COVID-19 in Workplace Settings: Lessons Learned for Occupational Medicine in the UK
Contenuto principale dell'articolo
Keywords
Abstract
This paper addresses lessons learned from the COVID-19 pandemic from a UK Occupational Medicine perspective to permit comparison with other national accounts. In spite of good prior research and statute, the necessary resources to protect workers’ health were seriously lacking when the pandemic struck. Weak public health guidance, which did not recognise dominant airborne transmission, was applied to workplaces, leaving workers and others unprotected, especially in respect to Respiratory Protective Equipment (RPE). The Health and Safety Executive (HSE) as regulator was lacking, for example, in not producing guidance to protect HealthCare Workers (HCW) who were amongst the most at risk. The UK COVID-19 Public Inquiry should address shortcomings such as these, but recommendations must be accompanied by robust means to ensure appropriate implementation. These should range from substantial measures to improve indoor air quality, to a permanent pandemic management organization with adequate resources. The enforcing authority has to be obliged to publish more specific workplace guidance than the public health authorities. Occupational medicine as a discipline needs to be better prepared, and hence to assert its responsibility towards high standards of workers’ health protection. Future research has to include investigating the best means of mitigation against airborne infection and the management of post-acute covid sequelae.
Riferimenti bibliografici
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2. McKee M, Hanson K, Abbasi K. Guided by the science? Questions for the UK’s Covid-19 public inquiry. BMJ. 2022;378:o2066 Doi: 10.1136/bmj.o2066
3. Agius RM. Prevention of COVID-19 in workers: preparation, precaution, and protection. Ann Work Expo Health. 2023; [in press] wxad060. Doi: https://doi.org/10.1093/annweh/wxad060
4. Hughes L. Boris Johnson fought against lockdown in autumn 2020, inquiry told. Financial Times. Lon-don. November 7 2023. https://www.ft.com/content/eba83c20-d4df-412b-aad4-2903c70c2c96 [Last Accessed on 8 November 2023]
5. Torjesen I. Covid inquiry: Government developed intervention package without scientists’ advice be-fore second lockdown. BMJ. 2023;383:p2465 Doi: https://doi.org/10.1136/bmj.p2465
6. Fetzer T. Subsidising the spread of COVID-19: Evidence from the UK’S Eat-Out-to-Help-Out Scheme. The Economic Journal. 2022;132(643):1200-1217. Doi: https://doi.org/10.1093/ej/ueab074
7. Horton R. Offline: “Laughing at the Italians”. Lancet. 2023;402(10414):1735. Doi: https://doi.org/10.1016/S0140-6736(23)02504-7
8. Office for National Statistics (ONS). Prevalence of ongoing symptoms following coronavirus (COVID-19) infection in the UK: 30 March 2023. Available online: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulle-tins/prevalenceofongoingsymptomsfollowingcoronaviruscovid19infectionintheuk/30march2023/pdf [Last Accessed on 8 November 2023]
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10. Bland D, Evans R, Binesmael A, et al. Ost-acute Covid-19 complications in UK doctors: results of a cross-sectional survey. Occup Med. 2023. (in press). Available online: https://doi.org/10.1093/occmed/kqad120
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12. Nafilyan V, Pawelek P, Ayoubkhani D, et al. Occupation and COVID-19 mortality in England: a national linked data study of 14.3 million adults. Occup Env Med. 2022;79(7):433-441. https://oem.bmj.com/content/79/7/433
13. Cherrie M, Rhodes S, Wilkinson Jack. et al. Longitudinal changes in proportionate mortality due to COVID-19 by occupation in England and Wales. Scand J Work Env Health. 2022;48(8):611-620. Doi: https://doi.org/10.5271/sjweh.4048
