Wei Gong, David C. Byrne, Christa L. Themann, H. Amy Feng
Background
Workers in industry settings are often exposed to complex noise, which poses a greater risk to hearing loss than continuous noise at equivalent energy levels. Previous studies have identified kurtosis as an essential metric for evaluating complex noise-induced hearing loss (NIHL). This study aimed to characterize the distribution of workers exposed to complex noise, examine the associations between kurtosis and changes in hearing thresholds at various frequencies, and explore kurtosis's role in estimating NIHL and its integration into occupational hearing loss prevention programs.
Methods
The study quantitatively analyzed data from 2400 workers exposed to industrial complex noise and 1520 non-noise-exposed workers in China. Both arithmetic and geometric average kurtosis were used to characterize the work-shift noise records. Linear regression models assessed noise-induced permanent threshold shift (NIPTS) across different frequency ranges.
Results
For workers exposed to average noise levels between 80 and 92 dBA, increased kurtosis levels correlated with worsening NIPTS across frequencies from 0.5 to 8 kHz. However, the impact of kurtosis at lower noise exposure levels (70–79 dBA) remains uncertain.
Conclusions
Kurtosis is crucial for predicting hearing loss among workers exposed to complex noise at average levels of 85 and 90 dBA. The findings have potential implications for occupational safety and health, particularly for the recruitment of workers into hearing loss prevention programs. Further risk assessment analysis could use the noise kurtosis metric to examine the excess risk of NIHL associated with complex noise exposure.
{"title":"A Quantitative Analysis of Kurtosis Impact on Occupational Complex Noise-Induced Hearing Loss","authors":"Wei Gong, David C. Byrne, Christa L. Themann, H. Amy Feng","doi":"10.1002/ajim.70021","DOIUrl":"10.1002/ajim.70021","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Workers in industry settings are often exposed to complex noise, which poses a greater risk to hearing loss than continuous noise at equivalent energy levels. Previous studies have identified kurtosis as an essential metric for evaluating complex noise-induced hearing loss (NIHL). This study aimed to characterize the distribution of workers exposed to complex noise, examine the associations between kurtosis and changes in hearing thresholds at various frequencies, and explore kurtosis's role in estimating NIHL and its integration into occupational hearing loss prevention programs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study quantitatively analyzed data from 2400 workers exposed to industrial complex noise and 1520 non-noise-exposed workers in China. Both arithmetic and geometric average kurtosis were used to characterize the work-shift noise records. Linear regression models assessed noise-induced permanent threshold shift (NIPTS) across different frequency ranges.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>For workers exposed to average noise levels between 80 and 92 dBA, increased kurtosis levels correlated with worsening NIPTS across frequencies from 0.5 to 8 kHz. However, the impact of kurtosis at lower noise exposure levels (70–79 dBA) remains uncertain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Kurtosis is crucial for predicting hearing loss among workers exposed to complex noise at average levels of 85 and 90 dBA. The findings have potential implications for occupational safety and health, particularly for the recruitment of workers into hearing loss prevention programs. Further risk assessment analysis could use the noise kurtosis metric to examine the excess risk of NIHL associated with complex noise exposure.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 11","pages":"988-1003"},"PeriodicalIF":3.1,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008064","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}
Arif Jetha, Hyunmi Lee, Maxwell J. Smith, Victoria H. Arrandale, Aviroop Biswas, Cameron Mustard, Peter M. Smith
Background
Artificial intelligence (AI) can modernize occupational health and safety (OHS) practice and provide solutions to the most complex health and safety challenges. Empirical data on firm-level AI utilization in OHS practice remain limited. The objective of this study was to examine AI use for OHS and firm-level descriptive and OHS characteristics associated with AI use.
Methods
A total of 810 OHS professionals in British Columbia and Ontario, Canada were surveyed in the summer of 2024. Surveys asked about firm-level AI use for OHS and items asked about descriptive and OHS characteristics. Participants were also asked about perceived AI concerns and OHS impact. A multivariate logistic regression model was fitted to examine factors associated with firm-level AI use for OHS.
Results
In total, 29% reported firm-level AI use for OHS. Larger-sized firms and those with hybrid work arrangements had a greater odds of AI use for OHS. Also, firms with high workplace hazard exposure had a greater odds of AI OHS use. More positive perceptions of AI's impact on OHS were associated with firm-level AI use for OHS.
Conclusions
AI use for OHS may be concentrated among hazardous firms and those with the conditions to support technological adoption. Research examining AI's effectiveness in OHS settings is needed to guide evidence-based implementation in occupational health practice.
