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Introduction Previous studies on occupational health focussed predominately on the occurrence of occupational diseases. Relatively few studies have measured how employment is associated with the use of healthcare services. This study investigates the association between employment and the extent and range of healthcare use, such as medical expenditures, of women in South Korea. Methods We analyze data of the Korean Health Panel, an ongoing longitudinal national representative survey, from 2008 to 2017, to identify the status of economic activity of women by year and age group. We estimate the association between female employment status and medical expenditures by using random effect panel Tobit models. Furthermore, we investigate the association between employment status and the range of healthcare services in biomedicine and traditional Korean medicine (KM) by conducting conditional fixed-effects logistic regression analyses. Results For women aged between 25 and 65 in 2017, the majority of them were employed or self-employed. (The proportion of employment of self-employment equals 64.80%). In addition, working women spent 11.6% less on healthcare than nonworking women, and self-employment lowered the healthcare expenditure by 13.1%. Neither work nor the type of work is related to the types and range of healthcare service use. Being employed or self-employed is negatively associated with women’s expenditure on healthcare. Conclusions The findings show that employment is associated with less spending on healthcare. They imply that employment has a positive impact on women’s health.

Background To examine the association of job strain with cognitive ability and the influence of life-course job strain on later life cognitive decline. Methods Data were derived from six waves of the Survey of Health, Aging, and Retirement in Europe. The study sample consists of 13349 participants aged 50 to 98 years at wave 2 and has been followed up for 12-years. Job strain status across working life was assessed using a short demand-control job strain model containing two core dimensions: job demands and job control collected in wave 3. Cognitive abilities concerning episodic memory was assessed by immediate recall and delayed recall tests, executive function was evaluated by verbal fluency test collected in all waves (waves 2–7) except wave 3. Mixed-effects model was used to estimate working life job strain and its cumulative effect on cognitive decline. Results Both passive and high strain jobs were associated with lower levels of cognitive ability (episodic memory and verbal fluency) in comparison with active job. Long exposure to active- or low strain-job was associated with higher cognitive ability whereas long exposure to passive job or moderate duration of high strain job was associated with lower cognitive ability. The rate of memory decline was positively related to moderate duration of passive job and negatively related to long-term exposure to low strain job. Limitations Information on working conditions was based on self-reported recollections. Conclusions Working life variation in job strain status and their duration may explain individual differences in cognitive ability in later life.

Background The prevailing global work scenario and deteriorating health facilities in economies indulge the risk perspective in the labor market model. This is the reason that the risk factor is cautiously attributed to wages and labor market efficiencies specifically in developing and emerging economies. In this respect, Occupational Injuries of Workers (OIW) is considered essential to demonstrate the risk and Occupational Health and Safety (OHS) setups given the constraints of the labor. Intuitively, the prime objective of this study is to make an assessment of the labor market considering the OIW through the indicators of industry division, employment status, occupational distribution, adopted treatment, gender and regionality. Methods The assessment strategy of the study has been categorized into trend analysis and Index Value Calculation (IVC) segments employing the data from 2001 to 2018. Results The pattern of the selected indicators of the OIW has been observed in the available data while the IVC estimations are considered through time and reference categories. The findings of both exercises revealed absolute and relative heterogeneities at both industry and occupational levels. Conclusion The consistency for gender and regional distribution of both assessments points out the need for effective policy initiatives. The study suggests separate analyses of industry and occupations for a better understanding of the OHS setups and up-gradation in Pakistan.

Resume Introduction L'objectif de cette etude consiste a comparer l'hypothese de vulnerabilite et l'hypothese d'expression pour expliquer la plus grande detresse psychologique des femmes en emploi. Ces deux hypotheses sont contrastees en integrant les stresseurs du travail, de la famille, le conflit travail-famille et les ressources psychosociales. Methode Les modeles conceptuels ont ete testes par des analyses de chemins en multiniveaux aupres de 2026 employes quebecois (Canada) repartis dans 63 etablissements. Resultats Les resultats soutiennent partiellement les deux hypotheses. Dans le cas de l'hypothese de vulnerabilite, la monoparentalite, les problemes avec les enfants et l'estime de soi sont indirectement impliques dans la variation du niveau de la detresse psychologique parmi les femmes par l'intermediaire de l'interference famille-travail. Dans le cas de l'hypothese d'expression, bien que l'interference famille-travail soit associee a plus de detresse psychologique parmi les femmes, ce stresseur est associe a davantage de consommation d'alcool a risque parmi les hommes. Les tensions avec le conjoint et le sentiment de controle participent egalement au mecanisme d'expression a travers l'interference famille-travail. Conclusion Ces resultats soulignent l'importance de considerer les multiples mecanismes par lesquels le genre contribue aux inegalites de sante mentale. Ils invitent egalement a distinguer les deux directions du conflit travail-famille comme mediateurs genres.

Publisher Copyright: © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under CC BY-NC-ND 4.0 license Background: High emotional demands at work can affect employees’ health and there is a need to understand whether such an association might be modified by other working conditions. We aimed to examine emotional demands at work as a risk factor for long-term sickness absence and analyse whether influence, possibilities for development, role conflicts, and physical demands at work might modify this risk. Methods: We did a nationwide, population-based, prospective cohort study in Denmark and included employed individuals who were residing in Denmark in 2000, aged 30–59 years, who had complete data on age, sex, and migration background, with information on emotional demands and possible effect modifiers from job exposure matrices, and covariates and outcome (sickness absence) from population registers. Individuals with long-term sickness absence (≥6 weeks of consecutive sickness absence) between Jan 1, 1998, and Dec 31, 2000, and self-employed individuals were excluded. We assessed long-term sickness absence during a 10-year period from Jan 1, 2001, to Dec 31, 2010. Using Cox regression, we estimated hazard ratios (HRs) and 95% CIs and tested interaction as departure from additivity, estimating relative excess risk due to interaction (RERI). Multivariable adjusted models included sex, age, cohabitation, migration background, and income. Findings: 1 521 352 employed individuals were included and contributed data between Jan 1, 2000, and Dec 31, 2010. During 11 919 021 person-years (mean follow-up 7·8 years), we identified 480 685 new cases of long-term sickness absence. High emotional demands were associated with increased risk of long-term sickness absence compared with low emotional demands, after adjusting for age, sex, cohabitation, migration background, income, and the four possible effect modifiers (adjusted HR 1·55 [95% CI 1·53–1·56]). The association between high emotional demands and risk of long-term sickness absence was stronger in a synergistic way when individuals were also exposed to low possibilities for development (RERI 0·35 [95% CI 0·22–0·47]; 28·9 additional cases per 1000 person-years) and high role conflicts (0·13 [0·11–0·15]; 22·0 additional cases per 1000 person-years). No synergy was observed for influence and physical demands at work. Interpretation: People in occupations with high emotional demands were at increased risk of long-term sickness absence. Our findings on synergistic interactions suggest that, in emotionally demanding occupations, increasing possibilities for development and reducing work-related role conflicts might reduce long-term sickness absence. Further interventional studies are needed to confirm or refute this hypothesis. Funding: Danish Work Environment Research Fund, NordForsk.

Resume Objectifs Presenter la methodologie de l’evaluation du risque et les resultats biometrologiques de travailleurs du BTP intervenant sur des sites ou des sols pollues par des substances chimiques. Methodes L’identification des dangers et leur hierarchisation reposent sur l’examen critique des analyses de sols. L’evaluation de l’exposition previsible doit tenir compte de la bioaccessibilite des substances impliquees, liee a leurs proprietes physicochimiques. Celles-ci conditionnent leur comportement dans les milieux et leur toxicocinetique chez l’homme. La biometrologie permet de valider la pertinence de cette evaluation et l’efficacite des mesures preventives, et d’assurer la tracabilite des expositions. Resultats Entre 2012 et 2020, 39 chantiers mobilisant l’intervention de salaries du BTP, le plus souvent pour des travaux de terrassement/excavation de terres polluees, ont fait l’objet d’une evaluation a priori par le groupe Toxicologie medicale de BTP Sante au Travail Rhone-Isere. Dans la majorite des situations, a l’exception notable du mercure, aucun risque toxique, ni meme d’impregnation anormale de l’organisme, n’a ete mis en evidence : substances non bioaccessibles et/ou faiblement concentrees dans les terres et/ou EPI adaptes. Les dosages biometrologiques sont (mercure excepte) soit inferieurs aux limites de detection/quantification du laboratoire, soit non modifies entre le debut et la fin du chantier. Conclusion Une evaluation du risque pour les travailleurs du BTP intervenant sur des sites et sols pollues est possible si on dispose de donnees fiables sur la nature et la concentration des polluants, et si on met en œuvre une reflexion sur la bioaccessibilite des substances impliquees. Cette evaluation, le plus souvent tres rassurante, est confirmee par la biometrologie, ainsi que par l’analyse de la litterature, aucune publication ne faisant etat d’intoxication ni meme d’impregnation de l’organisme par les substances chimiques presentes dans les terres chez les travailleurs du BTP intervenant sur sites et sols pollues.