14. Rhodes S, Wilkinson J, Pearce N, et al. Occupational differences in SARS-CoV-2 infection: analy-sis of the UK ONS COVID-19 infection survey. J Epidemiol Community Health. 2022;76:841-846. Doi: http://dx.doi.org/10.1136/jech-2022-219101
15. Mutambudzi M, Niedwidz C, Macdonald EB, et al. Occupation and risk of severe COVID-19: prospective cohort study of 120,075 UK Biobank participants. Occup Environ Med. 2020;78(5):307-314. Doi: http://dx.doi.org/10.1136/oemed-2020-106731
16. Shah ASV, Wood R, Bishop J, et al. Risk of hospital admission with coronavirus disease 2019 in healthcare workers and their households: nationwide linkage cohort study. BMJ. 2020;371:m3582 Doi: https://doi.org/10.1136/bmj.m3582
17. Health Data Research UK. COVID-19 National Core Studies. 2020. Available online: https://www.hdruk.ac.uk/covid-19/covid-19-national-core-studies/ [Last Accessed on 30 October 2023]
18. Greenhalgh T, Jimenez JL, Prather KA, et al. Ten scientific reasons in support of airborne transmission of SARS-CoV-2. Lancet. 2021;397(10285):1603-1605. Doi: https://doi.org/10.1016/S0140-6736(21)00869-2
19. Ferris M, Ferris R, Workman C, et al. Efficacy of FFP3 respirators for prevention of SARS-CoV-2 infection in healthcare workers. eLife. 2021;10:e71131. Doi: https://doi.org/10.7554/eLife.71131
20. Butler MJ, Sloof D, Peters C, et al. Impact of supplementary air filtration on aerosols and particulate mat-ter in a UK hospital ward: a case study. J Hosp Infect. 2023;135:81-89. https://doi.org/10.1016/j.jhin.2023.02.006
21. Sachs JD, Karim SSA, Aknin L, et al. The Lancet Commission on lessons for the future from the COVID-19 pandemic. Lancet. 2022: 400(10359):1224–1280. https://doi.org/10.1016/S0140-6736(22)01585-9
22. Agius RM, MacDermott N. (2022) Covid-19 and workers’ protection: lessons to learn, and lessons overlooked. Occup Med; 72(2):62-64 Doi: https://doi.org/10.1093/occmed/kqab034
23. Agius R. Covid-19 and health at work. Occup Med. 2020;70(5):349-351. Doi: https://doi.org/10.1093/occmed/kqaa075
24. Cherrie JW, Loh M, Aitken RJ. Protecting healthcare workers from inhaled SARS-CoV-2 virus. Occup Med. 2020;70(5):335-337. Doi: https://doi.org/10.1093/occmed/kqaa077
25. Williams K, Cherrie JW, Dobbie J, Agius RM. The Development of a COVID-19 Control Measures Risk Ma-trix for Occupational Hygiene Protective Measures. Ann Work Expo Health. 2022;66:269-275. Doi: https://doi.org/10.1093/annweh/wxab050
26. Sietsema M, Radonovich L, Hearl FJ, et al. A Control Banding Framework for Protecting the US Work-force from Aerosol Transmissible Infectious Disease Outbreaks with High Public Health Consequences. Health Secur. 2019;17(2):124-32. Doi: https://doi.org/10.1089/hs.2018.0103
27. Greenhalgh T, 2020. Will COVID-19 be evidence-based medicine’s nemesis? PLoS Medicine. 2020;17(6):p.e1003266. Doi: https://doi.org/10.1371/journal.pmed.1003266
28. NHS England (2023). National infection prevention and control manual for England. 4 October 2023 V2.7. Publication reference: PRN00908 https://www.england.nhs.uk/wp-content/uploads/2022/04/PRN00908-national-infection-prevention-and-control-manual-for-england-v2.7.pdf [Last Accessed on 30 October 2023].
29. Hamilton F, Arnold D, Bzdek BR, et al. Aerosol generating procedures: are they of relevance for trans-mission of SARS-CoV-2? Lancet Respir Med. 2021;9(7):687-689. Doi: 10.1016/S2213-2600(21)00216-2
30. Roach S. Health Risks from Hazardous Substances at Work. Assessment, Evaluation and Control. Per-gamon Press: Oxford, UK 1992:468.
31. Gawn JM, Clayton M, Makison C, Crook B. (2008) Evaluating the protection afforded by surgical masks against influenza bioaerosols. Research Report RR619, Health and Safety Executive (HSE) Buxton, UK. Available online: https://www.hse.gov.uk/research/rrpdf/rr619.pdf [Last Accessed on 30 October 2023].
