Association of overtime work and obesity with needle stick and sharp injuries in medical practice

BACKGROUND Needle stick and sharps injuries(NSIs)may cause infections among medical personnel.Obesity and overtime work among medical personnel increase the incidence of work injuries.AIM To investigate whether overtime work and obesity increase the risk of NSIs.METHODS This cross-sectional study used the data of 847 hospital personnel,including 104 doctors,613 nurses,67 medical laboratory scientists,54 specialist technicians,and nine surgical assistants.Of them,29 participants notified the hospital of having at least one NSI in 2017.The data collected included age,overtime work,body mass index,medical specialty such as doctor or nurse,and professional grade such as attending physician or resident.Theχ2 and Fisher’s exact tests were used to compare categorical variables.Multiple logistic regression analysis and the Sobel test were used to assess the risk of NSIs.RESULTS Overtime work,body weight,and medical specialty were significantly associated with NSIs(P<0.05).After adjustment for risk factors,heavy overtime work was an independent risk factor for NSIs,and healthy body weight and nursing specialty were independent protective factors against NSIs.After adjustment for risk factors,medical personnel with healthy body weight has half as many NSIs as those with unhealthy body weight;the proportion of NSIs in doctors with healthy body weight was 0.2 times that in doctors with unhealthy body weight;the proportion of injuries among residents was 17.3 times higher than that among attending physicians;the proportion of injuries among junior nurses was 3.9 times higher than that among experienced nurses;the proportion of injuries among nurses with heavy overtime work was 6.6 times higher than that among nurses with mild overtime work;and the proportion of injuries among residents was 19.5 times higher than that among junior nurses.Heavy overtime work mediated the association of medical specialty with NSIs.CONCLUSION In addition to promoting the use of safety needles and providing infection control education,managers should review overtime schedules,and medical personnel should be encouraged to maintain a healthy weight.

Is burnout a mediating factor between sharps injury and workrelated factors or musculoskeletal pain?

BACKGROUND Burnout,musculoskeletal pain,and sharps injuries(SIs)affect medical workers.AIM To establish a model between SIs,burnout,and the risk factors to assess the extent to which burnout affects SIs.METHODS This questionnaire was used for an observational and cross-sectional study,which was based on members at a hospital affiliated with a medical university in Taichung,Taiwan,in 2020.The valid responses constituted 68.5%(1734 of 2531).The items were drawn from the Nordic Musculoskeletal Questionnaire and Copenhagen burnout inventory and concerned work experience,occupational category,presence of chronic diseases,sleep duration,overtime work,and work schedule.Factor analysis,chi-square test,Fisher exact test,Multiple linear,logistic regression and Sobel test were conducted.The present analyses were performed using SAS Enterprise Guide 6.1 software(SAS Institute Inc.,Cary,NC,United States),and significance was set at P<0.05.RESULTS Personal and work-related burnout ranks, sex, work experience ranks, occupationalgroups, drinking in the past month, sleep duration per day, presence ofchronic diseases, overtime work ranks, and work schedule were associated withSIs. Frequent upper limb and lower limb pain (pain occurring every day or once aweek) determined to be related to SIs. High personal burnout (> Q3) and highwork-related burnout (> Q3) mediated the relationship between SIs and frequentlower limb pain. Similarly, frequent lower limb pain mediated the relationship ofSIs with high personal and high work-related burnout. High personal and highwork-related burnout mediated the relationships of SIs with overtime work andirregular shift work. The mediating model provides strong evidence of anassociation between mental health and SIs.CONCLUSIONBurnout was determined to contribute to SIs occurrence;specifically, it mediatedthe relationships of SIs with frequent musculoskeletal pain, overtime work, andirregular shift work.

Long-term Effects of Antihypertensive Drug Use and New-onset Osteoporotic Fracture in Elderly Patients： A Population-based Longitudinal Cohort Study

Background： Antihypertensive drugs have been linked to new-onset osteoporotic fracture （NOF）, and different classes of antihypertensive drugs may alter the risk for the development of NOF; however, the classic effect of different antihypertensive drugs on the development of NOF in the elderly has not been well studied during long-term follow-up. Methods： In this study, we investigated the association between different classic antihypertensives and the development of NOF in the elderly. This was a longitudinal cohort study performed using data from claim forms submitted to the Taiwan Bureau of National Health Insurance in Central Taiwan, China including case patients with NOF aged 65–80 years from January 2002 to December 2012 and non-NOF controls. Prescriptions for antihypertensives before the index date were retrieved from a prescription database. We estimated the hazard ratios （HR s） of NOF associated with antihypertensive use. Non-NOF controls served as the reference group. Results： A total of 128 patients with NOF were identified from among 1144 patients with hypertension during the study period. The risk of NOF after adjusting age, sex, comorbidities, and concurrent medications was higher among the users of angiotensin-converting enzyme （ACE） inhibitors （HR, 1.64; 95% confidence interval [CI], 1.01–2.66） than among nonusers. Patients who took calcium channel blockers （CCBs） （HR, 0.70; 95% CI, 0.49–0.99） were at a lower risk of developing NOF than nonusers. Loop diuretics, thiazide diuretics, angiotensin receptor blocker, beta-blocker, and alpha-blocker were not associated with the risk of NOF. Conclusions： Elderly with hypertension who take CCBs are at a lower risk of NOF and that the use of ACE inhibitors was associated with a significantly increased risk of developing NOF during the 11-year follow-up.