{"title":"Landscape of Artificial Intelligence Use for Occupational Health and Safety Practice in Two Canadian Provinces","authors":"Arif Jetha, Hyunmi Lee, Maxwell J. Smith, Victoria H. Arrandale, Aviroop Biswas, Cameron Mustard, Peter M. Smith","doi":"10.1002/ajim.70018","DOIUrl":"10.1002/ajim.70018","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Artificial intelligence (AI) can modernize occupational health and safety (OHS) practice and provide solutions to the most complex health and safety challenges. Empirical data on firm-level AI utilization in OHS practice remain limited. The objective of this study was to examine AI use for OHS and firm-level descriptive and OHS characteristics associated with AI use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 810 OHS professionals in British Columbia and Ontario, Canada were surveyed in the summer of 2024. Surveys asked about firm-level AI use for OHS and items asked about descriptive and OHS characteristics. Participants were also asked about perceived AI concerns and OHS impact. A multivariate logistic regression model was fitted to examine factors associated with firm-level AI use for OHS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 29% reported firm-level AI use for OHS. Larger-sized firms and those with hybrid work arrangements had a greater odds of AI use for OHS. Also, firms with high workplace hazard exposure had a greater odds of AI OHS use. More positive perceptions of AI's impact on OHS were associated with firm-level AI use for OHS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>AI use for OHS may be concentrated among hazardous firms and those with the conditions to support technological adoption. Research examining AI's effectiveness in OHS settings is needed to guide evidence-based implementation in occupational health practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 11","pages":"965-972"},"PeriodicalIF":3.1,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajim.70018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008049","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}
Fergus K. O'Connor, Kristina-Marie T. Janetos, Brodie J. Richards, Roberto C. Harris-Mostert, Katie E. Wagar, Leonidas G. Ioannou, James J. McCormick, Robert D. Meade, Emily J. Tetzlaff, Ronald J. Sigal, W. Shane Journeay, Glen P. Kenny
Rationale
Industry guidelines recommend work-rest schedules to prevent unsafe core temperature elevations (> 38.0°C or > Δ1.0°C above baseline resting) in an “average” worker exposed to occupational heat stress. While permissible initial work durations (initial stay times [IST]) before implementing rest schedules have been suggested, existing data are limited to moderate-intensity efforts.
Objectives
The objective of this study was to assess whether factors of sex and age influence IST during heavy-intensity work.
Methods
We assessed work durations before reaching unsafe core temperature thresholds (i.e., > 38.0°C or > Δ1.0°C above baseline resting) among young (18–30 years) and older (50–69 years) males and females during simulated heavy-intensity work at 26°C, 29°C, and 32°C wet-bulb globe temperatures (WBGT).
Findings
The likelihood of surpassing a core temperature of 38.0°C significantly increased at 32°C WBGT (hazard ratio [95% confidence interval]: 2.0 [1.5, 2.7], p = 0.001), but not at 29°C WBGT (1.1 [0.9, 1.4], p = 0.342), compared to 26°C WBGT. Median (interquartile range) durations to reach 38.0°C across groups were 32 (23–52), 29 (23–47), and 26 (18–35) minutes at 26°C, 29°C, and 32°C WBGT, respectively. The likelihood of reaching Δ1.0°C above baseline resting significantly increased at both 32°C (3.8 [2.6, 5.4], p < 0.001) and 29°C WBGT (1.5 [1.1, 2.0], p < 0.001), with median durations being 55 (40–82), 42 (35–56), and 33 (29–42) min, respectively. Older females were more likely to reach 38.0°C (2.4 [1.3, 4.3], p = 0.004) and Δ1.0°C above baseline resting (2.5 [1.4, 4.7], p = 0.003) compared to young males. No other sex- or age-related differences were detected (p > 0.145).
Impact
These findings highlight the heightened vulnerability of older females during heavy-intensity occupational heat stress, emphasizing the need for tailored guidelines to ensure equitable workforce protection.
