Workers' compensation insurance is an important financial resource for workers, and a key source of occupational injury and illness surveillance and research data. Underutilization of workers compensation is an ongoing concern. Using statewide data for a general working population, we estimated the portion of workers whose work-related injury or illness (WRII) was paid by workers' compensation and assessed workers' compensation utilization by industry, occupation, demographic and health characteristics, and over time.
Methods
We combined 5 years of Behavioral Risk Factor Surveillance System telephone survey data (2017–2022, excluding 2020) from Washington State for workers (n = 31,171) and identified respondents with WRII (n = 1463). We estimated the percent of workers who utilized workers' compensation to pay for treatment of their WRII, and calculated adjusted prevalence ratios to estimate underutilization controlling for sociodemographic, work and health factors. Estimates were weighted to be representative of the Washington adult population.
Results
Of the 5.1% of Washington workers who experienced a WRII within the past 12 months, just over half (51.3%, 95% CI: 48.1%, 54.5%) reported that their WRII was paid by workers' compensation insurance. Controlling for other sociodemographic, work and health factors, workers' compensation utilization was lower among workers who were younger, male, graduated from college, reported poorer mental health, and could not afford medical care. Workers' compensation utilization was lower among most service-related industries and occupations. Annual estimates of utilization statewide changed little over time.
Conclusion
Underutilization of workers' compensation insurance is substantial. Workers' compensation data are more likely to miss younger workers, and workers in service-related industries and occupations.
{"title":"Sociodemographic, Industry and Health Factors Associated With Underutilization of Workers' Compensation Insurance","authors":"Sara Wuellner, David Bonauto","doi":"10.1002/ajim.70032","DOIUrl":"10.1002/ajim.70032","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Workers' compensation insurance is an important financial resource for workers, and a key source of occupational injury and illness surveillance and research data. Underutilization of workers compensation is an ongoing concern. Using statewide data for a general working population, we estimated the portion of workers whose work-related injury or illness (WRII) was paid by workers' compensation and assessed workers' compensation utilization by industry, occupation, demographic and health characteristics, and over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We combined 5 years of Behavioral Risk Factor Surveillance System telephone survey data (2017–2022, excluding 2020) from Washington State for workers (<i>n</i> = 31,171) and identified respondents with WRII (<i>n</i> = 1463). We estimated the percent of workers who utilized workers' compensation to pay for treatment of their WRII, and calculated adjusted prevalence ratios to estimate underutilization controlling for sociodemographic, work and health factors. Estimates were weighted to be representative of the Washington adult population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 5.1% of Washington workers who experienced a WRII within the past 12 months, just over half (51.3%, 95% CI: 48.1%, 54.5%) reported that their WRII was paid by workers' compensation insurance. Controlling for other sociodemographic, work and health factors, workers' compensation utilization was lower among workers who were younger, male, graduated from college, reported poorer mental health, and could not afford medical care. Workers' compensation utilization was lower among most service-related industries and occupations. Annual estimates of utilization statewide changed little over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Underutilization of workers' compensation insurance is substantial. Workers' compensation data are more likely to miss younger workers, and workers in service-related industries and occupations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"69 1","pages":"3-13"},"PeriodicalIF":3.1,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajim.70032","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145290684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Megan Guardiano, Ross Andel, Xavier Trudel, Jian Li
Background
The job demand-control (JDC) psychosocial work model has demonstrated effects on objective cognitive performance, but its association with subjective memory is still poorly understood. We examined longitudinal associations of JDC characteristics with objective (general cognitive function/episodic memory) and subjective (perceived memory) cognition.
Methods
Using the Health and Retirement Study (HRS) data, 3497 workers aged 50+ were followed from 2006–2008 to 2018. Self-reported job demand and job control were dichotomized and later combined into quadrants reflecting high/low job strain and active/passive jobs. Analyses used covariate-adjusted generalized estimating equations.
Results
High job control was significantly positively associated with general cognitive function (regression coefficient: 0.409, p < 0.001), episodic memory (0.373, p < 0.001), and subjective memory (0.057, p = 0.034). “Low demand and high control” (low strain work) exhibited significant, positive associations with all cognitive outcomes. “High demand and high control” (active work) was significantly positively associated with objective cognitive outcomes.
Conclusions
Opportunities for enhancing job control may promote objective cognition and subjective memory health in the US aging workforce.
