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The article focuses on examining how the financialization and marketization of healthcare infrastructures, specifically through the case of Slotervaart Hospital in Amsterdam, Netherlands, contributed to its bankruptcy and left it unprepared for a pandemic. Topics discussed include the intersection of Social Reproduction Theory and financialization, the impact of financialization on healthcare provision, and the shift towards market efficiency in healthcare management.

• Safety is a competency, rooted in interactions and embedded in everyday practices. • Standardized and non-contextualized OHS-management tend to lead to unsafe practices. • Developing a safety culture at work requires a responsive leadership style. Introduction: Organizations place strong emphasis on the standardized occupational health and safety procedures to reduce work-related illnesses and workplace accidents. However, standardized procedures are not always followed up in daily work practices. Organizations must cope with the differences between standardized procedures and local adaptation by employees. Methods: This ethnographic field study at an industrial workplace in the Netherlands provides insights into employees' everyday work practices, how these work practices are shaped, and how they relate to local occupational health and safety procedures. Acknowledging safety as a competency embedded in work practices, as introduced by Gherardi and Nicolini (2002), offers a theoretical point of view for looking beyond the dichotomy of standardization and local adaptations. Results: The results show that a standardized and noncontextualized occupational health and safety management system that focuses on accident-free days and compliance actually leads to ignorance of practical and tacit competences of workers and no learning and improvement of safety procedures can take place. However, our findings also illustrate how employees in their informal everyday work practices reduce the risks produced by the safety system itself. Conclusion: Overall, the results indicate that social interactions among employees, leaders, and management within the organization play an important role in workplace safety. The analysis highlights the value of vulnerability and trust in relationships at work to be able to learn and develop safety procedures that align with local demands. Practical applications: This study emphasizes the need for participatory approaches in creating safer and healthier workplaces. The cocreation of occupational health and safety (OHS) rules and procedures, however, can only function if they are combined with a responsive leadership style. [ABSTRACT FROM AUTHOR]

This study investigated the circumstances of chemical occupational eye exposures reported to the Dutch Poisons Information Center. During a 1-year prospective study, data were collected through a telephone survey of 132 victims of acute occupational eye exposure. Victims were often exposed to industrial products (35%) or cleaning products (27%). Most patients developed no or mild symptoms. Organizational factors (such as lack of work instructions (52%)), and personal factors (such as time pressure and fatigue (50%), and not adequately using personal protective equipment (PPE, 14%), were the main causes of occupational eye exposures. Exposure often occurred during cleaning activities (34%) and personal factors were reported more often during cleaning (67%) than during other work activities (41%). Data from Poison Control Centers are a valuable source of information, enabling the identification of risk factors for chemical occupational eye exposure. This study shows that personal factors like time pressure and fatigue play a significant role, although personal factors may be related to organizational issues such as poor communication. Therefore, risk mitigation strategies should focus on technical, organizational, and personal factors. The need to follow work instructions and proper use of PPE should also have a prominent place in the education and training of workers. [ABSTRACT FROM AUTHOR]

In the article, the authors present their study and recommendations for hospital-based physical therapy for managing patients with coronavirus diseas based on the suggestions from physical therapists working with COVID-19 patients in Dutch hospitals.