{"title":"Defining Sex- and Age-Specific Initial Stay Times for Continuous Heavy-Intensity Work in Hot Environments Before Heat-Mitigation Controls Are Implemented—Part B","authors":"Fergus K. O'Connor, Kristina-Marie T. Janetos, Brodie J. Richards, Roberto C. Harris-Mostert, Katie E. Wagar, Leonidas G. Ioannou, James J. McCormick, Robert D. Meade, Emily J. Tetzlaff, Ronald J. Sigal, W. Shane Journeay, Glen P. Kenny","doi":"10.1002/ajim.70015","DOIUrl":"10.1002/ajim.70015","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Industry guidelines recommend work-rest schedules to prevent unsafe core temperature elevations (> 38.0°C or > Δ1.0°C above baseline resting) in an “average” worker exposed to occupational heat stress. While permissible initial work durations (initial stay times [IST]) before implementing rest schedules have been suggested, existing data are limited to moderate-intensity efforts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The objective of this study was to assess whether factors of sex and age influence IST during heavy-intensity work.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We assessed work durations before reaching unsafe core temperature thresholds (i.e., > 38.0°C or > Δ1.0°C above baseline resting) among young (18–30 years) and older (50–69 years) males and females during simulated heavy-intensity work at 26°C, 29°C, and 32°C wet-bulb globe temperatures (WBGT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>The likelihood of surpassing a core temperature of 38.0°C significantly increased at 32°C WBGT (hazard ratio [95% confidence interval]: 2.0 [1.5, 2.7], <i>p</i> = 0.001), but not at 29°C WBGT (1.1 [0.9, 1.4], <i>p</i> = 0.342), compared to 26°C WBGT. Median (interquartile range) durations to reach 38.0°C across groups were 32 (23–52), 29 (23–47), and 26 (18–35) minutes at 26°C, 29°C, and 32°C WBGT, respectively. The likelihood of reaching Δ1.0°C above baseline resting significantly increased at both 32°C (3.8 [2.6, 5.4], <i>p</i> < 0.001) and 29°C WBGT (1.5 [1.1, 2.0], <i>p</i> < 0.001), with median durations being 55 (40–82), 42 (35–56), and 33 (29–42) min, respectively. Older females were more likely to reach 38.0°C (2.4 [1.3, 4.3], <i>p</i> = 0.004) and Δ1.0°C above baseline resting (2.5 [1.4, 4.7], <i>p</i> = 0.003) compared to young males. No other sex- or age-related differences were detected (<i>p</i> > 0.145).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Impact</h3>\u0000 \u0000 <p>These findings highlight the heightened vulnerability of older females during heavy-intensity occupational heat stress, emphasizing the need for tailored guidelines to ensure equitable workforce protection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 11","pages":"949-964"},"PeriodicalIF":3.1,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajim.70015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991191","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}
Fergus K. O'Connor, Kristina-Marie T. Janetos, Brodie J. Richards, Roberto C. Harris-Mostert, Katie E. Wagar, Leonidas G. Ioannou, James J. McCormick, Robert D. Meade, Emily J. Tetzlaff, Ronald J. Sigal, W. Shane Journeay, Glen P. Kenny
Rationale
Industry guidelines recommend work-rest allocations to limit increases in core temperature (Tcore; > 38.0°C or > Δ1.0°C above resting) during work in the heat. However, the initial duration of permissible work before implementing these allocations is not specified (initial stay time [IST]) and individual factors such as sex and age affecting thermoregulation are not considered.
Objectives
The objective of this study was to assess whether factors of sex and age influence IST.
Methods
We examined the permissible work duration before reaching Tcore of 38.0°C or Δ1.0°C above resting in young (18–30 years) and older (50–69 years) males and females performing moderate-intensity (200 W/m2) simulated work at ambient conditions of 26, 29, and 32°C wet-bulb globe temperature (WBGT).
Findings
IST significantly decreased as ambient conditions intensified (p < 0.0001). Median (95% CI) durations to 38°C across groups were 59 (43–87) minutes at 26°C, 40 (34–65) minutes at 29°C, and 35 (31–46) minutes at 32°C WBGT. Likewise, median times to achieve Δ1.0°C above resting temperature significantly differed by environmental conditions (p < 0.0001): 66 (56–128) minutes at 26°C, 68 (54–80) minutes at 29°C, and 44 (41–53) minutes at 32°C WBGT. Older females were significantly more likely to experience Tcore elevations of 38.0°C (hazard ratio [95% CI]: (3.1 [1.6, 5.8], p < 0.001) and Δ1.0°C above resting (1.9 [1.1, 3.0], p = 0.007) compared to young males. In contrast, IST for young females and older males were similar to young males.
Impact
Our findings underscore the impact of hotter ambient conditions on IST and identify older females as particularly susceptible during moderate-intensity work in heat emphasizing the need for tailored occupational heat exposure guidelines.
