American journal of industrial medicine最新文献_第7页

A pilot study to identify factors associated with frailty within the World Trade Center general responder cohort 一项试点研究，旨在确定世贸中心一般响应者队列中与虚弱有关的因素。

IF 3.5 3区医学 Q2 Medicine

American journal of industrial medicine

Pub Date : 2024-05-12 DOI: 10.1002/ajim.23590

Hannah M. Thompson MD, MPH, Erin Thanik MD, MPH, Ahmad Sabra MS, MPH, Fred Ko MD, William W. Hung MD, MPH, Elena Colicino PhD, Roberto G. Lucchini MD, Ghalib Bello PhD, Michael Crane MD, MPH, Susan L. Teitelbaum PhD, Katherine A. Ornstein PhD, MPH

Background

Given the significant exposures experienced by the World Trade Center (WTC) general responders, there is increasing interest in understanding the effect of these exposures on aging in this population. We aim to identify factors that may be associated with frailty, a clinical syndrome characterized by a decrease in one's reserve that has been linked to poor health outcomes.

Methods

WTC general responders enrolled in the WTC Health Program aged 50 and older provided informed consent. Validated frailty assessments, the Frailty Phenotype (with the Johns Hopkins Frailty Assessment Calculator) along with the FRAIL scale, categorized nonfrail from prefrail/frail. Fall risk, functional status, and cognition were also assessed. WTC variables, including an identified WTC-certified condition, were utilized. The risk of frailty was estimated using log binomial regression analysis. A 95% confidence interval (CI) was used to estimate the prevalence ratio (PR).

Results

One hundred and six participants were included; 38 (35.8%) were classified as pre-frail or frail. More of the pre-frail/frail group were obese (57.9% vs. 25%; p = 0.004) and had a WTC-certified condition (78.9% vs. 58.8%; p = 0.036). Obesity (PR = 2.43, 95% CI = 1.31, 4.53), a WTC-certified condition (PR = 1.77, 95% CI = 1.09, 2.89), and risk of falling (PR = 1.97, 95% CI = 1.01, 3.84) were independently associated with frailty.

Conclusions

Obesity and having a WTC-certified condition were found to be risk factors for frailty in our pilot study. Future work may focus on further identifying risk factors for frailty in the larger WTC general responder population.

背景：鉴于世界贸易中心（WTC）的一般响应者所经历的重大暴露，人们越来越有兴趣了解这些暴露对这一人群衰老的影响。虚弱是一种临床综合症，其特点是储备能力下降，与不良的健康状况有关：方法：参加永利国际娱乐健康计划的 50 岁及以上的永利国际娱乐普通响应者均已知情同意。经过验证的虚弱评估、虚弱表型（使用约翰-霍普金斯大学虚弱评估计算器）和 FRAIL 量表将非虚弱与预虚弱/虚弱进行了分类。此外，还对跌倒风险、功能状态和认知能力进行了评估。此外，还使用了 WTC 变量，包括已确定的 WTC 认证条件。虚弱风险采用对数二项式回归分析法进行估算。使用 95% 置信区间 (CI) 估算患病率比 (PR)：共纳入了 16 名参与者，其中 38 人（35.8%）被归类为前期虚弱或体弱。在前期衰弱/虚弱组中，肥胖者（57.9% 对 25%；P = 0.004）和患有永利国际娱乐认证疾病者（78.9% 对 58.8%；P = 0.036）更多。肥胖（PR = 2.43，95% CI = 1.31，4.53）、有 WTC 证书（PR = 1.77，95% CI = 1.09，2.89）和跌倒风险（PR = 1.97，95% CI = 1.01，3.84）与体弱独立相关：结论：在我们的试点研究中发现，肥胖和患有经 WTC 认证的疾病是导致虚弱的风险因素。未来的工作重点可能是在更大的永利国际娱乐平台一般反应人群中进一步确定导致虚弱的风险因素。

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引用次数: 0

Quality of life in retired workers with past exposure to asbestos 曾接触石棉的退休工人的生活质量。

IF 3.5 3区医学 Q2 Medicine

American journal of industrial medicine

Pub Date : 2024-05-11 DOI: 10.1002/ajim.23592

Emmanuelle Siefert MD, MSc, Fleur Delva MD, PhD, Christophe Paris MD, PhD, Jean-Claude Pairon MD, PhD, Isabelle Thaon MD, PhD

Background

Asbestos causes cancer and non-cancerous lung and pleural diseases and can also have a negative psychological impact but little is known about its effect on health-related quality of life.