Resume L’evaluation de l’exposition est difficile pour le chercheur du domaine des risques professionnels. L’objectif du travail est de developper et de valider une matrice emplois-exposition (MEE) pour l’exposition professionnelle au SARS-CoV-2 appelee « Mat-O-Covid ». Grâce a un groupe d’expert francais, la matrice a ete developpee pour tous les travailleurs sur la profession et les categories socioprofessionnelles de 2003 (avec une passerelle de transcodage vers la Classification internationale type des professions de 2008) et un focus sur le secteur de soin et medicosocial. La moyenne des codages des experts a ete utilisee comme estimation pour l’exposition « sujets » (collegues et/ou public) et « patients » pour le focus secteurs sanitaires, ainsi que la probabilite de prevention pour chaque. Les correlations intraclasses ont ete considerees comme bonnes a excellentes, sauf pour la prevention en sante. Comparees a la matrice americaine O*Net, l’evaluation a ete consideree comme satisfaisante. En conclusion, une MEE « Mat-O-Covid » fournissant une probabilite d’exposition professionnelle au SARS-CoV-2 aura des implications pour la recherche et en sante publique, sous reserve de connaitre ses limites et de poursuivre sa validation.

Background Rodeo is an extreme sport involving powerful forces created by large animals. Objective The objective of this study was to characterize rodeo-related injuries among adolescents treated at United States emergency departments (EDs). Methods Cases were rodeo-related injuries among patients ages 13–19 years reported to the National Electronic Injury Surveillance System during 2000–2019. The distribution of the national injury estimates was determined for selected variables. Results A total of 408 adolescent rodeo-related injuries were identified, resulting in a national estimate of 17,363 injuries. Bulls were involved in 58.4% of the injuries and horses in 28.8%. The patients were 84.7% male and 15.3% female. The most frequently reported mechanisms of injury were: fell or thrown from an animal (41.4%), stepped on by an animal (22.4%), other contact with an animal (7.4%), contact with infrastructure (6.6%), and kicked by an animal (5.9%). The most common diagnoses were contusion or abrasion (29.5%), fracture (22.8%), strain or sprain (15.0%), laceration (8.1%), and concussion (8.0%). The affected body part was 26.9% head and neck, 25.9% upper extremity, 24.6% lower extremity, and 21.6% trunk. Conclusion Most of the injuries involved bulls. The majority of patients were male. Most of the injuries resulted from falling or being thrown by an animal or stepped on by an animal. The most frequently reported injuries were contusion or abrasion, fracture, strain or sprain, laceration, and concussion. The injuries most often affected the head and neck followed by the upper extremity and lower extremity.

Background: The present study investigated the association between two domains of physical activity (occupational physical activity [OPA] and leisure-time physical activity [LTPA]) and sleep duration. Methods: We investigated 3,421 paid workers from the Korea National Health and Nutrition Examination Survey, 2014–2015. Sleep duration was categorized into three categories (short for less than 5 h, optimal for 5–9 h, and long for more than 9 h). OPA and LTPA were defined in terms of answers to relevant questions. Odds ratios were calculated for sleep duration according to each physical activity domain using multinomial logistic regression models. Results: There were 464 subjects (13.6%) who showed short sleep duration, and 169 subjects (4.9%) who showed long sleep duration. Prevalence of OPA and LTPA was higher in male workers than in female workers (for OPA: 3.67% and 1.76%, respectively, p = 0.0108; for LTPA: 16.14% and 6.07%, respectively, p

Resume L’infection COVID-19 est une maladie emergeante qui peut etre grave, voire meme mortelle. Depuis son eclosion, cette maladie a genere de nombreuses situations de l’exercice medical ou la vie du patient ou son integrite physique se trouvent menacees, et pour lesquelles l’intervention salvatrice urgente du medecin est indispensable. Cette intervention en urgence pour porter secours a personne en peril constitue avant tout une obligation morale mais egalement ethique, deontologique et legale. En effet, la non-assistance a personne est consideree penalement comme un delit passible de sanctions graves. Toutefois, dans le contexte de la pandemie COVID-19, il existe un flou entourant cette infraction complexe, notamment en ce qui concerne l’evaluation du peril, et l’appreciation du risque pour soi ou pour autrui. D’ou l’interet de ce travail qui se propose d’analyser les particularites du delit de non-assistance a personne en peril dans le contexte de la pandemie COVID-19, et de detailler les enjeux judiciaires dans le domaine penal qui decoulent de cette infraction.

Backround Working condition surveys are widely recognized as useful tools for monitoring the quality of working life and the improvements introduced by health and safety policy frameworks at the European and national level. The Italian Workers' Compensation Authority carried out a national survey (Insula) to investigate the employer's perceptions related to working conditions and their impact on health. Methods The present study is based on the data collected from the Italian survey on health and safety at work (INSULA) conducted on a representative sample of the Italian workforce (n = 8,000). This focuses on the relationship between psychosocial risk factors and self-reported health using a set of logistic and linear regression models. Results Working conditions such as managerial support, job satisfaction, and role act as protective factors on mental and physical health. On the contrary, workers' risk perceptions related to personal exposure to occupational safety and health risks, concern about health conditions, and work-related stress risk exposure determine a poorer state of health. Conclusions This study highlights the link between working conditions and self-report health, and this aims to provide a contribution in the field of health at work. Findings show that working conditions must be object of specific preventive measures to improve the workers' health and well-being.

Objective To analyse the genotoxic risk of cytostatic drugs in health professionals after occupational exposure. Method Literature was searched for the databases PubMed, Lilacs, The Cochrane Library and Scopus with free and controlled language (MeSH terms) using boolean operators AND and OR. The research was limited to articles published between 2005–2016. Results 11 articles were selected depending on their relevancy to this review’s aim. Nine of the 11 articles proved the existence of damage to genetic material (DNA) of health workers, who were exposed to cytostatics. Furthermore, current security practices do not eliminate the chance of exposure completely. Therefore, the creation of new clinical trials is required. Conclusions Handling cytostatic drugs can cause a genotoxic risk to health workers who are exposed to these substances. This exposure may cause damage on the workers’ DNA. There are not enough data to prove a cause-effect relationship between the genotoxic risk and adverse reactions on individuals. Health education will be the main way to raise the awareness and prevention this problem.

Resumen Objetivo Analizar el riesgo genotoxico de los farmacos citostaticos en personal sanitario tras su exposicion ocupacional. Metodo Revision narrativa mediante busqueda bibliografica en bases de datos Pubmed, Lilacs, The Cochrane Library y Scopus, con lenguaje libre y controlado (terminos MeSH) utilizando los operadores booleanos AND y OR. La busqueda se limito a articulos publicados entre 2005-2016. Resultados Se analizaron 11 articulos seleccionados para esta revision bibliografica en funcion de su relevancia, de los cuales 9 mostraban dano en el material genetico (ADN) del personal sanitario expuesto a citostaticos. Ademas, cabe senalar que las actuales practicas de seguridad no eliminan por completo las posibilidades de exposicion, por lo que es necesaria la creacion de nuevos estudios clinicos. Conclusiones La manipulacion de citostaticos puede causar un riesgo genotoxico al personal sanitario que se encuentra expuesto a estas sustancias. Dicho riesgo puede producir modificaciones en el ADN del organismo de estos trabajadores. No existen datos suficientes para demostrar la relacion causa-efecto entre el riesgo genotoxico y el efecto adverso en el individuo. La educacion para la salud sera el principal medio para la concienciacion y prevencion del personal en riesgo.

