ObjectivesWillingness to participate in disasters is usually overlooked and not addressed in disaster preparedness training courses to ensure health service coverage. This will lead to issues during ...the disaster’s response. This study, therefore, aims to assess healthcare workers willingness to participate in biological and natural disasters, and to identify its associated factors.DesignThis is a cross-sectional study using a self-administered questionnaire. The questionnaire was distributed to 1093 healthcare workers. The data were analysed using multiple logistic regression with significance level p<0.05. Ethical clearance and consent of the participants were duly obtained.SettingIn three public hospitals that provide tertiary-level healthcare in Sana’a City, Yemen.ParticipantsThere were 692 nurses and doctors (response rate 63.3%) completed the questionnaires.ResultsAlmost half of the participants 55.1% were nurses and 44.9% were doctors. The study found that self-efficacy was associated with willingness to participate in disaster response for any type of disasters (OR 1.319, 95% CI 1.197 to 1.453), natural disasters (OR 1.143, 95% CI 1.069 to 1.221) and influenza pandemic (OR 1.114, 95% CI 1.050 to 1.182). The results further show that willingness is associated with healthcare workers being young, male and having higher educational qualifications.ConclusionSelf-efficacy has been found to be an important factor associated with willingness. Improving self-efficacy through training in disaster preparedness may increase willingness of healthcare workers to participate in a disaster.
Background
Dentistry is a profession with a high prevalence of work‐related musculoskeletal disorders (WMSD) among practitioners, with symptoms often starting as early in the career as the student ...phase. Ergonomic interventions in physical, cognitive, and organisational domains have been suggested to prevent their occurrence, but evidence of their effects remains unclear.
Objectives
To assess the effect of ergonomic interventions for the prevention of work‐related musculoskeletal disorders among dental care practitioners.
Search methods
We searched CENTRAL, MEDLINE PubMed, Embase, PsycINFO ProQuest, NIOSHTIC, NIOSHTIC‐2, HSELINE, CISDOC (OSH‐UPDATE), ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform (ICTRP) Search Portal to August 2018, without language or date restrictions.
Selection criteria
We included randomised controlled trials (RCTs), quasi‐RCTs, and cluster RCTs, in which participants were adults, aged 18 and older, who were engaged in the practice of dentistry. At least 75% of them had to be free from musculoskeletal pain at baseline. We only included studies that measured at least one of our primary outcomes; i.e. physician diagnosed WMSD, self‐reported pain, or work functioning.
Data collection and analysis
Three authors independently screened and selected 20 potentially eligible references from 946 relevant references identified from the search results. Based on the full‐text screening, we included two studies, excluded 16 studies, and two are awaiting classification. Four review authors independently extracted data, and two authors assessed the risk of bias. We calculated the mean difference (MD) with 95% confidence intervals (CI) for continuous outcomes and risk ratios (RR) with 95% confidence intervals for dichotomous outcomes. We assessed the quality of the evidence for each outcome using the GRADE approach.
Main results
We included two RCTs (212 participants), one of which was a cluster‐randomised trial. Adjusting for the design effect from clustering, reduced the total sample size to 210. Both studies were carried out in dental clinics and assessed ergonomic interventions in the physical domain, one by evaluating a multi‐faceted ergonomic intervention, which consisted of imparting knowledge and training about ergonomics, work station modification, training and surveying ergonomics at the work station, and a regular exercise program; the other by studying the effectiveness of two different types of instrument used for scaling in preventing WMSDs. We were unable to combine the results from the two studies because of the diversity of interventions and outcomes.
Physical ergonomic interventions. Based on one study, there is very low‐quality evidence that a multi‐faceted intervention has no clear effect on dentists' risk of WMSD in the thighs (RR 0.57, 95% CI 0.23 to 1.42; 102 participants), or feet (RR 0.64, 95% CI 0.29 to 1.41; 102 participants) when compared to no intervention over a six‐month period. Based on one study, there is low‐quality evidence of no clear difference in elbow pain (MD −0.14, 95% CI −0.39 to 0.11; 110 participants), or shoulder pain (MD −0.32, 95% CI −0.75 to 0.11; 110 participants) in participants who used light weight curettes with wider handles or heavier curettes with narrow handles for scaling over a 16‐week period.
Cognitive ergonomic interventions. We found no studies evaluating the effectiveness of cognitive ergonomic interventions.
Organisational ergonomic interventions. We found no studies evaluating the effectiveness of organisational ergonomic interventions.
Authors' conclusions
There is very low‐quality evidence from one study showing that a multi‐faceted intervention has no clear effect on dentists' risk of WMSD in the thighs or feet when compared to no intervention over a six‐month period. This was a poorly conducted study with several shortcomings and errors in statistical analysis of data. There is low‐quality evidence from one study showing no clear difference in elbow pain or shoulder pain in participants using light weight, wider handled curettes or heavier and narrow handled curettes for scaling over a 16‐week period.
We did not find any studies evaluating the effectiveness of cognitive ergonomic interventions or organisational ergonomic interventions.
