Professional activity, information demands, training and updating needs of occupational medicine physicians in Italy: National survey.

Objectives: Occupational medicine is a discipline continually evolving in response to technological advances, changes in workplaces and production processes, emergence of new occupational risks and diseases and modifications in regulatory framework for occupational health and safety. Therefore, the recurrent revaluation of professional activity, information demands and education and training needs of occupational physicians is essential in order to identify methodologies and tools that may contribute to improvement of their professional knowledge and competency. In this regard, we conducted the first large-scale national survey of Italian occupational medicine physicians to define their demographic and professional activity and to assess their information demands, training and updating needs. Material and Methods: A random sample of occupational physicians, listed in the national register of the Italian Ministry of Health, was selected to complete a voluntary survey. Subjects recruited in this study were asked to complete 3 different sections (personal and professional information, training and updating needs, professional activity and practice characteristics) of a questionnaire for a total of 35 questions. Results: Most of participants were specialized in occupational medicine, worked for a large number of companies and carried out health surveillance on a total number of workers that exceeds 1500. Occupational physicians would like to have a higher training offer towards practical aspects of health surveillance, risks assessment, manual handling of loads, chemical substances and upper limb biomechanical overload. Interestingly, statistically significant differences were observed subdividing the sample into different groups according to the legal requirements to perform the professional activity of occupational physicians in Italy or according to particular aspects of their professional activity. Conclusions: This study has provided interesting findings that may help to guide future discussion on alternative and additional instruments and/or methodologies that may be adopted to implement the quality and effectiveness of occupational medicine practice. Int J Occup Med Environ Health 2016;29(5):837–85

Artificial neural network analyzing wearable device gait data for identifying patients with stroke unable to return to work

A potential dramatic effect of long-term disability due to stroke is the inability to return to work. An accurate prognosis and the identification of the parameters inflating the possibility of return to work after neurorehabilitation are crucial. Many factors may influence it, such as mobility and, in particular, walking ability. In this pilot study, two emerging technologies have been combined with the aim of developing a prognostic tool for identifying patients able to return to work: a wearable inertial measurement unit for gait analysis and an artificial neural network (ANN). Compared with more conventional statistics, the ANN showed a higher accuracy in identifying patients with respect to healthy subjects (90.9 vs. 75.8%) and also in identifying the subjects unable to return to work (93.9 vs. 81.8%). In this last analysis, the duration of double support phase resulted the most important input of the ANN. The potentiality of the ANN, developed also in other fields such as marketing on social networks, could allow a powerful support for clinicians that today should manage a large amount of instrumentally recorded parameters in patients with stroke

Stigma, Discrimination and Disclosure of the Diagnosis of Multiple Sclerosis in the Workplace: A Systematic Review

The objective of the study was to describe and analyze the stigma, discrimination and the disclosure of the diagnosis of Multiple Sclerosis (MS) in the workplace. The protocol was registered in PROSPERO (CRD42022320437). We systematically searched four scientific databases with key search terms. We included any original peer-reviewed articles reporting the stigma or discrimination experienced at work due to MS or the disclosure of the diagnosis of MS in the workplace. No time limits were set for the search. An appraisal of the individual study quality was performed with the JBI critical appraisal checklist. Overall, 26 studies were deemed to fulfil all the eligibility criteria. The total number of participants in this review was 9571. The prevalence of people with MS who experience some degree of stigma in the workplace can be as high as 79.2%. Those who report greater feelings of discrimination are more likely to be unemployed. The prevalence of employers' and co-workers' awareness of the diagnosis varies from 31.7 to 90.2%. The main reason for non-disclosure is the fear of being discriminated against. The psychosocial work environment needs to be taken into consideration as part of public and individual policies to promote the health of patients with MS

Spatial and temporal distribution of the prevalence of unemployment and early retirement in people with multiple sclerosis: A systematic review with meta-analysis

