American journal of industrial medicine最新文献_第5页

Sarcoidosis in Beryllium Exposed Workers: A Case-Case Study 铍接触工人的肉样瘤病：病例研究。

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

American journal of industrial medicine

Pub Date : 2024-11-25 DOI: 10.1002/ajim.23676

Annyce S. Mayer, Margaret M. Mroz, Michael K. Van Dyke, Karin A. Pacheco, E. Brigitte Gottschall, James L. Crooks, Lisa A. Maier

Background

Despite the utility of the beryllium lymphocyte proliferation test (BeLPT), distinguishing sarcoidosis, a disease of unknown etiology, from chronic beryllium disease (CBD), has long posed a diagnostic challenge. It is unclear if beryllium-exposed sarcoidosis cases (Be-exp-Sarc) are clinically distinct from CBD, or are misdiagnosed cases of CBD.

Methods

We performed a case-case study of 40 beryllium-exposed individuals diagnosed with Be-exp-Sarc compared to 40 frequency-matched CBD cases. We compared demographics, exposure, clinical, physical, and radiographic characteristics and HLA DBPI E69 genotype.

Results

Compared to CBD, Be-exp-Sarc cases were diagnosed at a younger age, had lower lung function, were less likely to have normal radiographic imaging, were more likely to have massive adenopathy and extra-thoracic manifestations and were more likely to have been prescribed systemic immunosuppressive therapy. Be-exp-Sarc tended to have fewer years of beryllium exposure, but there were no significant differences in the amount of beryllium exposure. HLA DPBI E69 was present in 53% of Be-exp-Sarc cases, not different from the general population, versus 92% of CBD cases (p < 0.001).

Conclusions

While a number of differences were observed, the only absolute distinguishing features were lack of confirmed beryllium sensitization in Be-exp-Sarc and lack of extra-thoracic manifestations in CBD. These findings suggest that Be-exp-Sarc may be distinct from CBD, and beryllium or some other workplace exposure may possibly play an as yet to be defined etiologic role, although the possibility that these cases could be due to selection bias from heightened surveillance in beryllium workforces cannot be excluded.

背景：尽管铍淋巴细胞增殖试验（BeLPT）很有用，但将肉样瘤病（一种病因不明的疾病）与慢性铍病（CBD）区分开来一直是一个诊断难题。目前还不清楚铍暴露肉样瘤病例（Be-exp-Sarc）在临床上是否有别于 CBD，或者是 CBD 的误诊病例：我们对 40 例诊断为 Be-exp-Sarc 的铍暴露者和 40 例频率匹配的 CBD 病例进行了个案研究。我们比较了人口统计学、接触、临床、物理和放射学特征以及 HLA DBPI E69 基因型：与 CBD 病例相比，Be-exp-Sarc 病例的确诊年龄较小、肺功能较低、放射影像学检查正常的可能性较小、出现大面积腺病和胸外表现的可能性较大、接受全身免疫抑制治疗的可能性较大。Be-exp-Sarc患者接触铍的年数较少，但接触铍的数量没有显著差异。53%的Be-exp-Sarc病例中存在HLA DPBI E69，与普通人群无差异，而CBD病例中则有92%存在HLA DPBI E69（p 结论：Be-exp-Sarc病例中的HLA DPBI E69与CBD病例中的92%无差异：虽然观察到了一些差异，但唯一绝对的区别特征是，Be-exp-Sarc 病例中没有确诊的铍致敏，而 CBD 病例中没有胸腔外表现。这些研究结果表明，Be-exp-Sarc 可能有别于 CBD，铍或其他工作场所接触可能是尚未确定的致病因素，但也不排除这些病例可能是由于加强了对铍工作场所的监控而造成的选择偏差。

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引用次数: 0

A Review of Job Assignments and Asbestos Workplace Exposure Measurements for TAWP Mesothelioma Deaths Through 2011 截至 2011 年的 TAWP 间皮瘤死亡病例的工作分配和石棉工作场所暴露测量回顾。

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

American journal of industrial medicine

Pub Date : 2024-11-18 DOI: 10.1002/ajim.23675

Valerie J. Willis, Jeffrey L. Levin, Dalia E. Nessim

Introduction

Asbestos workers have a higher risk of developing mesothelioma; however, few studies have looked at specific jobs and job locations within asbestos factories. The purpose of this study was to investigate asbestos exposure in different job locations of the Tyler, Texas asbestos plant to determine if there was a relationship between the duration of exposure and air fiber concentration burden in workers who developed pleural versus peritoneal mesothelioma.