{"title":"Longitudinal Associations of Job Demand-Control Characteristics With Objective and Subjective Cognitive Outcomes in Older Workers: The Health and Retirement Study","authors":"Megan Guardiano, Ross Andel, Xavier Trudel, Jian Li","doi":"10.1002/ajim.70031","DOIUrl":"10.1002/ajim.70031","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The job demand-control (JDC) psychosocial work model has demonstrated effects on objective cognitive performance, but its association with subjective memory is still poorly understood. We examined longitudinal associations of JDC characteristics with objective (general cognitive function/episodic memory) and subjective (perceived memory) cognition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using the Health and Retirement Study (HRS) data, 3497 workers aged 50+ were followed from 2006–2008 to 2018. Self-reported job demand and job control were dichotomized and later combined into quadrants reflecting high/low job strain and active/passive jobs. Analyses used covariate-adjusted generalized estimating equations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>High job control was significantly positively associated with general cognitive function (regression coefficient: 0.409, <i>p</i> < 0.001), episodic memory (0.373, <i>p</i> < 0.001), and subjective memory (0.057, <i>p</i> = 0.034). “Low demand and high control” (low strain work) exhibited significant, positive associations with all cognitive outcomes. “High demand and high control” (active work) was significantly positively associated with objective cognitive outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Opportunities for enhancing job control may promote objective cognition and subjective memory health in the US aging workforce.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 12","pages":"1115-1130"},"PeriodicalIF":3.1,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajim.70031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dunya Tomic, Ryan F. Hoy, Janneke Berecki-Gisolf, Win Wah, Stella May Gwini, Malcolm R. Sim, Karen Walker-Bone
Background
Silicosis has re-emerged in middle- and high-income countries globally due to high silica exposures from manufacturing and fabrication of artificial stone countertops. No studies have reported the costs of workers' compensation claims for silicosis; we therefore examined cost trends in Victoria, Australia, and projected claim costs to 2031.
Methods
Data from the WorkSafe Victoria Compensation Research Database were used to identify all silicosis compensation claims among males from 2019 to 2024, and claim rates were estimated per year and age group. Using Poisson regression model estimates, claim cost projections were calculated for 2025–2031, separately for statutory (no-fault) and common law (fault-based) payments.
Results
From 2019 to 2024, there were 663 silicosis compensation claims made by 356 males aged 15–74 years in Victoria. Cumulative costs totaled AU $111.78 million. Annual cost projections suggest an increase over time, with a total of AU $29.88 million per year by 2031. Most claims remained active for over a year, particularly those by workers aged 25–54 years. Within 4-year follow-up, common law (fault-based) payments accounted for approximately 30% of total costs but dominated younger workers' claims. Projected 2031 costs were highest for claims by workers aged 35–44 years.
Conclusions
This study presents the first comprehensive estimate of projected workers' compensation costs for silicosis, highlighting a sustained financial burden driven by ongoing claims among younger workers. As artificial stone continues to be used internationally, these findings underscore the need for regulatory action to prevent a foreseeable health and economic burden.
{"title":"Counting the Costs of Silicosis in Victoria, Australia, 2019–2024, With Projections to 2031","authors":"Dunya Tomic, Ryan F. Hoy, Janneke Berecki-Gisolf, Win Wah, Stella May Gwini, Malcolm R. Sim, Karen Walker-Bone","doi":"10.1002/ajim.70030","DOIUrl":"10.1002/ajim.70030","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Silicosis has re-emerged in middle- and high-income countries globally due to high silica exposures from manufacturing and fabrication of artificial stone countertops. No studies have reported the costs of workers' compensation claims for silicosis; we therefore examined cost trends in Victoria, Australia, and projected claim costs to 2031.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from the WorkSafe Victoria Compensation Research Database were used to identify all silicosis compensation claims among males from 2019 to 2024, and claim rates were estimated per year and age group. Using Poisson regression model estimates, claim cost projections were calculated for 2025–2031, separately for statutory (no-fault) and common law (fault-based) payments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 2019 to 2024, there were 663 silicosis compensation claims made by 356 males aged 15–74 years in Victoria. Cumulative costs totaled AU $111.78 million. Annual cost projections suggest an increase over time, with a total of AU $29.88 million per year by 2031. Most claims remained active for over a year, particularly those by workers aged 25–54 years. Within 4-year follow-up, common law (fault-based) payments accounted for approximately 30% of total costs but dominated younger workers' claims. Projected 2031 costs were highest for claims by workers aged 35–44 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study presents the first comprehensive estimate of projected workers' compensation costs for silicosis, highlighting a sustained financial burden driven by ongoing claims among younger workers. As artificial stone continues to be used internationally, these findings underscore the need for regulatory action to prevent a foreseeable health and economic burden.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 12","pages":"1105-1114"},"PeriodicalIF":3.1,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145249405","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}
Imelda S. Wong, Toni Alterman, Beverly M. Hittle, Raquel Velazquez-Kronen, I-Chen Chen
Background
Many factors have resulted in the normalization of nonstandard work schedules in recent decades, including globalization requiring working across time zones and growing demands for goods and services. This paper provides national estimates of overnight work in the USA.
