American journal of industrial medicine最新文献_第10页

Alternative Formulations of Job Strain and Sleep Disturbances: A Longitudinal Study in the United States 工作压力和睡眠障碍的不同表述：美国的一项纵向研究。

IF 2.7 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine

Pub Date : 2025-01-08 DOI: 10.1002/ajim.23686

Yijia Sun, Megan Guardiano, Mayumi Saiki, Jian Li

Background

Sleep disturbances are a major public health concern in the United States, leading to adverse health outcomes. In the working population, job strain has been identified as an important risk factor for sleep disturbances, but evidence from the United States remained limited. This study aimed to examine longitudinal associations between job strain and sleep disturbances in the United States, with a focus on the alternative formulations of job strain.

Methods

A total of 1721 participants were drawn from two waves of the Midlife in the United States (MIDUS) study, with an average 9-year follow-up period. Job strain was measured using Karasek's Job-Demand-Control model and operationalized in six formulations: standard quadrant, simplified quadrant, linear, quotient, logarithm quotient, and quartile based on quotient. Generalized Estimating Equations were used to estimate longitudinal associations of alternative formulations of job strain at baseline with sleep disturbances across follow-up. Corrected Quasi-likelihood Information Criterion (QICu) was used to assess the goodness of fit.

Results

All approaches showed that higher job strain at baseline was significantly associated with an increase in sleep disturbances across follow-up. QICu scores indicated that continuous Demand-Control formulations (linear, quotient, logarithm quotient) had better model performance of 4602.66, 4604.28, and 4601.99, respectively. The logarithm quotient showed the best fit.

Conclusions

Our findings imply the importance of early workplace interventions in reducing job strain to improve sleep hygiene. They further show that the continuous formulations quantifying job strain were more consistent and robust, which provides suggestions for future workplace health research in the United States.

背景：睡眠障碍是美国一个主要的公共卫生问题，可导致不良的健康结果。在工作人群中，工作压力已被确定为睡眠障碍的一个重要风险因素，但来自美国的证据仍然有限。本研究旨在考察美国工作压力和睡眠障碍之间的纵向联系，重点关注工作压力的替代公式。方法：共有1721名参与者从美国中年（MIDUS）研究的两波中抽取，平均随访期为9年。工作压力测量采用Karasek的工作需求-控制模型，并采用标准象限、简化象限、线性、商、对数商和基于商的四分位数六个公式进行操作。使用广义估计方程来估计基线时工作压力的不同表述与随访期间睡眠障碍的纵向关联。采用校正准似然信息准则（QICu）评价拟合优度。结果：所有方法均表明，基线时较高的工作压力与随访期间睡眠障碍的增加显著相关。QICu得分表明，连续需求控制公式（线性、商、对数商）的模型性能较好，分别为4602.66、4604.28和4601.99。对数商的拟合效果最好。结论：我们的研究结果暗示了早期工作场所干预在减少工作压力以改善睡眠卫生方面的重要性。他们进一步表明，量化工作压力的连续公式更加一致和稳健，这为美国未来的工作场所健康研究提供了建议。

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引用次数: 0

Enhancing Construction Safety Through Workplace Surveillance and Systematic Follow-Ups 透过监察工作场所及系统跟进，加强建筑安全

IF 2.7 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine

Pub Date : 2025-01-06 DOI: 10.1002/ajim.23703

Gollapalli Muralidhar, A. Vinoth, Upasana Uniyal, Krishna Nirmalya Sen

Background

Globally, construction jobs are associated with serious occupational safety and health (OSH) risks. In large construction projects, managing OSH risks is challenging due to a multitude of factors, and it is important to have sound management strategies and innovative solutions to tackle these ever-evolving OSH risks. Safety surveillance plays a pivotal role in accident prevention in the construction industry. We evaluated the effectiveness of ongoing surveillance coupled with proactive management follow-up in a cross-section of 26 large construction workplaces.

