Pub Date : 2024-03-04DOI: 10.1101/2024.03.03.24303615
Zainab Zuzer Lal, Christopher A Martin, Mayuri Gogoi, Irtiza Qureshi, Luke Bryant, Padmasayee Papineni, Susie Lagrata, Laura B Nellums, Amani S Al-Oraibi, Jonathon Chaloner, Katherine Woolf, Manish Pareek
Background Increasing demands of COVID-19 on the healthcare system necessitated redeployment of HCWs outside their routine specialties. Previous studies, highlighting ethnic and occupational inequalities in redeployment, are limited by small cohorts with limited ethnic diversity. Aims To assess how ethnicity, migration status, and occupation are associated with HCWs redeployment experiences during COVID-19 in a nationwide ethnically diverse sample. Methods We conducted a cross-sectional analysis using data from the nationwide United Kingdom Research Study into Ethnicity And COVID-19 outcomes in Healthcare workers (UK-REACH) cohort study. We used logistic regression to examine associations of ethnicity, migration status, and occupation with redeployment experiences of HCWs, including provision of training and supervision, patient contact during redeployment and interaction with COVID-19 patients. Results Of the 10,889 HCWs included, 20.4% reported being redeployed during the first UK national lockdown in March 2020. Those in nursing roles (Odds Ratio (OR) 1.22, 95% Confidence Interval (CI) 1.04 to 1.42, p=0.009) (compared to medical roles) had higher likelihood of being redeployed as did migrants compared to those born in the UK (OR 1.26, 95% CI 1.06 to 1.49, p=0.01) (in a subcohort of HCWs on the agenda for change (AfC) pay scales). Asian HCWs were less likely to report receiving training (OR 0.66, 95% CI 0.50 to 0.88, p=0.005) and Black HCWs (OR 2.02, 95% CI 1.14 to 3.57, p=0.02) were more likely to report receiving supervision, compared to White colleagues. Finally, redeployed Black (OR 1.33, 95% CI 1.07 to 1.66, p=0.009) and Asian HCWs (OR 1.30, 95% CI 1.14 to 1.48, p<0.001) were more likely to report face-to-face interaction with COVID-19 patients than White HCWs. Conclusions Our findings highlight disparities in HCWs redeployment experiences by ethnicity, migration, and job role which are potentially related to structural inequities in healthcare. For future emergencies, redeployment should be contingent upon risk assessments, accompanied by training and supervision tailored to individual HCWs experience and skillset.
{"title":"Redeployment Experiences of Healthcare Workers in the UK during COVID-19: data from the nationwide UK-REACH study","authors":"Zainab Zuzer Lal, Christopher A Martin, Mayuri Gogoi, Irtiza Qureshi, Luke Bryant, Padmasayee Papineni, Susie Lagrata, Laura B Nellums, Amani S Al-Oraibi, Jonathon Chaloner, Katherine Woolf, Manish Pareek","doi":"10.1101/2024.03.03.24303615","DOIUrl":"https://doi.org/10.1101/2024.03.03.24303615","url":null,"abstract":"Background\u0000Increasing demands of COVID-19 on the healthcare system necessitated redeployment of HCWs outside their routine specialties. Previous studies, highlighting ethnic and occupational inequalities in redeployment, are limited by small cohorts with limited ethnic diversity.\u0000Aims\u0000To assess how ethnicity, migration status, and occupation are associated with HCWs redeployment experiences during COVID-19 in a nationwide ethnically diverse sample.\u0000Methods\u0000We conducted a cross-sectional analysis using data from the nationwide United Kingdom Research Study into Ethnicity And COVID-19 outcomes in Healthcare workers (UK-REACH) cohort study. We used logistic regression to examine associations of ethnicity, migration status, and occupation with redeployment experiences of HCWs, including provision of training and supervision, patient contact during redeployment and interaction with COVID-19 patients.\u0000Results\u0000Of the 10,889 HCWs included, 20.4% reported being redeployed during the first UK national lockdown in March 2020. Those in nursing roles (Odds Ratio (OR) 1.22, 95% Confidence Interval (CI) 1.04 to 1.42, p=0.009) (compared to medical roles) had higher likelihood of being redeployed as did migrants compared to those born in the UK (OR 1.26, 95% CI 1.06 to 1.49, p=0.01) (in a subcohort of HCWs on the agenda for change (AfC) pay scales). Asian HCWs were less likely to report receiving training (OR 0.66, 95% CI 0.50 to 0.88, p=0.005) and Black HCWs (OR 2.02, 95% CI 1.14 to 3.57, p=0.02) were more likely to report receiving supervision, compared to White colleagues. Finally, redeployed Black (OR 1.33, 95% CI 1.07 to 1.66, p=0.009) and Asian HCWs (OR 1.30, 95% CI 1.14 to 1.48, p<0.001) were more likely to report face-to-face interaction with COVID-19 patients than White HCWs. Conclusions\u0000Our findings highlight disparities in HCWs redeployment experiences by ethnicity, migration, and job role which are potentially related to structural inequities in healthcare. For future emergencies, redeployment should be contingent upon risk assessments, accompanied by training and supervision tailored to individual HCWs experience and skillset.","PeriodicalId":501555,"journal":{"name":"medRxiv - Occupational and Environmental Health","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140037334","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 : 2024-03-04DOI: 10.1101/2024.02.27.24303347
