Влияние условий труда приоритетных секторов экономики Казахстана на формирование профессиональных рисков

The purpose of this study was to evaluate the availability, accessibility and proper use of personal protective equipment (PPE) in the wards at Queen Elizabeth Central Hospital (QECH). We conducted an observational study with a cross-section design. Convenience sampling method was used for selection of healthcare workers (HCWs) in wards. HCWs filled a checklist on accessibility of PPEs and they were observed on proper use of PPE while conducting clinical procedures. Nurse ward in-charge was asked to fill out a checklist on availability of PPE in their ward. PPE was available in 75.8% of wards, not available in 12.5%. Goggles were absent in 70.8% of wards. PPEs were 71.4% accessible and 28.6% inaccessible to healthcare workers in the wards. The most inaccessible PPEs were goggles (83.2%) and footwear (73.7%) while facemasks, sterile and non-sterile gloves and aprons were readily accessible. Non sterile gloves were 100% available and accessible. Only 13.5% of the HCWs had good compliance with PPE standard procedures. The average PPE compliance score of those who had been trained was 6 % greater than those who were not trained. This study identified areas of improvement in healthcare system delivery regarding standard precautions with emphasis on PPE. Improvements in training during professional college education and in-service refresher training could improve compliance with appropriate use of PPE for relatively low cost. Management support could improve availability and accessibility of PPE in the wards at QECH, with active supervision to improve adherence levels to personal protective equipment usage. The study can also help in the development of policies and guidelines regarding PPE usage by showing that most HCWs need to be trained in proper PPE usage.

Increased food production requires fertilizers and pesticides. Fertilizers are used to increase soil fertility and pesticides are used to eradicate pests in food crops and plantations. Problems of farmers in Pucak Village, Kec. Tompobulu as a partner does not know the level of exposure to pesticides, does not know the impact of pesticides on health problems and does not have Personal Protective Equipment (PPE) when spraying. The solutions are: (1) Counseling on prevention and the impact of the use of fertilizers and pesticides on the incidence of dermatitis, (2) Provision of PPE in the form of masks and gloves in fertilizing and spraying pesticides. The results of community service are (1) Counseling on prevention and the impact of using fertilizers and pesticides on the incidence of dermatitis, which is carried out by conducting home visits. Farmers experienced an average increase in knowledge of safe and healthy fertilizing and pesticide spraying management, (2) Provision of PPE, especially hats, masks and gloves to farmers. Abstract: Increasing food production requires fertilizer and pesticides. Fertilizer is used to increase soil fertility. Fertilizer has a negative impact in the form of disease and poisoning on farmers in Borisallo Village, Kec. Parangloe, Kab. Gowa as a partner does not yet know how to prevent exposure to organic fertilizers on health, there is no provision of micronutrient supplementation (Calcium, Magnesium, Zinc, Boron and Vitamin D) as an increase in body immunity and detoxification of fertilizer exposure poisoning and there is no availability of Personal Protective Equipment in managing fertilizers in the form of masks and gloves for farmers. The solutions are: (1) Counseling on preventing fertilizer exposure to farmers, (2) Providing micronutrient supplementation (Calcium, Magnesium, Zinc, Boron and Vitamin D) to increase body immunity and detoxify fertilizer poisons, (3) Providing Personal Protective Equipment (PPE) in the form of masks and gloves when carrying out inorganic fertilization on farmers. The results of community service are (1) Counseling on prevention and the impact of using organic fertilizer on health, which is carried out by conducting home visits. Farmers experienced an average increase in knowledge of safe and healthy management of fertilization and pesticide spraying, (2) providing micronutrients and explaining sources of other food ingredients containing micronutrients in their environment, (3) Providing PPE, especially hats, masks and gloves to farmers

