Kenyatta National Hospital (KNH) is the largest public referral hospital with a comprehensive cancer treatment facility in East and Central Africa. Occupational radiation monitoring is a significant technique for demo...Kenyatta National Hospital (KNH) is the largest public referral hospital with a comprehensive cancer treatment facility in East and Central Africa. Occupational radiation monitoring is a significant technique for demonstrating compliance of radiation regulatory limits. The objective of the study was to carry out assessment of occupational radiation exposure among radiotherapy personnel at KNH using thermoluminescence dosimeter, TLD. KNH staff were monitored using dosimeter type TLD-100 made of LiF:Mg,Ti, on monthly basis. The reader system used for analysis was Harshaw 8800. The measurement established the average monthly accumulated occupational personnel dose for KNH to be 0.21 mSv and 0.29 mSv for Hp (10) and Hp (0.07) respectively. The accumulated dose results were within the maximum acceptable dose of 1.67 mSv/month and 41.6 mSv/month for Hp (10) and Hp (0.07) respectively. The investigation results were higher than the acceptable public limit of 0.08 mSv/month. Moreover, incidences were noted where the fetus dose limit 0.42 was also exceeded. Evaluation of statistical dose exposure among doctors, nurses and radiographers’ measurement results were within ±0.02 mSv. The study established the average KNH occupational radiation exposure levels for both Hp (10) and Hp (0.07) were within the ICRU recommendation, validating radiation protection safe practice. Data analysis of healthcare workers did not indicate exposure trend biased to any healthcare profession. Hence radiation risk cut across all professional categories. It is recommended that Radiation Monitoring program be reviewed to include non-clinical staff who access the facility. Radiation reporting should not be limited to one facility, but reflect cases where workers are involved in multiple multiple jobs.展开更多
Introduction: Healthcare workers in Mogadishu, Somalia face significant occupational injury risks, particularly needle stick injuries, with 61.1% reporting incidents. This poses a serious threat to their health, leadi...Introduction: Healthcare workers in Mogadishu, Somalia face significant occupational injury risks, particularly needle stick injuries, with 61.1% reporting incidents. This poses a serious threat to their health, leading to infections such as hepatitis B, hepatitis C, and HIV. Despite the high prevalence of injuries, awareness of Post-Exposure Prophylaxis (PEP) accessibility is relatively high, with 84.0% of respondents aware of it. However, there are gaps in knowledge and implementation, as evidenced by variations in availability of PEP. Improving workplace safety measures, providing comprehensive training on injury prevention and PEP protocols, and ensuring consistent availability of PEP in healthcare facilities are crucial steps to safeguard the well-being of healthcare workers in Mogadishu, Somalia. Methods: A cross-sectional study was conducted among hospital workers in Mogadishu, Somalia, focusing on professionals from various healthcare facilities. The study targeted nurses, doctors, laboratory personnel, and pharmacists. Purposive sampling was employed, resulting in a sample size of 383 calculated using Fisher’s sample size formula. Data were collected using coded questionnaires entered into Microsoft Excel 2019 and analyzed with SPSS software to generate frequencies and proportions, presented through frequency tables and pie figures. Results: The study in Mogadishu, Somalia, examined the prevalence of occupational injuries and knowledge of Post-Exposure Prophylaxis (PEP) accessibility among healthcare workers. Findings indicate a high prevalence of injuries, with 61.1% reporting incidents, predominantly needle stick injuries (60.6%). Despite the majority seeking prompt medical attention (72.0%), work-related illnesses affected 53.2% of respondents, notably work-related stress (59.5%). While most received training on injury and illness prevention (68.9%), gaps exist in PEP awareness, with 16.0% unaware of it. Nonetheless, 84.0% were aware, predominantly through health facilities (52.0%). Availability of PEP was reported by 71.3% in healthcare facilities, with variations in shift availability. The majority reported guidelines for PEP use (55.7%). Efforts are needed to bolster PEP awareness and ensure consistent availability in healthcare facilities to safeguard worker health. Conclusion: High prevalence of occupational injuries among healthcare workers, with needle stick injuries being the most common (60.6%). Despite this, 84.0% of respondents were aware of Post-Exposure Prophylaxis (PEP), primarily learning about it from health facilities (52.0%). While 71.3% reported the availability of PEP in their facility, 28.7% noted its unavailability. These results emphasize the need for improved education and accessibility of PEP to mitigate occupational injury risks.展开更多
Cumulative inhalation of respirable coal mine dust(RCMD)can lead to severe lung diseases,including coal worker's pneu-moconiosis(CWP),silicosis,mixed dust pneumoconiosis,dust-related diffuse fibrosis(DDF),and prog...Cumulative inhalation of respirable coal mine dust(RCMD)can lead to severe lung diseases,including coal worker's pneu-moconiosis(CWP),silicosis,mixed dust pneumoconiosis,dust-related diffuse fibrosis(DDF),and progressive massive fibrosis(PMF).Statistics from the number of reported cases showed a significant decrease in the progression of respiratory diseases in the 1990s.However,an unexpected increase in the number of CWP cases was reported in the late 1990s.To date,there has been no comprehensive systematic review to assess all contributing factors to the resurgence of CWP cases.This study aims to investigate the effects of various mining parameters on the prevalence of CWP in coal mines.A systematic review using the preferred reporting items for systematic reviews and meta-analysis(PRISMA)method was conducted to investigate the health effects of RCMD exposure and identify the factors that may contribute to the recent resurgence of CWP cases.The systematic review yielded a total of 401 papers,which were added to the database.The total number of 148 and 208 papers were excluded from the database in the process of screening and eligibility,respectively.Then,18 papers were considered for data selection and full-text assessment.The review revealed that factors including geographic location,mine size,mining operation type,coal-seam thickness,coal rank,changes in mining practices,technology advancement,and engi-neering dust control practices are contributing to the recent resurgence of CWP among coal workers.However,the evidence for root causes is limited owing to the methodological constraints of the studies;therefore,further detailed studies are needed.展开更多
