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

Defining Sex- and Age-Specific Initial Stay Times for Continuous Moderate-Intensity Work in Hot Environments Before Heat-Mitigation Controls Are Implemented – Part A 在实施减热控制之前，确定在高温环境中连续中等强度工作的特定性别和年龄初始停留时间-第A部分。

IF 3.1 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine

Pub Date : 2025-09-03 DOI: 10.1002/ajim.70013

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.

理由：行业指南建议工作-休息分配，以限制在高温下工作时核心温度的增加（Tcore; > 38.0°C或> Δ1.0°C以上休息）。然而，在实施这些分配之前，允许工作的初始持续时间没有规定（初始停留时间[IST]），也没有考虑影响体温调节的个人因素，如性别和年龄。目的：本研究的目的是评估性别和年龄因素是否影响IST。方法：我们研究了年轻（18-30岁）和老年（50-69岁）男性和女性在26,29和32°C湿球温度（WBGT）的环境条件下进行中等强度（200 W/m2）模拟工作时，在达到38.0°C或Δ1.0°C之前的允许工作时间。研究结果：随着环境条件的加强，IST显著下降(p影响：我们的研究结果强调了较热的环境条件对IST的影响，并确定老年女性在中等强度的高温工作中特别容易受到影响，强调了定制职业热暴露指南的必要性。

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引用次数: 0

Prevalence of Reduced Mid-Expiratory Flow Among Coal Workers' Health Surveillance Program Participants 煤矿工人健康监测项目参与者中呼气中期流量减少的患病率。

IF 3.1 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine

Pub Date : 2025-09-01 DOI: 10.1002/ajim.70019

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% (FEF_25%–75%) as < 65% predicted.

Results

The prevalence of FEF_25%–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.

背景：小气道疾病是发展为阻塞性肺疾病的危险因素，可能存在于没有阻塞性通气障碍的煤矿工人中。我们的研究估计了无阻塞性通气障碍的煤矿工人中呼吸中期流量减少的患病率。方法：数据来自2014-2022年参加煤矿工人健康监测计划（CWHSP）的第一秒用力呼气量（FEV1）和用力肺活量（FVC）符合质量标准且无肺活量测定参数缺失的煤矿工人。结果：在没有阻塞性通气障碍的矿工中，呼气中流量减少在任职时间较长的老矿工中更为普遍，特别是退休矿工。从监测的角度来看，呼气中肺活量减少可能是煤矿工人更严重的健康问题的早期指标，包括阻塞性肺病。

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引用次数: 0

AMWA's Commitment to Workplace Safety for Women Physicians: A Path Toward Equity and Protection AMWA对女医生工作场所安全的承诺：通往公平和保护的道路。

IF 3.1 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine

Pub Date : 2025-08-18 DOI: 10.1002/ajim.70016

Devki Patel, Meghan Etsey, Vaishnavi Patel, Brianna Clark, Ariela Marshall, Rosy Thachil, Kellie Lease Stecher, Roberta Gebhard

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.

一个安全的工作场所不仅仅是遵守规定，它是保护员工免受身体、情感和心理伤害的基本权利。本立场文件着眼于工作场所安全的各个方面，特别是对女医生而言，强调需要建立在信任、包容和尊重基础上的环境。即使在性别代表性方面取得了进步，医学领域的女性也经常面临骚扰、歧视和系统性不平等等问题，这些问题影响了她们的福祉和职业发展。工作场所安全和高质量患者护理之间的联系被检查，显示骚扰和系统性忽视可能导致临床医生倦怠和医疗差错，最终损害患者的结果的证据。本立场文件解决了阻碍女医生倡导自身安全的系统性障碍，如权力不平衡、限制性合同和社会经济挑战。该文件强调需要强有力的报告系统、独立监督和对受害者的支持做法，作为改善工作场所安全的广泛战略的重要组成部分。此外，报告认为，诸如更好的育儿假、注重多样性的招聘以及减少工作场所暴力等支持性措施对于建立一支强大的医疗队伍至关重要。通过致力于包容性和公平的政策，医学界可以赋予女医生权力，并为不同的患者群体提供高质量的护理。最后，一个安全和公平的工作场所对医疗保健行业的长期成功至关重要，为每个人带来更健康的未来。

