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Occupational Health & Safety Management—Risk Identification and Assessment

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (31 January 2024) | Viewed by 24850

Special Issue Editors


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Guest Editor
School of Emergency Management and Safety Engineering, China University of Mining & Technology, Beijing 100083, China
Interests: risk assessment; emergency management; urban safety; computational fluid dynamics
Institute of Public Safety Research, Department of Engineering Physics, Tsinghua University, Beijing 100084, China
Interests: public safety; emergency management

Special Issue Information

Dear Colleagues,

According to recent statistics from the WHO, more than 2 million people die of work-related diseases and injures every year, resulting in an economic loss of 4–6% of GDP for most countries. The loss has raised concerns of occupational health and safety both inside and outside the safety domain. Over the past several decades, due to natural hazards or climate extremes like heat/cold waves, traditional risks associated with electricity, chemical industry, mining, civil aviation, nuclear industry, etc. are increasingly threatening occupational health and safety. Moreover, emerging risks accompanying the rapid development of new energy, nanotechnology, digitalization, cyber-physical systems and so on also bring significant safety challenges. Risk assessment has attained more importance as an effective way to prevent and control hazards/accidents and support occupational health and safety management. At present, some state-of-the-art technologies, like artificial intelligence, 5G, digital twins, Internet of things, cloud computing, etc., have great potential to be integrated with risk assessment methods to identify, analyze, and control occupational health and safety risks. We welcome technological methods, as well as papers dealing with new approaches for safety management and safety culture of worker-related organizations. Papers focusing on these issues are invited for this Special Issue, including new theories and methodologies, experimental research, modelling or simulation, and literature reviews.

Prof. Dr. Jiansong Wu
Prof. Dr. Genserik Reniers
Dr. Rui Zhou
Guest Editors

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Keywords

  • occupational health and safety
  • workplace safety
  • environmental ergonomics and safety
  • emerging risk
  • risk assessment
  • risk treatment
  • safety management
  • emergency management
  • safety culture

Published Papers (13 papers)

