key: cord-0902611-5ih6vjgg authors: Goolsby, Craig; Lala, Vidya; Gebner, Riley; Dacuyan‐Faucher, Nicole; Charlton, Nathan; Schuler, Keke title: Emergency physician risk of occupational mortality: A scoping review date: 2021-10-04 journal: J Am Coll Emerg Physicians Open DOI: 10.1002/emp2.12554 sha: ac7eedf5d9ec7f98f8b55dd1d79799de9eea5513 doc_id: 902611 cord_uid: 5ih6vjgg BACKGROUND: Occupational hazards for emergency physicians are widely known, but the risk of work‐related mortality is not clear. The COVID‐19 pandemic generated new concerns about the risk of occupational mortality, particularly in the setting of inadequate personal protective equipment. The perception of increased risk generated ethical concerns regarding emergency physicians’ duty to treat and employers’ duty to protect their employees. We performed this scoping review to define prepandemic emergency physician occupational mortality. METHODS: We performed a scoping review of peer‐reviewed publications from PubMed, EMBASE, and Cochrane databases in September 2020. RESULTS: Of the 747 unique articles identified in the 3 databases, 1 article met inclusion criteria and was included in the final analysis. CONCLUSION: The baseline risk of occupational mortality for emergency physicians is not established in the scientific literature. Further study is needed to quantify risk, as this information would be useful to shape policy and ethical considerations. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. what breaches of an employer's duty to protect emergency physicians might justify a physician's refusal to work. 10 As the findings of this review show, we need further data to be able to answer questions like these. We conducted a scoping review of peer-reviewed scientific publications according to an established framework, and results are reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist. 9, 10 The study addressed the following research question: what was the pre-COVID-19 pandemic risk of occupational mortality for practicing emergency physicians? We performed searches on September 16, 2020, using the following our research team's concern about being able to classify accurately an emergency physician's suicide as wholly, partially, or not due to occupational exposure. Titles and abstracts were independently screened by 2 study team members, with a third study team member serving as a tiebreaker. Abstracts that met inclusion criteria underwent independent full-text review by 2 study team members with a third reviewer serving as a tiebreaker. The literature search yielded a total of 747 unique articles (Appendix 1, Figure 1 ). After abstract screening, 102 articles underwent full-text review ( Figure 1 ). One publication met criteria for inclusion in the final analysis. The single article included in the analysis discussed hospital-based shootings from 2000 to 2011. 4 The study showed that nearly one third of all hospital shootings occurred either inside or directly outside the ED. Shootings inside the ED accounted for 70% of all ED-related events, and shootings in the ED parking lot, ambulance ramp, or outside walkways Meta-Analyses (PRISMA) flow diagram accounted for 30%. Of those injured and killed inside the ED, 1 person (3%) was a physician. The article did not specify if the physician killed in the ED was an emergency physician. For the purposes of this analysis, we assumed this physician to be an emergency physician. This scoping review has several limitations. First, we included studies in scientific, peer-reviewed publications, and did not include informa- In this review, the baseline risk of occupational related mortality for emergency physicians could not be determined. Only 1 scientific article reported a physician occupational death due to work in the ED. None. Craig Goolsby MD, MEd https://orcid.org/0000-0001-9929-8764 The impact of occupational hazards and traumatic events among Belgian emergency physicians A study of occupational stress and depression among emergency physicians The occupational hazards of emergency physicians Hospital-based shootings in the United States Time to Put Negative Perceptions of Metal Detectors to Rest FAQs on Shortages of Surgical Masks and Gowns During the COVID-19 Pandemic. Centers for Disease Control and Prevention AAEM Position Statement on Protections for Emergency Medicine Physicians during COVID-19 Please Stop Calling Healthcare Workers 'Heroes'. It's Killing us. The Sydney Morning Herald Occupational Safety and Health Administration. Workers' Right to Refuse Dangerous Work. Occupational Safety and Health Administration Baby, I Can't Breathe': America's First ER Doctor To Die In The Heat Of COVID-19 Battle Physician deaths from corona virus (COVID-19) disease American College of Emergency Physicians. Code of Ethics for Emergency Physicians -Policy Statement. American College of Emergency Physicians Must i respond if my health is at risk? Pinette MG. U.S. acute care hospital shootings, 2012-2016: a content analysis study Violence in the emergency department: a national survey of emergency medicine residents and attending physicians The Urban emergency department: a potential increased occupational hazard for sharps-related injuries H1N1 hemagglutinin-inhibition seroprevalence in emergency department health care workers after the first wave of the 2009 influenza pandemic Emergency physician risk of occupational mortality: A scoping review OR emergency doctor*[tiab]) AND (physician*[tiab] OR doctor[tiab] OR doctors[tiab] OR provider*[tiab] OR residents[tiab] OR "healthcare personnel" OR "healthcare workers"[tiab] OR "health care personnel" OR "health care workers") AND ("Accidents, Occupational"[mh] OR "Occupational Injuries Embase (emergency-medicine OR emergency-department* OR emergencyroom OR emergency-physician* OR emergency-doctor*):ab,ti AND (physician* OR doctor OR doctors OR provider* OR residents OR healthcare-personnel OR healthcare-workers OR healthcare-personnel OR health-care-workers):ab,ti AND ("occupational accident"/exp OR "occupational exposure"/exp OR "disease transmission"/exp OR "workplace violence"/exp OR (workplacedeath* OR workplace-infection* OR workplace-violence OR homicide* OR occupational-hazard* OR occupational-accident* OR occupational-exposure* OR disease-transmission OR infectiontransmission OR Cochrane (emergency-medicine OR emergency-department* OR emergencyroom OR emergency-physician* OR emergency-doctor*).ab,ti. AND (physician* OR doctor OR doctors OR provider* OR residents OR healthcare-personnel OR healthcare-workers OR health-carepersonnel OR health-care-workers).ab,ti. AND (workplace-death* OR workplace-infection* OR workplace-violence OR homicide* OR occupational-hazard* OR occupational-accident* OR occupationalexposure* OR disease-transmission OR infection-transmission OR transmission-risk)