Pub Date : 2024-08-03DOI: 10.1101/2024.08.02.24311400
Bethany Croak, Laura E Grover, Simon Wessely, Kalpa Kharicha, Danielle Lamb, Sharon A.M. Stevelink
The relative income hypothesis theorises that the earnings of an individual relative to others exert a greater influence on subjective wellbeing than absolute income. Understanding the relationship between relative income and mental health could contribute to employee wellbeing. This review narratively synthesised the defining features and measurement of relative income, and its impact on mental health among UK employees. Systematic searches of qualitative and quantitative research evidence identified 13 studies. A conceptualisation of relative income revealed that an income comparison is either researcher-defined using averages or self-assessed based on the perception of an individual. Having a lower income than the reference group was commonly associated with diminished wellbeing, though moderating factors (gender, income inequality and composition of reference group) are discussed. Implications for practice and policy are considered amidst the cost of living crisis in the UK and ongoing pay disputes in various sectors.
{"title":"Relative income and its relationship with mental health in UK employees: a conceptual and methodological review.","authors":"Bethany Croak, Laura E Grover, Simon Wessely, Kalpa Kharicha, Danielle Lamb, Sharon A.M. Stevelink","doi":"10.1101/2024.08.02.24311400","DOIUrl":"https://doi.org/10.1101/2024.08.02.24311400","url":null,"abstract":"The relative income hypothesis theorises that the earnings of an individual relative to others exert a greater influence on subjective wellbeing than absolute income. Understanding the relationship between relative income and mental health could contribute to employee wellbeing. This review narratively synthesised the defining features and measurement of relative income, and its impact on mental health among UK employees. Systematic searches of qualitative and quantitative research evidence identified 13 studies. A conceptualisation of relative income revealed that an income comparison is either researcher-defined using averages or self-assessed based on the perception of an individual. Having a lower income than the reference group was commonly associated with diminished wellbeing, though moderating factors (gender, income inequality and composition of reference group) are discussed. Implications for practice and policy are considered amidst the cost of living crisis in the UK and ongoing pay disputes in various sectors.","PeriodicalId":501555,"journal":{"name":"medRxiv - Occupational and Environmental Health","volume":"373 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141943630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-02DOI: 10.1101/2024.08.01.24311359
Myvizhi Esai Selvan, Pei-Fen Kuan, Xiaohua Yang, John Mascarenhas, Robert J Klein, Benjamin J Luft, Paolo Boffetta, Zeynep H Gümüş
BACKGROUND Clonal hematopoiesis of indeterminate potential (CHIP) is a condition when healthy individuals harbor clonal mutations in myeloid (M-CHIP) and/or lymphoid (L-CHIP) cells at variant allele fraction (VAF) ≥0.02. While CHIP is associated with an increased risk of hematologic malignancy and cardiovascular disease, its association with airborne carcinogens is largely unknown. OBJECTIVES Here, we studied M/L-CHIP in responders to the 9/11 terrorist attacks on the World Trade Center (WTC), who were exposed to a complex mix of airborne carcinogens. Then we explored the association of CHIP mutations with phenotypes such as age, ancestry, exposure, HLA zygosity, and other clinical, laboratory, mental and cognitive data. Finally, we compared CHIP prevalence in WTC responders to 293 unexposed controls. METHODS Using banked peripheral blood and ultra-deep whole-exome sequencing at 250X, we characterized CHIP mutations and their interaction with clinical, mental and cognitive characteristics, exposure, peripheral blood counts, and HLA zygosity in 350 WTC responders. We used Fisher′s exact test for categorical variables; Wilcoxon rank sum test for continuous variables; and logistic regression for multivariate analysis. RESULTS Among WTC participants, M-CHIP prevalence was 16.2% and L-CHIP 21.4%. M-CHIP prevalence increased with age (p=0.02), was elevated in previous-smokers (p=0.01), and associated with lower platelet counts (p=0.03). The most frequently occurring genes for M-CHIP were DNMT3A, TET2, PPM1D and for L-CHIP were EEF1A1, DDX11 and KMT2D. Notably, harboring a DDX11 mutation associated with a lower Montreal Cognitive Assessment score (p=6.57e-03). Overall, M/L-CHIP was more prevalent in WTC responders versus controls. DISCUSSION Study results will inform the development of personalized risk-adapted CHIP and cancer screening programs in individuals exposed to airborne carcinogens.
