a b s t r a c tBackground: Among healthcare professions, critical care healthcare workers (HCWs) have one of the most stressful jobs. This study was conducted to determine the relationship between job stress and burnout syndrome (BOS) among nurses and healthcare technicians at the surgical emergency department and intensive care unit of Critical Care department at the Alexandria University Hospital. Methods: A cross-sectional approach was conducted from October 2014 to March 2015. Eighty-two nurses and healthcare technicians participated in the research (response rate = 80.39%). Data was collected by an interview questionnaire using selected subscales of NIOSH Generic job stress Questionnaire and Maslach Burnout Inventory of Health and human service Questionnaire. The relationship between BOS and job stress was examined using bivariate and multivariate analyses. Results: Although majority of participants reported variation of workload (84.15%), quantitative overload (76.8%), responsibility for peoples' life (69.5%) and lack of perceived control (63.41%), yet, 85.4% were satisfied with their job. Moreover, high levels of emotional exhaustion was reported by the majority of participants (80%), while less than one third reported either high levels of depersonalization or low levels of personal accomplishment domains of BOS. In multiple regression analysis, skill underutilization, variation in workload, and intragroup conflicts were negatively associated with BOS domains. While, job satisfaction and responsibility for peoples' life were positively associated with personal accomplishment domain of BOS. Conclusion: Critical care HCWs had high BOS. The study concluded that reducing intragroup conflict, improving skills utilization, and raising job satisfaction are crucial to reduce BOS among critical care HCWs. More attention and psychological support is recommended to critical care HCWs. Ó 2017 Alexandria University Faculty of Medicine. Production and hosting by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Background: Formaldehyde can be toxic, allergenic and carcinogenic. Evaporation of formaldehyde from formalin-treated cadavers in the anatomy dissection rooms can produce high exposure. This study was conducted to assess acute and chronic toxic effects of formalin-treated cadavers on medical students, staff members, and workers at the Anatomy department in the Alexandria Faculty of Medicine (AFM). Methods: A cross sectional approach was adopted to investigate medical students (n = 454). Staff members and workers at the Anatomy department (n = 16), and unexposed staff members and workers in the AFM (n = 19) were included in the study. Medical students filled self-administered predesigned questionnaire. Formalin-exposed and unexposed staff members filled a questionnaire and a Complete Blood Count was done for them. Results: The most frequently reported symptoms by medical students were unpleasant smell (91.2%), itching in the eyes (81.3%), and excessive lacrimation (76.1%). Majority of them reported duration of relief within one hour (>80%), and more than two thirds reported wearing laboratory coats and hand gloves. Formalin-exposed staff reported symptoms of skin disorders as drying (75%), eczema (68.8%), and allergic contact dermatitis (87.5%), besides, eye irritation (68.8%), respiratory tract irritation (93.8%), and workrelated bronchial asthma (53.3%). The mean RBCs and platelets counts were significantly lower among formalin-exposed staff (4.08 ± 0.65 Â 10 6 /ul and 237,375 ± 71745.73/ul respectively) compared with unexposed staff (4.95 ± 0.50 Â 10 6 /ul and 280473.68 ± 54456.27/ul respectively). WBCs count was abnormal (low or high) among formalin-exposed staff members (6.2%, and 18.8% respectively), while all unexposed staff had normal WBCs counts. Conclusion:The research highlighted the irritating action of formalin on medical students, and chronic toxic effects on staff members. This necessitates re-evaluation of the concentration of formalin, proper ventilation and assessment of working practices in the dissecting rooms at the Anatomy department.

Background: Of the estimated 384,000 needle-stick injuries occurring in hospitals each year, 23% occur in surgical settings. This study was conducted to assess safe injection procedures, injection practices, and circumstances contributing to needlestick and sharps injures (NSSIs) in operating rooms. Methods: A descriptive cross sectional approach was adopted. Modified observational checklists based on World Health Organization (WHO) definitions were used in operating rooms (n = 34) and interview questionnaire was administered to HCWs (n = 318) at the Alexandria Main University Hospital. Results: Safe injection procedures regarding final waste disposal were sufficiently adopted, while measures regarding disposable injection equipment, waste containers, hand hygiene, as well as injection practices were inadequately carried out. Lack of job aid posters that promote safe injection and safe disposal of injection equipment (100%), overflowing of sharps containers and presence of infectious waste outside containers (50%), HCWs not cleaning their hands with soap and water or alcohol-based hand rub (58.1%), and HCWs not wearing gloves during IV cannula insertion (58.1%), were all findings during observations. High prevalence of NSSIs was reported (61.3%), mostly during handling suture needles (50.8%). In addition, 66.2% of the injured HCWs were the original user of the sharp item which was contaminated in 80% of injuries. At time of NSSI, 79% HCWs were wearing gloves. The most common injured sites were left fingers (39.5%), and 55.4% of injuries were superficial. After exposure, 97.9% did not report their exposure. The source patient was not tested for HBV, HCV and HIV infection in more than 70% of injuries and 96.9% of injured HCWs did not receive post exposure prophylaxis. Conclusion: The study highlighted that inadequately adopted safe injection procedures and insufficient injection practices lead to high prevalence of NSSIs in operating rooms.