Methods
We used cross-sectional data from the 2015 National Health Interview Survey (n = 19,386 US employed adults ≥ 18 years). This survey contained a unique definition of overnight work (i.e., between 1:00 a.m. and 5:00 a.m.), based on the window of circadian low. Weighted prevalence rates were provided across categories of sociodemographic characteristics, health status, health behaviors, and occupational factors.
Results
We estimated more than 21 million US employed adults experienced overnight work (14.2%). Higher prevalence was found among men (17.8%), non-Hispanic Black adults (17.2%), non-US born adults (11.2%), those with some college (15.9%) or a high school (16.7%) education, or living in the Midwest region (15.8%). Compared to those sleeping 7–9 h (10.5%), higher percentages of adults working overnight slept < 7 h (21.4%) and > 9 h (17.0%). Increasing prevalence was observed with increasing weekly work hours (p < 0.0001). Higher prevalence was reported among multiple job holders (19.5%). Industries and occupations with the greatest percentage of overnight workers were Transportation, Warehousing and Utilities (29.3%), and Protective Services (47.4%).
Conclusion
Our estimates of overnight work in 2015 are almost five times higher than estimates from 2004. Given that overnight work has been associated with adverse safety and health outcomes, additional policies and programs are needed to protect this growing population of workers.
{"title":"Prevalence of Overnight Work (1 a.m. to 5 a.m.) Among United States Workers","authors":"Imelda S. Wong, Toni Alterman, Beverly M. Hittle, Raquel Velazquez-Kronen, I-Chen Chen","doi":"10.1002/ajim.70027","DOIUrl":"10.1002/ajim.70027","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Many factors have resulted in the normalization of nonstandard work schedules in recent decades, including globalization requiring working across time zones and growing demands for goods and services. This paper provides national estimates of overnight work in the USA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used cross-sectional data from the 2015 National Health Interview Survey (<i>n</i> = 19,386 US employed adults ≥ 18 years). This survey contained a unique definition of overnight work (i.e., between 1:00 a.m. and 5:00 a.m.), based on the window of circadian low. Weighted prevalence rates were provided across categories of sociodemographic characteristics, health status, health behaviors, and occupational factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We estimated more than 21 million US employed adults experienced overnight work (14.2%). Higher prevalence was found among men (17.8%), non-Hispanic Black adults (17.2%), non-US born adults (11.2%), those with some college (15.9%) or a high school (16.7%) education, or living in the Midwest region (15.8%). Compared to those sleeping 7–9 h (10.5%), higher percentages of adults working overnight slept < 7 h (21.4%) and > 9 h (17.0%). Increasing prevalence was observed with increasing weekly work hours (<i>p</i> < 0.0001). Higher prevalence was reported among multiple job holders (19.5%). Industries and occupations with the greatest percentage of overnight workers were Transportation, Warehousing and Utilities (29.3%), and Protective Services (47.4%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our estimates of overnight work in 2015 are almost five times higher than estimates from 2004. Given that overnight work has been associated with adverse safety and health outcomes, additional policies and programs are needed to protect this growing population of workers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 12","pages":"1088-1104"},"PeriodicalIF":3.1,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajim.70027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sammy Almashat, Matthew Horch, Brian Chen, Melissa McDiarmid
Public health registries collect and maintain demographic and health data on a cohort of people with a common disease or exposure. While disease registries have proliferated in recent decades, registries comprising persons with potentially hazardous exposures—known commonly as exposure registries—are rare. Occupational exposure registries allow for hazardous work exposures to toxicants, including carcinogens, to be systematically tracked to facilitate preventive and mitigating interventions for exposed workers. However, the virtual absence of such registries, combined with the fact that state-based cancer registries do not systematically collect occupational or other exposure information, hinders efforts to study the role of occupation in US cancer cases or undertake appropriate medical surveillance for exposed workers. Given the considerable, and under-recognized, risk of occupational cancer, exposure registries focused on workplace carcinogens could fill this gap. A recent initiative at the authors' home institution has established a national exposure registry of oncology personnel handling hazardous drugs, most notably antineoplastic drugs, many of which are themselves known human carcinogens. The registry aims to facilitate the comprehensive collection of data on exposure scenarios; aid in raising awareness of, and tracking compliance with, best practices in hazardous-drug handling to mitigate risks; and assess long-term cancer, reproductive, and other potentially exposure-associated health outcomes in this worker population. Occupational exposure registries are an underutilized tool in occupational health surveillance. The development of such a registry for hazardous drug exposures is a feasible and scalable model for registry development in other high-risk work environments.
