American journal of industrial medicine最新文献

Introduction: Fall injuries are the second leading cause of traumatic injury and death for all US workers and are a leading injury concern for the Department of the Air Force (DAF). Bundled interventions can improve the likelihood of injury reduction, especially in large, heterogeneous working populations. In 2013, the DAF implemented the "Air Force Fall Prevention Focus," a bundled intervention of prevention efforts designed to reduce occupational fall injury events among DAF members. The purpose of this study is to describe the burden and risk factors associated with fall injuries and evaluate the effectiveness of the Fall Prevention Focus in reducing the burden of fall injuries.

Methods: The National Institute for Occupational Safety and Health (NIOSH) partnered with the US Air Force Safety Center (AFSEC) to examine the impact of the Fall Prevention Focus as a bundled intervention. Injury events included a narrative description of the injury event, demographics, work environment, job tasks, and other structured details. Descriptive statistics and pre-post longitudinal modeling were used to evaluate changes in fall injury rates.

Results: The Fall Prevention Focus Implementation (2013-2018) resulted in an annual 10.4% (95% confidence interval [CI]: 8.5%, 12.2%) reduction, and a 6-year cumulative 48.3% (95% CI: 41.4%, 54.3%) reduction in fall injury event rates by 2018.

Discussion: Safety in the DAF involves a comprehensive approach. Documenting the impact of the Fall Prevention Focus may help translate these findings to improve fall prevention efforts in other sectors of the military and high fall-risk industries in the private sector, such as construction.

Background: Essential workers across multiple industries faced a disproportionate burden of morbidity and mortality during the COVID-19 pandemic. The effects were especially severe for agricultural and food processing workers, many of whom are members of the structurally vulnerable Latine community. Under current U.S. federal laws, children under 12 years old can legally work in agriculture, one of the most hazardous U.S. industries. Many of these working youth are Latine and experience health and educational inequities.

Methods: Using a community-based participatory research approach and a qualitative design, we conducted semi-structured in-depth interviews in North Carolina in 2022, with service providers in health, education, and advocacy fields (n = 10) and Latine youth farmworkers aged 10-17 (n = 24). We used participatory qualitative analysis methods and a reflexive thematic analysis to understand and describe the work experiences of these youth during the first 2 years of the pandemic.

Results: Amidst precarious economic and school situations exacerbated by the COVID-19 pandemic, many youths described an increased need to work to support their families. While aware and sometimes fearful of the added occupational health risks of COVID-19, youth and their families felt they had few other options. Service providers and youth described minimal employer-provided safety protocols or equipment, yet some workers organized their own attempts at safety protocols. Youth narratives imply limited knowledge of basic workplace safety requirements.

Conclusions: Study findings emphasize the urgent need to address structural vulnerabilities shaping workplace policies and norms to protect Latine youth farmworkers to support their healthy development.

Introduction: Contemporary asbestos exposure occurs during construction, remediation, and maintenance involving asbestos-containing materials (ACM), as compared to the historical exposure scenarios of asbestos mining and milling. The Ontario Asbestos Workers Register (AWR) was established in 1986 to track asbestos exposure among construction workers. This study reports on the risk of asbestos-related diseases (ARD) among workers in the AWR.

Methods: AWR registrants were linked probabilistically with administrative health databases (1986-2019) to identify cases of ARD including both cancer and chronic respiratory disease. Follow-up began at AWR enrollment and continued prospectively. Incidence rates were compared to the general population using standardized incidence ratios (SIRs). Associations between ACM exposure and ARD were estimated among AWR registrants using Poisson regression.

