Jennifer M. Cavallari, Sierra M. Trudel, Natalie R. Charamut, Megan N. Miskovsky, Matthew Brennan, Amanda J. L. Hiner, Rebecca J. Gore, Lisa M. H. Sanetti, Alicia G. Dugan
Background
Educator mental health plays an important role in schools, yet the long-term impacts of the COVID-19 pandemic remain unknown. We sought to estimate the prevalence of school employee stress, anxiety, and depression in the 2022–2023 school year within two school districts in the Northeastern United States.
Methods
An electronic survey was distributed to school employees. Stress was assessed with the 10-item Perceived Stress Scale with scores 0–13, 14–26, and 27–40 representing low, moderate, and high stress. The Generalized Anxiety Disorder 7-item scale and the Center for Epidemiologic Studies Depression 10-item scale were used to assess clinically significant anxiety and depressive symptoms, with a cut-point of 10 applied to the total summed score of each scale. We used log-binomial regression models to estimate prevalence ratios (PR) and 95% confidence intervals (CI).
Results
The majority (76.0%) of the 725 school employees surveyed reported moderate to severe stress with 31.2% and 49.5% reporting clinically significant anxiety or depressive symptoms, respectively. A significantly higher prevalence of anxiety was reported among females (PR = 1.15 (CI: 1.02, 1.30)), instructional staff (PR = 1.15 (CI: 1.02, 1.30)), and employees reporting financial insecurity (PR = 1.18 (CI: 1.10, 1.27)). Likewise, a significantly higher prevalence of depression was reported was reported among women (PR = 1.24; CI (1.00–1.52)), instructional staff (PR = 1.31; CI (1.06–1.62)), and employees reporting financial insecurity (PR = 1.38; CI (1.19–1.60)). Stress, anxiety, and depression were each associated with employees’ intention to quit.
Conclusions
The residual effects of the pandemic remain prevalent among school employees. Improving school employees’ mental health is crucial for the well-being and retention of educators.
{"title":"Psychological Well-Being of US Educators Remains a Post-Pandemic Concern: Findings From a Cross-Sectional Study","authors":"Jennifer M. Cavallari, Sierra M. Trudel, Natalie R. Charamut, Megan N. Miskovsky, Matthew Brennan, Amanda J. L. Hiner, Rebecca J. Gore, Lisa M. H. Sanetti, Alicia G. Dugan","doi":"10.1002/ajim.23731","DOIUrl":"10.1002/ajim.23731","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Educator mental health plays an important role in schools, yet the long-term impacts of the COVID-19 pandemic remain unknown. We sought to estimate the prevalence of school employee stress, anxiety, and depression in the 2022–2023 school year within two school districts in the Northeastern United States.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An electronic survey was distributed to school employees. Stress was assessed with the 10-item Perceived Stress Scale with scores 0–13, 14–26, and 27–40 representing low, moderate, and high stress. The Generalized Anxiety Disorder 7-item scale and the Center for Epidemiologic Studies Depression 10-item scale were used to assess clinically significant anxiety and depressive symptoms, with a cut-point of 10 applied to the total summed score of each scale. We used log-binomial regression models to estimate prevalence ratios (PR) and 95% confidence intervals (CI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The majority (76.0%) of the 725 school employees surveyed reported moderate to severe stress with 31.2% and 49.5% reporting clinically significant anxiety or depressive symptoms, respectively. A significantly higher prevalence of anxiety was reported among females (PR = 1.15 (CI: 1.02, 1.30)), instructional staff (PR = 1.15 (CI: 1.02, 1.30)), and employees reporting financial insecurity (PR = 1.18 (CI: 1.10, 1.27)). Likewise, a significantly higher prevalence of depression was reported was reported among women (PR = 1.24; CI (1.00–1.52)), instructional staff (PR = 1.31; CI (1.06–1.62)), and employees reporting financial insecurity (PR = 1.38; CI (1.19–1.60)). Stress, anxiety, and depression were each associated with employees’ intention to quit.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The residual effects of the pandemic remain prevalent among school employees. Improving school employees’ mental health is crucial for the well-being and retention of educators.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 7","pages":"642-650"},"PeriodicalIF":2.7,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952480","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}
Tessa Bonney, Dana Madigan, Vinay Espinosa-Ravi, Linda Forst
Background
There is a growing appreciation of the importance of health and well-being and of the complex set of factors, within and outside the workplace, that interact to affect the well-being of workers. Migrant and seasonal farmworkers experience particular challenges, and measurement of factors that influence their health and well-being is important to the ethical sustainability of this critical workforce.