{"title":"Defining Sex- and Age-Specific Initial Stay Times for Continuous Moderate-Intensity Work in Hot Environments Before Heat-Mitigation Controls Are Implemented – Part A","authors":"Fergus K. O'Connor, Kristina-Marie T. Janetos, Brodie J. Richards, Roberto C. Harris-Mostert, Katie E. Wagar, Leonidas G. Ioannou, James J. McCormick, Robert D. Meade, Emily J. Tetzlaff, Ronald J. Sigal, W. Shane Journeay, Glen P. Kenny","doi":"10.1002/ajim.70013","DOIUrl":"10.1002/ajim.70013","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Industry guidelines recommend work-rest allocations to limit increases in core temperature (Tcore; > 38.0°C or > Δ1.0°C above resting) during work in the heat. However, the initial duration of permissible work before implementing these allocations is not specified (initial stay time [IST]) and individual factors such as sex and age affecting thermoregulation are not considered.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The objective of this study was to assess whether factors of sex and age influence IST.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We examined the permissible work duration before reaching Tcore of 38.0°C or Δ1.0°C above resting in young (18–30 years) and older (50–69 years) males and females performing moderate-intensity (200 W/m<sup>2</sup>) simulated work at ambient conditions of 26, 29, and 32°C wet-bulb globe temperature (WBGT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>IST significantly decreased as ambient conditions intensified (<i>p</i> < 0.0001). Median (95% CI) durations to 38°C across groups were 59 (43–87) minutes at 26°C, 40 (34–65) minutes at 29°C, and 35 (31–46) minutes at 32°C WBGT. Likewise, median times to achieve Δ1.0°C above resting temperature significantly differed by environmental conditions (<i>p</i> < 0.0001): 66 (56–128) minutes at 26°C, 68 (54–80) minutes at 29°C, and 44 (41–53) minutes at 32°C WBGT. Older females were significantly more likely to experience Tcore elevations of 38.0°C (hazard ratio [95% CI]: (3.1 [1.6, 5.8], <i>p</i> < 0.001) and Δ1.0°C above resting (1.9 [1.1, 3.0], <i>p</i> = 0.007) compared to young males. In contrast, IST for young females and older males were similar to young males.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Impact</h3>\u0000 \u0000 <p>Our findings underscore the impact of hotter ambient conditions on IST and identify older females as particularly susceptible during moderate-intensity work in heat emphasizing the need for tailored occupational heat exposure guidelines.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 11","pages":"933-948"},"PeriodicalIF":3.1,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajim.70013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991193","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}
Laura Kurth, Noemi B. Hall, Brian Ansell, A. Scott Laney, David J. Blackley
Background
Small airways disease is a risk factor for the development of obstructive lung disease and may be present among coal miners without obstructive ventilatory impairment. Our study estimated the prevalence of reduced spirometric mid-expiratory flow among coal miners without obstructive ventilatory impairment.
Methods
Data were from coal miners participating in the Coal Workers' Health Surveillance Program (CWHSP) during 2014–2022 with forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) meeting quality criteria and no missing spirometry parameter values. We defined low forced expiratory flow at 25%–75% (FEF25%–75%) as < 65% predicted.
Results
The prevalence of FEF25%–75% < 65% predicted among miners without obstructive ventilatory impairment was 7.1% overall, 10.7% among retired miners, and 16.8% among miners with radiographic evidence of coal workers' pneumoconiosis (CWP).
Conclusions
Among miners without obstructive ventilatory impairment, reduced mid-expiratory flow was more prevalent in older miners with longer tenure, specifically retired miners. From a surveillance perspective, reduced spirometric mid-expiratory flow can be an early indicator of more serious health problems in coal miners, including obstructive lung disease.
{"title":"Prevalence of Reduced Mid-Expiratory Flow Among Coal Workers' Health Surveillance Program Participants","authors":"Laura Kurth, Noemi B. Hall, Brian Ansell, A. Scott Laney, David J. Blackley","doi":"10.1002/ajim.70019","DOIUrl":"10.1002/ajim.70019","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Small airways disease is a risk factor for the development of obstructive lung disease and may be present among coal miners without obstructive ventilatory impairment. Our study estimated the prevalence of reduced spirometric mid-expiratory flow among coal miners without obstructive ventilatory impairment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were from coal miners participating in the Coal Workers' Health Surveillance Program (CWHSP) during 2014–2022 with forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) meeting quality criteria and no missing spirometry parameter values. We defined low forced expiratory flow at 25%–75% (FEF<sub>25%–75%</sub>) as < 65% predicted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of FEF<sub>25%–75%</sub> < 65% predicted among miners without obstructive ventilatory impairment was 7.1% overall, 10.7% among retired miners, and 16.8% among miners with radiographic evidence of coal workers' pneumoconiosis (CWP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Among miners without obstructive ventilatory impairment, reduced mid-expiratory flow was more prevalent in older miners with longer tenure, specifically retired miners. From a surveillance perspective, reduced spirometric mid-expiratory flow can be an early indicator of more serious health problems in coal miners, including obstructive lung disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 11","pages":"1028-1033"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939487","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}
A safe workplace goes beyond simply following regulations, it is a basic right that shields employees from physical, emotional, and psychological harm. This position paper looks at the various aspects of workplace safety, especially for women physicians, highlighting the need for an environment built on trust, inclusivity, and respect. Even with advancements in gender representation, women in medicine often face problems like harassment, discrimination, and systemic inequalities that affect their well-being and career development. The connection between workplace safety and quality patient care is examined, showing evidence that harassment and systemic neglect can cause clinician burnout and medical errors, ultimately harming patient outcomes. This position paper addresses systemic obstacles, such as power imbalances, restrictive contracts, and socioeconomic challenges that prevent women physicians from advocating for their safety. The paper highlights the need for strong reporting systems, independent oversight, and supportive practices for victims as essential parts of a broad strategy to improve workplace safety. Additionally, it argues that supportive measures like better parental leave, hiring focused on diversity, and steps to reduce workplace violence are vital for building a strong medical workforce. By committing to inclusivity and fair policies, the medical community can empower women physicians and provide high-quality care for diverse patient groups. In the end, a safe and fair workplace is crucial for the long-term success of the healthcare profession, leading to a healthier future for everyone.