Methods

Trained safety observers were deployed using a digital platform to record and report risk conditions, along with the details such as category, potential risk, responsible persons, and so forth. At the same time a predictive tool to calculate the possibility of severe adverse outcomes such as “Lost Time Incident” (LTI) or fatality was introduced. The outcomes were followed up and reviewed by the leadership teams on a regular basis.

Results

Enhanced efforts from worksite safety observers resulted in capturing of higher number of safety lapses, which necessitated additional efforts from the line managers to take prompt corrective and preventive actions to mitigate OSH-related risks. Over the study period, the rate of risk conditions being recorded showed a gradual downward trend, as did the associated rates of recorded injuries.

Conclusion

This study affirms the hypothesis that a structured proactive approach with active leadership involvement and prompt remedial actions can aid in significant improvement of working conditions and safety performance at construction projects.

在全球范围内，建筑工作与严重的职业安全与健康（OSH）风险相关。在大型建筑项目中，由于多种因素的影响，管理职业安全健康风险具有挑战性，重要的是要有健全的管理策略和创新的解决方案来应对这些不断变化的职业安全健康风险。安全监控在建筑行业事故预防中起着举足轻重的作用。我们在26个大型建筑工作场所的横截面上评估了持续监测与主动管理跟进的有效性。方法通过数字化平台部署经过培训的安全观察员，记录和报告风险情况，以及风险类别、潜在风险、责任人等详细信息。同时，引入了一种预测工具来计算严重不良后果的可能性，如“损失时间事件”（LTI）或死亡。领导小组定期跟进和检讨结果。结果工地安全监察人员加强工作，发现更多的安全失误，这需要直线经理作出额外努力，迅速采取纠正和预防措施，以减轻与职业安全健康有关的风险。在研究期间，记录的危险状况率呈逐渐下降趋势，记录的相关伤害率也是如此。结论本研究证实了一个假设，即一个结构化的主动方法，积极的领导参与和及时的补救行动，可以帮助显著改善建筑项目的工作条件和安全绩效。

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引用次数: 0

California Warehouse Industry Worker Injury Rates in the Occupational Health and Safety Administration's Injury Tracking Application, 2018–2023 2018-2023年职业健康与安全管理局伤害跟踪应用程序中的加州仓储业工人伤害率

IF 2.7 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine

Pub Date : 2024-12-27 DOI: 10.1002/ajim.23697

Stella Beckman, Naissem Andamel, Robert Harrison

Background

Occupational health and safety surveillance in the US relies primarily on federal and state administrative data sources which all have limitations created by underreporting and different sampling frames. To begin closing data gaps, in 2019 the federal Occupational Health and Safety Administration began requiring many US business establishments to submit injury and illness data to the Injury Tracking Application (ITA). We present an example use of these data by characterizing injuries in the California warehousing industry.

Methods

Yearly ITA data for 2018–2023 were obtained and cleaned to exclude invalid records, resulting in 3717 records from California General Warehousing and Storage (GWS, NAICS 493110) establishments. Annual rates of total reportable injuries and cases of injuries requiring days of job transfer or restriction (DJTR) were calculated.

Results

Total injury rates peaked in 2021, with 5.87 injuries per 100 workers. While total injury rates subsequently declined, 2023 DJTR rates remained elevated over 2018 rates (3.21 vs. 1.84 per 100 workers). The primary analytical limitations were potential bias due to underreporting, and difficulty in identifying warehouse establishments.

Conclusion

The ITA data are a valuable addition to existing administrative data sources, with several limitations similar to those in other administrative datasets. The findings of consistently elevated total and DJTR injury rates in California's warehousing industry are consistent with previous research and indicate that outreach and enforcement efforts should be expanded to protect the health and safety of warehouse workers.

