Key aspects of occupational risks for healthcare workers

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UDC: 
614.2, 614.3, 614.4
DOI: 
10.21668/health.risk/2024.2.17.eng
Authors: 

N.I. Shulakova, A.V. Tutelyan, V.G. Akimkin

Organization: 

Central Research Institute of Epidemiology, 3a Novogireevskaya St., Moscow, 111123, Russian Federation

Abstract: 

At present, the greatest challenge associated with risks in healthcare is the lack of research on occupational diseases associated with healthcare workers’ activities. Despite all achievements of the modern medicine and use of high-tech equipment, occupational health risks remain high in healthcare organizations. Few available literature sources assume that the level of actual occupational morbidity among healthcare workers is considerably higher than the official figures. This does not allow us to fully assess its prevalence. No unified approaches to investigating morbidity among healthcare workers have been developed yet. Analysis of available literature sources has revealed that most studies with their focus on peculiarities of working conditions and health of healthcare workers as well as associated risk factors are rather fragmentary and do not fully encompass all relevant aspects. At present, there is no unified organizational system for occupational safety that includes, among other things, scientific study of the issue. It is advisable to create a concept of occupational health risks in order to provide effective substantiation for selecting managerial decisions on regulation of effects produced by risk factors on personnel employed by healthcare organizations. The methodology for occupational health risk analysis is eligible for becoming an instrument that can ensure an effective policy aimed at protecting and promoting health of healthcare workers.

Keywords: 
healthcare workers, risks, occupational infections, occupational morbidity, working conditions
Shulakova N.I., Tutelyan A.V., Akimkin V.G. Key aspects of occupational risks for healthcare workers. Health Risk Analysis, 2024, no. 2, pp. 185–195. DOI: 10.21668/health.risk/2024.2.17.eng
References: 
  1. Esaulenko E.V. The growing role of infectious diseases in the modern world and the importance of continuing medical education of specialists for the successful fight against them. Vestnik Novgorodskogo gosudarstvennogo universiteta im. Yaroslava Mudrogo, 2020, no. 3 (119), pp. 4–9. DOI: 10.34680/2076-8052.2020.3 (119).4-9 (in Russian).
  2. Sepkowitz K.A., Eisenberg L. Occupational deaths among healthcare workers. Emerg. Infect. Dis., 2005, vol. 11, no. 7, pp. 1003–1008. DOI: 10.3201/eid1107.041038
  3. Bektasova M.V., Kaptsov V.A., Sheparev A.A. Struktura professional'noi zabolevaemosti infektsionnogo geneza med-itsinskogo personala lechebno-profilakticheskikh organizatsii, osushchestvlyayushchikh meditsinskuyu deyatel'nost' Primorskogo kraya za 1996–2012 gg. [The structure of occupational morbidity of infectious genesis of healthcare workers employed by medical and preventive organizations and engaged in medical activities in Primorsky Krai for 1996–2012]. Okhrana truda i tekhnika bezopasnosti v uchrezhdeniyakh zdravookhraneniya, 2013, no. 2, pp. 8–11 (in Russian).
  4. Petrukhin N.N. Prevalence of occupational morbidity among healthcare workers in the Russian Federation and abroad (literature review). Gigiena i sanitariya, 2021, vol. 100, no. 8, pp. 845–850. DOI: 10.47470/0016-9900-2021-100-8-845-850 (in Russian).
  5. Dubel E.V., Unguryanu T.N. Estimation of health risk factors perception by medical workers. Ekologiya cheloveka, 2015, no. 2, pp. 33–34 (in Russian).
  6. Bogovskaya E.A., Aleksandrova O.Y. Current problems of special assessment of labor standards in medical services. Problemy standartizatsii v zdravookhranenii, 2017, no. 11–12, pp. 17–22. DOI: 10.26347/1607-2502201911-12003-008 (in Rus-sian).
  7. Korzh V.A. Sovershenstvovanie sistemy otsenki i monitoringa uslovii truda – zalog zdorov'ya rabotayushchikh [Improv-ing the system of assessment and monitoring of working conditions is the key to workers’ health]. Occupation and Health: Russian National Congress with International Participation, 2019. Available at: https://congress.oh-events.ru/doc/arch/2019_plenSes-KorzhVA.pdf (January 31, 2024).
  8. Zhukova S.A., Smirnov I.V. Analysis of labour conditions and protection of healthcare workers. Sotsial'no-trudovye issledovaniya, 2020, no. 41 (4), pp. 145–154. DOI: 10.34022/2658-3712-2020-41-4-145-154 (in Russian).