BACKGROUND The existing literature indicates that psychotherapeutic treatment,especially exposure and response prevention(ERP)is efficacious in treating obsessivecompulsive disorder(OCD).The coronavirus disease 2019 p...BACKGROUND The existing literature indicates that psychotherapeutic treatment,especially exposure and response prevention(ERP)is efficacious in treating obsessivecompulsive disorder(OCD).The coronavirus disease 2019 pandemic adversely impacted many patients with OCD and disrupted their usual treatment.Moreover,the pandemic forced a global switch to telemental health(TMH)services to maintain the standards and continuity of care.Consequently,clinicians are increasingly using TMH-based psychotherapeutic treatments to treat OCD.However,several challenges have made it difficult for them to implement these treatments in the changed circumstances imposed by the pandemic.AIM To describe the formulation,implementation,feasibility,and usefulness of videoconferencing-based ERP(VC-ERP)treatment for OCD during the coronavirus disease 2019 pandemic.METHODS This prospective,observational study was conducted in the psychiatric unit of a multi-specialty hospital in north India over 12 mo(July 2020-June 2021).All patients with OCD were assessed using the home-based TMH services of the department.The VC-ERP protocol for OCD was the outcome of weekly Zoom meetings with a group of clinicians involved in administering the treatment.After a systematic evaluation of the available treatment options,an initial protocol for delivering VC-ERP was developed.Guidelines for clinicians and educational materials for patients and their families were prepared.The protocol was implemented among patients with OCD attending the TMH services,and their progress was monitored.The weekly meetings were used to upgrade the protocol to meet the needs of all stakeholders.Feasibility and efficacy outcomes were examined.RESULTS All patients were diagnosed with OCD as a primary or a comorbid condition according to the International Classification of Diseases,10th version criteria.Out of 115 patients who attended the services during the study period,37 were excluded from the final analysis.Of the remaining 78 patients,VC-ERP was initiated in 43 patients.Six patients dropped out,and three were hospitalized for inpatient ERP.Eleven patients have completed the full VC-ERP treatment.One patient completed the psychoeducation part of the protocol.VC-ERP is ongoing in 22 patients.The protocol for VC-ERP treatment was developed and upgraded online.A large proportion of the eligible patients(n=34/43;79%)actively engaged in the VC-ERP treatment.Drop-out rates were low(n=6/43;14%).Satisfaction with the treatment was adequate among patients,caregivers,and clinicians.Apart from hospitalization in 3 patients,there were no other adverse events.Hybrid care and stepped care approaches could be incorporated into the VC-ERP protocol.Therefore,the feasibility of VC-ERP treatment in terms of operational viability,service utilization,service engagement,need for additional in-person services,frequency of adverse events,and user satisfaction was adequate.The VC-ERP treatment was found to be efficacious in the 11 patients who had completed the full treatment.Significant reductions in symptoms and maintenance of treatment gains on follow-up were observed.CONCLUSION This study provided preliminary evidence for the feasibility and usefulness of VC-ERP in the treatment of OCD.The results suggest that VC-ERP can be a useful option in resource-constrained settings.展开更多
Occupational exposure to flour dust within bakery environments presents significant health hazards to bakery personnel.Flour dust,generated as a byproduct during baking,becomes airborne during the baking process,thus ...Occupational exposure to flour dust within bakery environments presents significant health hazards to bakery personnel.Flour dust,generated as a byproduct during baking,becomes airborne during the baking process,thus constituting a respiratory threat.Adverse health consequences include respiratory diseases,skin irritation,allergic reactions,and potential long-term health impacts.Data indicates that a broad segment of bakery workers encounters exposure to flour dust,with specific subgroups,such as bakers and dough mixers,being particularly susceptible.Contributing factors to this exposure encompass insufficient ventilation and a lack of awareness.It is vital to assess exposure levels through air quality monitoring and health surveillance.Efficient interventions encompass engineering solutions(e.g.,ventilation systems,dust extraction),administrative measures(including training and the use of personal protective equipment),and the implementation of occupational health and safety programs.Collaborative efforts with healthcare professionals and regulatory authorities are paramount for achieving success.Case studies underscore the effectiveness of such interventions,resulting in improved worker health,thus underscoring the advantages of protective measures.Challenges in this endeavor include industry resistance to change,financial considerations,and issues related to compliance.Future recommendations entail further research,policy enhancements,and the involvement of industry stakeholders and labor unions in advocating for worker safety.展开更多
Objective To study the association between metal exposure and risk of diabetes and prediabetes among Chinese workers exposed to metals.Methods We used data obtained from the baseline survey of the Jinchang Cohort Stud...Objective To study the association between metal exposure and risk of diabetes and prediabetes among Chinese workers exposed to metals.Methods We used data obtained from the baseline survey of the Jinchang Cohort Study of workers in Jinchang Industry,the largest nickel production company in China.A total of 42,122 workers ≥20 years of age were included in the study.A standardized,structured questionnaire was used to collect epidemiological information.Physical examinations and laboratory tests were conducted to evaluate the health status of the participants and to measure various biomarkers including blood sugar,lipids,and urinary metal concentrations.Logistic regression was used to study the association between occupational groups categorized according to the measured metal levels(office workers,low-level;mining/production workers,mid-level;and smelting/refining workers,high-level)and risk of diabetes and prediabetes.Results The overall prevalence of diabetes and prediabetes was 7.5% and 16.8%,respectively.The adjusted odds ratios for diabetes among mining/production workers and smelting/refining workers compared to office workers were 1.5(95% CI:1.3,1.7)and 3.8(95% CI:3.4,4.3),respectively.No association was observed between these occupational groups and prediabetes in this study.Conclusion Occupations associated with higher levels of metal exposure were associated with an increased risk of diabetes in this cohort.More studies are needed to confirm this observed association.展开更多
A traditional belief widespread across the biomedical community was that dietary habits and genetic predisposition were the basic factors causing colorectal cancer.In more recent times,however,a growing evidence has s...A traditional belief widespread across the biomedical community was that dietary habits and genetic predisposition were the basic factors causing colorectal cancer.In more recent times,however,a growing evidence has shown that other determinants can be very important in increasing(or reducing) incidence of this malignancy.The hypothesis that environmental and occupational risk factors are associated with colorectal cancer is gaining ground,and high risks of colorectal cancer have been reported among workers in some industrial branches.The aim of this study was to investigate the epidemiologic relationship between colorectal cancer and occupational exposures to several industrial activities,by means of a scientific literature review and meta-analysis.This work pointed out increased risks of colorectal cancer for labourers occupied in industries with a wide use of chemical compounds,such as leather(RR = 1.70,95%CI:1.24-2.34),basic metals(RR = 1.32,95%CI:1.07-1.65),plastic and rubber manufacturing(RR = 1.30,95%CI:0.98-1.71 and RR = 1.27,95%CI:0.92-1.76,respectively),besides workers in the sector of repair and installation of machinery exposed to asbestos(RR = 1.40,95%CI:1.07-1.84).Based on our results,the estimated crude excess risk fraction attributable to occupational exposure ranged from about 11% to about 15%.However,homogeneous pattern of association between colorectal cancer and industrial branches did not emerge from this review.展开更多