Objectives

The aim of this study is to describe the health-related quality of life (HRQoL) of retired men with a history of occupational exposure to asbestos and examine factors linked with low HRQoL.

Methods

Retired male workers of the French Asbestos-Related Disease Cohort (ARDCO) completed self-questionnaires that included SF-36v2 and HAD scales, questions about their perception of asbestos (perceived dangers and level of exposure, expectations to fall ill, or knowing someone who is) and their respiratory symptoms. Asbestos exposure was assessed by industrial hygienists. A perceived risk score was created using factorial analysis. Multivariable regressions were performed for all SF-36 subscales.

Results

A total of 1266 of 2075 questionnaires (61%) were returned complete and included in analysis. After adjustment for potential confounders, an increase in perceived risk score resulted in a decrease in physical component summary score (PCS), up to 10.7 points (p = 0.048) and in mental component summary score (MCS) (p = 0.044). Presence of respiratory symptoms was also associated with significantly decreased PCS and MCS (p < 0.001). Poor HRQoL was linked to higher perceived risk score with p ≤ 0.01 for all SF-36 dimensions. Asbestos exposure assessed by an expert was not associated with any outcome.

Conclusions

All dimensions of HRQoL appear to be affected by the perceived risk of incurring asbestos-related disease and respiratory symptoms.

背景：石棉会导致癌症和非癌症肺部及胸膜疾病，还会产生负面的心理影响，但人们对石棉对健康相关生活质量的影响知之甚少：本研究旨在描述有石棉职业接触史的退休男性的健康相关生活质量（HRQoL），并研究与低HRQoL相关的因素：法国石棉相关疾病队列（ARDCO）中的退休男性工人填写了自我问卷，其中包括 SF-36v2 和 HAD 量表、有关他们对石棉的看法（认为的危险和接触程度、预期生病或认识生病的人）以及呼吸道症状的问题。石棉暴露由工业卫生学家进行评估。通过因子分析得出了感知风险分数。对所有 SF-36 分量表进行了多变量回归：在 2075 份问卷中，共有 1266 份问卷（61%）被完整收回并纳入分析。在对潜在的混杂因素进行调整后，感知风险得分的增加导致身体部分总分（PCS）和精神部分总分（MCS）的下降，前者最多下降 10.7 分（p = 0.048），后者最多下降 0.044 分（p = 0.044）。呼吸道症状的存在也与 PCS 和 MCS 的显著下降有关（p 结论：P = 0.044）：所有方面的 HRQoL 似乎都会受到罹患石棉相关疾病的感知风险和呼吸道症状的影响。

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引用次数: 0

Identifying factors associated with physical therapy use versus non-use among injured workers with back pain in Washington State 确定华盛顿州背部疼痛的受伤工人使用与不使用物理治疗的相关因素。

IF 3.5 3区医学 Q2 Medicine

American journal of industrial medicine

Pub Date : 2024-05-09 DOI: 10.1002/ajim.23591

Brian Chin PhD, MSPH, Sean D. Rundell PT, DPT, PhD, Jeanne M. Sears PhD, RN, Deborah Fulton-Kehoe PhD, MPH, June T. Spector MD, MPH, Gary M. Franklin MD, MPH

Background

There is little information about predictors of physical therapy (PT) use among injured workers with back pain. The primary objective of this study is to investigate the associations between PT use and baseline factors not routinely captured in workers’ compensation (WC) data.

Methods

We conducted a secondary analysis using the Washington State Workers’ Compensation Disability Risk Identification Study Cohort, which combines self-reported surveys with claims data from the Washington State Department of Labor and Industries State Fund. Workers with an accepted or provisional WC claim for back injury between June 2002 and April 2004 were eligible. Baseline factors for PT use were selected from six domains (socio-demographic, pain and function, psychosocial, clinical, health behaviors, and employment-related). The outcome was a binary measure for PT use within 1 year of injury. Bivariate and multivariable logistic regression models were conducted to evaluate the associations between PT use and baseline factors.

