Francesco Chirico

We believe that Bangladesh has lacked coordinated policy decision and enforcement measures to curtail COVID-19 transmission thus far. We urge policy makers to follow WHO guidance and observe other countries' experiences, which point to a strategy of acting decisively, quickly, and early, well before case numbers reach a crisis level for containment. We believe Bangladesh has not yet reached this point, so urgent implementation of a coordinated policy may prevent a spike in cases that is likely to stretch Bangladesh's health system well beyond its capacity.

The coronavirus-19 (COVID-19) pandemic is putting a severe strain on all healthcare systems. Several occupational risk factors are challenging healthcare workers (HCWs) who are at high risk of mental health outcomes, including Burnout Syndrome (BOS). BOS is a psychological syndrome characterized by emotional exhaustion, depersonalization, and low personal accomplishment. An umbrella review of systematic reviews and meta-analyses concerning BOS and coronavirus (SARS/MERS/SARS-CoV-2) outbreaks was carried out on PubMed Central/Medline, Cochrane Library, PROSPERO, and Epistemonikos databases. Data relating to COVID-19 is insufficient, but in previous SARS and MERS outbreaks about one-third of HCWs manifested BOS. This prevalence rate is similar to the figure recorded in some categories of HCWs exposed to chronic occupational stress and poor work organization during non-epidemic periods. Inadequate organization and worsening working conditions during an epidemic appear to be the most likely causes of BOS. Preventive care and workplace health promotion programs could be useful for protecting healthcare workers during pandemics, as well as during regular health activities.

Healthcare workers employed in the COVID-19 emergency are at high risk of stress, burnout and post-traumatic stress disorders. The most important occupational risk factors that employers should address include insufficient staff training and resources available, and lack of training and treatment protocols. In Italy, recent guidelines were released for providing all healthcare workers who are employed in this emergency with psychological support services based on coping strategies for managing stress. We suggest that preventive measures and a psychological intervention plan should be framed within the mandatory occupational health surveillance programme, and carried out by occupational physicians in cooperation with mental healthcare providers in the workplace.

Background This systematic review with meta-analysis was carried out to study the relationship between workplace violence and sleep problems. Methods The PRISMA statement was used to conduct a systematic search of the literature on PubMed/MEDLINE, Scopus, Sociological abstract, DOAJ, Web of Science and Google Scholar databases. Of the original number of 749 studies, 34 were included in the systematic review and 7 in the meta-analysis. Results A total of 119,361 participants from fifteen different countries took part in these studies which were published between 1999 and 2019. Significant heterogeneity was observed among the studies (I2 = 96%). In a random-effects meta-analysis model, pooled odds ratio (OR) analysis revealed that there was a direct relationship between occupational exposure to violence and sleep problems (OR 2.55; 95% CI: 1.77–3.66). According to the GRADE guidelines, the quality of evidence of the association was low. Conclusions The findings of this study demonstrate that occupational exposure to physical, verbal or sexual violence is associated with sleep problems. Further research on the relationship between violence and sleep is needed so that appropriate measures can be taken to prevent violence and improve sleep hygiene in the workplace. Trial registration number PROSPERO International prospective register of systematic reviews (CRD42019124903) February 9, 2019.

This study aimed to find out which countries around the world require psychosocial hazards and workplace violence to be assessed by employers through a mandatory occupational risk assessment process and to compare the type of legislation between countries. We systematically searched the International Labour Office (ILO) "LEGOSH" database for documents published during the period between December 2017 and February 2018. The search included 132 countries, of which 23 were considered as developed and 109 as developing according to the United Nations. Our review showed that most countries (85, i.e., 64%) have not included mandatory psychosocial risk assessment and prevention in their national occupational safety and health legislation. Moreover, we found differences between developed and developing countries, showing that developed countries more frequently have legislative measures. Within developed countries, we also found differences between countries following the Scandinavian model of workplace health and safety culture and other countries. Moreover, in many countries, workplace violence was prohibited only if it involves an offence to moral or religious customs. In conclusion, the marked difference in psychosocial hazards and workplace violence regulations among countries leads to unequal levels of workers' protection, with adverse effects on global health.