背景：美国的职业健康和安全监测主要依赖于联邦和州的行政数据来源，这些数据来源都有低报和不同抽样框架造成的局限性。为了开始缩小数据差距，2019年，联邦职业健康与安全管理局开始要求许多美国商业机构向伤害跟踪应用程序（ITA）提交伤害和疾病数据。我们提出了一个例子，这些数据的使用特征伤害在加州仓储行业。方法：获取2018-2023年年度ITA数据并进行清理，以排除无效记录，得到来自加州通用仓储和存储（GWS, NAICS 493110）机构的3717条记录。计算了每年报告的总伤害率和需要转移或限制工作天数（DJTR）的伤害病例。结果：总受伤率在2021年达到峰值，每100名工人有5.87人受伤。虽然总伤害率随后下降，但2023年DJTR率仍高于2018年的水平（3.21比1.84 / 100名工人）。主要的分析限制是由于少报造成的潜在偏差，以及难以确定仓库设施。结论：ITA数据是对现有管理数据源的一个有价值的补充，与其他管理数据集中的数据有一些类似的限制。加州仓储业总伤害率和DJTR伤害率持续上升的调查结果与先前的研究一致，表明应扩大宣传和执法力度，以保护仓库工人的健康和安全。

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引用次数: 0

Dermal Exposure to Agrochemicals as Risk Factor for Skin Cancer in Farmers and Ranchers in the US Central States 皮肤暴露于农用化学品是美国中部各州农民和牧场主皮肤癌的危险因素。

IF 2.7 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine

Pub Date : 2024-12-27 DOI: 10.1002/ajim.23696

Sarah Tucker, Yi Du, Rishad Ahmed, Gleb Haynatzki, Suraj Adhikari, Risto H. Rautiainen

Background

Farm operators are at a high risk of developing skin cancer due to their occupational sun exposure. With the growing incidence of skin cancer, it is also important to evaluate other occupational risk factors. Farm operators confront numerous physical, chemical, and biological hazards in their work environment. This study investigated whether dermal exposures to pesticides/fertilizers, animals/livestock, detergents/disinfectants, and fuels/solvents/paints were associated with the risk of skin cancer in farm and ranch operators.

Methods

Surveillance data from the Central States Center for Agricultural Safety and Health (CS-CASH) Farm and Ranch Health and Safety Surveys in 2018 and 2020 were used to explore the risk of skin cancer in farm operators in seven US central states. Farm production variables from the DTN Farm Market database were merged with survey responses. The associations of skin cancer and exposure variables were analyzed using descriptive statistics and regression modeling.

Results

The prevalence of skin cancer was 10% among 7943 operators. Univariable analyses showed that men had 1.62 times higher odds of skin cancer compared to women. The odds of skin cancer increased significantly with age. Livestock, fed cattle, cow-calf, and beef production increased the odds of skin cancer. Exposure to pesticides/fertilizers and fuels/solvents/paints also increased the odds of skin cancer compared to unexposed operators. In the final multivariable model, the associations of skin exposure to pesticides/fertilizers (odds ratio (OR) = 1.30, 95% CI: 1.08–1.56) and to fuels/solvents/paints (OR = 1.21, 95% CI: 1.01–1.45) remained statistically significant after adjusting for sex, age, and state. Having livestock also increased the odds of skin cancer (OR = 1.18, 95% CI: 1.00–1.38).

Conclusion

Skin is a critical source of occupational exposures among farm operators. Increased odds of skin cancer in this study emphasizes the need for better protection against exposures to chemicals including pesticides/fertilizers, and fuels/solvents/paints.