{"title":"Distinct characteristics of lymphoid and myeloid clonal hematopoiesis in Word Trade Center first responders","authors":"Myvizhi Esai Selvan, Pei-Fen Kuan, Xiaohua Yang, John Mascarenhas, Robert J Klein, Benjamin J Luft, Paolo Boffetta, Zeynep H Gümüş","doi":"10.1101/2024.08.01.24311359","DOIUrl":"https://doi.org/10.1101/2024.08.01.24311359","url":null,"abstract":"BACKGROUND\u0000Clonal hematopoiesis of indeterminate potential (CHIP) is a condition when healthy individuals harbor clonal mutations in myeloid (M-CHIP) and/or lymphoid (L-CHIP) cells at variant allele fraction (VAF) ≥0.02. While CHIP is associated with an increased risk of hematologic malignancy and cardiovascular disease, its association with airborne carcinogens is largely unknown. OBJECTIVES\u0000Here, we studied M/L-CHIP in responders to the 9/11 terrorist attacks on the World Trade Center (WTC), who were exposed to a complex mix of airborne carcinogens. Then we explored the association of CHIP mutations with phenotypes such as age, ancestry, exposure, HLA zygosity, and other clinical, laboratory, mental and cognitive data. Finally, we compared CHIP prevalence in WTC responders to 293 unexposed controls. METHODS\u0000Using banked peripheral blood and ultra-deep whole-exome sequencing at 250X, we characterized CHIP mutations and their interaction with clinical, mental and cognitive characteristics, exposure, peripheral blood counts, and HLA zygosity in 350 WTC responders. We used Fisher′s exact test for categorical variables; Wilcoxon rank sum test for continuous variables; and logistic regression for multivariate analysis. RESULTS\u0000Among WTC participants, M-CHIP prevalence was 16.2% and L-CHIP 21.4%. M-CHIP prevalence increased with age (p=0.02), was elevated in previous-smokers (p=0.01), and associated with lower platelet counts (p=0.03). The most frequently occurring genes for M-CHIP were DNMT3A, TET2, PPM1D and for L-CHIP were EEF1A1, DDX11 and KMT2D. Notably, harboring a DDX11 mutation associated with a lower Montreal Cognitive Assessment score (p=6.57e-03). Overall, M/L-CHIP was more prevalent in WTC responders versus controls. DISCUSSION\u0000Study results will inform the development of personalized risk-adapted CHIP and cancer screening programs in individuals exposed to airborne carcinogens.","PeriodicalId":501555,"journal":{"name":"medRxiv - Occupational and Environmental Health","volume":"80 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141883417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Despite tremendous efforts, including research, teaching, and extension, toward improving the safety of agricultural tractor drivers, the number of incidents related to agricultural tractor drivers has not declined. This evidence points out an urgent need to explore artificial intelligence (AI) solutions to improve the safety of tractor drivers. Methods: This paper uses 171 Fatality Assessment and Control Evaluation (FACE) reports related to tractor drivers and a new framework called Risk Evolution, Detection, Evaluation, and Control of Accidents (REDECA) to identify existing AI solutions and specific areas where AI solutions are missed and can be developed to reduce incidents and recovery time. Fatality reports of tractor drivers were categorized into six main categories, including run over, pinned by, fall, others (fire and crashes), roll over, and overturn. Each category was then subcategorized based on similarities of incident causes in the reports. Results: The application of the REDECA framework revealed potential AI solutions that could improve the safety of tractor drivers. In all categories, the REDECA framework lacks AI solutions for three elements, including the probability of reducing recovery time in R3, detecting changes between R2 and R3, and intervention to send workers to R2. Except for the run over category, all other categories were missing AI solutions for interventions to prevent entry to the R3 element of the REDECA. In addition, the fall, roll over, and overturn categories lacked AI intervention that minimized damage and recovery in R3. Conclusions: The outcome of this study shows an urgent need to develop AI solutions to improve tractor driver safety.