Our ability to draw definitive conclusions is restricted by the paucity of suitable studies available to us, and the high risk of bias of the studies that are available. This review highlights the need for well‐designed, conducted, and reported RCTs, with long‐term follow‐up that assess prevention strategies for WMSDs among dental care practitioners.
•Perceived risk is reasonably high among artisanal gold miners in Sudan.•Multiple drivers contribute towards shaping miners’ perception of risk.•Personal hazard experience has the greatest impact on ...perceived risk.•Social communication can share risk perception and promote a culture of safety.•Conventional safety practices are determined by the level of perceived risk.
Artisanal gold mining poses significant threats to miners and to communities near mining sites. Risk perception can provide information to policy- and decision-makers for risk mitigation and prioritization of interventions. The present study applies hierarchical regression analysis to factors influencing perceived risk among artisanal gold miners in the Berber locality of Sudan. Following principal component analysis, ten indicators were used to compute a composite index for miners’ perceived risk. Each assessment indicator was considered to make an equal contribution to perceived risk. The factors determining the perceived risk included education, unemployment, years of work, income, personal experience of natural hazards, distance to health facility, access to water and sanitation, experience of social communication, and hazard characteristics. The present study found that age, limited livelihoods options, household size, and self-rated health status were not statistically significant. Although miners' perception of risk was reasonably high, there was always a shortcoming in translating this perception into safer behavior. Thus, miners were persistently exposed to accidents and fatal injuries. As risk perception could be enhanced and shared through social communication, effective communal platforms are imperative for raising risk awareness and promoting a culture of safety, thereby reducing the gross health risks at various stages.
Abstract: A Comparison of Hand-arm Vibration Syndrome between Malaysian and Japanese Workers: Anselm Ting SU, et al. Centre for Occupational and Environmental Health, Department of Social and ...Preventive Medicine, University of Malaya, Malaysia-The evidence on hand-arm vibration syndrome (HAVS) in tropical environments is limited. The legislation for the control of occupational vibration exposure has yet to be established in Malaysia. Objectives: The aim of this study was to investigate the clinical characteristics of HAVS in a tropical environment in comparison with a temperate environment. Methods: We conducted a series medical examinations among the forestry, construction and automobile industry workers in Malaysia adopting the compulsory medical examination procedure used by Wakayama Medical University for Japanese vibratory tools workers. We matched the duration of vibration exposure and compared our results against the Japanese workers. We also compared the results of the Malaysian tree fellers against a group of symptomatic Japanese tree fellers diagnosed with HAVS. Results: Malaysian subjects reported a similar prevalence of finger tingling, numbness and dullness (Malaysian=25.0%, Japanese=21.5%, p=0.444) but had a lower finger skin temperature (FST) and higher vibrotactile perception threshold (VPT) values as compared with the Japanese workers. No white finger was reported in Malaysian subjects. The FST and VPT of the Malaysian tree fellers were at least as bad as the Japanese tree fellers despite a shorter duration (mean difference=20.12 years, 95%CI=14.50, 25.40) of vibration exposure. Conclusions: Although the vascular disorder does not manifest clinically in the tropical environment, the severity of HAVS can be as bad as in the temperate environment with predominantly neurological disorder. Hence, it is essential to formulate national legislation for the control of the occupational vibration exposure.
Work-related upper limb and neck musculoskeletal disorders (MSDs) are one of the most common occupational disorders around the world. Although ergonomic design and training are likely to reduce the ...risk of workers developing work-related upper limb and neck MSDs, the evidence is unclear.
To assess the effects of workplace ergonomic design or training interventions, or both, for the prevention of work-related upper limb and neck MSDs in adults.
We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, AMED, Web of Science (Science Citation Index), SPORTDiscus, Cochrane Occupational Safety and Health Review Group Database and Cochrane Bone, Joint and Muscle Trauma Group Specialised Register to July 2010, and Physiotherapy Evidence Database, US Centers for Disease Control and Prevention, the National Institute for Occupational Safety and Health database, and International Occupational Safety and Health Information Centre database to November 2010.
We included randomised controlled trials (RCTs) of ergonomic workplace interventions for preventing work-related upper limb and neck MSDs. We included only studies with a baseline prevalence of MSDs of the upper limb or neck, or both, of less than 25%.
Two review authors independently extracted data and assessed risk of bias. We included studies with relevant data that we judged to be sufficiently homogeneous regarding the intervention and outcome in the meta-analysis. We assessed the overall quality of the evidence for each comparison using the GRADE approach.