Background A well-designed shift schedule has been reported to have a positive effect on improving health problems associated with shift work. This study aimed to identify compliance with the 17 recommendations on work schedule (WSRs) for shift nurses and related factors. Methods The descriptive study was conducted with 182 nurses who worked in three shifts for more than 1 year at superior general and general hospitals in three regions. Data were collected with self-administered questionnaire and 13-week work schedule tables, and analyzed with both person- and cycle-based compliance. Results Person-based compliance was 11.77 among 17 items in total. However, no one completely complied with WSRs of “no work on weekends” and which showed the lowest cycle-based compliance (22.3%). Compliance with some WSRs was related to hospital type, proportion of nurses in school and having standards on work schedule at institutional level. Conclusion Compliance with WSRs of shift nurses in Korea is still unsatisfactory, and one day off after night shift and work on weekend are quite common. Hospitals should keep the standards on work schedule, monitor compliance with standards, and try to introduce modified shift systems to improve the current problems.

Background Noise-induced hearing loss is a well-known occupational disease that affects many fish harvesters from many fisheries worldwide, whose risk factor is prolonged exposure to hazardous noise levels. To date, academic research activities and regulatory bodies have not provided any comparative analysis among the existing methods to assess noise exposure levels of fish harvesters. This paper provides a comparison of four relevant assessment methods of noise exposure, examining the results of a measurement campaign performed onboard small fishing vessels from Newfoundland and Labrador. Methods We traveled onboard 11 vessels engaged in multiple fisheries from Newfoundland and Labrador and performed extensive noise exposure surveys using the simplified International Maritime Organization method, the full-day measurement method, and the two methods provided by ISO 9612:2009, the task-based method and job-based method (JBM). Results The results showed that the four methods yield similar values when the noise components are dominated by the engine and auxiliaries (steady-state sources); when noise components are dominated by the fishing gear, task-based method and the simplified International Maritime Organization method estimates are less accurate than JBM, using full-day measurements as baseline. Conclusion The JBM better assesses noise exposure in small-scale fisheries, where noise exposure has significant variance and uncertainties on the exposure levels are higher.

Introduction We evaluated depression and anxiety in service and sales workers from Korea who interacted with angry clients to identify factors that mediated and moderated depression and anxiety in these workers. Methods This was a secondary analysis of data from the fifth Korean Working Conditions Survey conducted in 2017. A structural equation model was used for mediation and moderation analysis. Results Service and sales workers who had more interactions with angry clients had increased risk for depression and anxiety. Experiencing clients' adverse behaviors (acute episodes) mediated the relationship between interacting with angry clients (a chronic situation) on depression and anxiety. Job satisfaction and managers' support moderated the relationship between interacting with angry clients and mental health problems. Conclusion We suggest that employers of service and sales workers should recruit staff based on their aptitude for such work, thus ensuring job satisfaction, and train them to deal with angry clients in such a way that they experience less emotional burden. Employers should also make bylaws requiring managers to directly take care of adverse social behavior by clients. Furthermore, a sociocultural campaign to prevent adverse social behavior by clients is also needed.

Resume Objectif Decrire les conditions de travail des internes en medecine au cours de leur grossesse. Decrire les issues defavorables et identifier les facteurs professionnels associes a ces issues. Methode Cette etude observationnelle descriptive s’est interessee aux conditions de travail des internes enceintes mais egalement aux issues des grossesses, par l’intermediaire d’un questionnaire en ligne envoye aux 773 internes, de toutes specialites, inscrites a la faculte de Nancy, France. Resultats Trois cent un internes ont participe a l’etude (38,9 %). Le temps de travail quotidien moyen des internes etait de 9 heures, quel que soit le trimestre, avec un temps de pause qui excedait rarement une heure. Les internes ont declare continuer a faire des gardes dans 87,5 % des cas au-dela de 10 semaines d’amenorrhee, terme legal d’arret des gardes. Le taux d’issues defavorables etait de 42,6 % (23/54). Les taux de menaces d’accouchement premature et d’accouchements prematures etaient de 22,5 et 15 % respectivement. Une association significative a ete retrouvee entre des amplitudes horaires ≥ 10 h/j au 2e trimestre de grossesse et la survenue d’issues defavorables. Conclusion Un renforcement du suivi en sante au travail permettant l’amenagement des postes de travail, des campagnes d’information, ainsi que la designation de personnes-ressources au sein des facultes semblent indispensables.

Background Occupational health and safety (OHS) is a significant interest of all governments to prevent workplace hazards. Although appropriate legislation and regulations are essentials for the protection of workers, they are solely not enough. Application of them in practice should be secured by an efficient inspection system. Fundamental components of an inspection system are inspectors and their audit tasks. Maintaining the fair balanced task assignment among inspectors strictly enhances the efficiency of the overall system. Methods This study proposes a two-phased goal programming approach for OHS inspectors' task assignments and presents a case study. Results The solution approach gives the balanced assignment of inspectors to the workplaces in different cities of the country in the planning period. The obtained schedule takes into account the distances covered by the work places and the number of the workplaces' employees to be audited and pays attention to the human factors by considering the preferences of the inspectors. The comparisons between the obtained optimal schedule and the implemented one that is produced manually show that the approach not only maintains the technical requirements of the problem, but also provides social and physical balance to the task assignment. Conclusion Both the approach and the application study are expected to offer fruitful inspirations in the area of safety management and policy and they provide a good guide for social policy and organizational aspects in the field of OHS inspectors' task assignment.

Background A number of accidents have occurred in small and medium enterprises (SMEs). Efforts in reducing accidents have been undertaken through the implementation of safety behaviors. Unfortunately, few studies have examined motives behind unsafe behaviors, such as safety silence motives. This study aimed to observe the motives underlying safety behaviors, namely safety silence motive (SSM) (SSM-relation, SSM-climate, SSM-issue, and SSM-job) and to evaluate the effect of SSM and safety communication on safety participation in different industrial sectors and scales. Materials and Methods Eighty workers from two industrial sectors and scales of SMEs were involved. They were instructed to fill out a set of questionnaires. A five-Likert scale was used to respond. An independent t test was applied to find any significant differences. The partial least square-structural equation modeling for multigroup was used to develop a model on relations among the variables. Results The results showed that SSM scores were high in SMEs, and the scores were different across industrial sectors and scales. SSM had a negative influence on safety communication, and safety communication positively influenced safety participation. Conclusion The study of SSM, safety communication, and safety participation in different sectors and scales should be separated in SMEs.

Resume Objectif Le metier de chauffeur-livreur de farine est d’une grande intensite physique qui vient questionner nos pratiques de prevention en service de sante au travail. Nous avons decide d’accompagner une entreprise pour diminuer cette penibilite. Ainsi, pour evaluer l’intensite physique du travail et valider l’amelioration des conditions de travail ressenties par les salaries, deux etudes ont ete realisees sur 10 ans par une equipe pluridisciplinaire (medecin du travail et ergonome). Methode Deux etudes de cardiofrequencemetrie et d’ergonomie ont ete realisees en 2010–2012 et en 2017–2019 avec les memes outils d’observation et d’analyse. Au total, 52 journees d’enregistrement de frequence cardiaque pour 13 salaries et 6 journees d’observation des postes de travail ont ete analysees. La participation active de l’entreprise a ete constante (direction, CHSCT, salaries). Resultats Les ameliorations proposees (organisation des tournees, materiel mis a disposition des chauffeurs-livreurs, l’amenagement des lieux de stockage chez les boulangers …) par le service de sante au travail ont ete reprises et retravaillees par l’entreprise ce qui explique, pour une large part, la diminution de la penibilite. En effet, nos analyses montrent une tres nette reduction de l’astreinte cardiaque (cretes de frequence cardiaque, grilles de penibilite et temps de depassement des seuils aerobie et anaerobie) et des contraintes physiques (evolution des modes operatoires) entre les deux periodes. Elles valident le ressenti des salaries qui temoignaient de la diminution de la penibilite au cours des visites medicales. Conclusion Le travail pluridisciplinaire medecin du travail/ergonome, avec l’utilisation des deux outils cardiofrequencemetrie/ergonomie permet de valider ou non une diminution de la penibilite des postes physiques en impliquant tous les acteurs de l’entreprise. L’absence de cadre juridique des etudes de cardiofrequencemetrie ne nous permet pas d’intervenir plus largement la ou des salaries en auraient besoin et ou les entreprises hesitent a s’engager dans ce type d’etude.