{"title":"Application of REDECA Framework to Improve Safety and Health of Agricultural Tractor Drivers","authors":"Negin Ashrafi, Kamiar Alaei, Greg Placencia, Maryam Pishgar","doi":"10.1101/2024.07.10.24310227","DOIUrl":"https://doi.org/10.1101/2024.07.10.24310227","url":null,"abstract":"Introduction: Despite tremendous efforts, including research, teaching, and extension, toward improving the safety of agricultural tractor drivers, the number of incidents related to agricultural tractor drivers has not declined. This evidence points out an urgent need to explore artificial intelligence (AI) solutions to improve the safety of tractor drivers. Methods: This paper uses 171 Fatality Assessment and Control Evaluation (FACE) reports related to tractor drivers and a new framework called Risk Evolution, Detection, Evaluation, and Control of Accidents (REDECA) to identify existing AI solutions and specific areas where AI solutions are missed and can be developed to reduce incidents and recovery time. Fatality reports of tractor drivers were categorized into six main categories, including run over, pinned by, fall, others (fire and crashes), roll over, and overturn. Each category was then subcategorized based on similarities of incident causes in the reports. Results: The application of the REDECA framework revealed potential AI solutions that could improve the safety of tractor drivers. In all categories, the REDECA framework lacks AI solutions for three elements, including the probability of reducing recovery time in R3, detecting changes between R2 and R3, and intervention to send workers to R2. Except for the run over category, all other categories were missing AI solutions for interventions to prevent entry to the R3 element of the REDECA. In addition, the fall, roll over, and overturn categories lacked AI intervention that minimized damage and recovery in R3. Conclusions: The outcome of this study shows an urgent need to develop AI solutions to improve tractor driver safety.","PeriodicalId":501555,"journal":{"name":"medRxiv - Occupational and Environmental Health","volume":"244 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141611104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-03DOI: 10.1101/2024.07.02.24309839
Josiah L Kephart, Usama Bilal, Nelson Gouveia, Olga Lucia Sarmiento, Emily Shingara, Karla Rangel Moreno, Maryia Bakhtsiyarava, Juan Pablo Rodriguez, Salvador Ayala, Gabriel Carrasco Escobar, Ana V Diez Roux
Background: Climate change is expected to greatly increase exposure to flooding, particularly in urban populations in low- and middle-income countries. We examined within-city social disparities in exposure to flooding in 276 Latin American cities and associated features of the neighborhood urban environment. Methods: We used a spatially granular dataset of historical flood events from 2000 to 2018 to describe neighborhood flooding within cities across eight Latin American countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Guatemala, Mexico, and Panama). We estimated the percentage of the population living in flooded neighborhoods, described social disparities in flooding based on neighborhood educational attainment, and compared the magnitude of disparities across and within cities. We used multilevel models to examine how city- and neighborhood-level factors are related to neighborhood flooding. Results: We examined 44,698 neighborhoods in 276 cities from eight countries with a total of 223 million residents and 117 distinct flood events from 2000-2018. One in four residents in neighborhoods in the lowest education quintile lived in neighborhoods with flooding, compared to one in 20 residents of the highest neighborhood education quintile. Greater neighborhood flooding was associated with lower neighborhood-level educational attainment and with neighborhoods that were coastal, less dense (population or intersection), further from the city center, greener, and had steeper slopes. There was no association between city-level educational attainment and flooding. Conclusion: There are large social disparities in neighborhood flooding within Latin American cities. Residents of areas with lower education attainment face substantially higher risks of flooding. Policymakers must prioritize flood adaptation and recovery efforts in neighborhoods with lower socioeconomic position.
{"title":"Social disparities in flood exposure and associations with the urban environment in 44,698 neighborhoods in 276 cities in eight Latin American countries","authors":"Josiah L Kephart, Usama Bilal, Nelson Gouveia, Olga Lucia Sarmiento, Emily Shingara, Karla Rangel Moreno, Maryia Bakhtsiyarava, Juan Pablo Rodriguez, Salvador Ayala, Gabriel Carrasco Escobar, Ana V Diez Roux","doi":"10.1101/2024.07.02.24309839","DOIUrl":"https://doi.org/10.1101/2024.07.02.24309839","url":null,"abstract":"Background: Climate change is expected to greatly increase exposure to flooding, particularly in urban populations in low- and middle-income countries. We examined within-city social disparities in exposure to flooding in 276 Latin American cities and associated features of the neighborhood urban environment.\u0000Methods: We used a spatially granular dataset of historical flood events from 2000 to 2018 to describe neighborhood flooding within cities across eight Latin American countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Guatemala, Mexico, and Panama). We estimated the percentage of the population living in flooded neighborhoods, described social disparities in flooding based on neighborhood educational attainment, and compared the magnitude of disparities across and within cities. We used multilevel models to examine how city- and neighborhood-level factors are related to neighborhood flooding. Results: We examined 44,698 neighborhoods in 276 cities from eight countries with a total of 223 million residents and 117 distinct flood events from 2000-2018. One in four residents in neighborhoods in the lowest education quintile lived in neighborhoods with flooding, compared to one in 20 residents of the highest neighborhood education quintile. Greater neighborhood flooding was associated with lower neighborhood-level educational attainment and with neighborhoods that were coastal, less dense (population or intersection), further from the city center, greener, and had steeper slopes. There was no association between city-level educational attainment and flooding.\u0000Conclusion: There are large social disparities in neighborhood flooding within Latin American cities. Residents of areas with lower education attainment face substantially higher risks of flooding. Policymakers must prioritize flood adaptation and recovery efforts in neighborhoods with lower socioeconomic position.","PeriodicalId":501555,"journal":{"name":"medRxiv - Occupational and Environmental Health","volume":"67 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141548436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-03DOI: 10.1101/2024.07.02.24309814
