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Introduction From the beginning of the COVID-19 pandemic, healthcare workers had to face unprecedented emergency needs associated with an extraordinary amount of psychological distress. In this cross-sectional multicenter study, we investigated sleep disturbances, and the level of anxiety and depression among the healthcare and non-healthcare staff of three hospitals in Milan (Italy) during the COVID-19 outbreak. Moreover, we explored potential predisposing factors for affective symptoms and poor sleep. Methods Between June and July 2020, we administered an online questionnaire to evaluate the presence of sleep disorders (Pittsburgh Sleep Quality Index), insomnia (Sleep Condition Indicator), anxiety (State Trait Anxiety Inventory), and depression (Beck Depression Inventory-II). We used univariate and multivariate analysis to evaluate the association between the personal conditions and sleep and affective disorders. Results The 964 participants reported high rates of sleep disorders (80.3%)—mainly insomnia (30.5%)—anxiety (69.7%), and depression (32.8%). The multivariate analysis showed a strong association of sleep disorders, especially insomnia, with female gender (p = 0.004), divorced marital status (p = 0.015), self-isolation (p = 0.037), and chronic diseases (p = 0.003). Anxiety was significantly associated with teleworking (p = 0.001), while depressive symptoms were associated with self-isolation (p = 0.028), modified work schedules (p = 0.03), and chronic diseases (p = 0.027). Conclusion In hospital workers, the high prevalence of sleep and psychiatric symptoms during the COVID-19 outbreak appears to be determined mainly by modifications of personal or work habits. Teleworking was associated with increased anxiety. An accurate planning of hospital activities and a psychological support are needed to prevent and manage sleep and mental disorders.

This review aims to map the digital educational technologies on mental health have been validated for health professionals during the Covid-19 pandemic.

On March 11, 2020 the World Health Organisation declared the SARS-CoV-2 viral outbreak a pandemic. This rapid review aimed to identify the pandemic's impact on frontline healthcare workers during the viral outbreak's initial months. Database searches December 1, 2019 to August 29, 2020 retrieved 18 relevant studies. Findings showed that healthcare workers internationally were negatively impacted by the pandemic. Compared to non-frontline healthcare workers a significantly greater proportion of frontline healthcare workers experienced: burnout, stress, and stressors regarding: childcare, job interference with work-family balance and difficulty getting off-duty time. Compared to male physicians, a significantly greater proportion of female physicians scored low for psychological well-being. Mean scores for stress were significantly higher among females and young healthcare workers (22 to 35 years). Mean scores for anxiety were significantly higher for: nurses compared to technicians, healthcare workers reporting extreme lack of protective equipment and those aged > 30 years. The prevalence of depression among frontline healthcare workers across studies in this review ranged from 9% to 51%. The prevalence of sleep issues ranged from 24% to 60% with some reporting nightmares. However, these studies lack homogeneity. Healthcare workers experienced fear of: contracting the virus (89.8%), spreading it to family (91.3%) and fear of an uncontrollable epidemic (86.8%). Over 90% reported skin lesions due to prolonged use of personal protective equipment. Many lost their lives to the SARS-CoV-2 virus. One prominent impact of the SARS-CoV-2 pandemic is the reported loss of healthcare worker's lives and this paper wishes to pay them tribute.

Summary Background Healthcare workers (HCWs) have been disproportionately affected by coronavirus disease 2019 (COVID-19), which may be driven, in part, by nosocomial exposure. If HCW exposure is predominantly nosocomial, HCWs in paediatric facilities, where few patients are admitted with COVID-19, may lack antibodies to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and be at increased risk during the current resurgence. Aim To compare the seroprevalence of SARS-CoV-2 amongst HCWs in paediatric facilities in seven European countries and South Africa (N=8). Methods All categories of paediatric HCWs were invited to participate in the study, irrespective of previous symptoms. A single blood sample was taken and data about previous symptoms were documented. Serum was shipped to a central laboratory in London where SARS-CoV-2 immunoglobulin G was measured. Findings In total, 4114 HCWs were recruited between 1st May and mid-July 2020. The range of seroprevalence was 0–16.93%. The highest seroprevalence was found in London (16.93%), followed by Cape Town, South Africa (10.36%). There were no positive HCWs in the Austrian, Estonian and Latvian cohorts; 2/300 [0.66%, 95% confidence interval (CI) 0.18–2.4] HCWs tested positive in Lithuania; 1/124 (0.81%, 95% CI 0.14–4.3) HCWs tested positive in Romania; and 1/76 (1.3%, 95% CI 0.23–7.0) HCWs tested positive in Greece. Conclusion Overall seroprevalence amongst paediatric HCWs is similar to their national populations and linked to the national COVID-19 burden. Staff working in paediatric facilities in low-burden countries have very low seroprevalence rates and thus are likely to be susceptible to COVID-19. Their susceptibility to infection may affect their ability to provide care in the face of increasing cases of COVID-19, and this highlights the need for appropriate preventative strategies in paediatric healthcare settings.