Portal hypertension,liver fibrosis,and angiosarcoma of the liver(ASL)have been reported among workers exposed to vinyl chloride monomer(VCM)since the 1970s.In 2007,the International Agency for Research on Cancer estab...Portal hypertension,liver fibrosis,and angiosarcoma of the liver(ASL)have been reported among workers exposed to vinyl chloride monomer(VCM)since the 1970s.In 2007,the International Agency for Research on Cancer established the association of VCM with hepatocellular carcinoma(HCC),though only on the basis of the few cases available.Thereafter,recent reports from the United States cohort and a European sub-cohort of vinyl chloride workers provided compelling evidence of a strong association between cumulative VCM exposure and HCC risk.Further areas of research include the risk of liver cancer at lower levels of exposure and different patterns of risk of ASL and HCC with the time since exposure.The evidence of interaction between VCM exposure and other known liver carcinogens such as alcohol and chronic viral infection provides clues for the health surveillance of exposed workers.Notably,also the risk of VCM-associated chronic liver disease is modulated by alcohol consumption,viral infection,and genetic polymorphism.A counter-intuitive finding from cohort studies of exposed workers is the lower mortality from liver cirrhosis with respect to the general population;this can be attributed to the healthy worker effect and to the selection of liver cancer as the cause of death in the presence of concomitant chronic liver disease.Studies designed to overcome these intricacies confirmed an association between cumulative VCM exposure and the risk of liver cirrhosis.展开更多
Hepatocellular carcinoma(HCC)is the most common type of liver cancer.The main risk factors for HCC are alcoholism,hepatitis B virus,hepatitis C virus,nonalcoholic steatohepatitis,obesity,type 2 diabetes,cirrhosis,afla...Hepatocellular carcinoma(HCC)is the most common type of liver cancer.The main risk factors for HCC are alcoholism,hepatitis B virus,hepatitis C virus,nonalcoholic steatohepatitis,obesity,type 2 diabetes,cirrhosis,aflatoxin,hemochromatosis,Wilson’s disease and hemophilia.Occupational exposure to chemicals is another risk factor for HCC.Often the relationship between occupational risk and HCC is unclear and the reports are fragmented and inconsistent.This review aims to summarize the current knowledge regarding the association of infective and non-infective occupational risk exposure and HCC in order to encourage further research and draw attention to this global occupational public health problem.展开更多
This study aims to establish the occupational exposure limit (OEL) in the air for workplace of warfarin based on the available toxicological studies and field investigations by using questionnaire and air monitoring...This study aims to establish the occupational exposure limit (OEL) in the air for workplace of warfarin based on the available toxicological studies and field investigations by using questionnaire and air monitoring. The clinical therapeutic dose was used as lowest observed effect level (LOEL), and no observed effect level (NOEL) was achieved by using a safety factor. The highest concentration of warfarin monitored in the worksite of centrifuge washing, drying and packing were 0.029 mg/m3, 0.052 mg/m3 respectively, which did not exceed the OEL 0.2 mg/m3 recommended by NIOSH and ACGIH. Considering its feasibility for enforcement and protection for workers, we recommend OEL 0.2 mg/m3 of warfarin in China.展开更多
To show the risks and harm caused by the occupational exposure to the benzene, toluene, ethylbenzene and xylenes compounds (BTEX), the working conditions of 113 persons employed at gas stations in the cities of Riach?...To show the risks and harm caused by the occupational exposure to the benzene, toluene, ethylbenzene and xylenes compounds (BTEX), the working conditions of 113 persons employed at gas stations in the cities of Riach?o do Jacuipe, Feira de Santana and Salvador in the state of Bahia, Brazil were investigated by experts who correlated protection measures required by law and those applied to the workers. Data collection was performed by help of a questionnaire and non-participant observation record. The age groups of the workers in the three cities surveyed were between 18 to 25 years (30.08%) and 26 to 33 years (34.51%) of the total. The study revealed an association between occupational habits of workers at gas stations and the prevalence of symptoms due to the exposure to the BTEX compounds. Regarding the use of Personal Protective Equipment (PPE) most workers wear boots. The data show that these workers reported symptoms such as headache, rhinitis, leg pain, drowsiness, cough, fatigue, insomnia, tremors and palpitations. These disorders are related back to previous exposure to BTEX compounds which is associated with inadequate occupational habits of the workers which potentiate chemical contamination in their respective environment.展开更多
AIM: To critically evaluate the current epidemiology data on exposures, rather than infection, to hepatitis C virus(HCV) transmission and recommend epidemiologic strategies to fill gaps. METHODS: Standard methods for ...AIM: To critically evaluate the current epidemiology data on exposures, rather than infection, to hepatitis C virus(HCV) transmission and recommend epidemiologic strategies to fill gaps. METHODS: Standard methods for identifying and evaluating relevant epidemiologic literature and available data were used. RESULTS: There is a large body of literature on the epidemiology of HCV transmission in Egypt that collectively identifies ongoing iatrogenic exposures as the major driver for HCV transmission due to short comings in infection control and standard procedures. Additional epidemiologic studies on HCV transmission that requires the participation of human subject is unwarranted. Alternatively, very little literature was found on the epidemiology of exposure to HCV, infection control, and safe injection practices. The information that is available on patterns of HCV exposure shows high frequencies of inadequate infection control, problems in sterilization in health care facilities, low rates of hand washing, untrained personnel, lack of stated policies in facilities, HCV contamination of instruments and very large injection frequencies with low but very significant syringe and needle reuse. There is an important need to increase the number, size, and diversity of epidemiologic studies on HCV exposures, patterns of risk factors for infection, infection control, and safe injection practices. In addition to health care facilities evaluation, relevant knowledge attitude and practice studies are recommended. CONCLUSION: Epidemiologic methods on HCV ex-posure can be used to characterize the magnitude of exposures to HCV infection, target interventions to reduce exposures, and provide the best method for evaluating interventions by demonstrating the reduction of exposure to HCV infection.展开更多
Objective To investigate the effect of long-term and low-level occupational Mn exposure on the level of uric acid (UA) in human urine. Methods In this study, 65 volunteers were recruited, who were working on welding...Objective To investigate the effect of long-term and low-level occupational Mn exposure on the level of uric acid (UA) in human urine. Methods In this study, 65 volunteers were recruited, who were working on welding and foundry work in an plant in Gansu province, China. Additionally, 29 control samples were collected from individuals who did not have any history of excessive Mn exposure. An improved high performance liquid chromatography system equipped with a diode-array detector (HPLC-DAD) method was developed to determine the UA level in human urine. A Spectra AA 220 Atomic Absorption Spectrophotometer (AAS) was used to measure the Mn level in the urine. Results The analytical method was validated acceptable accuracy, precision, and recovery significantly lower than that of control samples for concentrations ranging from 3.82-45.84 pg/mL with Overall, the UA levels of Mn exposure samples were (P〈O.O5). Conclusion The practical method developed here is suitable for both routine monitoring of UA level in human urine and metabolism research. Long-term and low-level occupational Mn exposure may lead to a lower UA level in urine, and UA might be an indicator of the early stage of manganism.展开更多