{"title":"AMWA's Commitment to Workplace Safety for Women Physicians: A Path Toward Equity and Protection","authors":"Devki Patel, Meghan Etsey, Vaishnavi Patel, Brianna Clark, Ariela Marshall, Rosy Thachil, Kellie Lease Stecher, Roberta Gebhard","doi":"10.1002/ajim.70016","DOIUrl":"10.1002/ajim.70016","url":null,"abstract":"<div>\u0000 \u0000 <p>A safe workplace goes beyond simply following regulations, it is a basic right that shields employees from physical, emotional, and psychological harm. This position paper looks at the various aspects of workplace safety, especially for women physicians, highlighting the need for an environment built on trust, inclusivity, and respect. Even with advancements in gender representation, women in medicine often face problems like harassment, discrimination, and systemic inequalities that affect their well-being and career development. The connection between workplace safety and quality patient care is examined, showing evidence that harassment and systemic neglect can cause clinician burnout and medical errors, ultimately harming patient outcomes. This position paper addresses systemic obstacles, such as power imbalances, restrictive contracts, and socioeconomic challenges that prevent women physicians from advocating for their safety. The paper highlights the need for strong reporting systems, independent oversight, and supportive practices for victims as essential parts of a broad strategy to improve workplace safety. Additionally, it argues that supportive measures like better parental leave, hiring focused on diversity, and steps to reduce workplace violence are vital for building a strong medical workforce. By committing to inclusivity and fair policies, the medical community can empower women physicians and provide high-quality care for diverse patient groups. In the end, a safe and fair workplace is crucial for the long-term success of the healthcare profession, leading to a healthier future for everyone.</p></div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 10","pages":"920-925"},"PeriodicalIF":3.1,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144870983","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}
Nicole D. Ford, Alexandra F. Dalton, Deja Edwards, Hope King, Sara E. Luckhaupt, Kevin C. Ma, Douglas Slaughter, Sharon R. Silver, Sharon Saydah
Introduction
Long COVID may limit people's ability to carry out daily activities, including work. Little is known about the potential effect of long COVID on work limitations and absenteeism. We describe employment status and characteristics, work limitations, cognitive dysfunction, and sickness absenteeism among adults with and without long COVID.
Methods
Using data from the cross-sectional 2022 National Health Interview Survey, we estimated the prevalence (95% confidence intervals [CI]) of work-related outcomes by long COVID status among US adults ≥ 18 years (n = 26,270). Among employed adults with prior COVID-19 illness, we estimated crude and adjusted odds ratios for work limitations (compared to no limitations), cognitive dysfunction (some or a lot of difficulty with memory or concentration compared to no difficulty), and sickness absenteeism ( ≥ 11 sick days compared to 0–10 days) in the prior year. All estimates account for survey design and are weighted to the US noninstitutionalized population. Analyses were conducted in 2024.
Results
3.4% of adults reported long COVID. Adults with long COVID more often reported being unable to work due to health or disability compared to adults without long COVID (p = 0.0006). Among employed adults with prior COVID-19 illness, long COVID was associated with higher odds of work limitations (aOR 1.3, 95% CI 1.1–1.5), cognitive dysfunction (aOR 1.3, 95% CI 1.1–1.5), and sickness absenteeism (aOR 1.4, 95% CI 1.2–1.5) compared to those who did not develop long COVID.
Conclusions
Long COVID was associated with work limitations, cognitive dysfunction, and sickness absenteeism among employed US adults. Workplace accommodations may be important considerations for people with long COVID.