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Research

Jump to: Review, Other

12 pages, 311 KiB  
Article
Investigating the Risk of Patient Manual Handling Using the Movement and Assistance of Hospital Patients Method among Hospital Nurses in Botswana
by Kagiso Kgakge, Paul Kiprono Chelule, Morris Kahere and Themba Geoffrey Ginindza
Int. J. Environ. Res. Public Health 2024, 21(4), 399; https://doi.org/10.3390/ijerph21040399 - 26 Mar 2024
Viewed by 963
Abstract
Background: Evidence on the prevalence of lower back pain (LBP) among nurses is widespread in the literature, with several risk factors being reported. These include manual handling of patients, repetitive bending and twisting movements, and long working hours. It is reported that LBP [...] Read more.
Background: Evidence on the prevalence of lower back pain (LBP) among nurses is widespread in the literature, with several risk factors being reported. These include manual handling of patients, repetitive bending and twisting movements, and long working hours. It is reported that LBP has negative health outcomes and causes poor work performance among healthcare workers (HCWs). The magnitude of ergonomic risks associated with these healthcare activities has not been adequately investigated in Botswana. Thus, this study aimed to investigate the ergonomic risk levels associated with the manual handling of patients and its association with the prevalence of LBP among nurses in Botswana. Methods: This was an observational cross-sectional hospital-based study conducted in a Botswana public tertiary hospital from March to April 2023. The Movement and Assistance of Hospital Patients (MAPO) tool was used to collect data on ergonomic risk levels. Data on the demographic characteristics of participants were collected using a tool adapted from the Nordic Musculoskeletal Questionnaire (NMQ). Odds ratios and 95% confidence intervals were estimated to determine the association between ergonomic risk levels and the prevalence of LBP. Results: A total of 256 nurses participated and completed the study. The self-reported prevalence of LBP in this study was 76.6%. The risk of acquiring LBP was high (90.5%) based on the MAPO index. Although the frequencies of self-reported LBP were high among nurses, these did not show any significant association with the MAPO index data. This could be partly due to the small sample size. Conclusions: There was a high prevalence of LBP in this study, which was corroborated by the MAPO index data. This has demonstrated the value of the MAPO index in forecasting the risk of patient manual handling. The findings might help Botswana formulate policies intended to address ergonomic preventive measures, directed towards reducing the MAPO index score by addressing the single risk determinants. Full article
20 pages, 2067 KiB  
Article
Analyzing Subway Operation Accidents Causations: Apriori Algorithm and Network Approaches
by Yongliang Deng, Ying Zhang, Zhenmin Yuan, Rita Yi Man Li and Tiantian Gu
Int. J. Environ. Res. Public Health 2023, 20(4), 3386; https://doi.org/10.3390/ijerph20043386 - 15 Feb 2023
Cited by 2 | Viewed by 1987
Abstract
Subway operation safety management has become increasingly important due to the severe consequences of accidents and interruptions. As the causative factors and accidents exhibit a complex and dynamic interrelationship, the proposed subway operation accident causation network (SOACN) could represent the actual scenario in [...] Read more.
Subway operation safety management has become increasingly important due to the severe consequences of accidents and interruptions. As the causative factors and accidents exhibit a complex and dynamic interrelationship, the proposed subway operation accident causation network (SOACN) could represent the actual scenario in a better way. This study used the SOACN to explore subway operation safety risks and provide suggestions for promoting safety management. The SOACN model was built under 13 accident types, 29 causations and their 84 relationships based on the literature review, grounded theory and association rule analysis, respectively. Based on the network theory, topological features were obtained to showcase different roles of an accident or causation in the SOACN, including degree distribution, betweenness centrality, clustering coefficient, network diameter, and average path length. The SOACN exhibits both small-world network and scale-free features, implying that propagation in the SOACN is fast. Vulnerability evaluation was conducted under network efficiency, and its results indicated that safety management should focus more on fire accident and passenger falling off the rail. This study is beneficial for capturing the complex accident safety-risk–causation relationship in subway operations. It offers suggestions regarding safety-related decision optimization and measures for causation reduction and accident control with high efficiency. Full article
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25 pages, 20105 KiB  
Article
Multi-Source Data Fusion and Hydrodynamics for Urban Waterlogging Risk Identification
by Zongjia Zhang, Yiping Zeng, Zhejun Huang, Junguo Liu and Lili Yang
Int. J. Environ. Res. Public Health 2023, 20(3), 2528; https://doi.org/10.3390/ijerph20032528 - 31 Jan 2023
Cited by 7 | Viewed by 1775
Abstract
The complex formation mechanism and numerous influencing factors of urban waterlogging disasters make the identification of their risk an essential matter. This paper proposes a framework for identifying urban waterlogging risk that combines multi-source data fusion with hydrodynamics (MDF-H). The framework consists of [...] Read more.
The complex formation mechanism and numerous influencing factors of urban waterlogging disasters make the identification of their risk an essential matter. This paper proposes a framework for identifying urban waterlogging risk that combines multi-source data fusion with hydrodynamics (MDF-H). The framework consists of a source data layer, a model parameter layer, and a calculation layer. Using multi-source data fusion technology, we processed urban meteorological information, geographic information, and municipal engineering information in a unified computation-oriented manner to form a deep fusion of a globalized multi-data layer. In conjunction with the hydrological analysis results, the irregular sub-catchment regions are divided and utilized as calculating containers for the localized runoff yield and flow concentration. Four categories of source data, meteorological data, topographic data, urban underlying surface data, and municipal and traffic data, with a total of 12 factors, are considered the model input variables to define a real-time and comprehensive runoff coefficient. The computational layer consists of three calculating levels: total study area, sub-catchment, and grid. The surface runoff inter-regional connectivity is realized at all levels of the urban road network when combined with hydrodynamic theory. A two-level drainage capacity assessment model is proposed based on the drainage pipe volume density. The final result is the extent and depth of waterlogging in the study area, and a real-time waterlogging distribution map is formed. It demonstrates a mathematical study and an effective simulation of the horizontal transition of rainfall into the surface runoff in a large-scale urban area. The proposed method was validated by the sudden rainstorm event in Futian District, Shenzhen, on 11 April 2019. The average accuracy for identifying waterlogging depth was greater than 95%. The MDF-H framework has the advantages of precise prediction, rapid calculation speed, and wide applicability to large-scale regions. Full article
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16 pages, 2953 KiB  
Article
The Impact of Biosecurity on Biological and Psychosocial Risks for Health Workers of COVID Hospitals in Guadalajara, Jalisco, Mexico
by María de la Luz Galván-Ramírez, María de Lourdes Preciado-Serrano and Mildred Gallegos-Bonifaz
Int. J. Environ. Res. Public Health 2023, 20(1), 858; https://doi.org/10.3390/ijerph20010858 - 03 Jan 2023
Cited by 1 | Viewed by 1642
Abstract
Background: Some data support that health care workers (HCWs) must have sufficient and good quality personal protective equipment (PPE) and the necessary training to manage COVID patients to avoid contagion that can lead to death. The objective of this study was to determine [...] Read more.
