies (pain contracts, urine tests, monthly visits, and co-management) as reported by primary care providers for patients with chronic pain.Results: After the introduction of IStop, 25 percent (32/128) of providers increased usage of monthly visits, 28 percent (36/128) of providers increased usage of pain management co-management with other healthcare providers, and 46 percent (60/129) of providers increased usage of at least one of four risk reduction strategies. Residents indicated much higher rates of change in risk reduction strategies due to IStop usage; increasing in the use of monthly visits (32 vs. 13 percent, p = 0.02) and co-management (36 vs. 13 percent, p = 0.01) occurred at a much higher rate in residents than attending physicians. Interview themes revealed an emphasis on finding opioid alternatives when possible, the need for frequent patient visits in effective pain management, and the importance of communication between the patient and provider to protect the relationship in chronic pain management.Conclusions: After the introduction of IStop, primary care providers have increased usage of risk reduction strategies in the care of chronic pain patients.

scholarly journals Evaluation of flood risk reduction strategies through combinations of interventions

2018 ◽  
Vol 12 (S2) ◽  
Author(s):  
Erik C. Berchum ◽  
William Mobley ◽  
Sebastiaan N. Jonkman ◽  
Jos S. Timmermans ◽  
Jan H. Kwakkel ◽  
...  
Keyword(s):  
Risk Reduction ◽  
Flood Risk ◽  
Reduction Strategies ◽  
Flood Risk Reduction ◽  
Risk Reduction Strategies
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