Healthcare workers (HCWs) who are employed in traditional health care workplaces face a serious danger that may threaten their life;it is their exposure to blood and body fluids (BBF). In Lebanon, the introduction of ...Healthcare workers (HCWs) who are employed in traditional health care workplaces face a serious danger that may threaten their life;it is their exposure to blood and body fluids (BBF). In Lebanon, the introduction of a hospital accreditation system has put a particular emphasis on staff safety, and on the evaluation of professional practice (EPP) programs. Methods: A cross-sectional survey was conducted amongst 277 HCWs working in 4 general hospitals in South Lebanon. Objective: 1) describe the prevalence and the risk factors for occupational exposure to BBF among HCWs;2) evaluate knowledge, attitude, and practices of HCW concerning blood-borne pathogens and adherence to universal safety precautions. Results: The mean age of the respondents was 32.14 years (SD = 10.33), 57.4% were females. 43.3% of HCWs expressed that they use gloves all the time for every activeity of care. 67.1% were aware that needles should not be recapped after use;registered nurses and nursing students were more aware than physicians and nursing assistants (nurse) in this subject. 30% of HCWs declared having had at least one occupational exposure to BBF;62.7% of all accidental exposure was reported to the department responsible for managing exposures. Percutaneous injuries were the most frequently reported. Vaccination coverage was 88.4% for hepatitis B, and 48.4% against influenza. The source patient was tested in 43.4% of reported BBF exposures. Accidental exposure to BBF was more frequent in older people (OR = 3.42;p = 0.03) and the more experienced. Subjects working in intensive care unit ward reported more exposure to BBF (OR = 3;p = 0.04). Participants incurring exposure to BBF resorted to different measures after the injury suggesting a lack of a uniform policy for post-exposure prophylaxis. Conclusion: Exposure to BBF represents an important and frequently preventable occupational hazard for HCWs in Lebanon that requires continuous EPP of HCWs, and a comprehensive approach for prevention and management.展开更多
Case reports of indium-related lung disease in workers have raised public concern to the human toxicity of indium (In) and its compounds. However, studies evaluating the exposure or health of workers in In smelting ...Case reports of indium-related lung disease in workers have raised public concern to the human toxicity of indium (In) and its compounds. However, studies evaluating the exposure or health of workers in In smelting plants are rare. Therefore, in this study, we focused on four In smelting plants, with the main objective of characterizing In in smelter plants in China and discussing the potential exposure biomarkers of In exposure.展开更多
BACKGROUND Although minimal change disease(MCD)and focal segmental glomerulosclerosis(FSGS)have been described as two separate forms of nephrotic syndrome(NS),they are not completely independent.We report a case of a ...BACKGROUND Although minimal change disease(MCD)and focal segmental glomerulosclerosis(FSGS)have been described as two separate forms of nephrotic syndrome(NS),they are not completely independent.We report a case of a patient transitioning from MCD to FSGS,review the literature,and explore the relationship between the two diseases.CASE SUMMARY A 42-year-old male welder,presenting with lower extremity edema and elevated serum creatinine,was diagnosed with NS and end-stage kidney disease(ESKD)based on laboratory test results.The patient had undergone a kidney biopsy for NS 20 years previously,which indicated MCD,and a second recent kidney biopsy suggested FSGS.The patient was an electric welder with excessive levels of cadmium and lead in his blood.Consequently,we suspect that his aggravated pathology and occurrence of ESKD were related to metal nephrotoxicity.The patient eventually received kidney replacement therapy and quit his job which involved long-term exposure to metals.During the 1-year follow-up period,the patient was negative for metal elements in the blood and urine and recovered partial kidney function.CONCLUSION MCD and FSGS may be different stages of the same disease.The transition from MCD to FSGS in this case indicates disease progression,which may be related to excessive metal contaminants caused by the patient’s occupation.展开更多
Code of Occupational Disease Prevention of P.R.China was promulgated in 2002. As per law-enforcement requirement, we need a prompt establishment of occupational disease prevention standard system to become compatible ...Code of Occupational Disease Prevention of P.R.China was promulgated in 2002. As per law-enforcement requirement, we need a prompt establishment of occupational disease prevention standard system to become compatible with advanced world standards and make up our current technical standards on occupational disease prevention (TSODP). With an eye to improving TSODP system and reinforcing legislative construction, this project focuses on TSODP of workplace and occupational protection, and will be of momentous importance to guide employing units in preventing occupational disease. In addition, this project attaches importance to the integration of the said standards into those of advanced international ones, which will be conductive to update China’s ODP and foster a good and healthy international image for China. This article gives you a general profile of this project through anticipated goals, progress and achievements of particular stages, so that you can have some knowledge of this project.展开更多
<strong>Context:</strong> Health Care Workers (HCWs) involved in field-level activities are exposed to COVID-19 which puts them under physical and psychological stress. <strong>Aim:</strong> Th...<strong>Context:</strong> Health Care Workers (HCWs) involved in field-level activities are exposed to COVID-19 which puts them under physical and psychological stress. <strong>Aim:</strong> The objective of this study was to understand the perception of the health care workers regarding their occupational exposure to COVID-19, including the safety measures used during field surveillance activities. <strong>Settings and Design:</strong> This cross-sectional study was conducted from June 2020 to July 2020 among the health care workers involved in COVID-19 field containment activities in two south Indian states—Telangana and Tamil Nadu. <strong>Methods and Material:</strong> Respondents were purposively sampled based on their involvement in the COVID-19 field level activities. Sixteen In-Depth Interviewees (IDIs) were conducted telephonically with medical officers, district epidemiologists, community health workers, sanitary workers, emergency medical technicians, and ambulance coordinators.<strong> Statistical Analysis</strong> <strong>Used:</strong> IDIs were analyzed using manual thematic analysis. <strong>Results:</strong> Seven themes and sub-themes emerged: awareness and training, occupational exposure to COVID-19 and duration, safety measures, occupational burnout, social stigma, psychological violence, and facilitating factors. Respondents felt a high level of occupational exposure to COVID-19 in addition to increased workload and stress due to fear of infection, shortage of workforce, denial of week off, psychological violence, and social stigma which affected them deeply. Support from supervisors and family, and measures ensuring the safety of women were facilitating factors to cope with the situation. <strong>Conclusions:</strong> It is important to safeguard the general and mental health of field-level health workers involved in COVID-19 activities, to keep their morale high during the continuing pandemic.展开更多
