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The impact of night work on subjective reports of well-being: an exploratory study of health care workers from five nations.

OBJECTIVE: To carry out a survey data collection from health care workers in Brazil, Croatia, Poland, Ukraine and the USA with two primary goals: (1) to provide information about which aspects of well-being are most likely to need attention when shiftwork management solutions are being developed, and (2) to explore whether nations are likely to differ with respect to the impacts of night work on the well-being of workers involved in health care work. METHODS: The respondents from each nation were sorted into night worker and non-night worker groups. Worker perceptions of being physically tired, mentally tired, and tense at the end of the workday were examined. Subjective reports of perceived felt age were also studied. For each of these four dependent variables, an ANCOVA analysis was carried out. Hours worked per week, stability of weekly work schedule, and chronological age were the covariates for these analyses. RESULTS: The results clearly support the general proposal that nations differ significantly in worker perceptions of well-being. In addition, perceptions of physical and mental tiredness at the end of the workday were higher for night workers. For the perception of being physically tired at the end of a workday, the manner and degree to which the night shift impacts the workers varies by nation. CONCLUSIONS: Additional research is needed to determine if the nation and work schedule differences observed are related to differences in job tasks, work schedule structure, off-the-job variables, and/or other worker demographic variables.

Adult↗

Somatic cell mutations at the glycophorin a locus in erythrocytes of radiation workers from the Sellafield nuclear facility.

The glycophorin A (GPA) somatic mutation assay for N0 and NN mutant erythrocytes was performed on 245 current and 48 retired workers who had been occupationally exposed to radiation at the British Nuclear Fuels plc facility at Sellafield. A positive association with increasing age was found for current workers for both N0 and NN frequencies of 0.14 +/- 0.05 x 10(-6) (P = 0.012) and 0.25 +/- 0.07 x 10(-6) (P = 0.0003) per year, respectively. No association with age was found for the retired workers. In a comparison of ever-smokers with never-smokers, no difference was observed for N0 frequencies for current workers, but a significantly higher frequency was found for ever-smokers in the retired group (P = 0.001). NN mutant frequencies were slightly higher in ever-smokers than in never-smokers for both current and retired workers, but in neither case was the increase significant. In age-adjusted analyses for N0 mutant frequencies, a slight positive radiation dose response was found for current workers (1.6 +/- 3.8 x 10(-6) per Sv), for retired workers (2.9 +/- 2.5 x 10(-6) per Sv), and in the combined analysis (2.6 +/- 2.2 x 10(-6) per Sv), but in no case did this reach significance. Similar analyses for NN mutant frequencies revealed a positive dose response for current workers (4.7 +/- 4.6 x 10(-6) per Sv) and a negative response for retired workers (-2.4 +/- 3.6 x 10(-6) per Sv) that was maintained in the combined analysis (-1.4 +/- 2.8 x 10(-6) per Sv), but none of these slopes was significantly different from zero. The results suggest that the GPA mutation assay is insufficiently sensitive to be used as a biological marker of low-dose chronic exposure and provide further evidence that, in contrast to high acute radiation exposure, protracted exposure is much less effective at inducing somatic mutations in vivo.

Adolescent↗

Effects of smoking on respiratory function and exercise performance in asbestos workers.

To determine the role of smoking in the development of pulmonary impairment in asbestos workers, 66 nonsmoking asbestos workers and 70 smoking asbestos workers were studied. Occupational and medical questionnaires, lung function and exercise test were conducted in all subjects. The frequencies of dyspnea and cough on questions were significantly higher in the smoking workers than those in nonsmoking workers. Similarly, FEV1, FEV1/FVC and DLco were significantly lower in the smoking workers. Exercise performance showed that the smoking workers had higher index of dyspnea and lower breathing reserve, Vo2 and Vo2 max than nonsmoking workers did. We concluded that cigarette smoking has marked effects on both of respiratory function and exercise performance in asbestos workers. Among them, smokers show more serious obstructive impairment in static lung function testing and more significant limitation during exercise. The history of cigarette smoking deserves close attention in the evaluation of pulmonary impairment from asbestos exposure.

Asbestos↗

Does job stress affect injury due to labor accident in Japanese male and female blue-collar workers?