Background: Some data support that health care workers (HCWs) must have sufficient and good quality personal protective equipment (PPE) and the necessary training to manage COVID patients to avoid contagion that can lead to death. The objective of this study was to determine the relationship between biosafety on the biological risks of SARS-CoV-2 and risks of fatigue, anxiety, or depression in health workers who care for patients in COVID hospitals, from September 2020 to August 2021. Material and methods: The questionnaire used in this study (Q6S64I) consisted of 6 spheres: Sociodemographic aspects, working conditions; Personal Protection Equipment; safety and health; training and knowledge about COVID-19, the form of transport, and personal health conditions. The answers were online. The Goldberg questionnaire (EADG) measures anxiety and depression, and the questionnaire measures fatigue (Barrientos-Gutiérrez et al.) (PSSF). Results: In total, 76.5% of the HCWs were doctors, 25.2% worked in the emergency services, 79.3% received PPE from their institution, 82.9% cared for COVID-19 patients, and 27.9% tested positive for COVID-19. The PPE provided by the employer was 80%, but the quality was deficient, insufficient, and associated with a relative risk of 4.6. A total of 99% acquired better PPE on their own. The exposure to COVID-19 and the surgical mask provided by the institution had an associated relative risk of 2.8 for the HCWs. A total of 39% of the HCWs reported being calm. Conclusions: PPE, risk exposure, and safety at work were significantly associated with drowsiness and heaviness, difficulty concentrating, anxiety, and depression. Full article
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14 pages, 3497 KiB  
Article
Safety Risk Estimation of Construction Project Based on Energy Transfer Model and System Dynamics: A Case Study of Collapse Accident in China
by Yongcheng Zhang, Xuejiao Xing, Maxwell Fordjour Antwi-Afari and Mingqing Wu
Int. J. Environ. Res. Public Health 2022, 19(21), 14386; https://doi.org/10.3390/ijerph192114386 - 03 Nov 2022
Cited by 3 | Viewed by 1652
Abstract
Analyzing and understanding the occurrence and evolution mechanisms of construction accidents are important for construction safety management. This study proposed a hybrid approach of integrating the energy transfer model (ETM) and system dynamics (SD) theory to delineate the entire evolution stage of the [...] Read more.
Analyzing and understanding the occurrence and evolution mechanisms of construction accidents are important for construction safety management. This study proposed a hybrid approach of integrating the energy transfer model (ETM) and system dynamics (SD) theory to delineate the entire evolution stage of the construction accident. Specifically, the Fengcheng Power Plant construction platform collapse accident (FPCA) was taken as a practical case study. First, the ETM is applied to demonstrate the evolving nature of the accident. Then, the network of the accident-causing factors is constructed using the SD theory to analyze the dynamic change characteristics. The results indicate that the accident was caused by risk factors with complex interactions at the management level. An energy constraint failure occurred when the transfer of dangerous energy transpired at the physical entity level, inducing the event. The proposed approach can provide a useful reference for safety risk estimation and management in future major construction projects. Full article
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16 pages, 3421 KiB  
Article
A Risk Treatment Strategy Model for Oil Pipeline Accidents Based on a Bayesian Decision Network Model
by Chao Zhang, Wan Wang, Fengjiao Xu, Yong Chen and Tingxin Qin
Int. J. Environ. Res. Public Health 2022, 19(20), 13053; https://doi.org/10.3390/ijerph192013053 - 11 Oct 2022
Cited by 2 | Viewed by 1275
Abstract
Risk treatment is an effective way to reduce the risk of oil pipeline accidents. Many risk analysis and treatment strategies and models have been established based on the event tree method, bow-tie method, Bayesian network method, and other methods. Considering the characteristics of [...] Read more.
Risk treatment is an effective way to reduce the risk of oil pipeline accidents. Many risk analysis and treatment strategies and models have been established based on the event tree method, bow-tie method, Bayesian network method, and other methods. Considering the characteristics of the current models, a risk treatment strategy model for oil pipeline accidents based on Bayesian decision network (BDNs) is proposed in this paper. First, the quantitative analysis method used in the Event-Evolution-Bayesian model (EEB model) is used for risk analysis. Second, the consequence weights and initial event likelihoods are added to the risk analysis model, and the integrated risk is obtained. Third, the risk treatment strategy model is established to achieve acceptable risk with optimal resources. The risk treatment options are added to the Bayesian network (BN) risk analysis model as the decision nodes and utility nodes. In this approach, the BN risk analysis model can be transformed into a risk treatment model based on BDNs. Compared to other models, this model can not only identify the risk factors comprehensively and illustrate the incident evolution process clearly, but also can support diverse risk treatment strategies for specific cases, such as to reduce the integrated risk to meet acceptable criterion or to balance the benefit and cost of an initiative. Furthermore, the risk treatment strategy can be updated as the risk context changes. Full article
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21 pages, 1503 KiB  
Article
The “Transparency for Safety” Triangle: Developing a Smart Transparency Framework to Achieve a Safety Learning Community
by Paul Lindhout and Genserik Reniers
Int. J. Environ. Res. Public Health 2022, 19(19), 12037; https://doi.org/10.3390/ijerph191912037 - 23 Sep 2022
Viewed by 1433
Abstract
Transparency about health and safety risks is a complex societal, moral, ethical and political concept. Full transparency does not come natural for any of the key stakeholder groups: organizations, authorities and the people. If safety information is not sufficiently shared between them, people [...] Read more.
Transparency about health and safety risks is a complex societal, moral, ethical and political concept. Full transparency does not come natural for any of the key stakeholder groups: organizations, authorities and the people. If safety information is not sufficiently shared between them, people and the environment can be harmed. The authors explored the literature on transparency in sharing health and safety information. The findings show that such transparency as a subject is abundant in the literature but the exchange of information is far from complete in practice. Health and safety information is shared both via internal flows within each stakeholder group and via external flows between them. All three main stakeholders in pursuit of true safety for their own reasons, building trust via sharing of health and safety information, require improvement in transparency and a safety information broker between them. This constitutes a smart transparency and information exchange framework. The authors recommend developing a transparency standard, to study cyber-socio-technical systems safety and to include currently underutilized experiential knowledge available from the general public in the societal discourse. The authors propose a societal domain extension to a holistic safety culture model in support of a learning safety community. Full article
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30 pages, 5706 KiB  
Article
Integrated Approach for Safety Culture Factor Evaluation from a Sustainability Perspective
by Małgorzata Jasiulewicz-Kaczmarek, Katarzyna Antosz, Ryszard Wyczółkowski and Małgorzata Sławińska
Int. J. Environ. Res. Public Health 2022, 19(19), 11869; https://doi.org/10.3390/ijerph191911869 - 20 Sep 2022
Cited by 1 | Viewed by 1756
Abstract
Traditionally, sustainable development has been seen as a combination of three pillars: economic, social and environmental development. In recent years, another one has been added to these three pillars, namely culture, as being indispensable in achieving sustainable development. This study proposes an integrated [...] Read more.