背景：农场经营者由于其职业阳光照射，患皮肤癌的风险很高。随着皮肤癌发病率的增加，对其他职业危险因素的评估也很重要。农场经营者在其工作环境中面临着许多物理、化学和生物危害。本研究调查了皮肤接触农药/化肥、动物/牲畜、洗涤剂/消毒剂和燃料/溶剂/油漆是否与农场和牧场经营者患皮肤癌的风险有关。方法：利用2018年和2020年中央州农业安全与健康中心（CS-CASH）农场和牧场健康与安全调查的监测数据，探讨美国中部7个州农场经营者患皮肤癌的风险。DTN农场市场数据库中的农场生产变量与调查回复合并。使用描述性统计和回归模型分析皮肤癌与暴露变量的关联。结果：7943名操作人员中皮肤癌患病率为10%。单变量分析显示，男性患皮肤癌的几率是女性的1.62倍。随着年龄的增长，患皮肤癌的几率显著增加。牲畜、饲养的牛、小牛和牛肉生产增加了患皮肤癌的几率。与未接触农药/化肥和燃料/溶剂/油漆的操作员相比，接触农药/化肥和燃料/溶剂/油漆也增加了患皮肤癌的几率。在最后的多变量模型中，在调整性别、年龄和州后，皮肤暴露于农药/肥料（比值比(OR) = 1.30, 95% CI: 1.08-1.56）和燃料/溶剂/油漆（OR = 1.21, 95% CI: 1.01-1.45）的关联仍然具有统计学意义。饲养牲畜也增加了患皮肤癌的几率（OR = 1.18, 95% CI: 1.00-1.38）。结论：皮肤是农场经营者职业暴露的重要来源。这项研究增加了皮肤癌的几率，强调需要更好地保护人们不接触化学物质，包括杀虫剂/化肥、燃料/溶剂/油漆。

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引用次数: 0

Reviewers for the American Journal of Industrial Medicine 2024 2024年美国工业医学杂志的审稿人。

IF 2.7 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine

Pub Date : 2024-12-25 DOI: 10.1002/ajim.23699

John D. Meyer

引用次数: 0

The Psychosocial Hierarchy of Controls: Effectively Reducing Psychosocial Hazards at Work 控制的社会心理层次：有效减少工作中的社会心理危害。

IF 2.7 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine

Pub Date : 2024-12-21 DOI: 10.1002/ajim.23694

Asta Kjærgaard, Emilie Marie Rudolf, Julie Palmqvist, Mikala Ernebjerg Jakobsen, Jeppe Zielinski Nguyen Ajslev

Background

Psychosocial hazards in the workplace contribute to mental disorders, cardiovascular diseases, and musculoskeletal ill-health. The Hierarchy of Controls applied to NIOSH Total Worker Health (TWH HOC) aims to mitigate these hazards through effective interventions. This study proposes a revision of the model resulting in a HOC for psychosocial hazards (P-HOC) and explores its application in improving the working environment.

Methods

We reviewed recent literature on organizational and individual interventions to revise the TWH HOC to a psychosocial HOC framework. Subsequently, the modified P-HOC was applied to a qualitative case study of nine Danish companies participating in the Danish “Agreement to problem-solve” labor inspection strategy. We analyzed the types of initiatives implemented and gathered qualitative data on employee and management perspectives on their effectiveness.

Results

The study led to a revision of the TWH HOC resulting in a P-HOC prioritizing organizational measures with documented effect, and indicating the importance of comprehensive measures. Findings from the qualitative study indicate a predominant contemporary focus on lower-level P-HOC initiatives, such as individual-based approaches and administrative controls. While these interventions show some improvements in mental well-being and work culture, they seem insufficient to enhance the comprehensive psychosocial environment. Companies implementing higher-level interventions experienced greater efficacy, particularly when employing multifaceted approaches.

Conclusions

The study emphasizes the need for a more robust application of higher-level measures and multifaceted interventions to better improve the psychosocial working environment. Future research should investigate the P-HOC's varying impact and explore alternative frameworks for better intervention outcomes.