BackgroundAvailability and appropriate use of personal protective equipment (PPE) is of particular importance in Low and Middle-Income countries (LMICs) where disease outbreaks other than COVID-19 are frequent and health workers are scarce. This study assesses the availability of necessary PPE items during the COVID-19 pandemic at health facilities in seven LMICs.MethodsData were collected using a rapid-cycle survey among 1554 health facilities in seven LMICs via phone-based surveys between August 2020 and December 2021. We gathered data on the availability of World Health Organization (WHO)-recommended PPE items and the use of items when examining patients suspected to be infected with COVID-19. We further investigated the implementation of service adaptation measures in a severe shortage of PPE.ResultsThere were major deficiencies in PPE availability at health facilities. Almost 3 out of 10 health facilities reported a stock-out of medical masks on the survey day. Forty-six percent of facilities did not have respirator masks, and 16% did not have any gloves. We show that only 43% of health facilities had sufficient PPE to comply with WHO guidelines. Even when all items were available, healthcare workers treating COVID-19 suspected patients were reported to wear all the recommended equipment in only 61% of health facilities. We did not find a statistically significant difference in implementing service adaptation measures between facilities experiencing a severe shortage or not.ConclusionAfter more than a year into the COVID-19 pandemic, the overall availability of PPE remained low in our sample of low and middle-income countries. Although essential, the availability of PPE did not guarantee the proper use of the equipment. The lack of PPE availability and improper use of available PPE enable preventable COVID-19 transmission in health facilities, leading to greater morbidity and mortality and risking the continuity of service delivery by healthcare workers.

How clinicians manage routinely low supplies of personal protective equipment

"Test and Standard Precautions"-Is It Enough to Protect Us From False-Negative Severe Acute Respiratory Syndrome Coronavirus 2 Test Results?

ABSTRACTThe global COVID-19 pandemic is predicted to compromise the achievement of global reproductive, maternal, and newborn health (RMNH) targets. The objective of this study was to determine the health facility (HF) preparedness for RMNH service delivery during the outbreak from the perspective of RMNH providers and to determine what factors significantly predict this. An anonymous cross-sectional online survey of RMNH providers was conducted from to July 1–21, 2020 in Lagos State, Nigeria. We conducted a descriptive and ordinal regression analysis, with RMNH worker perception of HF preparedness for RMNH service delivery during the outbreak as the dependent variable. In all, 256 RMNH workers participated, 35.2% reported that RMNH services were unavailable at some time since March 2020, 87.1% felt work-related burnout, 97.7% were concerned about the availability of personal protective equipment (PPE) and related guidelines, and only 11.7% were satisfied with the preparedness of their HFs. Our final model was a statistically significant predictor of RMNH worker perception of HF preparedness explaining 54.7% of the variation observed. The most significant contribution to the model was communication by HF management (likelihood ratio chi-square [LRCS]: 87.94, P < 0.001) and the availability of PPE and COVID-19 guidelines (LRCS: 15.43, P < 0.001). A one-unit increase in the level of concern about the availability of PPE and COVID-19 guidelines would increase the odds of observing a higher category of satisfaction with HF COVID-19 preparedness. Adequate support of RMNH providers, particularly provision of PPE and guidelines, and appropriate communications about COVID-19 should be prioritized as part of HF preparedness.

Introduction. The Russian aluminum industry is one of the world’s leading producers of aluminum. At the same time, the features of aluminum production technology contribute to the formation of unfavorable working conditions and increased risk to the health of workers. In this regard, an urgent but insufficiently studied issue in the production of aluminum is the assessment of occupational risks that establish the likelihood of health disorders in workers. Material and methods. The basis of the assessment of occupational risks was the existing regulatory documents (Guidelines) issued by the Federal Center for Hygiene and Epidemiology of Russian Consumer Health and Epidemiology. Existing methodical recommendations and medical technologies were used to calculate occupational risks and allowable working time (experience) under the chemical factor. The values of the annual volume of the air inhaled by the individual of the production environment and the average annual concentrations of toxicants, determined in the air of the working zone of the employees of the main occupational groups, were used. Occupational risk calculations were carried out over a period of 25 years. The total risk assessment for individual occupational groups was conducted under the probability (risk) rule calculated for individual chemicals. Results. Studies have found the average annual concentrations of harmful substances in the air of the working area over the past 5 years to be significantly lower when using the upgraded electrolysis technology (UET) compared to the traditional technology of self-burning anodes (SBA). The exception was hydrofluoride, whose concentrations did not depend on the technologies used, exceeding the MPC by 1.7 - 3.0 times. The total health risk for employees of the main occupations over a period of 25 years was in the range of 7.2 to 22.1% when using SBA, which is almost 2 times higher than when using UET (from 3.7 to 11.6 %). The highest levels of risk were observed in the group of workers using SBA and operators of electrolysis baths with UET, and the lowest - in the crane operators using both technologies. Conclusion. The use of indices of occupational risk and acceptable working hours under the influence of adverse production factors allows identifying a contingent of employees with an increased level of exposure to occupational hazards. Based on the obtained data, it is possible to predict the levels of occupational morbidity and evaluate the effectiveness of measures to improve working conditions, which plays an important role in managing occupational risk.