Il a ete estime que 2,3 % de l’ensemble des cas de cancer, toutes localisations confondues, sont attribuables a une origine professionnelle. Or, il existe une meconnaissance des cancerogenes professionnels et du dispositif de suivi post-professionnel (SPP) des salaries au sein du corps medical francais. Le projet de plateforme web « POST-PRO » vise a concevoir et mettre a disposition des medecins un outil d’aide a la decision medicale pour ameliorer l’application et la mise en place du SPP aupres des anciens travailleurs. Methode : 35 agents cancerogenes ont ete selectionnes en suivant le cadre reglementaire du Code de la Securite Sociale et les avis de la Caisse Primaire d’Assurance Maladie (CPAM). Des donnees toxicologiques et medicales ont ete collectees. Nous avons developpe un site informatique avec un lexique interactif permettant l’acces a des fiches de synthese sur chacun des agents chimiques concernes. Resultats : la plateforme web « POST-PRO » est disponible a l’adresse : http://suivipostprofessionnel.fr. Elle met a disposition des medecins 14 fiches pour les agents cancerogenes decrits par le Code de la Securite Sociale et 21 fiches pour les agents qui peuvent justifier d’un SPP apres accord du medecin conseil de la CPAM. Conclusion : la generalisation de l’utilisation de l’outil d’aide a la decision medicale « POST-PRO » par les medecins francais pourrait permettre l’amelioration du SPP, amenant a une detection et une prise en 11 charge plus precoces des cancers d’origine professionnelle et s’inscrivant ainsi dans les objectifs du Plan Cancer 2014-2019.

Resume Introduction Les Sapeurs-Pompiers de Paris sont soumis en intervention a l’avertisseur sonore des vehicules de secours d’urgence. L’impact sur l’audition de cette exposition chronique a des sons d’intensite elevee n’est, a ce jour, pas connue. L’hypothese de depart etait que l’avertisseur sonore des vehicules de secours d’urgence emettant a une frequence proche de 500 a 800 Hz entrainait chez les conducteurs une baisse d’audition predominante a gauche, cote de la fenetre. La sirene etant placee sur le toit de la cabine de pilotage, nous avons suppose une plus forte exposition sonore de leur oreille gauche, cote fenetre, frequemment ouverte. L’objectif de cette etude retrospective etait de decrire les effets de l’exposition chronique a des avertisseurs sonores sur l’audition et de preciser si cette exposition etait lateralisee chez les conducteurs des vehicules de secours d’urgence de la Brigade de Sapeurs-Pompiers de Paris (BSPP). Methodologie Entre septembre et novembre 2017, tous les conducteurs de vehicules de secours d’urgence de la BSPP ayant beneficie de leur visite d’aptitude reguliere, ont participe sur la base du volontariat a une enquete sous forme de questionnaire. Les donnees collectees etaient : le sexe, l’âge, les antecedents ORL, les conduites a risque auditif, l’anciennete d’exercice a la BSPP. Les valeurs des audiogrammes a l’incorporation, a 5 ans, a 10 ans, a 15 ans et en fin de contrat ont ete colligees. Une analyse uni puis multivariee avec regression logistique a ete effectuee. Le p etait considere comme significatif lorsque inferieur a 0,05. Resultats Soixante-dix conducteurs dont 69 hommes (99 %) ont ete inclus. L’âge moyen etait de 32 ± 3 ans. L’anciennete mediane d’exercice a la BSPP etait de 12 [9–14] ans dont 9 [6–10] ans en tant que conducteur. Avec un seuil de 25 dB considere comme significatif pour la perte auditive, 18 (26 %) conducteurs presentaient un deficit auditif. Aucune difference significative entre l’oreille gauche et l’oreille droite n’a ete retrouvee. Conclusion Un quart des conducteurs de vehicules de secours d’urgence de la BSPP presentaient un deficit auditif significatif. L’exposition professionnelle chronique a l’avertisseur sonore des vehicules de secours d’urgence ne semblait pas etre a l’origine de ce deficit et n’etait pas associee a une lateralisation de cette derniere.

Introduction Training standards for long-haul truck drivers (LHTD) are rapidly evolving in Canada, yet the opinions of the drivers themselves have not been adequately considered. The purpose was to survey LHTD on their work training history and to examine LHTD perceptions of driver training and licensing protocols. Methods LHTD were recruited across two Western Canadian provinces from seven different truck stops. The sample completed 207 surveys and 67 semi-structured interviews. Results The average age of the participants was 52.5 ± 11.5 years (range 24–79); 96% were men. Approximately 33% of the LHTD had at least one crash. Those who did not receive formal driver training were significantly more likely to crash than those who had received training. Participants stated that current training standards are inadequate for the industry, particularly for new drivers. According to participants, entry-level curriculums should consist of both classroom and practical training, as well as on-road observation with a senior mentor. LHTD reported that many new drivers are not equipped to drive in various contexts and settings (e.g., mountains, slippery roads). Conclusions LHTD are not confident in the current training guidelines for novice truck drivers. Revisions to the training curriculum and standardization across Canada should be considered. Practical Application A federal mandatory entry-level training program is needed in Canada to ensure that all new LHTD ascertain the necessary skills to drive safely. Such a program requires government involvement and input from LHTD to facilitate appropriate licensure and consistent training for all drivers.

Background Traditional safety concept, which is called Safety-I, and its relevant methods and models have much contributed toward enhancing the safety of industrial systems. However, they have proved insufficient to be applied to complex socio-technical systems. As an alternative, Safety-II and resilience engineering have emerged and gained much attention for the last two decades. However, it seems that safety professionals have still difficulty understanding their fundamental concepts and methods. Accordingly, it is necessary to offer an introductory guide to them that helps safety professionals grasp them correctly in consideration of their current practices. Methods This article firstly explains the limitations of Safety-I and how Safety-II can resolve them from the four points of view. Next, the core concepts of resilience engineering and Functional Resonance Analysis Method are described. Results Workers' performance adjustment and performance variability due to it should be the basis for understanding human-related accidents in socio-technical systems. It should be acknowledged that successful and failed work performance have the same causes. However, they are not well considered in the traditional safety concept; in contrast, Safety-II and resilience engineering have conceptual bases and practical approaches to reflect them systematically. Conclusion It is necessary to move from a find-and-fix and reactive approach to a proactive approach to safety management. Safety-II and resilience engineering give a set of useful concepts and methods for proactive safety management. However, if necessary, Safety-I methods need to be properly used for situations where they can still be useful as well.

Resume Introduction Lorsque le poste de travail d’un salarie n’est plus compatible avec son etat de sante et que l’ensemble des solutions de maintien au poste ont ete epuisees, le medecin du travail rend un avis d’inaptitude. Ce statut n’est pas anodin car une desinsertion professionnelle ulterieure est souvent constatee. L’objectif de cette etude etait d’identifier les facteurs medico-socio-professionnels associes au devenir professionnel des salaries. Methode Cette etude retrospective a porte sur l’ensemble des inaptitudes prononcees au sein d’un service de sante au travail inter-entreprises d’Ille-et-Vilaine au cours de l’annee 2018. Les caracteristiques medico-socio-professionnelles des salaries ont ete collectees via leur dossier. Le devenir professionnel a douze mois de l’inaptitude a ete recueilli par rappel telephonique et classe en trajectoire « positive » (en emploi ou en formation) ou « hors emploi ». Des analyses univariees puis une analyse de type regression logistique ont permis d’analyser les facteurs associes a ce devenir. Resultats Au final, 420 salaries ont ete inclus et ont pu etre recontactes. A un an, les trajectoires positives etaient de 40,2 % (28,6 % en emploi et 11,7 % en formation) et 68,1 % des salaries relataient une perte de revenus. Les facteurs statistiquement associes a un risque plus faible de trajectoire « positive » a 12 mois etaient : le fait de beneficier d’une RQTH (OR : 0,58, IC95 % : [0,35–0,96]), d’une pension d’invalidite deuxieme categorie (OR :0,19, IC95 % : [0,07–0,52]), l’âge plus eleve (OR :0,43 IC95 % : [0,22 ; 0,85] pour les 49-56 ans vs 21–40ans ; et OR : 0,20 IC95 % : [0,09 ; 0,44] pour les 56–68 ans vs 21–40 ans), et les affections de la sphere psychologique (vs troubles locomoteurs) (OR : 0,50, IC95 % : [0,27 ; 0,90]). Conclusion Le reperage precoce de ces determinants doit permettre au medecin du travail d’etre particulierement attentif a ces publics « a risque » et d’activer, au moment opportun, l’ensemble des dispositifs de maintien dans l’emploi a sa disposition.