Methods
To examine the applicability of the NIOSH Worker Well-Being Framework to the health and well-being of farmworkers, we conducted a literature review to (1) explore the ways in which the domains, subdomains, and constructs of the framework are described in studies of farmworkers, and (2) identify additional constructs that are not described or not in alignment with the framework.
Results
Four reviewers used a thematic analysis approach to identify and summarize key areas of alignment and non-alignment of 163 included articles. We found alignment with the five framework domains and their sub-domains, though several are understudied or narrowly operationalized in studies of farmworkers. The vast majority of studies addressed contributors to poor health. We found five additional cross-cutting or unaligned themes (legal status, discrimination, exploitation, fear of retaliation, fear of deportation).
Conclusions
External and work-related social factors are important to the well-being of the farmworker workforce. Contextual determinants of employment precarity, hazardous occupational and nonoccupational exposures, and social safety nets should be considered in comprehensive assessments of worker well-being. Other precarious and immigrant workforces may also require expansion of the NIOSH Worker Well-Being Framework.
{"title":"Applying the NIOSH Worker Well-Being Framework to Migrant and Seasonal Farmworkers: Insights From the Literature","authors":"Tessa Bonney, Dana Madigan, Vinay Espinosa-Ravi, Linda Forst","doi":"10.1002/ajim.23728","DOIUrl":"10.1002/ajim.23728","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>There is a growing appreciation of the importance of health and well-being and of the complex set of factors, within and outside the workplace, that interact to affect the well-being of workers. Migrant and seasonal farmworkers experience particular challenges, and measurement of factors that influence their health and well-being is important to the ethical sustainability of this critical workforce.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>To examine the applicability of the NIOSH Worker Well-Being Framework to the health and well-being of farmworkers, we conducted a literature review to (1) explore the ways in which the domains, subdomains, and constructs of the framework are described in studies of farmworkers, and (2) identify additional constructs that are not described or not in alignment with the framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four reviewers used a thematic analysis approach to identify and summarize key areas of alignment and non-alignment of 163 included articles. We found alignment with the five framework domains and their sub-domains, though several are understudied or narrowly operationalized in studies of farmworkers. The vast majority of studies addressed contributors to poor health. We found five additional cross-cutting or unaligned themes (legal status, discrimination, exploitation, fear of retaliation, fear of deportation).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>External and work-related social factors are important to the well-being of the farmworker workforce. Contextual determinants of employment precarity, hazardous occupational and nonoccupational exposures, and social safety nets should be considered in comprehensive assessments of worker well-being. Other precarious and immigrant workforces may also require expansion of the NIOSH Worker Well-Being Framework.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 7","pages":"573-587"},"PeriodicalIF":2.7,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajim.23728","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971503","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}
John Howard, Vladimir Murashov, Gary Roth, Christopher Wendt, Jacob Carr, Marvin Cheng, Scott Earnest, K. C. Elliott, Emily Haas, Ci-Jyun Liang, Gretchen Petery, Jennifer Ragsdale, Christopher Reid, Peregrin Spielholz, Douglas Trout, Divya Srinivasan
Starting in the 1970s with robots that were physically isolated from contact with their human co-workers, robots now collaborate with human workers towards a common task goal in a shared workspace. This type of robotic device represents a new era of workplace automation. Industrial robotics is rapidly evolving due to advances in sensor technology, artificial intelligence (AI), wireless communications, mechanical engineering, and materials science. While these new robotic devices are used mainly in manufacturing and warehousing, human-robot collaboration is now seen across multiple goods-producing and service-delivery industry sectors. Assessing and controlling the risks of human-robot collaboration is a critical challenge for occupational safety and health research and practice as industrial robotics becomes a pervasive feature of the future of work. Understanding the physical, psychosocial, work organization, and cybersecurity risks associated with the increasing use of robotic technologies is critical to ensuring the safe development and implementation of industrial robotics. This commentary provides a brief review of the uses of robotic technologies across selected industry sectors; the risks of current and future industrial robotic applications for worker and employer alike; strategies for integrating human-robot collaboration into a health and safety management system; and the role of robotic safety standards in the future of work.
