COVID-19 and healthcare workers: a rapid systematic review into risks and preventive measures

Objective The COVID-19 pandemic is demanding for occupational medicine and for public health. As healthcare workers (HCWs) fight impacts of SARS-CoV-2 on front lines, we must create safe work environments through comprehensive risk assessments, evaluation and effective implementation of counter-measures. We ask: 'What does current literature report on health risks at workplaces regarding COVID-19?' and 'What do current studies report on the effectiveness of enacted preventative recommendations?' Methods As a snapshot of early HCW research, on 26 April 2020, we conducted a rapid systematic literature search in three databases (PubMed, Web of Science and PsycInfo) for COVID-19-related health outcomes and preventive measures in healthcare-associated workplaces. Results 27 studies were identified as relevant for exploring the risk of infection, 11 studies evaluated preventive measures. The studies described that SARS-CoV-2 impacts significantly on HCW's health and well-being, not only through infections (n=6), but also from a mental health perspective (n=16). 4 studies reported indirect risks such as skin injuries, one study described headaches to result from the use of personal protective equipment. Few studies provided information on the effectiveness of prevention strategies. Overall, most studies on health risks as well as on the effectiveness of preventive measures were of a moderate-to-low quality; this was mainly due to limitations in study design, imprecise exposure and outcome assessments. Conclusions Due to widespread exposure of HCW to SARS-CoV-2, workplaces in healthcare must be as safe as possible. Information from HCW can provide valuable insights into how infections spread, into direct and indirect health effects and into how effectively counter-measures mitigate adverse health outcomes. However, available research disallows to judge which counter-measure(s) of a current 'mix' should be prioritised for HCW. To arrive at evidence-based cost-effective prevention strategies, more well-conceived studies on the effectiveness of counter-measures are needed

Perinatal photoperiod associations with diabetes and chronotype prevalence in a cross-sectional study of the UK Biobank

Experimental studies indicate that perinatal light may imprint the circadian timing system, subsequently affect later life physiology, and possibly disease risk. We combined individual time-of-year of birth and corresponding latitude to determine perinatal photoperiod characteristics for UK Biobank participants (n = 460,761) and tested for associations with diabetes mellitus (DM, the pathophysiology of which is often linked with circadian disruption) and chronotype (a trait co-governed by the circadian timing system) prevalence in a cross-sectional investigation. The UK Biobank is a population-based cohort with a 5.5% participation rate (similar to 9.2 million individuals were invited into the study between 2006 and 2010). We defined three groups based on photoperiods experienced in the 3(rd) trimester of pregnancy and first 3 months post-birth time windows: (1) those who exclusively experienced non-extreme photoperiods (NEP, 8-16 hours), (2) those who experienced at least one extreme short photoperiod (ESP, 16 hours). For individuals in each group and time window, mean daily photoperiod and relative photoperiod range (relative = relative to the mean) were calculated. Inclusion of relative photoperiod range adds dispersion information (relative change of photoperiods) to statistical models. Multivariable and multinomial logistic regression analyses were used to estimate odds ratios (ORs) and corresponding 95% confidence intervals (CIs). Increased 3rd trimester relative range was associated with decreased odds of DM (OR 0.63 95%CI 0.49-0.81) in the NEP group, but increased odds of DM were detected for the ESP (OR 1.34, 95%CI 0.96-1.86) and ELP groups (OR 1.32, 95%CI 0.78-2.22). Increased 3(rd) trimester relative range was associated with increased odds of being a Morning (OR 1.20, 95%CI 1.02-1.41) or Evening (OR 1.43, 95%CI 1.21-1.69) chronotype in the NEP group, but this was not observed in other groups. Additionally, different effect sizes and directions of association with DM were observed in different strata of ethnicity and chronotype and statistically significant odds ratio modifications were detected. In conclusion, perinatal photoperiod associations with DM and chronotype prevalence are detected in the UK Biobank. NEP, ESP, and ELP differences are speculated to be caused by a non-linear dose-response to photoperiods from 0-24 hours or by confounding due to artificial light playing a dominant role in ESP individuals and seeking darkness in ELP individuals. Ethnicity and chronotype may be important effect modifiers of perinatal photoperiod associations with DM. Potential for selection biases due to low UK Biobank participation rate disallows stating conclusions too strongly. Overall, further studies are needed to confirm different perinatal photoperiod associations with DM and chronotype. Further investigations into the hypothesized imprinting mechanism are also warranted

Contribution of Occupational Health to multidisciplinary team work for COVID-19 prevention and management

Introduction: The SARS-CoV-2/Covid-19 pandemic is a challenge for public health and occupational medicine and developing prevention and protection strategies needs expertise from many disciplines. To make prevention successful, individuals have to be motivated to participate and, in turn, motivation depends on understanding how and why prevention measures are implemented. We present a structured approach (the Cycle of prevention) which involves different stakeholders and perspectives to develop, and monitor, prevention strategies in transparent and effective ways

Work-related recovery opportunities: testing scale properties and validity in relation to health

Objectives Recovery opportunities allow employees to recuperate from work and diminish load effects. The aims of this study are to present a scale for measuring recovery opportunities, study its psychometric properties and its relationship with health. Methods Data from three Dutch worker samples were used with response rates over 60%. Sample 1 contained 6,863 employees working in a wide variety of jobs in 114 organizations. Sample 2 contained data from 992 mental health care workers from ten different organizations. Sample 3 were 436 employees working in several specialized health care clinics. Results Internal consistency of the nine-item recovery opportunities scale is good. Content validity of recovery opportunities, especially how it discriminates from other aspects of job control, is also good. Recovery opportunities show significant effects on work-related fatigue (need for recovery), sleep complaints, and health complaints, but not on future absenteeism. Conclusion The recovery opportunities scale has good reliability and shows good content-, construct- and criterion-related validity in three samples of workers that differ in amount of heterogeneit