To clarify whether job stressors affecting injury due to labor accidents differ between Japanese male and female blue-collar workers, the Job Content Questionnaire (JCQ), assessing dimensions of job stressors based on the demand-control-support model, was applied to 139 blue-collar workers in a manufacturing factory. Of them, 24 male and 15 female workers suffered from injuries at work. In the female workers with the experience of work injury, the job demand score and job strain index (i.e., the ratio of job demand to job control) of the JCQ were significantly higher and the score of coworker support was significantly lower, than those in the female workers without the experience. High job demand (or, high job strain and low coworker support) was significantly related to work injury in all the female workers. Between the male workers with and without work injury, however, there was no significant difference in any job stressors. This pilot study suggests that high job strain (specifically, high job demand), as well as low coworker support, are important factors affecting work injury in Japanese female blue-collar workers. Further research with a large number of male blue-collar workers will be required to seek other factors that may be associated with work injury.

Accidents, Occupational↗

An accident-risk assessment study of temporary piece rated workers.

An occupational injury surveillance study (record study of five years duration) was conducted involving the workers of a fertilizer producing industry in eastern India to assess whether the risk of occupational accidents in temporary piece rated workers was higher in comparison to the permanent time rated workers. At the same time, to collect the personal details of the workers who have worked in the industry in the study period, an interview was also conducted. Mean age of temporary piece rated workers and permanent time rated workers were (35.9 +/- 12.5) and (35.3 +/- 11.4) respectively. Distribution of other variables like nature of work, level of education, experience, habits were also very similar between the two worker groups. Accident incidence rate, accident frequency rate and accident severity rate were found to be significantly higher in temporary piece rated workers. This difference was more prominent in case of time-loss accidents than in no time-loss accidents. Relative risk has varied from 2.3 to 18.0 in case of time-loss accidents. In case of no time-loss accidents, it has varied from 1.1 to 2.6. When relative risk is considered after taking both types of accidents together, it has ranged from 1.2 to 3.5. This study concluded that the temporary piece rated workers are more vulnerable to occupational accidents.

Accidents, Occupational↗

Respiratory tract inflammation in swine confinement workers studied using induced sputum and exhaled nitric oxide.

OBJECTIVE: To further define the asthma-like syndrome seen in swine confinement workers. DESIGN: A cross-sectional study was performed at a swine confinement facility in rural Nebraska and at the University of Nebraska Medical Center, Omaha, Nebraska. PARTICIPANTS: 24 swine confinement workers and 14 urban normal control subjects. All subjects completed a questionnaire concerning respiratory complaints. We performed hypertonic saline challenges on the swine confinement workers and control subjects in order to induce expectoration of sputum. Cell counts and cell differentials were determined in the induced sputum samples. Nasal, mean, and peak exhaled nitric oxide was measured in both groups. Spirometry was also done. RESULTS: Swine confinement workers were significantly more likely to report wheezing, cough, and sinusitis symptoms than controls (p = .003). Macrophages were significantly elevated in the induced sputum samples of the swine confinement workers vs the control subjects (0.59 macrophages/mL +/- 0.1 SEM vs 0.36 +/- .16; p = .006), while there was no difference in numbers of neutrophils. No eosinophils were observed. A small elevation in mean exhaled nitric oxide was seen in the swine confinement workers compared to normal controls (11.7 ppb +/- 0.6 SEM vs 10.2 +/- 1.6; p = 0.023). Spirometry values did not differ statistically between swine confinement workers and the control group. CONCLUSIONS: Swine confinement workers have signs and symptoms of lower respiratory tract inflammation when studied using induced sputum and exhaled nitric oxide. Findings in the swine confinement workers differ from those in asthmatics and chronic bronchitis.

Adult↗

[Home care workers' oral health awareness and practice for disabled elderly].

The purpose of this study was to investigate the level of oral health awareness, and to explore the needs for home care workers to provide oral health care for disabled elderly. We conducted a questionnaire survey at two home-help service centers and a social welfare council. Subjects for this investigation were 63 home care workers. The results were as follows: 1. Ninety-six percent of home care workers thought it was necessary to provide oral health care for disabled elderly, but only 11 percent of them put oral care into practice on a daily basis. 2. From the results of a cause and effect diagram, necessities of oral care were summarized as six major causes: 1) Disabled elderly are often unable to brush their teeth, 2) The oral hygiene level may affect physical condition, 3) Disabled elderly should be protected from oral diseases, 4) Disabled elderly should have their mouths kept clean, 5) Eating and swallowing may become increasingly difficult, 6) Disabled elderly should take in adequate nutrition. 3. Sixty-eight percent of home care workers took part in a training course of nursing care including oral care. 4. Home care workers, dentists, dental hygienists, and nurses taught oral health care to home care workers. 5. From the results of a cause and effect diagram, there were three major items that home care workers want to know: 1) denture management, 2) the routine of oral care, 3) infection control. 6. Home care workers recognized that oral care should be provided by family members of disabled elderly or home care workers.