Methods

This study used a patient information database to compile secondary data on 23 workers who died from mesothelioma through 2011. The airborne fiber exposure burdens for each of the 23 workers were estimated and then stratified by job location category and by type of mesothelioma for analysis.

Results

Most of the worker cases were assigned to the forming area which had the overall highest fiber concentration of all the plant's job locations. Workers who developed pleural mesothelioma spent the most time in the packing and miscellaneous locations, whereas workers who developed peritoneal mesothelioma worked mostly in the forming and miscellaneous locations. There were significant differences in days worked and estimated airborne exposure fiber burden between the pleural and peritoneal mesothelioma cases in the forming and curing locations.

Conclusion

Results from this study reiterate the association between occupational asbestos exposure and mesothelioma, emphasizing the importance of concentration of respirable asbestos dust levels and duration of exposure.

导言：石棉工人罹患间皮瘤的风险较高；然而，很少有研究对石棉工厂内的特定工作和工作地点进行调查。本研究的目的是调查得克萨斯州泰勒石棉厂不同工作地点的石棉暴露情况，以确定患胸膜间皮瘤和腹膜间皮瘤的工人的暴露时间和空气纤维浓度负担之间是否存在关系：本研究利用患者信息数据库，汇编了2011年之前死于间皮瘤的23名工人的二手数据。对这 23 名工人的空气传播纤维暴露负担进行了估算，然后按工作地点类别和间皮瘤类型进行了分层分析：结果：大多数工人的病例都发生在成型区，该区的纤维浓度是工厂所有工作地点中最高的。患胸膜间皮瘤的工人在包装和杂项工作地点工作的时间最长，而患腹膜间皮瘤的工人则主要在成型和杂项工作地点工作。胸膜间皮瘤病例和腹膜间皮瘤病例在成型和固化地点的工作天数和估计的空气传播纤维负荷有明显差异：这项研究的结果重申了职业石棉暴露与间皮瘤之间的联系，强调了可吸入石棉粉尘浓度水平和暴露时间长短的重要性。

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引用次数: 0

Association Between Employment Factors and Prevalence of Cardiovascular Disease in US Law Enforcement Workers: The National Health Interview Survey, 2006–2018 美国执法人员的就业因素与心血管疾病患病率之间的关系：2006-2018年全国健康访谈调查》。

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

American journal of industrial medicine

Pub Date : 2024-11-08 DOI: 10.1002/ajim.23674

Chibuzor Abasilim, Brett Shannon, Oluwabunmi Ogungbe, Katherine E. McCoy, Linda Forst, Lee S. Friedman

Background

Law enforcement workers face a higher risk of cardiovascular disease (CVD), however, employment factors impacting CVD remain systematically understudied, particularly in a national US sample. We describe temporal trends in prevalent CVD including coronary heart disease (CHD), angina, myocardial infarction (MI) and other heart disease; and investigate associations of select employment factors with CVD among law enforcement workers using the National Health Interview Survey (NHIS) from 2006 to 2018.

Methods

We analyzed prevalent CVD in law enforcement workers employed in local, state, and federal establishments using the NHIS, a nationally representative sample of US workers. We estimated odds ratios (OR [95% confidence interval, CI]) of CVD in relation to employment factors using survey-weighted multivariable logistic regression models adjusted for sociodemographic and traditional CVD risk factors.

Results

Among 2177 law enforcement workers, mean age 46 years, 19% female, prevalence of CVD was higher among disabled (OR = 5.37; 95% CI: 2.53, 11.38 for aggregate CVD outcome) and retired (OR = 2.14; 95% CI: 1.18, 3.88 for aggregate CVD outcome) workers compared to currently employed workers. Workers employed in smaller (1–24 employees) or larger (≥ 500 employees) departments and those with tenure > 20 years also demonstrated higher prevalence odds of select CVD outcomes. Although not statistically significant, higher prevalence odds across CVD outcomes were observed in local government employees, hourly paid workers, and workers with 10–19 years of tenure.