Empirical research conducted by education researchers over a period of approximately 20 years confirms that uncertainty exists whether the provisions of the Occupational Health and Safety Act (OHSA) apply to technology workshops at academic, technical and special schools; whether compliance with the safety provisions of the OHSA is lacking; and whether serious injuries at technology workshops at schools occur from time to time. A comparative study of foreign law regarding occupational safety at technology workshops at high schools confirms that many countries have national or federal occupational safety and health statutes that apply to workplaces as well as public schools, although some have specific statutes or regulations addressing occupational safety at public schools. Countries like Germany, the Netherlands and some states of the United States of America define school-going children and students as "workers" in terms of their occupational safety legislation. Germany includes all school-going children in its statutory accident insurance scheme to provide for faultless compensation in case of injury. In determining whether the OHSA applies to technical workshops at high schools, the fundamental rights, as well as its spirit and purport, must be considered through the prism of the Constitution of the Republic of South Africa. Applying the traditional literalist-cumintentionalist approach to the interpretation of the OHSA, the conclusion is that this Act does indeed apply to technology workshops at schools. In terms of section 60(1)(a) of the South African Schools Act state liability for damages occurring as a result of school activities does provide essential legal protection. However, the South African Schools Act, school safety policies and school infrastructure regulations do not make explicit provision for the application of health and safety standards at school premises that use potentially dangerous machinery and equipment in places such as technical workshops and science laboratories. It is therefore recommended that the OHSA, the Compensation for Occupational Injuries and Diseases Act, the Schools Act and the School Infrastructure Regulations be amended to provide legal certainty in respect of the application of occupational safety to technical workshops at high schools. [ABSTRACT FROM AUTHOR]

Many studies into surface contamination of hospital environments have demonstrated that occupational exposure to cytotoxics through the dermal route remains a possible risk. In this study, we assess the actual dermal exposure of the hands of pharmacy technicians and cleaning personnel in a panel of hospitals performing tasks that pose a risk of exposure. We compare the dermal exposure to a tentative limit value for cyclophosphamide. Pharmacy technicians and cleaning personnel were asked for hand rinsing after performance of nine tasks previously identified as posing a risk of occupational exposure. All samples were analyzed for the presence and quantity of eight antineoplastic drugs. By using data on both the frequency of the performance of the tasks and the measured dermal contamination during these tasks, weekly exposure to the marker drug (cyclophosphamide) was calculated. In five Dutch hospitals, 70 hand rinse samples and 8 blanks were collected. These were analyzed and results were used to calculate weekly exposure. The tentative limit value used was 0.74 µg of cyclophosphamide. For cleaning personnel, all results remained below this threshold value. For pharmacy technicians, the compounding itself also remained well below the limit; however, the task involving preparatory work, as well as the checking of compounded drugs, had a 13% chance of exceeding the limit. All of the highest values were found when employees were not wearing gloves on these tasks. Cleaning personnel and pharmacy technicians compounding cytotoxic drugs in our study were sufficiently protected from occupational exposure. In contrast, pharmacy technicians who perform preparatory and finishing tasks (before and after the actual compounding) are not protected enough when they do not wear gloves. [ABSTRACT FROM AUTHOR]

The Netherlands' system for occupational exposure limits (OELs) encompasses two kinds of OELs: public and private. Public OELs are set by the government. Private OELs are derived by industry and cover all substances without a public OEL. In parallel, the regulation concerning the Registration, Evaluation, Authorisation and Restriction of Chemicals (REACH) has introduced an exposure guidance value similar to the OEL, namely the Derived No-Effect Level (DNEL) for workers' inhalation exposure. This study aimed to investigate issues encountered by occupational health professionals regarding private OELs, and how they perceive the DNELs for workers in relation to private OELs. Towards this aim, we sent out a web-based questionnaire to the members of the Dutch professional organization for occupational hygienists (Nederlandse Vereniging voor Arbeidshygiëne [NVVA], n = 513) and to members of the Dutch professional organization for safety engineers (NVVK, n = 2916). Response rates were 27% (n = 139) and 7% (n = 198), respectively. More occupational hygienists (59%) than safety engineers (17%) reported to derive private OELs themselves. Our respondents reported several challenges with the derivation of private OELs. Fifty-one percent of the occupational hygienists and 20% of the safety engineers stated to see a role of REACH Registrants' worker DNELs as private OELs. However, more than half of our respondents were undecided or unfamiliar with worker DNELs. In addition, stated opinions on where worker DNELs fit in the hierarchy of private OELs varied considerably. To conclude, both these professional groups derive private OELs and stated that they need more guidance for this. Furthermore, there is a lack of clarity whether worker DNELs may qualify as private OELs, and where they would fit in the hierarchy of private OELs. [ABSTRACT FROM AUTHOR]

