American journal of industrial medicine最新文献

Objective: To examine the prevalence of workplace cannabis use across industry and occupation categories, and potential associations between workplace use, intoxication, and work-related injuries.

Method: National survey data from Wave 7 (2024) of the International Cannabis Policy Study (ICPS) were used, including 30,123 workers aged 16-65 years from the United States. Separate logistic regression models examined past 30-day cannabis use at work across standard industry and occupation categories, and the association between past 30-day self-reported use, intoxication at work, and work-related injuries in the past 12 months.

Results: Approximately 1 in 10 workers reported using cannabis at work/within 2 h before work, of whom 2 in 5 reported feeling high at work "often" or "every time." The prevalence of workplace consumption was greatest among those working in the "Agriculture, forestry, fishing and hunting" (24.9%), "Construction" (14.4%), and "Accommodation and food services" (12.6%) industries. Similar results were observed by occupation. The odds of experiencing a work-related injury in the past 12 months were greater among workplace cannabis consumers who reported feeling high "sometimes," "often," or "every time" versus those who reported no past-year cannabis use (29.6% vs. 11.2%, adjusted OR = 1.66, p < 0.001).

Conclusions: Workplace cannabis use is common in some occupations and industries, including those with substantial occupational risks. Self-reported cannabis intoxication at work was associated with increased odds of experiencing a work-related injury. Workplaces could consider developing policies that minimize cannabis intoxication at work, specifically, rather than all cannabis use.

Background: Sleep duration is a well-established factor associated with all-cause mortality and cardiovascular mortality. Poor sleep quality was also suggested to affect all-cause mortality risk among adults. The Cardiovascular Occupational Risk Factor determination in Israel Study (CORDIS) is a prospective cohort study of industrial workers who entered the study during 1985-1990 and have been followed for 36 years. We examined the relationship between sleep duration, sleeping problems and difficulties, and all-cause mortality in the CORDIS cohort.

Method: Self-reported data, including sleep duration and sleeping problems, from 7287 participants were merged with data on all-cause mortality obtained from the National Death Registry and the Central Bureau of Statistics.

Results: Over the 36-year follow-up, 2159 participants died: 445 were < 45 years and 1714 were ≥ 45 years. Sleep duration of ≤ 5 h significantly increased mortality risk (hazard ratio [HR] = 1.30, p = 0.0032), with a more pronounced effect in those < 45 years (HR = 1.55, p = 0.0028). Sleeping problems also increased mortality risk (HR = 1.30, p = 0.0088), with a stronger association among younger individuals (HR = 1.63, p = 0.0399). Conversely, difficulty sleeping when anticipating something unpleasant was linked to increased mortality only in those aged ≥ 45 years (HR = 1.17, p = 0.0440).

Conclusions: Our analysis showed that short sleep duration and sleeping problems are significant predictors for all-cause mortality, particularly in younger individuals (< 45 years). These results emphasize the importance of addressing sleep problems among different age groups to potentially reduce mortality risk.

Background: Fatal occupational injury rates among agricultural workers are within the top 10 most dangerous civilian jobs. However, tracking and documenting non-fatal agricultural injuries in Maine, as in other states, has proved challenging. In 2021, we developed a machine learning-based strategy to extract injury cases from free-text pre-hospital care records (PCRs), which together with final human coding, produces injury time-series records coded by type, severity, location, date, and subject industry. In this paper we explore and summarize novel time-series records for agriculture obtained from PCR from Maine.

Methods: From a fully labeled Maine dataset (N = 57,960) comprising coded injuries, we selected only agricultural events, yielding 1604 injuries from 2008 to 2022. We summarize by year, month and age category, and establish seasonality before decomposing time series data, divided into three roughly equal 4-year sub-periods, into seasonal, trend and random components using a classical additive model. We investigate associations between age category and injury rate via mixed effects regression, then perform time series regression on differenced monthly injury time series and temperature records to determine if, seasonality aside, temperature extrema are responsible for increased injuries. Finally, we visualize and summarize trend and random components for each study sub-period.

Results: Injury rates show strong seasonality with a peak in July-August, and a trough in January or February. Subject age drifts slowly upwards during our study period, and there is a significant and positive association between age category and injury rate for all but the most elderly farm workers. Injury rates in the age categories of 40-81 years increase dramatically between 2016 and the 2019-2022 period, as does the moving average of the injury rates, and the variability of the random component of the time series.

Conclusions: There is a significant positive association between increasing age category and injury rate across all periods. While our injury data has strong seasonality, we find no significant associations between monthly temperature extremes and injury rates. Moving average trends for injury rates in the two periods comprising 2008-2016 show little change in trend, but injury rate trend shifts upward in 2019-2022, almost doubling in mean value.