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引用次数: 0

Employment Status, Work Limitations, Cognitive Dysfunction, and Sickness Absenteeism Among US Adults With and Without Long COVID 美国成年和非长期COVID患者的就业状况、工作限制、认知功能障碍和病假缺勤

IF 3.1 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine

Pub Date : 2025-08-18 DOI: 10.1002/ajim.70014

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。

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引用次数: 0

Citizenship Status and the Family and Medical Leave Act: Examining Inequities in Eligibility Among Hispanic Workers 公民身份和家庭和医疗休假法案：审查西班牙裔工人资格的不平等。

IF 3.1 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine

Pub Date : 2025-08-10 DOI: 10.1002/ajim.70011

Susana Quirós, Mansoo Yu

Background

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.

背景：《家庭和医疗休假法》（FMLA）是美国唯一保护医疗或育儿假期间工作保障的政策。我们通过分析西班牙裔工人的国籍和性别的FMLA总体资格来扩展先前的工作。我们考察了哪些标准——雇主规模、工作任期和最低工作时间——导致了公民身份的差异。我们还研究了预测FMLA资格的因素，并检查了导致FMLA公民身份差异的人口水平特征。方法：我们使用2018年当前人口调查（n = 5632）来比较西班牙裔外国出生工人按国籍身份和性别的FMLA资格。我们使用多元线性回归和Blinder-Oaxaca分解来调查FMLA资格中的公民不平等。结果：调查结果显示了资格差异：38.9%的非公民男性和42.2%的非公民女性符合FMLA标准，而超过一半的非公民同行。对于男性来说，这种差异主要源于雇主规模的差异，只有不到一半的非公民为符合条件的雇主工作。对妇女来说，雇主规模和工作年限都是导致不合格的原因。分解分析显示，教育和职业的差异可以解释男性雇主规模的公民身份差异的大约一半。在女性中，职业、全职状态和教育程度占雇主规模差异的85%。年龄、居住时间和全职身份解释了近75%的工作任期公民差距。结论：FMLA的设计排除了西班牙裔非公民在关键生活事件中的影响。解决职业隔离和教育障碍以及修改资格标准对于减轻这些差距至关重要。迫切需要一项全国带薪家庭假和病假政策。

{"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}

引用次数: 0

Clearing the Air: A Pilot Study of Ventilation Interventions in New York City Nail Salons 净化空气：纽约市美甲沙龙通风干预的试点研究。

IF 3.1 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine

Pub Date : 2025-08-07 DOI: 10.1002/ajim.70012

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.

导言：在美甲沙龙接触空气中的化学物质会对职业和公众健康造成危害。尽管纽约州在2015年颁布了一项法令，要求美甲沙龙使用局部和一般的排气通风设备（LEV和GEV），但许多美甲沙龙仍在努力遵守规定。本研究评估了一种量身定制的通风干预措施，通过更有效地利用现有的通风基础设施来减少纽约市沙龙的暴露。方法：6家美甲沙龙参与。在每个沙龙，我们使用直读仪器连续7天每隔1分钟测量空气中总挥发性有机化合物（TVOC）的基线浓度。利用基线数据，我们为每个沙龙创建了一份暴露报告，并制定了个性化的计划，以更有效地利用沙龙现有的通风系统或其他控制措施（如打开窗户/门）来主动应对不断恶化的空气质量。然后，我们收集了另外七天的TVOC测量数据，并比较了干预前后沙龙营业时间内的空气质量。结果：干预效果各不相同。有效使用LEV和GEV的沙龙的TVOC浓度降低了16.3%-73.8%，而完全依赖LEV的沙龙的TVOC浓度没有显著变化。一个没有机械通风的沙龙通过打开窗户/门减少了82.2%。结论：优化现有的通风系统可以显著减少美甲沙龙空气中的化学物质暴露，尽管有效性取决于通风基础设施的可用性和正确使用。GEV和自然通风可能是改善美甲沙龙空气质量的特别有效和低成本的解决方案，尽管在推荐自然通风时必须考虑环境条件。

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引用次数: 0

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 在野外消防员暴露和健康影响（WFFEHE）研究中，火灾季节和季节中期火灾事件中肾脏功能和损伤的生物标志物。

IF 3.1 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine

Pub Date : 2025-08-03 DOI: 10.1002/ajim.70006

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 (eGFR_cys).