Highlights • Dutch safety professionals have gone through major transformations. • From company safety inspectors in the 1920s, safety technicians in the 1950s. • In the 1970s safety officers are dealing with employee behaviour, and organisational aspects. • In the late 1990s safety services are privatized, and safety officers become to safety consultants. • There is a major gap between academic and professional developments in safety. Abstract The origin of occupational safety, as an area of main interest of the government, the industry, the unions, and scientists starts in the Netherlands at the end of the 19th century. Roughly in the same period occupational medicine becomes a separate domain. Only just after World War II are safety professionals organised in associations. Starting as a 'Club/werkgroep van veiligheidsinspecteurs' (Club/Working group of Company Safety Inspectors) in 1947, it changes in 1962 into the 'Nederlandse Vereniging van Veiligheidstechnici, NVVT' (Dutch Association of Safety Technicians). In 1978 there is another change into a professional association, and the 'Nederlandse Vereniging van Veiligheidskundigen, NVVK' (Dutch Association of Safety Professionals) is formed. In 1986 this association is transformed into a knowledge association, the 'Nederlandse Vereniging voor Veiligheidskunde, NVVK' (Dutch Association of Safety Science). Nowadays the NVVK is still a knowledge platform for and by safety experts in the Netherlands. The association is a network of 3000 safety experts in various disciplines and departments, and by far the biggest network of experts on working conditions in the Netherlands. The NVVK is actively involved in changes in legislation and regulations, and also represents the interests of members and safety experts in general. During these 71 years of organised safety professions, major changes in position and content have occurred. [ABSTRACT FROM AUTHOR]

Highlights • For employees and managers in construction, the urgency to work safe is not a dominant story. • 3 narratives are frequently revisited in conversations among employees, managers, and change team. • The narratives in the struggle are called carpe diem, carpe pecunia and memento mori for this study. • In the narrative struggle of the 3 narratives, safety is often outpaced by other concerns like money. • The memento-narrative cannot always gain a foothold when narrators adopt narrative techniques. Abstract This study on safety culture focuses on the way people make sense of safety in urgency narratives in small–medium construction enterprises in the northeastern Netherlands, the so-called "earthquake region." Three composite narratives are frequently revisited in the conversations among the employees, managers, and Vlink team. Employees turn to a carpe diem narrative, regarding safety as not a real problem, while appreciating the freedom of that comes with this type of work. In this practice, safety is predominantly the responsibility of the employee—incidents and unsafety are accepted as part of the job. Managers narrate a carpe pecunia narrative, supporting the carpe diem narrative through the logic that employees are responsible for safety while the project budget and satisfying the client carries much weight. Thereby, safety is negotiated on a constant basis and often outpaced by other concerns. These narratives create a cultural practice that demoralizes construction workers to work safely. The memento-narrative, developed by a team of consultants, is a narrated change attempting to influence this cultural practice and stresses the moral obligation of leaders to evaluate the risks of the work they assign to their (or external) employees. The logic of the narrative is that safety should be the main concern and not part of a negotiation. This study shows how the memento-narrative cannot always gain a foothold when narrators adopt certain narrative techniques, like blocking and reframing. Only in small remarks and specific moments during conversations are there opportunities for further conversation on and sharing of the memento-narrative. [ABSTRACT FROM AUTHOR]