BackgroundWe aimed to summarise the prevalence of unemployment and early retirement among people with MS and analyze data according to a spatio-temporal perspective.MethodsWe undertook a systematic search of PubMed/MEDLINE, Scopus, SciVerse ScienceDirect, and Web of Science. We included any peer-reviewed original article reporting the prevalence of unemployment and early retirement in the working-age population with MS. We excluded articles off-topic, with other study designs, whose study sample were unlikely to be representative of the MS population and in case of unavailability of the full text or essential information. A random-effects meta-analysis was used to measure overall prevalence estimates of unemployment and early retirement. We used meta-regression and subgroup analysis to evaluate potential moderators of prevalence estimates and the leave-one-out method for sensitivity analyses.ResultsOur research identified 153 studies across 29 countries encompassing 188436 subjects with MS. The pooled overall effect size for unemployment and early retirement was 35.6% (95% CI 32.8-38.4; I-2 = 99.31) and 17.2% (95% CI 14.6-20.2; I-2 = 99.13), respectively. The prevalence of unemployment varied according to the year of publication (p < 0.001) and there was a statistically significant decrease in the prevalence of unemployment over time (p = 0.042). Regarding early retirement, only seven (31.8%) estimates obtained from studies that were published before 2010 were below the overall effect size in comparison to 27 (60.0%) estimates extracted from data published between 2010 and 2021 (p = 0.039). There was a significant difference in prevalence according to countries (p < 0.001). Psychiatric illness was an important clinical feature responsible for patients leaving the workforce in regions with a high MS prevalence.ConclusionsUnemployment and early retirement due to MS remain highly prevalent, despite a slight decline in the last decade. The prevalence of unemployment and early retirement varies globally

Occupational outcomes of people with multiple sclerosis: a scoping review

Objectives To update the knowledge on the occupational outcomes associated with multiple sclerosis (MS), systematically examine the extent, scope and nature of the pre-existing literature and identify research gaps in the existing literature. Design Scoping review. Data sources A comprehensive database search of PubMed/MEDLINE, Scopus, SciVerse ScienceDirect and Web of Science was performed. There were no time limits. Eligibility criteria We included any peer-reviewed original article reporting the occupational outcomes of people with MS between the ages of 18 and 65 years. We excluded those off-topic and with insufficient information. Methods This review was conducted following the Joanna Briggs Institute recommendations and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for scoping review checklist. Screening, reading of full-texts and data extraction was performed in a standardised way by expert reviewers from 14 July 2021 to 31 October 2021. We provided a narrative synthesis and an overview of findings. Results The initial systematic search yielded 104 228 results. After removing duplicates and applying the exclusion criteria, 403 articles were included in the review. In total, the studies evaluated 492 062 subjects with MS. One hundred fifty-four (38.2%) articles were published in the last 5 years, mostly from Europe and North America (50.9% and 33.0%, respectively). Concerning the occupational outcomes, studies mostly addressed unemployment (311, 77.2%), early retirement (120, 29.8%), disability pension (117, 29.0%), sick leave (77, 19.1%), the indirect cost of MS (74, 18.4%) and work characteristics (57, 14.1%). The results were categorised into seven subtopics: 'Changes in work and occupational status due to MS', 'work-related socio-economic consequences of MS', 'risk factors for unfavourable occupational outcomes', 'reported barriers to employment', 'reported job accommodations and vocational rehabilitation strategies', 'job satisfaction, stigma, and disclosing the diagnosis in the workplace' and 'rating clinical scales'. Conclusions There are several issues that deserve further in-depth study by the scientific community in order to improve the occupational outcomes of people with MS

Do Italian Companies Manage Work-Related Stress Effectively? A Process Evaluation in Implementing the INAIL Methodology

Studies on Intervention Process Evaluation are attracting growing attention in the literature on interventions linked to stress and the wellbeing of workers. There is evidence that some elements relating to the process and content of an intervention may have a decisive role in implementing it by facilitating or hindering the effectiveness of the results. This study aimed to provide a process evaluation on interventions to assess and manage risks related to work-related stress using a methodological path offered by INAIL. The final sample is composed of 124 companies participating to an interview on aspects relating to each phase of the INAIL methodological path put in place to implement the intervention. INAIL methodology has been defined as useful in the process of assessing and managing the risks related to work-related stress. Some factors related to the process (e.g., implementation of a preliminary phase, workers’ involvement, and use of external consultants) showed a role in significant differences that emerged in the levels of risk, particularly in relation to findings from the preliminary assessment. Main findings provide information on the key aspects of process and content that are useful in implementing an intervention for assessing and managing risks related to work-related stress

