Sleep disturbance affects Covid-19 medics
Almost 40% of paediatric healthcare workers in Wuhan experienced sleep disturbance during the Covid-19 pandemic and 25% reported symptoms of anxiety and depression, according to this survey-based study. Sleep disturbance was independently associated with being an only child, exposure to Covid-19 patients and depression. The authors call for more mental health services for frontline healthcare workers managing the outbreak.
Wang S et al. “Sleep disturbances among medical workers during the outbreak of COVID-2019”, Occupational Medicine, published online 6 May 2020.
Work quality and emotional exhaustion
Social integration at work, and the social relevance of work, can mitigate the impact of emotional exhaustion amongst nurses, according to this study of 432 Malaysian nurses. Other factors reducing the impact of emotional exhaustion included the way in which work is organised and the operation of effective safe and healthy working conditions, the authors find. They conclude that “by addressing the emotional exhaustion issue among the nursing staff, their work responsibilities and work performance can be enhanced.”
Yukthamarani P et al. “Effects of quality of work-life on emotional exhaustion: a study among nurses in Malaysia”, Journal of Workplace Behavioral Health, published online 5 May 2020.
Covid-19 disinfection chambers: are they safe?
Human disinfection chambers are an example of how medical practice is rapidly innovating in response to the global burden of Covid-19. Most chambers being used in healthcare settings to disinfect healthcare staff have an entry and exit point, an enclosed chamber where the disinfection takes place, a solvent supply, chemical chamber, air supply and mixer. This article looks at the effectiveness, health hazards and safety aspects of disinfection chambers, particularly as the main routes of potential exposure are inhalation and absorption. It concludes: “When two or more chemicals are compounded together, the properties of the compound cannot be assumed to carry the same risk category as the individual chemicals. Assuming that a safe chemical plus safe chemical makes a safe compound is a dangerous assumption.” The authors add that changing the chemical’s formulation and route of administration may drastically affect its safety profile. A chemical may be safe when applied topically in liquid form, but extremely toxic when atomized and inhaled.
Wickramatillake A and Kurukularatne C. “SARS-CoV-2 human disinfection chambers: a critical analysis”, Occupational Medicine, published 6 May 202.
Carpal tunnel rehabilitation
Most patients with carpal tunnel syndrome (CTS) can return to work within a year of carpal tunnel decompression treatment, according to this occupational analysis of patients between 2014 and 2017. However, manual workers and patients with poorer pre-operative hand function have poorer return-to-work outcomes, the study suggests. Median return-to-work time amongst the 469 patients was four weeks after surgery; however, 15% of those undertaking manual labour were unable to return (compared with 5% of the total sample).
P H C Stirling et al. “Occupation classification predicts return to work after carpal tunnel decompression”, Occupational Medicine, published online 7 May 2020.
HPV and surgical smoke
Surgical smoke generated during the treatment of patients for HPV-related lesions should be treated as potentially infectious, according to this systematic review of 21 articles. The research literature demonstrates that surgical smoke can contain HPV-related DNA, and that this can contaminate the upper airways of operating theatre staff. Whether this corresponds to infectious virus is unknown, and there is no evidence showing an increased prevalence of HPV infection or disease in OT staff following exposure. The authors conclude, however, that “it would be safest to treat surgical smoke as potentially infectious”, advising that precautions should include local exhaust ventilation, general room ventilation and full PPE including fit-tested respirator use at a minimum of N95 grade.
Fox-Lewis A et al. “Human papillomavirus and surgical smoke: a systematic review”, Occupational & Environmental Medicine, published online 8 May 2020.
Working from home: preserving occupational health
Employers have a duty to preserve the health of employees required to telework as a result of Covid-19, according to this postscript published in Occupational & Environmental Health. The authors argue that the current increase in home working has occurred in an anxiety-provoking context linked to the pandemic, which is likely to worsen telework-associated psychological and behavioural risks, “especially those associated with addictions”. Those with pre-existing mental health problems may face particular issues arising from isolation, so that taken together, “the covid-19 pandemic may exacerbate occupational hazards beyond the more obvious examples of healthcare settings or other jobs on the front line.”
Bouziri H et al. “Working from home in the time of Covid-19: how to best preserve occupational health?“, Occupational & Environmental Medicine, published online 30 April 2020.
Physical work and life expectancy
High physical work demands are a risk factor for a shortened working life and increased years of sickness absence and unemployment, according to this Danish study. Individuals with physical work had a significantly lower working life expectancy than those with low physical work demands. This is particularly the case for women. At age 30, women with high physical work demands can expect 3.1 years less working life, 11 months more sickness absence and 16 months more unemployment than low-exposed women. For men, the comparable differentials were two years, 12 months and eight months respectively. The authors conclude their results are important in the context of expanding the knowledge base for informed political decision-making concerning statutory retirement age.
Pedersen J et al. “High physical work demands and working life expectancy in Denmark”, Occupational & Environmental Medicine, published online 12 May 2020.
Workplace yoga can be “convenient and low-cost” intervention
A group mindfulness-based yoga course may be a convenient and low-cost approach to support the health and wellbeing of healthcare workers, according to this study of 43 healthcare professionals. The study investigates if an eight-week intervention can help manage burnout amongst the group, concluding that at post-intervention follow-up members of the group had significantly better scores on personal accomplishment, depression, stress and anxiety, perceived resilience and compassion. They also had a positive perception of the intervention itself.
Ofei-Dodoo S et al. “Impact of a Mindfulness-based, workplace group yoga intervention on burnout, self-care and compassion in healthcare professionals, a pilot study”, Journal of Occupational and Environmental Medicine, published online 28 April 2020.