Kaya Grocott, Adelle Mansour, Rebecca Bentley, Kate E Mason
Exposure to environmental noise in residential areas has been associated with adverse mental health outcomes; however, the mechanisms of this relationship remain underexplored. This study investigates the contribution of reduced sleep quality to the negative association between perceived neighbourhood environmental noise exposure and poor mental health. We used the Household Income and Labour Dynamics in Australia (HILDA) survey and applied causal mediation methods to examine the role of sleep in the association between self-reported exposure to road traffic noise and plane, train and industry (PTI) noise and mental wellbeing at three time points between 2012 and 2021. Road traffic noise was associated with poorer mental health in 2012-13 and 2016-17, while no evidence of an association was observed in 2020-2021 (the period of COVID-related lockdowns in Australia). For the years where a significant association was observed, mediation analyses suggest that reduced sleep quality accounts for 21% (in 2012-13; 95% CI: 7-35%) and 33% (in 2016-17; 95% CI: 26-64%) of the total effect of perceived traffic noise on mental health. Perceived PTI noise was associated with poorer mental health in 2016-2017 and 2020-2021, with mediation through sleep observed in 2016-2017 (proportion mediated 20% (95% CI:3-38%)). Mediation by sleep quality was stronger among people reporting exposure to multiple noise sources than among people reporting exposure to a single noise source. As much as a third of the association between road traffic noise and poor mental wellbeing may be due to poorer sleep quality following exposure to unwanted noise.
{"title":"The mediating role of sleep in the association between environmental noise and mental health","authors":"Kaya Grocott, Adelle Mansour, Rebecca Bentley, Kate E Mason","doi":"10.1101/2024.07.02.24309814","DOIUrl":"https://doi.org/10.1101/2024.07.02.24309814","url":null,"abstract":"Exposure to environmental noise in residential areas has been associated with adverse mental health outcomes; however, the mechanisms of this relationship remain underexplored. This study investigates the contribution of reduced sleep quality to the negative association between perceived neighbourhood environmental noise exposure and poor mental health. We used the Household Income and Labour Dynamics in Australia (HILDA) survey and applied causal mediation methods to examine the role of sleep in the association between self-reported exposure to road traffic noise and plane, train and industry (PTI) noise and mental wellbeing at three time points between 2012 and 2021. Road traffic noise was associated with poorer mental health in 2012-13 and 2016-17, while no evidence of an association was observed in 2020-2021 (the period of COVID-related lockdowns in Australia). For the years where a significant association was observed, mediation analyses suggest that reduced sleep quality accounts for 21% (in 2012-13; 95% CI: 7-35%) and 33% (in 2016-17; 95% CI: 26-64%) of the total effect of perceived traffic noise on mental health. Perceived PTI noise was associated with poorer mental health in 2016-2017 and 2020-2021, with mediation through sleep observed in 2016-2017 (proportion mediated 20% (95% CI:3-38%)). Mediation by sleep quality was stronger among people reporting exposure to multiple noise sources than among people reporting exposure to a single noise source. As much as a third of the association between road traffic noise and poor mental wellbeing may be due to poorer sleep quality following exposure to unwanted noise.","PeriodicalId":501555,"journal":{"name":"medRxiv - Occupational and Environmental Health","volume":"2014 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141548435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-30DOI: 10.1101/2024.06.28.24309658
Anna Navin Young, Zelda Di Blasi, Sarah Foley, Eithne Hunt
Background High rates of poor employee mental health and wellbeing have spurred growing demands for initiatives that support wellbeing in the workplace. The promotion of positive mental health and wellbeing is an essential component of workplace wellbeing initiatives, focusing on enhancing positive aspects of work, workers’ capacities, and positive behaviors. As one of the fastest growing practices in personal and professional development, coaching is found to improve workers’ wellbeing and performance through reflection, awareness, and meaningful goal pursuit. As time-related challenges exacerbate workplace stressors and threaten wellbeing, specific time-focused coaching approaches are essential to the promotion of positive mental health and wellbeing in the workplace. Effectively addressing work-time challenges is especially critical for hybrid workers, who divide their work-time across multiple onsite and remote locations. Methods The current paper is a protocol for a pilot three-armed randomized controlled trial that aims to evaluate the effectiveness of a time awareness coaching (TAC) intervention to support hybrid workers’ wellbeing. Sixty hybrid working participants will be randomized to either the TAC intervention, reflective time tracking (active control), or a passive control group. Professional coaches will be recruited and trained to facilitate the TAC intervention. Pre-post intervention measures of chronic time pressure, perceived control of time, perceived stress, wellbeing, and self-efficacy will be evaluated and compared across intervention arms. Qualitative feedback from participants and coaches will be collected to assess the intervention’s acceptability and implementation. Discussion The results of the study will offer insights into intervention effectiveness as well as the feasibility of critical intervention elements such as recruitment, retention, and implementation. The findings will inform recommendations for the use of TAC in future research studies and workplace wellbeing initiatives.