{"title":"Exposure Registries as a Prevention Tool for Occupational Cancers: Establishing a New Hazardous Drug Registry for Oncology Personnel","authors":"Sammy Almashat, Matthew Horch, Brian Chen, Melissa McDiarmid","doi":"10.1002/ajim.70029","DOIUrl":"10.1002/ajim.70029","url":null,"abstract":"<p>Public health registries collect and maintain demographic and health data on a cohort of people with a common disease or exposure. While disease registries have proliferated in recent decades, registries comprising persons with potentially hazardous exposures—known commonly as exposure registries—are rare. Occupational exposure registries allow for hazardous work exposures to toxicants, including carcinogens, to be systematically tracked to facilitate preventive and mitigating interventions for exposed workers. However, the virtual absence of such registries, combined with the fact that state-based cancer registries do not systematically collect occupational or other exposure information, hinders efforts to study the role of occupation in US cancer cases or undertake appropriate medical surveillance for exposed workers. Given the considerable, and under-recognized, risk of occupational cancer, exposure registries focused on workplace carcinogens could fill this gap. A recent initiative at the authors' home institution has established a national exposure registry of oncology personnel handling hazardous drugs, most notably antineoplastic drugs, many of which are themselves known human carcinogens. The registry aims to facilitate the comprehensive collection of data on exposure scenarios; aid in raising awareness of, and tracking compliance with, best practices in hazardous-drug handling to mitigate risks; and assess long-term cancer, reproductive, and other potentially exposure-associated health outcomes in this worker population. Occupational exposure registries are an underutilized tool in occupational health surveillance. The development of such a registry for hazardous drug exposures is a feasible and scalable model for registry development in other high-risk work environments.</p>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 12","pages":"1037-1047"},"PeriodicalIF":3.1,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajim.70029","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marianne Cloeren, John Dement, Jane Quackenbush, Patricia Quinn, Knut Ringen
Background
Age-related hearing loss is associated with increased dementia risk. We examined the association between hearing loss and dementia in a population at high risk for hearing loss from occupational noise exposures.
Methods
We conducted cross-sectional and longitudinal analyses using logistic regression and interval-censored Cox models using data from the Building Trades National Medical Screening Program (BTMed), from inception in 1996 through March 2024. Hearing loss was defined as a speech-frequency pure-tone average ≥ 20 decibels (dB) in the better ear and categorized as mild (20–34 dB), moderate (35–49 dB), moderately severe (50–64 dB), or severe to complete (≥ 65 dB). Dementia was defined using criteria from medical history, physical exams, and medication data across all medical screening examinations.
Results
The study included 44,000 exams in 24,958 BTMed participants; 54.6% had hearing loss. Hearing loss was strongly associated with dementia prevalence (211 cases, p < 0.001), with prevalence increasing by severity. Cross-sectional analysis found a significant association between hearing loss ≥ 20 dB and dementia (adjusted odds ratio = 1.88, 95% confidence interval (CI) = 1.15–3.07). In longitudinal analysis, a Cox model adjusted for confounders estimated a hazard ratio of 1.60 (95% CI = 0.99–2.59, p-trend = 0.0928) for incident dementia.
Discussion
Cross-sectional results support an association between occupational hearing loss and dementia, consistent in direction with findings for age-related hearing loss; longitudinal estimates were not significant but were directionally similar. If confirmed in other high-risk cohorts with repeated audiometry, these findings underscore the potential for hearing conservation and hearing loss rehabilitation in dementia prevention.