Advancing workplace mental health prevention is paramount, yet to date there are no effective, evidence-based strategies that can be widely recommended for prevention of occupational trauma-related symptoms. Because the conceptual framework of prevention following potentially psychologically traumatic exposure (PPTE) is to intervene prior to the development or worsening of trauma-related symptoms, an index of successful prevention is to observe no change or minimal change in baseline symptom levels. Considering common pitfalls of statistically interpreting an absence of change, in this review, we address the widespread problem of null findings in prevention science and discuss theoretical and analytical concepts to advance the quality and strength of inferences that can be drawn from statistical analysis in quantitative prevention science. Public safety personnel (PSP) comprise a unique set of occupational groups where frequent exposure to PPTEs is an inherent occupational hazard. Correspondingly, PSP demonstrate elevated prevalence rates of trauma-related disorders including PTSD, depression, anxiety, sleep problems, and substance use, and development of effective, evidence-based prevention is urgently needed. Using insights from research with PSP samples as a case study, we summarize current limitations constraining occupation-related prevention science and offer an overview of research design and analytical strategies to promote the development and testing of rigorous and effective prevention strategies to support occupational mental health.

Background: Existing research on the economic outcomes of 9/11 remains limited and has primarily focused on early retirement. Little is known about the prevalence of work disability and loss of a loved one and whether they are associated with survey attrition.

Methods: The World Trade Center Health Registry (WTCHR) is a closed longitudinal cohort that recruited more than 71,000 participants at baseline (2003-2004). Bivariate analyses were conducted to compare the distribution of 9/11 exposure and sociodemographic factors for (1) work disability, (2) early retirement, and (3) loss of a loved one. Separate Poisson models were constructed to predict survey attrition.

Results: Both those who were work-disabled and early-retired were more likely to be older, male, a rescue/recovery worker, and have greater 9/11 exposure. In addition, work disability was associated with lower income and educational attainment, and PTSD diagnosis. Loss of a loved one was associated with PTSD diagnosis and some measures of 9/11. Work disability was associated with higher and early retirement was associated with lower risk survey attrition at wave 4. Loss of a loved one was not associated with survey attrition.

Conclusion: Early retirement, work disability, and loss of a loved one can have major impacts on an individual's economic wellbeing and are potentially qualifying events for social programs, such as Social Security Administration (SSA) benefits. Future research is needed to overcome the limitations of self-reported data in order to understand how timely receipt of SSA benefits can lead to better health trajectories among disaster- and trauma-exposed populations.

Background: Increased robot adoption and advancements in robotics have led to the emergence of robotic arms for collaborative applications that work alongside humans, increasing direct human-robot interaction. This shift highlights the need to address new safety challenges posed by emerging robotic technologies. Currently, there is limited research on robot-related injuries.

Methods: Robot-related workers' compensation claims from 2001 to 2020 were identified using a keyword search from the Ohio Bureau of Workers' Compensation (OHBWC) database. Descriptive analyses were conducted on this claims dataset.

Results: From 2001 to 2020, 1076 robot-related claims were identified, with 85% medical-only claims (medical care only and/or ≤ 7 days away from work). Most claimants were male (74.2%), and 51.1% were 25-44 years old. More than half of the claims were due to contact with objects and equipment (57.9%), followed by overexertion and bodily reaction (20.6%). Most injuries occurred in the manufacturing sector (75.1%), followed by the service sector (14.7%). The claims resulted in over $8.3 million in costs. Of this figure, 91% was incurred due to lost-time claims ($7.6 million). Almost 30% of claims included diagnoses from multiple diagnosis groups. Most claims involved working with robotic arms for collaborative applications (75.7%) in a shared workspace.

Conclusions: Robotics is rapidly evolving to remove workers from hazardous environments and reduce risks from hazardous, repetitive, and manual tasks, but it may introduce new workplace hazards. There is a need to study robot-related injuries, identify high-risk exposures, and develop sector- or application-specific comprehensive safety approaches for safer implementation of robots in the workplace.

Introduction: It is well established that exposure to chemical, radiological, and biological hazards in the workplace are infertility risk factors. Although workplace-specific infertility risks have been documented, the associations between employment history and infertility risk remain largely unexplored. The cross-sectional, nationally representative US National Health and Nutrition Examination Survey (NHANES) provided an opportunity to explore the relationship between employment history and infertility risk.

Methods: Employment history and reproductive measures are available in the NHANES 2013-2014 cycle. Infertility was assessed using self-reported, binary indicators: unsuccessful conception attempts and sought fertility consultation; combined to create a third, aggregate infertility measure. Associations between infertility risk and employment history, categorized by industry group and compared to respondents with no work history, were examined using three weighted binary logistic regression models while adjusting for sociodemographic, reproductive health, and relevant behavioral covariates.

Results: The sample consisted of 1126 women, aged 20 to 50 years; 1082 (96.1%) with a history of employment across 10 industry groups. Infertility was reported by 177 (17.2%), who reported unsuccessful conception attempts or fertility consultations. Across industry sectors, employment in the manufacturing of durable goods industry was significantly associated with unsuccessful conception attempts (adjusted odds ratio [AOR]: 4.15; 95% CI: 1.22, 14.08), fertility consultations (AOR: 6.94; 95% CI: 1.44, 25.25), and the aggregate infertility measure (AOR: 4.43; 95% CI: 1.32, 14.81).