  9. Gatiyatullina L.L. Health status of medical professionals. Vestnik sovremennoi klinicheskoi meditsiny, 2016, vol. 9, iss. 3, pp. 69–75. DOI: 10.20969/VSKM.2016.9 (3).69-75 (in Russian).
  10. Ermolina T.A., Martynova N.A., Kalinin A.G., Krasilnikov S.V. Medical workers’ state of health; literature review. Vestnik novykh meditsinskikh tekhnologii, 2012, vol. XIX, no. 3, pp. 197 (in Russian).
  11. Gicheva I.M., Nikolaev K.Y., Davidovich G.A., Nikolaeva A.A., Oteva E.A., Khodanov A.I., Zeinalova D.K., Tikhonova L.A. Evaluation of the health status of medical workers and their life quality in arterial hypertension. Zdravookhranenie Rossiiskoi Federatsii, 2009, no. 6, pp. 20–24 (in Russian).
  12. Korichkina L.N., Radkov O.V., Komarov I.I., Poselyugina O.B., Romanova N.P. The main reasons and procedure for identifying occupational diseases among healthcare workers. Meditsinskaya sestra, 2018, vol. 20, no. 8, pp. 44–47. DOI: 10.29296/25879979-2018-08-ll (in Russian).
  13. Kurakova N. Infektsionnaya bezopasnost' medpersonala i patsientov v LPU: puti ee dostizheniya [Infectious safety of medical staff and patients in healthcare institutions: ways to achieve]. Menedzher zdravookhraneniya, 2011, no. 10, pp. 70–71 (in Russian).
  14. Kotelnikov G.P., Sushina N.V., Arshin V.V. The new method of prophylaxis and treatment of orthopedic diseases from functional overstrain. Travmatologiya i ortopediya Rossii, 2005, no. 1 (34), pp. 29–35 (in Russian).
  15. Garipova R.V. Improving the monitoring of the health status of medical workers. Kazanskii meditsinskii zhurnal, 2011, vol. 92, no. 1, pp. 78–82 (in Russian).
  16. Levanyuk A.I., Ermolina T.A., Sergeyeva E.V., Martynova N.A., Kalinin A.G., Kononov E.I. Immunological respon-siveness in medical workers of therapeutic-and-prophylactic institutions. Zdravookhranenie Rossiiskoi Federatsii, 2011, no. 2, pp. 51–52 (in Russian).
  17. Kondrova N.S., Shaikhlislamova E.R., Sandakova I.V., Simonova N.I., Karpova N.N. Occupational morbidity among healthcare workers in the Republic of Bashkortostan: long-term dynamics, structure, specificities of formation. Bezopasnost' i okhrana truda, 2020, no. 3 (84), pp. 47–51 (in Russian).
  18. Sindrom vygoraniya vrachei luchshe vsego lechitsya s pomoshch'yu povysheniya zarplaty [Doctors' burnout syndrome is best treated with a salary increase]. Menedzher zdravookhraneniya, 2011, no. 7, pp. 64–69 (in Russian).
  19. Polyakov I.V., Dobritsyna A.A., Zelenskaya T.M. The evaluation of health of medical personnel of ambulance care and impacting factors. Problemy sotsial'noi gigieny, zdravookhraneniya i istorii meditsiny, 2012, no. 1, pp. 25–28 (in Russian).
  20. Gorblyansky Yu.Yu. Topical problems of occupational morbidity among medical staffers. Meditsina truda i promysh-lennaya ekologiya, 2003, no. 1, pp. 8–12 (in Russian).
  21. Dudintseva N.V., Babanov S.A., Lotkov V.S., Azovskova T.A. Tuberculosis – a factor of professional risk for medical organizations employees of the Samara region. Health And Safety At The Workplace: Materials of the II International Scientific forum, Minsk, 2018, pp. 295–298. DOI: 10.31089/978-985-7153-46-6-2018-1-2-295-298 (in Russian).
  22. Joshi R., Reingold A.L., Menzies D., Pai M. Tuberculosis among health-care workers in low and middle income countries: a systematic review. PLoS Med., 2006, vol. 3, no. 12, pp. e494. DOI: 10.1371/journal.pmed.0030494
  23. Menzies D., Joshi R., Pai M. Risk of tuberculosis infection and disease associated with work in health care settings. Int. J. Tuberc. Lung Dis., 2007, vol. 11, no. 6, pp. 593–605.