背景：工作场所的社会心理危害会导致精神障碍、心血管疾病和肌肉骨骼疾病。应用于NIOSH全体工人健康（TWH HOC）的控制层次旨在通过有效的干预措施减轻这些危害。本研究提出一种修正的模型，从而产生心理社会危害的HOC (P-HOC)，并探讨其在改善工作环境中的应用。方法：我们回顾了最近关于组织和个人干预的文献，将TWH HOC修改为社会心理HOC框架。随后，将修改后的P-HOC应用于参与丹麦“问题解决协议”劳动检查策略的九家丹麦公司的定性案例研究。我们分析了实施的举措类型，并收集了员工和管理层对其有效性的定性数据。结果：该研究导致TWH HOC的修订，导致P-HOC优先组织措施具有文件效应，并表明综合措施的重要性。定性研究的结果表明，当代主要关注较低层次的P-HOC举措，如基于个人的方法和行政控制。虽然这些干预措施在精神健康和工作文化方面有所改善，但它们似乎不足以改善全面的社会心理环境。实施更高层次干预措施的公司获得了更大的效果，特别是在采用多方面方法时。结论：该研究强调需要更有力地应用更高水平的措施和多方面的干预措施，以更好地改善心理社会工作环境。未来的研究应该调查P-HOC的不同影响，并探索更好的干预结果的替代框架。

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引用次数: 0

Hearing Loss Is Associated With Increased Mortality in a Cohort of Older Construction Trades Workers 听力损失与老年建筑行业工人死亡率增加有关。

IF 2.7 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine

Pub Date : 2024-12-20 DOI: 10.1002/ajim.23693

John Dement, Knut Ringen, Marianne Cloeren, Sammy Almashat, William Grier, Patricia Quinn, Kim Cranford, Anna Chen, Scott Haas

Background

Hearing loss has been associated with increased mortality, and there is evidence that regular use of hearing aids reduces the mortality risk. However, these associations have not been sufficiently studied in worker populations at high risk for noise-induced hearing loss.

Methods

Medical examination data for 19,379 workers employed in US Department of Energy (DOE) facilities were used. Speech-frequency pure-tone average hearing loss and hearing aid use were ascertained. Mortality status through 2021 was obtained from the National Death Index. Cox regression examined the association between hearing loss and mortality and the impact of hearing aid use.

Results

Eight thousand eighty-one workers (41.3%) had speech-frequency hearing loss and 2228 (15.3%) of these workers reported use of hearing aids. A total of 5398 deaths occurred over a median follow-up of 11.1 years. Hearing loss was an independent risk factor for higher mortality with an adjusted hazard ratio (HR) of 1.10 (95% CI = 1.03−1.17). The HR increased with hearing loss severity but the relationship was non-linear. Hearing aid users were at 30% reduced risk of mortality compared to those not using hearing aids (HR = 0.70, 95% CI = 0.63−0.77).

Conclusions

Results are consistent with research linking hearing loss with increased mortality and the preventive impact of hearing aid use. These findings should inform workers' compensation programs in favor of: (1) better coverage of hearing loss for noise-exposed workers, and (2) inclusion of hearing aids in medical benefits. Reduction in noise exposures is a priority and workers with hearing loss should be encouraged to use hearing aids.

背景：听力损失与死亡率增加有关，有证据表明，经常使用助听器可降低死亡风险。然而，这些关联尚未在噪声性听力损失高风险的工人人群中得到充分研究。方法：采用美国能源部（DOE）设施19379名工作人员的体检数据。确定语音频率、纯音平均听力损失和助听器使用情况。截至2021年的死亡率状况来自国家死亡指数。Cox回归检验了听力损失和死亡率之间的关系以及助听器使用的影响。结果：881名工人（41.3%）存在语频性听力损失，其中2228名工人（15.3%）使用助听器。在11.1年的中位随访期间，共发生5398例死亡。听力损失是高死亡率的独立危险因素，校正危险比（HR）为1.10 （95% CI = 1.03-1.17）。HR随听力损失严重程度的增加而增加，但呈非线性关系。与不使用助听器的患者相比，助听器使用者的死亡率降低了30% （HR = 0.70, 95% CI = 0.63-0.77）。结论：研究结果与听力损失与死亡率增加和助听器使用的预防作用相一致。这些发现应该为工人的赔偿计划提供信息，以便：(1)更好地覆盖噪音暴露工人的听力损失，(2)将助听器纳入医疗福利。减少噪音暴露是一个优先事项，应鼓励有听力损失的工人使用助听器。