Conclusions

Our study highlights that select employment factors, some previously underexplored, may be associated with prevalent CVD in law enforcement workers. Leveraging national surveys and worker cohorts to enhance surveillance of identified groups in this high-risk population could help elucidate the role of employment on CVD development and inform workplace interventions.

背景：执法人员罹患心血管疾病（CVD）的风险较高，然而，对影响心血管疾病的就业因素的系统研究仍然不足，特别是在美国全国样本中。我们描述了包括冠心病（CHD）、心绞痛、心肌梗死（MI）和其他心脏病在内的流行性心血管疾病的时间趋势；并利用 2006 年至 2018 年的全国健康访谈调查（NHIS）研究了执法人员中某些就业因素与心血管疾病的关联：我们利用具有全国代表性的美国工人样本 NHIS 分析了受雇于地方、州和联邦机构的执法人员的心血管疾病流行情况。我们使用调查加权多变量逻辑回归模型估算了与就业因素相关的心血管疾病几率比（OR [95%置信区间，CI]），并对社会人口学因素和传统心血管疾病风险因素进行了调整：在平均年龄为 46 岁、19% 为女性的 2177 名执法人员中，与目前就业的人员相比，残疾人员（OR = 5.37；95% CI：2.53-11.38 为心血管疾病综合结果）和退休人员（OR = 2.14；95% CI：1.18-3.88 为心血管疾病综合结果）的心血管疾病患病率更高。受雇于规模较小（1-24 名员工）或较大（≥ 500 名员工）部门的工人以及任职时间大于 20 年的工人也显示出较高的心血管疾病结果发生率。虽然没有统计学意义，但在地方政府雇员、小时工资工人和工作年限为10-19年的工人中观察到了更高的心血管疾病流行几率：我们的研究强调，某些就业因素可能与执法人员的心血管疾病流行有关，其中一些因素以前未得到充分探讨。利用全国性调查和工人队列来加强对这一高风险人群中已确定群体的监测，有助于阐明就业对心血管疾病发展的作用，并为工作场所干预措施提供依据。

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引用次数: 0

Practical Considerations for Using Personal Cooling Garments for Heat Stress Management in Physically Demanding Occupations: A Systematic Review and Meta-Analysis Using Realist Evaluation 在体力要求较高的职业中使用个人降温衣进行热应激管理的实际考虑因素：采用现实主义评估方法进行系统回顾和荟萃分析。

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

American journal of industrial medicine

Pub Date : 2024-11-05 DOI: 10.1002/ajim.23672

Emily J. Tetzlaff, Leonidas G. Ioannou, Fergus K. O'Connor, Antonia Kaltsatou, Valentina Ly, Glen P. Kenny

Introduction

Due to rising temperature extremes, workplaces are seeking new solutions, such as using personal cooling garments (PCG) to mitigate and manage workplace heat exposure. This systematic review sought to assess the physiological and perceptual effects of PCGs on workers in standard work clothing performing moderate-to-heavy intensity tasks in hot environments.

Methods

A peer-reviewed search strategy was conducted in MEDLINE, Embase, CINAHL, Scopus, Global Health, and Business Source Complete with no language or time limits. A meta-analysis using a realist evaluation framework was then performed to evaluate the effectiveness of the PCGs.

Results

Thirty-three studies with 764 participants (98% male; average 21 ± 34 participants per study), conducted primarily in a laboratory setting (76%) were included. The studies were 193 ± 190 min in duration and consisted of a moderate-to-heavy work effort of 3.3 ± 1.0 METs in hot ambient conditions (temperature: 35.9 ± 3.3°C, 51.4 ± 12.1% relative humidity, wet bulb globe temperature [WBGT] 31.2 ± 2.6°C). The PCGs (n = 67) facilitated heat exchange through conduction (n = 39), evaporation (n = 4), convection (n = 2), radiation (n = 2), or hybrid combinations (n = 20). Conductive and hybrid PCGs offered the greatest thermoregulatory benefit, whereby core temperature (T_c) and heart rate (HR) reductions were consistently observed (Conductive: T_c: −0.3°C, HR: −12 bpm; Hybrid: T_c:−0.2°C, HR: −10 bpm), while PCGs directed at enhancing evaporative and radiative heat exchange had no or minimal effect on the physiological outcomes assessed (i.e., T_C < 0.1°C, HR: < 0.7 bpm).