This study aimed to estimate the level of underestimation of National Dose Registry (NDR) doses based on the workers’ dosimeter wearing compliance. In 2021, a nationwide survey of Korean medical radiation workers was conducted. A total of 989 medical workers who performed fluoroscopically-guided interventional procedures participated, and their NDR was compared with the adjusted doses by multiplying the correction factors based on the individual level of dosimeter compliance from the questionnaire. Ordinal logistic regression analysis was performed to identify the factors for low dosimeter wearing. Based on the data from the NDR, the average annual effective radiation dose was 0.95 mSv, while the compliance-adjusted dose was 1.79 mSv, yielding an 89% increase. The risks for low compliance with wearing a badge were significantly higher among doctors, professionals other than radiologists or cardiologists, workers not frequently involved in performing fluoroscopically-guided interventional procedures, and workers who did not frequently wear protective devices. This study provided quantitative information demonstrating that the NDR data may have underestimated the actual occupational radiation exposure. The underestimation of NDR doses may lead to biased risk estimates in epidemiological studies for radiation workers, and considerable attention on dosimetry wearing compliance is required to interpret and utilize NDR data.

Background: About 90% of individuals will experience back pain at one point or the other in their lives. Hospital workers are considered to have a considerable risk of developing low back pain. Objective: To determine the prevalence and risk factors for low back pain among health workers in tertiary hospitals in Kano, Nigeria. Methods: The study was a cross-sectional survey. A questionnaire was designed and administered to 200 personnel of the teaching hospitals in Kano. Socio-demographic characteristics, presence of low back pain, factors that relieve and aggravate the low back pain and relationship of back pain and work activities, were recorded on the questionnaire. Results: The mean age of the respondents was 33.4±7.08 years. Sixty-six per cent of the respondents had back pain within a year of the study. There was a 29% point prevalence of low back pain among the respondents. Statistically significant association was established between various activities such as prolonged sitting and walking and pain in the lower back (p = 0.000). There was an association between low back pain and the type of job (department) of the respondents (p = 0.016). The dull ache was the predominant presentation (58%) followed by piercing and gripping in 20% and 19% respectively. Prolonged sitting was the main aggravating factor, while numbness was the main feature of referral in 18%. Only 5.0% of the respondents used medications for their back pain. Conclusion: Low back pain is common among hospital workers with a point prevalence of 29.1%. About 25% had low back pains that prevented participated in normal duty. Majority of the respondents believed back pain is preventable.

The distribution of metabolic and obesity phenotypes in Taiwanese medical personnel is unknown. In this study, trajectory analysis with repeated measurements was used to explore the development and associated risk factors of different metabolic and obesity phenotypes in hospital staff from a Taiwanese medical center. The results demonstrated that metabolically unhealthy workers presented with a higher body mass index (BMI) compared with their metabolically healthy counterparts. Male and aged > 40 years hospital workers were more likely to be in a deleterious metabolic/obesity state. Meanwhile, profession and working hours were not significantly associated with the development of certain phenotypes in our study. These results shed light on the necessity of adequate data retrieval regarding working hours, and a nuanced examination of working conditions among different professions. Our findings are helpful for the development of advanced guidance regarding health promotion in hospital workers.

Hospital workers have increased exposure risk of healthcare-associated infections due to the frontline nature of their work. Olfactory dysfunction is highly prevalent. The objectives for this investigation are to study the prevalence of long-lasting olfactory dysfunction associated with COVID-19 infection in hospital workers during the first pandemic wave, to identify clinical characteristics and associated symptomatology, and to analyze how many patients with COVID-19 infection had developed olfactory dysfunction during infection and maintained a reduced olfactory function for approximately 10 weeks after diagnosis. Between June and July of 2020, a cross-sectional study was carried out at the Hospital Central de la Cruz Roja San José and Santa Adela in Madrid, Spain. One hundred sixty-four participants were included, of which 110 were patient-facing healthcare staff and 54 were non-patient-facing healthcare staff. Participants were split into three groups, according to COVID-19 diagnosis and presence of COVID-19 related olfactory symptomatology. Participants were asked to complete a structured online questionnaire along with Sniffin’ Stick Olfactory Test measurements. In this study, 88 participants were confirmed for COVID-19 infection, 59 of those participants also reported olfactory symptomatology. The prevalence of COVID-19 infection was 11.35%, and the prevalence for olfactory dysfunction was 67.05%. Olfactory dysfunction associated with COVID-19 infection leads to long-lasting olfactory loss. Objective assessment with Sniffin’ Stick Olfactory Test points to odor identification as the most affected process. Lemon, liquorice, solvent, and rose are the odors that are worst recognized. Mint, banana, solvent, garlic, coffee, and pineapple, although they are identified, are perceived with less intensity. The findings of this study confirmed a high prevalence of SARS-CoV-2 infection among the hospital workers.