Traditionally, sustainable development has been seen as a combination of three pillars: economic, social and environmental development. In recent years, another one has been added to these three pillars, namely culture, as being indispensable in achieving sustainable development. This study proposes an integrated approach for the identification and classification of safety culture factors in the company in a sustainability context. The research design was based on the assumption that safety culture is part of organizational culture that should support the development of corporate sustainability. Firstly, the identification of the safety culture factors (SCFs) based on the literature review was presented. Then, the ISM method was used to identify the interaction between SCFs and to develop the hierarchical structure of these factors. In the next step, ISM was integrated with the MICMAC method to cluster the factors based on driving power and dependence power into four categories. Finally, safety culture factors with high driving power were rated using the fuzzy TOPSIS method from the sustainability dimension perspective. This approach was used in an automotive industry company to improve and develop the company’s practices aimed at implementing a sustainable development strategy. A sensitivity analysis was also carried out to monitor the robustness of the approach. Full article
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34 pages, 3795 KiB  
Article
A Model to Evaluate the Effectiveness of the Maritime Shipping Risk Mitigation System by Entropy-Based Capability Degradation Analysis
by Jun Shen, Xiaoxue Ma and Weiliang Qiao
Int. J. Environ. Res. Public Health 2022, 19(15), 9338; https://doi.org/10.3390/ijerph19159338 - 30 Jul 2022
Cited by 2 | Viewed by 1491
Abstract
Accurate evaluation of the risk mitigation status of navigating ships is essential for guaranteeing navigational safety. This research mainly focuses on the feasibility and accuracy of evaluating the real effectiveness of a risk mitigation system for navigating ships, including addressing the problem of [...] Read more.
Accurate evaluation of the risk mitigation status of navigating ships is essential for guaranteeing navigational safety. This research mainly focuses on the feasibility and accuracy of evaluating the real effectiveness of a risk mitigation system for navigating ships, including addressing the problem of immeasurableness for risk mitigation capability and determining the degradation regulation of risk mitigation capability over time. The proposed method to solve the problem is an effectiveness evaluation model based on the capability perspective, composed of a capability measurement algorithm based on entropy theory and capability degradation regulation analysis based on numerical process fitting. First, combined with the theoretical framework of a comprehensive defence system, the risk mitigation system designed for navigating ships is reconstructed based on capability building. Second, using a numerical fitting method, the degradation regulation of risk mitigation capability with time is obtained to improve the accuracy of the dynamic evaluation. Finally, referring to entropy theory, the uncertainty of capability is calculated, and then the model is constructed based on this uncertainty to realize the effectiveness evaluation from a capability perspective. The results obtained in an application test of the proposed model indicate that using the entropy of capability can realize an accurate effectiveness evaluation of a risk mitigation system for navigating ships, with a 9% improvement in accuracy, and the Weibull curve fitting is more consistent with capability degradation regulation, with a signification level of 2.5%. The proposed model provides a new path for evaluating the effectiveness of a risk mitigation system for navigating ships from the entropy of capability, and compared with the traditional probabilistic method, the model is more realistic and accurate in actual applications. Full article
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17 pages, 2806 KiB  
Article
Evaluation of Occupational Health and Safety Management of Listed Companies in China’s Energy Industry Based on the Combined Weight-Cloud Model: From the Perspective of FPE Information Disclosure
by Yujie Wang, Hong Chen, Ruyin Long, Shiyan Jiang and Bei Liu
Int. J. Environ. Res. Public Health 2022, 19(14), 8313; https://doi.org/10.3390/ijerph19148313 - 07 Jul 2022
Cited by 2 | Viewed by 1682
Abstract
Protecting labor safety and health and actively carrying out occupational safety and health management (OSHM) is a common need worldwide, and it is also one of the important efforts of Chinese enterprises under the background of promoting the implementation of the Healthy China [...] Read more.
Protecting labor safety and health and actively carrying out occupational safety and health management (OSHM) is a common need worldwide, and it is also one of the important efforts of Chinese enterprises under the background of promoting the implementation of the Healthy China strategy. Based on in-depth thinking on the current stage of OHSM, this study incorporated “management framework, management process, management effectiveness” (FPE) into an integrated framework and constructed an FPE evaluation system for enterprise OHSM. This study innovatively collected and refined FPE information from the perspective of information disclosure and used the combined weight cloud model to evaluate the occupational health and safety management level (OHSML) of 69 listed companies in China’s energy industry from 2009–2019. The results showed the following. (1) The OHSML of most listed companies in China’s energy industry was still at a low-end level. Among the companies that have issued relevant information reports, only 5.58% (S = 30) of the sample companies’ OHSML were at an acceptable level (Level IV) or declarable level (Level V). The OHSML comprehensive evaluation level of 92.56% (S = 498) of the sample companies was between the transitional level (Level III) and the improved level (Level II). (2) During 2009–2019, although the annual OHSML of listed companies in China’s energy industry showed an upward trend, the growth rate was low, and even the OHSML of some listed companies in the energy industry showed the characteristics of reduced fluctuations. (3) From the perspective of the PFT three-dimensional subsystem level of OHSM, the evaluation level of the governance framework subsystem was the highest, whereas the evaluation level of the management process subsystem and the management effectiveness subsystem were relatively low. Finally, according to the relevant results, some suggestions were proposed to improve the OHSML of listed companies in China’s energy industry. These findings can provide guidance for companies to improve their OSHM performance. Full article
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17 pages, 2272 KiB  
Article
Heat Strain Evaluation of Power Grid Outdoor Workers Based on a Human Bioheat Model
by Letian Li, Boyang Sun, Zhuqiang Hu, Jun Zhang, Song Gao, Haifeng Bian and Jiansong Wu
Int. J. Environ. Res. Public Health 2022, 19(13), 7843; https://doi.org/10.3390/ijerph19137843 - 26 Jun 2022
Cited by 1 | Viewed by 1659
Abstract
Power grid outdoor workers are usually exposed to hot environments and could suffer the threats to occupational health and safety like heat strain and injury. In order to predict and assess the thermophysiological responses of grid workers in the heat, the clothing thermal [...] Read more.
Power grid outdoor workers are usually exposed to hot environments and could suffer the threats to occupational health and safety like heat strain and injury. In order to predict and assess the thermophysiological responses of grid workers in the heat, the clothing thermal insulation of grid worker ensembles was measured by a thermal manikin and a multi-segment human bioheat model was employed to evaluate the thermophysiological response parameters of grid workers such as core temperature, skin temperature and sweat loss. The results show that working in a hot environment can cause a obvious increase in core temperature and skin temperature of grid workers, and the acceptable maximum working time of grid workers varies greatly in different hot environments. A reasonable work organization strategy can effectively decrease the core temperature and sweat loss, increasing the duration of acceptable maximum working time for grid workers. This study is helpful to assess heat-related risks of grid workers and support power grid companies to rationalize work organization strategies and personal protection guidelines. Full article
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Review