Conclusion

While the PCGs had a positive overall effect, conductive options offered the most consistent benefit to workers. WBGT, clothing insulation, and duration of wear significantly affected some physiological and perceptual outcomes.

导言：由于极端温度不断升高，工作场所正在寻求新的解决方案，例如使用个人降温衣（PCG）来减轻和管理工作场所的热暴露。本系统综述旨在评估个人降温衣对穿着标准工作服在炎热环境中执行中等至高强度任务的工人的生理和感知影响：在 MEDLINE、Embase、CINAHL、Scopus、Global Health 和 Business Source Complete 中采用同行评议检索策略，没有语言或时间限制。然后采用现实主义评估框架进行了荟萃分析，以评估 PCGs 的有效性：共纳入 33 项研究，764 名参与者（98% 为男性；平均每项研究 21 ± 34 名参与者），主要在实验室环境中进行（76%）。研究持续时间为 193 ± 190 分钟，包括在炎热环境条件下进行 3.3 ± 1.0 METs 的中度至重度工作（温度：35.9 ± 3.3 摄氏度）：温度：35.9 ± 3.3°C，相对湿度 51.4 ± 12.1%，湿球温度 [WBGT] 31.2 ± 2.6°C）。PCG （n = 67）通过传导（n = 39）、蒸发（n = 4）、对流（n = 2）、辐射（n = 2）或混合组合（n = 20）促进热交换。传导式和混合式 PCG 对体温调节的益处最大，核心温度（Tc）和心率（HR）持续下降（传导式：Tc：-0.3°C，HR：-12 bpm；混合式：Tc：：-0.2°C，HR：-10 bpm），而旨在增强蒸发式和辐射式热交换的 PCG 对所评估的生理结果（即 TC）没有影响或影响甚微：虽然 PCGs 总体上有积极的影响，但传导性选择对工人的益处最为一致。WBGT、衣物隔热性能和穿着时间对某些生理和感知结果有显著影响。

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引用次数: 0

Functional disabilities and adverse well-being by COVID-19 and Long COVID history and employment status: 2022 Behavioral Risk Factor Surveillance System 按 COVID-19 和 Long COVID 历史及就业状况分列的功能性残疾和不良幸福感：2022 年行为风险因素监测系统。

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

American journal of industrial medicine

Pub Date : 2024-10-25 DOI: 10.1002/ajim.23669

Sharon R. Silver MS, MA, Jia Li MS, Nicole D. Ford PhD, Sharon H. Saydah PhD

Background

Long COVID can lead to functional disabilities and decreased well-being and limit the ability to work. No study has yet assessed associations of SARS-CoV-2-infection and Long COVID with specific measures of well-being and functional disabilities among workers by employment status.

Methods

Using data from the U.S. Behavioral Risk Factor Surveillance System, we assessed the prevalence of functional disabilities and well-being measures among adults of prime working age (25–54 years) by employment status and self-reported COVID-19 and Long COVID history. Within each employment status, we generated adjusted prevalence ratios (aPRs) comparing respondents from each 2022 COVID-19/Long COVID category to respondents in that employment status before the pandemic (2019).

Results

In 2022, prevalences of each functional disability except vision and all adverse well-being measures were highest among the 9.2% of respondents reporting a history of Long COVID. For each outcome, prevalences were lowest for workers and highest among those unable to work. 2022 prevalence of cognitive disability (16.4% of employees, 21.4% of the self-employed) and depression (31.2% and 36.4%, respectively) among workers reporting a history of Long COVID were more than double 2019 levels. Increases in cognitive disability and depression were lower but statistically significant among workers not reporting a history of Long COVID.

Conclusions

The high prevalence of functional disabilities and adverse well-being among workers reporting a history of Long COVID have implications for workers and employers. Also concerning are smaller increases among workers not reporting a history of Long COVID, given the large number of affected workers. Mitigating the effects of Long COVID on workers will involve efforts in multiple domains: reducing incidence, increasing healthcare practitioner awareness, improving diagnosis and treatments, and increasing employer awareness of best practices for accommodating workers with Long COVID.