Adult↗

Investigations of patients of health care workers infected with HIV. The Centers for Disease Control and Prevention database.

OBJECTIVE: To assess the risk for transmission of the human immunodeficiency virus (HIV) from an infected health care worker to patients. DESIGN: Survey of investigators from health departments, hospitals, and other agencies who had elected to notify patients who had received care from health care workers infected with HIV. MEASUREMENTS: Information was collected about infected health care workers, their work practices, their patients' HIV test results, procedures that they did on those of their patients who were tested for HIV, and patient notification procedures. RESULTS: As of 1 January 1995, information about investigations of 64 health care workers infected with HIV was reported to the Centers for Disease Control and Prevention; HIV test results were available for approximately 22,171 patients of 51 of the 64 health care workers. For 37 of the 51 workers, no seropositive patients were reported among 13,063 patients tested for HIV. For the remaining 14 health care workers, 113 seropositive patients were reported among 9108 patients. Epidemiologic and laboratory follow-up did not show any health care worker to have been a source of HIV for any of the patients tested. CONCLUSION: Despite limitations, these data are consistent with previous assessments that state that the risk for transmission of HIV from a health care worker to a patient is very small. These data also support current recommendations that state that retrospective patient notification need not be done routinely.

Centers for Disease Control and Prevention, U.S.↗

The prevalence of specific IgE antibodies to natural rubber latex in healthcare workers in Israel.

BACKGROUND: According to studies from different countries, the prevalence of natural rubber latex sensitization in healthcare workers ranges from 2.9 to 17%. OBJECTIVE: To estimate the prevalence of NRL-specific IgE antibodies in healthcare workers in Israel. METHODS: Three hundred healthcare workers, mostly from a major pediatric tertiary care facility, and 15 non-healthcare workers completed a questionnaire on signs and symptoms of NRL allergy and other respiratory and food allergies. NRL-specific IgE antibodies were assayed with the DPC AlaSTAT-ELISA method. RESULTS: Seventy of the 300 workers (23.3%) reported symptoms of NRL allergy: hand eczema and pruritus in 63, upper respiratory tract and ocular symptoms in 10, shortness of breath in 2, and generalized rash in 6. None had anaphylaxis due to latex exposure. There was a significant correlation of symptoms of NRL allergy with atopy and job category (nurses, laboratory technicians, nurse assistants and dental medicine workers), but not with gender, age, or years of employment. The in vitro tests for specific IgE antibodies against NRL were positive (> or = 0.70 IU/ml) in five workers (1.66%). CONCLUSIONS: This is the first study of the prevalence of NRL-specific IgE antibodies in healthcare workers in Israel. Our 1.66% sensitization rate is much lower than that reported for healthcare workers in other countries. This difference may be due to our inclusion of a study population with a relatively low exposure to latex gloves (pediatricians compared to surgeons). Further studies are needed in this and other high risk populations in Israel.

Dermatitis, Atopic↗

[Obesity, hypertension and the lumbar syndrome in workers at the Neoplanta Meat Plant in Novi Sad].