Background: Globally, there is an expansion in computer-related work, which may have contributed to an increased burden of complaints of the arm, neck and/or shoulder (CANS). The study was conducted to determine the prevalence and factors associated with CANS among computer office workers (OWs) in Alexandria. Participants and Methods: Computer OWs at four banks and two telecommunication companies (n=211) were included in a cross-sectional study in 2016. Data were collected using the self-administered Musculoskeletal Upper Extremity Questionnaire-Arabic version. Potentially related factors were examined using bivariate and multivariate analyses. Results: The sample comprised 95 (45.02%) males and 116 (54.97%) females. Overall, 72% aged 25-35 years. Prevalence with 95% confidence interval (CI) for CANS was 0.73 (95% CI: 0.66-0.79), 0.69 (95% CI: 0.62-0.75) and 0.70 (95% CI: 0.64-0.76), respectively. The majority of the complaints were minor (86%). Factors significantly associated with neck complaints were female sex (P=0.03), inappropriate office equipment (P=0.02), task complexity (P<0.01), break autonomy (P=0.02) and low decision authority (P=0.05). Factors significantly associated with arm/hand complaints were female sex (P=0.01), awkward body posture (P=0.05), break autonomy (P<0.01) and low break quality (P=0.04) Conclusion: The study revealed high prevalence of CANS and highlighted associated factors, namely, task complexity, inappropriate office equipment, low decision authority, low break quality and female sex. Improving ergonomic conditions, reducing job demands, and increasing job control are crucial to reduce CANS among computer OWs.

Background Few data were documented about risk factors for lower limb varicose veins (LLVV) among Egyptian population. Identifying modifiable risk factors is crucial to plan for prevention. The current research aims to study the epidemiological, life style, and occupational factors associated with LLVV in a sample of Egyptian population. Methods A case control study was adopted. Cases with LLVV (n = 150) were compared with controls (n = 150). Data was collected using an interview questionnaire and clinical assessment. Data was analyzed using the univariate and multivariate logistic regression analyses. Results According to multivariate analysis among all participants (n = 300), the odds of LLVV was 59.8 times greater for those who frequently lift heavy objects (95% CI = 6.01, 584.36) and 6.95 times higher for those who drink < 5 cups of water/day (95% CI = 2.78, 17.33). Moreover, it was 4.27 times greater for those who infrequently/never consume fiber-rich foods (95% CI = 1.95, 9.37) and 3.65 times greater for those who stand > 4 h/day (95% CI = 1.63, 8.17). Additionally, odds of LLVV was 3.34 times greater for those who report irregular defecation habit (95% CI = 1.68, 6.60), and 2.86 times higher for those who sleep < 8 h/day (95% CI = 1.14, 7.16), and 2.53 times higher for smokers compared with ex-smokers/non-smokers (95% CI = 1.15, 5.58). In addition, a standing posture at work was an independent predictor of LLVV among ever employed participants (n = 234) in the current study (OR = 3.10; 95% CI = 1.02, 9.38). Conclusions This study highlighted seven modifiable independent predictors of LLVV mostly related to the life style, namely, frequent lifting of heavy objects, drinking < 5 cups of water/day, infrequent/no consumption of fiber-rich food, standing more than 4 h/day, irregular defecation habit, sleeping less than 8 h/day, and smoking. These findings provide a basis to design an evidence-based low-cost strategy for prevention of LLVV among Egyptian population.