背景：长COVID可导致功能障碍和幸福感下降，并限制工作能力。目前还没有研究按就业状况评估 SARS-CoV-2 感染和长 COVID 与工人幸福感和功能性残疾的具体衡量标准之间的关系：利用美国行为风险因素监测系统的数据，我们按就业状况和自我报告的 COVID-19 和 Long COVID 史评估了处于黄金工作年龄（25-54 岁）的成年人中功能性残疾和幸福感的流行程度。在每种就业状况下，我们将 2022 年 COVID-19/Long COVID 类别中的受访者与大流行前（2019 年）处于该就业状况的受访者进行比较，得出调整流行率（aPRs）：2022 年，在 9.2% 的受访者中，除视力之外的各项功能性残疾以及所有不良福祉指标的流行率最高，这些受访者报告了 Long COVID 的历史。在各项结果中，工人的患病率最低，而无法工作的人的患病率最高。2022 年，在报告有长期慢性视力障碍病史的工人中，认知残疾（16.4% 的雇员和 21.4% 的自营职业者）和抑郁症（分别为 31.2% 和 36.4%）的患病率是 2019 年水平的两倍多。在未报告有Long COVID病史的工人中，认知残疾和抑郁症的增加率较低，但在统计学上具有显著意义：结论：在报告有 Long COVID 病史的工人中，功能性残疾和不良健康状况的发生率很高，这对工人和雇主都有影响。同样令人担忧的是，考虑到受影响的工人人数众多，未报告长期慢性病毒性反应病史的工人中的患病率增幅较小。减轻长COVID对工人的影响需要在多个领域做出努力：降低发病率、提高医疗从业人员的认识、改善诊断和治疗、提高雇主对照顾长COVID工人的最佳实践的认识。

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引用次数: 0

A longitudinal pre-post study: An evaluation of the Department of the Air Force bundled occupational fall prevention efforts 事后纵向研究：对空军部捆绑式职业跌倒预防工作的评估。

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

American journal of industrial medicine

Pub Date : 2024-10-22 DOI: 10.1002/ajim.23673

Christina Socias-Morales DrPH, Melody Gwilliam MPH, MSJ, Harold Gomes PStat®, CStat, Heidi Stallings USAF, BSC, Bruce Burnham DVM, MPH, Cammie K. Chaumont Menéndez PhD, MS, MPH, James Collins PhD, MSME

Introduction

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

Methods

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

Results

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

Discussion

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

导言：坠落伤害是造成美国工人外伤和死亡的第二大原因，也是空军部（DAF）关注的主要伤害问题。捆绑式干预措施可以提高减少伤害的可能性，尤其是在大型异质工作人群中。2013 年，DAF 实施了 "空军跌倒预防重点"，这是一项捆绑式预防干预措施，旨在减少 DAF 成员的职业性跌倒伤害事件。本研究的目的是描述与坠落伤害相关的负担和风险因素，并评估 "坠落预防重点 "在减少坠落伤害负担方面的有效性：方法：美国国家职业安全与健康研究所（NIOSH）与美国空军安全中心（AFSEC）合作，对作为捆绑干预措施的 "跌倒预防重点 "的影响进行了研究。伤害事件包括伤害事件的叙述、人口统计学、工作环境、工作任务和其他结构化细节。描述性统计和前后纵向模型用于评估跌倒伤害率的变化：预防跌倒重点实施计划（2013-2018 年）每年减少 10.4%（95% 置信区间 [CI]：8.5%, 12.2%），到 2018 年，跌倒伤害事件发生率 6 年累计减少 48.3%（95% 置信区间 [CI]：41.4%, 54.3%）：DAF的安全涉及到一个全面的方法。记录 "跌倒预防重点 "的影响可能有助于将这些发现转化为改善军队其他部门和私营部门高跌倒风险行业（如建筑业）的跌倒预防工作。

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引用次数: 0

Essential(ly forgotten) workers: Latine youth farmworkers during the COVID-19 pandemic 被遗忘的重要工人：COVID-19 大流行期间的拉美青年农场工人。