{"title":"Industrial Robotics and the Future of Work","authors":"John Howard, Vladimir Murashov, Gary Roth, Christopher Wendt, Jacob Carr, Marvin Cheng, Scott Earnest, K. C. Elliott, Emily Haas, Ci-Jyun Liang, Gretchen Petery, Jennifer Ragsdale, Christopher Reid, Peregrin Spielholz, Douglas Trout, Divya Srinivasan","doi":"10.1002/ajim.23729","DOIUrl":"10.1002/ajim.23729","url":null,"abstract":"<div>\u0000 \u0000 <p>Starting in the 1970s with robots that were physically <i>isolated</i> from contact with their human co-workers, robots now <i>collaborate</i> with human workers towards a common task goal in a shared workspace. This type of robotic device represents a new era of workplace automation. Industrial robotics is rapidly evolving due to advances in sensor technology, artificial intelligence (AI), wireless communications, mechanical engineering, and materials science. While these new robotic devices are used mainly in manufacturing and warehousing, human-robot collaboration is now seen across multiple goods-producing and service-delivery industry sectors. Assessing and controlling the risks of human-robot collaboration is a critical challenge for occupational safety and health research and practice as industrial robotics becomes a pervasive feature of the future of work. Understanding the physical, psychosocial, work organization, and cybersecurity risks associated with the increasing use of robotic technologies is critical to ensuring the safe development and implementation of industrial robotics. This commentary provides a brief review of the uses of robotic technologies across selected industry sectors; the risks of current and future industrial robotic applications for worker and employer alike; strategies for integrating human-robot collaboration into a health and safety management system; and the role of robotic safety standards in the future of work.</p></div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 7","pages":"559-572"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966009","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}
Ja K. Gu, Luenda E. Charles, Chol Seung Lim, Anna Mnatsakanova, Stacey Anderson, Lisa Dzubak, Erin McCanlies
Purpose
Per- and polyfluoroalkyl substances (PFAS) are associated with multiple health effects including pregnancy-induced hypertension and pre-eclampsia, increased serum hepatic enzymes, increased in serum lipids, decreased antibody response to vaccines, and decreased birth weight. Millions of US workers are exposed to PFAS at their workplaces. Our objective was to estimate the serum levels of the five PFAS that are most frequently detected in the US general population(perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorohexane sulfonic acid (PFHxS), perfluorodecanoic acid (PFDA), and perfluorononanoic acid (PFNA)) among US adult workers.
Methods
Participants were 4476 workers aged ≥ 20 years with PFAS analyte results available who participated in the National Health and Nutrition Examination Survey (NHANES), 2005–2014. Geometric mean serum levels of PFAS (ng/mL) were obtained across industry and occupation groups using the PFAS subsample weight in SAS-callable SUDAAN V11.