INTRODUCTION: Obesity is more and more considered a serious medical problem associated with hyperlipoproteinemia, diabetes, cardiovascular disease, locomotor system diseases not only in the workers with hypertension and increased body fat, but also in the workers with lumbar syndrome. The objective of this study was to examine obesity and trends in frequency of lumbar syndrome and hypertension in workers employed in the meat industry, starting from the premise that obese workers are more prone to developing lumbar syndrome, hypertension or both diseases jointly. MATERIAL AND METHODS: The following data: sex, age, years of employment in meat industry, body mass and height were filled out in the epidemiological questionnaire. The sample represented 36% of the statistical mass--475 examined subjects, 285 men and 190 women. The workers were divided by BMI values into the following groups: normal weight, overweight, significantly obese and extremely obese. Frequency of lumbar syndrome and hypertension among obese and normal weight workers were tested, p < 0.05. RESULTS: The obtained results showed that 34.31% of the examined workers were with normal weight, 43.58% overweight, 20.84% significantly obese and 1.26% extremely obese. Tested occurrence of lumbar syndrome among normal and overweight workers, value chi 2 = 2.80, showed no significant difference, while there was difference in hypertension chi 2 = 11.7 and in both diseases jointly chi 2 = 12.25. However, significant frequency of lumbar syndrome, chi 2 = 5.26, hypertension, chi 2 = 39.72 and both diseases jointly chi 2 = 37.25 was found among normal weight and obese workers. DISCUSSION: It should be pointed out that increase in body mass leads to significant increase in both diseases jointly, not just hypertension. The absence of significant difference of lumbar syndrome, chi 2 = 2.80, is to be associated with the shorter length of service. On determining the share of lumbar syndrome in absenteeism the relation of obesity and imbalanced nutritional patterns has to be taken into consideration. CONCLUSION: With the increase of body mass, frequency of occurrence of hypertension and lumbar syndrome accompanied with hypertension increases too.

Female↗

[Detection of numerical chromosome aberrations in sperm of workers exposed to benzene series by two-color fluorescence in situ hybridization].

OBJECTIVE: To study the numerical aberrations of sex chromosomes in sperm of workers exposed to benzene series. METHODS: The interphase sperm from workers of exposed and control groups were hybridized using two color fluorescence in situ hybridization with X and Y(alpha)-satellite chromosome specific DNA probes, and the aneuploidy frequencies of X and Y chromosome in X and Y sperms were detected simultaneously. RESULTS: Geometric mean concentration of benzene in workplace air was 83.95 mg/m(3), one fold higher than national maximum allowable concentration. A total of 74,517 sperm nuclei in 13 benzene-exposed workers and 89,662 sperm nuclei in 13 control workers were counted. Frequencies of disomic sperm for X, Y and XY were (0.15 +/- 0.05)%, (0.13 +/- 0.05)% and (0.20 +/- 0.11)% in workers exposed to benzene series, and (0.10 +/- 0.04)%, (0.10 +/- 0.04)% and (0.13 +/- 0.06)% in control workers. There was statistical difference in disomic frequency of X sperm and overall disomic frequency between the benzene series-exposed workers (0.15% and 0.48%, respectively) and the control workers (0.10% and 0.33%, respectively). CONCLUSION: Exposed to benzene at higher concentration may induce increase in aneuploidy frequency of sperm sex chromosome in exposed workers.

Adult↗

Response of furniture factory workers to work-related airborne allergens.

The aim of this work was to determine the reactivity of furniture factory workers to microbial allergens associated with wood dust. Allergological examinations by skin and precipitin tests were performed in 48 workers employed in a factory producing furniture from fibreboards and chipboards, and in 32 healthy urban dwellers not exposed to organic dusts (referents). The skin test was performed by the intradermal method with the saline extracts of the cultures of 3 microbial species (Rahnella sp., Arthrobacter globiformis, Aspergillus fumigatus) associated with wood dust. Skin reactions were recorded after 20 minutes, 8 hours and 24 hours and graded 1-4, depending on the diameter of the reaction. The agar-gel test for the presence of precipitins in serum was performed with the extracts of 15 microbial isolates. The furniture factory workers showed a high skin response to the extracts of environmental microbes. The frequency of early grade 2 reactions (diameter 10 mm) to the extract of Rahnella sp. was 64.6% among furniture workers, being significantly higher (p < 0.001) compared to reference group (18.7%). High frequencies of grade 2 reactions in furniture workers were also found with the extracts of A. globiformis and A. fumigatus (52.1% and 62.5%, respectively). The frequencies of grade 2 delayed (after 8 h) and late (after 24 h) reactions to Rahnella sp. in furniture workers were non-specifically high (97.9%/93.7%) while the response rates to A. globiformis and A. fumigatus were much lower (10.4%/25.0%, and 4.2%/37.5%, respectively). In agar-gel test for detection of precipitins, in most cases very low percentages of positive reactions (0-2.1%) were noted in furniture factory workers. The only exception was a high percentage of positive reactions (27.1%) to the antigen of Pseudomonas maltophilia, which was significantly greater in furniture workers compared to the reference group (p < 0.01). The obtained results suggest that early allergic reactions to microorganisms associated with wood dust are common among workers of furniture industry, which may increase a potential risk of work-related disease in this occupational group.

