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                <text>Safety and Health at Work Vol. 13 Issue 4 2022&#13;
Trend Analysis by Risk Observation: How the German Statutory Accident Insurance Prepares for the Future in Occupational Safety and Health (Original article)</text>
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                <text>Background: The risk observatory (RO) of the German Social Accident Insurance (DGUV) provides strategic support to the German Social Accident Insurance Institutions (GSAII) in proactive prevention. It does so by identifying future challenges and opportunities for occupational safety and health (OSH) resulting from new trends and developments that affect employees as well as children in elementary education, pupils, and students.&#13;
Methods: The core of the RO is an online survey that relies on a pool of new trends and developments identified via internet and literature research. 865 prevention experts of the GSAII and the DGUV&#13;
participated in the survey. They rated trends and developments regarding their sector-specific risks and opportunities for OSH in the 5 years to come.&#13;
Results: Sector-specific and over-all results show that besides well-known OSH risks such as musculoskeletal stress and noise, developments relevant for OSH come to the fore that do not have their origin in work itself, but are strongly influenced by political, social, economic, environmental, or technical developments that accident insurance can only peripherally influence. Shortage of skilled staff was identified as a threat to OSH in almost all sectors.&#13;
Conclusions: Prevention must find ways to address repercussions of such OSH risks. Cooperation and political awareness are therefore gaining in importance. Also, implementing a prevention culture in&#13;
society and strengthening individuals’ health and safety literacy, e.g., by target-group-specific communication and sensitization, as well as early safety and health education, help to counteract those OSH risks.</text>
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                <text>Angelika Hauke, Eva Flaspöler, Ruth Klüser, Ina Neitzner, Dietmar Reinert</text>
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                <text>Sri Wahyuni</text>
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                <text>Safety and Health at Work Vol. 13 Issue 4 2022&#13;
Synthesis of Evidence to Support EMS Personnel’s Mental Health During Disease Outbreaks: A Scoping Review (Review Article)</text>
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                <text>Emergency medical services (EMS) personnel are at high risk for adverse mental health outcomes during disease outbreaks. To support the development of evidence-informed mitigation strategies, we conducted a scoping review to identify the extent of research pertaining to EMS personnel’s mental health during disease outbreaks and summarized key factors associated with mental health outcomes. We systematically searched three databases for articles containing keywords within three concepts: EMS personnel, disease outbreaks, and mental health. We screened and retained original peer-reviewed articles that discussed, in English, EMS personnel’s mental health during disease outbreaks. Where inferential statistics were reported, the associations between individual and work-related factors and mental health outcomes were synthesized. Twenty-five articles were eligible for data extraction. Our&#13;
findings suggest that many of the contributing factors for adverse mental health outcomes are related to inadequacies in fulfilling EMS personnel’s basic safety and informational needs. In preparation for future disease outbreaks, resources should be prioritized toward ensuring adequate provisions of personal protective equipment and infection prevention and control training. This scoping review serves as a&#13;
launching pad for further research and intervention development.</text>
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                <text>Bronson B. Du, Sara Rezvani, Philip Bigelow , Behdin Nowrouzi-Kia , Veronique M. Boscart, Marcus Yung, Amin Yazdani</text>
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                <text>Sri Wahyuni</text>
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                <text>Safety and Health at Work Vol. 13 Issue 4 2022</text>
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                <text>Safety and Health at Work Vol. 13 Issue 4 2022&#13;
Healthcare Workers’ Mental Health in Pandemic Times: The Predict Role of Psychosocial Risks (Original article)</text>
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                <text>COVID-19, Healthcare workers, Mental health, Psychosocial risks</text>
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                <text>Background: Healthcare workers perform an emotionally exhausting daily work activity, making them prone to occupational hazards, namely psychosocial ones. This study aims to assess the impact of psychosocial risk factors on healthcare workers’ mental health.&#13;