Results
Among 21 industry groups, the highest geometric mean PFAS levels (ng/mL) were observed in Construction (PFOS = 12.61 ng/mL, PFOA = 3.76, PFHxS = 2.10, PFNA = 1.23, and PFDA = 0.33), followed by Utilities (PFOS = 12.46), and Real Estate/Rental/Leasing (PFOS = 12.15). The lowest geometric mean PFAS levels were seen in Private Households (PFOS = 6.34, PFOA = 2.12, PFHxS=0.75, PFNA = 0.86, and PFDA = 0.25). Among 22 occupation groups, the highest geometric mean PFAS levels were observed in Life/Physical/Social Science occupations (PFOS = 13.19, PFOA = 3.54, PFHxS= 1.69, PFNA = 1.23, and PFDA = 0.33), followed by Installation/Maintenance/Repair occupations (PFOS = 12.75), and Construction/Extraction occupations (PFOS = 12.15). The lowest geometric mean PFAS levels were found in Personal Care/Service occupations (PFOS = 7.25, PFOA = 2.43, PFHxS = 1.07, PFNA = 0.94, and PFDA = 0.25).
Conclusions
Some industry and occupation groups had higher geometric mean levels of PFAS in serum compared to others. Further investigation of these industries and occupations may result in a better understanding of the sources and degree of occupational exposure to PFAS.
{"title":"Serum Concentration of Selected Per- and Polyfluoroalkyl Substances (PFAS) by Industry and Occupational Groups Among US Adult Workers, NHANES 2005–2014","authors":"Ja K. Gu, Luenda E. Charles, Chol Seung Lim, Anna Mnatsakanova, Stacey Anderson, Lisa Dzubak, Erin McCanlies","doi":"10.1002/ajim.23726","DOIUrl":"https://doi.org/10.1002/ajim.23726","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Per- and polyfluoroalkyl substances (PFAS) are associated with multiple health effects including pregnancy-induced hypertension and pre-eclampsia, increased serum hepatic enzymes, increased in serum lipids, decreased antibody response to vaccines, and decreased birth weight. Millions of US workers are exposed to PFAS at their workplaces. Our objective was to estimate the serum levels of the five PFAS that are most frequently detected in the US general population(perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorohexane sulfonic acid (PFHxS), perfluorodecanoic acid (PFDA), and perfluorononanoic acid (PFNA)) among US adult workers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants were 4476 workers aged ≥ 20 years with PFAS analyte results available who participated in the National Health and Nutrition Examination Survey (NHANES), 2005–2014. Geometric mean serum levels of PFAS (ng/mL) were obtained across industry and occupation groups using the PFAS subsample weight in SAS-callable SUDAAN V11.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 21 industry groups, the highest geometric mean PFAS levels (ng/mL) were observed in Construction (PFOS = 12.61 ng/mL, PFOA = 3.76, PFHxS = 2.10, PFNA = 1.23, and PFDA = 0.33), followed by Utilities (PFOS = 12.46), and Real Estate/Rental/Leasing (PFOS = 12.15). The lowest geometric mean PFAS levels were seen in Private Households (PFOS = 6.34, PFOA = 2.12, PFHxS=0.75, PFNA = 0.86, and PFDA = 0.25). Among 22 occupation groups, the highest geometric mean PFAS levels were observed in Life/Physical/Social Science occupations (PFOS = 13.19, PFOA = 3.54, PFHxS= 1.69, PFNA = 1.23, and PFDA = 0.33), followed by Installation/Maintenance/Repair occupations (PFOS = 12.75), and Construction/Extraction occupations (PFOS = 12.15). The lowest geometric mean PFAS levels were found in Personal Care/Service occupations (PFOS = 7.25, PFOA = 2.43, PFHxS = 1.07, PFNA = 0.94, and PFDA = 0.25).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Some industry and occupation groups had higher geometric mean levels of PFAS in serum compared to others. Further investigation of these industries and occupations may result in a better understanding of the sources and degree of occupational exposure to PFAS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 6","pages":"531-542"},"PeriodicalIF":2.7,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143939612","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}
Steven Ronsmans, Benoit Nemery, Nico De Crem, Birgit Weynand
{"title":"Silicosis, Sarcoidosis, or Both? Rethinking Disease Labels in Light of Co-Occurrence","authors":"Steven Ronsmans, Benoit Nemery, Nico De Crem, Birgit Weynand","doi":"10.1002/ajim.23730","DOIUrl":"https://doi.org/10.1002/ajim.23730","url":null,"abstract":"","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 6","pages":"487-490"},"PeriodicalIF":2.7,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143939648","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 healthy worker survivor bias may vary by sex. This study investigated three component associations necessary for this bias to determine the origins of sex differences in this bias among male and female workers.