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

American journal of industrial medicine

Pub Date : 2024-10-15 DOI: 10.1002/ajim.23671

Taylor J. Arnold PhD, Sharon D. Morrison PhD, Michelle Y. Martin Romero PhD, Sandra E. Echeverria PhD, Sylvia Zapata BA, Sara A. Quandt PhD, Fabiola Torres-Lara BA, Jose A. Robles Arvizu MS, Thomas A. Arcury PhD

Background

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

Methods

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

Results

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

Conclusions

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

背景：在 COVID-19 大流行期间，多个行业的基本工人面临着不成比例的发病和死亡负担。农业工人和食品加工工人受到的影响尤为严重，其中许多人都是结构脆弱的拉丁裔社区成员。根据美国现行联邦法律，12 岁以下儿童可以合法从事农业工作，而农业是美国最危险的行业之一。这些工作的青少年中有许多是拉丁裔，在健康和教育方面遭受着不平等待遇：我们采用基于社区的参与式研究方法和定性设计，于 2022 年在北卡罗来纳州对健康、教育和宣传领域的服务提供者（10 人）和 10-17 岁的拉丁裔务农青少年（24 人）进行了半结构化深度访谈。我们采用参与式定性分析方法和反思性主题分析来了解和描述这些青少年在大流行病头两年的工作经历：结果：COVID-19 大流行加剧了经济和学校的不稳定状况，在这种情况下，许多青少年表示更需要工作来养家糊口。虽然青少年及其家人意识到 COVID-19 带来的更多职业健康风险，有时甚至对此感到恐惧，但他们认为几乎没有其他选择。服务提供者和青少年描述说，雇主提供的安全协议或设备少之又少，但一些工人自己组织尝试安全协议。青少年的叙述表明，他们对工作场所的基本安全要求了解有限：研究结果强调，迫切需要解决影响工作场所政策和规范的结构性弱点，以保护拉丁裔青年农场工人，支持他们的健康成长。

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引用次数: 0

Surveillance of asbestos related disease among workers enrolled in an exposure registry 对加入暴露登记册的工人中与石棉有关的疾病进行监测。

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

American journal of industrial medicine

Pub Date : 2024-10-14 DOI: 10.1002/ajim.23668

Victoria H. Arrandale PhD, Colin Berriault MA, Chaojie Song MSc, Nathan DeBono PhD, Paul A. Demers PhD

Introduction

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

Methods

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

Results

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

Conclusion

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

简介：与历史上的石棉开采和研磨相比，当代的石棉暴露发生在涉及含石棉材料（ACM）的施工、修复和维护过程中。安大略省石棉工人登记册（AWR）建立于 1986 年，旨在跟踪建筑工人的石棉暴露情况。本研究报告了安大略省石棉工人登记册中的工人罹患石棉相关疾病（ARD）的风险：将 AWR 登记人员与行政健康数据库（1986-2019 年）进行概率链接，以确定包括癌症和慢性呼吸系统疾病在内的 ARD 病例。随访工作从登记参加 AWR 时开始，并持续进行前瞻性随访。使用标准化发病率（SIR）将发病率与普通人群进行比较。使用泊松回归法估算 ACM 暴露与急性呼吸系统疾病之间的关系：共有 26 204 名登记人员（81%）成功建立了联系。常见的就业行业为建筑业（62%）、制造业（19%）和教育业（8%）。男性和女性间皮瘤（M:SIR 6.83 [95% CI = 5.56-8.31]；W:SIR 19.2 [3.86-56.1]）和肺纤维化（M:SIR 14.1 [12.2-16.2]；W:SIR 9.25 [2.49-23.7]）的发病率均高于普通人群。男性患石棉沉滞症的风险较高（M:SIR 11.2 [9.59-13.1]）。报告暴露时间较长（≥140 小时）的工人罹患肺癌（RR 1.34 [1.10-1.63]）、间皮瘤（RR 2.83 [1.75-4.58]）、石棉沉滞症（RR 3.07 [2.12-4.43]）、慢性阻塞性肺病（RR 1.42 [1.29-1.57]）和肺纤维化（RR 1.88 [1.35-2.62]）的风险较高：结论：在建筑和建筑维护过程中接触石棉仍然是导致急性呼吸道疾病发病率的原因之一。尽管加拿大禁止在新产品中使用石棉，但在建筑活动中接触现有含石棉材料的情况仍将持续存在。AWR 为持续监测安大略省由此导致的急性髓系白血病提供了机会。