Results

The eGFR_cys 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 eGFR_cys 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.

背景：从事艰苦工作或在高温环境中工作的野地消防员（wff）的职业热应激可能导致肾功能障碍和损伤。方法：对2018-2019年39例wff火灾前后的肾功能和损伤生物标志物（血清和尿液）进行检测。在2019年的一次季中火灾事件中，在这39个wff中，有19个在3天内测量了相同的生物标志物。使用Sign测试评估火灾季节和季节中期事件中生物标志物浓度的中位数差异。主要终点是基于胱抑素c的估计肾小球滤过率（eGFRcys）。结果：eGFRcys降低(中位数差值= -5 mL/min/1.73 m2；四分位间距[IQR] = -8, -2 mL/min/1.73 m2；P = 0.008)， 53%的参与者在季节中期火灾事件的第一天体重减轻了≥2%。中位数eGFRcys在整个火灾季节没有下降(中位数差异= 0 mL/min/1.73 m2；IQR = - 5,5 mL/min/1.73 m2；p = 0.52)。白蛋白-肌酐比值以及尿肾损伤分子-1和中性粒细胞明胶酶相关的脂钙蛋白浓度与尿渗透压比值在季节中期事件中增加≥1天。结论：在野火事件中观察到肾功能的暂时下降和肾损伤的生物标志物的变化。需要进一步的研究来证实这些发现，评估职业性热应激的相关性，并确定随着时间的推移，wff中是否会出现持续的、临床相关的肾损伤和功能障碍。研究结果还支持继续努力促进wff的最佳水合作用的必要性。

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引用次数: 0

Silica Hazards in Engineered Stone Countertop Production: Worker Experiences and Challenges in Los Angeles 工程石材台面生产中的二氧化硅危害：洛杉矶工人的经验和挑战。

IF 3.1 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine

Pub Date : 2025-07-28 DOI: 10.1002/ajim.70010

Jane C. Fazio, Sandra R. Garcia, Ivy R. Torres, Sheiphali A. Gandhi, Kristin J. Cummings, Russell G. Buhr, Kevin Riley, Ninez Ponce, Arturo Vargas Bustamante, Beth Glenn

Background

Silicosis is a progressive occupational lung disease caused by inhalation of respirable crystalline silica. Stone countertop workers are at risk of developing silicosis associated with engineered stone (ES) due to its high silica content and widespread use. This qualitative study assessed countertop workers' knowledge, attitudes, and practices regarding silica hazards.

Methods

We recruited 20 participants for semi-structured interviews through purposive sampling of workplaces in Los Angeles, California. Eligibility requirements: employment in countertop fabrication, exposure to engineered stone, ≥ 18 years old, and English or Spanish proficiency. Interviews were recorded, translated, and transcribed. Two researchers employed thematic and content analysis to code transcripts using both inductive and deductive methods.

Results

All respondents were Latino men, 90% of whom were foreign-born, with a median age of 44 years and a median work tenure of 20 years. We identified five themes: (1) Hazardous work environments: Respondents regularly engaged in dry-cutting practices (68%), and half reported that their employers did not reliably provide respirators. (2) Insufficient training and educational resources: Respondents possessed basic knowledge that dust caused lung disease (90%); however, most acquired knowledge through word-of-mouth or media. (3) Employment vulnerability: Workers feared being fired for raising safety concerns. (4) Workforce entrapment: Although many workers considered leaving the industry, they were hindered by a lack of legal immigration status or alternative skills, as well as the presumed lower pay in a new industry. (5) Worker-identified solutions: Workers suggested wet cutting, workplace training, and regulation of ES, including its elimination.

Conclusion

The results support continued policy, regulatory, and enforcement efforts aimed at minimizing silica exposure. Workers recommended workplace and upstream solutions, such as eliminating ES.

