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Blunted Blood Pressure Dipping During Night Shift Work: Does It Matter? Can We Intervene? 夜班工作时血压下降迟钝:这有关系吗?我们可以干预吗?
IF 2.7 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-02-15 DOI: 10.1002/ajim.23711
P. Daniel Patterson, David Hostler, Matthew F. Muldoon, Daniel J. Buysse, Steven E. Reis

Cardiovascular disease (CVD) is the leading cause of adult death in the United States. Numerous studies show that night shift workers face a disproportionately higher risk of CVD compared to non-shift workers. Despite these data, the scientific and medical communities have not identified the physiological mechanisms that contribute to increased CVD risks for night shift workers. We propose that repetitive exposure to blunted blood pressure (BP) dipping associated with sleep loss during night shift work is an important, clinically meaningful, understudied, and modifiable contributor to increased risk of CVD. Blunted BP dipping occurs when BP fails to decrease or “dip” 10%−20% during nighttime hours (typically while sleeping) relative to daytime hours (typically while awake). Blunted BP dipping is widely considered a clinically meaningful indicator of poor cardiovascular health. Previous research suggests it is a common consequence of night shift work and occurs during sleep before and immediately after night shifts. Relatively few studies of shift work and CVD have focused on blunted BP dipping as a mechanism of CVD risk. Recent experimental research shows that restoration of normal BP patterns—during night shift work—is achievable with strategic napping and may reduce the risk of CVD. We present a series of important mechanistic-related questions and next steps for future research focused on blunted BP dipping and night shift work.

心血管疾病(CVD)是美国成年人死亡的主要原因。大量研究表明,夜班工人比非夜班工人患心血管疾病的风险高得多。尽管有这些数据,科学界和医学界还没有确定导致夜班工人心血管疾病风险增加的生理机制。我们认为,夜班工作期间反复暴露于与睡眠不足相关的钝性血压(BP)下降是CVD风险增加的一个重要的、临床意义的、研究不足的、可改变的因素。当血压在夜间(通常是在睡觉时)相对于白天(通常是在醒着的时候)没有下降或“下降”10%-20%时,就会发生钝化的血压下降。钝性血压下降被广泛认为是心血管健康状况不佳的临床有意义的指标。先前的研究表明,这是夜班工作的常见后果,发生在夜班前和夜班后的睡眠中。相对较少的倒班工作和心血管疾病的研究集中在钝性血压下降作为心血管疾病风险的机制。最近的实验研究表明,恢复正常的血压模式——在夜班工作期间——可以通过有策略的午睡来实现,并可能降低心血管疾病的风险。我们提出了一系列重要的机械相关问题和未来研究的下一步,重点是钝化BP和夜班工作。
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引用次数: 0
Enhancing the Psychosocial Hierarchy of Controls: Contextual, Sequential, and Integrated Approaches for Workplace Mental Health 加强控制的社会心理层次:工作场所心理健康的情境、顺序和综合方法。
IF 2.7 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-02-01 DOI: 10.1002/ajim.23709
San-Ping Wang, Lien-Chung Wei
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引用次数: 0
Response to Enhancing the Psychosocial Hierarchy of Controls: Contextual, Sequential, and Integrated Approaches for Workplace Mental Health 对加强控制的社会心理层次的反应:工作场所心理健康的情境、顺序和综合方法。
IF 2.7 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-02-01 DOI: 10.1002/ajim.23710
Asta Kjærgaard, Emilie M. Rudolf, Julie Palmqvist, Mikala E. Jakobsen, Jeppe Z. Nguyen Ajslev
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引用次数: 0
Foreword: Progress in Construction Safety and Health 前言:建筑安全与健康研究进展。
IF 2.7 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-28 DOI: 10.1002/ajim.23708
Knut Ringen, Karl-Heinz Noetel, Krishna N. Sen, Miles Fisher

The construction industry has always been a large economic sector that is very hazardous to work in. Over the past 40 years there have been major improvements in safety and health practices driven by increased research and more rapid adoption of best practices, not just in the developed countries but also in emerging economies. This special issue aims to showcase a spectrum of perspectives from research to practice, about the current state of construction safety and health.