The research assess COVID-19 obsession among hospital workers in Jos-South local government area of Plateau State Nigeria. A total of 162 hospital workers (82, 50.6% males and 80, 49.4% females) with mean age of 34.01 participated in this survey research. Four hypotheses were tested utilizing Chi-square at p = 0.05 level of significance, result revealed that older hospital workers had higher prevalence of COVID-19 obsession compared to younger hospital worker, χ2 = 6.139, df = 1, p = 0.013 (p < 0.05). The prevalence of COVID-19 obsession did not differ among hospital workers in terms of gender, χ2 = 0.009, df = 1, p = 0.924 (p >0.05). Furthermore, results revealed that hospital workers with tertiary education had higher prevalence of COVID-19 obsession compared to those with lower educational status, χ2 = 7.168, df = 3, p = 0.028 (p < 0.05). Finally, prevalence of COVID-19 obsession did not differ among hospital workers in terms of marital status, χ2 = 6.996, df = 3, p = 0.072 (> 0.050). The authors concluded that more attention should be given to hospital workers in terms of policy formulation being that they are at the forefront in the fight against COVID-19. Also, there is need for setting up of psychological service centres across hospitals in Nigeria which would go a long way in not just evaluating the mental health status of hospital workers in relation to COVID-19 but it

Vitamin D supplementation has been shown to reduce the incidence of acute respiratory infections in populations at risk. The COVID-19 pandemic has highlighted the importance of preventing viral infections in healthcare workers. The aim of this study was to assess the hypothesis that vitamin D3 supplementation at 5000 IU daily reduces influenza-like illness (ILI), including COVID-19, in healthcare workers. We conducted a prospective, controlled trial at a tertiary university hospital. A random group of healthcare workers was invited to receive 5000 IU daily vitamin D3 supplementation for nine months, while other random healthcare system workers served as controls. All healthcare workers were required to self-monitor and report to employee health for COVID-19 testing when experiencing symptoms of ILI. COVID-19 test results were retrieved. Incidence rates were compared between the vitamin D and control groups. Workers in the intervention group were included in the analysis if they completed at least 2 months of supplementation to ensure adequate vitamin D levels. The primary analysis compared the incidence rate of all ILI, while secondary analyses examined incidence rates of COVID-19 ILI and non-COVID-19 ILI. Between October 2020 and November 2021, 255 healthcare workers (age 47 ± 12 years, 199 women) completed at least two months of vitamin D3 supplementation. The control group consisted of 2827 workers. Vitamin D3 5000 IU supplementation was associated with a lower risk of ILI (incidence rate difference: −1.7 × 10−4/person-day, 95%-CI: −3.0 × 10−4 to −3.3 × 10−5/person-day, p = 0.015) and a lower incidence rate for non-COVID-19 ILI (incidence rate difference: −1.3 × 10−4/person-day, 95%-CI −2.5 × 10−4 to −7.1 × 10−6/person-day, p = 0.038). COVID-19 ILI incidence was not statistically different (incidence rate difference: −4.2 × 10−5/person-day, 95%-CI: −10.0 × 10−5 to 1.5 × 10−5/person-day, p = 0.152). Daily supplementation with 5000 IU vitamin D3 reduces influenza-like illness in healthcare workers.

Social distancing measures can create psychological issues, especially among hospital staff who constantly deal with emergency patients. To explore the mediating role of COVID-19 anxiety on the association between COVID-19 safety protocols and mental health, and to test the moderating role of resilience between COVID-19 safety protocols and COVID-19 anxiety, this work collected data on hospital staff in terms of COVID-19 safety protocols, psychological resilience, COVID-19 anxiety, and improving staff mental health. The effects of the use of COVID-19 safety protocols on COVID-19 anxiety and the mental health of hospital workers in China were also analyzed. The experimental results showed that resilience remarkably moderated COVID-19 safety protocols and COVID-19 anxiety among Chinese hospital staff.