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引用次数: 0

Acute Kidney Injury Among Florida Construction Workers: A Pilot Study 佛罗里达州建筑工人急性肾损伤：一项试点研究。

IF 2.7 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine

Pub Date : 2024-12-20 DOI: 10.1002/ajim.23692

Roxana C. Chicas, Cathy Zhuang, Andrea Castellano, Leslie Trejo, Ernesto Ruiz, Vicki Hertzberg

Background

While construction workers have the second highest rate of heat-related mortality, less is known about the prevelance of heat-related illness (HRI) symptoms, dehydration and kidney dysfunction. The aim of this study was to conduct a biomedical field-based study with construction workers to characterize HRI symptoms, dehydration, and kidney dysfunction, and analyze relationships between post-work urine specific gravity (USG) percentiles and predictors such as work hours, water consumption, and sugary beverage consumption.

Methods

In collaboration with the Farmworker Association of Florida, 58 construction workers in Central Florida were monitored pre- and post-work shift on one workday. Research staff used a recreational vehicle to meet workers at their worksites, collect blood and urine pre- and post-work shift, and administer a survey on HRI symptoms. Acute kidney injury (AKI) was measured using serum creatinine and dehydration with USG. Predictors were examined in single covariate linear quantile mixed models against USG percentiles.

Results

The mean heat index was 88.4°F. Forty-two percent reported at least one symptom of HRI. Dehydration rates were 75% pre-work shift and 78% post-work shift. Severe dehydration increased from 16% to 33%. AKI was observed in 38% of the participants.

Conclusion

This is, to our knowledge, the first US field-based biomedical study to document AKI, dehydration, and HRI symptoms in construction workers. This study adds to the literature that supports occupational heat exposure as a risk factor for AKI and dehydration.

背景：虽然建筑工人的热相关死亡率第二高，但对热相关疾病（HRI）症状、脱水和肾功能障碍的患病率知之甚少。本研究的目的是对建筑工人进行一项基于生物医学领域的研究，以表征HRI症状、脱水和肾功能障碍，并分析工作后尿液比重（USG）百分位数与工作时间、饮水量和含糖饮料摄入量等预测因素之间的关系。方法：与佛罗里达州农场工人协会合作，对佛罗里达州中部的58名建筑工人在一个工作日的工作前后轮班进行监测。研究人员使用一辆休闲车在工作地点与工人会面，在轮班前和轮班后收集血液和尿液，并对HRI症状进行调查。急性肾损伤（AKI）采用血清肌酐和脱水联合USG测定。预测因子采用单协变量线性分位数混合模型对USG百分位数进行检验。结果：平均热指数为88.4°F。42%的人报告了至少一种HRI症状。脱水率分别为上班前75%和下班后78%。严重脱水从16%增加到33%。38%的参与者出现AKI。结论：据我们所知，这是美国第一个以现场为基础的生物医学研究，记录了建筑工人的AKI、脱水和HRI症状。这项研究增加了支持职业热暴露是AKI和脱水的危险因素的文献。

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引用次数: 0

Heat-Related Illness in California Firefighters, 2001–2020 2001-2020 年加利福尼亚消防员与高温有关的疾病。

IF 2.7 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine

Pub Date : 2024-12-18 DOI: 10.1002/ajim.23691

Margaret Murray, Stella Beckman, Amy Heinzerling, Matthew Frederick, Kristin J. Cummings, Sheiphali Gandhi, Robert Harrison

Background

Firefighters have a higher rate of heat-related illness (HRI) compared to other occupations. Given the changing climate, firefighters' risk of occupational HRI merits attention. Therefore, we aimed to identify demographic, temporal, and geographic risk factors associated with occupational HRI in California firefighters between 2001 and 2020.

Methods

Within the California Workers' Compensation Information Systems (WCIS), we identified firefighters from 2001 to 2020 using industry and class codes and assigned occupation titles using the NIOSH Industry and Occupation Computerized Coding system (NIOCCS). HRI claims among firefighters were identified using International Classification of Diseases (ICD) Ninth or Tenth revision codes, WCIS nature and cause of injury codes, and keywords. We calculated HRI incidence rates adjusted by sex, age, year, and county. Estimates of California firefighter employment were obtained from the American Community Survey.