Objective: To examine if clustering of root causes of sentinel events (SEs) can contribute to organisational improvement of healthcare and patient safety by providing insight into organisational risk factors, patterns and trends.Design: Retrospective, cross-sectional review of SEs from a hospital database reported to the Board of directors in 2016.Setting: A regional teaching hospital in the Netherlands.Intervention(s): Clustering of characteristics and variables of SEs to establish vulnerabilities and patterns of failure factors of the organisation.Main Outcome Measure(s): Characteristics and contributory causes of failure of SEs identified via root cause analysis (RCA). Outcomes reported using descriptive statistics.Results: A total of 21 events were included involving 21 patients. Mean age was 56.7 years (SD 24.4), 71.4% were above 50 years of age. In 81.8%, the care was multi-disciplinary and in 76.2% the event resulted in permanent harm or injury. Of the 132 identified contributory root causes, most were related to human factors (53.8%) and organisational factors (40.2%). Technical and patient-related factors were identified in 3.0%. Organisational improvement strategies focused on the care of elderly patients, patients subjected to multi-disciplinary care and on improving knowledge, protocols and coordination of care.Conclusion: Clustering variables of SEs and contributory factors of failure through RCA helps to delineate a hospital-specific profile by providing a detailed insight into risk factors, patterns and trends in an organisation and to determine the best strategies for improvement by drawing lessons across events. [ABSTRACT FROM AUTHOR]

Purpose A survey of guidelines and current practices was conducted to examine the safe handling procedures for antineoplastic and other hazardous drugs that are used in 24 countries including the Americas, Europe, the Mideast, Far East, and Australia. Methods Subject experts were asked to complete a brief survey regarding safe handling guidelines and practices for hazardous drugs in their countries. Questions addressed practices for handling monoclonal antibodies, the use of closed-system transfer devices, medical surveillance practices, and measurements of compliance with existing guidelines. Results Responses from 37 subject experts representing 24 countries revealed considerable variation in the content and scope of safe handling guidelines and pharmacy practices among the participating countries. Guidelines in the majority of countries used the term "cytotoxics," while others referred to "hazardous" or "antineoplastic" drugs. The International Society of Oncology Pharmacy Practice standard was cited by six countries, and five cited the National Institute for Occupational Safety and Health Alert. Others cited international guidelines other than International Society of Oncology Pharmacy Practice, or they have created their own guidelines. Approximately half reported that their guidelines were mandatory under federal, state, or provincial legislation. Only 11 countries reported that monoclonal antibodies were covered in their guidelines. Closed-system drug-transfer devices are widely used, but were not specifically recommended in four countries, while one country required their use. Medical surveillance programs are in place in 20 countries, but only in The Netherlands is surveillance mandatory. Nine countries reported that they have completed recent updates or revisions of guidelines, and the measures for their adoption have been initiated. Conclusions Although the overall goals in the participating countries were similar, the approaches taken to assure safe handling of hazardous drugs varied considerably in some cases. [ABSTRACT FROM AUTHOR]

Introduction: For continuous professional development, it is imperative that physicians regularly receive performance feedback from their peers. Research shows that professionals are more proactive in learning and knowledge sharing with peers in teams with more psychological safety. Psychological safety has however not been studied in relation to peers' performance feedback. This study investigated the association between physicians' perceptions of psychological safety and performance feedback received from their peers. Methods: We invited physicians of cardiology, gastroenterology, obstetrics and gynecology, otorhinolaryngology, pulmonology, neurology, and neurosurgery departments of an academic medical center to participate. Physicians evaluated psychological safety using Edmondson's seven-item validated scale and performance feedback using the adapted four-item feedback subscale of the validated System for Evaluation of Teaching Qualities, including corrective and positive feedback, explanations of feedback, and suggestions for improvement from peers. We analyzed the data using multilevel linear regression analyses adjusted for physicians' sex, years since being certified a medical specialist, and months working in the clinic under the study. Results: This study included 105 physicians (86.8% participated). Psychological safety was positively associated with physicians' perceptions of performance feedback from peers (B = 0.54, 95% confidence interval = 0.34-0.73, P -value <.001). Conclusions: Physicians who experienced more psychological safety were more likely to receive corrective and positive performance feedback from peers, explanations of feedback, and suggestions for improvement. Medical teams should consider investing in psychological safety to encourage performance feedback from peers, and thus support physicians' continuous professional development and their efforts to provide high-quality patient care. [ABSTRACT FROM AUTHOR]