Methods
We analyzed a data set of 93,918 South Korean diagnostic medical radiation workers registered in the National Dose Registry from 1996 to 2011, linked with mortality and cancer incidence data. Component associations were assessed using Cox regression to estimate hazard ratios (HRs) and logistic regression with generalized estimating equations to estimate odds ratios (ORs).
Results
A significant association between prior cumulative exposure and employment status was observed for all-cause mortality in male (HR 1.06, 95% CI 1.02–1.10), whereas an inverse association was noted in female workers (HR 0.82, 95% CI 0.78–0.87). Adjusted ORs for employment status and subsequent exposure for all-cause mortality, as well as HRs for employment status and survival time, demonstrated associations in the same direction in both males and females.
Conclusions
Our findings demonstrate that sex-specific differences in healthy worker survivor bias were primarily driven by the association between prior exposure and employment status. To improve bias mitigation in occupational cohort studies, sex-specific components should be incorporated.
健康工人幸存者偏见可能因性别而异。本研究调查了这种偏见所必需的三个组成部分的关联，以确定这种偏见在男性和女性工人中性别差异的起源。方法我们分析了1996年至2011年在国家剂量登记处注册的93,918名韩国诊断医疗放射工作者的数据集，与死亡率和癌症发病率数据相关。采用Cox回归估计风险比（hr），采用广义估计方程进行logistic回归评估优势比（ORs）。结果在男性全因死亡率中，既往累积暴露与就业状况之间存在显著相关性（HR 1.06, 95% CI 1.02-1.10），而在女性全因死亡率中存在负相关（HR 0.82, 95% CI 0.78-0.87）。调整就业状态和随后暴露导致的全因死亡率的ORs，以及就业状态和生存时间的hr，在男性和女性中都显示出相同方向的关联。我们的研究结果表明，健康工人幸存者偏见的性别差异主要是由先前暴露与就业状况之间的关联驱动的。为了改善职业队列研究中的偏倚缓解，应纳入性别特异性成分。
{"title":"Component Associations of the Healthy Worker Survivor Bias in Medical Radiation Workers","authors":"Won Jin Lee, Jaeho Jeong, Young Min Kim","doi":"10.1002/ajim.23727","DOIUrl":"https://doi.org/10.1002/ajim.23727","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The healthy worker survivor bias may vary by sex. This study investigated three component associations necessary for this bias to determine the origins of sex differences in this bias among male and female workers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed a data set of 93,918 South Korean diagnostic medical radiation workers registered in the National Dose Registry from 1996 to 2011, linked with mortality and cancer incidence data. Component associations were assessed using Cox regression to estimate hazard ratios (HRs) and logistic regression with generalized estimating equations to estimate odds ratios (ORs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A significant association between prior cumulative exposure and employment status was observed for all-cause mortality in male (HR 1.06, 95% CI 1.02–1.10), whereas an inverse association was noted in female workers (HR 0.82, 95% CI 0.78–0.87). Adjusted ORs for employment status and subsequent exposure for all-cause mortality, as well as HRs for employment status and survival time, demonstrated associations in the same direction in both males and females.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings demonstrate that sex-specific differences in healthy worker survivor bias were primarily driven by the association between prior exposure and employment status. To improve bias mitigation in occupational cohort studies, sex-specific components should be incorporated.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 6","pages":"552-556"},"PeriodicalIF":2.7,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajim.23727","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143939387","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}
Jeremy T. Hua, Carlyne D. Cool, Einat Fireman Klein, Yochai Adir, Lukas J. Lee, Lauren M. Zell-Baran, Robert A. Cohen, Richard C. Kraus, E. Brigitte Gottschall, Silpa D. Krefft, Charles Van Hook, Cecile S. Rose
Sarcoidosis is a multisystem inflammatory disease of unknown etiology. Growing evidence indicates that occupational exposure to respirable crystalline silica (RCS) is associated with an increased incidence of sarcoidosis. Yet a diagnosis of sarcoidosis rarely prompts investigation to identify preventable exposures. We sought to elucidate features that identify this important clinical syndrome of silicosarcoidosis. We assembled a multinational case series of workers with sarcoidosis who also reported occupational RCS exposure. We characterized clinical and histopathologic findings using a standardized instrument. We also assessed lung specimens using a novel quantitative microscopy