How much do workers’ health examinations add to health and safety at the workplace? Occupational preventive usefulness of routine health examinations

ObjectiveDespite no evidence in favour, routine workers’ health examinations, mostly pre-employment and periodic, are extensively performed worldwide with important allocation of resources. In Spain they are performed within a theoretical job-specific health surveillance system. Our objective was to ascertain their occupational preventive usefulness from the perspective of occupational health professionals.MethodsCross sectional study. Online survey addressed to all physicians and nurses members of the Catalan Society of Safety and Occupational Medicine (n = 539) in 2011. Univariate and bivariate analyses of prevalence and prevalence differences of answers.ResultsResponse rate 53% (n = 285). According to more than 70% of respondents the health surveillance system isn’t cost-effective, doesn’t meet the goal of early detection of health damage related to work, and doesn’t contribute to improve the occupational risk prevention system. Further deficiencies were identified regarding specificity and scientific basis for health examinations, quality of collective health surveillance and referral of suspected cases to mutual insurance companies for diagnosis and treatment. Bivariate analysis showed a significantly more negative opinion for several items amongst physicians (versus nurses) and amongst professionals working in external prevention services (versus internal services).ConclusionsThis study raises serious concerns about how health examinations are performed within our workers’ health surveillance system, which should be reviewed to ensure the fulfilment of its occupational preventive objective. Our results might encourage other countries with similar practices to assess them in order to assure their fitness for purpose.     

Free GP care and psychological health: Quasi-experimental evidence from Ireland

There is considerable ambiguity in the literature on the effect of health insurance on health. While the majority of previous analyses have examined physical health outcomes, analyses of the broader dimensions of health such as psychological health and wellbeing have been less frequent. Using data from the Irish Longitudinal Study on Ageing (TILDA) and a difference-in-differences research design, we examine the impact of free general practitioner (GP) care on psychological health among the older population and explore potential mechanisms. While we find no impact of public health insurance expansions on quality of life, life satisfaction, depression, and worry, the removal of GP fees for all those 70+ leads to a significantly lower level of perceived stress. The impact is mainly driven by poorer, sicker and single individuals. Further analyses show that removing GP fees leads to greater access to GP services and lower levels of financial stress.     

Decreased efficacy of UV inactivation of Staphylococcus aureus after multiple exposure and growth cycles

UV disinfection is a relatively simple and cost-efficient disinfection method, especially for in-home greywater treatment. In this study, a bench scale experiment was performed using a LED collimated UV-C beam with a peak wavelength of 256?nm to determine if potentially pathogenic bacteria such as Staphylococcus aureus may become enriched in a semi-recirculating greywater system with UV as the sole disinfection step. A statistically significant (P?<?0.001) decreasing trend in UV-C efficacy was observed between the 1st and 6th UV exposure-growth cycles of S. aureus (ATCC 25923), resulting in a 1.5 decrease in log₁₀ removal (P?<?0.00000) by the 5th iteration. An eleven-point dose-response curve of the 7th iteration of S. aureus was estimated and compared to the dose-response curve of the original strain; due to a longer apparent shoulder period and a decay constant of lesser degree, the dose required for a 4-log reduction of the enriched S. aureus was estimated to be ～1.9 times greater (22.0?mJ?cm^?2 versus 11.8?mJ?cm^?2). However, experimental results with S. epidermidis (ATCC 12228) and two wild strains, S. aureus and S. warneri, exhibited no trend of increased resistance. UV doses exceeding 20?mJ?cm^?2 are generally sufficient in achieving a 4-log reduction of bacteria in drinking water systems; however, the results exhibited in this study suggest that when recirculation is involved, there may be a need for UV doses exceeding what is necessary for a 4-log reduction to suppress the enrichment of strains which could pose a public health risk.     

The Covid-19 infection: An opportunity to develop systematic vitamin D supplementation in psychiatry

Psychiatric patients are at risk of hypovitaminosis D and Covid-19-related mortality. In addition to the mental health benefits, vitamin D supplementation may be potentially effective in preventing severe forms of Covid-19 infections. Vitamin D supplementation is not necessary and is not reimbursed in France for this indication. A monthly supplementation of 50,000 IU may be sufficient in most cases. Double the dose is recommended for obese patients. The risk of renal lithiasis is not increased at these doses, even when supplemented in a patient without vitamin D deficiency. The Covid-19 crisis is an opportunity to disseminate vitamin D supplementation in psychiatric patients, as it has been shown to be effective in other respiratory diseases such as mild upper respiratory tract infections and influenza.     

Parliament in action: Drug withdrawals and policy changes in the U.K.

Previous studies on changes in health policies theorize such changes either as crises responses, or as the outcome of longer-term stakeholder conflicts. In this paper, we propose that parliaments function as overlooked, intermediate actors that contribute to translating the interests of stakeholders into policy changes. We study the role of parliament connecting policy makers and stakeholders in the context of drug regulation. Based on three high-profile cases of drug withdrawals between 1991 and 2005 in the United Kingdom (triazolam, rofecoxib, and co-proxamol), we distinguish partisan-political, individual-idiosyncratic, and collective-institutional pathways of parliamentary action on drug withdrawals. Distinguishing direct and indirect actions, we argue that indirect courses of action, including advocacy and educational work, can be just as effective as regular legislative endeavours, under certain conditions.     

口腔医疗机构应对国家突发公共卫生事件的问题与思考

突发公共卫生事件应急管理是一个全球性的课题。本文就2019年12月以来发生在中国的新型冠状病毒肺炎这一突发公共卫生事件,口腔医疗机构及其从业人员面临的相关问题进行法律层面的分析与思考,以期对口腔医疗行业应对突发公共卫生事件提供帮助和指导。     

Python爬虫技术在信息流行病学中的应用

Python网络爬虫技术是一种通过模拟用户的网络浏览行为以实现从网络中自动、大量提取信息的技术，是信息流行病学研究收集并整合多源异构信息数据的关键基础。Python网络爬虫可分为简单爬虫与大型爬虫，集数据采集与数据库构建于一体，语法简洁、灵活性高、学习成本低、维护成本低。它适用于信息流行病学的各种应用场景，通过对互联网中健康相关信息的分析，实现多种公共卫生监测、健康干预实施及效果评价、智慧寻医方略优化等目标。近年，我国政府开始鼓励对含互联网信息在内的多源大数据的整合利用，在此背景下，Python爬虫技术的应用场景势必会越来越多，相应的人才培养、技术革新建议纳入到公共卫生教育和科研体系之中。