Conclusion: Employment in durable goods manufacturing is associated with multiple self-reported infertility measures, compared to women with no work history. In the absence of individualized workplace risk assessments, industry-level analyses may better inform workplace health promotion, with emphasis on reproductive health protections.

Background: For much of the 20th century, the South African mining industry had a statutory compensation system for pneumoconiosis and tuberculosis characterized by gross racial inequality. This study examines the impact of inflation over the period 1973-2024 on the real value of miners' lung disease compensation, including the effect of the dropping of formal racial discrimination after 1993.

Methods: Sources of information included legislation, government reports, notices, and Gazettes, and mining industry reports.

Results: From 1973 to 1993, high rates of inflation hollowed out the value of compensation for all miners, greater in absolute terms for white miners. From 1994, inflation continued to erode both the real value of compensation payments, and, with the rise in earnings for all miners, the percentage of annual earnings covered by these payments. Until 2017 there were a few sporadic increases in statutory payment amounts, but a cap on "allowable earnings" used to calculate compensation severely limited any gain. Underlying factors include historic underfunding of the Compensation Fund via the statutory employer levy, administrative disarray in the state compensation agency, and unanticipated political, economic and epidemic disruptions. Recent years have seen a restoration of financial and administrative stability, with some degree of reversal of long-term trends.

Conclusions: Although formal Apartheid racial discrimination ended in 1994, inflation, and until recently legislative stasis, continued to disadvantage all miners with compensatable occupational lung disease. The system is currently undergoing legislative reform-including proper funding of operations but also with limitation on civil liability against employers. The question therefore remains open as to whether a fair and equitable system of compensation for miners will be achieved and sustained.

Truck drivers sustain the movement of goods across Europe, yet the sector faces a concurrent health and workforce retention crisis-mirroring trends observed in North America. Approximately 426,000 driver positions remain unfilled across Europe, while rates of fatigue, sleep disruption, obesity, depression, musculoskeletal pain, and cardiometabolic disease are markedly higher among drivers than in the general working population. These challenges are often framed as isolated hazards or lifestyle-related outcomes. However, growing evidence indicates that they emerge from cumulative, interacting exposures shaped by working conditions, employment structures, mobility regimes, and related nonwork factors rather than drivers' behaviors alone. This paper introduces the working-life-exposome of European truck driving (WLE-ETD)-a systems-science paradigm for understanding how biological, behavioral, psychosocial, occupational, environmental, and sociostructural domains interact across the working lifecourse to shape health and workforce participation. The WLE-ETD conceptualizes driver health deterioration and labor shortages as co-produced outcomes of a shared exposure ecosystem rather than separate problems. It further outlines how longitudinal, multimodal data streams-integrating surveys, administrative records, biomarkers, wearables, environmental sensors, audits, and psychosocial assessments-can be linked with network epidemiology and interpretable AI to identify syndemic "nodes" that disproportionately drive both chronic disease and premature workforce withdrawal. By reframing this crisis as a systems-level outcome, the WLE-ETD provides a foundation for anticipatory prevention, cross-sector intervention design, and coordinated European policy action. Addressing the syndemic attrition crisis requires alignment across labor regulation, rest infrastructure, employment protections, and population health services. The WLE-ETD offers a conceptual and operational roadmap for such integrated approaches.

We evaluated 12 workers with documented exposure to respirable crystalline silica who were referred to a tertiary care center due to clinical suspicion of silicosis, sarcoidosis, or silicosarcoidosis. Although silica exposure is a well-established risk factor for silicosis and has been associated with autoimmune diseases, mycobacterial infections, and lung cancer, growing evidence also suggests a link with sarcoidosis, creating important diagnostic and therapeutic challenges. All patients underwent at least two clinical evaluations, high-resolution computed tomography (HRCT), and pulmonary function tests over a minimum follow-up of 12 months. Diagnostic classification was based on predefined criteria integrating occupational exposure history, longitudinal clinical course, HRCT patterns, pulmonary function changes, and histopathology when available; ten patients underwent transbronchial biopsy and six bronchoalveolar lavage. Three patients were classified as having silicosis, five as sarcoidosis, and four as silicosarcoidosis. Despite comparable exposure histories, the groups demonstrated distinct radiologic features, functional trajectories, and responses to therapy. Overlapping HRCT findings and the absence of standardized diagnostic criteria contributed to classification challenges, particularly in cases with mixed granulomatous and fibrotic patterns. In silica-exposed workers, although silicosis remains the most frequent diagnosis, distinguishing it from sarcoidosis and silicosarcoidosis requires systematic longitudinal assessment. The integration of occupational history with serial clinical, radiologic, functional, and histopathologic evaluation enhances diagnostic accuracy and supports appropriate therapeutic decision-making.