{"title":"Does time awareness coaching support hybrid workers' wellbeing?: Protocol for a pilot randomized controlled trial","authors":"Anna Navin Young, Zelda Di Blasi, Sarah Foley, Eithne Hunt","doi":"10.1101/2024.06.28.24309658","DOIUrl":"https://doi.org/10.1101/2024.06.28.24309658","url":null,"abstract":"Background\u0000High rates of poor employee mental health and wellbeing have spurred growing demands for initiatives that support wellbeing in the workplace. The promotion of positive mental health and wellbeing is an essential component of workplace wellbeing initiatives, focusing on enhancing positive aspects of work, workers’ capacities, and positive behaviors. As one of the fastest growing practices in personal and professional development, coaching is found to improve workers’ wellbeing and performance through reflection, awareness, and meaningful goal pursuit. As time-related challenges exacerbate workplace stressors and threaten wellbeing, specific time-focused coaching approaches are essential to the promotion of positive mental health and wellbeing in the workplace. Effectively addressing work-time challenges is especially critical for hybrid workers, who divide their work-time across multiple onsite and remote locations.\u0000Methods\u0000The current paper is a protocol for a pilot three-armed randomized controlled trial that aims to evaluate the effectiveness of a time awareness coaching (TAC) intervention to support hybrid workers’ wellbeing. Sixty hybrid working participants will be randomized to either the TAC intervention, reflective time tracking (active control), or a passive control group. Professional coaches will be recruited and trained to facilitate the TAC intervention. Pre-post intervention measures of chronic time pressure, perceived control of time, perceived stress, wellbeing, and self-efficacy will be evaluated and compared across intervention arms. Qualitative feedback from participants and coaches will be collected to assess the intervention’s acceptability and implementation.\u0000Discussion\u0000The results of the study will offer insights into intervention effectiveness as well as the feasibility of critical intervention elements such as recruitment, retention, and implementation. The findings will inform recommendations for the use of TAC in future research studies and workplace wellbeing initiatives.","PeriodicalId":501555,"journal":{"name":"medRxiv - Occupational and Environmental Health","volume":"80 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141502769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-19DOI: 10.1101/2024.06.18.24309118
John J Fraser, Joshua Halfpap, Michael Rosenthal
Introduction: Musculoskeletal injuries (MSKI) are the most common clinical condition in the military that affect medical readiness. Evaluation of MSKI burden and the effects of these injuries on readiness in large deck Navy ships is warranted. Materials and Methods: A retrospective cohort study assessing population-level MSKI rates, limited duty (LIMDU), and long-term disability episode counts of all Sailors assigned to US Navy Aircraft Carriers (CVNs) and Amphibious Assault Ships (LHA/LHD) from November 2016 to February 2023 were extracted from the Musculoskeletal Naval Epidemiological Surveillance Tool. A negative binomial regression and general additive (gaussian) models evaluated the association of ship platform, deployment status, days underway, and sex on MSKI rates and the proportion of cases that resulted in LIMDU, returned-to-duty following LIMDU, or progressed to long-term disability. Results: Sailors attached to CVNs contributed a mean 17893.8±23280.6 person-months, with those attached to LHA/LHDs contributing an average 5981.8±8432.7 person-months. Aboard CVNs, MSKI occurred at a rate of 0.30±0.16/1000 person-months while deployed and 0.64±0.31/1000 person-months in homeport. Aboard LHA/LHDs, Sailors incurred MSKI at a rate of 0.59±0.58/1000 person-months while on deployment and 1.24±0.68/1000 person-months in homeport. Among Sailors aboard CVNs, LIMDU occurred in 7.95±7.75% of MSKI cases while deployed and 5.13±5.26% while in homeport. Aboard LHA/LHDs, 8.57±13.42% of MSKI cases were placed on LIMDU while deployed and 4.95±5.27% while in homeport. In the multivariable assessment of LIMDU, being deployed underway was a significant factor (B=3.62 p=.03, variance explained=3.86%). Sailors that were female and served aboard LHA/LHDs returned to full duty at a significantly greater frequency compared to their male counterparts and Sailors serving aboard CVNs. None of the independent variables evaluated were associated with long-term disability. Conclusion: The findings in the current study demonstrate the substantial burden of MSKI aboard large deck ships, both in homeport and while deployed. Inclusion of a PT aboard LHA/LHDs, like the CVN, may help to prevent and mitigate the effects of MSKI through early access to specialized care and integral injury prevention and performance optimization methods.