Despite wide application of hydrated calcium sulfate, possible respiratory effects of long-term occupational exposure to high concentrations of this chemical have only been investigated in a limited number of epidemio...Despite wide application of hydrated calcium sulfate, possible respiratory effects of long-term occupational exposure to high concentrations of this chemical have only been investigated in a limited number of epidemiological studies. This study is undertaken to examine this issue, more thoroughly. This cross-sectional study is carried out at a local gypsum plant in Shiraz, capital of Fars province situated in south western Iran. All exposed subjects (20 male workers) and 20 healthy non-exposed male individuals as the referent group are investigated. Prevalence of respiratory symptoms among the studied subjects is evaluated and they undergo spirometry test (twice for the exposed group and once for the unexposed employees). Moreover, to assess the extent to which workers are exposed to gypsum dust and using standard methods, inhalable and respirable fractions of this compound are measured in different dusty worksites. Average airborne concentration of inhalable dust fraction is estimated to be 24 ± 14.76 mg/m3 which is higher than the recommended threshold limit value (TLV) for this chemical. Respiratory symptoms such as phlegm, wheezing and dyspnea are significantly more prevalent in exposed subjects than in non-exposed employees (p < 0.05). The results of ventilatory function tests (pre- shift) don’t show any significant differences between both groups. However, some post-shift parameters of ventilatory function such as FVC, FEV1 and FEV1/FVC ratio are significantly lower than those of preshift and referent group. Exposure to high atmospheric concentrations of gypsum dust is associated with a significant increase in the prevalence of respiratory symptoms along with acute reversible significant decreases in some parameters of ventilatory function.展开更多
文摘Kenyatta National Hospital (KNH) is the largest public referral hospital with a comprehensive cancer treatment facility in East and Central Africa. Occupational radiation monitoring is a significant technique for demonstrating compliance of radiation regulatory limits. The objective of the study was to carry out assessment of occupational radiation exposure among radiotherapy personnel at KNH using thermoluminescence dosimeter, TLD. KNH staff were monitored using dosimeter type TLD-100 made of LiF:Mg,Ti, on monthly basis. The reader system used for analysis was Harshaw 8800. The measurement established the average monthly accumulated occupational personnel dose for KNH to be 0.21 mSv and 0.29 mSv for Hp (10) and Hp (0.07) respectively. The accumulated dose results were within the maximum acceptable dose of 1.67 mSv/month and 41.6 mSv/month for Hp (10) and Hp (0.07) respectively. The investigation results were higher than the acceptable public limit of 0.08 mSv/month. Moreover, incidences were noted where the fetus dose limit 0.42 was also exceeded. Evaluation of statistical dose exposure among doctors, nurses and radiographers’ measurement results were within ±0.02 mSv. The study established the average KNH occupational radiation exposure levels for both Hp (10) and Hp (0.07) were within the ICRU recommendation, validating radiation protection safe practice. Data analysis of healthcare workers did not indicate exposure trend biased to any healthcare profession. Hence radiation risk cut across all professional categories. It is recommended that Radiation Monitoring program be reviewed to include non-clinical staff who access the facility. Radiation reporting should not be limited to one facility, but reflect cases where workers are involved in multiple multiple jobs.
文摘Introduction: Healthcare workers in Mogadishu, Somalia face significant occupational injury risks, particularly needle stick injuries, with 61.1% reporting incidents. This poses a serious threat to their health, leading to infections such as hepatitis B, hepatitis C, and HIV. Despite the high prevalence of injuries, awareness of Post-Exposure Prophylaxis (PEP) accessibility is relatively high, with 84.0% of respondents aware of it. However, there are gaps in knowledge and implementation, as evidenced by variations in availability of PEP. Improving workplace safety measures, providing comprehensive training on injury prevention and PEP protocols, and ensuring consistent availability of PEP in healthcare facilities are crucial steps to safeguard the well-being of healthcare workers in Mogadishu, Somalia. Methods: A cross-sectional study was conducted among hospital workers in Mogadishu, Somalia, focusing on professionals from various healthcare facilities. The study targeted nurses, doctors, laboratory personnel, and pharmacists. Purposive sampling was employed, resulting in a sample size of 383 calculated using Fisher’s sample size formula. Data were collected using coded questionnaires entered into Microsoft Excel 2019 and analyzed with SPSS software to generate frequencies and proportions, presented through frequency tables and pie figures. Results: The study in Mogadishu, Somalia, examined the prevalence of occupational injuries and knowledge of Post-Exposure Prophylaxis (PEP) accessibility among healthcare workers. Findings indicate a high prevalence of injuries, with 61.1% reporting incidents, predominantly needle stick injuries (60.6%). Despite the majority seeking prompt medical attention (72.0%), work-related illnesses affected 53.2% of respondents, notably work-related stress (59.5%). While most received training on injury and illness prevention (68.9%), gaps exist in PEP awareness, with 16.0% unaware of it. Nonetheless, 84.0% were aware, predominantly through health facilities (52.0%). Availability of PEP was reported by 71.3% in healthcare facilities, with variations in shift availability. The majority reported guidelines for PEP use (55.7%). Efforts are needed to bolster PEP awareness and ensure consistent availability in healthcare facilities to safeguard worker health. Conclusion: High prevalence of occupational injuries among healthcare workers, with needle stick injuries being the most common (60.6%). Despite this, 84.0% of respondents were aware of Post-Exposure Prophylaxis (PEP), primarily learning about it from health facilities (52.0%). While 71.3% reported the availability of PEP in their facility, 28.7% noted its unavailability. These results emphasize the need for improved education and accessibility of PEP to mitigate occupational injury risks.
基金funded by the National Institute for Occupational Safety and Health (NIOSH) (75D30119C06390).
文摘Cumulative inhalation of respirable coal mine dust(RCMD)can lead to severe lung diseases,including coal worker's pneu-moconiosis(CWP),silicosis,mixed dust pneumoconiosis,dust-related diffuse fibrosis(DDF),and progressive massive fibrosis(PMF).Statistics from the number of reported cases showed a significant decrease in the progression of respiratory diseases in the 1990s.However,an unexpected increase in the number of CWP cases was reported in the late 1990s.To date,there has been no comprehensive systematic review to assess all contributing factors to the resurgence of CWP cases.This study aims to investigate the effects of various mining parameters on the prevalence of CWP in coal mines.A systematic review using the preferred reporting items for systematic reviews and meta-analysis(PRISMA)method was conducted to investigate the health effects of RCMD exposure and identify the factors that may contribute to the recent resurgence of CWP cases.The systematic review yielded a total of 401 papers,which were added to the database.The total number of 148 and 208 papers were excluded from the database in the process of screening and eligibility,respectively.Then,18 papers were considered for data selection and full-text assessment.The review revealed that factors including geographic location,mine size,mining operation type,coal-seam thickness,coal rank,changes in mining practices,technology advancement,and engi-neering dust control practices are contributing to the recent resurgence of CWP among coal workers.However,the evidence for root causes is limited owing to the methodological constraints of the studies;therefore,further detailed studies are needed.