technique to measure birefringent dust density in silicosarcoidosis cases and compared them to control groups. We identified 35 silicosarcoidosis cases (97% male, mean age 48 years) from the United States, Israel, and Taiwan who reported 21 ± 9 years of RCS exposure. On histology scoring, 25/29 (86%) had granulomas and 17/18 (94%) with evaluable lung tissue had lymphocytic inflammation and/or lymphoid aggregates. Common lung interstitial findings included silicotic nodules (39%), mixed-dust macules/nodules (44%), and birefringent dust (50%). Quantitative birefringent dust density was significantly greater (p < 0.001) in silicosarcoidosis cases compared with healthy controls (147 ± 179 vs. 12 ± 9 particles/mm2) but lower than in coal miners with silica-related progressive massive fibrosis (623 ± 777). We found significant differences in the frequency of histologic abnormalities in large versus small biopsy specimens, with fewer findings of RCS exposure in smaller tissue samples. The use of the term silicosarcoidosis should enhance recognition of this significant exposure-related granulomatous lung disease and will help guide clinical management that addresses exposure prevention in combination with appropriate pharmacologic treatment.
{"title":"Silicosarcoidosis: Histologic and Clinical Features of an Occupational Granulomatous Disease","authors":"Jeremy T. Hua, Carlyne D. Cool, Einat Fireman Klein, Yochai Adir, Lukas J. Lee, Lauren M. Zell-Baran, Robert A. Cohen, Richard C. Kraus, E. Brigitte Gottschall, Silpa D. Krefft, Charles Van Hook, Cecile S. Rose","doi":"10.1002/ajim.23724","DOIUrl":"https://doi.org/10.1002/ajim.23724","url":null,"abstract":"<p>Sarcoidosis is a multisystem inflammatory disease of unknown etiology. Growing evidence indicates that occupational exposure to respirable crystalline silica (RCS) is associated with an increased incidence of sarcoidosis. Yet a diagnosis of sarcoidosis rarely prompts investigation to identify preventable exposures. We sought to elucidate features that identify this important clinical syndrome of silicosarcoidosis. We assembled a multinational case series of workers with sarcoidosis who also reported occupational RCS exposure. We characterized clinical and histopathologic findings using a standardized instrument. We also assessed lung specimens using a novel quantitative microscopy technique to measure birefringent dust density in silicosarcoidosis cases and compared them to control groups. We identified 35 silicosarcoidosis cases (97% male, mean age 48 years) from the United States, Israel, and Taiwan who reported 21 ± 9 years of RCS exposure. On histology scoring, 25/29 (86%) had granulomas and 17/18 (94%) with evaluable lung tissue had lymphocytic inflammation and/or lymphoid aggregates. Common lung interstitial findings included silicotic nodules (39%), mixed-dust macules/nodules (44%), and birefringent dust (50%). Quantitative birefringent dust density was significantly greater (<i>p</i> < 0.001) in silicosarcoidosis cases compared with healthy controls (147 ± 179 vs. 12 ± 9 particles/mm<sup>2</sup>) but lower than in coal miners with silica-related progressive massive fibrosis (623 ± 777). We found significant differences in the frequency of histologic abnormalities in large versus small biopsy specimens, with fewer findings of RCS exposure in smaller tissue samples. The use of the term silicosarcoidosis should enhance recognition of this significant exposure-related granulomatous lung disease and will help guide clinical management that addresses exposure prevention in combination with appropriate pharmacologic treatment.</p>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 6","pages":"491-507"},"PeriodicalIF":2.7,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajim.23724","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143939388","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}
Bakari Ibrahim, Nicole Le Moual, Guillaume Sit, Marcel Goldberg, Bénédicte Leynaert, Céline Ribet, Nicolas Roche, Raphaëlle Varraso, Marie Zins, Rachel Nadif, Laurent Orsi, Orianne Dumas
Background
Disinfectants and cleaning products (DCPs) are important asthma risk factors among healthcare workers. However, healthcare work involves heterogenous cleaning tasks and co-exposure to many chemicals. These multidimensional aspects have rarely been considered. We aimed to identify patterns of occupational exposure to DCPs and study their associations with asthma.