Background: The “effort character” (EC) is a resistance training method without reaching muscle failure. It was defined by González-Badillo and Gorostiaga Ayestarán (2002) as the relationship between the repetitions performed and the repetitions achievable. Then, the EC is at its maximum (i.e., 100%) when the subject realizes all the repetitions possible in a series with any load. Therefore, an EC of 50% indicates execution of 50% of the repetitions achievable in a series. This study aimed to determine the effects of two programs of eight weeks of concurrent training (CT) with different EC over muscle strength (MS), cardiorespiratory fitness (CRF), functional mobility (FM), health-related quality of life (HRQoL), and lipid profile (LP) among hospital workers. Methods: Fourteen hospital workers (age: 41.1 ± 10.8 years, body mass: 63.0 ± 10.8 kg, height: 165.2 ± 6.5 cm, body mass index (BMI): 23.0 ± 3.4 kg/m2) were randomly assigned to an EC 50% (n = 7) or EC 100% (n = 7) group. Results: The main finding was that both groups significantly improved in MS and FM levels but not HRQoL, with no statistical differences between EC 50% and EC 100% in adherence and any test despite performing half the volume of the strength workout. Conclusions: An eight-week CT program with different EC (i.e., EC 50% vs. EC 100%) seems to improve the MS and FM levels in hospital workers similarly. These findings could be very useful in health-training practices because of the possibility of planning training loads with half the volume of strength workouts without the loss of any training adaptation.

Healthcare workers are at elevated risk to develop symptoms of post‐traumatic stress disorder (PTSD) in response to an outbreak of a highly infectious disease. The current study set‐out to model the complex interrelations between PTSD symptoms during the peak of the Coronavirus Disease 2019 outbreak in 291 Chinese healthcare workers and 291 matched control cases that were selected from the general population. For this purpose, we estimated regularized partial correlation networks. Within the network of healthcare workers, we observed a central role for avoidance of reminders of the traumatic event, physiological cue reactivity, anger/irritability, re‐experiencing, and startle. We identified three clusters of closely interconnected PTSD symptoms in healthcare workers, consisting of (a) symptoms of re‐experiencing and anxious arousal, (b) symptoms of avoidance and amnesia and (c) symptoms of emotional numbing and dysphoric arousal. Respectively, startle, avoidance of reminders and feeling detached emerged as bridging nodes in these communities. Although yielding highly similar network models, the PTSD symptom structure of healthcare workers showed several unique features compared to the matched control sample. This is informative for interventions aimed at targeting PTSD symptoms in healthcare workers in the context of a public health emergency.

Background The Hadassah Medical Organization operates two hospitals in Jerusalem. During the COVID-19 pandemic it made an administrative decision to operate one hospital as a COVID-19 treatment hospital (CTH) and to have the second function as a non-COVID-19 treating hospital (NCTH) offering general medical services. The purpose of this study was to assess how this decision affected hospital worker anxiety. Methods From April 27 to May 1, during the COVID-19 pandemic in Israel, while the country was under lock-down, an electronic questionnaire survey was carried out among hospital workers of the CTH and NCTH. The questionnaire includes personal demographics and attitudes about COVID-19 and assesses present anxiety state using the State-Trait Anxiety Inventory for Adults (STAI-S) validated questionnaire. A STAI-S score of ≥45 was considered to represent clinical anxiety. Results Completed questionnaires were received from 1570 hospital employees (24%). 33.5% of responders had STAI-S scores ≥45. Multivariable regression analysis showed that being a resident doctor (odds ration [OR] 2.13; 95% CL, 1.41–3.23; P = 0.0003), age ≤ 50 (OR, 2.08; 95% Cl, 1.62–2.67; P P = 0.039), female gender (OR, 1.63; 95% CL, 1.25–2.13; P = 0.0003) and having risk factors for COVID-19 (OR, 1.51; 95% CL, 1.19–1.91; P = 0.0007), but not hospital workplace (p = 0.08), were associated with the presence of clinical anxiety. 69% of the responders had been tested for COVID-19, but only nine were positive. CTH workers estimated that the likelihood of their already being infected with COVID-19 to be 21.5 ± 24.7% as compared to the 15.3 ± 19.5% estimate of NCTH workers (p = 0.0001). 50% (545/1099) of the CTH workers and 51% (168/330) of the NCTH workers responded that the most important cause of their stress was a fear of infecting their families (p = 0.7). Conclusions By multivariable analysis the creation of a NCTH during the COVID-19 pandemic was not found to be associated with a decrease in the number of hospital workers with clinical anxiety. Hospital worker support resources can be focused on the at-risk groups identified in this study.