Resume Introduction Le stress est un facteur favorisant l’apparition et les exacerbations du psoriasis ainsi que l’intensite du prurit. Peu d’etudes ont ete realisees sur les effets du stress professionnel sur ces affections cutanees. Etudier l’association entre le stress professionnel et le niveau de prurit chez les patients atteints de psoriasis. Methode Il s’agit d’une etude prospective non-interventionnelle monocentrique. Les patients etaient des travailleurs atteints de psoriasis et etaient recrutes dans le service de dermatologie d’un centre hospitalier regional universitaire. Nous avons utilise le modele du desequilibre effort–recompense (effort–reward imbalance [ERI]) pour evaluer le stress professionnel et le questionnaire Itchy Quality of Life (ItchyQoL) pour le niveau de prurit des patients. Nous avons recueilli l’âge, le sexe, l’indice de masse corporelle, le traitement du psoriasis, la profession et le temps de travail hebdomadaire. L’association entre les scores ERI et ItchyQoL a ete etudiee a l’aide d’un modele logistique univarie. Resultats Trente patients ont ete inclus. La mediane du score ERI etait de 0,61. Six d’entre eux presentaient un desequilibre de la balance effort–recompense. La mediane du score ItchyQoL etait de 70. Nous n’avons retrouve aucune association significative entre le score ERI et le score ItchyQoL (p = 1). Discussion Il s’agit de la premiere etude sur les effets du stress professionnel issu du desequilibre effort–recompense sur le prurit. Cette etude preliminaire n’a pas permis de trouver une association significative entre le stress professionnel et le niveau de prurit chez des travailleurs atteints de psoriasis. Nous avons ete confrontes a des problemes pratiques de recrutement qui ont conduit a un effectif limite. Afin d’avoir une population plus importante et plus representative de la population generale atteinte de psoriasis, il faudrait mener une etude multicentrique en associant des dermatologues de ville et envisager d’autres options pour recruter davantage de patients.

Background During the period 2001 to 2016, the maximum temperatures in Thailand rose from 38–41oC to 42–44oC. The current occupational heat exposure standard of Thailand issued in 2006 is based on wet bulb globe temperature (WBGT) defined for three workload levels without a work–rest regimen. This study examined whether the present standard still protects most workers. Methods The sample comprised 168 heat acclimatized workers (90 in construction sites, 78 in foundries). Heart rate and auditory canal temperature were recorded continuously for 2 hours. Workplace WBGT, relative humidity, and wind velocity were monitored, and the participants' workloads were estimated. Heat-related symptoms and signs were collected by a questionnaire. Results Only 55% of the participants worked in workplaces complying with the heat standard. Of them, 79% had auditory canal temperature ≤ 38.5oC, compared with only 58% in noncompliant workplaces. 18% and 43% of the workers in compliant and noncompliant workplaces, respectively, had symptoms from heat stress, the trend being similar across all workload levels. An increase of one degree (C) in WBGT was associated with a 1.85-fold increase (95% confidence interval: 1.44–2.48) in odds for having symptoms. Conclusion Compliance with the current occupational heat standard protects 4/5 of the workers, whereas noncompliance reduces this proportion to one half. The reasons for noncompliance include the gaps and ambiguities in the law. The law should specify work/rest schedules; outdoor work should be identified as an occupational heat hazard; and the staff should include occupational personnel to manage heat stress in establishments involving heat exposure.

National audience; Introduction: The purpose of this study is to reflect on the interest of transposing the concept of frailty developed in geriatrics into occupational health and propose a tool for identifying vulnerability factors during the visit made by the occupational health nurses. Method: Starting from the definition of the concept of frailty in Geriatrics and two researches on frailty of 50 years and over, the SHARE survey and the HEAF study, we applied the criteria identified on three clinical situations encountered in an occupational health service. Results: We observe that the identification of frailty and the implementation of corrective actions allow an improvement in the quality of life and felt comfort and a prevention of occupational exclusion. Discussion: The concept of frailty therefore appears to be transposable to the younger subject and could in particular help to sensitize certain healthcare physicians to a global care and certain public health decision-makers to the importance of the preventive visit for 45–50 years old. Basically, this concept is already applied in occupational health, which is concerned not only with biomedical determinants but also with environmental ones. Following the detection of vulnerability factors, the occupational physician can intervene on the professional environment to adapt work to humans. Conclusion: Ultimately, the development of a simple tracking tool could be made available to occupational health nurses to allow suitable and relevant referral to the occupational physician. © 2020 Elsevier Masson SASIntroduction: L'objet de ce travail est de réfléchir à l'intérêt d'une transposition en Santé au travail du concept de fragilité développé en gériatrie et de proposer un outil de repérage des facteurs de vulnérabilité lors de la visite réalisée par l'infirmier(e) en Santé au travail. Méthode: Partant de la définition du concept de fragilité en gériatrie et de deux travaux sur la fragilité des 50 ans et plus, l'enquête SHARE et l’étude HEAF, nous avons appliqué les critères dégagés à trois situations cliniques rencontrées dans un service de Santé au travail. Résultats: Nous observons que le repérage de la fragilité et la mise en place d'actions correctrices permettent une amélioration de la qualité de vie et du confort ressenti et une prévention de la désinsertion professionnelle. Discussion: Le concept de fragilité paraît donc transposable chez le sujet plus jeune et pourrait notamment contribuer à sensibiliser certains médecins de soins à une prise en charge globale et certains décideurs en Santé publique à l'importance de la visite préventive des 45–50 ans. Au fond, ce concept est déjà appliqué en Santé au travail celle-ci s'intéressant non seulement aux déterminants biomédicaux mais aussi aux déterminants environnementaux. Suite à la détection de facteurs de vulnérabilité, le médecin du travail peut intervenir sur l'environnement professionnel pour adapter le travail à l'homme. Conclusion: À terme, le développement d'un outil simple de repérage pourrait être mis à disposition des infirmier(e)s en Santé au travail pour permettre une orientation adaptée et pertinente vers le médecin du travail. © 2020 Elsevier Masson SAS

This review article addresses the role of safety professionals in the diffusion strategies for predictive analytics for safety performance. The article explores the models, definitions, roles, and relationships of safety professionals in knowledge application, access, management, and leadership in safety analytics. The article addresses challenges safety professionals face when integrating safety analytics in organizational settings in four operations areas: application, technology, management, and strategy. A review of existing conventional safety data sources (safety data, internal data, external data, and context data) is briefly summarized as a baseline. For each of these data sources, the article points out how emerging analytic data sources (such as Industry 4.0 and the Internet of Things) broaden and challenge the scope of work and operational roles throughout an organization. In doing so, the article defines four perspectives on the integration of predictive analytics into organizational safety practice: the programmatic perspective, the technological perspective, the sociocultural perspective, and knowledge-organization perspective. The article posits a four-level, organizational knowledge-skills-abilities matrix for analytics integration, indicating key organizational capacities needed for each area. The work shows the benefits of organizational alignment, clear stakeholder categorization, and the ability to predict future safety performance.

We report a case of venous leg ulceration in a reconstructive oral and maxillofacial surgeon. An online survey was created by the British Association of Oral and Maxillofacial Surgeons (BAOMS) Reconstruction Surgical Subspecialty Interest Group (SSIG), primarily to target head and neck surgeons, to investigate the perceived risk and occurrence of venous leg disease. Two respondents had received treatment for lower limb venous disease thus compromising their ability to work, while 13 had symptoms of early venous disease. Our study shows an interesting area of concern for occupational health in surgeons, particularly in those carrying out long operations, as will be the case for members of the Reconstruction SSIG.

Resume Introduction Les dermatites des mains representent 20 a 34 % des pathologies professionnelles entrainant des retentissements socio professionnels. La Marine Nationale comprend 50 corps de metiers (me-caniciens, restaurateurs, personnels de sante…) dont certains a risque de developper des DM. L’objectif principal de ce travail etait de decrire les etiologies des DM chez les marins. L’objectif secondaire etait d’apprehender l’impact de cette pathologie dans la pratique du medecin militaire. Materiels et methode Une etude retrospective monocentrique etait conduite sur les dossiers de consultants pour des DM dans le service de dermatologie a l’Hopital militaire Sainte-Anne de Toulon. Puis, des questionnaires etaient envoyes aux medecins des forces de Marine de l’aire Toulonnaise. Resultats L’etude concernait 37 militaires a predominance masculine (73 %), d’âge moyen 32,4 ans. La specialite la plus representee etait le secteur administratif a 21,6 % puis les « RESTAU » (19 %), les mecaniciens (11 %) et les specialites « MACHINES » (8 %). Les principales etiologies etaient des ecze-mas allergiques (32 %) avec pour principaux allergenes : le caoutchouc et ses agents de vulcanisation et des dysidroses (21 %). Conclusion Les DM posent des problematiques en termes de prevention, d’aptitude et de prise en charge.