Economic Impacts of the COVID-19 Crisis: An Orthopaedic Perspective.

Perceptions of Occupational Risk and Changes in Clinical Practice of United States Vitreoretinal Surgery Fellows during the COVID-19 Pandemic

Background: In June 2019, 3 people were diagnosed with Ebola virus disease (EVD) in Kasese district, Uganda, all of whom had come from the Democratic Republic of Congo (DRC). Although no secondary transmission of Ebola occurred, an assessment of infection prevention and control (IPC) using the WHO basic IPC facility assessment checklist revealed significant gaps. Robust IPC systems are critical for the prevention of healthcare-associated infections like EVD. A rapid intervention was developed and implemented in Kasese to strengthen IPC capacity in high-risk facilities. Methods: Of 117 healthcare facilities, 50 were considered at high risk of receiving suspected EVD cases from DRC based on population movement assessments. In August 2019, IPC mentors were selected from 25 high-risk facilities and assigned to support their facility and a second high-risk facility. Mentors ensured formation of IPC committees and implemented the national mentorship strategy for IPC preparedness in non-EVD treatment facilities. This effort focused on screening, isolation, and notification of suspect cases: 4 mentorship visits were conducted (1 per week for 1 month). Middle and terminal assessments were conducted using the WHO IPC checklist 2 and 4 weeks after the intervention commenced. Results were evaluated against baseline data. Results: Overall, 39 facilities had data from baseline, middle, and end assessments. Median scores in facility IPC standard precautions increased from baseline 50% (IQR, 39%–62%) to 73% (IQR, 67%–76%) at the terminal assessments. Scores increased for all measured parameters except for water source (access to running water). Greatest improvements were seen in formation of IPC committees (41% to 75%), hand hygiene compliance (47% to 86%), waste management (51% to 83%), and availability of dedicated isolation areas (16% to 42%) for suspect cases. Limited improvement was noted for training on management of suspect isolated cases and availability of personal protective equipment (PPE) (Fig. 1). No differences were noted in scores for facilities with nonresident mentors versus those with resident mentors at baseline (48% vs 50%) and end assessments (72% vs 74%). Conclusions: This intervention improved IPC capacity in health facilities while avoiding the cost and service disruption associated with large-scale classroom-based training of health workers. The greatest improvements were seen in activities relying on behavior change, such as hand hygiene, IPC committee, and waste management. Smaller changes were seen in areas requiring significant investments such as isolation areas, steady water source, and availability of personal protective equipment (PPE). Mentorship is ongoing in moderate- and lower-risk facilities in Kasese district.Funding: NoneDisclosures: Mohammed Lamorde reports contract research for Janssen Pharmaceutica, ViiV, Mylan.

Emerging infectious diseases are infectious diseases that appear and increase so rapidly that they can be said to be epidemics or non-natural disasters. As the front line, nurses are faced with uncertainties that increase the risk of exposure to disease, so preparedness is needed. This study aims to analyze the factors that affect the preparedness of emergency nurses in dealing with patients with emerging infectious diseases. This study is a correlational analytic study involving 109 emergency nurses in Bali. Data were collected through an online survey using a general questionnaire on demographic factors, a questionnaire on nurses' knowledge of EID, and a questionnaire on nurse preparedness in dealing with EID that had been tested for validity and reliability. The results of the bivariate analysis using the Spearman rank test showed that only the availability of personal protective equipment (p-value 0.007, p &lt; α (0.05) and nurses' knowledge had a significant correlation with emergency nurse preparedness in dealing with patients with emerging infectious diseases (p-value 0.005, p &lt; α (0.05). Therefore, it can be suggested to the hospital management in providing opportunities for emergency nurses to receive training related to emergencies in dealing with emerging infectious diseases and increase the assurance of the availability of adequate personal protective equipment (PPE).