Joseph Warwick, Sophie Cooper, Flaminia Ronca
Objectives: Law enforcement agencies require minimum fitness standards to safeguard their officers and training staff. Firearms instructors (FI) are expected to maintain the same standards as their operational counterparts. This study aimed to quantify the daily physiological demands placed on FI. Methods: 19 FI (45 ± 5 years) completed occupational tasks whilst wearing heart rate (HR) monitors for a minimum 10 days. VO2max testing was conducted on FI during a treadmill test (TT) and a multistage shuttle test (ST). Linear regression models were used to model the relationship between VO2 and HR throughout the TT. This model was applied to HR data from occupational tasks to infer oxygen consumption. Repeated Measures ANOVAs were used to compare time spent in VO2max equivalent zones throughout. Results: The VO2max achieved during ST (45.1 ± 5.6 ml/kg/min) was significantly higher than TT (39 ± 3 ml/kg/min) (p = 0.014). Time to exhaustion was sooner on ST (06:26 min) compared to TT (13:16 min) (p < .001). FI spent ~85% of occupational time with an oxygen demand ≤20 ml/kg/min (p < .005). The most intense occupational tasks saw FI achieve a VO2max ≥30 ml/kg/min, but <40 ml/kg/min. Conclusion: Using ST to assess cardiorespiratory fitness resulted in a quicker time to exhaustion and a higher VO2max. Predominantly, FI occupational tasks are low intensity with sporadic exposures requiring a VO2max of >40 ml/kg/min. To safeguard FI from occupational-related cardiorespiratory or long-term health issues, it is intuitive to suggest fitness standards should exceed a VO2max of 40 ml/kg/min.
{"title":"Cardiorespiratory demands of firearms training instruction and 15m shuttle tests in law enforcement.","authors":"Joseph Warwick, Sophie Cooper, Flaminia Ronca","doi":"10.1101/2024.02.27.24303347","DOIUrl":"https://doi.org/10.1101/2024.02.27.24303347","url":null,"abstract":"Objectives: Law enforcement agencies require minimum fitness standards to safeguard their officers and training staff. Firearms instructors (FI) are expected to maintain the same standards as their operational counterparts. This study aimed to quantify the daily physiological demands placed on FI. Methods: 19 FI (45 ± 5 years) completed occupational tasks whilst wearing heart rate (HR) monitors for a minimum 10 days. VO2max testing was conducted on FI during a treadmill test (TT) and a multistage shuttle test (ST). Linear regression models were used to model the relationship between VO2 and HR throughout the TT. This model was applied to HR data from occupational tasks to infer oxygen consumption. Repeated Measures ANOVAs were used to compare time spent in VO2max equivalent zones throughout. Results: The VO2max achieved during ST (45.1 ± 5.6 ml/kg/min) was significantly higher than TT (39 ± 3 ml/kg/min) (p = 0.014). Time to exhaustion was sooner on ST (06:26 min) compared to TT (13:16 min) (p < .001). FI spent ~85% of occupational time with an oxygen demand ≤20 ml/kg/min (p < .005). The most intense occupational tasks saw FI achieve a VO2max ≥30 ml/kg/min, but <40 ml/kg/min. Conclusion: Using ST to assess cardiorespiratory fitness resulted in a quicker time to exhaustion and a higher VO2max. Predominantly, FI occupational tasks are low intensity with sporadic exposures requiring a VO2max of >40 ml/kg/min. To safeguard FI from occupational-related cardiorespiratory or long-term health issues, it is intuitive to suggest fitness standards should exceed a VO2max of 40 ml/kg/min.","PeriodicalId":501555,"journal":{"name":"medRxiv - Occupational and Environmental Health","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140025090","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 : 2024-02-23DOI: 10.1101/2024.02.22.24303198
Mei Huang, Hongxiao Li, Jiahui Chen, Liuqiang Li, Yifei Zhan, Yuxuan Du, Bian Jun, Meiling Chen, Dehui Lai
Background: Lead is a toxic metal for human health, but its carcinogenicity is controversial, and the effect on bladder cancer is still unknown. The object of this study was to demonstrate the link between blood lead and bladder cancer. Objectives: We investigated associations of lead exposures with bladder cancer. Methods: We used the database from the National Health and Nutrition Examination Survey (NHANES, 1999-2018) to perform a cross-sectional study. We performed Weighted multivariate logistic regression to examine the association between blood lead level with bladder cancer, and then a subgroup analysis was performed. The nonlinear association between BLL and bladder cancer was described using fitted smoothing curves. Results: A total of 40,486 participants were included in this study, the mean (SD) BMI was 28.71 ± 6.68 kg/m2. A fully adjusted model showed that BLL was parallel associated with bladder cancer (Odds ratio [OR] = 2.946, 