Resume Le passage de la matiere a des dimensions nanometriques fait apparaitre des proprietes inattendues et souvent totalement differentes de celles des memes materiaux a l’echelle micro- ou macroscopique. Les expositions professionnelles aux nanomateriaux manufactures (NM) concernent des travailleurs dans les laboratoires de recherche, les usines de fabrication ou les sites d’utilisation de NM, dont le nombre reste a ce jour non determine. Par ailleurs, des quantites importantes de NM sont deployees annuellement en France dans des secteurs tres varies selon le registre national de declaration annuelle obligatoire des substances a l’etat nanoparticulaire R-Nano. En parallele, plusieurs etudes experimentales, quoiqu’eparses, lacunaires, voire meme contradictoires, suggerent des effets biologiques deleteres pour certaines familles de NM. Des incertitudes demeurent donc sur les risques engendres par certains NM. De plus, des limites metrologiques persistent pour l’evaluation des expositions. Neanmoins, en depit de ce contexte d’incertitudes, la prevention des risques professionnels chez les travailleurs exposes aux NM s’impose, et la reglementation existante en matiere de prevention des risques professionnels reste applicable sous la responsabilite des employeurs. Des recommandations professionnelles sont mises a disposition des employeurs et des services de sante au travail par l’Institut national de recherche et de securite (INRS) ainsi que le Haut Conseil de Sante Publique (HCSP). En complement, la veille sanitaire (Dispositif national EpiNano) est incontournable pour fournir des donnees probantes concernant les risques pour la sante des travailleurs exposes aux NM. Ce manuscrit, redige par un groupe pluridisciplinaire, presente un apercu de l’etat de l’art relatif aux NM.

Resume Objectif L’objectif principal de cette etude etait de determiner le taux de maintien en emploi, 4 ans apres l’apparition d’un handicap locomoteur reconnu administrativement. Les objectifs secondaires etaient d’evaluer les modalites du maintien en emploi et le ressenti professionnel ainsi que rechercher des facteurs associes au maintien en emploi. Methodes Etude descriptive, transversale et retrospective au sein de la Maison departementale des personnes handicapees (MDPH) du departement de la Vienne. Un recueil administratif a ete realise dans les dossiers de la MDPH de 2013. Les personnes en emploi ayant obtenu une 1re Reconnaissance de la qualite de travailleur handicape (RQTH) pour un handicap locomoteur en 2013 ont ete contactees par telephone pour connaitre leur devenir professionnel. Le critere de jugement principal etait le taux de personnes maintenues en emploi 4 ans apres. Resultats Selon le recueil administratif, 352 personnes ont ete inclues et contactees par telephone entre le 30/10/2017 et le 04/02/2018 avec un taux de participation de 60,5 %. Le taux de maintien en emploi etait de 64,79 % se repartissant en 13,04 % au meme poste de travail sans modification, 62,32 % d’amenagement de poste, 22,5 % de reclassement interne et 2 % de reclassement externe. Une association significative positive avec le maintien en emploi etait retrouvee pour l’anciennete superieure a 10 ans dans l’entreprise, l’etablissement public et l’accompagnement individuel et une association negative pour l’arret de travail initial superieur a 2 ans et les ressources de type invalidite ou rente. La satisfaction professionnelle varie selon la presence ou non d’un accompagnement individuel et le type de maintien en emploi (39 % de satisfaction si aucune modification, 81 % si amenagement(s) de poste et 84 % si reclassement interne). Conclusion Les resultats sur les facteurs associes au maintien en emploi soulignent l’importance de limiter les arrets de travail prolonges et developper l’accompagnement specifique pour le maintien en emploi avec des axes de progres identifies en termes d’orientation, d’information et de communication. De plus, dans la population etudiee, la RQTH semble avoir ete une aide au maintien en emploi, en favorisant les amenagements et un accompagnement individuel.

Resume Objectif En France, les visites en service de sante au travail (SST) representent une occasion privilegiee de reperer les cas d’asthme en relation avec le travail (ART). Ce travail vise a fournir une demarche simple, confrontee aux resultats d’une expertise, susceptible d’aider le medecin du travail a reperer un ART. Methode Dans le cadre d’une etude epidemiologique avec un recrutement en SST, les sujets reperes, par autoquestionnaire, comme ayant un asthme actif potentiel, se voyaient proposer des autoquestionnaires sur les symptomes et les expositions professionnelles et la tenue d’un journal de debit expiratoire de pointe (DEP). Une expertise basee sur ces informations les classait en potentiellement non-asthmatiques (NA), asthmatiques sans relation avec le travail (ASRT) et ART. La recherche d’informations discriminant des sujets ART et ASRT, tels qu’identifies par l’expertise, a ete faite par le test du Chi2, puis par la regression logistique. Resultats L’expertise des 152 questionnaires approfondis a classe 16 salaries comme NA, 43 comme ASRT et 93 ART. La demarche d’expertise est detaillee sur la base d’exemples. L’amelioration des symptomes hors du travail, l’exposition professionnelle aux asthmogenes, la rythmicite de la variabilite du DEP et la recherche d’une sensibilisation par tests cutanes ont permis de discriminer les ART et les ASRT selon l’expertise avec une bonne valeur predictive positive. Conclusion Un autoquestionnaire simple et un journal de DEP permettent de reperer potentiellement des asthmes en relation avec le travail dans une population tout-venant suivie en SST.

Background: Assembly lines work is frequently associated to work-related upper limb musculoskeletal disorders. The related disability and absenteeism make it important to implement efficient health surveillance systems. The main objective of this study was to identify self-reported variables that can determine work-related upper limb musculoskeletal symptoms—discomfort/pain–during a 6-month follow-up. Methods: This was a prospective study with a 6-month follow-up period, performed in an assembly line. Upper limb musculoskeletal discomfort/pain was assessed through the presence of self-reported symptoms. Uni- and multivariate logistic regression analyses were used to evaluate which self-reported variables were associated to upper limb symptoms after 6 months at the present and to upper limbs symptoms in the past month. Results: Of the 200 workers at baseline, 145 replied to the survey after 6 months. For both outcomes, “having upper limb symptoms during the previous 6 months” and “education” were possible predictors. Conclusion: Our results suggest that having previous upper limb symptoms was related to its maintenance after 6 months, sustaining it as a specific determinant. It can be a hypothesis that this population had mainly workers with chronic symptoms, although our results give only limited support to self-reported indicators as determinants for upper limb symptoms. Nevertheless, the development of an efficient health surveillance system for high demanding jobs should implicate self-reported indicators, but also clinical and work conditions assessment should be accounted on the future. publishersversion published

Emergency Department (ED) nurses are medical professionals who work in a shift-work system. The implementation of shift work will affect the level of work-related fatigue and stress in ED nurses, which eventually affects their working performance, service quality, and the implementation of patient safety at the emergency department. Based on a preliminary study conducted in Badung Regency and Denpasar City, it was revealed that there were other shift schemes beside the 6-6-12 shift, namely the 7-7-10 shift and 12-12 shift. There has been no research conducted to evaluate work-related fatigue and stress in ED nurses working under those schemes. The aim of this research was to identify the different levels of work-related fatigue and stress in ED nurses working under the 7-7-10 and 12-12 shift schemes at the hospitals in Badung and Denpasar. This research was a quantitative study using an analytical-observational design with a cross-sectional approach. The sampling technique used was purposive sampling, with a sample of 45 nurses taken from four EDs of the hospitals in Badung Regency and Denpasar City. The data were collected by means of the OFER and ENSS questionnaires, which had been translated into Indonesian and tested for their validity and reliability. A statistical test showed that there was a significant difference in the effect of the shift-work schemes on nurses' work-related fatigue (p=0.012), but there was no meaningful difference in the effect of the schemes on their work-related stress (p=0.267). It was revealed that there was a difference in the influence of shift work on work-related fatigue, but there was no significant difference in the work-related stress level between the nurses working under those shifts.