Epidemic viral infections, including the outbreak of severe acute respiratory syndrome (SARS) in 2003 and SARS-CoV-2 in 2019, have brought tremendous loss to people across the nations. The aim of this study was to compare the psychological impact of the SARS-CoV-2 pandemic in 2020 and the SARS pandemic in 2003 on hospital workers. Hospital workers at a medical center in Southern Taiwan (n = 1816) were invited to complete questionnaires (SARS-CoV-2 Exposure Experience, the Impact of Event Scale, the Chinese Health Questionnaire, and the Distress Thermometer). The current data were compared to the data collected from hospital workers (n = 1257) at the same medical center during the SARS pandemic in 2003. We found the psychological impact on hospital workers during the SARS-CoV-2 pandemic was significantly lower than that during the previous SARS period. During the SARS-CoV-2 pandemic period, hospital workers with SARS experience were more accepting of the risk, felt a greater responsibility to take care of the SARS-CoV-2 patients, and were more likely to perceive the danger of becoming infected. The associated factors of psychiatric morbidity in hospital workers with SARS experience were being female, the degree of intrusion severity, and severity of psychological distress. Proper management strategies and lessons learned from the SARS experience might have led to low psychiatric morbidity during the SARS-CoV-2 pandemic.

Background Musculoskeletal and sleep disorders have been reported to be very common among health care and hospital workers and particularly nurses. They are assumed or found to be a result of psychological stress and/or physical strain or pain. However, no other study so far – at least in a hospital setting and for Switzerland – has considered and investigated musculoskeletal as well as sleep disorders in consequence of or rather in association with both physical workload and psychological stress. Methods Cross-sectional survey data of 1232 health professionals were used and analysed. Data were collected in 2015/16 among the health care workforces of three public hospitals and two rehabilitation clinics in the German-speaking part of Switzerland. Musculoskeletal and sleep disorders were assessed by three items taken from the Swiss Health Survey, a 2-item measure of accumulated low back, back, neck and shoulder pain and a single-item measure of problems in getting to sleep or sleeping through. Stratified and adjusted bivariate logistic and multivariate linear regression analyses were performed to calculate measures of association (adjusted odds ratios, z-standardized beta coefficients), to control for potential confounders, and to compare different health professions (nurses, physicians, therapists, other). Results Almost every fourth of the studied health professionals reported severe or even very severe musculoskeletal disorders (MSDs) and nearly every seventh severe sleep disorders (SDs). These prevalence rates were significantly or at least slightly higher among nurses than among physicians and other health care workers. General stress, work stress, physical effort at work, and particularly a painful or tiring posture at work were found to be clear and strong risk factors for MSDs, whereas only general and work-related stress were found to be significantly associated with SDs. There was no or only weak association between MSDs and SDs. Conclusions This study found MSDs to be largely a result of physical workload or rather poor posture at work and only secondarily a consequence of (general) stress, whereas SDs were revealed to be primarily a consequence of stress on and particularly off the job. Preventive strategies therefore have to differentiate and combine measures for the reduction of both psychological stress and physical strain.

ObjectiveHealthcare workers are highly exposed to various types of disinfectants and cleaning products. Assessment of exposure to these products remains a challenge. We aimed to investigate the feasibility of a method, based on a smartphone application and bar codes, to improve occupational exposure assessment among hospital/cleaning workers in epidemiological studies.MethodsA database of disinfectants and cleaning products used in French hospitals, including their names, bar codes and composition, was developed using several sources: ProdHyBase (a database of disinfectants managed by hospital hygiene experts), and specific regulatory agencies and industrial websites. A smartphone application has been created to scan bar codes of products and fill a short questionnaire. The application was tested in a French hospital. The ease of use and the ability to record information through this new approach were estimated.ResultsThe method was tested in a French hospital (7 units, 14 participants). Through the application, 126 records (one record referred to one product entered by one participant/unit) were registered, majority of which were liquids (55.5%) or sprays (23.8%); 20.6% were used to clean surfaces and 15.9% to clean toilets. Workers used mostly products with alcohol and quaternary ammonium compounds (>90% with weekly use), followed by hypochlorite bleach and hydrogen peroxide (28.6%). For most records, information was available on the name (93.7%) and bar code (77.0%). Information on product compounds was available for all products and recorded in the database.ConclusionThis innovative and easy-to-use method could help to improve the assessment of occupational exposure to disinfectants/cleaning products in epidemiological studies.

