Diagnosing occupational COVID-19 in Croatian healthcare workers

Coronavirus disease 2019 (COVID-19) can be diagnosed as occupational disease by an occupational health physician (OHP), if supported by relevant work-related and medical documentation. The aim of this study was to analyse such documentation submitted by Croatian healthcare workers (HCWs) and discuss its relevance in view of European and Croatian guidelines. The study included 100 Croatian HCWs who were SARS-CoV-2-positive and requested that their infection be diagnosed as occupational disease by their OHPs from 1 May 2020 to 10 March 2021. As participants they were asked to fill out our online Occupational COVID-19 in Healthcare Workers Questionnaire. For the purpose of this study we analysed answers about the type of close contact at the workplace, COVID-19 symptoms, and enclosed work-related (job description, employer statement about exposure to SARS-CoV-2) and medical documentation (positive SARS-CoV-2 polymerase chain reaction test and patient history confirming the diagnosis of COVID-19). Most participants were working in hospitals (N=95), mostly nurses (N=75), who became infected by a patient (N=68) or colleague (N=31), and had at least one COVID-19 symptom (N=87). Eighty participants did not enclose obligatory documents, 41 of whom failed to submit job description and 31 both job description and employer statement. These findings confirm that the major risk of occupational COVID-19 in HCWs is close contact with patients and colleagues, and points out the need for better cooperation between OHPs, occupational safety experts, employers, and diseased workers.

EDITORIAL INTRODUCTION

If you are an employee or employer, occupational health physician, or a physician concerned with the work–life balance of your patient, this fourth issue on work–life balance and burnout is for you. It culminates in practical guidance captured in the Tokyo Declaration on Work–Life balance together with five articles that clarifies the golden reach of person-centered medicine (PCM) in occupational health of both a clinician and a patient. How this golden reach extends much further than patient-centered medicine is captured in the first article. An employed person, whether patient or practitioner, works within an interpersonal context in which all role players including the employer should actively contribute in nurturing an employee’s well-being and work–life balance. The second article engages with the reach of PCM in reporting on the personality features needed to cope with (or avert) unemployment as is evident in a comparison between 245 long-term unemployed individuals and a control group of 1,948. The third article articulates how the golden reach of PCM is informed by the empirical relationship between work engagement and burnout. The fourth article considers the work–life balance among Japan’s physicians in the context of ongoing work style reform. The fifth article underscores that a person-centered work environment is crucial in addressing the challenges of burnout among physicians and medical students.

Processionary caterpillar reactions in Southern Italy forestry workers: description of three cases

Background Processionary caterpillar (PC), also named Thaumatopea pityocampa, has been reported to cause hypersensitivity reactions after contact with a toxin contained in hair-like bristles which cover this insect. Occupational exposure to PC is underestimated in outdoor workers and especially in forestry workers (FW) and is globally diffusing because of rising temperatures. Cases presentation We present the first three cases of FW from Sicily, a Southern Italy (SI) region, which reported hypersensitivity reactions due to exposure to PC infested trees. These cases were identified by the occupational health physician during the annual screening of FW working in the Mountains of north-eastern Sicily. Interviewing a population of 630 FW, 1 male and 2 females reported direct contact skin reactions together with airborne contact reactions to PC hairs causing mild respiratory symptoms in two cases and ocular symptoms in one case, which needed treatment with systemic corticosteroids and antihistamines. Conclusions This is the first report of hypersensitivity reactions in SI FW due to occupational exposure to PC. Further screenings not only in FW but also in other populations of outdoor workers are needed in order to assess the real incidence of contact and airborne reactions due to occupational exposure to PC. Though so far no correlation has been found with atopy, it seems apparent that the reactions occur in susceptible subjects; further research is needed for a correct diagnosis and to identify possible desensitization procedures.

Screening of Work-Related Musculoskeletal Upper Limb Disorders Using the SALTSA Protocol: A Work-Site Study in Belgium

Background: Long-term absenteeism continues to rise in Belgium and musculoskeletal disorders (MSDs) have been considered a primary cause. However, there is still uncertainty about the prevalence of MSDs, and about the contribution of work-related factors in the etiology of MSDs. SALTSA, which was developed in 2001, is a European diagnostic criterion document that aims to standardize the reporting of work-related upper limb MSDs (ULMSDs). The purpose of this work-site study was to implement SALTSA in daily occupational health practice and to determine the prevalence of ULMSDs in a Belgian company. Methods: During health examinations, occupational health nurses and an occupational health physician screened employees in a company with ergonomically high-risk activities for the occurrence of ULMSDs using the SALTSA protocol. In order to explore associations between ULMSDs and lifestyle and work-related factors, bivariate and logistic regression analyses were performed. Findings: Three hundred and eight (94.0%, 308/328) employees were screened resulting in an ULMSD prevalence of 20.5% (95% CI = [16.0–25.3]). Rotator cuff syndrome was the most common condition. Prevalence varied significantly between men (9.6%, 95% CI = [5.6–14.9]) and women (35.0%, 95% CI = [26.9–43.9]). Being female ( p < .001) and working in the cabling assembly unit ( p = .002) were found to be significant predictors of ULMSDs. Conclusion/Application to Practice: By using the SALTSA protocol in occupational health practices, ULMSDs can be screened unequivocally, enabling comparisons between different occupational sectors and countries. Occupational health nurses can play an important role in detecting and screening MSDs among workers.

Stroke and drivers' job fitness

Introduction: Stroke is considered a relatively common disease in developing societies. This disease is one of the most important causes of sudden non-cardiac incapacity. On the other hand, the disease can naturally occur in working-age and drivers. Therefore evaluation of the fitness for work in a driver with a history of stroke can be a significant challenge for the occupational health physician and road safety. Materials and Methods: In this study, to identify the main indicators and evaluate job fitness in a driver with stroke history, research has been conducted in valid databases such as Embase, UpToDate, PubMed, Medline (Ovid), Scopus, and web of science. Indicators that should be considered in this evaluation include the type and severity of the stroke, the probability of recurrence of the stroke attack, the degree and type of limb defect in the driver following the stroke, etc. Also in this study has been paid to some guidelines for help in deciding how to continue driving. Results: Stroke is the most common acute neurological disease among working-age adults. About a quarter of strokes occur at working age. Cerebrovascular disease can lead to sudden disability. Approximately 50% of people with stroke in developed countries want to continue driving. Conclusion: Things such as the probability of occurrence of stroke and sudden incapacity in the future and comparing this amount with acceptable risk and the amount of limb defect caused by stroke and its interference with driving should be considered. Also, consumption medications and their side effects and other comorbidities should be considered in this job fitness evaluation.