La metodologia per la valutazione e gestione del rischio stress lavoro-correlato. Modulo contestualizzato al settore sanitario

Il monografico illustra i risultati delle attività di ricerca e di sperimentazione sul campo effettuate dal Laboratorio rischi psicosociali e tutela dei lavoratori vulnerabili con la collaborazione di strutture sanitarie afferenti al Servizio Sanitario Nazionale (Ssn), che hanno portato allo sviluppo del Modulo contestualizzato al settore sanitario della Metodologia Inail per la valutazione e gestione del rischio stress lavoro-correlato

Managing stress and preventing burnout in healthcare professionals during the Covid-19 emergency

Research goals and background: Protecting the mental health of health workers during the Covid-19 emergency was a relevant topic due to the negative effects on psychophysical health, the increasing stress, and the potential occurrence of burnout (Greenberget al., 2020; Jianbo et al., 2020). Healthcare professionals are among the workers at greatest risk of exposure to the virus and their commitment at the forefront of the health emergency exposes them to a growing operational and emotional overload (Kinman et al., 2020; Theorell, 2020). In reflection of this, the Italian Workers Compensations Authority (INAIL), in collaboration with the Italian Council of the Order of Psychologists, promoted an initiative aimed at providing psychological support to health professionals through the dissemination of procedural guidelines and useful tools intended for psychological aid in hospitals. Methods: After the guidelines, several task forces of psychologists started counselling and psychological support services targeted healthcare professionals, with the aim of understanding their needs and responding to possible psychological problems that may arise in healthcare workers during the Covid-19 emergency. INAIL also created a network with 15 units of psychologists from hospitals located throughout Italy for monitoring such psychological support activities. Monitoring was made possible by the collection of an anonymized psychological triage checklist developed by INAIL that allowed collecting standardised information on psychological support activities provided by the national health service. Data from each unit were aggregated and analysed by Inail. Results: The network of 15 units involved 229 professional psychologists working in the hospitals. The network provided 808 checklists of psychological triage to INAIL, including information from about 2,000 psychological sessions (average = 3.5 sessions per healthcare worker asking for help). Data monitoring refers to the period from February to September 2020. Most of health care professionals asking for help from the services were female (74%), nurses (49,4%), or doctors (20,4%). Among the others, the most frequent reactions to the event found were depressive symptoms (59%) and psychosomatic disorders (44%). Findings about impacts and interventions will be discussed. Conclusions: During the emergency, it was required to provide immediate interventions of individual psychological support to equip health care professionals with tools and strategies for coping, adaptation, and recovery. The development, at a later stage, of a second level monitoring was useful to analyse how the procedure at the local level has been implemented and the impacts on mental health in the hospital setting. Findings offer information also to optimize the tools and resources provided with the aim of promoting a procedure with high quality standards

Meta-analytic study on substance intake and work-related accidents calls for attention to bio-psycho-social factors

: Accidents at work are a major concern because of their social and economic impact. The causes are highly variable and often linked to risk behaviors that could be avoided, of which substance use is a prime example. The aim of this paper was to meta-analytically review the scientific literature on substance intake and its link to work-related accidents. From an initial pool of 19954 papers, we considered a final sample of 27 clustered in three groups according to substances class (alcohol, recreational drugs, medicines). Despite different pharmacological effects, substances consumed for recreational purposes significantly increased the risk of work-related accidents (odds ratio: alcohol 1.78, recreational drugs 1.47), whereas medicines did not: however, these results require caution due to the heterogeneity of the included studies and suspected publication bias. While bio-psycho-social factors could have helped to understand this association, selected studies neglected both the variegated effects and the root causes of recreational substance consumption. Future studies and interventions should consider these complexity factors to transcend the mere description of the phenomenon