• The effectiveness of safety interventions is often unclear in practice. • Safety practitioners were surveyed on the intervention types that they use. • The use and perceived effectiveness of these intervention types is shown. In the Netherlands, approximately 2.300 workers have a serious reportable accident at work every year, of which around 60 are fatal (Inspectie SZW, 2020 ; Bellamy et al., 2014). Safety practitioners employ many methods to improve occupational safety for workers within their companies. Interventions might, for example, be aimed at improving companies' overall 'safety culture', at the introduction of a safety management system (e.g. Robson et al., 2007), or at improving the compliance of workers to specific safety rules (e.g. Peuscher and Groeneweg 2012; Bryden et al., 2016). However, the effectiveness of many of those interventions remains largely unclear (Dyreborg et al, 2015). The Dutch National Institute for Public Health and the Environment (RIVM) has started a project with the ultimate goal of developing a database filled with effective safety interventions. Developers can submit their interventions using a fixed protocol. To support this project, we developed a survey, which was sent to all members of the Dutch Society for Safety Science (NVVK). In the survey, we used a list of 48 predefined descriptions of common interventions. Respondents could indicate whether they made use of these common interventions and the extent to which they considered these effective. The survey thus provided an extensive overview of the use and perceived effectiveness of 48 specific safety interventions. In the future, these insights can support the development and testing of more effective safety interventions. [ABSTRACT FROM AUTHOR]

Background: Healthcare professionals encounter ethical dilemmas and concerns in their practice. More research is needed to understand these ethical problems and to know how to educate professionals to respond to them. Research objective: To describe ethical dilemmas and concerns at work from the perspectives of Finnish and Dutch healthcare professionals studying at the master’s level. Research design: Exploratory, qualitative study that used the text of student online discussions of ethical dilemmas at work as data. Method: Participants’ online discussions were analyzed using inductive content analysis. Participants: The sample consisted of 49 students at master’s level enrolled in professional ethics courses at universities in Finland and the Netherlands. Ethical considerations: Permission for conducting the study was granted from both universities of applied sciences. All students provided their informed consent for the use of their assignments as research data. Findings: Participants described 51 problematic work situations. Among these, 16 were found to be ethical dilemmas, and the remaining were work issues with an ethical concern and did not meet criteria of a dilemma. The most common problems resulted from concerns about quality care, safety of healthcare professionals, patients’ rights, and working with too few staff and inadequate resources. Discussion: The results indicated that participants were concerned about providing quality of care and raised numerous questions about how to provide it in challenging situations. The results show that it was difficult for students to differentiate ethical dilemmas from other ethical work concerns. Conclusion: Online discussions among healthcare providers give them an opportunity to relate ethical principles to real ethical dilemmas and problems in their work as well as to critically analyze ethical issues. We found that discussions with descriptions of ethical dilemmas and concerns by health professionals provide important information and recommendations not only for education and practice but also for health policy. [ABSTRACT FROM AUTHOR]

Influenza vaccination uptake among health care workers (HCWs) protects patients and staff. Still, many health institutions' coverage rates are unsatisfactory. We aimed to test the effect of communicating moral appeals in increasing vaccination uptake in a real life setting. In three field experiments among HCWs, a moral appeal highlighting morally relevant consequences of influenza vaccination was manipulated. The outcome variables were vaccination intention right after exposure to the moral appeal (Study 1; N = 569 US and UK HCWs from various institutions) and vaccination uptake in subsequent weeks for those respondents who consented in sharing this data during the survey (Studies 2 and 3, respectively N = 121 and N = 770 Dutch hospital employees). Studies 1 and 3 showed that moral appeal enhanced vaccination intention and uptake (vaccination uptake increased by 11%), due to increased awareness that vaccination is a moral decision. In Study 2, moral appeal had no effect, probably because people with more outspoken vaccination attitudes had responded to the call to fill in the survey. Moreover, moral appeal increased support for an influenza vaccination mandate. Furthermore, the results suggest that moral appeal was especially effective among HCWs with no history of influenza vaccination. These results indicate that moral appeal can be a useful tool for increasing both vaccination uptake and mandate support within health care institutions. • Influenza vaccination coverage rates among health care workers are unsatisfying. • Moral appeal was tested in a field experiment among health care workers (HCWs). • Exposure to a moral appeal increased influenza vaccination uptake with 11%. • Exposure to a moral appeal increased support for an influenza vaccination mandate. • Moral appeal affected HCWs without an influenza vaccination history more strongly. [ABSTRACT FROM AUTHOR]