Results

Among the 1370 eligible study participants, we identified 673 (49%) who received at least one PT service. Baseline factors from five of the six domains (all but health behaviors) were associated with PT use, including gender, income, pain and function measures, injury severity rating, catastrophizing, recovery expectations, fear avoidance, mental health score, body mass index, first provider seen for injury, previous injury, and several work-related factors.

Conclusion

We identify baseline factors that are associated with PT use, which may be useful in addressing disparities in access to care for injured workers with back pain in a WC system.

背景：有关背痛受伤工人使用物理治疗（PT）的预测因素的信息很少。本研究的主要目的是调查物理治疗的使用与工伤赔偿（WC）数据中未常规记录的基线因素之间的关联：我们利用华盛顿州工人赔偿残疾风险识别研究队列进行了二次分析，该队列将自我报告调查与华盛顿州劳工和工业部国家基金的理赔数据相结合。在 2002 年 6 月至 2004 年 4 月期间，因背部受伤而接受或临时申请工伤赔偿的工人均符合条件。从六个领域（社会人口、疼痛和功能、社会心理、临床、健康行为和就业相关）中选择了使用物理治疗的基线因素。结果是受伤后 1 年内使用康复治疗的二元测量。研究人员采用二元和多元逻辑回归模型来评估使用运动疗法与基线因素之间的关系：在 1370 名符合条件的研究参与者中，我们发现有 673 人（49%）至少接受过一次 PT 服务。六个领域中五个领域的基线因素（除健康行为外的所有因素）都与使用物理治疗相关，包括性别、收入、疼痛和功能测量、受伤严重程度评级、灾难化、康复预期、恐惧回避、心理健康评分、体重指数、首次因伤就诊的医疗服务提供者、之前的受伤情况以及几个与工作相关的因素：我们发现了与使用康复治疗相关的基线因素，这些因素可能有助于解决在工伤医疗系统中背部疼痛的工伤工人在获得医疗服务方面的差异。

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引用次数: 0

Suicide mortality according to occupation and method of suicide, Massachusetts, 2010–2019 2010-2019 年马萨诸塞州按职业和自杀方式分列的自杀死亡率。

IF 3.5 3区医学 Q2 Medicine

American journal of industrial medicine

Pub Date : 2024-05-09 DOI: 10.1002/ajim.23593

Devan Hawkins ScD, Jagvi Patel BS

Background

Suicide rates in the United States have been increasing. Work-related factors may contribute to risk for suicide. These work-related factors may be reflected in a varied risk for different suicide methods between occupations. This study sought to assess occupational differences in suicide rates according to the method used.

Methods

Death certificate data about suicide deaths in Massachusetts between 2010 and 2019 were used to calculate mortality rates and rate ratios with univariable and multivariable models controlling for age, sex, race ethnicity, and educational attainment for suicides overall, and for three specific methods of suicide (hanging/strangulation/suffocation, firearms, and poisoning) by occupation.

Results

In multivariate models, the risk for suicide was significantly elevated for workers in arts, design, entertainment, sports, and media (relative risk [RR] = 1.84, 95% confidence interval [CI] = 1.53, 2.22); construction trades (RR = 1.68, 95% CI = 1.53, 1.84); protective services (RR = 1.49, 95% CI = 1.26, 1.77); and healthcare support occupations (RR = 1.55, 95% CI = 1.25, 1.93). Occupational risk for suicide differed across different methods. For hanging/strangulation/suffocation, workers in arts, design, entertainment, sports, and media occupations had the highest RR (2.09, 95% CI = 1.61, 2.71). For firearms, workers in protective service occupations had the highest RR (4.20, 95% CI = 3.30, 5.34). For poisoning, workers in life, physical, and social science occupations had the highest RR (2.32, 95% CI = 1.49, 3.60).

Conclusions

These findings are useful for identifying vulnerable working populations for suicide. Additionally, some of the occupational differences in the risk for suicide and for specific methods of suicide may be due to workplace factors. Further research is needed to understand these workplace factors so that interventions can be designed for prevention.