Results

We identified 2185 firefighter HRI claims between 2001 and 2020 (305.5 claims/100,000 firefighters, 90% CI: 278.7–740.7). Firefighters aged 18 to 29 years had a statistically significant higher risk of HRI compared to those aged 40 to 49 years (rate ratio = 3.5, 90% CI: 3.1–3.9). The HRI rate increased over time, and the risk from 2016 to 2020 was 1.8 times higher than it was from 2001 to 2005 (90% CI: 1.7–1.9). Northern California counties, including Shasta (2313.9) and Sacramento (1772.1), had the highest HRI rates.

Conclusions

Firefighters in certain demographic groups and northern California counties were at highest risk of HRI. With rising temperatures and larger wildfires, additional prevention efforts are needed to reduce HRI in California firefighters.

背景：与其他职业相比，消防员患热相关疾病（HRI）的比例更高。考虑到气候的变化，消防员的职业HRI风险值得关注。因此，我们旨在确定2001年至2020年间加州消防员职业HRI相关的人口统计学、时间和地理风险因素。方法：在加州工人赔偿信息系统（WCIS）中，我们使用行业和类别代码识别2001年至2020年的消防员，并使用NIOSH行业和职业计算机编码系统（NIOCCS）分配职业名称。消防员的HRI索赔使用国际疾病分类（ICD）第九或第十版代码、WCIS伤害性质和原因代码以及关键字进行识别。我们计算了按性别、年龄、年份和县调整的HRI发病率。加州消防员的就业估计来自美国社区调查。结果：在2001年至2020年期间，我们确定了2185名消防员的HRI索赔（305.5索赔/100,000名消防员，90% CI: 278.7-740.7）。18 - 29岁的消防员发生HRI的风险比40 - 49岁的消防员高（比率比= 3.5,90% CI: 3.1-3.9）。HRI率随着时间的推移而增加，2016 - 2020年的风险是2001 - 2005年的1.8倍（90% CI: 1.7-1.9）。包括沙斯塔（2313.9）和萨克拉门托（1772.1）在内的北加州县的HRI率最高。结论：消防员在某些人口群体和北加州县的HRI风险最高。随着气温上升和野火规模扩大，需要采取额外的预防措施来降低加州消防员的HRI。

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引用次数: 0

Occupational Injury and Suicide in Washington State, Adjusting for Pre-Injury Depression 华盛顿州的职业伤害和自杀：对伤前抑郁的调整。

IF 2.7 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine

Pub Date : 2024-12-17 DOI: 10.1002/ajim.23682

Katie M. Applebaum, Abay Asfaw, Paul K. O'Leary, Matthew P. Fox, Yorghos Tripodis, Andrew Busey, Jaimie L. Gradus, Leslie I. Boden

Introduction

Occupational injuries have been associated with increased suicide mortality, but prior studies have not accounted for pre-injury depression.

Methods

We linked injuries that occurred from 1994 to 2000 in the Washington State workers' compensation system with Social Security Administration data on earnings and mortality through 2018. We estimated the subdistribution hazard ratio (sHR) and 95% confidence interval using competing risks regression of suicide deaths with lost time compared with medical-only injuries separately for men and women, adjusting for age, pre-injury annual earnings, and industry. We further adjusted for pre-injury diagnosis of major depressive disorder by using a quantitative bias analysis (QBA), with the prevalence of this disorder in workers derived from an external health insurance claims data set.

Results

Elevated suicide mortality was observed following lost-time injuries compared with medical-only injuries for men (sHR = 1.49, 95% CI [1.14, 1.93]) and women (sHR = 1.30, 95% CI [1.00, 1.69]), adjusting for age, pre-injury earnings, and industry. Adjusted for pre-injury depression using a QBA, elevated suicide risk in men remained statistically significant (median sHR = 1.33, simulation interval [1.18, 1.47]) but not for women.

