Nicola Gartland

Background: Work-related stress (WRS) accounts for 52% of self-reported work-related ill-health. In 2004, the Health and Safety Executive (HSE) developed the Management Standards (MS), aimed at helping organisations reduce WRS. This work investigates WRS post implementation, with reference to six MS risk factor domains: control, support, relationships, demand, change, and role . Method: Cases of WRS were extracted from The Health and Occupation Research (THOR) database and mapped to the six domains. Trends in WRS incidence rates attributed to each of the domains were split at 2004 and compared with the overall WRS trend using mixed generalised regression models. Results: Before 2004, annual incidence in WRS increased by 1.4%(-0.5%,3.1%), whereas after 2004, there was a decrease of -0.9%(-1.5%,-0.2%), based on 10,815 WRS cases reported between 1996 and 2019. Three of the six MS domains ( demands, relationships, and change ) were reported in ∼82% of cases. Pre-2004, four of the six domains were observed to be increasing per year. Post 2004, cases increasingly contained multiple precipitating events e.g. demands + another (+2.6% per year ) and relationships + another (6 . 1%) . Reports of the two most common domains decreased post 2004 ( demands -0.46%, relationships -0.55% per year), whereas incidence in less common domains increased (change 1.1%, support 2.4%, control 4.8%, role 4.7%). Conclusion: Trends in WRS, and their common risk factors appear to be decreasing gradually, since introduction of MS in 2004. However, less common risk factors are becoming more prominent, contributing to reporting of WRS with multiple risk factors.

The COVID-19 pandemic had a significant impact on the operations and functionality of the public transport sector in the UK. This paper reflects on the experience of this sector through the pandemic period, and considers recommendations for any future mitigations required for either new COVID-19 waves or a different public health emergency. Semi-structured interviews were carried out with public transport experts, organisational leaders, workers and passengers in two phases: Phase 1 from January to May 2021, and Phase 2 from December 2021 to February 2022. Interviews were analysed thematically. Using the ‘What? So What? Now What?’ reflective model, ideas are drawn out to describe (a) what changes occurred, (b) what effects these changes had on service provision as well as perceptions of risk and mitigation and (c) what lessons have been learned and how these findings can feed into pandemic preparedness for the future. Respondent reflections focussed on the importance of communication, leadership, and maintaining compliance. The wealth of experience gained through the COVID-19 pandemic in the public transport sector is extremely valuable. Through reflection on this experience, specific recommendations are made relating to these factors, covering: maintaining links across industry, access to information and data, understanding of mitigation effectiveness, improving messaging, challenges of behavioural mitigations, and clear lines of accountability. The recommendations made on the basis of this reflective process will help to improve public health strategy within the public transport sector.

Background: Transmission of airborne viruses can be mitigated by wearing face coverings but evidence suggests that face covering declines with the removal of relevant legislation, partly due to low automatic motivation. Purpose: Test whether an intervention based on implementation intentions could support people’s automatic motivation and promote face covering during the COVID-19 pandemic. Methods: Randomized controlled design. At baseline (May 20 to June 6, 2022), 7,835 UK adults reported how much time they spent wearing face coverings in work, public transport, and indoor leisure settings as well as their capabilities, opportunities, and motivations. 3,871 participants were randomized to form implementation intentions; 3,964 control participants completed questionnaires only. Measures were repeated 6 months postbaseline (November 1 to November 14, 2022). Data were analyzed using mixed measures ANOVAs and Bayes Factors to examine whether the observed data supported the experimental hypothesis. Results: The proportion of time spend wearing face coverings declined substantially across the 6-month study period, from 15.28% to 9.87% in work settings, 38.31% to 24.55% on public transport, and 9.58% to 7.85% in leisure settings. Bayes Factors indicated moderate relative evidence of no effect of implementation intentions on behavior in work and leisure settings, and inconclusive evidence of a positive effect on public transport. Conclusions: In the context of declining COVID-19 rates and removal of legal mandates, implementation intentions were not effective in sustaining face covering. Further research is required to ensure that evidence-based interventions are prepared and deployed in the event of future pandemics.

Background UK local authorities that experience high sustained levels of COVID-19 prevalence are termed areas of enduring prevalence (AEP) according to SAGE (2021). A study was carried out as part of the PROTECT National Core Study on Transmission and Environment, to investigate reasons for sustained high prevalence, along with mitigation strategies employed by Directors of Public Health (DsPH). Methods Interviews were conducted with DsPH in 19 local authority areas across England, between July and October 2021. This included nine areas identified as AEP and ten comparison areas (CA), including statistical neighbours of the AEP (PHE, 2019) that had not experienced enduring prevalence. DsPH were asked about factors contributing to enduring prevalence, along with mitigating strategies employed during the pandemic. Results Participants identified various factors associated with enduring prevalence, including high deprivation levels, overcrowded housing, and low vaccination rates. Deprivation and employment were often jointly discussed as creating major barriers for people to be able to sef-isolate or work remotely. Not receiving sick pay, working on zero-hours contracts or in insecure employment were associated with inability to self-isolate. There were strong similarities in the drivers of enduring prevalence described by DsPH in the AEP and CA. All participants asserted that there were differences in these drivers between wards or geographical areas within their local authority area, and between different groups of people, including people from different and age groups and ethnic backgrounds. Participants in the AEP were more likely to discuss the impact of structural factors such as deprivation or work insecurity. All DsPH implemented a variety of effective mitigation strategies over the course of the pandemic, including local contact tracing, local testing and vaccination efforts, isolation support, communication campaigns, engagement with business and education, and community engagement. Conclusion The research shows that deprivation, employment and housing, along with vaccination rates, are key drivers of COVID-19 prevalence. Work related factors such as insecurity and absence of sick pay may influence behaviours and increase the risk of virus transmission. DsPH advised that more research is needed on the factors that drive prevalence, on the effectiveness of mitigation strategies, and on the long-term impacts of the pandemic, including the impact on health inequalities and on the wider system for recovery.