  24. Seidler A., Nienhaus A., Diel R. Review of epidemiological studies on the occupational risk of tuberculosis in low-incidence areas. Respiration, 2005, vol. 72, no. 4, pp. 431–446. DOI: 10.1159/000086261
  25. Cuhadaroglu C., Erelel M., Tabak L., Kilicaslan Z. Increased risk of tuberculosis in health care workers: a retrospective survey at a teaching hospital in Istanbul, Turkey. BMC Infect. Dis., 2002, vol. 2, pp. 14. DOI: 10.1186/1471-2334-2-14
  26. Kilinc O., Ucan E.S., Cakan M.D.A., Ellidokuz M.D.H., Ozol M.D.D., Sayiner A., Ozsoz M.D.A. Risk of tuberculosis among healthcare workers: can tuberculosis be considered as an occupational disease? Respir. Med., 2002, vol. 96, no. 7, pp. 506–510. DOI: 10.1053/rmed.2002.1315
  27. Baussano I., Nunn P., Williams B., Pivetta E., Bugiani M., Scano F. Tuberculosis among healthcare workers. Emerg. Infect. Dis., 2011, vol. 17, no. 3, pp. 488–494. DOI: 10.3201/eid1703.100947
  28. Diehl R., Seidler A., Ninhaus A., Rusch-Gerdes S., Nieman S. Occupational risk of tuberculosis transmission in an area with low morbidity. Respir. Res., 2005, vol. 6, no. 1, pp. 35–45. DOI: 10.1186/1465-9921-6-35
  29. Sevаstyanovа E.V., Puzаnov V.A., Volchenkov G.V., Chernousovа L.N. Biosafety provisions in bacteriological laboratories of the Russian TB units. Tuberkulez i bolezni legkikh, 2017, vol. 95, no. 5, pp. 18–23. DOI: 10.21292/2075-1230-2017-95-5-18-23 (in Russian).
  30. Kruuner A., Danilovitsh M., Pehme L., Laisaar T., Hoffner S.E., Katila M.L. Tuberculosis as an occupational hazard for health care workers in Estonia. Int. J. Tuberc. Lung Dis., 2001, vol. 5, no. 2, pp. 170–176.
  31. Skodric V., Savic B., Jovanovic M., Pesic I., Videnovic J., Zugic V., Rakovic J., Stojkovic M. Occupational risk of tuberculosis among health care workers at the Institute for Pulmonary Diseases of Serbia. Int. J. Tuberc. Lung Dis., 2000, vol. 4, no. 9, pp. 827–831.
  32. Shrestha P., Shakya M., Caws M., Shrestha S., Karki B., Shrestha S., Karki D.B., Maharjan B. [et al.]. Tuberculosis in Staft and students of Patan Hospital. J. Nepal Health Res. Counc., 2018, vol. 15, no. 3, pp. 268–274. DOI: 10.3126/jnhrc.v15i3.18853
  33. von Delft A., Dramowski A., Khosa C., Kotze K., Lederer P., Mosidi T., Peters J.A., Smith J. [et al.]. Why healthcare workers are sick of TB. Int. J. Infect. Dis., 2015, vol. 32, pp. 147–151. DOI: 10.1016/j.ijid.2014.12.003
  34. Flick R.J., Munthali A., Simon K., Hosseinipour M., Kim M.H., Mlauzi L., Kazembe P.N., Ahmed S. Assessing in-fection control practices to protect health care workers and patients in Malawi from nosocomial transmission of Mycobacterium tuberculosis. PLoS One, 2017, vol. 12, no. 12, pp. e0189140. DOI: 10.1371/journal.pone.0189140
  35. Sterlikov S.A., Popov S.A., Sabgayda T.P. The actual role of microbiology analysis in program of lungs tuberculosis control in Russia. Zdravookhranenie Rossiiskoi Federatsii, 2014, vol. 58, no. 2, pp. 30–34 (in Russian).
  36. Xie Z., Zhou N., Chi Y., Huang G., Wang J., Gao H., Xie N., Ma Q. [et al.]. Nosocomial tuberculosis transmission from 2006 to 2018 in Beijing Chest Hospital, China. Antimicrob. Resist. Infect. Control, 2020, vol. 9, no. 1, pp. 165. DOI: 10.1186/s13756-020-00831-5
  37. Mahamat G., Kenmoe S., Akazong E.W., Ebogo-Belobo J.T., Mbaga D.S., Bowo-Ngandji A., Foe-Essomba J.R., Amougou-Atsama M. [et al.]. Global prevalence of hepatitis B virus serological markers among healthcare workers: A systematic review and meta-analysis. World J. Hepatol., 2021, vol. 13, no. 9, pp. 1190–1202. DOI: 10.4254/wjh.v13.i9.1190
  38. Kosarev V.V., Babanov S.A. Occupational hepatitis in medical workers. Meditsinskaya sestra, 2010, no. 8, pp. 30–33 (in Russian).