{"title":"Is Work-Related Hearing Loss Associated With Dementia? Evidence From a High-Risk Population","authors":"Marianne Cloeren, John Dement, Jane Quackenbush, Patricia Quinn, Knut Ringen","doi":"10.1002/ajim.70026","DOIUrl":"10.1002/ajim.70026","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Age-related hearing loss is associated with increased dementia risk. We examined the association between hearing loss and dementia in a population at high risk for hearing loss from occupational noise exposures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted cross-sectional and longitudinal analyses using logistic regression and interval-censored Cox models using data from the Building Trades National Medical Screening Program (BTMed), from inception in 1996 through March 2024. Hearing loss was defined as a speech-frequency pure-tone average ≥ 20 decibels (dB) in the better ear and categorized as mild (20–34 dB), moderate (35–49 dB), moderately severe (50–64 dB), or severe to complete (≥ 65 dB). Dementia was defined using criteria from medical history, physical exams, and medication data across all medical screening examinations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 44,000 exams in 24,958 BTMed participants; 54.6% had hearing loss. Hearing loss was strongly associated with dementia prevalence (211 cases, <i>p</i> < 0.001), with prevalence increasing by severity. Cross-sectional analysis found a significant association between hearing loss ≥ 20 dB and dementia (adjusted odds ratio = 1.88, 95% confidence interval (CI) = 1.15–3.07). In longitudinal analysis, a Cox model adjusted for confounders estimated a hazard ratio of 1.60 (95% CI = 0.99–2.59, <i>p</i>-trend = 0.0928) for incident dementia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Cross-sectional results support an association between occupational hearing loss and dementia, consistent in direction with findings for age-related hearing loss; longitudinal estimates were not significant but were directionally similar. If confirmed in other high-risk cohorts with repeated audiometry, these findings underscore the potential for hearing conservation and hearing loss rehabilitation in dementia prevention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 11","pages":"1013-1027"},"PeriodicalIF":3.1,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajim.70026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emily J. Tetzlaff, Bruce E. Oddson, Kristina-Marie T. Janetos, Robert D. Meade, Glen P. Kenny
Introduction
With the frequency and intensity of extreme heat events rising, occupational health and safety (OHS) personnel must be well-informed about heat management solutions. Consequently, assessing the knowledge level and technical expertise of OHS personnel is essential for equipping workplaces to operate safely in hotter conditions.
Methods
The Human and Environmental Physiology Research Unit-Occupational Heat Stress Knowledge Assessment Test (HEPRU-OHSKAT) was distributed among OHS personnel and the general working population (GWP) (> 18 years) throughout Ontario, Canada, to assess their current knowledge regarding managing occupational heat stress. The instrument included 31 items grouped into four core competency areas including: (A) General Heat Stress Knowledge (items (q): 8, max score (ms): 13), (B) Knowing the Signs and Symptoms of Heat Stress and First Aid (q: 7, ms: 32), (C) Exposure Limits and Heat Monitoring Practices (q: 13, ms: 40), and (D) Workplace Controls for Heat (q: 3, ms: 15). The number of respondents and the percentage of the total sample were calculated based on individual response rates to each question.
Results
A total of 317 respondents (female: 110, median age: 42 years, range: 18–74) from 17 industries (OHS: 68% vs. GWP: 32%) completed the HEPRU-OHSKAT. The average total knowledge score for all respondents was 54 ± 22% (56 ± 22% vs. 48 ± 21%), with no respondents exceeding 90% overall and scores on individual knowledge categories varying substantially.
Conclusions
The HEPRU-OHSKAT identified knowledge gaps among OHS personnel in Ontario's workplaces, particularly for knowledge of control measures for reducing or preventing exposure to heat stress.
Practical Applications
Training and education are necessary across all HEPRU-OHSKAT knowledge categories to enhance heat stress management and minimize the OHS hazards associated with working in the heat.