导语：长冠状病毒可能会限制人们进行日常活动的能力，包括工作。人们对长期COVID对工作限制和缺勤的潜在影响知之甚少。我们描述了患有和不患有长期COVID的成年人的就业状况和特征、工作限制、认知功能障碍和病假缺勤情况。方法：使用来自2022年全国健康访谈调查（National Health Interview Survey）的横断面数据，我们估计了≥18岁的美国成年人（n = 26,270）因长时间感染COVID而导致工作相关结果的患病率（95%置信区间[CI]）。在先前患有COVID-19疾病的在职成年人中，我们估计了前一年工作限制（与无限制相比）、认知功能障碍（与无困难相比，在记忆或注意力方面有一些或很多困难）和病假缺勤（与0-10天相比，病假天数≥11天）的粗比值比和调整后的比值比。所有的估计都考虑了调查设计，并对美国非机构人口进行了加权。分析于2024年进行。结果：3.4%的成年人报告长COVID。与没有长COVID的成年人相比，长COVID的成年人更常报告因健康或残疾而无法工作（p = 0.0006）。在先前患有COVID-19疾病的在职成年人中，与未患长期COVID的人相比，长期COVID与更高的工作限制（aOR 1.3, 95% CI 1.1-1.5），认知功能障碍（aOR 1.3, 95% CI 1.1-1.5）和病假缺勤（aOR 1.4, 95% CI 1.2-1.5）相关。结论：在美国成年雇员中，长COVID与工作限制、认知功能障碍和病假缺勤有关。对于长期感染COVID的人来说，工作场所的住宿可能是重要的考虑因素。
{"title":"Employment Status, Work Limitations, Cognitive Dysfunction, and Sickness Absenteeism Among US Adults With and Without Long COVID","authors":"Nicole D. Ford, Alexandra F. Dalton, Deja Edwards, Hope King, Sara E. Luckhaupt, Kevin C. Ma, Douglas Slaughter, Sharon R. Silver, Sharon Saydah","doi":"10.1002/ajim.70014","DOIUrl":"10.1002/ajim.70014","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Long COVID may limit people's ability to carry out daily activities, including work. Little is known about the potential effect of long COVID on work limitations and absenteeism. We describe employment status and characteristics, work limitations, cognitive dysfunction, and sickness absenteeism among adults with and without long COVID.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using data from the cross-sectional 2022 National Health Interview Survey, we estimated the prevalence (95% confidence intervals [CI]) of work-related outcomes by long COVID status among US adults ≥ 18 years (<i>n</i> = 26,270). Among employed adults with prior COVID-19 illness, we estimated crude and adjusted odds ratios for work limitations (compared to no limitations), cognitive dysfunction (some or a lot of difficulty with memory or concentration compared to no difficulty), and sickness absenteeism ( ≥ 11 sick days compared to 0–10 days) in the prior year. All estimates account for survey design and are weighted to the US noninstitutionalized population. Analyses were conducted in 2024.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>3.4% of adults reported long COVID. Adults with long COVID more often reported being unable to work due to health or disability compared to adults without long COVID (<i>p</i> = 0.0006). Among employed adults with prior COVID-19 illness, long COVID was associated with higher odds of work limitations (aOR 1.3, 95% CI 1.1–1.5), cognitive dysfunction (aOR 1.3, 95% CI 1.1–1.5), and sickness absenteeism (aOR 1.4, 95% CI 1.2–1.5) compared to those who did not develop long COVID.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Long COVID was associated with work limitations, cognitive dysfunction, and sickness absenteeism among employed US adults. Workplace accommodations may be important considerations for people with long COVID.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 10","pages":"909-919"},"PeriodicalIF":3.1,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144870984","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}
The Family and Medical Leave Act (FMLA) is the sole U.S. policy protecting job security during medical or parental leave. We extend prior work by analyzing overall FMLA eligibility by citizenship and gender among Hispanic workers. We examine which criteria—employer size, job tenure, and minimum work hours—drive citizenship disparities. We also investigate the factors predicting FMLA eligibility and examine the population-level characteristics contributing to FMLA citizenship disparities.
Methods
We used the 2018 Current Population Survey (n = 5632) to compare FMLA eligibility by citizenship status among Hispanic foreign-born workers by sex. We used multivariate linear regressions and Blinder-Oaxaca decompositions to investigate citizenship inequities in FMLA eligibility.
Results
Findings showed eligibility disparities: 38.9% of noncitizen men and 42.2% of noncitizen women met FMLA criteria compared to over half of their citizen counterparts. For men, this disparity stemmed primarily from differences in employer size, with less than half of non-citizens working for eligible employers. For women, both employer size and job tenure contributed to the ineligibility. Decomposition analyses showed that educational and occupational differences explained roughly half the employer-size citizenship disparity among men. Among women, occupation, full-time status, and education accounted for 85% of the employer size disparity. Age, residency duration, and full-time status explained nearly 75% of the job tenure citizen gap.