背景：矽肺病是一种进行性职业性肺病，由吸入可吸入的结晶二氧化硅引起。由于工程石材的高硅含量和广泛使用，石材台面工人有患与工程石材相关的矽肺病的风险。这项定性研究评估了台面工人关于二氧化硅危害的知识、态度和实践。方法：我们通过有目的的抽样，在加利福尼亚州洛杉矶的工作场所招募了20名参与者进行半结构化访谈。资格要求：工作在台面制造，接触工程石材，≥18岁，英语或西班牙语熟练。采访被录音、翻译和转录。两位研究者采用主题分析和内容分析两种方法对转录本进行归纳和演绎编码。结果：所有受访者都是拉丁裔男性，其中90%是外国出生的，平均年龄为44岁，平均工作年限为20年。我们确定了五个主题：(1)危险的工作环境：受访者经常从事干切作业（68%），一半的人报告说他们的雇主没有可靠地提供呼吸器。(2)培训教育资源不足：受访者掌握粉尘导致肺部疾病的基本知识（90%）；然而，大多数人通过口口相传或媒体获得知识。(3)就业脆弱性：工人害怕因为提出安全问题而被解雇。(4)劳动力陷阱：尽管许多工人考虑离开这个行业，但由于缺乏合法移民身份或替代技能，以及新行业的工资较低，他们受到了阻碍。(5)工人确定的解决方案：工人建议湿切割、工作场所培训和ES法规，包括消除ES。结论：研究结果支持旨在减少二氧化硅暴露的持续政策、监管和执法努力。工人们推荐了工作场所和上游解决方案，例如消除ES。

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引用次数: 0

Cow-Related Injuries in Wisconsin During 2017−2023 2017-2023年威斯康星州奶牛相关伤害。

IF 3.1 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine

Pub Date : 2025-07-22 DOI: 10.1002/ajim.70009

Komi K. S. Modji, Katherine McCoy, Paul D. Creswell, Morris R. Collin, Carrie Tomasallo, Sheryl Bedno

Introduction

The dairy industry–a key industry for the economy–remains a potentially hazardous industry across the nation. The literature on animal-related injuries in the agriculture industry is sparse. This analysis aimed to describe cow-related injuries, the utilization of workers' compensation, and the circumstances of the injuries.

Methods

This mixed methods analysis of agricultural injuries focused on cow-related injuries in hospital discharge and workers' compensation data during 2017–2023. Cases, aged 12 or older, were identified in the hospital discharge data using ICD10-CM codes. Cow-related claim injury narratives and industry and occupation data were extracted from workers' compensation data.

Results

During 2017–2023, cow-related injuries represented 13.1% (n = 2659) of agricultural injuries and were the second most predominant cause of work-related agricultural injuries. These injury figures were stable, compared to a downward trend of non-cow-related injuries (p = 0.01). Young workers (12−34 years) and Hispanic workers had the highest burden for cow-related injuries. The top five body parts affected by cow injuries were the upper (24%) and lower (23%) extremities, other head, face, and neck (22.1%), chest (15.2%), and traumatic brain injury (5.1%). Workers' compensation was used in 28.5% of cases identified in the hospital discharge data. Animal handling, lack of farm worker safety measures, and equipment safety were identified as factors associated with cow-related injuries.

Conclusion

This analysis identified a surprising number of cow-related injuries, including some life-threatening injuries. It is important to continue to promote safety measures and injury prevention best-practices to ensure worker well-being and farm productivity.

