Tuberculosis among Health Workers—A Secondary Data Analysis of German Social Accident Insurance Data from 2002–2017

Tuberculosis (TB) is the most common cause of fatal infections worldwide. Recent TB figures in Europe indicate that 30 people were infected with tuberculosis each hour in 2017. Healthcare workers are at particular risk of being infected through patient contact. TB is the second most common occupational infectious disease among German healthcare workers. Routine data from the German Social Accident Insurance were used to examine trends in occupational TB diseases. We analyzed annual cross-sectional data for the years 2002 to 2017. The data underwent descriptive analysis. A total of 4653 TB cases were recognized as occupational diseases (OD) in the period under study. In 2002, 60 TB cases were recognized as OD No. 3101, i.e., transmissions from person to person. Since 2013, the level has settled at around 500 recognized cases per year. This is around eight times the number of cases compared to 2002. The following three groups collectively accounted for the largest share of TB cases (88.5%): nurses (including geriatric nurses), other healthcare employees, and physicians. The upward trend in the number of TB cases recognized as occupational diseases is probably due to improvements in diagnostic tests used to diagnose TB infections. TB in health and welfare workers remains an important issue in the health and welfare sector in Germany, partly due to the long latency period between potential exposure to infectious patients or materials and the recognition of the latent tuberculosis infection (LTBI) or active TB as OD.

W sprawie podlegania nieformalnych opiekunów osób niesamodzielnych ubezpieczeniu wypadkowemu

ON THE SOCIAL INSURANCE OF THE CAREGIVERS OF DEPENDENT PERSONSThe author considers whether the caregivers of dependent persons can obtain social accident insurance. In the first place, he defines who should be treated as a caregiver of a dependent person for the purposes of the study. In the following part, he considers the legal structure of paying a contribution towards the pension and disability pension insurance for the caregivers of dependent persons. Applying the language and system interpretation, he concludes that it is a legal construction that is different from the classic insurance entitlement. In the context of caregivers, it has significant legal consequences because it deprives them of the protection of accident insurance. The legal structure applied by the legislator means that they are not subject to this insurance even though care constitutes an increased risk of an accident. Finally, the author postulates that the health damages of caregivers caused by accidents occuring as part of the caring should be protected as part of the social compensation system.

TO THE ANALYSIS OF EXTRAORDINARY EXPERIENCE OF SOCIAL INSURANCE FROM ACCIDENTS OF PRODUCTION AND PROFESSIONAL DISEASE

The article analyzes the foreign experience of social accident insurance industrial accidents and occupational diseases in countries such as Bulgaria, Germany, France, the Netherlands, Spain and others. The author noted that the use of advanced foreign experience in the field of social insurance against industrial accidents and occupational disease is impossible without rethinking and abandoning the dominant today in Ukrainian society the state-paternalistic approach, according to which the full responsibility for the social security of the population rests with government agencies.

Hand-Arm-Vibrationseinwirkungen durch Einzelstöße im Freizeitbereich/Hand-arm vibration effects from individual impacts in the leisure sector

Hand-Arm-Vibrationseinwirkungen durch Einzelstöße sind ein Phänomen, das aus der Berufswelt bekannt und im Bereich der Hand-Arm-Vibrationen angesiedelt ist. Beispielsweise sind Arbeiten mit schlagenden Geräten wie Bolzensetzern und Druckluftnaglern mit stoßartigen Belastungen des Hand-Arm-Systems verbunden. Auch im Freizeitbereich lassen sich stoßartige Belastungen des Hand-Arm-Systems beobachten. Typische Freizeitaktivitäten, in denen stoßartige Belastungen auf das Hand-Arm-System erfolgen, sind z. B. Tennis, Golf oder Squash. Am Beispiel der Freizeitaktivität Golf untersuchte das Institut für Arbeitsschutz der Deutschen Gesetzlichen Unfallversicherung (IFA) die Hand-Arm-Vibrationseinwirkungen durch Einzelstöße im Freizeitbereich.   Single-impact hand-arm vibration is a phenomenon well known in the world of work and in the area of hand-arm vibration. For example, work with beating devices such as bolt makers and pneumatic nailers are associated with shock loads on the hand-arm system. Even in the leisure sector can be observed shock loads of the hand-arm system. Typical recreational activities in which shock loads on the hand-arm system take place, for. As tennis, golf or squash. Using the example of leisure activity Golf, the Institute for Occupational Safety of the German Social Accident Insurance (IFA) examined the hand-arm vibration effects caused by individual impacts in the leisure sector.

Arbeitsunfall 4.0

Digitisation and tertiarisation have made it difficult to categorise activities as private or work-related. The two notions that have traditionally been used to make that distinction – i.e. place of work and working time – are losing their importance. An increasing number of employees are subject to the phenomenon of blurred boundaries: They set their own hours, work from home or on-the-go. German Social Accident Insurance, however, determines the question of coverage on the allocation of the accident to either the work sphere or the private sphere of the aggrieved party. The book explores the extent to which it is necessary to modernise the way risks are allocated in order to not discriminate against those who have jobs outside of traditional parameters and discusses whether it is still adequate to base allocation mechanisms on the principles of the employers’ business risk and duties of care. By way of extensive dogmatic analysis and a comparison with other systems of risk allocation, the study proposes a modern take on allocating risks with just results for both employers and employees from all fields of work.

Workplace-related rehabilitation after foot fractures

Background: For injured workers facing increased physical requirements the VBG, a German Social Accident Insurance Institution, provides 2 types of outpatient medical treatment for the last phase of rehabilitation. One option is a functionally orientated extended physiotherapy including the opportunity for work-ability testing at the workplace with a gradual increase of workload and working time. Second option is a newly-developed multidisciplinary workplace-related rehabilitation integrating the specific work-relevant functional flows in therapy under the direction of a qualified physician and therapists in rehab facilities.Objective: To evaluate the effects of workplace-related rehabilitation after foot fractures in outpatient rehab facilities. Methods: Data of all completed cases with severe fractures of the calcaneus or the ankle joint, undergoing workplace-related therapy in 2013 (n = 27), were compared to consecutive data of 27 completed cases undergoing extended physiotherapy.Findings: Mean age in both groups was 48 years. In the extended physiotherapy group 14 patients additionally received a work-ability testing directly at the workplace. Mean duration from accident to capacity for work was 169.81 days (SD 60.4) for extended physiotherapy and 176.81 days (SD 49.3) for workplace-related rehabilitation. 23 patients with extended physiotherapy and 26 patients with workplace-related rehabilitation maintained work ability 3 months after achieving full capacity for work. Subsequent rehab measures after regaining capacity for work were needed in 6 cases in the extended physiotherapy group and in one case in the workplace-related rehabilitation group.Discussion: Though no statistically verifiable difference in duration of incapacity for work between both groups was found, the results provide apparently evidence that multidisciplinary workplace-related rehabilitation is more sustainable. It is suggested, that a systematic approach and individually tailored multidisciplinary training of the specific work-relevant movement patterns under constant medical and therapeutic direction lead to more stable rehabilitation results.Conclusion: Further research is needed to consolidate our empirical findings.