Quality of work-life issues significantly impact the economic, physical, and psychological well-being of health professionals and their families. Enhancing QWL aims to foster a conducive environment and improve work performance. This study evaluated the quality of work life of health professionals in government and private health institutions in the Awi zone, Ethiopia. A comparative cross-sectional approach was employed, with study participants selected via the lottery method in 2022. Socio-demographic and organizational-related data were collected, coded, cleaned, and entered into Epi-Data version 3.1, then analyzed using SPSS version 27. Candidate variables were selected using bivariable logistic regression (p < 0.20). We used multivariable logistic regression to identify factors associated with quality of work life, presenting AOR with a 95% CI at a 5% significance level. The study included 385 private health professionals and 395 government health professionals, with response rates of 90.38 and 92.72%, respectively. Overall quality of work-life satisfaction was 53.08% (95% CI: 49.2-57.0), with private health institution workers reporting satisfaction at 42.3% (95% CI: 37.4-47.30) and government health professionals at 63.54% (95% CI: 58.78-68.31). The difference between the two groups was 21.2% (95% CI: 14.3, 27.9). Factors significantly associated with quality of work life included type of health institutions (AOR = 2.272; 1.684, 3.065), family size (AOR = 1.536; 1.122, 2.103), personnel protective equipment (AOR = 1.369; 1.006, 1.863), eye protection (AOR = 2.090; 1.514, 2.885), engineering control (AOR = 1.563; 1.140, 2.143), and accessibility of alcohol (AOR = 1.714; 1.219, 2.410). Health professionals in private health institutions exhibited lower quality of work-life satisfaction than government health institutions. Quality of work life was significantly associated with the type of health institutions, family size, availability of personal protective equipment, eye protection, engineering control, and accessibility of alcohol. Regular monitoring and evaluation of the quality of work life, ensuring the availability of appropriate personal protective equipment, and providing sufficient materials and equipment for both groups were recommended based on the findings.

IntroductionCOVID-19 pandemic has caused a healthcare crisis across the world. Low-economic countries like Pakistan lag behind in an adequate response including supply of Personal Protective Equipment (PPE), leading to panic among healthcare workers. We aim to evaluate hospital settings and state in Pakistan regarding availability of resources and views of healthcare workers on COVID-19. MethodA questionnaire survey was carried out among healthcare workers in public and private sector hospitals across Pakistan for a period of one month. The primary measured outcomes were presence of local Standard Operating Procedures (SOPs), availability and training of PPE, specific isolation wards and staff wellbeing support by the hospital management. ResultsThere were 337 participants, 307 (91.1%) doctors and 11 nurses (3.3%). About two-third of the participants (n = 199, 59%) reported non-availability of PPE and 40% (n = 136) denied availability of local Standard Operating Procedures. About a quarter of the participants (n = 94, 27.8%) had training in Donning and Doffing. Most of the participants (n = 277, 82.1%) felt that it was necessary to have testing available for frontline workers. ConclusionThere is lack of PPE and adequate facilities in hospitals as COVID-19 continue to spread in Pakistan. Local medical governing bodies and societies should come forward with guidelines to ascertain wellbeing of the healthcare workers.