{"title":"An Evaluation of Health and Safety Personnel and Workers' Occupational Heat Stress Knowledge in Ontario: Paper B","authors":"Emily J. Tetzlaff, Bruce E. Oddson, Kristina-Marie T. Janetos, Robert D. Meade, Glen P. Kenny","doi":"10.1002/ajim.70025","DOIUrl":"10.1002/ajim.70025","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>With the frequency and intensity of extreme heat events rising, occupational health and safety (OHS) personnel must be well-informed about heat management solutions. Consequently, assessing the knowledge level and technical expertise of OHS personnel is essential for equipping workplaces to operate safely in hotter conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Human and Environmental Physiology Research Unit-Occupational Heat Stress Knowledge Assessment Test (HEPRU-OHSKAT) was distributed among OHS personnel and the general working population (GWP) (> 18 years) throughout Ontario, Canada, to assess their current knowledge regarding managing occupational heat stress. The instrument included 31 items grouped into four core competency areas including: (A) General Heat Stress Knowledge (items (q): 8, max score (ms): 13), (B) Knowing the Signs and Symptoms of Heat Stress and First Aid (q: 7, ms: 32), (C) Exposure Limits and Heat Monitoring Practices (q: 13, ms: 40), and (D) Workplace Controls for Heat (q: 3, ms: 15). The number of respondents and the percentage of the total sample were calculated based on individual response rates to each question.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 317 respondents (female: 110, median age: 42 years, range: 18–74) from 17 industries (OHS: 68% vs. GWP: 32%) completed the HEPRU-OHSKAT. The average total knowledge score for all respondents was 54 ± 22% (56 ± 22% vs. 48 ± 21%), with no respondents exceeding 90% overall and scores on individual knowledge categories varying substantially.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The HEPRU-OHSKAT identified knowledge gaps among OHS personnel in Ontario's workplaces, particularly for knowledge of control measures for reducing or preventing exposure to heat stress.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practical Applications</h3>\u0000 \u0000 <p>Training and education are necessary across all HEPRU-OHSKAT knowledge categories to enhance heat stress management and minimize the OHS hazards associated with working in the heat.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 12","pages":"1077-1087"},"PeriodicalIF":3.1,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajim.70025","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145224841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Edite Macaringue Raja, Sujatha Hariparsad, Rajen N. Naidoo
Background
Work exposure-related declines in lung function among aluminum smelter workers are well documented, yet task-varying exposures are likely to contribute differently to respiratory outcomes. This study aimed to assess the association between potroom exposure and lung function changes over time among aluminum smelter workers.
Methods
A retrospective review of spirometric assessments of 265 potroom workers and their exposure to sulfur dioxide (SO2) and fluoride was conducted. Cumulative exposure was described through job exposure matrices by job titles and exposure across the lifetime of employment. Associations between exposure and lung function were determined using mixed-effect models and a 1-year lag exposure.
Results
Exposures were within the prescribed occupational exposure limits. SO2 was highest in the maintenance section (mean: 0.4 ppm [range 0.3–0.5 ppm]), while the process control section (mean: 1.1 mg/m3 [range 0.04–2.6 mg/m3]) had the highest level of fluoride. Among those workers who contributed lung function measures at each of the 10 years (n = 98), there was a decline in the percentpredicted forced expiratory volume in 1 second/forced vital capacity ratio (FEV1/FVC) of 0.21% (95% CI: 0.35–0.07). Within the entire sample, there was an estimated decline of 2.9% (95% CI: −3.9 to −1.9) and 0.15% (95% CI: −0.23 to −0.07) in percentage-predicted FEV1/FVC, associated with cumulative SO2 and cumulative fluoride exposure, respectively. A 1-year lagged decline was also seen for the FEV1/FVC ratio for both pollutants.
Conclusion
SO2 and fluoride exposure in aluminum smelting is associated with statistically significant lung function declines over the years of exposure.