背景：美国的自杀率一直在上升。与工作有关的因素可能会导致自杀风险。这些与工作有关的因素可能反映在不同职业采用不同自杀方式的风险上。本研究试图根据所使用的自杀方法来评估自杀率的职业差异：方法：使用马萨诸塞州 2010 年至 2019 年期间自杀死亡的死亡证明数据，通过单变量和多变量模型计算总体自杀死亡率和比率，控制年龄、性别、种族族裔和受教育程度，并按职业计算三种特定自杀方式（绞刑/勒死/窒息、枪杀和投毒）的死亡率和比率：在多变量模型中，艺术、设计、娱乐、体育和媒体行业（相对风险 [RR] = 1.84，95% 置信区间 [CI] = 1.53，2.22）、建筑行业（RR = 1.68，95% 置信区间 = 1.53，1.84）、保护服务行业（RR = 1.49，95% 置信区间 = 1.26，1.77）和医疗保健辅助行业（RR = 1.55，95% 置信区间 = 1.25，1.93）的自杀风险明显升高。不同方法的自杀职业风险不同。就上吊/绞刑/窒息而言，从事艺术、设计、娱乐、体育和媒体职业的工人的 RR 最高（2.09，95% CI = 1.61，2.71）。在枪支方面，从事防护服务职业的工人的 RR 值最高（4.20，95% CI = 3.30，5.34）。在中毒方面，从事生活、物理和社会科学职业的工人的 RR 值最高（2.32，95% CI = 1.49，3.60）：这些研究结果有助于确定容易自杀的工作人群。此外，自杀风险和特定自杀方式的职业差异可能是由工作场所因素造成的。需要进一步研究了解这些工作场所因素，以便设计干预措施进行预防。

{"title":"Suicide mortality according to occupation and method of suicide, Massachusetts, 2010–2019","authors":"Devan Hawkins ScD, Jagvi Patel BS","doi":"10.1002/ajim.23593","DOIUrl":"10.1002/ajim.23593","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Suicide rates in the United States have been increasing. Work-related factors may contribute to risk for suicide. These work-related factors may be reflected in a varied risk for different suicide methods between occupations. This study sought to assess occupational differences in suicide rates according to the method used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Death certificate data about suicide deaths in Massachusetts between 2010 and 2019 were used to calculate mortality rates and rate ratios with univariable and multivariable models controlling for age, sex, race ethnicity, and educational attainment for suicides overall, and for three specific methods of suicide (hanging/strangulation/suffocation, firearms, and poisoning) by occupation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In multivariate models, the risk for suicide was significantly elevated for workers in arts, design, entertainment, sports, and media (relative risk [RR] = 1.84, 95% confidence interval [CI] = 1.53, 2.22); construction trades (RR = 1.68, 95% CI = 1.53, 1.84); protective services (RR = 1.49, 95% CI = 1.26, 1.77); and healthcare support occupations (RR = 1.55, 95% CI = 1.25, 1.93). Occupational risk for suicide differed across different methods. For hanging/strangulation/suffocation, workers in arts, design, entertainment, sports, and media occupations had the highest RR (2.09, 95% CI = 1.61, 2.71). For firearms, workers in protective service occupations had the highest RR (4.20, 95% CI = 3.30, 5.34). For poisoning, workers in life, physical, and social science occupations had the highest RR (2.32, 95% CI = 1.49, 3.60).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings are useful for identifying vulnerable working populations for suicide. Additionally, some of the occupational differences in the risk for suicide and for specific methods of suicide may be due to workplace factors. Further research is needed to understand these workplace factors so that interventions can be designed for prevention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140896737","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

Practical cooling interventions for preventing heat strain in indoor factory workers in Thailand 预防泰国室内工厂工人中暑的实用降温干预措施

IF 3.5 3区医学 Q2 Medicine

American journal of industrial medicine

Pub Date : 2024-05-02 DOI: 10.1002/ajim.23589

Aaron J. E. Bach, Phayong Thepaksorn, Elizabeth K. Hom Thepaksorn, David N. Borg, Shannon Rutherford, Nicholas J. Osborne, Darsy Darssan, Dung Phung

Background

Occupational heat stress, exacerbated by factors such as climate change and insufficient cooling solutions, endangers the health and productivity of workers, especially in low-resource workplaces.

Objective

To evaluate the effectiveness of two cooling strategies in reducing physiological strain and productivity of piece-rate workers over a 9-h work shift in a southern Thailand sawmill.