导读：乳制品行业是经济的关键行业，但在全国范围内仍然是一个潜在的危险行业。关于农业中动物相关伤害的文献很少。本分析旨在描述与奶牛有关的伤害，工人赔偿的利用，以及伤害的情况。方法：采用混合方法对2017-2023年农业伤害进行分析，重点分析奶牛相关的出院伤害和工伤赔偿数据。使用ICD10-CM代码在医院出院数据中识别年龄在12岁或以上的病例。从工人赔偿数据中提取与奶牛相关的索赔伤害叙述和行业和职业数据。结果：2017-2023年期间，奶牛相关伤害占农业伤害的13.1% (n = 2659)，是农业工伤的第二大主要原因。这些伤害数字是稳定的，而与奶牛无关的伤害呈下降趋势（p = 0.01）。年轻工人（12-34岁）和西班牙裔工人对奶牛相关伤害的负担最高。奶牛受伤最多的5个身体部位分别是上肢（24%）和下肢（23%）、其他头部、面部和颈部（22.1%）、胸部（15.2%）和外伤性脑损伤（5.1%）。出院数据中确定的28.5%的病例使用了工人赔偿。动物处理、农场工人缺乏安全措施以及设备安全被确定为与奶牛相关伤害相关的因素。结论：该分析确定了数量惊人的奶牛相关伤害，包括一些危及生命的伤害。重要的是继续促进安全措施和预防伤害的最佳做法，以确保工人的福祉和农场生产力。

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引用次数: 0

Ethylene Oxide Measurements From OSHA Workplace Investigations: Patterns in Exposure by Industry, Occupation, and Over Time 来自OSHA工作场所调查的环氧乙烷测量：工业、职业和随时间的暴露模式。

IF 3.1 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine

Pub Date : 2025-07-21 DOI: 10.1002/ajim.70008

Brian Christensen, Matthew M. Dahm, I-Chen Chen, Kaitlin Kelly-Reif

Background

Ethylene oxide (EtO) is an occupational carcinogen; however, contemporary exposure scenarios in US workplaces are not well characterized within the literature. We aim to describe EtO exposure trends in the US workplace using historical data from the Occupational Safety and Health Administration (OSHA) Chemical Exposure Health Database and the OSHA Information System.

Method

We collated and analyzed air sampling data collected between 1979 and 2020 to characterize exposures across key industries and occupations. We evaluated exposure by industry and occupational category, examined changes in exposures over time, and quantified the proportion of samples that exceeded existing occupational exposure limits.

Results

Exposures generally decreased over time. However, the magnitude and pattern of reductions were not consistent across industries. Within the aggregated dataset, approximately 46% of samples exceeded the National Institute for Occupational Safety and Health recommended exposure limit (NIOSH REL) of 0.1 parts per million (ppm), and approximately 18% of samples exceeded the OSHA permissible exposure limit (PEL) of 1 ppm. 70% of samples collected from industrial sterilization workplaces exceeded the NIOSH REL. Exposure data was limited between 2000 and 2020, most notably for the health services and chemical manufacturing industries.

Conclusions

Contemporary EtO exposures for key industries and occupational categories are poorly characterized. Still, exposures in the industrial sterilization industry appear higher than in other industries and have proportionally declined the least over time. Additional exposure assessment research and further efforts in occupational risk assessment are important to better understand the health burdens of workers exposed to EtO.

背景：环氧乙烷（EtO）是一种职业致癌物；然而，在文献中并没有很好地描述当代美国工作场所的暴露情况。我们的目标是利用职业安全与健康管理局（OSHA）化学暴露健康数据库和OSHA信息系统的历史数据来描述美国工作场所的EtO暴露趋势。方法：我们整理和分析了1979年至2020年间收集的空气采样数据，以表征关键行业和职业的暴露特征。我们按行业和职业类别评估了暴露情况，检查了暴露随时间的变化，并量化了超过现有职业暴露限值的样本比例。结果：随着时间的推移，暴露量普遍减少。然而，减少的幅度和模式在各个行业并不一致。在汇总数据集中，约46%的样本超过了国家职业安全与健康研究所建议的0.1 ppm的暴露限值（NIOSH REL），约18%的样本超过了OSHA允许的1ppm的暴露限值（PEL）。从工业消毒工作场所收集的样本中有70%超过了NIOSH REL。2000年至2020年期间的暴露数据有限，特别是卫生服务和化学制造业。结论：当代关键行业和职业类别的EtO暴露特征不佳。尽管如此，工业灭菌行业的暴露率似乎高于其他行业，并且随着时间的推移比例下降最少。进一步的接触评估研究和进一步的职业风险评估工作对于更好地了解接触外源性毒物的工人的健康负担非常重要。

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引用次数: 0