Background: Chronic exposure to antineoplastic drugs (ADs) may result in reproductive, liver, renal, lung, and cardiac toxicity. Moreover, bone marrow suppression, mucosal ulcers, and cancer may develop. In developing countries, adverse health effects owing to occupational exposure to ADs and adherence to safe handling guidelines are not well documented. Aim: This study was conducted to determine the health effect of occupational exposure to ADs and evaluate adherence to control methods. Materials and Methods: A comparative cross-sectional approach was adopted. ADs-exposed nurses and clinical pharmacists (n=54) were compared with nonexposed group (n=54). Self-reported clinical manifestations. and use of exposure controls were reported via an interview questionnaire. Blood samples were collected for complete blood count and liver and kidney function tests. Results: Significantly higher rate of impaired fertility (31%) and oral ulcers (36.36%) were reported by ADs-exposed nurses and clinical pharmacists compared with nonexposed group (3.8 and 7.4%, respectively; P=0.01 and P=0.00, respectively). Moreover, ADs-exposed group had significantly lower mean white blood cell count (6518±2064.79/μl) and significantly higher mean creatinine level (056±0.13 mg/dl) compared with nonexposed group (7307±2001.4/μl and 0.51±0.12 mg/dl, respectively; t=2.02, P=0.04; and P=0.04, respectively). Inadequate controls were reported, mainly lack of medical surveillance (100%), lack of training (69.1%), insufficient handling practices, and low usage of personal protective equipment, particularly among nurses. Conclusion: The study highlighted chronic adverse effects associated with occupational exposure to ADs and inadequate implementation of exposure control methods. Findings necessitate raising awareness among ADs-exposed nurses and clinical pharmacists to introduce engineering controls, conduct hazard awareness training, initiate medical surveillance program, and ensure adherence to safe handling practices.

Background: Worldwide, prevalence of anti-HCV positivity in health care workers (HCWs) ranges from 0% to 9.7%. The current study was conducted to calculate prevalence of HCV infection, frequency and characteristics of blood and body fluid (BBF) exposure among HCW at the Alexandria University Hospitals. Methods: Hospital-based cross-sectional approach was adopted. At the Hospitals, 62.2% of available nurses and paramedical personnel voluntarily participated (n = 499), and were interviewed, screened for HCV antibodies. Quantitative estimation of HCV-RNA was done to seropositive cases. Results: Prevalence of anti-HCV antibodies and HCV infection was 8.6%, and 4.4% respectively. The frequency of BBF exposures was 66.7%. Blood/blood products were mainly involved (92.1%). More than half of exposed HCWs reported not wearing personal protective devices. Anatomical site of exposure was mainly right hand palm (36.2%). Regarding needle-stick injuries, two thirds of injured HCWs were the original user of sharp item which was contaminated in 79.7% of injuries. In 70.2% of injuries, disposable syringes were involved and occurred during item disposal. About 61% of injuries were superficial. Conclusion: Prevalence of HCV infection among HCWs is similar to that among general population in the country. Nurses and housekeepers are frequently exposed to BBF. Adherence to infection control measures according to the National Guidelines is crucial to reduce HCV transmission.

Background Healthcare workers' (HCWs) compliance with infection prevention and control (IPC) measures during the COVID-19 pandemic is crucial to reducing the spread of infection to their colleagues, families, and community. This study assessed the risk perception and compliance with personal protective equipment (PPE) usage, hand hygiene, and specific IPC measures and explored the factors associated with compliance among nurses during the third wave of the COVID-19 pandemic in Egypt. Methods A hospital-based cross-sectional survey was conducted at the Alexandria Main University Hospital (AMUH) in Alexandria city from May to August 2021, where 354 nurses were included with a response rate of 94.9%. A structured interviewer-administered questionnaire was used for data collection. Univariate and multivariate logistic regression analyses were conducted. Results The overall compliance with PPE usage, hand hygiene, and IPC measures was 81.9%. The mean risk perception score was 40.9 ± 3.3. More than 95% of nurses were aware of the high risk of COVID-19 infection at their workplace, the serious consequences of the disease, and the risk that can be minimized by using PPE, whereas a relatively low percentage of nurses believed that the risk of COVID-19 infection could be reduced by using a surgical mask (19.2%) or gloves (50.5%). Good compliance was independently predicted by risk perception (OR = 1.25; 95% CI = 1.13, 1.39), and knowledge about PPE usage and hand hygiene (OR = 3.53; 95%CI = 2.40, 5.19). Facilitators of compliance with the PPE usage were attending suspected or confirmed COVID-19 cases in their hospital ($$\overline{x}$$ x ¯ = 9.82), comfort to use the PPE ($$\overline{x}$$ x ¯ = 9.16), availability of PPE ($$\overline{x}$$ x ¯ = 8.96), hospital policy ($$\overline{x}$$ x ¯ = 8.74), and senior compliance ($$\overline{x}$$ x ¯ = 6.5). Conclusions Nurses at AMUH reported high risk perceptions. The rate of compliance with PPE usage, hand hygiene, and IPC measures was 81.9%. The personal risk perception and knowledge about the PPE usage and hand hygiene are the keys to improving compliance in a healthcare facility.