We included 13 RCTs (2397 workers). Eleven studies were conducted in an office environment and two in a healthcare setting. We judged one study to have a low risk of bias. The 13 studies evaluated effectiveness of ergonomic equipment, supplementary breaks or reduced work hours, ergonomic training, a combination of ergonomic training and equipment, and patient lifting interventions for preventing work-related MSDs of the upper limb and neck in adults.Overall, there was moderate-quality evidence that arm support with alternative mouse reduced the incidence of neck/shoulder disorders (risk ratio (RR) 0.52; 95% confidence interval (CI) 0.27 to 0.99) but not the incidence of right upper limb MSDs (RR 0.73; 95% CI 0.32 to 1.66); and low-quality evidence that this intervention reduced neck/shoulder discomfort (standardised mean difference (SMD) -0.41; 95% CI -0.69 to -0.12) and right upper limb discomfort (SMD -0.34; 95% CI -0.63 to -0.06).There was also moderate-quality evidence that the incidence of neck/shoulder and right upper limb disorders were not reduced when comparing alternative mouse and conventional mouse (neck/shoulder RR 0.62; 95% CI 0.19 to 2.00; right upper limb RR 0.91; 95% CI 0.48 to 1.72), arm support and no arm support with conventional mouse (neck/shoulder RR 0.67; 95% CI 0.36 to 1.24; right upper limb RR 1.09; 95% CI 0.51 to 2.29), and alternative mouse with arm support and conventional mouse with arm support (neck/shoulder RR 0.58; 95% CI 0.30 to 1.12; right upper limb RR 0.92; 95% CI 0.36 to 2.36).There was low-quality evidence that using an alternative mouse with arm support compared to conventional mouse with arm support reduced neck/shoulder discomfort (SMD -0.39; 95% CI -0.67 to -0.10). There was low- to very low-quality evidence that other interventions were not effective in reducing work-related upper limb and neck MSDs in adults.
We found moderate-quality evidence to suggest that the use of arm support with alternative mouse may reduce the incidence of neck/shoulder MSDs, but not right upper limb MSDs. Moreover, we found moderate-quality evidence to suggest that the incidence of neck/shoulder and right upper limb MSDs is not reduced when comparing alternative and conventional mouse with and without arm support. However, given there were multiple comparisons made involving a number of interventions and outcomes, high-quality evidence is needed to determine the effectiveness of these interventions clearly. While we found very-low- to low-quality evidence to suggest that other ergonomic interventions do not prevent work-related MSDs of the upper limb and neck, this was limited by the paucity and heterogeneity of available studies. This review highlights the need for high-quality RCTs examining the prevention of MSDs of the upper limb and neck.
To determine the association of vitamin D status with depression and health-related quality of life among women.
This was a cross-sectional study conducted among women in Kuala Lumpur, Malaysia. ...Sociodemographic characteristics, physical activity status, perceived depression and health-related quality of life were assessed via a self-administered questionnaire. Fasting blood samples were taken for the analysis of 25-hydroxyvitamin D, parathyroid hormone, fasting blood glucose and full lipid profile. Complex samples multiple logistic regression analysis was performed.
Public secondary schools in Kuala Lumpur, Malaysia.
Seven hundred and seventy female teachers were included.
The mean age of participants was 41·15 (95 % CI 40·51, 41·78) years and the majority were ethnic Malays. Over 70 % of them had vitamin D deficiency (<20 ng/ml or <50 nmol/l) and two-thirds were at risk for depression. In the multivariate analysis, ethnic Malays (adjusted OR (aOR)=14·72; 95 % CI 2·12, 102·21) and Indians (aOR=14·02; 95 % CI 2·27, 86·59), those at risk for depression (aOR=1·88, 95 % CI 1·27, 2·79) and those with higher parathyroid hormone level (aOR=1·13; 95 % CI 1·01, 1·26) were associated with vitamin D deficiency, while vitamin D deficiency was negatively associated with mental health-related quality of life (Mental Component Summary) scores (aOR=0·98; 95 % CI 0·97, 0·99).
Vitamin D deficiency is significantly associated with depression and mental health-related quality of life among women in Kuala Lumpur, Malaysia.
The rapidly increasing uptake of e-cigarettes in Malaysia as of late demands a study to identify factors leading to its increased popularity and user intentions to quit smoking e-cigarettes. A ...convenience sample of e-cigarette smokers visiting e-cigarette retail shops in Selangor and Kuala Lumpur was recruited. The majority of e-cigarette smokers were youth in colleges or universities (39 %), and young professionals and managers (36 %). The main reasons for using e-cigarettes were to help the user quit tobacco cigarettes (88 %), the perception that e-cigarettes are not as intrusive as tobacco cigarettes (85 %) and can be used in public areas (70 %), the perception that e-cigarettes are healthier than tobacco cigarettes (85 %), and its relatively lower cost compared to tobacco cigarettes (65 %). A total of 65.3 % of respondents expressed intentions to quit e-cigarettes. In a multivariate analysis, the respondents who earned monthly income of RM1000 or less were significantly more likely to intend to quit smoking e-cigarettes OR 1.551; 95 % CI 1.022–2.355; p = 0.015 compared to the respondents who earned a monthly income of more than RM2000. The respondents who disagreed with the statement ‘Smoking e-cigs is relatively cheaper compared to tobacco cigarettes’ were significantly more likely to intend to quit smoking e-cigarettes OR 1.548; 95 % CI 1.045–2.293; p = 0.027 compared to respondents who did not agree. e-cigarette preventive interventions should target areas related to the identified main reasons for using e-cigarettes, namely as an aid for quitting tobacco cigarettes, the perception that e-cigarettes are not as intrusive as tobacco cigarettes and can be used in public areas, the idea that e-cigarettes are healthier than tobacco cigarettes, and its relatively lower cost compared to tobacco cigarettes.
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