Methods

In a crossover randomized control trial design, 12 (33 ± 7 y; 1.58 ± 0.05 m; 51 ± 9 kg; n = 5 females) medically screened sawmill workers were randomly allocated into three groups comprising an established phase change material vest (VEST), an on-site combination cooling oasis (OASIS) (i.e., hydration, cold towels, fans, water dousing), and no cooling (CON) across 3 consecutive workdays. Physiological strain was measured via core temperature telemetry and heart rate monitoring. Productivity was determined by counting the number of pallets of wood sorted, stacked, and stowed each day.

Results

Relative to CON, OASIS lowered core temperature by 0.25°C [95% confidence interval = 0.24, 0.25] and heart rate by 7 bpm [6, 9] bpm, compared to 0.17°C [0.17, 0.18] and 10 [9,12] bpm reductions with VEST. It was inconclusive whether productivity was statistically lower in OASIS compared to CON (mean difference [MD] = 2.5 [–0.2, 5.2]), and was not statistically different between VEST and CON (MD = 1.4 [–1.3, 4.1]).

Conclusions

Both OASIS and VEST were effective in reducing physiological strain compared to no cooling. Their effect on productivity requires further investigation, as even small differences between interventions could lead to meaningful disparities in piece-rate worker earnings over time.

背景职业热应激因气候变化和冷却解决方案不足等因素而加剧，危及工人的健康和生产率，尤其是在资源匮乏的工作场所。目标评估两种冷却策略在减轻泰国南部锯木厂计件工人 9 小时轮班工作的生理负荷和生产率方面的效果。方法采用交叉随机对照试验设计，将 12 名经过体检的锯木厂工人（33 ± 7 岁；1.58 ± 0.05 米；51 ± 9 千克；n = 5 名女性）随机分配到三组，分别是既定的相变材料背心 (VEST)、现场组合冷却绿洲 (OASIS)（即：水合作用、冷毛巾、风扇、空调）、水、冷毛巾、风扇、浇水），以及连续 3 个工作日不降温（CON）。生理应变通过核心温度遥测和心率监测进行测量。结果与CON相比，OASIS使核心温度降低了0.25°C [95%置信区间 = 0.24, 0.25]，心率降低了7 bpm [6, 9] bpm，而VEST使核心温度降低了0.17°C [0.17, 0.18]，心率降低了10 [9, 12] bpm。与 CON 相比，OASIS 的生产率在统计学上是否更低尚无定论（平均差 [MD] = 2.5 [-0.2, 5.2]），而 VEST 与 CON 之间在统计学上没有差异（MD = 1.4 [-1.3, 4.1]）。它们对生产率的影响还需要进一步研究，因为即使干预措施之间存在微小差异，也可能导致计件工资工人的收入随着时间的推移出现显著差异。

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引用次数: 0

A blueprint for a new commercial driving epidemiology: An emerging paradigm grounded in integrative exposome and network epistemologies 新的商业流行病学蓝图：以综合暴露组和网络认识论为基础的新兴范式

IF 3.5 3区医学 Q2 Medicine

American journal of industrial medicine

Pub Date : 2024-04-30 DOI: 10.1002/ajim.23588

Yorghos Apostolopoulos PhD, Sevil Sönmez PhD, Matthew S. Thiese PhD, Mubo Olufemi MSc, Lazaros K. Gallos PhD

Excess health and safety risks of commercial drivers are largely determined by, embedded in, or operate as complex, dynamic, and randomly determined systems with interacting parts. Yet, prevailing epidemiology is entrenched in narrow, deterministic, and static exposure-response frameworks along with ensuing inadequate data and limiting methods, thereby perpetuating an incomplete understanding of commercial drivers' health and safety risks. This paper is grounded in our ongoing research that conceptualizes health and safety challenges of working people as multilayered “wholes” of interacting work and nonwork factors, exemplified by complex-systems epistemologies. Building upon and expanding these assumptions, herein we: (a) discuss how insights from integrative exposome and network-science-based frameworks can enhance our understanding of commercial drivers' chronic disease and injury burden; (b) introduce the “working life exposome of commercial driving” (WLE-CD)—an array of multifactorial and interdependent work and nonwork exposures and associated biological responses that concurrently or sequentially impact commercial drivers' health and safety during and beyond their work tenure; (c) conceptualize commercial drivers' health and safety risks as multilayered networks centered on the WLE-CD and network relational patterns and topological properties—that is, arrangement, connections, and relationships among network components—that largely govern risk dynamics; and (d) elucidate how integrative exposome and network-science-based innovations can contribute to a more comprehensive understanding of commercial drivers' chronic disease and injury risk dynamics. Development, validation, and proliferation of this emerging discourse can move commercial driving epidemiology to the frontier of science with implications for policy, action, other working populations, and population health at large.