{"title":"Differences in neuromusculoskeletal injury and disability rates between US Navy aircraft carrier and amphibious assault ships.","authors":"John J Fraser, Joshua Halfpap, Michael Rosenthal","doi":"10.1101/2024.06.18.24309118","DOIUrl":"https://doi.org/10.1101/2024.06.18.24309118","url":null,"abstract":"<strong>Introduction:</strong> Musculoskeletal injuries (MSKI) are the most common clinical condition in the military that affect medical readiness. Evaluation of MSKI burden and the effects of these injuries on readiness in large deck Navy ships is warranted. <strong>Materials and Methods</strong>: A retrospective cohort study assessing population-level MSKI rates, limited duty (LIMDU), and long-term disability episode counts of all Sailors assigned to US Navy Aircraft Carriers (CVNs) and Amphibious Assault Ships (LHA/LHD) from November 2016 to February 2023 were extracted from the Musculoskeletal Naval Epidemiological Surveillance Tool. A negative binomial regression and general additive (gaussian) models evaluated the association of ship platform, deployment status, days underway, and sex on MSKI rates and the proportion of cases that resulted in LIMDU, returned-to-duty following LIMDU, or progressed to long-term disability. <strong>Results:</strong> Sailors attached to CVNs contributed a mean 17893.8±23280.6 person-months, with those attached to LHA/LHDs contributing an average 5981.8±8432.7 person-months. Aboard CVNs, MSKI occurred at a rate of 0.30±0.16/1000 person-months while deployed and 0.64±0.31/1000 person-months in homeport. Aboard LHA/LHDs, Sailors incurred MSKI at a rate of 0.59±0.58/1000 person-months while on deployment and 1.24±0.68/1000 person-months in homeport. Among Sailors aboard CVNs, LIMDU occurred in 7.95±7.75% of MSKI cases while deployed and 5.13±5.26% while in homeport. Aboard LHA/LHDs, 8.57±13.42% of MSKI cases were placed on LIMDU while deployed and 4.95±5.27% while in homeport. In the multivariable assessment of LIMDU, being deployed underway was a significant factor (B=3.62 p=.03, variance explained=3.86%). Sailors that were female and served aboard LHA/LHDs returned to full duty at a significantly greater frequency compared to their male counterparts and Sailors serving aboard CVNs. None of the independent variables evaluated were associated with long-term disability. <strong>Conclusion:</strong> The findings in the current study demonstrate the substantial burden of MSKI aboard large deck ships, both in homeport and while deployed. Inclusion of a PT aboard LHA/LHDs, like the CVN, may help to prevent and mitigate the effects of MSKI through early access to specialized care and integral injury prevention and performance optimization methods.","PeriodicalId":501555,"journal":{"name":"medRxiv - Occupational and Environmental Health","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141502768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-04DOI: 10.1101/2024.05.02.24306716
Émile Sylvestre, William J. Rhoads, Timothy R. Julian, Frederik Hammes
Quantitative polymerase chain reaction (qPCR) offers a rapid, automated, and potentially on-site method for quantifying L. pneumophila in building potable water systems, complementing and potentially replacing traditional culture-based techniques. However, the application of qPCR in assessing human health risks is complicated by its tendency to overestimate such risks due to the detection of genomic copies that do not correspond to viable, infectious bacteria. This study examines the relationship between L. pneumophila measurements obtained via qPCR and culture-based methods, aiming to understand and establish qPCR-to-culture concentration ratios needed to inform associated health risks. We developed a Poisson lognormal ratio model and a random-effects meta-analysis to analyze variations in qPCR-to-culture ratios within and across sites. Our findings indicate these ratios typically vary from 1:1 to 100:1, with ratios close to 1:1 predicted at all sites. Consequently, adopting a default 1:1 conversion factor appears necessary as a cautious approach to convert qPCR concentrations to culturable concentrations for use in models of associated health risks, for example, through quantitative microbial risk assessment (QMRA) frameworks. Where this approach may be too conservative, targeted sampling and the applications of viability-qPCR could improve the accuracy of qPCR-based QMRA. Standardizing qPCR and culture-based methods and reporting site-specific environmental factors that affect the culturability of L. pneumophila would improve the understanding of the relationship between the two methods. The ratio model introduced here shifts us beyond simple correlation analyses, facilitating investigations of temporal and spatial heterogeneities in the relationship. This analysis is a step forward in the integration of QMRA and molecular biology, as the framework demonstrated here for L. pneumphila is applicable to other pathogens monitored in the environment.
