This study aims to identify the determinants of exhaustion of frontline and second-line healthcare workers (HCW) during the third wave of the COVID-19 pandemic. A case–control study was conducted based on an anonymously distributed questionnaire, which was completed by 1872 HCW. Exhaustion was assessed with a validated Romanian questionnaire. The Siegrist questionnaire was used to determine workload, reward and overcommitment. Frontline HCW reported significantly more frequent longer working hours (p = 0.0009) and a better perception of the management of the risk for infection (p = 0.0002) than second-line HCW. The effort and overcommitment scores were higher in frontline HCW (9.51 + 1.98 vs. 8.45 + 21, p < 0.001 and 16.34 ± 2.80 vs. 15.24 ± 2.94, p < 0.001, respectively) and the reward scores were lower (5.21 ± 1.522 vs. 5.99 ± 1.44, p < 0.001). In the fully adjusted regression model, age, imbalance between effort and reward, overcommitment and management of the risk of infection in the workplace were associated with the exhaustion score in each category of HCW. The number of working hours was correlated with exhaustion in frontline HCW and occupation in second-line HCW. There were more similarities than differences between frontline and second-line HCW. Even if frontline HCW had a higher risk of exhaustion, the risk was not negligible for all HCW.

Lead and its compounds are hazardous chemical agents; some lead compounds, are classified as carcinogens in humans. In Romania, the occupational exposure to inorganic lead and its compounds occurs in many sectors: production of lead, manufacture of batteries, manufacture of thermal ceramic products (terracotta), production of electric and electronic components, manufacture of articles of metal wire, production of dyes and additives for plastics, recovery of lead from waste batteries, waste collection and treatment of electrical and electronic equipment, etc. The binding occupational limit value for inorganic lead compounds established under the national regulations is 0.15 mg/m3 in the air (measured in relation to a reference period of eight hours, time-weighted average, TWA). The binding biological limit value is 70 μg Pb/100 ml blood. We have summarized lead occupational exposure data collected from the regional public health authorities in Romania, for the period 2011-2019. The concentrations of lead recorded in the workplaces air varied between “not detected” and 0.22 mg/m3. The lead concentrations in the blood had high values (over the alert value of 40 μg/100 ml blood) in several activities (production of lead, recovery-recycling of lead from waste batteries, manufacture of batteries, and manufacture of articles of metal wire) leading to the need of continuous surveillance of health status for the exposed workers.

Context. It has been decades since the circadian variation of the secretion of the thyroid stimulating hormone (TSH) was proven in humans. Even so, there are few studies on human beings that explored the relationship existing between night shift circadian rhythm deregulation and thyroid disorders. Methods. We have revised the occupational medicine files of all employees in a single speciality hospital to conduct an observational study on the prevalence of thyroid disorders in night shift compared to day shift workers. Age, gender, occupational history, body mass index and specialist diagnosed thyroid disorders were recorded. Numerical variables were compared with ANOVA test, and categorical ones with chi test (StatPlus for Mac version v6). Results. Obesity was slightly more prevalent in night shift workers, but not statistically significant. Instead, we found a significant increase in the prevalence of thyroid disorders in night shift workers (X= 7.424, p = 0.006). As this is a mere observational study, our results only contribute to the pool of data concerning the relationship between thyroid dysfunction and night shifts. Conclusions: These results should raise awareness, particularly among occupational physicians and endocrinologists, about the influence of sleep and circadian rhythm deregulation on the raising incidence of thyroid disorders.

In many large cohort studies, the night shift constitutes a risk factor for developing cardiovascular disease and diabetes in workers. Current screening tests for people working in night shift include fasting glycaemia and electrocardiography. In fact, there are few studies focused on the description of the electrocardiographic changes after the night shift. This article describes the protocol of the “ECG modifications induced by the disturbance of the circadian rhythm in night-shift workers (ECGNoct)” study, which was initiated by the National Institute for Infectious Diseases “Prof. Dr. Matei Balș”. Nurses represent the target population. The protocol includes a full medical and occupational history, lifestyle habits (smoking, alcohol, nutrition), anthropometric and blood pressure measurements, blood tests (fasting glycemia, total cholesterol, triglycerides and high density lipoprotein cholesterol) and electrocardiogram recording. For nurses working in (night) shifts, we will record the electrocardiogram before and soon after the night shift. A cross sectional study will analyze the incidence of the metabolic syndrome criteria, the cardio-metabolic diseases and the electrocardiographic modifications and will compare the results between the group of nurses working and the group of nurse who do not. Based on these results, a longitudinal study will test the hypothesis that night shift increases the risk for cardio-metabolic diseases and that the electrocardiographic modifications precede the clinical symptoms. The results of the study will provide data on the association of night shifts and other non-occupational risk factors with the cardio-metabolic diseases in this specific population of healthcare workers that potentially will integrate into the occupational medicine policies.