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引用次数: 0

Prevalence of COVID-19 and Long COVID by Industry and Occupation: Behavioral Risk Factor Surveillance System 2022 按行业和职业划分的 COVID-19 和 Long COVID 流行率：行为风险因素监测系统 2022。

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

American journal of industrial medicine

Pub Date : 2024-10-11 DOI: 10.1002/ajim.23665

S. R. Silver, J. Li, N. D. Ford, D. Shi, S. H. Saydah

Background

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

Methods

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

Results

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

Conclusions

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

背景：在大流行早期，医疗保健和其他重要职业的工人感染 COVID-19 的风险较高。迄今为止，还没有一项针对美国工人的调查能全面、详细地评估各行业和职业（I&O）中 COVID-19 和 Long COVID 的流行情况：方法：使用行为风险因素监测系统 2022 年来自 39 个州、关岛和美属维尔京群岛的数据，按广泛和详细的 I&O 估算自我报告的 COVID-19 和 Long COVID 病史流行率，以及报告曾患 COVID-19 的人员中 Long COVID 的流行率。调整后的患病率比用于比较每个 I&O 的结果患病率和所有其他工人的患病率：结果：按广泛的 I&O 划分，医疗保健、保护服务和教育工作者的 COVID-19 患病率较高。医疗保健和防护服务行业的长COVID患病率较高，而教育行业的患病率较低。COVID-19 患病率明显升高而 Long COVID 不升高的详细 I&O 包括乳制品制造业工人和采矿工人子集。调酒师/饮酒场所以及个人护理和外貌工作者的 COVID-19 和 Long COVID 患病率均有所升高。在报告曾感染过 COVID-19 的农场工人中，Long COVID 的流行率较高：结论：本研究中 COVID-19 或 Long COVID 感染率较高的行业和职业可能需要采取更多措施来预防空气传播的呼吸道病毒。住宿是支持所有工作场所工人的关键因素。有关长 COVID 在各工种和职业中分布情况的新信息表明，为支持受影响工人继续就业，雇主最需要了解并实施量身定制的工作场所支持和适应措施。

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引用次数: 0

Retrospective quality review of Department of Transportation (DOT) commercial drivers medical examination forms 对美国交通部 (DOT) 商业驾驶员体检表的质量进行回顾性审查。

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

American journal of industrial medicine

Pub Date : 2024-10-11 DOI: 10.1002/ajim.23661

Maria Starchook-Moore MD, MPH, Ashley Nadeau MD, MPH, Dominik Dabrowski MD, MPH, John Briggs DO, MPH, LaDonna Kool LPN, Mezzie Belt RMA, Ralph Bovard MD, MPH, Paul Anderson MD, MPH, Hyun Kim ScD, MSc, Andre Montoya-Barthelemy MD, MPH, Zeke J. McKinney MD, MHI, MPH

Objective

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

Methods

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

Results

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

Conclusions

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

目的：本研究旨在评估驾驶员和体检人员填写商业驾驶员体检报告表的质量：本研究旨在评估驾驶员和体检人员填写商业驾驶员（CD）体检报告表的质量：这是一项横断面回顾性研究，研究对象为 2019 年的抽取数据。CD 体检报告表从一家全国性雇主处收集，由公司医务总监进行初步审核，研究小组对驾驶员和体检人员（ME）提供的文件的完整性进行了评估。相关结果包括：未回答的问题、回答不一致以及对肯定回答缺乏必要的阐述：在 1603 次体检中，有 30% 的体检者（n = 484）填写的体检报告表不完整或不正确。有 38.7% 的司机在填写健康史时前后矛盾。最常见的是，在28.7%的体检中，他们没有详细说明正面的健康史回答，但也发现了其他类型的错误：相当一部分驾驶员或体检人员（n = 890，55%）未能充分或正确填写 CD 体检报告表。

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引用次数: 0