  39. Tarantola A., Abiteboul D., Rachline A. Infection risks following accidental exposure to blood or body fluids in health care workers: A review of patho-gens transmitted in published cases. Am. J. Infect. Control, 2006, vol. 34, no. 6, pp. 367–375. DOI: 10.1016/j.ajic.2004.11.011
  40. Wicker S., Jung J., Allwinn R., Gottschalk R., Rabenau H.F. Prevalence and prevention of needlestick injuries among health care workers in a German university hospital. Int. Arch. Occup. Environ. Health, 2008, vol. 81, no. 3, pp. 347–354. DOI: 10.1007/s00420-007-0219-7
  41. Nikitina G.Yu., Semenenko T.A., Gotvyanskaya T.P., Hahaeva I.B., Konopleva M.V., Nikolaeva O.G., Yarosh L.V., Kozhevnikova L.K., Suslov A.P. The prevalence of parenteral hepatitis markers among the medical personnel in the Russian Federation regions with different intensity of epidemic process. Klinicheskaya mikrobiologiya i antimikrobnaya khimioterapiya, 2017, vol. 19, no. 2, pp. 161–167 (in Russian).
  42. Mengistu D.A., Dirirsa G., Mati E., Ayele D.M., Bayu K., Deriba W., Alemu F.K., Demmu Y.M. [et al.]. Global Oc-cupational Exposure to Blood and Body Fluids among Healthcare Workers: Systematic Review and Meta-Analysis. Can. J. Infect. Dis. Med. Microbiol., 2022, vol. 2022, pp. 5732046. DOI: 10.1155/2022/5732046
  43. Marnejon T., Gemmel D., Mulhern K. Patterns of needlestick and sharps injuries among training residents. JAMA In-tern. Med., 2016, vol. 176, no. 2, pp. 251–252. DOI: 10.1001/jamainternmed.2015.6828
  44. Prüss-Ustün A., Rapiti E., Hutin Y. Estimation of the global burden of disease attributable to contaminated sharps in-juries among health-care workers. Am. J. Ind. Med., 2005, vol. 48, no. 6, pp. 482–490. DOI: 10.1002/ajim.20230
  45. Deisenhammer S., Radon K., Nowak D., Reichert J. Needlestick injuries during medical training. J. Hosp. Infect., 2006, vol. 63, no. 3, pp. 263–267. DOI: 10.1016/j.jhin.2006.01.019
  46. Hofmann F., Kralj N., Beie M. Needle stick injuries in health care – frequency, causes und preventive strategies. Gesundheitswesen, 2002, vol. 64, no. 5, pp. 259–266. DOI: 10.1055/s-2002-28353 (in German).
  47. Katsevman G.A., Sedney C.L., Braca J.A. III, Hatchett L. Interdisciplinary differences in needlestick injuries among healthcare professionals in training: Improving situational awareness to prevent high-risk injuries. Work, 2020, vol. 65, no. 3, pp. 635–645. DOI: 10.3233/WOR-203118
  48. Profilaktika zarazheniya meditsinskikh rabotnikov gemotransmissivnymi infektsiyami [Prevention of infection of healthcare workers with hemotransmissive infections]. Okhrana truda i pozharnaya bezopasnost' v uchrezhdeniyakh zdra-vookhraneniya, 2016, no. 8, pp. 45–48 (in Russian).
  49. Spiridonov A.M., Berezin I.I., Nikiforova G.A. [et al.]. Otsenka riska professional'noi infektsionnoi zabolevaemosti u meditsinskikh rabotnikov [Assessment of the risk of occupational infectious morbidity in healthcare workers]. Okhrana truda i tekhnika bezopasnosti v uchrezhdeniyakh zdravookhraneniya, 2012, no. 2, pp. 10–12 (in Russian).
  50. Ho P.L., Becker M.M., Chang-Yong M.M. Emerging occupational lung infections. Int. J. Tuberc. Lung Dis., 2005, vol. 11, no. 7, pp. 710–721.