文摘BACKGROUND The existing literature indicates that psychotherapeutic treatment,especially exposure and response prevention(ERP)is efficacious in treating obsessivecompulsive disorder(OCD).The coronavirus disease 2019 pandemic adversely impacted many patients with OCD and disrupted their usual treatment.Moreover,the pandemic forced a global switch to telemental health(TMH)services to maintain the standards and continuity of care.Consequently,clinicians are increasingly using TMH-based psychotherapeutic treatments to treat OCD.However,several challenges have made it difficult for them to implement these treatments in the changed circumstances imposed by the pandemic.AIM To describe the formulation,implementation,feasibility,and usefulness of videoconferencing-based ERP(VC-ERP)treatment for OCD during the coronavirus disease 2019 pandemic.METHODS This prospective,observational study was conducted in the psychiatric unit of a multi-specialty hospital in north India over 12 mo(July 2020-June 2021).All patients with OCD were assessed using the home-based TMH services of the department.The VC-ERP protocol for OCD was the outcome of weekly Zoom meetings with a group of clinicians involved in administering the treatment.After a systematic evaluation of the available treatment options,an initial protocol for delivering VC-ERP was developed.Guidelines for clinicians and educational materials for patients and their families were prepared.The protocol was implemented among patients with OCD attending the TMH services,and their progress was monitored.The weekly meetings were used to upgrade the protocol to meet the needs of all stakeholders.Feasibility and efficacy outcomes were examined.RESULTS All patients were diagnosed with OCD as a primary or a comorbid condition according to the International Classification of Diseases,10th version criteria.Out of 115 patients who attended the services during the study period,37 were excluded from the final analysis.Of the remaining 78 patients,VC-ERP was initiated in 43 patients.Six patients dropped out,and three were hospitalized for inpatient ERP.Eleven patients have completed the full VC-ERP treatment.One patient completed the psychoeducation part of the protocol.VC-ERP is ongoing in 22 patients.The protocol for VC-ERP treatment was developed and upgraded online.A large proportion of the eligible patients(n=34/43;79%)actively engaged in the VC-ERP treatment.Drop-out rates were low(n=6/43;14%).Satisfaction with the treatment was adequate among patients,caregivers,and clinicians.Apart from hospitalization in 3 patients,there were no other adverse events.Hybrid care and stepped care approaches could be incorporated into the VC-ERP protocol.Therefore,the feasibility of VC-ERP treatment in terms of operational viability,service utilization,service engagement,need for additional in-person services,frequency of adverse events,and user satisfaction was adequate.The VC-ERP treatment was found to be efficacious in the 11 patients who had completed the full treatment.Significant reductions in symptoms and maintenance of treatment gains on follow-up were observed.CONCLUSION This study provided preliminary evidence for the feasibility and usefulness of VC-ERP in the treatment of OCD.The results suggest that VC-ERP can be a useful option in resource-constrained settings.
文摘Occupational exposure to flour dust within bakery environments presents significant health hazards to bakery personnel.Flour dust,generated as a byproduct during baking,becomes airborne during the baking process,thus constituting a respiratory threat.Adverse health consequences include respiratory diseases,skin irritation,allergic reactions,and potential long-term health impacts.Data indicates that a broad segment of bakery workers encounters exposure to flour dust,with specific subgroups,such as bakers and dough mixers,being particularly susceptible.Contributing factors to this exposure encompass insufficient ventilation and a lack of awareness.It is vital to assess exposure levels through air quality monitoring and health surveillance.Efficient interventions encompass engineering solutions(e.g.,ventilation systems,dust extraction),administrative measures(including training and the use of personal protective equipment),and the implementation of occupational health and safety programs.Collaborative efforts with healthcare professionals and regulatory authorities are paramount for achieving success.Case studies underscore the effectiveness of such interventions,resulting in improved worker health,thus underscoring the advantages of protective measures.Challenges in this endeavor include industry resistance to change,financial considerations,and issues related to compliance.Future recommendations entail further research,policy enhancements,and the involvement of industry stakeholders and labor unions in advocating for worker safety.
基金supported by the Project of Employees Health Status and Disease Burden Trend Study in Jinchuan Nonferrous Metals Corporation,Grant JKB20120013Fogarty training grants D43TW 008323 and D43TW 007864-01 from the US National Institutes of Health
文摘Objective To study the association between metal exposure and risk of diabetes and prediabetes among Chinese workers exposed to metals.Methods We used data obtained from the baseline survey of the Jinchang Cohort Study of workers in Jinchang Industry,the largest nickel production company in China.A total of 42,122 workers ≥20 years of age were included in the study.A standardized,structured questionnaire was used to collect epidemiological information.Physical examinations and laboratory tests were conducted to evaluate the health status of the participants and to measure various biomarkers including blood sugar,lipids,and urinary metal concentrations.Logistic regression was used to study the association between occupational groups categorized according to the measured metal levels(office workers,low-level;mining/production workers,mid-level;and smelting/refining workers,high-level)and risk of diabetes and prediabetes.Results The overall prevalence of diabetes and prediabetes was 7.5% and 16.8%,respectively.The adjusted odds ratios for diabetes among mining/production workers and smelting/refining workers compared to office workers were 1.5(95% CI:1.3,1.7)and 3.8(95% CI:3.4,4.3),respectively.No association was observed between these occupational groups and prediabetes in this study.Conclusion Occupations associated with higher levels of metal exposure were associated with an increased risk of diabetes in this cohort.More studies are needed to confirm this observed association.
文摘A traditional belief widespread across the biomedical community was that dietary habits and genetic predisposition were the basic factors causing colorectal cancer.In more recent times,however,a growing evidence has shown that other determinants can be very important in increasing(or reducing) incidence of this malignancy.The hypothesis that environmental and occupational risk factors are associated with colorectal cancer is gaining ground,and high risks of colorectal cancer have been reported among workers in some industrial branches.The aim of this study was to investigate the epidemiologic relationship between colorectal cancer and occupational exposures to several industrial activities,by means of a scientific literature review and meta-analysis.This work pointed out increased risks of colorectal cancer for labourers occupied in industries with a wide use of chemical compounds,such as leather(RR = 1.70,95%CI:1.24-2.34),basic metals(RR = 1.32,95%CI:1.07-1.65),plastic and rubber manufacturing(RR = 1.30,95%CI:0.98-1.71 and RR = 1.27,95%CI:0.92-1.76,respectively),besides workers in the sector of repair and installation of machinery exposed to asbestos(RR = 1.40,95%CI:1.07-1.84).Based on our results,the estimated crude excess risk fraction attributable to occupational exposure ranged from about 11% to about 15%.However,homogeneous pattern of association between colorectal cancer and industrial branches did not emerge from this review.
