Category Archives: Health & Safety

Prevention of Hand Eczema among Nurse Apprentice (PREVEDERM): An Interventional Study

Source: Horatiu Remus Moldovan, Ionela Manole, Alina Suru, Alexandra-Irina Butacu, Alin Laurentiu Tatu, Adriana Lupu, Mihai Dascalu, George-Sorin Tiplica, Carmen Maria Salavastru, Annals of Work Exposures and Health, Volume 65, Issue 2, March 2021
(subscription required)

From the abstract:
Background
Workers in the healthcare sector are at high risk of developing occupational hand eczema mainly due to frequent exposure to irritants and/or allergens. Amongst workers in healthcare, nurses are at higher risk of developing hand dermatitis.

Objectives
To evaluate the effectiveness of a short educational intervention program in preventing occupational hand eczema in nurse apprentices, using two objective tools, namely TEWL and EH, and the HECSI score.

Methods
Data regarding professions, wet work exposure, activities performed during working hours, self-reported eczema were collected from 230 nurse students, divided in two study groups: the intervention and the control group (CG). The intervention group (IG) was given education about risks and proper skin care and was provided with cosmeceuticals to be used for skin care during hospital activity. The evaluation of skin properties was performed using questionnaires, HECSI score, measurement of transepidermal water loss (TEWL) and epidermal hydration (EH).

Results
A number of 139 apprentice nurses completed the study. Of those participants who completed the study, 19.1% from CG and 19.6% from IG reported, at T1, hand eczema in the last 3 months, while at T2 (3 months later), 59.52 % of the CG and only 11.34 % from the IG stated having eczema in the last 3 months. In the IG, results showed an improvement of CM with 17% and of TEWL with 16%, with only a 0.5% improvement of CM in CG and a marked impairment of TEWL by 33%.

Conclusion
Hand eczema is a common occupational dermatosis affecting the medical staff, even during apprenticeship. Early preventive training programs are effective in reducing the burden of occupational contact dermatitis.

Inside a Long, Messy Year of Reopening Schools

Source: Rachel M. Cohen, New Republic, March 8, 2021

Teachers unions were accused of being obstinate and compromising education. The real story is a lot more complex.

Last month in Chicago, after months of heated negotiations, the teachers union and Chicago Public Schools emerged with one of the most detailed school reopening agreements in the nation. Brad Marianno, an education policy professor at the University of Nevada, Las Vegas, who has been studying these agreements since last spring, called it the most comprehensive he’s seen, citing its inclusion of things like testing protocols, measures that might lead to reclosing schools, and vaccination commitments. Among other things, the union succeeded in negotiating accommodations for hundreds more members at higher risk of Covid-19 complications, or who serve as the primary caregiver for someone at higher risk, than the district had originally agreed to accommodate.

Stacy Davis Gates, the vice president of the Chicago Teachers Union, said one of the most important components of the agreement was the so-called “school safety committees” a demand the union put forward in December to hold leadership accountable to the health and safety promises it’s made. The school-based committees include up to four CTU members, the principal, the building engineer, and a “reasonable” number of other employees like janitors, lunchroom staff, and security guards. On a regular basis, they will flag to the principal any issues that arise and can hold the school liable if they go ignored. ….

Medical claims paid by workers’ compensation insurance among US Medicare beneficiaries, 1999–2016

Source: Laura Kurth, Megan Casey, Brian Chin, Jacek M. Mazurek, Patricia Schleiff, Cara Halldin, David J. Blackley, American Journal of Industrial Medicine, Early View, First published: January 11, 2021
(subscription required)

From the abstract:
Background
Workers’ compensation claims among Medicare beneficiaries have not been described previously. To examine the healthcare burden of work‐related injury and illness among Medicare beneficiaries, we assessed the characteristics, healthcare utilization, and financial costs among Medicare beneficiaries with claims for which workers’ compensation was the primary payer.

Methods
We extracted final action fee‐for‐service Medicare claims from 1999 to 2016 where workers’ compensation had primary responsibility for claim payment and beneficiary, claim type, diagnoses, and cost information from these claims.