  51. Pon L.L., Guan I., Nicholls J.M., Yuen K.I., Paris J.S. The etiology, origin and diagnosis of severe acute respiratory syndrome. Lancet Infect. Dis., 2004, vol. 4, no. 11, pp. 663–671. DOI: 10.1016/C1473-3099(04)01172-7
  52. Lee N., Hui D., Wu A., Chan P., Cameron P., Joynt G.M., Ahuja A., Yung M.Y. [et al.]. A major outbreak of severe acute respiratory syndrome in Hong Kong. N. Engl. J. Med., 2003, vol. 348, no. 20, pp. 1986–1994. DOI: 10.1056/NEJMoa030685
  53. Booth K.M., Matukas L.M., Tomlinson G.A., Rakhlis A.R., Rose D.B., Dvosh H.A., Walmsley S.L., Mazzulli T. [et al.]. Сlinical features and short-term results of 144 patients with atypical pneumonia in the Greater Toronto area. JAMA, 2003, vol. 289, no. 21, pp. 2801–2809. DOI: 10.1001/jama.289.21.JOC30885
  54. Buxton Bridges S., Katz J.M., Seto V.H., Chan P.K., Tsang D., Ho V., Mack K.H., Lim V. [et al.]. Risk of influenza A (H5N1) infection among health care workers exposed to influenza A (H5N1) patients, Hong Kong. J. Infect. Dis., 2000, vol. 181, no. 1, pp. 344–348. DOI: 10.1086/315213
  55. Garipova R.V., Strizhakov L.A., Umbetova K.T., Safina K.R. Occupational diseases of health care workers from ex-posure to infectious agents: the current state of the problem. Meditsina truda i promyshlennaya ekologiya, 2021, vol. 61, no. 1, pp. 13–17. DOI: 10.31089/1026-9428-2021-61-1-13-17 (in Russian).
  56. Koh D. Occupational risks for COVID-19 infection. Occup. Med. (Lond.), 2020, vol. 70. no. 1, pp. 3–5. DOI: 10.1093/occmed/kqaa036
  57. Shaikhlislamova E.R., Valeeva E.T., Akhmetshina V.T., Malikova A.I., Sagadieva R.F. Professional'naya patologiya v Respublike Bashkortostan v period koronavirusnoi pandemii [Occupational pathology in the Republic of Bashkortostan during the coronavirus pandemic]. Analiz riska zdorov'yu – 2021. Vneshnesredovye, sotsial'nye, meditsinskie i povedencheskie aspekty. Sovmestno s mezhdunarodnoi vstrechei po okruzhayushchei srede i zdorov'yu RISE-2021: Materialy XI Vserossiiskoi nauchno-prakticheskoi konferentsii s mezhdunarodnym uchastiem, Perm, May 18–20, 2021, vol. 1, pp. 124–127 (in Russian).
  58. Sahu A.K., Amrithanand V.T., Mathew R., Aggarwal P., Nayer J., Bhoi S. COVID-19 in health care workers – A sys-tematic review and meta-analysis. Am. J. Emerg. Med., 2020, vol. 38, no. 9, pp. 1727–1731. DOI: 10.1016/j.ajem.2020.05.113
  59. Ing E.B., Xu Q.A., Salimi A., Torun N. Physician deaths from corona virus (COVID-19) disease. Occup. Med. (Lond.), 2020, vol. 70, no. 5, pp. 370– 374. DOI: 10.1093/occmed/kqaa088
  60. Jayadevan R. A hundred lives lost: doctor deaths in India during the times of COVID-19. Preprints, 2020, pp. 2020070346. DOI: 10.20944/preprints202007.0346.v1
  61. Levin A.B., Bol K.M., Featherstone P.J. From cholera to COVID-19: How pandemics have shaped the development of anaesthesia and intensive care medicine. Anesteziologiya i reanimatologiya, 2020, vol. 48, suppl. 3, pp. 28–38 (in Russian).
  62. Murthy V.H. Confronting Health Worker Burnout and Well-Being. N. Engl. J. Med., 2022, vol. 387, no. 7, pp. 577–579. DOI: 10.1056/NEJMp2207252
  63. Stepanyan I.V., Denisov E.I. Primenenie intellektual'nykh informatsionnykh sistem dlya prognozirovaniya otsenki riskov dlya zdorov'ya [Application of intelligent information systems to predict health risk assessment]. Neirokomp'yutery: raz-rabotka, primenenie, 2009, no. 12, pp. 69–74 (in Russian).
  64. Denisov E.I., Prokopenko L.V., Golovaneva G.V., Stepanyan I.V. Paradigm shift in health: forecasting and causation as a basis for risk management. Gigiena i sanitariya, 2012, vol. 91, no. 5, pp. 62–65 (in Russian).
Received: 
11.05.2024
Approved: 
19.06.2024
Accepted for publication: 
24.06.2024

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