Results: In total, 26,204 (81%) registrants were linked successfully. Common industries of employment were construction (62%), manufacturing (19%) and education (8%). Among men and women mesothelioma (M:SIR 6.83 [95% CI = 5.56-8.31]; W:SIR 19.2 [3.86-56.1]) and pulmonary fibrosis (M:SIR 14.1 [12.2-16.2]; W:SIR 9.25 [2.49-23.7]) rates were higher than the general population. Asbestosis risk was elevated among men (M:SIR 11.2 [9.59-13.1]). Workers with longer reported exposures (≥140 h) had increased rates of lung cancer (RR 1.34 [1.10-1.63]), mesothelioma (RR 2.83 [1.75-4.58]), asbestosis (RR 3.07 [2.12-4.43]), chronic obstructive pulmonary disease (RR 1.42 [1.29-1.57]), and pulmonary fibrosis (RR 1.88 [1.35-2.62]).

Conclusion: Exposure to asbestos in construction and building maintenance continues to contribute to ARD incidence. Despite a Canadian ban on asbestos in new products, exposures to existing ACM will persist from construction activities. The AWR offers an opportunity for ongoing surveillance of resulting ARD in Ontario.

Background: Workers in healthcare and other essential occupations had elevated risks for COVID-19 infection early in the pandemic. No survey of U.S. workers to date has comprehensively assessed the prevalence of both COVID-19 and Long COVID across industries and occupations (I&O) at a detailed level.

Methods: Behavioral Risk Factor Surveillance System data for 2022 from 39 states, Guam, and the U.S. Virgin Islands were used to estimate prevalence of self-reported history of COVID-19 and Long COVID, as well as the prevalence of Long COVID among those reporting prior COVID-19, by broad and detailed I&O. Adjusted prevalence ratios were used to compare outcome prevalence in each I&O to prevalence among all other workers combined.

Results: By broad I&O, workers in healthcare, protective services, and education had elevated prevalences of COVID-19. The prevalence of Long COVID was elevated in healthcare and protective service but not education workers. Detailed I&O with significantly elevated prevalences of COVID-19 but not Long COVID included Dairy Product Manufacturing industry workers and subsets of mining workers. Both COVID-19 and Long COVID were elevated among bartenders/drinking places and personal care and appearance workers. The prevalence of Long COVID was elevated among farmworkers who reported having had COVID-19.

Conclusions: Industries and occupations with elevated levels of COVID-19 or Long COVID in this study may warrant increased measures to prevent transmission of airborne respiratory viruses. Accommodations are a key component for supporting workers in all workplaces. This new information about the distribution of Long COVID by I&O suggests where employer understanding and implementation of tailored workplace supports and accommodations are most needed to support continued employment of affected workers.

Objective: This study aimed to evaluate the quality of completion among both drivers and medical examiners in filling out Commercial Driver's (CD) Medical Examination Report Forms.

Methods: This was a cross-sectional retrospective study of abstracted data from the year 2019. CD Medical Examination Report Forms, collected from a single nationally-based employer and initially reviewed by corporate medical directors, were evaluated by the study team for completeness of documentation provided by both drivers and medical examiners (MEs). Relevant findings included unanswered questions, inconsistency between responses, and lack of necessary elaboration for positive responses.

Results: Among 1603 examinations, MEs completed the Medical Examination Report Form incompletely or incorrectly in 30% of examinations (n = 484). Drivers inconsistently filled out their health history with elaborations 38.7% of the time. Most commonly, they failed to elaborate on positive health history responses in 28.7% of examinations, but other types of errors were noted as well.

Conclusions: A considerable proportion of drivers or examiners (n = 890, 55%) failed to adequately or correctly complete CD Medical Examination Report forms.

Purpose: Limited information is known about the burden of Long COVID by occupation and industry. This study compares the occurrence of self-reported new long-term symptoms lasting 4 weeks or longer among blood donors with and without prior SARS-CoV-2 infection by occupation and industry.

Methods: The American Red Cross invited blood donors 18 years and older who donated during May 4-December 31, 2021 to participate in online surveys. New long-term symptoms lasting 4 weeks or longer were assessed by self-reported occurrence of any of 35 symptoms since March 2020. SARS-CoV-2 infection status was determined by serological testing and self-report. We describe the prevalence of new long-term symptoms by SARS-CoV-2 infection status. We calculate the difference in reported new long-term symptoms by SARS-CoV-2 infection status within occupation and industry categories.