{"title":"Sulfur Dioxide- and Fluoride-Associated Declines in Lung Function Over an 11-Year Observation Among Aluminum Smelter Workers","authors":"Edite Macaringue Raja, Sujatha Hariparsad, Rajen N. Naidoo","doi":"10.1002/ajim.70023","DOIUrl":"10.1002/ajim.70023","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Work exposure-related declines in lung function among aluminum smelter workers are well documented, yet task-varying exposures are likely to contribute differently to respiratory outcomes. This study aimed to assess the association between potroom exposure and lung function changes over time among aluminum smelter workers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective review of spirometric assessments of 265 potroom workers and their exposure to sulfur dioxide (SO<sub>2</sub>) and fluoride was conducted. Cumulative exposure was described through job exposure matrices by job titles and exposure across the lifetime of employment. Associations between exposure and lung function were determined using mixed-effect models and a 1-year lag exposure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Exposures were within the prescribed occupational exposure limits. SO<sub>2</sub> was highest in the maintenance section (mean: 0.4 ppm [range 0.3–0.5 ppm]), while the process control section (mean: 1.1 mg/m<sup>3</sup> [range 0.04–2.6 mg/m<sup>3</sup>]) had the highest level of fluoride. Among those workers who contributed lung function measures at each of the 10 years (<i>n</i> = 98), there was a decline in the percentpredicted forced expiratory volume in 1 second/forced vital capacity ratio (FEV<sub>1</sub>/FVC) of 0.21% (95% CI: 0.35–0.07). Within the entire sample, there was an estimated decline of 2.9% (95% CI: −3.9 to −1.9) and 0.15% (95% CI: −0.23 to −0.07) in percentage-predicted FEV<sub>1</sub>/FVC, associated with cumulative SO<sub>2</sub> and cumulative fluoride exposure, respectively. A 1-year lagged decline was also seen for the FEV<sub>1</sub>/FVC ratio for both pollutants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>SO<sub>2</sub> and fluoride exposure in aluminum smelting is associated with statistically significant lung function declines over the years of exposure.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 12","pages":"1053-1061"},"PeriodicalIF":3.1,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajim.70023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145224811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emily J. Tetzlaff, Bruce E. Oddson, Kristina-Marie T. Janetos, Robert D. Meade, Glen P. Kenny
Introduction
Occupational heat stress poses a critical threat to workers' health, safety, and productivity. To effectively manage this hazard, occupational health and safety (OHS) representatives must comprehensively understand heat stress, heat-associated injury and disease outcomes, and heat mitigation measures to protect workers. We developed the Human and Environmental Physiology Research Unit-Occupational Heat Stress Knowledge Assessment Test (HEPRU-OHSKAT) as an initial step toward facilitating research in this area.
Method
The HEPRU-OHSKAT was developed using a mixed-methods approach. Preliminary items were developed after reviewing the academic and gray literature. A standardized content validity assessment was conducted with heat stress and OHS experts (n = 9); a trial distribution to refine and test feasibility was performed with an internal pilot group (n = 18). The instrument was then distributed to individuals involved with OHS (n = 216) and members of the general working population (n = 101) in Ontario, Canada (n = 317). Item analysis and item response theory modelling were used to refine the scale and scope of the instrument.
Results
Thirty-two items were developed for the preliminary instrument. Following expert consultation, a review of content validity, and the internal pilot, 31 items were retained in four subscales: General Heat Stress Knowledge (n = 8), Recognizing the Signs and Symptoms of Heat Stress and First Aid (n = 7), Exposure Limits and Heat Monitoring Practices (n= 13), and Workplace Controls for Heat (n = 3). Following item selection, the broader instrument was reduced to 20 items grouped into one scale.
Conclusions
The HEPRU-OHSKAT is the first instrument to assess knowledge of heat stress among those responsible for OHS. The instrument showed good reliability and internal consistency across knowledge categories.
Practical Applications
The instrument can help OHS representatives better evaluate knowledge of, and manage training about, heat stress.