Background Electrical socket outlets are used continuously until a failure occurs because they have no indication of manufacturing date or exchange specifications. For this reason, 659 electrical fires related to electrical socket outlets broke out in the Republic of Korea at 2018 only, an increase year on year. To reduce electrical fires from electrical socket outlets, it is necessary to perform an accelerated test and analyze the thermal, insulation resistance, and material properties of electrical socket outlets by installation years. Methods Thermal characteristics were investigated by measured the temperature increase of electrical socket outlets classified according to year with variation of the current level. Insulation resistance characteristics was measured according to temperature for an electrical socket outlets by their years of use. Finally, to investigate the thermal and insulation resistance characteristics in relation to outlet aging, this study analyzed electrical socket outlets’ conductor surface and content, insulator weight, and thermal deformation temperature. Results Analysis showed, regarding the thermal characteristics, that electrical socket outlet temperature rose when the current value increased. Moreover, the longer the time that had elapsed since an accelerated test and installation, the higher the electrical socket outlet temperature was. With respect to the insulation resistance properties, the accelerated test (30 years) showed that insulation resistance decreased from 110 °C. In relation to the installation year (30 years), insulation resistance decreased from 70 °C, which is as much as 40 °C lower than the result found by the accelerated test. Regarding the material properties, the longer the elapsed time since installation, the rougher the surface of conductor contact point was, and cracks increased. Conclusion The 30-year-old electrical socket outlet exceeded the allowable temperature which is 65 °C of the electrical contacts at 10 A, and the insulation resistance began to decrease at 70 °C. It is necessary to manage electrical socket outlets that have been installed for a long time.

Teachers are facing various job demands with psychosocial aspects being fundamental due to the nature of the occupation. Although teachers' work is associated with different psychosocial health risks, little is known on how to identify and tackle those. Thus, a systematic literature search as per the PRISMA statement was conducted via MEDLINE (PubMed), PSYNDEX (PubPsych), and ScienceDirect. Two reviewers independently screened 2261 titles and abstracts and 169 full-texts. According to the inclusion criteria established a priori, articles from peer-reviewed journals (English or German) on psychosocial risk management in teachers were incorporated. Despite a comprehensive and sensitive search, only four publications could be identified, outlining a process to implement risk management and different assessment tools. Taken together, data presented in the articles were scarce. Recommendations for process steps and the assessment of psychosocial risks can be derived from the findings. To implement effective psychosocial risk management in the teaching profession, further research is needed, though. Effective and practicable approaches, which are accepted by the target group, should be further developed and investigated. Relevant causes of occupational strain in the teaching profession must be identified and assessed reliably. Low-threshold interventions should be implemented, and the outcome must be evaluated afterward.

Zusammenfassung Hintergrund Die aktuelle COVID-19-Pandemie zeigt, wie sehr wir von Infektionskrankheiten bedroht sein konnen. Effektive Impfungen werden aber haufig nicht ausreichend durchgefuhrt. Im Marz 2020 wurde in Deutschland das Masernschutzgesetz eingefuhrt, um die Immunitat in der Bevolkerung auf uber 95 % zu steigern. Methode In der Bevolkerung wurde eine anonyme Online-Befragung zum neuen Masernschutzgesetz mit Selbstangaben zur Masernimpfung/-erkrankung der Teilnehmer*innen und ihrer Kinder und einer Bewertung verschiedener Strafen und Sanktionen durchgefuhrt. Ergebnisse 1594 Erwachsene nahmen teil. 19,3 % waren vom Masernschutzgesetz betroffen. Von diesen hatten nur 77,5 % eine Immunitat gegen Masern, 14,0 % wollten sich bei Inkrafttreten des Masernschutzgesetzes vollstandig gegen Masern impfen lassen, wodurch eine Immunitat von 91,5 % erreicht werden konnte. Unter der Annahme, dass Teilnehmer*innen mit unklarem Impfstatus bzw. Masernerkrankung immun sind, erreicht man eine Immunitat von > 9 5%. 86,4 % der Kinder (2–17 Jahre) hatten einen Immunschutz. Die Bereitschaft der Eltern, ihre Kinder aufgrund der Sanktionen des Masernschutzgesetzes impfen zu lassen, lag bei nur 0,8 %. Schlussfolgerung Die Immunitat gegen Masern bei Erwachsenen und Kindern (2–17 Jahre) lag in unserer Studie unter 95 %. Die Sanktionen des Masernschutzgesetzes sind fur Erwachsene ein groserer Anreiz zur Durchfuhrung der Masernimpfung als bei Kindern. Strategien zur Erhohung der Immunitat gegen das Masernvirus mit der Zielgruppe der Eltern sollten weiterhin verfolgt werden.

Background Most job exposure matrices (JEMs) have been developed for chemical and physical hazards in the United States (US). In addition, the overall validity of most JEMs of work organization hazards using self-reported data in the literature remains to be further tested due to several methodological weaknesses. Methods This paper aims to review important methodological issues with regard to a JEM of work organization hazards using self-report data and to present a research protocol for developing a four-axis (job titles, hazards, sex, and time) JEM of major work organization hazards using the US General Social Survey-Quality of Work-Life (GSS-QWL) data (2002–2018; N = 7,100 workers). Results Five methodological weaknesses in existing JEMs of work organization hazards using self-report data were identified: having only two axes (hazard and occupation), using psychometrically weak items and scales, including scales having little interoccupational variability, unresolved optimal minimum numbers of subjects per occupation, and low accessibility. The methodological weaknesses were successfully addressed in the proposed research protocol. Conclusion The work organization JEM to be developed will significantly facilitate and strengthen occupational epidemiological studies on work organization hazards and major health outcomes, improve national and occupational surveillance of work organization hazards, and promote interventions for a healthy work environment in the US.

Background The study tries to show the effect of Occupational Health and Safety (OHS) legislation implemented via Plan-Do-Check-Act (PDCA) methodology on accident and sickness absenteeism. Methods The data for the study gathered via a questionnaire from a large-sized organization operates in production and maintenance of passenger coaches in February-March 2019 in Turkey. The data analyzed via structural equation model analysis. Results The results showed that there are statistically meaningful relationships between OHS protective measures, training and informing of employees, and employee participation and accident and sickness absenteeism. Also, a meaningful relationship between internal control and accident and sickness absenteeism was determined. Statistically meaningful relationships between emergency measures, and health surveillance and internal control, and accident and sickness absenteeism could not be determined. Conclusion It is concluded that the actions implemented by organizations to reduce absenteeism should be according to OHS legislation.

Zusammenfassung Hintergrund Konzepte zur Delegation hausarztlicher Leistungen an medizinische Fachangestellte (MFA) wie die Entlastende Versorgungsassistentin (EVA) und die Versorgungsassistentin in der Hausarztpraxis (VERAH, VERAH Plus) werden durch die hohe Arbeitsverdichtung von Hausarzten immer wichtiger. Dieser Beitrag untersucht, welche Eigenschaften Hausarzte aufweisen, die an EVA, VERAH und VERAH Plus (sog. weiterqualifizierte MFA) delegieren. Neben der Delegation von Praxistatigkeiten geht es erganzend um Entlastungmoglichkeiten durch delegierte Haus- und Heimbesuche und das wahrgenommene Potential zukunftiger Delegation von Hausarzten. Methode Zwischen April und August 2016 wurde eine anonyme postalische Befragung einer reprasentativen randomisierten Stichprobe von niedergelassenen Hausarzten in Nordrhein-Westfalen durchgefuhrt (n = 2.404). Der Fragebogen enthielt Fragen zum Praxispersonal, zum Ort der durchgefuhrten delegierten Tatigkeit und zu empfundenen Mehrwerten und Barrieren. Die Analyse stellt Eigenschaften von Hausarzten gegenuber, die an weiterqualifizierte und an nicht-weiterqualifizierte MFAs delegieren. Ergebnisse Die Rucklaufquote betrug 32% (n = 762). Fast ein Drittel der Befragten (n = 239) delegiert Tatigkeiten an weiterqualifizierte MFA. Diese Hausarzte sind haufiger junger und mannlich und seltener in Einzelpraxen niedergelassen. Sie delegieren im Vergleich zu Hausarzten ohne weiterqualifizierte MFA mehr Praxistatigkeiten und mehr Haus- und Heimbesuche an ihre weiterqualifizierten MFA. Diskussion und Schlussfolgerung Sowohl die unterschiedlichen Einsatzorte der weiterqualifizierten MFA als auch die von den Hausarzten identifizierten Mehrwerte zeigen, dass die Hausarzte von den weiterqualifizierten MFA profitieren. Zur Sicherstellung der Versorgung sollten zukunftig noch mehr Hausarzte die Moglichkeit der Entlastung durch Delegation nutzen. Neben gesetzlichen Veranderungen sind weitere Masnahmen notwendig, um Hausarzte zu motivieren, sich mit den Moglichkeiten der Delegation auseinanderzusetzen, nichtarztliches Personal weiterzuqualifizieren und es entsprechend einzusetzen.