Background: Epilepsy is a common presentation at clinics in Psychiatric Hospitals, Teaching Hospitals, and general practice. In developing countries and Africa especially, awareness, attitude, and understanding are generally poor. People still believe in spirits as the cause of epilepsy. Objectives: The objectives were to assess the awareness; attitude and knowledge of Hospital workers in general practice concerning epilepsy. Methodology: The respondents were workers of all cadres who were working at a State Specialist Hospital and the study used a survey method proposed by Caveness and Gallup, with modifications and adaptations on the self-administered questionnaire. Results: One hundred and forty-four staffs of State Specialist Hospital completed the questionnaire containing items addressing demographics, awareness, attitude, and knowledge. Of these respondents, 89 were males and 55 were females. The mean age was 34.34 years. 96.5% heard of the disease, 77.8% knew someone with the disease, 64.6% will not object to their children playing with someone with epilepsy and 37.5% will not allow a relative to marry someone with epilepsy. Fifty-five percent (55%) of the respondents said; they will not employ such patients, and that patients with epilepsy should not be employed with others. Knowledge towards epilepsy was good, where 71.5% felt it was caused by a brain disorder. Conclusion: We found out that awareness and knowledge of epilepsy among Hospital staff were generally good. However, the attitude of healthcare workers had reservations towards patients with epilepsy (PWE) either working for them or working with other people. This attitude arose from deeply ingrained cultural misconceptions acquired over time. Thus, there is a need for consistent hospital staff education, aimed at allaying fears, mistrust as well as to lessen the stigma towards epileptics.

International audience; Objectives: This longitudinal study aimed to test the hypothesis that organizational work factors (OWFs) may be related to depressive symptoms through an increased effort-reward imbalance (ERI) ratio among registered nurses (RNs) and nursing assistants working in hospitals. Methods:We studied 2117 female RNs and nursing assistants who stayed in the same work unit and position during the follow-up from the ORSOSA (ORganisation des SOins-SAnt'e) longitudinal study. The work characteristics and workers' health were assessed in 2006 and 2008. Results: We confirmed our hypothesis of both direct and mediated effects of OWFs on workers' health. We showed that issues about patient-related information exchanges increased RNs' depressive disorders by increasing first a perceived ERI. Conclusions: Our results advocate integrating both the work organizational level and the individual level into preventive actions to improve workers' mental health.

Objective: To evaluate the sustainability and effectiveness of training as an intervention to improve the knowledge, attitude and practices of hospital workers on health care waste management. Method: We conducted this quasi-experimental study in two tertiary care teaching hospitals in Rawalpindi in October 2013. Training, practical demonstrations and reminders on standard waste management were given to 138 hospital workers in one hospital and compared with 137 workers from the control hospital. We collected data 18 months after intervention through a structured questionnaire to assess the impact of the intervention. We used paired t-test to compare the scores on knowledge, attitude and practices at baseline and first follow up and final impact assessment. Chi square test was used to compare group variables between intervention and control groups. Results: After 18 months since intervention the mean scores on knowledge attitude and practices differed statistically significantly since baseline and intervention group had statistically significantly better knowledge positive attitudes and good health care waste management practices (p < 0.001). Health care and sanitary workers in intervention group scored statistically significantly higher (p < 0.001). Conclusion: Trainings of health and sanitary workers on health care waste management guidelines were sustainable among the intervention group after 18 months which shows the positive impact of our intervention. It is recommended that the trainings as intervention be included in the overall policies of the public and private sector hospitals in Pakistan and other similar settings.

PurposeAccumulating evidence suggests an important role for psychosocial work factors in injury, but little is known about the interaction between psychosocial factors and previous injury experience on subsequent injury risk. We examined the relationships between psychosocial work factors and new or recurrent injury among hospital workers.MethodsWe studied 492 hospital workers including 116 cases with baseline injury and 376 injury-free referents at baseline over follow-up. Job strain, total support, effort-reward imbalance, overcommitment, and musculoskeletal injury at baseline were examined in logistic regression models as predictors of new or recurrent injury experienced during a 2-year follow-up period.ResultsThe overall cumulative incidence of injury over follow-up was 35.6 % (51.7 % for re-injury among baseline injury cases; 30.6 % for new injury among referents). Significantly increased risks with baseline job strain (OR 1.26; 95 % CI 1.02-1.55) and effort-reward imbalance (OR 1.42; 95 % CI 1.12-1.81) were observed for injury only among the referents. Overcommitment was associated with increased risk of injury only among the cases (OR 1.58; 95 % CI 1.05-2.39).ConclusionsThe effects of psychosocial work factors on new or recurrent injury risk appear to differ by previous injury experience, suggesting the need for differing preventive strategies in hospital workers.