Methods: A cross-sectional study was developed between May and June of 2021 with 479 healthcare workers from Portuguese hospitals. The Depression, Anxiety and Stress Scale was used to assess mental health, and psychosocial risks were assessed through the Health and Work Survey e INSAT. Statistical analysis was performed to identify the psychosocial risk factors related to anxiety, depression, and stress.&#13;
Subsequently, a multiple linear regression was performed to identify the models that better explained psychosocial risk factors’ relationship with anxiety, depression, and stress.&#13;
Results: Data showed a strong exposure to psychosocial risks. Work pace and intensity, work relationships, and emotional demands stood out with higher global average percentages for yes answers to&#13;
“exposure and discomfort.” The analysis of the b values and p-values from the multiple linear regression shows that some cross-sectional psychosocial risks are predictors of anxiety and stress dimensions, and&#13;
other psychosocial risks differ in the two mental health dimensions. However, it is important to highlight that healthcare workers still showed great joy and pleasure in performing their work activities.&#13;
Conclusion: Support network development in the work environment is needed to prevent healthcare workers’ emotional stress and promote their psychological well-being. Therefore, new research is essential to understand the psychosocial risks that affect healthcare workers and assess the less visible effects of workehealth relationships.</text>
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                <text>Carla Barros, Pilar Baylina, Rúben Fernandes, Susana Ramalho, Pedro Arezes</text>
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                <text>Sri Wahyuni</text>
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                <text>Safety and Health at Work Vol. 13 Issue 4 2022&#13;
Norms about Alcohol Use among US Firefighters (Original article)</text>
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                <text>Background: Problem drinking is a perennial concern in the US fire service. A large literature has documented the importance of addressing alcohol norms in intervention research. The purpose of this study was to explore alcohol norms in a national cohort of firefighters (FFs) to inform intervention development in this occupational group.&#13;
Methods: Data were from a national online survey of career and volunteer FFs (N 1⁄4 674). Participants were recruited through national fire service listservs and a database of FFs who had agreed to be con-&#13;
tacted for research. &#13;
Results: When asked about “acceptable” levels of alcohol consumption, FFs on average suggested levels which exceeded public health guidelines. Further, approximately half of career and volunteer FFs&#13;
believed that, at least under some circumstances, drinking until intoxicated was normative. When asked how long should elapse between a FFs last drink and reporting for duty, the average suggested lag was 11.2 hours (sd 1⁄4 4.6). However, among male volunteer FFs who reported heavy drinking, the average was 6.68 hours (sd 1⁄4 4.77).&#13;
Conclusions: Given the high prevalence of heavy and binge drinking in the fire service, it is not surprising that the alcohol norms found in this study were consistent with a culture of drinking. Participants’ reports of alcohol use among their peers were consistent with the actual prevalence of problem drinking Thus, education and prevention efforts in this occupation should focus on changing norms about alcohol use, including linking heavy drinking to other health and safety issues they face. </text>
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                <text>Christopher K. Haddock, Nattinee Jitnarin, Raul Caetano, Sara A. Jahnke, Brittany S. Hollerbach, Christopher M. Kaipust , Walker S.C. Poston</text>
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                <text>Safety and Health at Work Vol. 13 Issue 4 2022</text>
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                <text>Safety and Health at Work Vol. 13 Issue 4 2022&#13;
Protective Measures From Solar Ultraviolet Radiation for Beach Lifeguards in Tuscany (Italy): Shade and Clothing Strategies (Original article)</text>
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                <text>Background: The exposure to solar ultraviolet radiation is a significant risk factor generally underestimated by outdoor workers and employers. Several studies have pointed out that occupational solar exposure increased eye and skin diseases with a considerable impact on the lives and productivity of affected workers. The main purpose of this study was to evaluate the effectiveness against ultraviolet radiation of some&#13;
measures recently undertaken for the protection of lifeguards in a coastal area of Tuscany. &#13;
Methods: Different shading structures (gazebos and beach umbrella) were tested during a sunny summer’s day on a sandy beach by means of two radiometers; the UV protection offered by some T-shirts used by lifeguards was also tested in the laboratory with a spectrophotometer.&#13;