Serious incidents in the 1970s and continuous growth of factories producing and/or using hazardous substances formed the basis of a quantitative approach to risk. While discussions of risk were conducted in all industrialised countries they were particularly important in The Netherlands due to space limitations and short distances between industrial plants and residential areas. This article is part of a series covering the history of the safety science discipline (Swuste et al., 2015; Van Gulijk et al., 2009; Swuste et al., 2010). The concept risk entered the Dutch safety domain before the 1970s in relatively isolated case studies and in managing flood defences in The Netherlands. Since the 1970s these case studies paved the way for the development of mathematical models for quantitative risk analysis that were based on experience from nuclear power plants, the process industries and reliability engineering from operations research. ‘External safety’ was a focal point for these early developments in the process industries: adverse effects of dangerous goods outside the factory’s property boundaries. The models were documented in standardised textbooks for risk analysis in The Netherlands, the so-called ‘coloured books’. These works contributed to the development of the Seveso Directive. For internal safety (taking place within property boundaries) semi-quantitative approaches were developed simultaneously. The models for quantitative risk analysis were deemed reliable, but the acceptability of a quantified risk was another matter. Making decisions on risk relates to complex societal issues, such as ethics, stakeholder perception of risks, stakeholder involvement, and politics, all of which made the decision making process far from straightforward. With the introduction of the abstract concept of risk in the Dutch safety science domain, the question of risk perception became important in Dutch safety research. The concept risk and methods for quantitative risk analysis first entered into Dutch law in environmental risk regulations. It took a while for risk to be accepted by occupational safety experts, but just before the turn of the century ‘occupational risk inventory and evaluations’ or RI&E methods were introduced into Dutch occupational safety legislation. This finalised the paradigm shift to risk-based safety-decision making in the Dutch safety science domain. While methods for quantifying risk are now widely applied and accepted, the proper use of risk perception and risk in the political decision process are still being debated. [ABSTRACT FROM AUTHOR]

I analyze prostitution policy changes regarding worker rights and health protection for legal prostitutes in The Netherlands, Germany, and Nevada to determine whether the changes benefit the prostitutes. I critically analyze and compare laws, government policy briefs, advocacy studies, books, articles, and ethnographic studies. Problems were revealed in recognizing prostitution as legitimate work and in realization of health protection. Health and safety concerns exist in The Netherlands and Germany where policy does not mandate health requirements and condom usage. Nevada law requires safety precautions, health testing, and condom usage, resulting in no legal prostitutes testing positive for HIV. [ABSTRACT FROM PUBLISHER]

This paper examines how the economic climate and policy changes at national level have been affecting organisational practices, aimed at the extension of working lives of older workers, over the last decade. We analyse case studies conducted among Dutch organisations. Our findings show that personnel policies are typically short-term oriented and vary in their existence and content congruous to the economic climate. Policy changes in retirement arrangements, and the debate about raising the official retirement age, have made both employees and employers realise that the extension of working lives has become an unavoidable fact, although both parties still seem intrinsically opposed to it. Changes to safety regulations and the increase in costs for employers if employees drop out of work due to ill health have led to an increasing focus on health-related measures in professions with intense physical work over the last decade. We conclude that, while national level policy changes in areas like health and safety do percolate down and begin to affect organisational practice, it is at the organisational level that they still need to be worked through. [ABSTRACT FROM PUBLISHER]