Do hospital employees regulate their emotions so they are in line with their job requirements? What effects do such regulation processes have on workers' psychophysical wellbeing? What variables mediate their frequency, nature, and effects? To answer these questions, Italian men and women (N=180) working at a hospital as nurses, doctors, or in other technical roles, were administered a questionnaire comprising several scales, plus questions on socio-demographic and work-related variables. Results showed the regulation of felt emotions, that is, Emotional Labor (Hochschild, 1983) is a relevant variable of such jobs. Workers performed both (a) Surface Acting, that is, controlling expressed emotions so they are contextually adequate, and (b) Deep Acting, that is, trying to actually feel the required emotion; plus (c) Emotional Consonance, that is, effortlessly feeling the job-required emotions, was also a frequent experience for employees. Further, results showed the nature and frequency of such regulation processes have significant relations with both objective job-related features, such as the time spent in listening to patients, and with psychological variables such as burnout, and pleasurable emotions.

Health care personnel form the 5th category at major occupational risk of skin disease in Italy. The aim of this study was to assess the prevalence and clinical relevance of contact dermatitis in a group of 1301 employees of the Perugia Monteluce Hospital (658 females and 643 males; mean age 39.8 years) who answered a self-administered questionnaire elaborated by the authors. The subjects with anamnestic hand dermatitis and/or atopic mucosal reactions were clinically examined and submitted to skin tests (patch and/or prick tests). Contact dermatitis of the hands and/or forearms occurred in 21.2% and was significantly more frequent (p < 0.001) in women, subjects under 31 years of age, workers in internistic and surgical fields, cleaners and nurses. In the majority of cases (94.9%), the lesions were irritant in origin and mainly related to disinfectants (especially, chlorhexidine gluconate and glutaraldehyde) and gloves (latex proteins and starch glove powder, rather than accelerators and additives of rubber). Finally, atopy seemed to favour the onset of hand dermatitis. The importance of these results for preventive measures of contact dermatitis in hospital employees is discussed.

Objectives: The aim of this study is to assess chromosomal damage in Tunisian hospital workers occupationally exposed to low levels of ionizing radiation (IR). Materials and Methods: The cytokinesis-block micronucleus (CBMN) assay in the peripheral lymphocytes of 67 exposed workers compared to 43 controls matched for gender, age and smoking habits was used. The clastogenic/aneugenic effect of IR was evaluated using the CBMN assay in combination with fluorescence in situ hybridization with human pan-centromeric DNA in all the exposed subjects and controls. Results: The study showed a signifi cant increase of the micronucleus (MN) frequency in the lymphocytes of the exposed workers compared to the control group (13.63±4.9‰ vs. 6.52±4.21‰, p < 0.05). The centromere analysis performed in our study showed that MNs in hospital staff were predominantly centromere negative (72%) and the mean negative labeled micronucleus (C–MN) frequency was signifi cantly higher in the exposed subjects than in the controls (9.04±4.57‰ vs. 1.17±0.77‰). The multivariate regression analysis, taking into account all confounding factors, showed that only the time of exposure to IR had a signifi cant effect on the level of MNs and C–MN. Conclusion: The present study shows that chromosomal damage leading to the formation of micronucleated lymphocytes is more frequent in the hospital workers exposed to IR than in the controls, despite the low levels of exposure. The results of the study confi rm the well-known clastogenic properties of ionizing radiation. In regards to health monitoring, detection of early genotoxic effects may allow for the adoption of preventive biological control measures, such as hygienic improvements in the workplace or reduction of hours of occupational exposure.

BACKGROUND: In Malawi, the dramatic shortage of human resources for health is negatively impacted by HIV-related morbidity and mortality among health workers and their relatives. Many staff find it difficult to access HIV care through regular channels due to fear of stigma and discrimination. In 2006, two workplace initiatives were implemented in Thyolo District: a clinic at the district hospital dedicated to all district health staff and their first-degree relatives, providing medical services, including HIV care; and a support group for HIV-positive staff. METHODS: Using routine programme data, we evaluated the following outcomes up to the end of 2009: uptake and outcome of HIV testing and counselling among health staff and their dependents; uptake and outcomes of antiretroviral therapy (ART) among health staff; and membership and activities of the support group. In addition, we included information from staff interviews and a job satisfaction survey to describe health workers' opinions of the initiatives. RESULTS: Almost two-thirds (91 of 144, 63%) of health workers and their dependents undergoing HIV testing and counselling at the staff clinic tested HIV positive. Sixty-four health workers had accessed ART through the staff clinic, approximately the number of health workers estimated to be in need of ART. Of these, 60 had joined the support group. Cumulative ART outcomes were satisfactory, with more than 90% alive on treatment as of June 2009 (the end of the study observation period). The availability, confidentiality and quality of care in the staff clinic were considered adequate by beneficiaries. CONCLUSIONS: Staff clinic and support group services successfully provided care and support to HIV-positive health workers. Similar initiatives should be considered in other settings with a high HIV prevalence.