建筑业一直是一个很大的经济部门,工作起来非常危险。在过去40年里,不仅在发达国家,而且在新兴经济体,由于研究的增加和最佳做法的更迅速采用,安全和卫生做法取得了重大进展。本期特刊旨在展示从研究到实践的一系列观点,探讨建筑安全与健康的现状。
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引用次数: 0
Innovation Leading to Improved Safety, Health, and Productivity Is Enabled by Close Collaboration Between Construction Companies and Technology Start-Ups 通过建筑公司与科技初创企业的密切合作,创新可以改善安全、健康和生产力。
IF 2.7 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-28 DOI: 10.1002/ajim.23702
Melike Yildiz, Stéphanie Bigeon-Bienvenu

The transfer of innovation to practice is one of the fundamental challenges of efficient social advancement. Because of its structure, with mostly small employers with limited working capital and short-term thinking arising from working on time-limited projects, historically the construction industry has been a slow adopter of technological advances. Now it is faced with a barrage of new technologies that not only can help solve some of the most pressing occupational safety and health needs but at the same time also contribute to productivity improvements. To address this, we—and others—have been finding ways to bring together tech start-ups and their innovations with construction companies who are willing to put them to use. We present four examples to illustrate how this can be accomplished and discuss the lessons we have learned in doing so.

将创新转化为实践是高效社会进步的基本挑战之一。由于其结构,大多数小雇主的流动资金有限,并且由于工作时间有限的项目而产生的短期思维,从历史上看,建筑业一直是技术进步的缓慢采纳者。现在,它面临着大量的新技术,这些新技术不仅可以帮助解决一些最紧迫的职业安全和健康需求,同时还有助于提高生产率。为了解决这个问题,我们和其他人一直在寻找方法,将科技初创企业及其创新与愿意将其投入使用的建筑公司结合起来。我们将提供四个示例来说明如何实现这一点,并讨论我们在此过程中吸取的经验教训。
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引用次数: 0
Incidence of Occupational Injuries Among Military Working Dog Handlers, 2016–2023 2016-2023年军事工作犬训导员职业伤害发生率
IF 2.7 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-26 DOI: 10.1002/ajim.23707
Sithembile L. Mabila, Jessica H. Murray, Shauna L. Stahlman, Alexis A. McQuistan, Edward A. Sheriff

Objective

This study examines the incidence of injuries among active component service members in Military Working Dog (MWD) handler occupations compared to three other active component occupational groups.

Methods

A retrospective cohort study was conducted with a total of 2,524,092 active component service members including, 3935 MWD handlers, 2025 veterinary personnel, 113,413 military police, and 2,404,719 all other active component service members (ACSM). Incidence rate and incident rate ratios of injuries were determined.

Results

MWD handlers had the second highest rates of injuries (14,194.42 injuries per 10,000 p-yrs.) with veterinary personnel having the highest rate of injuries (17,320.11 injuries per 10,000 p-yrs.). Military police (11,521.71 injuries per 10,000 p-yrs.) and other ACSM (11,708.60 injuries per 10,000 p-yrs.) had similar incidence rates. Risk for injury was highest among women and older service members.

Conclusion

This study is among the first investigations into MWD handlers' occupational health outcomes. These results suggest the importance of continued MWD handler health assessment.