商业驾驶员的过高健康和安全风险在很大程度上是由复杂、动态和随机的系统决定的，这些系统中的各个部分相互影响。然而，流行病学却根深蒂固于狭隘、确定和静态的暴露-反应框架，以及随之而来的数据不足和方法限制，从而导致对商业驾驶员健康和安全风险的不完整理解长期存在。本文以我们正在进行的研究为基础，将工作人群的健康和安全挑战概念化为工作和非工作因素相互作用的多层次 "整体"，以复杂系统认识论为例。在此，我们将以这些假设为基础并加以扩展：(a) 讨论基于暴露组和网络科学的综合框架的见解如何能增强我们对商业驾驶员慢性疾病和伤害负担的理解；(b) 介绍 "商业驾驶工作寿命暴露组"（WLE-CD）--一系列多因素和相互依存的工作和非工作暴露以及相关的生物反应，这些暴露和反应同时或相继影响着商业驾驶员在工作期间和之后的健康和安全；(c) 将商业驾驶员的健康和安全风险概念化为以WLE-CD为中心的多层网络，以及网络关系模式和拓扑特性--即网络组成部分之间的排列、连接和关系--这些在很大程度上制约着风险动态；以及 (d) 阐明基于暴露组和网络科学的综合创新如何有助于更全面地了解商业驾驶员的慢性疾病和伤害风险动态。这一新兴论述的发展、验证和推广可将商业驾驶流行病学推向科学前沿，并对政策、行动、其他工作人群和整个人口健康产生影响。

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引用次数: 0

Heat-related fatalities in North Carolina 1999–2017 1999-2017 年北卡罗来纳州与高温有关的死亡人数

IF 3.5 3区医学 Q2 Medicine

American journal of industrial medicine

Pub Date : 2024-04-16 DOI: 10.1002/ajim.23587

Elizabeth S. McClure, Shabbar I. Ranapurwala, Maryalice Nocera, David B. Richardson

Objectives

Research shows the highest rates of occupational heat-related fatalities among farm laborers and among Black and Hispanic workers in North Carolina (NC). The Hispanic population and workforce in NC have grown substantially in the past 20 years. We describe the epidemiology of heat-related fatal injuries in the general population and among workers in NC.

Methods

We reviewed North Carolina death records and records of the North Carolina Office of the Chief Medical Examiner to identify heat-related deaths (primary International Classification of Diseases, Tenth Revision diagnosis code: X30 or T67.0-T67.9) that occurred between January 1, 1999, and December 31, 2017. Decedent age, sex, race, and ethnicity were extracted from both the death certificate and the medical examiner's report as well as determinations of whether the death occurred at work.

Results

In NC between 1999 and 2017, there were 225 deaths from heat-related injuries, and 25 occurred at work. The rates of occupational heat-related deaths were highest among males, workers of Hispanic ethnicity, workers of Black, multiple, or unknown race, and in workers aged 55–64. The highest rate of occupational heat-related deaths occurred in the agricultural industry.

Conclusions

Since the last report (2001), the number of heat-related fatalities has increased, but fewer were identified as workplace fatalities. Rates of occupational heat-related deaths are highest among Hispanic workers. NC residents identifying as Black are disproportionately burdened by heat-related fatalities in general, with a wider apparent disparity in occupational deaths.