Due to the infectious nature of some clinical waste, poor disposal practices have sparked concern regarding the impact on public health and the environment. Lack of sufficient knowledge of the associated risks may be a strong factor contributing to inadequate disposal practices. We conducted a survey to evaluate hospital workers' awareness of health and environmental impacts of poor clinical waste disposal in Cameroon. We randomly distributed 500 questionnaires to hospital workers in three hospitals in the Northwest Region of Cameroon in April 2008. In addition, we observed collection, segregation, transportation, and disposal of clinical waste at the three hospitals. Of 475 total respondents, most lacked sufficient awareness of any environmental or public health impacts of poor clinical waste disposal and had never heard of any policy--national or international--on safe clinical waste management. Methods of collecting, segregating, transporting and disposing clinical waste at the three hospitals was poor. The development of a comprehensive policy on efficient clinical waste management in Cameroon is imperative.

International audience; Few studies have analysed the association between the organisational work environment and depression in hospital workers and we still have little understanding of how processes in the practice environment are related to depressive disorders. However, individual perception of an imbalance between efforts made and expected rewards has been associated with incident depression. The main goal of this study was to test the hypothesis that some organisational constraints at the work-unit level may be related to depressive symptoms in hospital workers, either directly or through individual perceptions of effort–reward imbalance (ERI). In 2006, 3316 female registered nurses and nursing aids working in 190 work units in seven French university hospitals, recruited from the baseline screening of an epidemiological cohort study (the ORSOSA study), responded in 2006 to valid self-report questionnaires (CES-D, ERI). The organisational work environment was assessed with the self-rated Nursing Work Index – Extended Organisation (NWI-EO) aggregated at the work unit level. Multilevel models were used. We found that poor relations between workers within work units were associated with higher CES-D score, independently of perceived ERI. Low level of communication between workers in the unit was associated with individual perceptions of ERI and indirectly associated with depressive symptoms. Understaffing and non-respect of planned days off and vacations were associated with perceived ERI but these organisational constraints were not associated with depressive symptoms. Our study allowed us to identify and quantify organisational factors that have a direct effect on hospital workers’ depressive symptoms, or an indirect effect through perceived ERI. Better understanding of the effect of organisational factors on health through perceived ERI would provide targets for successful interventions. Organisational approaches may be more effective in improving mental health at work and may also have a longer-lasting impact than individual approaches.

Background Few comprehensive tuberculin surveys were carried out in a homogeneous population of health care workers (HCWs) in a low incidence area to assess the risk of tuberculosis (TB) infection by different occupational groups and units. Methods Community and occupational factors and tuberculin skin test (TST) reactivity were determined in 1,755 HCWs. Results The overall prevalence of tuberculin reactivity was 6%. Predicting factors for TST reactivity were age >47 years (OR = 2.88), history of household TB contact (OR = 2.41), years of work as HCW (OR = 2.57), physician (OR = 1.88), and working in microbiology (OR = 4.94), dialysis/nephrology (OR = 2.00), gynecology/obstetrics (OR = 2.01). In a multiple regression model working in microbiology [OR = 4.16 (1.27–13.6)], dialysis/nephrology [OR = 2.52 (1.36–4.65)], gynecology/obstetrics [OR = 2.46 (1.24–4.86)] and age >47 years [OR = 1.98 (1.14–3.46)] were significant predictors for infection. Conclusions A higher risk of latent infection can be demonstrated in well-defined groups of HCWs. Am. J. Ind. Med. 52:297–303, 2009. © 2009 Wiley-Liss, Inc.

The impact of locus of control and job type on the perception of autopsy among medical and nonmedical workers in University College Hospital, Ibadan, was investigated. Ninety-two medical and 46 nonmedical workers from the hospital participated in the study. An ex post facto design was used. The Autopsy Perception Scale and Locus of Control Scale were used as instruments. The t-test result (t[136] = −2.03; P < 0.05) showed that hospital workers with an internal locus of control reported to have a more positive perception of autopsy than those with an external locus of control; the t-test result (t[136] = −2.29; P < 0.05) showed that medical workers reported a more positive perception of autopsy than nonmedical workers. However, the t-test result (t[136] = −0.82; P > 0.05) showed that there was no significant difference between workers who had had an autopsy conducted on their deceased relatives and those who had not. The results were discussed in line with existing literature.