95% Confidence interval [CI] = 1.025 to 8.465, P = 0.047) in people with BMI < 28kg/m2. However, no difference was found in BMI≥28kg/m2 subgroup and in General population. In subgroup analysis of participants with BMI < 28kg/m2, blood lead was associated with bladder cancer in the male, non-hypertensive, < 70 year old subgroup (p < 0.05), but was not significantly different from the other subgroups. Additionally, we discovered a non-linear association between BLL and bladder cancer using a linear regression model. Discussion: In this cross-sectional study, we identified higher BLL level was independently associated with Bladder cancer in People with BMI<28kg/m2.The results compensated for earlier investigations, but more large-scale prospective cohorts were required for validation. Keywords: Blood lead level (BLL), Bladder cancer, NHANES (National Health and Nutrition Examination Survey)
{"title":"Blood lead levels and bladder cancer among US participants: NHANES 1999-2018","authors":"Mei Huang, Hongxiao Li, Jiahui Chen, Liuqiang Li, Yifei Zhan, Yuxuan Du, Bian Jun, Meiling Chen, Dehui Lai","doi":"10.1101/2024.02.22.24303198","DOIUrl":"https://doi.org/10.1101/2024.02.22.24303198","url":null,"abstract":"Background: Lead is a toxic metal for human health, but its carcinogenicity is controversial, and the effect on bladder cancer is still unknown. The object of this study was to demonstrate the link between blood lead and bladder cancer.\u0000Objectives: We investigated associations of lead exposures with bladder cancer.\u0000Methods: We used the database from the National Health and Nutrition Examination Survey (NHANES, 1999-2018) to perform a cross-sectional study. We performed Weighted multivariate logistic regression to examine the association between blood lead level with bladder cancer, and then a subgroup analysis was performed. The nonlinear association between BLL and bladder cancer was described using fitted smoothing curves.\u0000Results: A total of 40,486 participants were included in this study, the mean (SD) BMI was 28.71 ± 6.68 kg/m2. A fully adjusted model showed that BLL was parallel associated with bladder cancer (Odds ratio [OR] = 2.946, 95% Confidence interval [CI] = 1.025 to 8.465, P = 0.047) in people with BMI < 28kg/m2. However, no difference was found in BMI≥28kg/m2 subgroup and in General population. In subgroup analysis of participants with BMI < 28kg/m2, blood lead was associated with bladder cancer in the male, non-hypertensive, < 70 year old subgroup (p < 0.05), but was not significantly different from the other subgroups. Additionally, we discovered a non-linear association between BLL and bladder cancer using a linear regression model.\u0000Discussion: In this cross-sectional study, we identified higher BLL level was independently associated with Bladder cancer in People with BMI<28kg/m2.The results compensated for earlier investigations, but more large-scale prospective cohorts were required for validation. Keywords: Blood lead level (BLL), Bladder cancer, NHANES (National Health and Nutrition Examination Survey)","PeriodicalId":501555,"journal":{"name":"medRxiv - Occupational and Environmental Health","volume":"2013 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139945727","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: Accidental exposure to body fluids (AEBs) increases the risk of blood-borne infections among susceptible HCWs. While 90% of the AEB reported occur in developed nations, developing countries bear 90% of the burden of healthcare associated infections, especially those of sub-Saharan Africa. Social insecurity may contribute further to the vulnerability of HCWs. Our study sought to determine the prevalence, reporting and management of AEBs among HCWs in the security-challenged Region of South-West Cameroon. Methods: A cross-sectional study was carried out from February 2023 to April 2023, at the Buea Regional Hospital. Following informed consent, a 28-item interviewer-administered questionnaire to HCW was used. Data was entered and analyzed using R Statistics version 4.3.1. Results: Out of the 230 HCWs that were approached, 200 were responded for a participation rate of >85%. The prevalence of AEB was high (93%). Exposures occurred while administering injections (37%), during blood sample collection (16%), delivery (11%), surgery (10.2%) and washing. The main risk factors for AEB included female gender (aOR=2.86) and those exercising in the medical (aOR=5.95), pediatrics (aOR=10.5), obstetrical (aOR=22.6), dental (aOR=26.3) units. Only 46.8% of AEBs were reported. Post-exposure management was carried out for 67.2% of the reported cases. Most HCW were unaware of the existence of an Infection Control Committee within the study setting, corroborating gaps in the observance of Standard Precautions. Conclusions: Most HCWs experienced AEBs over the last year. There is a need to sensitize and enforce the observance of universal precautions among HCW of the Buea Regional Hospital. Such measures should be extended to other health facilities in related settings.
