Der Internist
-
Employee health and ability to perform is essential to a functioning health care system. Even before the coronavirus disease 2019 (COVID-19) pandemic, a substantial proportion of employees reported impaired mental health at work. This paper outlines the state of knowledge and evidence on interventions to promote mental health in the workplace, with particular focus on the organization of work and activities. In addition to an initial review of approaches, the factors facilitating successful and effective approaches are addressed.
-
Healthcare personnel (HCP) have an occupation-related risk of an infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and can transmit COVID-19 to patients. The related occupational disease is the BK 3101. ⋯ Occupation-related SARS-CoV‑2 infections are a real reason for concern. The registration data of the accident insurance institutions confirm high case numbers. Preventive measures, such as wearing personal protective equipment (PPE) and COVID-19 vaccinations significantly reduce the risk of infection among HCP as well as the risk of nosocomial transmission to patients.
-
Review
[Psychosocial stress at work and disease risks : Scientific evidence and implications for practice].
The modern working world makes a significant contribution to the development of diseases, which goes far beyond the field of traditional occupational diseases. Despite technological progress and successful medical healthcare, distinct widely disseminated psychosocial working conditions contribute to a remarkable burden of work-related diseases. By inducing chronic activation of psychobiological stress reactions, they promote the development of various physical and mental disorders. ⋯ Two theoretical concepts received particular attention, the demand-control and the effort-reward imbalance models. Results derived from meta-analyses indicate increased relative risks of these disorders in the range of 35-80% among those exposed to these stressors compared to nonexposed groups. Finally, practical implications of this scientific evidence for worksite screening and health promoting activities are discussed.
-
Intervertebral disc-related diseases of the cervical and lumbar spine are considered to be occupational diseases, if the occupational and medical prerequisites are fulfilled and the causal connection between the prerequisites is likely. The working conditions include occupational burdens with long-term lifting and carrying of heavy loads or long-term activities in an extremely bent position of the torso, long-term carrying of heavy loads on the shoulders and long-term effects of whole-body vibration in a sitting position. ⋯ Furthermore, the medical expert examines the causal connection between the fulfilled prerequisites, whereby the temporal connection (reaching the minimum load dose before realization of the conform damage pattern) and by exclusion of other competing factors are essential. As of 1 January 2021 the necessity to quit the burdening occupation has been omitted by law.
-
Immunotherapies have gained increasing importance in the treatment of cancer in recent years. This also includes tumor vaccines, which are used therapeutically to direct the immune system specifically against tumor cells. ⋯ For effective tumor vaccination, the selection of suitable tumor antigens present on the cell surface via human leukocyte antigen (HLA) molecules is essential. Suitable antigens should be present exclusively on tumor cells and able to induce a specific anti-tumor immune response, i.e. activate cytotoxic and T helper cells. For this purpose, neoepitopes derived from tumor-specific mutations or tumor-associated antigens (TAAs), which are present exclusively in tumor tissue due to altered gene expression or processing, can be used. For the application of the antigens, various strategies combined with suitable adjuvants are available, including peptide vaccines, DNA- or RNA-based vaccines, approaches with dendritic cells or whole tumor cell vaccines. Currently, numerous vaccination approaches as well as combination protocols are being evaluated in clinical trials with the aim to establish specific and low side effect immunotherapies to combat malignancies and enable long-term protection from disease recurrence via the induction of long-lasting antitumor immune responses.