研究表明，在北卡罗来纳州（NC），农场工人以及黑人和西班牙裔工人的职业高温致死率最高。在过去 20 年中，北卡罗来纳州的西班牙裔人口和劳动力大幅增长。我们描述了北卡罗来纳州普通人群和工人中与高温有关的致命伤害的流行病学。

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引用次数: 0

Forty years of struggle in North Carolina: Workplace segregation and fatal occupational injury rates 北卡罗来纳州四十年的斗争：工作场所隔离与致命工伤率

IF 3.5 3区医学 Q2 Medicine

American journal of industrial medicine

Pub Date : 2024-04-12 DOI: 10.1002/ajim.23586

Elizabeth S. McClure, Amelia T. Martin, Shabbar I. Ranapurwala, Maryalice Nocera, John Cantrell, Stephen Marshall, David B. Richardson

Objective

To assess workplace segregation in fatal occupational injury from 1992 to 2017 in North Carolina.

Methods

We calculated occupational fatal injury rates within categories of occupation, industry, race, age, and sex; and estimated expected numbers of fatalities among Black and Hispanic male workers had they experienced the rates of White male workers. We also estimated the contribution of workforce segregation to disparities by estimating the expected number of fatalities among Black and Hispanic male workers had they experienced the industry and occupation patterns of White male workers. We assessed person-years of life-lost, using North Carolina life expectancy estimates.

Results

Hispanic workers contributed 32% of their worker-years and experienced 58% of their fatalities in construction. Black workers were most overrepresented in the food manufacturing industry. Hispanic males experienced 2.11 (95% CI: 1.86–2.40) times the mortality rate of White males. The Black-White and Hispanic-White disparities were widest among workers aged 45 and older, and segregation into more dangerous industries and occupations played a substantial role in driving disparities. Hispanic workers who suffered occupational fatalities lost a median 47 life-years, compared to 37 among Black workers and 36 among White workers.

Conclusions

If Hispanic and Black workers experienced the workplace safety of their White counterparts, fatal injury rates would be substantially reduced. Workforce segregation reflects structural racism, which also contributes to mortality disparities. Root causes must be addressed to eliminate disparities.

方法我们计算了职业、行业、种族、年龄和性别类别中的职业致命伤害率；并估算了黑人和西班牙裔男性工人在经历白人男性工人的致命伤害率时的预期死亡人数。我们还估算了劳动力隔离对差异的影响，即如果黑人和西班牙裔男性工人的行业和职业模式与白人男性工人相同，他们的预期死亡人数也会有所变化。我们使用北卡罗来纳州的预期寿命估算值对损失的人年寿命进行了评估。结果西班牙裔工人贡献了 32% 的工人年寿命，58% 的死亡事故发生在建筑业。黑人工人在食品制造业的比例最高。西班牙裔男性的死亡率是白人男性的 2.11 倍（95% CI：1.86-2.40）。在 45 岁及以上的工人中，黑人-白人和西班牙裔-白人之间的差距最大，在更危险的行业和职业中的隔离在很大程度上造成了这种差距。遭受职业死亡事故的西班牙裔工人损失的寿命年数中位数为 47 年，而黑人工人为 37 年，白人工人为 36 年。劳动力隔离反映了结构性种族主义，也是造成死亡率差异的原因之一。要消除差异，就必须从根本上解决问题。

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引用次数: 0

An urgent call to address work-related psychosocial hazards and improve worker well-being 紧急呼吁解决与工作有关的社会心理危害并改善工人福祉

IF 3.5 3区医学 Q2 Medicine

American journal of industrial medicine

Pub Date : 2024-04-10 DOI: 10.1002/ajim.23583

Paul A. Schulte PhD, Steven L. Sauter PhD, Sudha P. Pandalai MD, Hope M. Tiesman PhD, Lewis C. Chosewood MD, Thomas R. Cunningham PhD, Steven J. Wurzelbacher PhD, Rene Pana-Cryan PhD, Naomi G. Swanson PhD, Chia-Chia Chang MPH, Jeannie A. S. Nigam MS, Dori B. Reissman MD, Tapas K. Ray PhD, John Howard MD

Work-related psychosocial hazards are on the verge of surpassing many other occupational hazards in their contribution to ill-health, injury, disability, direct and indirect costs, and impact on business and national productivity. The risks associated with exposure to psychosocial hazards at work are compounded by the increasing background prevalence of mental health disorders in the working-age population. The extensive and cumulative impacts of these exposures represent an alarming public health problem that merits immediate, increased attention. In this paper, we review the linkage between work-related psychosocial hazards and adverse effects, their economic burden, and interventions to prevent and control these hazards. We identify six crucial societal actions: (1) increase awareness of this critical issue through a comprehensive public campaign; (2) increase etiologic, intervention, and implementation research; (3) initiate or augment surveillance efforts; (4) increase translation of research findings into guidance for employers and workers; (5) increase the number and diversity of professionals skilled in preventing and addressing psychosocial hazards; and (6) develop a national regulatory or consensus standard to prevent and control work-related psychosocial hazards.