Results
During 1999–2016, workers’ compensation was the primary payer for 2,010,200 claims among 330,491 Medicare beneficiaries, and 58.7% of these beneficiaries had more than one claim. Carrier claims submitted by noninstitutional providers constituted the majority (94.5%) of claims. Diagnosis codes indicated 19.4% of claims were related to diseases of the musculoskeletal system and connective tissue and 12.9% were related to disease of the circulatory system. Workers’ compensation insurance paid $880.4 million for these claims while Medicare paid $269.7 million and beneficiaries paid $37.4 million.

Conclusions
Workers’ compensation paid 74% of the total amount to providers for these work‐related medical claims among Medicare beneficiaries. Claim diagnoses were similar to those of all workers’ compensation claims in the United States. Describing these work‐related claims helps identify the healthcare burden due to occupational injury and illness among Medicare beneficiaries resulting from employment and identifies a need for more comprehensive collection and surveillance of work‐related medical claims.

COVID‐19 as an occupational disease

Source: Christopher Carlsten, Mridu Gulati, Stella Hines, Cecile Rose, Kenneth Scott, Susan M. Tarlo, Kjell Torén, Akshay Sood, Rafael E. de la Hoz, American Journal of Industrial Medicine, Early View, First published: January 24, 2021

From the abstract:
The impact of coronavirus disease 2019 (COVID‐19) caused by the severe acute respiratory syndrome coronavirus 2 permeates all aspects of society worldwide. Initial medical reports and media coverage have increased awareness of the risk imposed on healthcare workers in particular, during this pandemic. However, the health implications of COVID‐19 for the global workforce are multifaceted and complex, warranting careful reflection and consideration to mitigate the adverse effects on workers worldwide. Accordingly, our review offers a framework for considering this topic, highlighting key issues, with the aim to prompt and inform action, including research, to minimize the occupational hazards imposed by this ongoing challenge. We address respiratory disease as a primary concern, while recognizing the multisystem spectrum of COVID‐19‐related disease and how clinical aspects are interwoven with broader socioeconomic forces.

COVID‐19 deaths by occupation, Massachusetts, March 1–July 31, 2020

Source: Devan Hawkins, Letitia Davis, David Kriebel, American Journal of Industrial Medicine, Early View, February 1, 2021

From the abstract:
Background
Exposure to COVID‐19 is more likely among certain occupations compared with others. This descriptive study seeks to explore occupational differences in mortality due to COVID‐19 among workers in Massachusetts.

Methods
Death certificates of those who died from COVID‐19 in Massachusetts between March 1 and July 31, 2020 were collected. Occupational information was coded and age‐adjusted mortality rates were calculated according to occupation.

Results
There were 555 deaths among MA residents of age 16–64, with usable occupation information, resulting in an age‐adjusted mortality rate of 16.4 per 100,000 workers. Workers in 11 occupational groups including healthcare support and transportation and material moving had mortality rates higher than that for workers overall. Hispanic and Black workers had age‐adjusted mortality rates more than four times higher than that for White workers overall and also had higher rates than Whites within high‐risk occupation groups.

Conclusion
Efforts should be made to protect workers in high‐risk occupations identified in this report from COVID‐19 exposure.

Voices of Strength: A Survey of Librarians Working with Chronic Illnesses or Conditions

Source: Susan Rathbun-Grubb, Journal of Library Administration, Volume 61 no. 1, 2021
(subscription required)

From the abstract:
This research attempts to understand the ways that librarians overcome the challenges associated with a chronic condition in the workplace. Six hundred sixteen respondents completed a survey about type of workplace, type of chronic condition, longevity of the condition, disclosure, accommodations, level of support, career mobility and advancement, work challenges, coping strategies, and perceptions on disability. Respondents report chronic illness and conditions of all sorts, both visible and invisible, with 46% having more than one type of illness. They cope by using creative strategies to supplement or replace formal accommodations, however 39% believe that their condition has negatively impacted their career advancement.