32. Health and Safety Executive (HSE). Respiratory Protective Equipment at Work. A practical guide. HSG53. 4th ed. HSE Books, Sudbury, UK: 2013. Available online: https://www.hse.gov.uk/pubns/priced/hsg53.pdf [Last Accessed on 30 October 2023]
33. Coia JE, Ritchie L, Adisesh A, et al. Guidance on the use of respiratory and facial protection equipment. J Hosp Infect. 2013;85(3):170-182. Doi: https://doi.org/10.1016/j.jhin.2013.06.020
34. Brosseau LM, MacIntyre CR, Ulrich A, Osterholm MT. Wear a respirator, not a cloth or surgical mask, to protect against respiratory viruses. Center for Infectious Disease Research and Policy. 2023; Available online: https://www.cidrap.umn.edu/covid-19/commentary-wear-respirator-not-cloth-or-surgical-mask-protect-against-respiratory-viruses [Last Accessed on 8 November 2023]
35. Agius RM, Cherrie JW, Noone P. Valved respirators may be preferable during the Covid-19 pandemic. Occup Med. 2021;71(6-7):302-303. Doi: https://doi.org/10.1093/occmed/kqab065
36. Rudd E, Walsh S. Mask related acne (“maskne”) and other facial dermatoses. BMJ. 2021;373:n1304. Doi: 10.1136/bmj.n1304
37. Agius RM. Mask related acne: alternative PPE for facial dermatoses. BMJ 2021;374:n1693 Doi: https://doi.org/10.1136/bmj.n1693
38. Licina A, Silvers A, Stuart RL. Use of powered air-purifying respirator (PAPR) by healthcare workers for preventing highly infectious viral diseases—a systematic review of evidence. Syst Rev. 2020;9:173. Doi: 10.1186/s13643-020-01431-5
39. Public Health England. Report: Exercise Alice. Middle East Respiratory Syndrome Coronavirus (MERS-CoV). 15 February 2016. Available online: https://covid19.public-inquiry.uk/wp-content/uploads/2023/06/26190532/INQ000090431_15-610-13.pdf [Last Accessed on 8 November 2023].
40. Scally G, Jacobson B, Abbasi K. The UK’s public health response to covid-19. BMJ. 2020; 369:m1932 Doi: https://doi.org/10.1136/bmj.m1932
41. Iacobucci G. Covid-19 inquiry: Ministers abandoned public health principles during pandemic, says BMA chief. BMJ. 2023;383:p2320 Doi: https://www.bmj.com/content/383/bmj.p2320
42. Coggon D, Croft P, Cullinan P, Williams A. Assessment of workers’ personal vulnerability to covid-19 using ‘covid-age’. Occup Med. 2020;70(7):461-464. Doi: https://doi.org/10.1093/occmed/kqaa150
43. Walters D. The role of the state in achieving compliance with occupational safety and health require-ments: Some lessons from the British regulatory response in the time of Covid-19. Diritto della Sicurezza sul Lavoro. 2021;1:118-137. Doi: https://doi.org/10.14276/2531-4289.2450
44. Watterson A. COVID-19 in the UK and Occupational Health and Safety: Predictable not Inevitable Fail-ures by Government, and Trade Union and Nongovernmental Organization Responses. New Solut. 2020;30(2):86-94. Doi: 10.1177/1048291120929763
45. Agius RM, Kloss D, Kendrick D, Stewart M, Robertson JFR. Protection from covid-19 at work: health and safety law is fit for purpose. BMJ. 2021;375. Doi: https://doi.org/10.1136/bmj.n3087
46. Gilleen J, Santaolalla A, Valdearenas L, Salice C, Fusté M. Impact of the COVID-19 pandemic on the mental health and well-being of UK healthcare workers. BJPsych Open. 2021;7(3):E88. Doi: 10.1192/bjo.2021.42
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Dec 7, 2023
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Come citare
1.
Redazione L. COVID-19 in Workplace Settings: Lessons Learned for Occupational Medicine in the UK. Med Lav [Internet]. 2023 Dec. 7 [cited 2024 Jul. 17];114(6):e2023055. Available from: https://mattioli1885journals.com/index.php/lamedicinadellavoro/article/view/15461
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La Redazione, Redazione LA MEDICINA DEL LAVORO Clinica del Lavoro "L. Devoto" Via S. Barnaba, 820122 Milano - tel. 02 503 20125 - fax 02 503 20126 - [email protected]
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Come citare
1.
Redazione L. COVID-19 in Workplace Settings: Lessons Learned for Occupational Medicine in the UK. Med Lav [Internet]. 2023 Dec. 7 [cited 2024 Jul. 17];114(6):e2023055. Available from: https://mattioli1885journals.com/index.php/lamedicinadellavoro/article/view/15461