{"title":"Accidental Exposure to Body Fluids Among Healthcare Workers in a Referral Hospital in the Security-Challenged Region of South West Cameroon","authors":"Innocent Takougang, Fabrice Zobel Lekeumo Cheuyem, Blessing Asongu Changeh, Ngatie Denetria Nyonga, Hortense Mengong Moneboulou","doi":"10.1101/2024.02.20.24303093","DOIUrl":"https://doi.org/10.1101/2024.02.20.24303093","url":null,"abstract":"Introduction: Accidental exposure to body fluids (AEBs) increases the risk of blood-borne infections among susceptible HCWs. While 90% of the AEB reported occur in developed nations, developing countries bear 90% of the burden of healthcare associated infections, especially those of sub-Saharan Africa. Social insecurity may contribute further to the vulnerability of HCWs. Our study sought to determine the prevalence, reporting and management of AEBs among HCWs in the security-challenged Region of South-West Cameroon.\u0000Methods: A cross-sectional study was carried out from February 2023 to April 2023, at the Buea Regional Hospital. Following informed consent, a 28-item interviewer-administered questionnaire to HCW was used. Data was entered and analyzed using R Statistics version 4.3.1. Results: Out of the 230 HCWs that were approached, 200 were responded for a participation rate of >85%. The prevalence of AEB was high (93%). Exposures occurred while administering injections (37%), during blood sample collection (16%), delivery (11%), surgery (10.2%) and washing. The main risk factors for AEB included female gender (aOR=2.86) and those exercising in the medical (aOR=5.95), pediatrics (aOR=10.5), obstetrical (aOR=22.6), dental (aOR=26.3) units. Only 46.8% of AEBs were reported. Post-exposure management was carried out for 67.2% of the reported cases. Most HCW were unaware of the existence of an Infection Control Committee within the study setting, corroborating gaps in the observance of Standard Precautions.\u0000Conclusions: Most HCWs experienced AEBs over the last year. There is a need to sensitize and enforce the observance of universal precautions among HCW of the Buea Regional Hospital. Such measures should be extended to other health facilities in related settings.","PeriodicalId":501555,"journal":{"name":"medRxiv - Occupational and Environmental Health","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139918749","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 : 2024-02-14DOI: 10.1101/2024.02.13.24302645
Saira Prasanth, Nire Oloyede, Xuezhixing Zhang, Kai Chen, Daniel Carrión
Residential segregation shapes access to health-promoting resources and drives health inequities in the United States. Connecticut Section 8-30g incentivizes municipalities to develop a housing stock that is at least 10% affordable housing. We used this implicit target to project the impact of increasing affordable housing across all 169 Connecticut municipalities on all-cause mortality among low-income residents. We modeled six ambient environmental exposures: fine particulate matter (PM2.5), ozone (O3), nitrogen dioxide (NO2), summertime daily maximum heat index, greenness, and road traffic noise. We allocated new affordable housing to reach the 10% target in each town and simulated random movement of low-income households into new units using an inverse distance weighting penalty. We then quantified exposure changes and used established exposure-response functions to estimate deaths averted stratified by four ethnoracial groups: Asian, Hispanic or Latino, non-Hispanic Black, and non-Hispanic White. We quantified racialized segregation by computing a multi-group index of dissimilarity at baseline and post-simulation. Across 1,000 simulations, in one year (2019) we found on average 169 (95% CI: 84, 255) deaths averted from changes in greenness, 71 (95% CI: 49, 94) deaths averted from NO2, 9 (95% CI: 4, 14) deaths averted from noise, and marginal impacts from other exposures, with the highest rates of deaths averted observed among non-Hispanic Black and non-Hispanic White residents. Multi-group index of dissimilarity declined on average in all eight Connecticut counties post-simulation. Sensitivity analyses simulating a different population movement strategy and modeling a different year (2018) yielded consistent results. Strengthening desegregation policy may reduce deaths from environmental exposures among low-income residents. Further research should explore non-mortality impacts and additional mechanisms by which desegregation may advance health equity.
{"title":"Simulating desegregation through affordable housing development: an environmental health impact assessment of Connecticut zoning law","authors":"Saira Prasanth, Nire Oloyede, Xuezhixing Zhang, Kai Chen, Daniel Carrión","doi":"10.1101/2024.02.13.24302645","DOIUrl":"https://doi.org/10.1101/2024.02.13.24302645","url":null,"abstract":"Residential segregation shapes access to health-promoting resources and drives health inequities in the United States. Connecticut Section 8-30g incentivizes municipalities to develop a housing stock that is at least 10% affordable housing. We used this implicit target to project the impact of increasing affordable housing across all 169 Connecticut municipalities on all-cause mortality among low-income residents. We modeled six ambient environmental exposures: fine particulate matter (PM2.5), ozone (O3), nitrogen dioxide (NO2), summertime daily maximum heat index, greenness, and road traffic noise. We allocated new affordable housing to reach the 10% target in each town and simulated random movement of low-income households into new units using an inverse distance weighting penalty. We then quantified exposure changes and used established exposure-response functions to estimate deaths averted stratified by four ethnoracial groups: Asian, Hispanic or Latino, non-Hispanic Black, and non-Hispanic White. We quantified racialized segregation by computing a multi-group index of dissimilarity at baseline and post-simulation. Across 1,000 simulations, in one year (2019) we found on average 169 (95% CI: 84, 255) deaths averted from changes in greenness, 71 (95% CI: 49, 94) deaths averted from NO2, 9 (95% CI: 4, 14) deaths averted from noise, and marginal impacts from other exposures, with the highest rates of deaths averted observed among non-Hispanic Black and non-Hispanic White residents. Multi-group index of dissimilarity declined on average in all eight Connecticut counties post-simulation. Sensitivity analyses simulating a different population movement strategy and modeling a different year (2018) yielded consistent results. Strengthening desegregation policy may reduce deaths from environmental exposures among low-income residents. Further research should explore non-mortality impacts and additional mechanisms by which desegregation may advance health equity.","PeriodicalId":501555,"journal":{"name":"medRxiv - Occupational and Environmental Health","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139766100","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 : 2024-02-13DOI: 10.1101/2024.02.11.24302663