文摘Portal hypertension,liver fibrosis,and angiosarcoma of the liver(ASL)have been reported among workers exposed to vinyl chloride monomer(VCM)since the 1970s.In 2007,the International Agency for Research on Cancer established the association of VCM with hepatocellular carcinoma(HCC),though only on the basis of the few cases available.Thereafter,recent reports from the United States cohort and a European sub-cohort of vinyl chloride workers provided compelling evidence of a strong association between cumulative VCM exposure and HCC risk.Further areas of research include the risk of liver cancer at lower levels of exposure and different patterns of risk of ASL and HCC with the time since exposure.The evidence of interaction between VCM exposure and other known liver carcinogens such as alcohol and chronic viral infection provides clues for the health surveillance of exposed workers.Notably,also the risk of VCM-associated chronic liver disease is modulated by alcohol consumption,viral infection,and genetic polymorphism.A counter-intuitive finding from cohort studies of exposed workers is the lower mortality from liver cirrhosis with respect to the general population;this can be attributed to the healthy worker effect and to the selection of liver cancer as the cause of death in the presence of concomitant chronic liver disease.Studies designed to overcome these intricacies confirmed an association between cumulative VCM exposure and the risk of liver cirrhosis.
文摘Hepatocellular carcinoma(HCC)is the most common type of liver cancer.The main risk factors for HCC are alcoholism,hepatitis B virus,hepatitis C virus,nonalcoholic steatohepatitis,obesity,type 2 diabetes,cirrhosis,aflatoxin,hemochromatosis,Wilson’s disease and hemophilia.Occupational exposure to chemicals is another risk factor for HCC.Often the relationship between occupational risk and HCC is unclear and the reports are fragmented and inconsistent.This review aims to summarize the current knowledge regarding the association of infective and non-infective occupational risk exposure and HCC in order to encourage further research and draw attention to this global occupational public health problem.
基金supported by the Occupational Health Standards Program (20100304) from Ministry of Health of China
文摘This study aims to establish the occupational exposure limit (OEL) in the air for workplace of warfarin based on the available toxicological studies and field investigations by using questionnaire and air monitoring. The clinical therapeutic dose was used as lowest observed effect level (LOEL), and no observed effect level (NOEL) was achieved by using a safety factor. The highest concentration of warfarin monitored in the worksite of centrifuge washing, drying and packing were 0.029 mg/m3, 0.052 mg/m3 respectively, which did not exceed the OEL 0.2 mg/m3 recommended by NIOSH and ACGIH. Considering its feasibility for enforcement and protection for workers, we recommend OEL 0.2 mg/m3 of warfarin in China.
文摘To show the risks and harm caused by the occupational exposure to the benzene, toluene, ethylbenzene and xylenes compounds (BTEX), the working conditions of 113 persons employed at gas stations in the cities of Riach?o do Jacuipe, Feira de Santana and Salvador in the state of Bahia, Brazil were investigated by experts who correlated protection measures required by law and those applied to the workers. Data collection was performed by help of a questionnaire and non-participant observation record. The age groups of the workers in the three cities surveyed were between 18 to 25 years (30.08%) and 26 to 33 years (34.51%) of the total. The study revealed an association between occupational habits of workers at gas stations and the prevalence of symptoms due to the exposure to the BTEX compounds. Regarding the use of Personal Protective Equipment (PPE) most workers wear boots. The data show that these workers reported symptoms such as headache, rhinitis, leg pain, drowsiness, cough, fatigue, insomnia, tremors and palpitations. These disorders are related back to previous exposure to BTEX compounds which is associated with inadequate occupational habits of the workers which potentiate chemical contamination in their respective environment.
文摘AIM: To critically evaluate the current epidemiology data on exposures, rather than infection, to hepatitis C virus(HCV) transmission and recommend epidemiologic strategies to fill gaps. METHODS: Standard methods for identifying and evaluating relevant epidemiologic literature and available data were used. RESULTS: There is a large body of literature on the epidemiology of HCV transmission in Egypt that collectively identifies ongoing iatrogenic exposures as the major driver for HCV transmission due to short comings in infection control and standard procedures. Additional epidemiologic studies on HCV transmission that requires the participation of human subject is unwarranted. Alternatively, very little literature was found on the epidemiology of exposure to HCV, infection control, and safe injection practices. The information that is available on patterns of HCV exposure shows high frequencies of inadequate infection control, problems in sterilization in health care facilities, low rates of hand washing, untrained personnel, lack of stated policies in facilities, HCV contamination of instruments and very large injection frequencies with low but very significant syringe and needle reuse. There is an important need to increase the number, size, and diversity of epidemiologic studies on HCV exposures, patterns of risk factors for infection, infection control, and safe injection practices. In addition to health care facilities evaluation, relevant knowledge attitude and practice studies are recommended. CONCLUSION: Epidemiologic methods on HCV ex-posure can be used to characterize the magnitude of exposures to HCV infection, target interventions to reduce exposures, and provide the best method for evaluating interventions by demonstrating the reduction of exposure to HCV infection.
基金supported by the Hundred Talents Program of the Chinese Academy of Sciences (CAS) in 2007the National Natural Sciences Foundation of China (NSFC No.20775083)
文摘Objective To investigate the effect of long-term and low-level occupational Mn exposure on the level of uric acid (UA) in human urine. Methods In this study, 65 volunteers were recruited, who were working on welding and foundry work in an plant in Gansu province, China. Additionally, 29 control samples were collected from individuals who did not have any history of excessive Mn exposure. An improved high performance liquid chromatography system equipped with a diode-array detector (HPLC-DAD) method was developed to determine the UA level in human urine. A Spectra AA 220 Atomic Absorption Spectrophotometer (AAS) was used to measure the Mn level in the urine. Results The analytical method was validated acceptable accuracy, precision, and recovery significantly lower than that of control samples for concentrations ranging from 3.82-45.84 pg/mL with Overall, the UA levels of Mn exposure samples were (P〈O.O5). Conclusion The practical method developed here is suitable for both routine monitoring of UA level in human urine and metabolism research. Long-term and low-level occupational Mn exposure may lead to a lower UA level in urine, and UA might be an indicator of the early stage of manganism.