Results: The analysed shading structures strongly reduced the ultraviolet radiation by up to 90%, however a not always negligible diffuse radiation is also present in the shade, requiring further protective&#13;
measures (T-shirt, sunglasses, sunscreen, etc.); the tested T-shirts showed a very good-excellent protection according to the Australian/New Zealand standard. &#13;
Conclusion: Results obtained in this study suggest how the adoption and dissemination of good practices, including those tested, could be particularly effective as a primary prevention for lifeguards who are&#13;
subjected to very high levels of radiation for long periods.</text>
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                <text>Daniele Grifoni, Giulio Betti, Andrea Bogi, Lucia Bramanti, Alessandra Chiarugi, Bernardo Gozzini, Marco Morabito, Francesco Picciolo, Francesco Sabatini, Lucia Miligi </text>
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Return to Work for Workers with Post-COVID Conditions (Editorial)</text>
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                <text>Individuals who suffer from coronavirus disease 2019 (COVID-19) generally fully recover with few or no symptoms following an acute infection. However, approximately 10–20% of individuals continue to report persistent or sometimes progressive or even incapacitating symptoms after the resolution of the initial infectionddescribed as post-COVID conditions [1]. Characterization of post-COVID conditions remains unclear with differences in case definitions adopted by various international organizations and institutions. Individuals with post-COVID conditions report highly heterogenous multisystemic symptoms, which may be nonspecific and fluctuating, which makes it difficult to clearly define the disease. Common symptoms reported include fatigue,&#13;
dyspnea, joint pain, chest pain, cough, change in sense of smell or taste, cognitive disturbances, and hoarseness of voice. Less common symptoms are insomnia, low-grade fevers, headaches , neurocognitive difficulties, myalgia and weakness, gastrointestinal symptoms, rashes, and depression [2]. Risk factors that have been described for post-COVID conditions include a history of severe COVID-19 illness during the acute infection, preexisting comorbidities such as obesity, diabetes, respiratory and cardiovascular diseases, patients who are immunocompromised, older patients, and females [2]. Recovery from post-COVID conditions can be slow, and symptoms may affect the individual’s function and impede return to work (RTW). It has been estimated that 1.2–4.8% of COVID-19 patients will develop post-COVID conditions with debilitating symptoms [3]. </text>
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                <text>David Koh,  Alvin Tan</text>
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                <text>Safety and Health at Work Vol. 13 Issue 4 2022&#13;
Comparisons of Fit Factors Between Two Quantitative Fit Testers (PortaCount vs. MT) (Short Communication)</text>
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                <text>This study evaluated the consistency between two quantitative fit test devices with different methods of ambient aerosol counting. Three types of respirators (N95, half mask, and full facepiece) were worn by 50&#13;
participants (male, n 1⁄4 25; female, n 1⁄4 25), PortaCount (Proþ 8038) and MT (05U) were connected to one probe to one mask, and fit factors (FFs) were measured simultaneously with the original and modified&#13;
protocols. As a result of comparing MT FFs with PortaCount FFs as references and by applying for the pass/fail criteria (FF 1⁄4 100), the consistency between the two devices for half masks and full facepieces&#13;
was very high. N95 was somewhat weaker than the two type of respirators in the consistency; however, the correlation between the two devices was very strong (p &lt; 0.0001). The results showed that an FF of 100 as measured by PortaCount was likely to be measured as 75 by the MT. Therefore, when performing the fit test for N95 using the MT and pass level of FF 100, a certain level of adjustment is necessary,&#13;
whether end-user or putting a scaling factor by manufacturer. </text>
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                <text>Don-Hee Han, Hyekyung Seo, Byoung-kab Kang, Hoyeong Jang, HuiJu Kim, &#13;
SuA Shim</text>
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                <text>Sri Wahyuni</text>
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                <text>Safety and Health at Work Vol. 13 Issue 4 2022&#13;
Exposure Assessment of Airborne Bacteria and Fungi in the Aircraft (Original article)</text>
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                <text>airborne bacteria, airborne fungi, aircraft, cleaning workers, exposure levels</text>
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                <text>Objective: The exposure levels of disease-causing bacteria and germs were assessed on aircraft cleaning workers on multiple different aircrafts.&#13;