Carolina Guidolin, Ljiljana Udovicic, Kai Broszio, David Baeza Moyano, Sofia Melero-Tur, Guadalupe Cantarero-Garcia, Roberto Alonso Gonzalez-Lezcano, Sam Aerts, John Bolte, Hongli Joosten-Ma, Maria Nilsson Tengelin, Oliver Stefani, Altug Didikoglu, Johannes Zauner, Manuel Spitschan
Light profoundly impacts many aspects of human physiology and behaviour, including the synchronization of the circadian clock, the production of melatonin, and cognition. These effects of light, termed the non-visual effects of light, have been primarily investigated in laboratory settings, where light intensity, spectrum and timing can be carefully controlled to draw associations with physiological outcomes of interest. Recently, the increasing availability of wearable light loggers has opened the possibility of studying personal light exposure in free-living conditions where people engage in activities of daily living, yielding findings associating aspects of light exposure and health outcomes, supporting the importance of adequate light exposure at appropriate times for human health. However, comprehensive protocols capturing environmental (e.g., geographical location, season, climate, photoperiod) and individual factors (e.g., culture, personal habits, behaviour, commute type, profession) contributing to the measured light exposure are currently lacking. Here, we present a protocol that combines smartphone-based experience sampling (ESM implementing Karolinska Sleepiness Scale, KSS, ratings) and high-quality light exposure data collection at three body sites (near-corneal plane between the two eyes mounted on spectacle, neck-worn pendant/badge, and wrist-worn watch-like design) to capture daily factors related to individuals' light exposure. We will be implement the protocol in an international multi-centre study to investigate the environmental and socio-cultural factors influencing light exposure patterns in Germany, Netherlands, Spain, Sweden, and Turkey (minimum n=15, target n=30 per site, minimum n=75, target n=150 across all sites). With the resulting dataset, lifestyle and context-specific factors that contribute to healthy light exposure will be identified. This information is essential in designing effective public health interventions.
{"title":"Protocol for a prospective, multi-centric, cross-sectional cohort study to assess personal light exposure","authors":"Carolina Guidolin, Ljiljana Udovicic, Kai Broszio, David Baeza Moyano, Sofia Melero-Tur, Guadalupe Cantarero-Garcia, Roberto Alonso Gonzalez-Lezcano, Sam Aerts, John Bolte, Hongli Joosten-Ma, Maria Nilsson Tengelin, Oliver Stefani, Altug Didikoglu, Johannes Zauner, Manuel Spitschan","doi":"10.1101/2024.02.11.24302663","DOIUrl":"https://doi.org/10.1101/2024.02.11.24302663","url":null,"abstract":"Light profoundly impacts many aspects of human physiology and behaviour, including the synchronization of the circadian clock, the production of melatonin, and cognition. These effects of light, termed the non-visual effects of light, have been primarily investigated in laboratory settings, where light intensity, spectrum and timing can be carefully controlled to draw associations with physiological outcomes of interest. Recently, the increasing availability of wearable light loggers has opened the possibility of studying personal light exposure in free-living conditions where people engage in activities of daily living, yielding findings associating aspects of light exposure and health outcomes, supporting the importance of adequate light exposure at appropriate times for human health. However, comprehensive protocols capturing environmental (e.g., geographical location, season, climate, photoperiod) and individual factors (e.g., culture, personal habits, behaviour, commute type, profession) contributing to the measured light exposure are currently lacking. Here, we present a protocol that combines smartphone-based experience sampling (ESM implementing Karolinska Sleepiness Scale, KSS, ratings) and high-quality light exposure data collection at three body sites (near-corneal plane between the two eyes mounted on spectacle, neck-worn pendant/badge, and wrist-worn watch-like design) to capture daily factors related to individuals' light exposure. We will be implement the protocol in an international multi-centre study to investigate the environmental and socio-cultural factors influencing light exposure patterns in Germany, Netherlands, Spain, Sweden, and Turkey (minimum n=15, target n=30 per site, minimum n=75, target n=150 across all sites). With the resulting dataset, lifestyle and context-specific factors that contribute to healthy light exposure will be identified. This information is essential in designing effective public health interventions.","PeriodicalId":501555,"journal":{"name":"medRxiv - Occupational and Environmental Health","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139766458","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 : 2024-02-11DOI: 10.1101/2024.02.09.24302573
Anna M Biller, Nayab Fatima, Chrysanth Hamberger, Laura Hainke, Verena Plankl, Amna Nadeem, Achim Kramer, Martin Hecht, Manuel Spitschan
Introduction The interplay of daily life factors, including mood, physical activity, or light exposure, influences sleep architecture and quality. Laboratory-based studies often isolate these determinants to establish causality, thereby sacrificing ecological validity. Furthermore, little is known about time-of-year changes in sleep and circadian-related variables at high resolution, including the magnitude of individual change across time of year under real-world conditions. Objectives This study investigates the combined impact of sleep determinants on individuals' daily sleep episodes to elucidate which waking events modify sleep patterns. A second goal is to describe high-resolution individual sleep and circadian-related changes across the year to understand intra- and interindividual variability. Methods and analysis This study is a prospective cohort study with a measurement-burst design. Healthy adults aged 18-35 (N = 12) will be enrolled for 12 months. Participants will continuously wear actimeters and pendant-attached light loggers. A subgroup will also measure interstitial fluid glucose levels (n = 6). Every four weeks, all participants will undergo three consecutive measurement days of four ecological momentary assessments each day ("bursts") to sample sleep determinants during wake. Participants will also continuously wear temperature loggers (iButtons) during the bursts. Body weight will be captured before and after the bursts, and visual function will be tested in the laboratory. The bursts are separated by two at-home electroencephalogram (EEG) recordings each night. Circadian phase and amplitude will be determined during the bursts from hair follicles, and habitual melatonin onset will be derived through saliva sampling. Environmental parameters (bedroom temperature, humidity, and air pressure) will be recorded continuously. Ethics and dissemination The Ethics Committee of the Technical University of Munich approved this study (#2023-653-S-SB). We adhere to research standards including the Declaration of Helsinki and open science principles. Results will be made available as future peer-reviewed publications and contributions to conferences.