Resume Objectif Determiner la prevalence du burnout (BO) dans la population des intervenants Samu/Smur tunisiens et identifier les facteurs specifiques associes au BO severe. Methode Une enquete transversale, multicentrique basee sur un auto-questionnaire accompagne de deux echelles pour rechercher les facteurs associes au BO chez les participants (modeles de Karasek et Siegrist) et une echelle specifique du BO (Maslach Burnout Inventory). Cette etude a concerne tout le personnel medical et paramedical âge de plus de 20 ans travaillant dans differentes structures publiques du Samu/Smur. Resultats Notre etude a concerne 129 intervenants Samu/Smur avec un taux de participation egale a 63,2 %. Tous les participants inclus dans l’etude etaient atteints de BO a differents niveaux. Le BO eleve etait statistiquement associe a l’âge Conclusion Nos resultats confirment que les intervenants Samu/Smur presentent une categorie professionnelle a haut risque de developper l’epuisement professionnel. Ainsi, la mise en place d’un programme de prevention, d’information et d’encadrement du personnel s’impose.

Resume Contexte et objectifs A la demande de la Direction generale de la sante, la Haute Autorite de sante (HAS), en partenariat avec la Societe de toxicologie clinique (STC) et avec la collaboration de la Societe francaise de medecine du travail (SFMT), la Societe francaise de sante publique (SFSP), la Societe francaise de toxicologie analytique (SFTA) et la Societe francophone de sante-environnement (SFSE) a elabore des recommandations pour le depistage des surexpositions environnementales a l’arsenic inorganique (Asi) et la prise en charge des populations concernees. Methode La methode d’elaboration utilisee est celle des Recommandations pour la pratique clinique (RPC) de la HAS (HAS, 2010). Resultats Les recommandations elaborees identifient : les sites susceptibles d’entrainer des surexpositions environnementales, a partir de la concentration d’Asi dans leur sol ; la fraction des residents qui constitue la population cible du depistage ; les modalites de ce depistage qui utilise le dosage de l’Asi et de ses metabolites dans les urines. En fonction des resultats du primo-depistage, elles precisent les indications et le deroulement de la surveillance biometrologique. Elles indiquent la fraction de la population exposee qui constitue la cible de la recherche de complications de la surexposition environnementale a l’Asi. Elles precisent les modalites de cette recherche. Enfin, elles proposent des mesures pour le traitement et la prevention des contaminations par l’Asi de l’environnement.

Resume Introduction Le burn-out (BO) est un etat chronique cause par un niveau de stress eleve. L’anesthesie reanimation est une discipline medicale stressante qui expose a l’epuisement professionnel. Objectifs Determiner la prevalence du BO chez une population de techniciens superieurs d’anesthesie reanimation (TSAR) et identifier les differents facteurs qui y sont associes. Materiel et methodes Etude transversale descriptive menee sur les trois derniers mois de l’annee 2015, aupres des TSAR exercant au Centre Hospitalo-Universitaire (CHU) Farhat Hached de Sousse. La collecte des donnees socio-professionnelles s’est basee sur un auto-questionnaire anonyme. L’evaluation du stress etait faite par des instruments de mesures valides, a savoir les questionnaires de Siegrist et de Karasek et l’evaluation du BO par le Maslach Burnout Inventory. Resultats Notre etude a concerne 46 TSAR, dont 41 % etaient en etat de job-strain. Par ailleurs, 23,9 % des TSAR presentaient un desequilibre effort/recompense. La prevalence du BO dans sa forme severe et complete etait de l’ordre de 8,7 % et dans sa forme incomplete de l’ordre de 39,1 %. Les TSAR du bloc operatoire de gyneco-obstetrique etaient les plus concernes par le BO. En etude univariee, aucun facteur personnel ni professionnel n’etait significativement associe a la survenue du BO. Conclusion Nos resultats rejoignent ceux des etudes anterieures confirmant le taux de prevalence non negligeable du BO aupres de TSAR. Par consequent, il s’avere important de prendre en consideration les facteurs qui y sont associes vu leur retentissement sur le bien-etre des anesthesistes et sur la qualite des soins fournis pour les patients.

Background Work-related Low back Pain (WR-LBP) represents an important impact on the health and economic burden of workers worldwide. The wide range of risk factors have been evaluated on nurses, however, there is limited understanding of the contributions of an individual, physical and psychosocial factors with work-related low back pain among nurses in Emergency Care Unit (ECU). The aim of this study was to understand the potential risk factors of WR-LBP among ECU nurses. Methods This was a cross-sectional survey of healthcare workers in ECU at seven Hospitals in Manado. Questionnaires were distributed to assess the demographics, individual lifestyle and physical job characteristics, psychosocial, and self-reported low back pain. The associations between risk factors and WR-LBP were determined using multivariate logistic analysis. Results In total, 162 nurses in ECU participated in this research (81% response rate). A high proportion of nurses (92%) had experienced Work related – Musculoskeletal Disorder (WR-MSD) in the last 12 months, and 77% reported had experienced WR-LBP within the previous 12 months. WR-LBP was associated with older age (p = 0.001), being government officers (p = 0.002), more than 5 years of employment status (p = 0.002), has additional work (p = 0.05), psychosocial effort (p = 0.003), the total score of awkward position (0.000). Most of the work awkward positions measured in this study. The multivariate analysis confirmed that age (OR = 1.14, 95%CI 1.05–1.23), psychosocial effort (OR = 1.493, 95%CI 1.08–2.07), and awkward position total score (OR = 1.13, 95%CI 1.07–1.19) were significantly associated with WR-LBP. Conclusions This study revealed that individual, physical and psychosocial risk factors were important for work-related low back pain among nurses in ECU, especially the physical effort. It is suggested to increase attention to nurses’ health and safety, in ECU. The physical load factors should be addressed when designing a prevention method for nurses in ECU.

La chasse est, pour ses amateurs, une pratique sportive en lien avec la nature et un instrument de regulation de la faune sauvage. Elle permet aussi la capture du gibier. Le pratiquant s’expose aux morsures de tiques ou aux infections liees a la manipulation et a la consommation de viandes parasitees. Les federations de chasseurs organisent des sessions de formation et d’information, mais les pharmaciens d’officine peuvent egalement participer a une demarche preventive.

Background Nursing service is a nonroutine work with an excessive physical load and diverse tasks. This study derived representative common tasks based on the frequently occurring tasks with a high physical load in the nursing workers' daily work and developed indicators to evaluate the work risk by reflecting the characteristics of nonroutine work. Methods Common tasks were classified through the following stages: literature review, first focus group interview (FGI) with experts, first classification of common tasks, second FGI with hospital health managers, a survey of nursing service workers, and the final classification of common tasks for each task type. To develop an objective risk index for physical load assessment, we investigated the frequency and duration of the derived common tasks via survey. Results Nursing common tasks were categorized into six task types and 56 subtasks. To evaluate the risks of various tasks in nonroutine works, three frequencies and three working time levels were defined by examining the task frequency and working hours. Exposure time was defined to reflect the characteristics of a nonroutine job. The final risk assessment was the product of the exposure time level and job intensity level. From this, four risk action levels were derived. Conclusion This study has the advantage of solving the problem of focusing on some tasks in evaluating the physical load. It was meaningful in that a new risk assessment index based on exposure time was proposed based on the development of an evaluation scale for frequency and time by reflecting the characteristics of nonroutine work.

Background Urban bus drivers work under conditions that are among the most demanding, stressful, and unhealthy with higher rates of mortality and morbidity as well as absenteeism and turnover. Methods Drawing on the job demand-resource model, this study investigates the impacts of job characteristics on emotional exhaustion and the effects of emotional exhaustion on job outcomes (including job satisfaction, life satisfaction, organizational commitment, and turnover intention) in the context of bus drivers. Results Using self-reported survey data collected from a sample of 320 Taiwanese urban bus drivers, results reveal that role overload and work-family conflict (as job demand factors) positively relate to emotional exhaustion, and organizational support (as a job resource factor) is negatively associated with emotional exhaustion. Emotional exhaustion has negative effects on both job satisfaction and organizational commitment. Job satisfaction positively leads to life satisfaction, whereas organizational commitment negatively relates to turnover intention. Conclusion This study concludes that role overload and work-family conflict as two stressors related to job demands and organizational support as the job resource factor to affect emotional exhaustion which further influence well-being in bus driver context. The moderating effects of both extraversion and neuroticism on the relationship between job demands and emotional exhaustion are evident.