Age-standardized mortality rates for taxi drivers, chauffeurs, bus and coach drivers show that public transport workers were at high risk at the beginning of the COVID-19 pandemic. Nevertheless, the public transport sector was required to continue services throughout the pandemic. This paper aims to develop a better understanding of the experiences of organizational leaders and workers within the UK public transport sector (bus, rail, and tram). Specifically, it aims to explore the perceived balance of risk and mitigation of SARS-CoV-2 transmission, report on their perceptions of safety in public transport during the pandemic and in the future, and consider how these perceptions and changes impact on long-term worker health and wellbeing. This study formed part of a larger stakeholder engagement with the public transport sector. Organizational leaders and workers were recruited (n = 18) and semi-structured interviews carried out between January and May 2021. Data were analysed thematically. Overarching and subthemes were identified. Themes relating to perceptions and impacts of risk of COVID-19 for employees included: acceptability of risk for workers, perceptions of risk mitigation effectiveness, changes to working practices and their impact on morale and wellbeing, issues with compliance to mitigations such as social distancing and face coverings in passenger and co-worker groups alongside a lack of power to challenge behaviour effectively, and the roles of leadership and messaging. Themes related to long-lasting impacts of COVID-19 on working practices and effects on health and wellbeing included: continuing mitigations, impact of increasing passenger numbers, impact of vaccination programme, and impact of changes to business structure. Most public transport employees reported feeling safe, related to the extent to which their role was public-facing. However, data were collected during a time of very low passenger numbers. Current mitigation measures were thought effective in reducing the risk of viral transmission, although measures may have a detrimental effect on worker morale and wellbeing. Issues relating to non-compliance with guidance and ‘in-group’ behaviour were identified. Impacts on wider business sustainability and individual wellbeing of staff should be considered when developing responses to any future pandemics. Recommendations are made for prioritizing employee engagement with colleagues, and the importance of strong leadership and clear messaging in promoting adherence to behavioural mitigations.

This review summarises the extant literature investigating the relation between traffic-related air pollution levels in and around schools and executive functioning in primary-school-aged children. An electronic search was conducted using Web of Science, Scopus, and Education Literature Datasets databases (February 2020). Review articles were also searched, and forwards and backwards searches of identified studies were performed. Included papers were assessed for quality. We included 9 separate studies (published in 13 papers). Findings suggest that indoor and outdoor particulate matter with a diameter of 2.5 μm or less (PM_2.5) negatively influences executive function and academic achievement and that indoor and outdoor nitrogen dioxide (NO₂) adversely affects working memory. Evidence for the effects of particulate matter with a diameter of 10 μm or less (PM₁₀) is limited but suggests potential wide-ranging negative effects on attention, reasoning, and academic test scores. Air pollution in and around schools influences executive function and appears to impede the developmental trajectory of working memory. Further research is required to establish the extent of these effects, reproducibility, consequences for future attainment, and place within the wider context of cognitive development.

Purpose Although a cancer diagnosis is linked with decrements to quality of life (QoL), it is unknown exactly when QoL starts to deteriorate, and whether this occurs during the pre-diagnostic pathway. This study aimed to examine QoL during this phase, and in addition investigate whether QoL levels influence decisions about seeking professional help. This is important, because early diagnosis is linked to lower cancer mortality rates. Methods Working alongside a Cancer Research UK Roadshow in socially deprived communities, the recent QoL of adult visitors was assessed, before attending primary care. Using a cross-sectional design, we compared QoL in those presenting a potential cancer symptom/sign, with others seeking lifestyle advice to reduce cancer risk. Self-reported QoL (WHOQOL-BREF), and intention to seek help, were measured. Results Of 107 recruited, 50% were men. The potential cancer symptom group reported significantly poorer general QoL and psychological QoL, than lifestyle controls. Prior poorer physical QoL predicted stronger intentions to consult a general practitioner (GP) in the next 2 weeks, when controlling for symptom presence. Conclusions QoL is poorer for those with potential cancer symptoms, before they first seek advice from primary care. Poorer physical QoL is associated with stronger intentions to make a GP appointment. An implication for longer term health is that if public awareness about the impact of symptoms on QoL was raised, this could provide an impetus to seek help.