{"title":"The Ecology of Human Sleep (EcoSleep) Project: Protocol for a longitudinal cohort repeated-measurement-burst study to assess the relationship between sleep determinants and sleep outcomes under real-world conditions across time of year","authors":"Anna M Biller, Nayab Fatima, Chrysanth Hamberger, Laura Hainke, Verena Plankl, Amna Nadeem, Achim Kramer, Martin Hecht, Manuel Spitschan","doi":"10.1101/2024.02.09.24302573","DOIUrl":"https://doi.org/10.1101/2024.02.09.24302573","url":null,"abstract":"Introduction The interplay of daily life factors, including mood, physical activity, or light exposure, influences sleep architecture and quality. Laboratory-based studies often isolate these determinants to establish causality, thereby sacrificing ecological validity. Furthermore, little is known about time-of-year changes in sleep and circadian-related variables at high resolution, including the magnitude of individual change across time of year under real-world conditions.\u0000Objectives This study investigates the combined impact of sleep determinants on individuals' daily sleep episodes to elucidate which waking events modify sleep patterns. A second goal is to describe high-resolution individual sleep and circadian-related changes across the year to understand intra- and interindividual variability.\u0000Methods and analysis This study is a prospective cohort study with a measurement-burst design. Healthy adults aged 18-35 (N = 12) will be enrolled for 12 months. Participants will continuously wear actimeters and pendant-attached light loggers. A subgroup will also measure interstitial fluid glucose levels (n = 6). Every four weeks, all participants will undergo three consecutive measurement days of four ecological momentary assessments each day (\"bursts\") to sample sleep determinants during wake. Participants will also continuously wear temperature loggers (iButtons) during the bursts. Body weight will be captured before and after the bursts, and visual function will be tested in the laboratory. The bursts are separated by two at-home electroencephalogram (EEG) recordings each night. Circadian phase and amplitude will be determined during the bursts from hair follicles, and habitual melatonin onset will be derived through saliva sampling. Environmental parameters (bedroom temperature, humidity, and air pressure) will be recorded continuously. Ethics and dissemination The Ethics Committee of the Technical University of Munich approved this study (#2023-653-S-SB). We adhere to research standards including the Declaration of Helsinki and open science principles. Results will be made available as future peer-reviewed publications and contributions to conferences.","PeriodicalId":501555,"journal":{"name":"medRxiv - Occupational and Environmental Health","volume":"313 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139766102","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 : 2024-02-09DOI: 10.1101/2024.02.09.24302562
Jing Wen (Jenny) Liu, Natalie Ein, Rachel A Plouffe, Julia Gervasio, Kate St. Cyr, Anthony Nazarov, J. Don Richardson
Purpose. In a psychologically safe environment, individuals feel safe to share thoughts, acknowledge errors, experiment with new ideas, and exhibit mutual respect. However, there is little consensus on how psychological safety should be measured and the constructs that make up psychological safety. This meta-analysis and systematic review sought to evaluate the quality of measures used to assess psychological safety. Methodology. The meta-analysis and systematic review were conducted using Cochrane’s guidelines as a framework for data synthesis. A total of 217 studies were included in this review. Findings. Across 217 studies, the average internal consistency value ranged from Cronbach’s alpha of .77 to .81, with considerable heterogeneities across samples (I2 = 99.92, Q[221] = 259632.32, p < .001). Together, findings suggest that the quality of existing measures evaluating psychological safety may be acceptable. Originality. There is room for improvement with respect to examinations of factor structures within psychological safety, the degree of association between psychological safety and other constructs, and opportunities for exploring similarities and differences across populations and contexts.