Responsibilities and Rights of Employers and Employees During the COVID-19 Pandemic

Source: Joseph Maya, Julia Audibert, Zachary Sipala, Caroline Vandis, Calvin Carson, and Emily Prudente, Labor Law Journal, Vol. 71, Issue No. 4, Winter 2020
(subscription required)

The Occupational Safety and Health Administration (OSHA), Fair Labor and Standards Act (FLSA), Equal Employment Opportunity laws (which encompass the Americans with Disabilities Act and the Rehabilitation Act), and Title VII of the Civil Rights Act of 1964 are long-standing pillars of employment law in this country. Collectively, they aim to ensure individual privacy, safe work environments, and equal treatment free from discrimination in the workplace. Given their appealing and sensical nature, it seems axiomatic that these statutes and agencies operate in concert. However, complying with their provisions during a global pandemic requires navigating murky waters. In practice, these laws present sometimes competing demands for many employers and employees trying to understand the new reality imposed by COVID-19. Striking an effective balance between these rights and responsibilities during the upheaval caused by COVID-19 incurs a host of relatively novel challenges. In this article, the attorneys at Maya Murphy, P.C. demystify how to serve the best interests of employers and employees and offer a comprehensive analysis of legal guidelines, both old and new, to inform our readers how to best achieve that balance.

Impacts of the COVID-19 Pandemic on Home Health and Home Care Agency Managers, Clients, and Aides: A Cross-Sectional Survey, March to June, 2020

Source: Susan R. Sama, ScD, Margaret M. Quinn, ScD, Catherine J. Galligan, et. al., Home Health Care Management & Practice, OnlineFirst Published December 11, 2020
(subscription required)

From the abstract:
Home health and home care (HH&HC) agencies provide essential medical and supportive services to elders and people with disabilities, enabling them to live at home. Home-based care is an important alternative to facility-based care, especially for infection prevention during the COVID-19 pandemic. The majority of the HH&HC workforce is comprised of aides, who also are vulnerable to COVID-19. There are limited data on the COVID-19 experience of HH&HC agencies, clients and aides. A survey of Massachusetts HH&HC agency managers was conducted June 1 to 30, 2020 to assess the impact of COVID-19 on agencies, clients, and aides early in the pandemic and to identify needs for future pandemic planning. Of the 94 agencies with completed surveys, most (59.6%) provided services to clients with COVID-19 and 3-quarters (73.7%) employed aides who tested positive for COVID-19, were symptomatic, and/or quarantined. Most agencies (98.7%) experienced a decrease in demand for home visits, reflecting clients’ concern about infection, family members assuming care duties, and/or aides being unavailable for work. Simultaneously, managers’ workloads increased to develop more extensive infection prevention policies, procedures and workforce training and sourcing scarce personal protective equipment (PPE). The COVID-19 pandemic imposed substantial new infection prevention responsibilities on HH&HC agencies, clients, and aides. Specific HH&HC needs for future pandemic planning include complete information on the infection status of clients; ready access to affordable PPE and disinfectants; and guidance, tools, and training tailored for the industry. HH&HC should be incorporated more fully into comprehensive healthcare and public health pandemic planning.

Estimation of differential occupational risk of COVID‐19 by comparing risk factors with case data by occupational group

Source: Michael Zhang, American Journal of Industrial Medicine, Volume 64, Issue 1, January 2021
(subscription required)

From the abstract:
Background:
The disease burden of coronavirus disease 2019 (COVID‐19) is not uniform across occupations. Although healthcare workers are well‐known to be at increased risk, data for other occupations are lacking. In lieu of this, models have been used to forecast occupational risk using various predictors, but no model heretofore has used data from actual case numbers. This study assesses the differential risk of COVID‐19 by occupation using predictors from the Occupational Information Network (O*NET) database and correlating them with case counts published by the Washington State Department of Health to identify workers in individual occupations at highest risk of COVID‐19 infection.

Methods:
The ONET database was screened for potential predictors of differential COVID‐19 risk by occupation. Case counts delineated by occupational group were obtained from public sources. Prevalence by occupation was estimated and correlated with ONET data to build a regression model to predict individual occupations at greatest risk.

Results:
Two variables correlate with case prevalence: disease exposure (r = 0.66; p = 0.001) and physical proximity (r = 0.64; p = 0.002), and predict 47.5% of prevalence variance (p = 0.003) on multiple linear regression analysis. The highest risk occupations are in healthcare, particularly dental, but many nonhealthcare occupations are also vulnerable.

Conclusions:
Models can be used to identify workers vulnerable to COVID‐19, but predictions are tempered by methodological limitations. Comprehensive data across many states must be collected to adequately guide implementation of occupation‐specific interventions in the battle against COVID‐19.