Methods
CONSTANCES is a French population-based cohort of ≈220,000 adults. Current asthma and asthma symptom score were defined by questionnaire at inclusion (2012–2021). Healthcare workers completed a supplementary questionnaire on their current/last held occupation, workplace, and cleaning activities that were used in unsupervised learning algorithms to identify occupational exposure patterns. Logistic and negative binomial regression models, adjusted for potential confounders, were used to assess associations with asthma outcomes.
Results
In 5512 healthcare workers, four occupational exposure clusters were identified: Cluster1 (C1, 42%, reference), mainly characterized by low exposed nurses and physicians; C2 (7%), medical laboratory staff moderately exposed to common DCPs (chlorine/bleach, alcohol); C3 (41%), nursing assistants and nurses highly exposed to a few DCPs (mainly quaternary ammonium compounds); and C4 (10%), nurses and nursing assistants highly exposed to multiple DCPs (e.g., glutaraldehyde, hydrogen peroxide, and acids). Among women (n = 3734), C2 (mean score ratio [95% CI]: 1.31 [1.02; 1.68]) and C3 (1.18 [1.03; 1.36]) were associated with higher asthma symptom score, and an association was suggested between C3 and current asthma (odds ratio 1.22 [0.99; 1.51]).
Conclusion
In a large population of healthcare workers, four DCP exposure patterns were identified, reflecting the heterogeneity of healthcare jobs. Two patterns, including one characterized by laboratory workers, were associated with greater asthma symptoms in women.
{"title":"Occupational Exposure Patterns to Disinfectants and Cleaning Products and Its Association With Asthma Among French Healthcare Workers","authors":"Bakari Ibrahim, Nicole Le Moual, Guillaume Sit, Marcel Goldberg, Bénédicte Leynaert, Céline Ribet, Nicolas Roche, Raphaëlle Varraso, Marie Zins, Rachel Nadif, Laurent Orsi, Orianne Dumas","doi":"10.1002/ajim.23725","DOIUrl":"https://doi.org/10.1002/ajim.23725","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Disinfectants and cleaning products (DCPs) are important asthma risk factors among healthcare workers. However, healthcare work involves heterogenous cleaning tasks and co-exposure to many chemicals. These multidimensional aspects have rarely been considered. We aimed to identify patterns of occupational exposure to DCPs and study their associations with asthma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>CONSTANCES is a French population-based cohort of ≈220,000 adults. Current asthma and asthma symptom score were defined by questionnaire at inclusion (2012–2021). Healthcare workers completed a supplementary questionnaire on their current/last held occupation, workplace, and cleaning activities that were used in unsupervised learning algorithms to identify occupational exposure patterns. Logistic and negative binomial regression models, adjusted for potential confounders, were used to assess associations with asthma outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In 5512 healthcare workers, four occupational exposure clusters were identified: Cluster1 (C1, 42%, reference), mainly characterized by low exposed nurses and physicians; C2 (7%), medical laboratory staff moderately exposed to common DCPs (chlorine/bleach, alcohol); C3 (41%), nursing assistants and nurses highly exposed to a few DCPs (mainly quaternary ammonium compounds); and C4 (10%), nurses and nursing assistants highly exposed to multiple DCPs (e.g., glutaraldehyde, hydrogen peroxide, and acids). Among women (<i>n</i> = 3734), C2 (mean score ratio [95% CI]: 1.31 [1.02; 1.68]) and C3 (1.18 [1.03; 1.36]) were associated with higher asthma symptom score, and an association was suggested between C3 and current asthma (odds ratio 1.22 [0.99; 1.51]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In a large population of healthcare workers, four DCP exposure patterns were identified, reflecting the heterogeneity of healthcare jobs. Two patterns, including one characterized by laboratory workers, were associated with greater asthma symptoms in women.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 6","pages":"516-530"},"PeriodicalIF":2.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajim.23725","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143939595","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}