{"title":"Meta-Analysis and Systematic Review of the Measures of Psychological Safety","authors":"Jing Wen (Jenny) Liu, Natalie Ein, Rachel A Plouffe, Julia Gervasio, Kate St. Cyr, Anthony Nazarov, J. Don Richardson","doi":"10.1101/2024.02.09.24302562","DOIUrl":"https://doi.org/10.1101/2024.02.09.24302562","url":null,"abstract":"Purpose. In a psychologically safe environment, individuals feel safe to share thoughts, acknowledge errors, experiment with new ideas, and exhibit mutual respect. However, there is little consensus on how psychological safety should be measured and the constructs that make up psychological safety. This meta-analysis and systematic review sought to evaluate the quality of measures used to assess psychological safety. Methodology. The meta-analysis and systematic review were conducted using Cochrane’s guidelines as a framework for data synthesis. A total of 217 studies were included in this review.\u0000Findings. Across 217 studies, the average internal consistency value ranged from Cronbach’s alpha of .77 to .81, with considerable heterogeneities across samples (I2 = 99.92, Q[221] = 259632.32, p < .001). Together, findings suggest that the quality of existing measures evaluating psychological safety may be acceptable. Originality. There is room for improvement with respect to examinations of factor structures within psychological safety, the degree of association between psychological safety and other constructs, and opportunities for exploring similarities and differences across populations and contexts.","PeriodicalId":501555,"journal":{"name":"medRxiv - Occupational and Environmental Health","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139766027","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 : 2024-01-30DOI: 10.1101/2024.01.30.24301985
James Scales, Hajar Hajmohammadi, Max Priestman, Luke C McIlvenna, Ingrid E de Boer, Haneen Hassan, Anja H Tremper, Gang Chen, Helen E Wood, David C Green, Klea Katsouyanni, Ian S Mudway, Christopher Griffiths
Background People living with asthma are disproportionately affected by air pollution, with increased symptoms, medication usage, hospital admissions and the risk of death. To date there has been a focus on exhaust emissions, but traffic-related air pollution (TRAP) can also arise from the mechanical abrasion of tyres, brakes, and road surfaces. Non-exhaust emissions (NEE) currently make up a greater proportion of TRAP by mass than exhaust emissions. With the increasing weight of vehicle fleets due to electrification, and increasing uptake of larger vehicles, it is likely that NEE will continue to be an increasing health challenge. These NEE remain unregulated and underexplored in terms of their health impacts, particularly in vulnerable groups such as people living with asthma. To date, few real-world studies have attempted to explore the impacts of non-exhaust emissions on human health. We therefore created a study with the aim of investigating the acute impacts of NEE on the lung function and airway immune status of asthmatic adults. Methods The IONA study will expose adults with asthma in random order at three locations in London selected to provide the greatest contrast in the NEE components within TRAP. Health responses will be assessed before and after each exposure, with lung function measured by spirometry as the primary outcome variable. Discussion Collectively this study will provide us with valuable information on the health effects of NEE components within ambient PM2.5 and PM10, whilst establishing a biological mechanism to help contextualise current epidemiological observations.
{"title":"Assessing the Impact of Non-exhaust Emissions on the Asthmatic Airway (IONA) Protocol for a randomised three exposure crossover study","authors":"James Scales, Hajar Hajmohammadi, Max Priestman, Luke C McIlvenna, Ingrid E de Boer, Haneen Hassan, Anja H Tremper, Gang Chen, Helen E Wood, David C Green, Klea Katsouyanni, Ian S Mudway, Christopher Griffiths","doi":"10.1101/2024.01.30.24301985","DOIUrl":"https://doi.org/10.1101/2024.01.30.24301985","url":null,"abstract":"Background\u0000People living with asthma are disproportionately affected by air pollution, with increased symptoms, medication usage, hospital admissions and the risk of death. To date there has been a focus on exhaust emissions, but traffic-related air pollution (TRAP) can also arise from the mechanical abrasion of tyres, brakes, and road surfaces. Non-exhaust emissions (NEE) currently make up a greater proportion of TRAP by mass than exhaust emissions. With the increasing weight of vehicle fleets due to electrification, and increasing uptake of larger vehicles, it is likely that NEE will continue to be an increasing health challenge. These NEE remain unregulated and underexplored in terms of their health impacts, particularly in vulnerable groups such as people living with asthma. To date, few real-world studies have attempted to explore the impacts of non-exhaust emissions on human health. We therefore created a study with the aim of investigating the acute impacts of NEE on the lung function and airway immune status of asthmatic adults. Methods\u0000The IONA study will expose adults with asthma in random order at three locations in London selected to provide the greatest contrast in the NEE components within TRAP. Health responses will be assessed before and after each exposure, with lung function measured by spirometry as the primary outcome variable. Discussion\u0000Collectively this study will provide us with valuable information on the health effects of NEE components within ambient PM2.5 and PM10, whilst establishing a biological mechanism to help contextualise current epidemiological observations.","PeriodicalId":501555,"journal":{"name":"medRxiv - Occupational and Environmental Health","volume":"65 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139649574","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 : 2024-01-29DOI: 10.1101/2024.01.27.24301873