Adult↗

The health problems of old workers.

With the growing number of old people in many countries, the problem of the elderly worker becomes of increasing importance. Data from some countries, such as Great Britain and the USA, indicate a tendency for fewer old people to be employed than hitherto.Several studies have shown that the employment of old people may raise special problems, but that these can in most cases be solved without great difficulty. The provision of separate workshops for the elderly-a measure adopted by some firms-does not appear to be the best solution, since the workers themselves tend to resent such segregation, feeling that they are being singled out for special treatment. The ideal arrangement seems to be to place elderly workers in small groups on specific jobs, which are an integral part of the main flow of work in the factory, but are not subject to special pressures.The output of elderly workers seems on the whole to be satisfactory and comparable to that of the younger ones. In choosing suitable jobs for old workers, the heaviness of the job appears to be a less important consideration than that the effort required should not be continuous. Elderly workers seem to have a greater need than their younger workmates for good lighting at work. They may be prevented by their physical condition from doing many unskilled jobs where health and strength are essential, but they can easily be kept in productive employment in jobs which depend largely upon skill and experience. It is generally accepted that work is beneficial to old people and will help to keep up their health and morale; this has been borne out in many studies. When transferring an elderly worker to a new job, it is important to find a job with the same prestige as the former one.An annual medical examination by the industrial physician is a very useful guide when fitting the old worker to his job. The medical examination should be voluntary and must be carried out tactfully, since old workers are often suspicious that some excuse may be found for discharging them.

Aged↗

National study of knowledge of AIDS, testing patterns, and self-assessed risk among health care workers.

We conducted a study to assess the level of AIDS knowledge, testing behavior patterns, and self-assessed risk of contracting AIDS for a representative sample of health care workers in the United States. The study was based on data collected in the 1989 AIDS Knowledge and Attitudes Supplement to the National Health Interview Survey. Health care workers in four occupational groups were compared with other members of the labor force and with one another. The survey included 1,620 respondents identified as health care workers and 25,217 respondents with occupations other than in health care. Health care workers were more knowledgeable about AIDS than were other workers; approximately 55% and 25%, respectively, reported knowing a lot about AIDS. They were also more likely to have been tested (34%) than other workers (24%) and to have done so voluntarily (28% versus 14%). Health care workers also believed they had higher risk of contracting AIDS (8% versus 3%), although they were about equally likely to report being in one of the six high-risk groups. Among health care workers, those in the health diagnosing occupations were the most knowledgeable about AIDS (74% reported knowing a lot) and were the most likely to have been tested (41% were tested at least once). Health service workers were the least knowledgeable; only 38% reported knowing a lot about AIDS and only 26% reported being tested.

Acquired Immunodeficiency Syndrome↗

Adaptation of the older worker to occupational challenges.

The occupational adaptation practice model guided the search for and the analysis of the literature on the older worker. The purpose of this literature review was to: identify the occupational challenges that older workers experience, determine ways in which the occupational therapist can promote the occupational adaptation of older workers, and articulate the research and policy changes implied in the model related to health and improved productivity. The analysis of the worker's personal characteristics, work tasks, and environments highlighted the types of occupational challenges that may overwhelm the older worker's adaptive capacity. Straining adaptive capacity of the older worker leads to degradation in levels of mastery. The occupational therapist and others could assist the older worker to achieve relative mastery in response to occupational challenges through ergonomic solutions, training, assistive devices, management policy, and health promotion. Combined efforts of the employer, of the occupational therapist, and of the older work to capitalize on the older worker's years of experience, existing skills, and knowledge facilitates higher job satisfaction, better performance, and an increased sense of well-being in the older worker.

Adaptation, Physiological↗

[Results of risk and impairment assessment in groups of workers exposed to repetitive strain and movement of the upper limbs in various sectors of industry].