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35 pages, 8036 KiB  
Review
Barriers Involved in the Safety Management Systems: A Systematic Review of Literature
by Weiliang Qiao, Enze Huang, Hongtongyang Guo, Yang Liu and Xiaoxue Ma
Int. J. Environ. Res. Public Health 2022, 19(15), 9512; https://doi.org/10.3390/ijerph19159512 - 03 Aug 2022
Cited by 3 | Viewed by 3193
Abstract
Safety barriers are widely accepted in various industries as effective risk management tools to prevent hazardous events and mitigate the consequences caused by these events. Studies on safety barriers have been increasing in recent decades; therefore, the general idea of this article is [...] Read more.
Safety barriers are widely accepted in various industries as effective risk management tools to prevent hazardous events and mitigate the consequences caused by these events. Studies on safety barriers have been increasing in recent decades; therefore, the general idea of this article is to present a systematic review of the field. The purpose of this article is threefold: (1) to map various networks for the barrier-related articles collected from WoS; (2) to summarize the advances of the safety barrier at both the individual level and barrier management level on the basis of six issues, and (3) to propose the research perspectives associated with safety barriers considering the latest theories and methodologies in the field of safety management. Based on the findings and insights obtained from the literature collected by a bibliometric and systematic review, studies on barrier management within the complex socio-technical system are analyzed, and the framework of “risk-barrier capacity” is proposed for future development, in which the challenges stemming from industrial intelligence may be solved through resilience theory. Meanwhile, intelligent technologies are also able to serve as health status monitoring devices for various barrier elements. Full article
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Other