Results: Data were collected from 27,907 employed adults - 9763 were previously infected and 18,234 were never infected with SARS-CoV-2. New long-term symptoms were more prevalent among those previously infected compared to the never-infected respondents (45% vs 24%, p < 0.05). Among all respondents, new long-term symptoms by occupation ranged from 26% (installation, maintenance, and repair) to 41% (healthcare support) and by industry ranged from 26% (mining) to 55% (accommodation and food services). New long-term neurological and other symptoms were commonly reported by those previously infected with SARS-CoV-2.

Discussion: New long-term symptoms are more prevalent among certain occupation and industry groups, which likely reflects differential exposure to SARS-CoV-2. These findings highlight potential need for workplace accommodations in a variety of occupational settings to address new long-term symptoms.

Aim: The aim was to investigate mortality among Swedish seafarers compared to the general population, and differences in mortality between occupational categories and differences over time.

Methods: Longitudinal register-based cohort study of 85,169 Swedish seafarers registered in the Swedish Transport Agency's Seafarers' Registry (SR) 1985-2013. The cohort was matched with the Swedish Cause of Death Register. Standardized mortality ratios (SMRs) and 95% confidence intervals (CIs) were calculated stratified by gender, job category, start of sea service, and time registered in the SR. Seafarers were followed until 66 years of age. Mortality by diseases was analyzed for seafarers with at least 5 years of sea service and mortality due to external causes was analyzed for all seafarers.

Results: Total mortality was increased among men who started to work before 1985 (SMR: 1.27, 95% CI: 1.21-1.32) and borderline significantly increased among women (SMR: 1.14, 95% CI: 0.99-1.32). Mortality ratios due to lung cancer, accidents, suicides, and mental disorders including substance abuse, were increased among seafarers who started to work before 1985. Mortality risks were particularly increased among the crew. SMRs tended to decrease over time, but mortality due to accidents was still increased among the crew who started to work 1985 or later (SMR: 1.64, 95% CI: 1.02-2.63).

Conclusion: Swedish seafarers had an increased mortality compared to the general population in 1985-2013, particularly the crew. There is still an increased mortality in accidents among crew who started to work 1985 or later.

Background: To mitigate health risks associated with occupational heat stress, workers are advised to adhere to a work-rest regimen, and hydrate regularly. However, it remains unclear if beverage temperature influences whole-body heat exchange during work-rest cycles, and if responses differ in older workers who have a blunted heat loss capacity.

Methods: Ten young (mean [SD]: 22 [3] years) and 10 older (60 [4] years) males performed four 15-min bouts of moderate-intensity cycling at a fixed rate of metabolic heat production (200 W·m^-2), each interspersed by 15-min rest in dry heat (40°C, ~12% relative humidity). On separate days, participants consumed either ice-slurry (~0°C), standardized to provide a heat transfer capacity of 75 kJ·m^-2, or an identical mass of warm fluid (37.5°C) before the first and third exercise bouts. Evaporative and dry heat exchange (direct calorimetry) and metabolic heat production (indirect calorimetry) were measured continuously to determine cumulative heat storage (summation of heat loss and heat gain) over the entire protocol. Rectal temperature was also measured continuously.

Results: Relative to warm fluid, ice-slurry ingestion reduced cumulative heat storage in young (69 [181] vs. 216 [94] kJ) and older males (90 [104] vs. 254 [140] kJ, main effect: p < 0.01), but was unaffected by age (p = 0.49). However, rectal temperature was unaffected by beverage temperature in both groups (all p ≥ 0.15).

Conclusion: We show that cold fluid ingestion is an appropriate administrative control for both young and older males as it can mitigate increases in body heat content during moderate-intensity work-rest cycles in dry heat.