文摘Healthcare workers (HCWs) who are employed in traditional health care workplaces face a serious danger that may threaten their life;it is their exposure to blood and body fluids (BBF). In Lebanon, the introduction of a hospital accreditation system has put a particular emphasis on staff safety, and on the evaluation of professional practice (EPP) programs. Methods: A cross-sectional survey was conducted amongst 277 HCWs working in 4 general hospitals in South Lebanon. Objective: 1) describe the prevalence and the risk factors for occupational exposure to BBF among HCWs;2) evaluate knowledge, attitude, and practices of HCW concerning blood-borne pathogens and adherence to universal safety precautions. Results: The mean age of the respondents was 32.14 years (SD = 10.33), 57.4% were females. 43.3% of HCWs expressed that they use gloves all the time for every activeity of care. 67.1% were aware that needles should not be recapped after use;registered nurses and nursing students were more aware than physicians and nursing assistants (nurse) in this subject. 30% of HCWs declared having had at least one occupational exposure to BBF;62.7% of all accidental exposure was reported to the department responsible for managing exposures. Percutaneous injuries were the most frequently reported. Vaccination coverage was 88.4% for hepatitis B, and 48.4% against influenza. The source patient was tested in 43.4% of reported BBF exposures. Accidental exposure to BBF was more frequent in older people (OR = 3.42;p = 0.03) and the more experienced. Subjects working in intensive care unit ward reported more exposure to BBF (OR = 3;p = 0.04). Participants incurring exposure to BBF resorted to different measures after the injury suggesting a lack of a uniform policy for post-exposure prophylaxis. Conclusion: Exposure to BBF represents an important and frequently preventable occupational hazard for HCWs in Lebanon that requires continuous EPP of HCWs, and a comprehensive approach for prevention and management.
基金supported by the Public Welfare Special Projects of National Health and Family Planning Commission of the People’s Republic of China(No.201402021)The ‘Twelfth Five-Year Plan’ of the National Science and Technology Support(No.2014BAI12B01)
文摘Case reports of indium-related lung disease in workers have raised public concern to the human toxicity of indium (In) and its compounds. However, studies evaluating the exposure or health of workers in In smelting plants are rare. Therefore, in this study, we focused on four In smelting plants, with the main objective of characterizing In in smelter plants in China and discussing the potential exposure biomarkers of In exposure.
文摘BACKGROUND Although minimal change disease(MCD)and focal segmental glomerulosclerosis(FSGS)have been described as two separate forms of nephrotic syndrome(NS),they are not completely independent.We report a case of a patient transitioning from MCD to FSGS,review the literature,and explore the relationship between the two diseases.CASE SUMMARY A 42-year-old male welder,presenting with lower extremity edema and elevated serum creatinine,was diagnosed with NS and end-stage kidney disease(ESKD)based on laboratory test results.The patient had undergone a kidney biopsy for NS 20 years previously,which indicated MCD,and a second recent kidney biopsy suggested FSGS.The patient was an electric welder with excessive levels of cadmium and lead in his blood.Consequently,we suspect that his aggravated pathology and occurrence of ESKD were related to metal nephrotoxicity.The patient eventually received kidney replacement therapy and quit his job which involved long-term exposure to metals.During the 1-year follow-up period,the patient was negative for metal elements in the blood and urine and recovered partial kidney function.CONCLUSION MCD and FSGS may be different stages of the same disease.The transition from MCD to FSGS in this case indicates disease progression,which may be related to excessive metal contaminants caused by the patient’s occupation.
文摘Code of Occupational Disease Prevention of P.R.China was promulgated in 2002. As per law-enforcement requirement, we need a prompt establishment of occupational disease prevention standard system to become compatible with advanced world standards and make up our current technical standards on occupational disease prevention (TSODP). With an eye to improving TSODP system and reinforcing legislative construction, this project focuses on TSODP of workplace and occupational protection, and will be of momentous importance to guide employing units in preventing occupational disease. In addition, this project attaches importance to the integration of the said standards into those of advanced international ones, which will be conductive to update China’s ODP and foster a good and healthy international image for China. This article gives you a general profile of this project through anticipated goals, progress and achievements of particular stages, so that you can have some knowledge of this project.
文摘<strong>Context:</strong> Health Care Workers (HCWs) involved in field-level activities are exposed to COVID-19 which puts them under physical and psychological stress. <strong>Aim:</strong> The objective of this study was to understand the perception of the health care workers regarding their occupational exposure to COVID-19, including the safety measures used during field surveillance activities. <strong>Settings and Design:</strong> This cross-sectional study was conducted from June 2020 to July 2020 among the health care workers involved in COVID-19 field containment activities in two south Indian states—Telangana and Tamil Nadu. <strong>Methods and Material:</strong> Respondents were purposively sampled based on their involvement in the COVID-19 field level activities. Sixteen In-Depth Interviewees (IDIs) were conducted telephonically with medical officers, district epidemiologists, community health workers, sanitary workers, emergency medical technicians, and ambulance coordinators.<strong> Statistical Analysis</strong> <strong>Used:</strong> IDIs were analyzed using manual thematic analysis. <strong>Results:</strong> Seven themes and sub-themes emerged: awareness and training, occupational exposure to COVID-19 and duration, safety measures, occupational burnout, social stigma, psychological violence, and facilitating factors. Respondents felt a high level of occupational exposure to COVID-19 in addition to increased workload and stress due to fear of infection, shortage of workforce, denial of week off, psychological violence, and social stigma which affected them deeply. Support from supervisors and family, and measures ensuring the safety of women were facilitating factors to cope with the situation. <strong>Conclusions:</strong> It is important to safeguard the general and mental health of field-level health workers involved in COVID-19 activities, to keep their morale high during the continuing pandemic.
文摘Despite wide application of hydrated calcium sulfate, possible respiratory effects of long-term occupational exposure to high concentrations of this chemical have only been investigated in a limited number of epidemiological studies. This study is undertaken to examine this issue, more thoroughly. This cross-sectional study is carried out at a local gypsum plant in Shiraz, capital of Fars province situated in south western Iran. All exposed subjects (20 male workers) and 20 healthy non-exposed male individuals as the referent group are investigated. Prevalence of respiratory symptoms among the studied subjects is evaluated and they undergo spirometry test (twice for the exposed group and once for the unexposed employees). Moreover, to assess the extent to which workers are exposed to gypsum dust and using standard methods, inhalable and respirable fractions of this compound are measured in different dusty worksites. Average airborne concentration of inhalable dust fraction is estimated to be 24 ± 14.76 mg/m3 which is higher than the recommended threshold limit value (TLV) for this chemical. Respiratory symptoms such as phlegm, wheezing and dyspnea are significantly more prevalent in exposed subjects than in non-exposed employees (p < 0.05). The results of ventilatory function tests (pre- shift) don’t show any significant differences between both groups. However, some post-shift parameters of ventilatory function such as FVC, FEV1 and FEV1/FVC ratio are significantly lower than those of preshift and referent group. Exposure to high atmospheric concentrations of gypsum dust is associated with a significant increase in the prevalence of respiratory symptoms along with acute reversible significant decreases in some parameters of ventilatory function.