目的:本研究比较了军事工作犬(MWD)训导员职业中现役军人的伤害发生率,并与其他三个现役军人职业群体进行了比较。方法:采用回顾性队列研究方法,共纳入现役军人2,524,092人,其中MWD处理人员3935人,兽医人员2025人,宪兵113,413人,其他现役军人(ACSM) 2,404,719人。测定损伤发生率和事故率比。结果:MWD处理人员的伤害率第二高(14,194.42伤害/ 10,000 p-年),兽医人员的伤害率最高(17,320.11伤害/ 10,000 p-年)。宪兵(11,521.71人每10,000 p年受伤)和其他ACSM(11,708.60人每10,000 p年受伤)的发生率相似。受伤的风险在女性和老年服役人员中最高。结论:本研究是第一次对MWD操作人员的职业健康结果进行调查。这些结果表明持续进行随钻作业人员健康评估的重要性。
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引用次数: 0
A Qualitative Analysis of Immigrant Latinx Housecleaners' Experiences of How Power Relations With “Employers” Influence Working Conditions in New York City: The Safe and Just Cleaners Study 拉丁裔移民清洁工与“雇主”的权力关系如何影响纽约市工作条件的定性分析:安全与公正清洁工研究。
IF 2.7 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-26 DOI: 10.1002/ajim.23705
Isabel Cuervo, Sherry L. Baron, Deysi Flores, Ana Gonzalez, Homero Harari

Background

Housecleaning work has been characterized as precarious employment with unstable work hours, arbitrary and low pay and benefits, and exposures to chemical, physical, and psychosocial stressors. Understanding how interpersonal power dynamics between workers and clients, a component of precarious work, contributes to work exposures can inform and improve prevention programs.

Methods

We used reflexive thematic analysis of data from seven focus groups with Latinx immigrant housecleaners in New York City to explore workers' experience of interpersonal power dynamics with their clients—whom they referred to as their “employers”—and its influences on working conditions.

Results

Employer direction and monitoring varied and mostly reduced workers' autonomy to choose products, sometimes leading workers to complete tasks in more hazardous ways. Housecleaners reported using larger quantities of products, products with stronger scents, and more physical exertion to increase the efficiency of their cleaning, to complete tasks quickly, and to please their clients. Allotted time, tasks, and pay were interconnected, often resulting in negative reports about health and well-being. As immigrants, they also experienced discrimination and intimidation, which compounded their anxiety due to their employment insecurity. Nevertheless, participants learned and navigated high variance in employers' cleaning preferences and attempted to take control over the conduct of their work, when possible, and sometimes expressed self-advocacy.

Conclusions

Housecleaners' precarious employment arrangements affect how they navigate interpersonal relationships with employers, which impairs their working conditions and occupational exposures. Improvements in labor and social protections, such as designing supportive policies and training for workers and employers, are needed to improve working conditions.

背景:房屋清洁工作一直被认为是不稳定的工作,工作时间不稳定,工资和福利随意且低,并暴露于化学、物理和社会心理压力源。了解员工和客户之间的人际权力动态(不稳定工作的一个组成部分)如何导致工作暴露,可以为预防计划提供信息和改进。方法:我们使用反身性的主题分析,对来自纽约市拉丁裔移民清洁工的七个焦点小组的数据进行分析,以探索工人与他们的客户(他们称之为“雇主”)之间的人际权力动态的经验,以及它对工作条件的影响。结果:雇主的指导和监督各不相同,而且大多减少了工人选择产品的自主权,有时导致工人以更危险的方式完成任务。据报道,清洁人员会使用更多的产品,气味更强的产品,并消耗更多的体力来提高清洁效率,更快地完成任务,并取悦客户。分配的时间、任务和报酬是相互关联的,经常导致有关健康和幸福的负面报告。作为移民,他们也经历了歧视和恐吓,这加剧了他们因就业不安全而产生的焦虑。然而,参与者了解并驾驭了雇主在清洁偏好方面的高度差异,并试图在可能的情况下控制他们的工作,有时还表达了自我主张。结论:家政保洁员的不稳定就业安排影响了他们如何处理与雇主的人际关系,这损害了他们的工作条件和职业暴露。改善工作条件需要改善劳动和社会保护,例如设计支持性政策和对工人和雇主的培训。
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引用次数: 0
The Rapid Rise of Silicosis in Victoria, Australia Associated With Artificial Stone Countertop Industry Work 澳大利亚维多利亚州与人造石台面工业工作有关的矽肺病迅速上升。
IF 2.7 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-20 DOI: 10.1002/ajim.23704
Ryan F. Hoy, Dunya Tomic, StellaMay Gwini, Christina Dimitriadis, Michael Abramson, Alex Collie, Hayley Barnes, Deborah C. Glass, Fiona Hore-Lacy, Natasha Kinsman, Malcolm R. Sim, Karen Walker-Bone

Background

The fabrication and installation of artificial (engineered) stone countertops is a relatively new cause of silicosis. Our aim was to investigate silicosis rates in Victoria, Australia, and the association with stone countertop industry work.