Frank J Bove
Abstract Background Drinking water at U.S. Marine Corps Base Camp Lejeune, North Carolina was contaminated with trichloroethylene and other industrial solvents from 1953 to 1985. Methods A cohort cancer incidence study was conducted of Marines/Navy personnel who, between 1975 and 1985, began service and were stationed at Camp Lejeune, North Carolina (N=154,821) or Camp Pendleton, California (N=163,484), and civilian workers employed at Camp Lejeune (N=6,494) or Camp Pendleton (N=5,797) between October 1972 and December 1985. Camp Pendleton drinking water was not known to be contaminated between 1972 and 1985. Individual-level information on all primary invasive cancers and in-situ bladder cancer diagnosed from 1996 to 2017 was obtained from data linkages with 54 cancer registries in the U.S. Survival methods were used to calculate hazard ratios (HRs) comparing cancer incidence between the Camp Lejeune and Camp Pendleton cohorts. Precision of effect estimates were evaluated using the 95% confidence interval (CI) ratio. Results Cancers among Camp Lejeune Marines/Navy personnel and civilian workers totaled 12,083 (354/100,000) and 1,563 (1,301/100,000), respectively. Cancers among Camp Pendleton Marines/Navy personnel and civilian workers totaled 12,144 (335/100,000) and 1,416 (1,372/100,000), respectively. Compared to Camp Pendleton, Camp Lejeune Marines/Navy personnel had adjusted HRs ≥1.20 with 95% CI ratios (CIRs) ≤3 for acute myeloid leukemia (HR=1.38, 95% CI: 1.03, 1.85), all myeloid cancers including polycythemia vera (HR=1.24, 95% CI:1.03, 1.49), myelodysplastic and myeloproliferative syndromes (HR=1.68, 95% CI: 1.07, 2.62), polycythemia vera alone (HR=1.41, 95% CI: 0.94, 2.11), cancers of the esophagus (HR=1.27, 95% CI: 1.03, 1.56), larynx (HR=1.21, 95% CI: 0.98, 1.50), soft tissue (HR=1.21, 95% CI: 0.92, 1.59) and thyroid (HR=1.22, 95% CI: 1.03, 1.45). Compared to Camp Pendleton, Camp Lejeune civilian workers had adjusted HRs ≥1.20 with 95% CIRs ≤3 for all myeloid cancers including polycythemia vera (HR=1.40, 95% CI: 0.83, 2.36), squamous cell lung cancer (HR=1.63, 95% CI: 1.10, 2.41) and female ductal breast cancer (HR=1.32, 95% CI:1.02, 1.71). Sensitivity analyses indicated that confounding bias due to unmeasured risk factors (e.g., smoking and alcohol consumption) is unlikely to significantly impact the findings. Conclusion Increased risks of several cancers were observed among Marines/Navy personnel and civilian workers likely exposed to contaminated drinking water at Camp Lejeune compared to personnel at Camp Pendleton.
{"title":"Evaluation of cancer incidence among Marines and Navy personnel and civilian workers exposed to contaminated drinking water at USMC Base Camp Lejeune","authors":"Frank J Bove","doi":"10.1101/2024.01.27.24301873","DOIUrl":"https://doi.org/10.1101/2024.01.27.24301873","url":null,"abstract":"Abstract\u0000Background\u0000Drinking water at U.S. Marine Corps Base Camp Lejeune, North Carolina was contaminated with trichloroethylene and other industrial solvents from 1953 to 1985.\u0000Methods\u0000A cohort cancer incidence study was conducted of Marines/Navy personnel who, between 1975 and 1985, began service and were stationed at Camp Lejeune, North Carolina (N=154,821) or Camp Pendleton, California (N=163,484), and civilian workers employed at Camp Lejeune (N=6,494) or Camp Pendleton (N=5,797) between October 1972 and December 1985. Camp Pendleton drinking water was not known to be contaminated between 1972 and 1985. Individual-level information on all primary invasive cancers and in-situ bladder cancer diagnosed from 1996 to 2017 was obtained from data linkages with 54 cancer registries in the U.S. Survival methods were used to calculate hazard ratios (HRs) comparing cancer incidence between the Camp Lejeune and Camp Pendleton cohorts. Precision of effect estimates were evaluated using the 95% confidence interval (CI) ratio.\u0000Results\u0000Cancers among Camp Lejeune Marines/Navy personnel and civilian workers totaled 12,083 (354/100,000) and 1,563 (1,301/100,000), respectively. Cancers among Camp Pendleton Marines/Navy personnel and civilian workers totaled 12,144 (335/100,000) and 1,416 (1,372/100,000), respectively.\u0000Compared to Camp Pendleton, Camp Lejeune Marines/Navy personnel had adjusted HRs ≥1.20 with 95% CI ratios (CIRs) ≤3 for acute myeloid leukemia (HR=1.38, 95% CI: 1.03, 1.85), all myeloid cancers including polycythemia vera (HR=1.24, 95% CI:1.03, 1.49), myelodysplastic and myeloproliferative syndromes (HR=1.68, 95% CI: 1.07, 2.62), polycythemia vera alone (HR=1.41, 95% CI: 0.94, 2.11), cancers of the esophagus (HR=1.27, 95% CI: 1.03, 1.56), larynx (HR=1.21, 95% CI: 0.98, 1.50), soft tissue (HR=1.21, 95% CI: 0.92, 1.59) and thyroid (HR=1.22, 95% CI: 1.03, 1.45). Compared to Camp Pendleton, Camp Lejeune civilian workers had adjusted HRs ≥1.20 with 95% CIRs ≤3 for all myeloid cancers including polycythemia vera\u0000(HR=1.40, 95% CI: 0.83, 2.36), squamous cell lung cancer (HR=1.63, 95% CI: 1.10, 2.41) and female ductal breast cancer (HR=1.32, 95% CI:1.02, 1.71). Sensitivity analyses indicated that confounding bias due to unmeasured risk factors (e.g., smoking and alcohol consumption) is unlikely to significantly impact the findings.\u0000Conclusion\u0000Increased risks of several cancers were observed among Marines/Navy personnel and civilian workers likely exposed to contaminated drinking water at Camp Lejeune compared to personnel at Camp Pendleton.","PeriodicalId":501555,"journal":{"name":"medRxiv - Occupational and Environmental Health","volume":"188 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139583926","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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