Abstract. Occupational Health and Safety (K3) is a crucial aspect in the mining industry. The working environment in mining can be considered dangerous, with a high risk of work accidents. The implementation of K3 is not just a regulation, but an absolute necessity to protect workers and maintain the smooth operation of mining activities. In reality, there are still many companies that have not implemented a work safety system that complies with applicable regulations. Therefore, research was conducted on K3 management at CV Fhadira Gemilang with the aim of identifying potential risk conditions or activities, knowing workers' opinions regarding the implementation of the K3 management system in the company, and the availability of Personal Protective Equipment (PPE) as well as K3 appeals/posters provided by the company. This research uses a quantitative method, namely the likelihood method, and a qualitative method using a Likert scale. The data obtained from this research are in the form of observation results and questionnaire processing. The questionnaire regarding the implementation of the K3 management system consists of 10 statements and the questionnaire regarding the use of PPE consists of 9 questions. The questionnaires were distributed and filled out by 27 workers, processed using descriptive statistical methods and the Likert scale. The implementation of SMK3 (Occupational Health and Safety Management System) based on workers' opinions processed using the Likert scale from 10 statements submitted to 27 workers, 34% stated "agree" and 28% stated "disagree", so it can be said that CV Fhadira Gemilang has not fully implemented a good K3 management system. The suboptimal implementation of K3 in the company is due to the lack of worker awareness. In the implementation of K3, both in the implementation of PPE use and in work that is not in accordance with SOPs. Thus, a review is needed by conducting socialization regarding the importance of K3 implementation and working in accordance with applicable SOPs. Abstrak. K3 merupakan aspek yang krusial dalam industri pertambangan. Lingkungan kerja di pertambangan dapat dikatakan berbahaya, dengan risiko kecelakaan kerja yang tinggi. Penerapan K3 bukan hanya sekedar peraturan, melainkan sebuah kebutuhan mutlak untuk melindungi pekerja, dan menjaga kelancaran operasional penambangan. Pada hakikatnya masih banyak perusahaan yang belum menerapkan sistem keselamatan kerja yang sesuai dengan regulasi yang berlaku. Oleh karena itu, dilakukan penelitian mengenai manajemen K3 di CV Fhadira Gemilang dengan tujuan untuk mengidentifikasi keadaan atau aktivitas yang berpotensi risiko, mengetahui pendapat pekerja mengenai penerapan sistem manajemen K3 di perusahaan, dan ketersediaan APD serta himbauan/poster K3 yang disediakan oleh perusahaan. Penelitian ini menggunakan metode kuantitatif yaitu dengan metode likehood dan metode kualitatifnya menggunakan skala likert. Data yang diperoleh dari penelitian ini berupa hasil observasi, dan pengolahan kuesioner. Kuesioner mengenai penerapan sistem manajemen K3 yang berupa 10 pernyataan dan kuesioner mengenai penggunaan APD sebanyak 9 pertanyaan. Kuesioner tersebut dibagikan dan diisi oleh 27 pekerja, diolah dengan menggunakan metode statistik deskriptif dan skala likert. Penerapan SMK3 berdasarkan pendapat pekerja yang diolah menggunakan metode skala likert dari 10 pernyataan yang diajukan kepada 27 orang pekerja 34% menyatakan “setuju” dan 28% menyatakan “tidak setuju”, maka dapat dikatakan bahwa CV Fhadira Gemilang belum sepenuhnya menerapkan sistem manajemen K3 dengan baik. Belum optimalnya penerapan K3 di perusahaan dikarenakan kurangnya kesadaran pekerja. Dalam penerapan K3 baik dari pelaksaan penggunaan APD maupun dalam bekerja yang tidak sesuai dengan SOP. Dengan demikian maka perlunya peninjauan dengan mengadakan sosialisasi mengenai pentingnya penerapan K3 dan bekerja sesuai dengan SOP yang berlaku.

Objective: Three occupational health risk assessment methods were used to assess the occupational health risk of noise exposed posts in an automobile manufacturing enterprise. According to the results, the selection of risk assessment methods and risk management of such occupational noise enterprises were provided. Methods: Form April to November 2021, The occupational health field survey was carried out in an automobile manufacturing industry in Tianjin. The occupational health MES risk assessment method, occupational health risk index risk assessment method and Australian occupational hazard risk assessment method were used to evaluate the occupational health risk of noise-exposed posts in this enterprise, and the evaluation results of different methods were analyzed and compared. Results: The average value of L(Aeq, 8 h) in the four workshops of automobile manufacturing industry was 82.95 dB (A) , and the noise detection exceeding rate was 22.41% (26/116) . The LAeq, 8h and exceeding rate noise of welding workshop were higher than those of other workshops (χ(2)=23.56, 32.94, P<0.01) . The three occupational health risk assessment methods have the same risk assessment results for the four major workshops. The assembly and painting workshops are level 4 risk (possible risk) , and the stamping and welding workshops are level 3 risk (significant risk) . Conclusion: Occupational noise has certain potential hazards to workers in automobile manufacturing enterprises. Therefore, in the future work, corresponding organizational management measures should be taken to improve the working environment and reduce the actual exposure level of workers in order to protect the health of occupational workers.