{"title":"Developing and Refining a Knowledge Assessment Instrument for Individuals Involved in Managing Occupational Heat Stress: Paper A","authors":"Emily J. Tetzlaff, Bruce E. Oddson, Kristina-Marie T. Janetos, Robert D. Meade, Glen P. Kenny","doi":"10.1002/ajim.70024","DOIUrl":"10.1002/ajim.70024","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Occupational heat stress poses a critical threat to workers' health, safety, and productivity. To effectively manage this hazard, occupational health and safety (OHS) representatives must comprehensively understand heat stress, heat-associated injury and disease outcomes, and heat mitigation measures to protect workers. We developed the Human and Environmental Physiology Research Unit-Occupational Heat Stress Knowledge Assessment Test (HEPRU-OHSKAT) as an initial step toward facilitating research in this area.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>The HEPRU-OHSKAT was developed using a mixed-methods approach. Preliminary items were developed after reviewing the academic and gray literature. A standardized content validity assessment was conducted with heat stress and OHS experts (<i>n</i> = 9); a trial distribution to refine and test feasibility was performed with an internal pilot group (<i>n</i> = 18). The instrument was then distributed to individuals involved with OHS (<i>n</i> = 216) and members of the general working population (<i>n</i> = 101) in Ontario, Canada (<i>n</i> = 317). Item analysis and item response theory modelling were used to refine the scale and scope of the instrument.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-two items were developed for the preliminary instrument. Following expert consultation, a review of content validity, and the internal pilot, 31 items were retained in four subscales: <i>General Heat Stress Knowledge</i> (<i>n</i> = 8), <i>Recognizing the Signs and Symptoms of Heat Stress and First Aid</i> (<i>n</i> = 7), <i>Exposure Limits and Heat Monitoring Practices</i> (<i>n</i>= 13), and <i>Workplace Controls for Heat</i> (<i>n</i> = 3). Following item selection, the broader instrument was reduced to 20 items grouped into one scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The HEPRU-OHSKAT is the first instrument to assess knowledge of heat stress among those responsible for OHS. The instrument showed good reliability and internal consistency across knowledge categories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practical Applications</h3>\u0000 \u0000 <p>The instrument can help OHS representatives better evaluate knowledge of, and manage training about, heat stress.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 12","pages":"1062-1076"},"PeriodicalIF":3.1,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajim.70024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145224808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Juliana G. E. Bartels, Jennifer R. Head, Simon K. Camponuri, Ellen A. Eisen
Valley fever is a fungal disease acquired through inhalation of spores of the fungus Coccidioides. Spores become airborne when soil is disturbed, making outdoor workers, such as agricultural or construction workers, at higher risk of exposure and disease. Valley fever is endemic and increasing in the American Southwest, with numerous documented outbreaks among construction crews, archeologists, prison employees, wildland firefighters, and military personnel. Valley fever is recognized as a work-related disease in California, but not Arizona or other states with endemic disease. Epidemiologists require surveillance data with patient industry and occupation to make the case to clinicians, legislators, and employers that Valley fever is an occupational disease that can be prevented through tailored interventions. Valley fever is a reportable disease in 28 states, including California and Arizona, and Washington, D.C.; however, most case reports are sent through automated lab reports or manual case reporting, which seldom include information about industry or occupation. Electronic case reporting (eCR), in which automated disease reports are sent to public health agencies from health care facilities via electronic medical records, provides a new pathway to streamline case reporting and is more conducive to inclusion of industry and occupation data in case reports. Occupational reporting through eCR would help build the epidemiological base to identify worker populations with excess cases of Valley fever, to identify occupational clusters, facilitate early outbreak detection, provide evidence for worker compensation claims of work-related infections, and support the development of more protective legislation to train and educate workers on prevention methods.
{"title":"Valley Fever Is an Occupational Illness: Let's Get the Data to Prevent It","authors":"Juliana G. E. Bartels, Jennifer R. Head, Simon K. Camponuri, Ellen A. Eisen","doi":"10.1002/ajim.70017","DOIUrl":"10.1002/ajim.70017","url":null,"abstract":"<p>Valley fever is a fungal disease acquired through inhalation of spores of the fungus <i>Coccidioides</i>. Spores become airborne when soil is disturbed, making outdoor workers, such as agricultural or construction workers, at higher risk of exposure and disease. Valley fever is endemic and increasing in the American Southwest, with numerous documented outbreaks among construction crews, archeologists, prison employees, wildland firefighters, and military personnel. Valley fever is recognized as a work-related disease in California, but not Arizona or other states with endemic disease. Epidemiologists require surveillance data with patient industry and occupation to make the case to clinicians, legislators, and employers that Valley fever is an occupational disease that can be prevented through tailored interventions. Valley fever is a reportable disease in 28 states, including California and Arizona, and Washington, D.C.; however, most case reports are sent through automated lab reports or manual case reporting, which seldom include information about industry or occupation. Electronic case reporting (eCR), in which automated disease reports are sent to public health agencies from health care facilities via electronic medical records, provides a new pathway to streamline case reporting and is more conducive to inclusion of industry and occupation data in case reports. Occupational reporting through eCR would help build the epidemiological base to identify worker populations with excess cases of Valley fever, to identify occupational clusters, facilitate early outbreak detection, provide evidence for worker compensation claims of work-related infections, and support the development of more protective legislation to train and educate workers on prevention methods.</p>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 11","pages":"929-932"},"PeriodicalIF":3.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajim.70017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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