Health care workers' influenza vaccination: motivations and mandatory mask policy

Background Vaccination of health care workers (HCW) against seasonal influenza (SI) is recommended but vaccination rate rarely reach >30%. Vaccination coverage against 2009 pandemic influenza (PI) was 52% in our hospital, whilst a new policy requiring unvaccinated HCW to wear a mask during patient care duties was enforced. Aims To investigate the determinants of this higher vaccination acceptance for PI and to look for an association with the new mask-wearing policy. Methods A retrospective cohort study, involving HCW of three critical departments of a 1023-bed, tertiary-care university hospital in Switzerland. Self-reported 2009-10 SI and 2009 PI vaccination statuses, reasons and demographic data were collected through a literature-based questionnaire. Descriptive statistics, uni- and multivariate analyses were then performed. Results There were 472 respondents with a response rate of 54%. Self-reported vaccination acceptance was 64% for PI and 53% for SI. PI vaccination acceptance was associated with being vaccinated against SI (OR 9.5; 95% CI 5.5-16.4), being a physician (OR 7.7; 95% CI 3.1-19.1) and feeling uncomfortable wearing a mask (OR 1.7; 95% CI 1.0-2.8). Main motives for refusing vaccination were: preference for wearing a surgical mask (80% for PI, not applicable for SI) and concerns about vaccine safety (64%, 50%) and efficacy (44%, 35%). Conclusions The new mask-wearing policy was a motivation for vaccination but also offered an alternative to non-compliant HCW. Concerns about vaccine safety and efficiency and self-interest of health care workers are still main determinants for influenza vaccination acceptance. Better incentives are needed to encourage vaccination amongst non-physician HC

Eating Habits of Professional Firefighters: Comparison With National Guidelines and Impact Healthy Eating Promotion Program.

Firefighters' eating habits may be an additional risk factor for metabolic diseases. We assessed eating habits of firefighters, compared them with national guidelines, and evaluated the impact of a prevention program. Twenty-eight professional firefighters from a Swiss airport benefited from a healthy-eating program. Food intake, eating behavior, and anthropometric data were collected at baseline and 1-year follow-up using an electronic food record, questionnaires, and bio-impedance. Participants had unbalanced diets with low-quality food choices associated with low intakes of fibers and micronutrients compared with national guidelines. Intervention did not impact eating habits or anthropometrics data at the group level, but changes were measured in sub-groups. Main reported barriers for healthy eating were lack of motivation, prioritization, or time. Intensive and culturally tailored prevention interventions targeting nutritional behaviors are needed at the individual, group, and organizational levels

Energy, Nutrient and Food Intakes of Male Shift Workers Vary According to the Schedule Type but Not the Number of Nights Worked.

Shift work is associated with increased risk of chronic diseases due to circadian rhythm disruptions and behavioral changes such as in eating habits. Impact of type of shifts and number of night shifts on energy, nutrient and food intake is as yet unknown. Our goal was to analyze shift workers' dietary intake, eating behavior and eating structure, with respect to frequency of nights worked in a given week and seven schedule types. Eating habits and dietary intakes of 65 male shift workers were analyzed in three steps based on 365 24-h food records: (1) according to the number of nights, (2) in a pooled analysis according to schedule type, and (3) in search of an interaction of the schedule and the timing of intake. Mean nutrient and food group intake during the study period did not depend on the number of nights worked. Amount and distribution of energy intake as well as quality of food, in terms of nutrient and food groups, differed depending on the type of schedule, split night shifts and recovery day (day after night shift) being the most impacted. Shift workers' qualitative and quantitative dietary intakes varied between different schedules, indicating the need for tailored preventive interventions

Health care workers' influenza vaccination: motivations and mandatory mask policy

BACKGROUND: Vaccination of health care workers (HCW) against seasonal influenza (SI) is recommended but vaccination rate rarely reach >30%. Vaccination coverage against 2009 pandemic influenza (PI) was 52% in our hospital, whilst a new policy requiring unvaccinated HCW to wear a mask during patient care duties was enforced. AIMS: To investigate the determinants of this higher vaccination acceptance for PI and to look for an association with the new mask-wearing policy. METHODS: A retrospective cohort study, involving HCW of three critical departments of a 1023-bed, tertiary-care university hospital in Switzerland. Self-reported 2009-10 SI and 2009 PI vaccination statuses, reasons and demographic data were collected through a literature-based questionnaire. Descriptive statistics, uni- and multivariate analyses were then performed. RESULTS: There were 472 respondents with a response rate of 54%. Self-reported vaccination acceptance was 64% for PI and 53% for SI. PI vaccination acceptance was associated with being vaccinated against SI (OR 9.5; 95% CI 5.5-16.4), being a physician (OR 7.7; 95% CI 3.1-19.1) and feeling uncomfortable wearing a mask (OR 1.7; 95% CI 1.0-2.8). Main motives for refusing vaccination were: preference for wearing a surgical mask (80% for PI, not applicable for SI) and concerns about vaccine safety (64%, 50%) and efficacy (44%, 35%). CONCLUSIONS: The new mask-wearing policy was a motivation for vaccination but also offered an alternative to non-compliant HCW. Concerns about vaccine safety and efficiency and self-interest of health care workers are still main determinants for influenza vaccination acceptance. Better incentives are needed to encourage vaccination amongst non-physician HCW

Producers of Engineered Nanomaterials-What Motivates Company and Worker Participation in Biomonitoring Programs?