Methods

Workers' compensation claims for silicosis from January 1, 1991 to December 31, 2022 were analyzed across 8-year time periods. Incidence rates per 100,000 persons were calculated by time period, age, and sex. Additionally, incident silicosis cases were reported to a clinical registry by respiratory physicians from May 1, 2019 to December 31, 2022, and analyzed by referral source and occupational history.

Results

Over 32 years, there were 536 workers' compensation claims for silicosis (98.9% male, median age 40 years). In total, 482 (89.9%) were received between 2015 and 2022, a 27-fold increase from the previous 8-year period. The incidence rate for silicosis claims in the adult population increased from 0.12 per 100,000 in 1991–1998 to 2.38 per 100,000 in 2015–2022. In the clinical registry there were 210 incident cases between 2019 and 2022; 97% worked in the countertop industry, 95% with artificial stone. Almost all (89%) cases had been referred following participation in a government screening program for stone countertop industry workers.

Conclusion

There has been a major rise in compensation claims for silicosis in Victoria. Active screening of stone countertop workers led to the diagnosis of almost all registered incident silicosis cases. This underscores the risk to stone countertop workers and highlights the potential for under-recognition of silicosis without screening at-risk workers, especially in countries where artificial stone has become popular.

背景:人造(工程)石材台面的制作和安装是矽肺病的一个相对较新的原因。我们的目的是调查澳大利亚维多利亚州的矽肺病发病率,以及与石材台面工业工作的关系。方法:对1991年1月1日至2022年12月31日期间矽肺病的工伤赔偿要求进行分析。每10万人的发病率按时间、年龄和性别计算。此外,2019年5月1日至2022年12月31日,呼吸内科医生向临床登记处报告了矽肺病例,并根据转诊来源和职业史进行了分析。结果:32年来矽肺工伤索赔536例,其中98.9%为男性,中位年龄40岁。2015年至2022年期间,共收到482份(89.9%),比前8年增长了27倍。成年人群中矽肺病的发病率从1991-1998年的0.12 / 10万上升到2015-2022年的2.38 / 10万。在临床登记处,2019年至2022年间有210例病例;97%从事台面行业,95%使用人造石。几乎所有(89%)的病例都是在参加了政府对石材台面行业工人的筛查项目后转诊的。结论:在维多利亚州,矽肺的赔偿要求有很大的上升。对石材台面工人进行主动筛查,几乎所有登记的矽肺病病例都被诊断出来。这强调了对石材台面工人的风险,并强调了在没有对有风险的工人进行筛查的情况下对矽肺病的认识不足的可能性,特别是在人造石已经流行的国家。
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引用次数: 0
Could Better-Quality Employment Improve Population Health? Findings From a Scoping Review of Multi-Dimensional Employment Quality Research and a Proposed Research Direction 高质量的就业能改善人口健康吗?多维就业质量研究的研究结果与研究方向
IF 2.7 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-15 DOI: 10.1002/ajim.23695
Emily Q. Ahonen, Megan R. Winkler, Kim Bosmans, Virginia Gunn, Mireia Julià

Background

Precarious employment, a specific part of the conceptual spectrum of employment quality (EQ), has been established as an important risk to individual and population health and well-being when compared to a standard employment circumstance. There remains a need, however, to explore whether and how EQ might be used as a tool to not only protect but also advance population health and well-being.