Method: Five measuring points were selected depending on the aircraft types. Four aircraft cleaning agencies were selected for the test. Aircraft cleaning work was classified as intensive cleaning and general cleaning work. Ventilation in aircraft when sampling during the cleaning operation was categorized into forced ventilation and natural ventilation. The collection of airborne microorganisms was made through inertial impactors which were installed 1.5 meters above the bottom of the aircraft. The airborne bacteria and fungus growth badges were selected by Trytpic Soy Agar and Sabouraud Dextrose Agar.&#13;
Results: The average concentrations of bacteria in the air were higher in the order of small, medium, and large airplanes. Rainy days had higher concentrations inside and outside the aircraft as compared to those in sunny days. Regarding ventilation, concentrations in natural ventilation were higher than concentrations in forced ventilation. According to the type of work, the concentrations in the intensive cleaning groups (cleaning one plane a day) were lower than those of the ordinary cleaning groups (cleaning several planes per day).&#13;
Conclusion: The concentration levels of airborne bacteria and fungi in the aircraft surveyed were lower than the indoor environmental standards of Korea (800 cfu/m3 and 500 cfu/m3 ). The average concen-&#13;
trations of bacteria in the air and fungi in the air were highest in small aircraft owned by Company D. </text>
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The Moderating Role of Emotional Intelligence on the Relationship Between Conflict Management Styles and Burnout among Firefighters (Original article)</text>
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                <text>Background: While the organizational factors that account for firefighters’ burnout have been extensively explored, the individual factors related to how they regulate interpersonal conflicts and emotions remain to be investigated. Previous research has demonstrated the association between emotional intelligence&#13;
and conflict management styles and burnout, but no study has looked at the interrelationships among these factors in high-risk sectors. The present exploratory study aimed to fill this research gap by&#13;
investigating the relationships between conflict management style, emotional intelligence and burnout in a sample of firefighters.&#13;
Methods: A cross-sectional study was conducted with 240 French firefighters. Measures comprised validated scales of conflict management styles, emotional intelligence and burnout.&#13;
Results: Results showed that the integrating conflict style reduced burnout. They also revealed the effects of emotion regulation on burnout, whereby the awareness and management of one’s own emotions reduced burnout. Moreover, awareness of one’s own emotions moderated the relationship between integrating conflict resolution style and burnout, whereby the effect of integrating style on reduced burnout was higher when awareness of one’s own emotions was high.&#13;
Conclusion: These results reveal that strategies used by firefighters to regulate their emotions in order to meet the emotional demands specific to their job are important for reducing the emotional exhaustion&#13;
component of burnout. Training programs for conflict and emotion management are needed to preserve the mental health of firefighters and ensure the safety of interventions.</text>
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Ergonomic Evaluation of Young Agricultural Operators Using Handle Equipment Through Electromyography and Vibrations Analysis Between the Fingers (Original article)</text>
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                <text>Background: Agricultural handle equipment is present on all production areas’ farms. They are handy and portable; however, excessive use can lead to acute traumas or accidental injuries. Repetitive movements, awkward postures, and hand-arm vibrations predispose them to pain and work-relatedmusculoskeletal disorders. The purpose of this study was to observe the interaction of handle equipment in terms of electromyographic activity and analyze the postural work-related alterations.&#13;
Materials and methods: Twenty male agricultural operators, mean age 24  1.54 years, underwent the electromyographic analysis testing their muscular activities with a brushcutter, electric saw, and hedge trimmer in four different test conditions.&#13;
Results: The brushcutter proved to be the agricultural handle equipment with the higher mean frequency (3.37  0.38 Hz) and root mean square (5.25  1.24 ms2 ). Furthermore, the digital postural analysis showed a general asymmetry of the main arm and the respective side of the trunk. The head resulted right inclined in the anterior frontal plane by 5.7  1.2; the right scapula lower than the left in the posterior frontal plane (8.5  1.8), and a working trunk inclination of 34.15  5.7 &#13;
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&#13;
musculoskeletal disorders all lifelong.</text>
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