Conclusions
The FMLA's design excludes Hispanic non-citizens during critical life events. Addressing occupational segregation and educational barriers and modifying eligibility criteria are crucial to mitigating these disparities. A national paid family and medical leave policy is urgently needed.
{"title":"Citizenship Status and the Family and Medical Leave Act: Examining Inequities in Eligibility Among Hispanic Workers","authors":"Susana Quirós, Mansoo Yu","doi":"10.1002/ajim.70011","DOIUrl":"10.1002/ajim.70011","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Family and Medical Leave Act (FMLA) is the sole U.S. policy protecting job security during medical or parental leave. We extend prior work by analyzing overall FMLA eligibility by citizenship and gender among Hispanic workers. We examine which criteria—employer size, job tenure, and minimum work hours—drive citizenship disparities. We also investigate the factors predicting FMLA eligibility and examine the population-level characteristics contributing to FMLA citizenship disparities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used the 2018 Current Population Survey (<i>n</i> = 5632) to compare FMLA eligibility by citizenship status among Hispanic foreign-born workers by sex. We used multivariate linear regressions and Blinder-Oaxaca decompositions to investigate citizenship inequities in FMLA eligibility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Findings showed eligibility disparities: 38.9% of noncitizen men and 42.2% of noncitizen women met FMLA criteria compared to over half of their citizen counterparts. For men, this disparity stemmed primarily from differences in employer size, with less than half of non-citizens working for eligible employers. For women, both employer size and job tenure contributed to the ineligibility. Decomposition analyses showed that educational and occupational differences explained roughly half the employer-size citizenship disparity among men. Among women, occupation, full-time status, and education accounted for 85% of the employer size disparity. Age, residency duration, and full-time status explained nearly 75% of the job tenure citizen gap.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The FMLA's design excludes Hispanic non-citizens during critical life events. Addressing occupational segregation and educational barriers and modifying eligibility criteria are crucial to mitigating these disparities. A national paid family and medical leave policy is urgently needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 10","pages":"881-895"},"PeriodicalIF":3.1,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144811524","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}
Rachel L. Thompson, A. Michael Ierardi, Samantha Fisher, Brian Pavilonis
Introduction
Exposure to airborne chemicals in nail salons poses occupational and public health risks. Despite a 2015 New York State mandate requiring local and general exhaust ventilation (LEV and GEV) in nail salons, many continue to struggle with compliance. This study evaluates a tailored ventilation intervention to mitigate exposures in New York City salons through more effective use of existing ventilation infrastructure.
Methods
Six nail salons participated. At each salon, we used direct reading instruments to measure baseline total volatile organic compound (TVOC) concentrations in air over 1-min intervals for seven consecutive days. Using baseline data, we created an exposure report for each salon and developed an individualized plan to use the salon's existing ventilation systems or other controls (such as opening windows/doors) more effectively to proactively respond to worsening air quality. We then collected an additional seven days of TVOC measurements and compared air quality in salons during operating hours before versus after the intervention.
Results
Intervention effects varied. Salons effectively using LEV and GEV saw TVOC reductions of 16.3%–73.8%, while those relying solely on LEV saw no significant changes in TVOC concentrations. One salon without mechanical ventilation achieved an 82.2% reduction by opening windows/doors.
Conclusions
Optimizing existing ventilation systems can significantly reduce airborne chemical exposures in nail salons, though effectiveness depends on the availability and proper use of ventilation infrastructure. GEV and natural ventilation may be particularly effective and low-cost solutions to improve nail salon air quality, though ambient conditions must be considered when recommending natural ventilation.
{"title":"Clearing the Air: A Pilot Study of Ventilation Interventions in New York City Nail Salons","authors":"Rachel L. Thompson, A. Michael Ierardi, Samantha Fisher, Brian Pavilonis","doi":"10.1002/ajim.70012","DOIUrl":"10.1002/ajim.70012","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Exposure to airborne chemicals in nail salons poses occupational and public health risks. Despite a 2015 New York State mandate requiring local and general exhaust ventilation (LEV and GEV) in nail salons, many continue to struggle with compliance. This study evaluates a tailored ventilation intervention to mitigate exposures in New York City salons through more effective use of existing ventilation infrastructure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Six nail salons participated. At each salon, we used direct reading instruments to measure baseline total volatile organic compound (TVOC) concentrations in air over 1-min intervals for seven consecutive days. Using baseline data, we created an exposure report for each salon and developed an individualized plan to use the salon's existing ventilation systems or other controls (such as opening windows/doors) more effectively to proactively respond to worsening air quality. We then collected an additional seven days of TVOC measurements and compared air quality in salons during operating hours before versus after the intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Intervention effects varied. Salons effectively using LEV and GEV saw TVOC reductions of 16.3%–73.8%, while those relying solely on LEV saw no significant changes in TVOC concentrations. One salon without mechanical ventilation achieved an 82.2% reduction by opening windows/doors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Optimizing existing ventilation systems can significantly reduce airborne chemical exposures in nail salons, though effectiveness depends on the availability and proper use of ventilation infrastructure. GEV and natural ventilation may be particularly effective and low-cost solutions to improve nail salon air quality, though ambient conditions must be considered when recommending natural ventilation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 10","pages":"896-908"},"PeriodicalIF":3.1,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793277","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}
Lynne E. Pinkerton, Sara E. Luckhaupt, Stephen Bertke, Corey R. Butler, Thomas R. Hales, Kathleen M. DuBose, Alejandra Ramirez-Cardenas, Deborah Sammons, Christine Toennis, Molly R. West, Christa R. Hale
Background
Occupational heat stress among wildland firefighters (WFFs) performing arduous work or working in hot work environments may cause kidney dysfunction and injury.