Methods

The purposes of this scoping review were to assess the analytic treatment of the multiple dimensions of EQ and the stances researchers take to characterize the state of knowledge of EQ that supports the idea that better EQ is a health-promoting factor. Quantitative, qualitative, and mixed-methods primary studies that included at least three of the seven conceptually-informed EQ dimensions were eligible. Studies were assessed for EQ dimensions represented, how dimensions were treated analytically, the pathogenic, ambivalent, or salutogenic stances used by investigators, and what each might tell us about how to leverage aspects of better-quality employment to improve population health.

Results

A total of 78 studies were included; 54 of these treated EQ dimensions in an interrelated way. Of the analytically interrelated studies, none had an explicit salutogenic stance. Some evidence suggests that a handful of EQ types might present an equal or reduced risk of poor health than the standard employment relationship, frequently used as a historic gold standard.

Conclusion

Research with a salutogenic stance might build our understanding of whether and how employment could be used to advance our collective well-being.

背景:与标准就业环境相比,不稳定就业是就业质量(EQ)概念范围的一个特定部分,已被确定为对个人和人口健康和福祉的重要风险。然而,我们仍有必要探索情商是否以及如何被用作一种工具,不仅可以保护还可以促进人们的健康和福祉。方法:本研究的目的是评估情商的多个维度的分析处理,以及研究人员对情商知识状态的描述立场,这些立场支持高情商是促进健康因素的观点。定量、定性和混合方法的初步研究,包括七个概念性情商维度中的至少三个,都是合格的。研究评估了所代表的情商维度,维度是如何分析处理的,研究者使用的致病、矛盾或有益健康的立场,以及每个研究可能告诉我们的关于如何利用高质量就业的各个方面来改善人口健康。结果:共纳入78项研究;其中54个以相互关联的方式处理情商维度。在分析相关的研究中,没有一个有明确的健康立场。一些证据表明,与经常被用作历史黄金标准的标准雇佣关系相比,少数几种EQ类型可能呈现出相同或更低的健康状况不佳风险。结论:从健康学角度进行的研究可能有助于我们理解就业是否以及如何被用来促进我们的集体福祉。
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引用次数: 0
What Control Measures Should I Use? Applying the Total Worker Health Hierarchy of Controls to Manage Workplace Fatigue 我应该采取什么控制措施?应用控制的总工人健康层次管理工作场所疲劳。
IF 2.7 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-14 DOI: 10.1002/ajim.23689
Imelda S. Wong, Drew Dawson, Sudha Pandalai, Madeline Sprajcer

Increased fatigue risk has been associated with safety-critical events such as work-related injuries. While control measures are needed to reduce these risks, the wide range and complexities of fatigue risk management strategies can make it difficult for organizations to prioritize efforts given limited resources and time. Given these challenges, the aims of this commentary are two-fold. The first is to conceptualize fatigue risk management strategies within the Total Worker Health (TWH) Hierarchy of Controls, a conceptual framework used to prioritize strategies to advance worker safety, health, and wellbeing. As an extension to the traditional Hierarchy of Controls, the TWH version presents strategies in order of effectiveness, ranging from “eliminate,” “substitute,” “redesign,” “educate,” and “encourage” categories. The second aim of this paper is to use the TWH Hierarchy of Controls to identify control measures which reflect the level of fatigue risk for adverse safety and health outcomes.

疲劳风险的增加与工伤等安全关键事件有关。虽然需要控制措施来减少这些风险,但疲劳风险管理策略的广泛和复杂性可能使组织在有限的资源和时间下难以确定工作的优先级。鉴于这些挑战,本文的目的是双重的。首先是在工人总健康(TWH)控制层次中概念化疲劳风险管理策略,这是一个概念框架,用于优先考虑促进工人安全,健康和福祉的策略。作为传统控制层次的延伸,TWH版本按照有效性顺序呈现策略,包括“消除”、“替代”、“重新设计”、“教育”和“鼓励”类别。本文的第二个目的是使用TWH控制层次来确定反映疲劳风险水平的控制措施,以产生不利的安全和健康结果。
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引用次数: 0
期刊
American journal of industrial medicine
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