{"title":"Quantification of Legionella pneumophila in building potable water systems: a meta-analysis comparing qPCR and culture-based detection methods","authors":"Émile Sylvestre, William J. Rhoads, Timothy R. Julian, Frederik Hammes","doi":"10.1101/2024.05.02.24306716","DOIUrl":"https://doi.org/10.1101/2024.05.02.24306716","url":null,"abstract":"Quantitative polymerase chain reaction (qPCR) offers a rapid, automated, and potentially on-site method for quantifying <em>L. pneumophila</em> in building potable water systems, complementing and potentially replacing traditional culture-based techniques. However, the application of qPCR in assessing human health risks is complicated by its tendency to overestimate such risks due to the detection of genomic copies that do not correspond to viable, infectious bacteria. This study examines the relationship between <em>L. pneumophila</em> measurements obtained via qPCR and culture-based methods, aiming to understand and establish qPCR-to-culture concentration ratios needed to inform associated health risks. We developed a Poisson lognormal ratio model and a random-effects meta-analysis to analyze variations in qPCR-to-culture ratios within and across sites. Our findings indicate these ratios typically vary from 1:1 to 100:1, with ratios close to 1:1 predicted at all sites. Consequently, adopting a default 1:1 conversion factor appears necessary as a cautious approach to convert qPCR concentrations to culturable concentrations for use in models of associated health risks, for example, through quantitative microbial risk assessment (QMRA) frameworks. Where this approach may be too conservative, targeted sampling and the applications of viability-qPCR could improve the accuracy of qPCR-based QMRA. Standardizing qPCR and culture-based methods and reporting site-specific environmental factors that affect the culturability of <em>L. pneumophila</em> would improve the understanding of the relationship between the two methods. The ratio model introduced here shifts us beyond simple correlation analyses, facilitating investigations of temporal and spatial heterogeneities in the relationship. This analysis is a step forward in the integration of QMRA and molecular biology, as the framework demonstrated here for <em>L. pneumphila</em> is applicable to other pathogens monitored in the environment.","PeriodicalId":501555,"journal":{"name":"medRxiv - Occupational and Environmental Health","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140886005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-03DOI: 10.1101/2024.05.01.24306679
Habyeong Kang, Sung Kyun Park, Dong Hyun Kim, Yoon-Hyeong Choi
Despite various health effects of per- and polyfluoroalkyl substances (PFAS) exposure, the association between PFAS exposure and age-related macular degeneration (AMD) has not been investigated. We aimed to assess associations of PFAS exposure with AMD, using data from 1,722 U.S. adults aged 40 years or more participating in the National Health and Nutrition Examination Survey 2005–2008 with complete data on PFAS measurement, AMD diagnosis, and covariates. Serum concentrations of PFAS, including perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorohexane sulfonic acid (PFHxS), and perfluorooctane sulfonic acid (PFOS), were measured. An overall PFAS burden score was calculated using item response theory scoring. Individual PFAS concentration and overall PFAS burden score were categorized into low (reference), medium, and high groups. Diagnosis of AMD was based on retinal image examination. Any AMD was defined as the presence of early or late AMD. Survey-weighted logistic regression adjusted for potential confounders was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for presence of AMD according to PFAS exposure. Overall, 132 (6.5%) individuals were diagnosed as any AMD, including 115 (5.7%) individuals with early AMD. A significant dose-response association was observed between serum PFOS concentration and any AMD (p-trend=0.03), with a significant OR of 1.99 (95% CI: 1.05, 3.79) for the high group compared to the reference. Overall PFAS burden showed a non-monotonic association with any AMD, with a significant OR of 2.18 (95% CI: 1.18, 4.04) for the medium. Inverted U-shaped associations were observed by restricted cubic spline analyses. Also, early AMD showed similar patterns in PFOS and overall PFAS burden and additionally an inverted U-shape association in PFNA. Our findings suggest that exposure to PFAS estimated by serum PFOS and PFNA as well as overall PFAS burden might be a risk factor for AMD in middle-aged and older population.