与工作有关的社会心理危害在造成疾病、伤害、残疾、直接和间接成本以及对企业和国家生产力的影响方面，即将超过许多其他职业危害。工作中暴露于社会心理危害的相关风险因工作年龄人口中心理健康失调的背景流行率不断上升而变得更加复杂。这些暴露的广泛和累积性影响是一个令人担忧的公共健康问题，值得立即给予更多关注。在本文中，我们回顾了与工作相关的社会心理危害和不良影响之间的联系、其经济负担以及预防和控制这些危害的干预措施。我们确定了六项关键的社会行动：(1) 通过全面的公共宣传活动提高人们对这一关键问题的认识；(2) 加强病因学、干预和实施研究；(3) 启动或加强监测工作；(4) 进一步将研究结果转化为对雇主和工人的指导；(5) 增加擅长预防和解决社会心理危害的专业人员的数量和多样性；以及 (6) 制定预防和控制与工作相关的社会心理危害的国家法规或共识标准。

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引用次数: 0

Work-related asthma prevalence among US employed adults 美国就业成年人中与工作有关的哮喘发病率

IF 3.5 3区医学 Q2 Medicine

American journal of industrial medicine

Pub Date : 2024-04-07 DOI: 10.1002/ajim.23585

Girija Syamlal MBBS, MPH, Katelynn E. Dodd MPH, Jacek M. Mazurek MD, MS, PHD

Background

Work-related asthma (WRA), a preventable occupational disease, can result in adverse health outcomes and employment disability, including decreased productivity, lost workdays, and job loss. Early identification of WRA cases and avoidance of further exposures is crucial for optimal management.

Objective

We estimate WRA prevalence among US workers by selected sociodemographic characteristics, industry, and occupation groups and assess the differences in adverse health outcomes, preventive care, and lost workdays between persons with WRA and those with non-WRA.

Methods

The 2020 National Health Interview Survey (NHIS) data for working adults aged ≥18 years employed in the 12 months before the survey were analyzed. Prevalence, and adjusted prevalence ratios with 95% confidence intervals were estimated using multivariate logistic regression.

Results

Of the estimated 170 million US adults working in the past year, 13.0 million (7.6%) had asthma. Among workers with asthma, an estimated 896,000 (6.9%) had WRA. WRA prevalence was highest among males, workers aged ≥55 years, those with no health insurance, those living in the Midwest, and those employed in the accommodation, food, and other services industry, and in production, installation, transportation, and material moving occupations. Workers with WRA were significantly more likely to use preventive medication and rescue inhalers, and to experience adverse health outcomes and lost workdays than workers with non-WRA.

Conclusion

Early identification of WRA cases, assessment of workplace exposures, and implementation of targeted interventions that consider the hierarchy of controls are critical to preventing future WRA cases and associated adverse health consequences.

背景与工作有关的哮喘（WRA）是一种可预防的职业病，可导致不良的健康后果和就业残疾，包括生产率下降、工作日损失和失业。我们按选定的社会人口特征、行业和职业组别估算了美国工人中的哮喘患病率，并评估了哮喘患者与非哮喘患者在不良健康后果、预防性护理和损失工作日方面的差异。结果在去年工作的约 1.7 亿美国成年人中，有 1300 万人（7.6%）患有哮喘。在患有哮喘的工人中，约有 896,000 人（6.9%）患有 WRA。男性、年龄≥55 岁的工人、没有医疗保险的人、居住在中西部的人以及受雇于住宿、食品和其他服务行业以及生产、安装、运输和材料搬运职业的人中，WRA 患病率最高。患有 WRA 的工人使用预防性药物和抢救性吸入器的可能性明显高于未患 WRA 的工人，他们也更容易出现不良健康后果和损失工作日。

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引用次数: 0