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45 pages, 1283 KiB  
Systematic Review
Occupation-Induced Fatigue and Impacts on Emergency First Responders: A Systematic Review
by Graham Marvin, Ben Schram, Robin Orr and Elisa F. D. Canetti
Int. J. Environ. Res. Public Health 2023, 20(22), 7055; https://doi.org/10.3390/ijerph20227055 - 12 Nov 2023
Cited by 1 | Viewed by 2628
Abstract
Fatigue in emergency first responders (EFRs) is known to affect performance abilities and safety outcomes for both patients and EFRs. The primary aim of this review was to determine the main contributors to occupation-induced fatigue in EFRs and its subsequent impacts. Following the [...] Read more.
Fatigue in emergency first responders (EFRs) is known to affect performance abilities and safety outcomes for both patients and EFRs. The primary aim of this review was to determine the main contributors to occupation-induced fatigue in EFRs and its subsequent impacts. Following the PRIMSA checklist, academic databases (Medline, Embase, CINAHL, and SPORTDiscus) were searched using key terms with results subjected to inclusion and exclusion criteria. Populations of interest were firefighters, paramedics, or emergency call centre personnel. Of the 5633 records identified, 43 studies, which reported on 186 unique measures from a total population of 6373 participants, informed the review. Synthesis revealed fatigue was caused by lack of sleep during the shift and consistent poor sleep quality which negatively impacted cognitive function, alertness, and physical and mental health while increasing safety-compromising behaviours and injuries. Both subjective and objective assessments of fatigue are necessary for effective risk management in EFRs. EFRs that are consistently fatigued are at a greater risk of poor physical and mental health, reduced cognitive function, and increased injuries. No studies reported on fatigue in emergency call centre personnel, highlighting a literature gap. Funding was provided by the Australian Capital Territory Emergency Services Agency. Preregistration was filed in OSF: osf.io/26f3s. Full article
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