Production and handling of engineered nanomaterials (ENMs) can yield worker exposure to these materials with the potential for unforeseen negative health effects. Biomonitoring enables regular exposure and health assessment and an effective risk management. We aimed to identify factors influencing biomonitoring acceptance according to hierarchical positions of ENM producers. Managers and workers were invited to complete an online questionnaire. Forty-three companies producing or handling ENMs such as titanium dioxide (61%) and multi-walled carbon nanotubes (44%) participated. The majority of managers (72%) and all workers responded positively to participating in biomonitoring studies. The main reasons for refusing participation included concerns about data confidentiality and sufficient knowledge about ENM health and safety. Acquisitions of individual study results, improvement of workers' safety, and help to the development of ENM-specific health and safety practice were among the most valuable reasons for positively considering participation. All workers indicated feeling comfortable with biomonitoring procedures of exhaled air sampling-about half were similarly comfortable with exhaled breath condensate, urine, and buccal cell sampling. The majority of both workers and managers stated that participation in a biomonitoring program should take place during working hours. Although our survey only had limited participation, our results are useful in designing appropriate biomonitoring programs for workers exposed to ENMs

Déterminants de la vaccination antigrippale dans le personnel travaillant en milieu hospitalier: comparaison entre la grippe saisonnière et la grippe pandémique A(H1N1)/2009

La vaccination des travailleurs de la santé (TDS) contre la grippe saisonnière (GS) est recommandée depuis des années, mais la couverture vaccinale dans cette population dépasse rarement les 30 %. En 2009, alors que la grippe pandémique était aux portes de la Suisse, une nouvelle directive institutionnelle a été implémentée dans un hôpital universitaire suisse, obligeant les TDS non vaccinés à porter un masque durant les soins aux patients. La couverture vaccinale contre la grippe pandémique A(HlNl)/2009 (GP) a par la suite été de 52 % dans cet hôpital. La thèse s'est construite autour de la question de recherche suivante : investiguer les déterminants de cette plus haute acceptation du vaccin contre la GP et rechercher une association de l'acceptation du vaccin avec cette nouvelle Directive de port de masque obligatoire. Dès lors, une étude rétrospective a été mise en place, impliquant les TDS dans 3 départements hospitaliers critiques - au sens de l'importance d'éviter des complications dues à la transmission nosocomiale d'Influenza chez les patients s'y trouvant. Un questionnaire basé sur la littérature a recueilli dans la population des TDS étudiés leur statut vaccinal auto- déclaré, ainsi que les raisons pour l'acceptation ou le refus des deux types de vaccins antigrippaux et des données démographiques concernant la GS 2009-2010 et la GP. Une étude statistique descriptive, puis uni- et multivariée a été ensuite conduite afin de répondre aux questions de recherche. L'acceptation vaccinale auto-déclarée auprès des 472 répondants (taux de réponse de 54 %) a été de 64 % pour la GP et de 53 % pour la GS. L'acceptation de la vaccination contre la GP était associée avec le fait d'être vacciné contre la GS (OR 9.5; 95% CI 5.5-16.4), d'être un médecin (OR 7.7; 95% CI 3.1-19.1) et de trouver inconfortable de porter un masque (OR 1.7; 95% CI 1.0-2.8). Les principaux motifs pour refuser la vaccination ont été la préférence pour le port du masque chirurgical (80% pour la GP, non applicable pour la GS) et les inquiétudes sur la sûreté (64%, 50%) et l'efficacité (44%, 35%) des vaccins. L'étude conclut que les inquiétudes au sujet de la sécurité et l'efficacité du vaccin, de même que l'intérêt personnel des TDS, restent encore actuellement les principaux déterminants associés à l'acceptation de la vaccination antigrippale. Par ailleurs, le port du masque chirurgical obligatoire a en soi été décrit comme promoteur de la vaccination, mais a aussi offert une alternative à la vaccination aux TDS non compilants avec la recommandation de se faire vacciner. Le design de l'étude ne permettait cependant pas de mesurer si la Directive a eu un impact réel sur l'augmentation de la compliance ; une étude ad hoc pourrait être développée. Dès lors, les perspectives offertes par cette étude sont, dans un contexte helvétique de vaccination antigrippale encouragée mais sur une base volontaire, que l'on doit encore travailler sur la promotion et l'incitation à la vaccination si l'on souhaite augmenter la compliance des TDS avec les recommandations actuelles, en particulier chez le personnel soignant non médecin