BACKGROUND: This presents study the results of a number of investigations regarding risks associated with biomechanical overload of the upper limbs and the consequent health effects (UL-WMSDs) in a large sample of workers in various different jobs. METHODS: Risk assessment regarded 15 different working environments in which 4044 subjects were employed. Most were metalworking factories in which the workers performed assembly tasks (3015 workers). Some made motors for electrical appliances (714 workers), others assembled miniature components (shock absorbers and remote controls: 259 workers), while others handled larger sized parts such as components of large domestic appliances (refrigerators, freezers, ovens: 2037 workers). The sample also included workers in the meat processing industry (chicken and turkey, 969 workers) and hotel room cleaners (60). Exposure assessment was performed using the OCRA checklist for quantifying the risk attributable intrinsically to each individual workstation, as if used for the entire shift. The values thus obtained were entered into a special software program that, for each working area, produced mean weighted values for the results of the checklist and their percentage distribution over four categories: no risk (green), low risk (yellow), moderate risk (red) and high risk (purple). In 11 of the 15 working environments considered, a total of 3511 workers (2221 women and 1290 men) underwent a complete and standardized clinical examination of the upper limbs. Comparisons of the results of exposure evaluation and of the clinical surveys were made between the different types of jobs and between males and females.

Adult↗

[Preliminary study on naphthalene-metabolites-albumin adduct as an exposure biomarker for coke oven workers].

OBJECTIVE: To study albumin adduct with naphthalene metabolites, namely 1,2-naphthoquinone (1,2-NPQ) and 1,4-naphthoquinone (1,4-NPQ), as a potential biomarker for intermediate/long-term exposure to polycyclic aromatic hydrocarbons (PAH) in coke oven workers. METHODS: Twenty-eight coke oven workers and 22 control workers were recruited from a cokery. Spot urine and venous blood samples were collected from the workers after four continuously working days and personal information was obtained by questionnaire. Plasma albumin adduct was detected with gas chromatography-mass spectrometry. RESULTS: Albumin adduct with 1,2- & 1,4-NPQ (1,2-NPQ and 1,4-NPQ), respectively, were detected in all coke oven workers and controls. Median plasma level of 1,2-NPQ-Alb in coke oven workers was significantly higher than that in controls (76.6 pmol/g vs. 44.9 pmol/g, P < 0.01). However, there was no significant difference in plasma median level of 1,4-NPQ-Alb between the two groups (48.6 pmol/g vs. 44.2 pmol/g, P > 0.05). Plasma level of 1,2-NPQ-Alb was significantly higher than that of 1,4-NPQ-Alb in coke oven workers. Urine levels of naphthalene, 1-naphthol, 2-naphthol and 1-pyrenol in coke oven workers correlated significantly with their plasma level of 1,2-NPQ-Alb (Pearson coefficient of correlation greater than 0.371, P < 0.01), but did not do significantly with 1,4-NPQ-Alb. CONCLUSION: Plasma level of 1,2-NPQ-Alb could effectively reflect their magnitude of personal internal dose of exposure to air PAH, so it could be used as a potential biomarker to evaluate their intermediate/long-term exposure to PAH in coke oven workers.

Air Pollutants, Occupational↗

[Judicial and medical/legal aspects of the responsibility of workers appointed to carry out first aid].

BACKGROUND: One of the innovations introduced by law 626/94 [the Italian law on occupational health and safety of workers] is the obligation of the employer to designate workers responsible for first aid. OBJECTIVES: To identify and discuss the duties, the role and the medical and legal responsibility of workers appointed to carry out first aid measures. METHODS: Analysis of legislation and current practice concerning medical and legal responsibility in first aid procedures. RESULTS: The worker appointed to carry out first aid measures is, by virtue of his appointment, obliged to take action. Therefore, he could commit an illegitimate act both by "acting" and by "omitting" to carry out a duty that is his responsibility. In the first case the worker could be accused of committing an unpremeditated criminal offence when his actions involve negligence, imprudence, inexperience or violation of regulations concerning his duties. A "serious criminal offence" is committed when the most elementary rules of diligence, prudence and skill are violated; the offence is "slight" when negligence, imprudence or inexperience are involved in particularly complex situations. The reference parameter for inexperience is not a first aid volunteer, nor a member of the public, but a worker designated to carry out first aid possessing "average" attitudes, training and ability. Briefly, a guilty error by the appointed worker consists of the following: i) the professional conduct of the operator was clearly wrong, serious and unjustifiable; ii) the operator clearly omitted doing his/her duty; iii) the consequence of the error is physical personal damage. CONCLUSIONS: The observations made clearly illustrate the delicacy of the tasks of the worker appointed to carry out first aid measures. Essential elements for minimizing wrong and/or negligent conduct are appropriate choice of the designated workers and their adequate training.

First Aid↗