{"title":"Exposure to per- and polyfluoroalkyl substances and age-related macular degeneration in U.S. middle-aged and older adults","authors":"Habyeong Kang, Sung Kyun Park, Dong Hyun Kim, Yoon-Hyeong Choi","doi":"10.1101/2024.05.01.24306679","DOIUrl":"https://doi.org/10.1101/2024.05.01.24306679","url":null,"abstract":"Despite various health effects of per- and polyfluoroalkyl substances (PFAS) exposure, the association between PFAS exposure and age-related macular degeneration (AMD) has not been investigated. We aimed to assess associations of PFAS exposure with AMD, using data from 1,722 U.S. adults aged 40 years or more participating in the National Health and Nutrition Examination Survey 2005–2008 with complete data on PFAS measurement, AMD diagnosis, and covariates. Serum concentrations of PFAS, including perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorohexane sulfonic acid (PFHxS), and perfluorooctane sulfonic acid (PFOS), were measured. An overall PFAS burden score was calculated using item response theory scoring. Individual PFAS concentration and overall PFAS burden score were categorized into low (reference), medium, and high groups. Diagnosis of AMD was based on retinal image examination. Any AMD was defined as the presence of early or late AMD. Survey-weighted logistic regression adjusted for potential confounders was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for presence of AMD according to PFAS exposure. Overall, 132 (6.5%) individuals were diagnosed as any AMD, including 115 (5.7%) individuals with early AMD. A significant dose-response association was observed between serum PFOS concentration and any AMD (<em>p</em>-trend=0.03), with a significant OR of 1.99 (95% CI: 1.05, 3.79) for the high group compared to the reference. Overall PFAS burden showed a non-monotonic association with any AMD, with a significant OR of 2.18 (95% CI: 1.18, 4.04) for the medium. Inverted U-shaped associations were observed by restricted cubic spline analyses. Also, early AMD showed similar patterns in PFOS and overall PFAS burden and additionally an inverted U-shape association in PFNA. Our findings suggest that exposure to PFAS estimated by serum PFOS and PFNA as well as overall PFAS burden might be a risk factor for AMD in middle-aged and older population.","PeriodicalId":501555,"journal":{"name":"medRxiv - Occupational and Environmental Health","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140886149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-30DOI: 10.1101/2024.04.27.24306487
Zhenqiu Liu, Igor Shuryak, David J Brenner, Robert L Ullrich
Contemporary radiation risk assessment predominantly depends on nonlinear parametric models, which typically include a baseline term, a dose-response term, and an effect modifier term. Despite their widespread application in estimating tumor risks, parametric models face a notable drawback: their rigid model structure can be overly restrictive, potentially introducing bias and inaccuracies into risk estimations.
{"title":"Novel Insights for Radiation Risk Assessment Unveiled by Deep Learning","authors":"Zhenqiu Liu, Igor Shuryak, David J Brenner, Robert L Ullrich","doi":"10.1101/2024.04.27.24306487","DOIUrl":"https://doi.org/10.1101/2024.04.27.24306487","url":null,"abstract":"Contemporary radiation risk assessment predominantly depends on nonlinear parametric models, which typically include a baseline term, a dose-response term, and an effect modifier term. Despite their widespread application in estimating tumor risks, parametric models face a notable drawback: their rigid model structure can be overly restrictive, potentially introducing bias and inaccuracies into risk estimations.","PeriodicalId":501555,"journal":{"name":"medRxiv - Occupational and Environmental Health","volume":"101 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140836578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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