Methods
Kidney function and injury biomarkers (serum and urine) were measured among 39 WFFs pre- and post-fire season in 2018–2019. The same biomarkers were measured in 19 of these 39 WFFs over 3 days during a 2019 mid-season fire incident. Median differences in biomarker concentrations across the fire season and across the mid-season incident were evaluated using the Sign test. The primary outcome of interest was the cystatin C-based estimated glomerular filtration rate (eGFRcys).
Results
The eGFRcys decreased (median difference = −5 mL/min/1.73 m2; interquartile range [IQR] = −8, −2 mL/min/1.73 m2; p = 0.008), and 53% of participants lost ≥ 2% of their body weight across the first day of the mid-season fire incident. Median eGFRcys did not decrease across the fire season (median difference = 0 mL/min/1.73 m2; IQR = −5, 5 mL/min/1.73 m2; p = 0.52). The albumin-creatinine ratio and the ratios of urine kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin concentrations to urine osmolality increased across ≥ 1 day during the mid-season incident.
Conclusions
A temporary decrease in kidney function and changes in biomarkers of kidney injury were observed during a wildland fire incident. Additional research is warranted to confirm these findings, assess associations with occupational heat stress, and determine whether persistent, clinically relevant kidney injury and dysfunction occur among WFFs over time. The findings also support the need for continued efforts to promote optimal hydration of WFFs.
{"title":"Biomarkers of Kidney Function and Injury Across Fire Seasons and During a Mid-Season Fire Incident in the Wildland Firefighter Exposure and Health Effect (WFFEHE) Study","authors":"Lynne E. Pinkerton, Sara E. Luckhaupt, Stephen Bertke, Corey R. Butler, Thomas R. Hales, Kathleen M. DuBose, Alejandra Ramirez-Cardenas, Deborah Sammons, Christine Toennis, Molly R. West, Christa R. Hale","doi":"10.1002/ajim.70006","DOIUrl":"10.1002/ajim.70006","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Occupational heat stress among wildland firefighters (WFFs) performing arduous work or working in hot work environments may cause kidney dysfunction and injury.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Kidney function and injury biomarkers (serum and urine) were measured among 39 WFFs pre- and post-fire season in 2018–2019. The same biomarkers were measured in 19 of these 39 WFFs over 3 days during a 2019 mid-season fire incident. Median differences in biomarker concentrations across the fire season and across the mid-season incident were evaluated using the Sign test. The primary outcome of interest was the cystatin C-based estimated glomerular filtration rate (eGFR<sub>cys</sub>).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The eGFR<sub>cys</sub> decreased (median difference = −5 mL/min/1.73 m<sup>2</sup>; interquartile range [IQR] = −8, −2 mL/min/1.73 m<sup>2</sup>; <i>p</i> = 0.008), and 53% of participants lost ≥ 2% of their body weight across the first day of the mid-season fire incident. Median eGFR<sub>cys</sub> did not decrease across the fire season (median difference = 0 mL/min/1.73 m<sup>2</sup>; IQR = −5, 5 mL/min/1.73 m<sup>2</sup>; <i>p</i> = 0.52). The albumin-creatinine ratio and the ratios of urine kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin concentrations to urine osmolality increased across ≥ 1 day during the mid-season incident.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A temporary decrease in kidney function and changes in biomarkers of kidney injury were observed during a wildland fire incident. Additional research is warranted to confirm these findings, assess associations with occupational heat stress, and determine whether persistent, clinically relevant kidney injury and dysfunction occur among WFFs over time. The findings also support the need for continued efforts to promote optimal hydration of WFFs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 10","pages":"829-844"},"PeriodicalIF":3.1,"publicationDate":"2025-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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