Discussion

Workplace injury requiring time off work appeared to remain influential in increasing suicide risk among men, even after controlling for pre-injury depression. The relationship between mental health before and after occupational injury is complex and studies should better integrate mental health pre-injury.

Conclusions

Though many questions remain on the complex relationship between work, depression, injuries, and suicide, employers should work to prevent injuries and consider implementing mental health programs, which could be helpful in reducing suicide risk.

导读：职业伤害与自杀死亡率增加有关，但之前的研究没有考虑到伤害前抑郁。方法：我们将1994年至2000年华盛顿州工人赔偿系统中发生的伤害与社会保障管理局截至2018年的收入和死亡率数据联系起来。我们分别对男性和女性自杀死亡与损失时间相比与单纯医疗伤害的竞争风险回归进行了亚分布风险比（sHR）和95%置信区间的估计，并对年龄、伤害前年收入和行业进行了调整。我们通过使用定量偏倚分析（QBA）进一步调整了重性抑郁症的损伤前诊断，该疾病在工人中的患病率来自外部健康保险索赔数据集。结果：在调整了年龄、伤害前收入和行业后，男性（sHR = 1.49, 95% CI[1.14, 1.93]）和女性（sHR = 1.30, 95% CI[1.00, 1.69]）在失时伤害后的自杀死亡率高于单纯医疗伤害。使用QBA校正伤前抑郁后，男性自杀风险升高仍具有统计学意义（sHR中位数= 1.33，模拟区间[1.18,1.47]），但女性自杀风险升高无统计学意义。讨论：即使在控制了受伤前的抑郁之后，需要请假的工伤似乎仍然对增加男性自杀风险有影响。职业伤害前后的心理健康关系复杂，研究应更好地整合伤害前的心理健康。结论：尽管工作、抑郁、受伤和自杀之间的复杂关系仍然存在许多问题，雇主应该努力预防受伤，并考虑实施心理健康计划，这可能有助于降低自杀风险。

{"title":"Occupational Injury and Suicide in Washington State, Adjusting for Pre-Injury Depression","authors":"Katie M. Applebaum, Abay Asfaw, Paul K. O'Leary, Matthew P. Fox, Yorghos Tripodis, Andrew Busey, Jaimie L. Gradus, Leslie I. Boden","doi":"10.1002/ajim.23682","DOIUrl":"10.1002/ajim.23682","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Occupational injuries have been associated with increased suicide mortality, but prior studies have not accounted for pre-injury depression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We linked injuries that occurred from 1994 to 2000 in the Washington State workers' compensation system with Social Security Administration data on earnings and mortality through 2018. We estimated the subdistribution hazard ratio (sHR) and 95% confidence interval using competing risks regression of suicide deaths with lost time compared with medical-only injuries separately for men and women, adjusting for age, pre-injury annual earnings, and industry. We further adjusted for pre-injury diagnosis of major depressive disorder by using a quantitative bias analysis (QBA), with the prevalence of this disorder in workers derived from an external health insurance claims data set.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Elevated suicide mortality was observed following lost-time injuries compared with medical-only injuries for men (sHR = 1.49, 95% CI [1.14, 1.93]) and women (sHR = 1.30, 95% CI [1.00, 1.69]), adjusting for age, pre-injury earnings, and industry. Adjusted for pre-injury depression using a QBA, elevated suicide risk in men remained statistically significant (median sHR = 1.33, simulation interval [1.18, 1.47]) but not for women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Workplace injury requiring time off work appeared to remain influential in increasing suicide risk among men, even after controlling for pre-injury depression. The relationship between mental health before and after occupational injury is complex and studies should better integrate mental health pre-injury.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Though many questions remain on the complex relationship between work, depression, injuries, and suicide, employers should work to prevent injuries and consider implementing mental health programs, which could be helpful in reducing suicide risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 2","pages":"122-131"},"PeriodicalIF":2.7,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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