Adrian Loerbroks, Haiou Yang, Jos A. Bosch, Julia Salandi, Stefanie Keymel, Jian Li
Background
Prior work has linked work stressors to asthma. However, research related to gender-specific associations remains sparse and yielded mixed results. We aimed to address this gap.
Methods
We drew on cross-sectional data from the 2015 National Health Interview Survey (individual-level response rate = 79.7%). Included were participants in employment who were aged 18–70 (n = 18,701). Work-to-family conflict, workplace bullying, and job insecurity were assessed as work stressors. Asthma was defined based on self-reports of a lifetime diagnosis by a doctor or other health professional. To account for the complex sampling design, variance estimation was used to compute weighted descriptive statistics and odds ratios (ORs) as well as corresponding 95% confidence intervals (CIs) using multivariable logistic regression. To test for interaction, interaction terms for work stressors and gender were included in additional models.
Results
In the full sample, work-to-family conflict, workplace bullying and job insecurity showed positive associations with asthma (OR = 1.20, 95%CI = 1.03–1.40; OR = 1.45, 95%CI = 1.17–1.80; and OR = 1.20, 95%CI = 0.99–1.45, respectively). We did not observe meaningful gender differences in the magnitudes of the ORs. All interaction terms were not statistically significant.
Conclusions
Work stressors were positively associated with asthma, but there was no evidence of gender differences. Prospective studies are needed to determine the potential temporal relation of these associations.
{"title":"Work Stressors and Asthma in Female and Male US Workers: Findings From the National Health Interview Survey","authors":"Adrian Loerbroks, Haiou Yang, Jos A. Bosch, Julia Salandi, Stefanie Keymel, Jian Li","doi":"10.1002/ajim.23722","DOIUrl":"https://doi.org/10.1002/ajim.23722","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Prior work has linked work stressors to asthma. However, research related to gender-specific associations remains sparse and yielded mixed results. We aimed to address this gap.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We drew on cross-sectional data from the 2015 National Health Interview Survey (individual-level response rate = 79.7%). Included were participants in employment who were aged 18–70 (<i>n</i> = 18,701). Work-to-family conflict, workplace bullying, and job insecurity were assessed as work stressors. Asthma was defined based on self-reports of a lifetime diagnosis by a doctor or other health professional. To account for the complex sampling design, variance estimation was used to compute weighted descriptive statistics and odds ratios (ORs) as well as corresponding 95% confidence intervals (CIs) using multivariable logistic regression. To test for interaction, interaction terms for work stressors and gender were included in additional models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the full sample, work-to-family conflict, workplace bullying and job insecurity showed positive associations with asthma (OR = 1.20, 95%CI = 1.03–1.40; OR = 1.45, 95%CI = 1.17–1.80; and OR = 1.20, 95%CI = 0.99–1.45, respectively). We did not observe meaningful gender differences in the magnitudes of the ORs. All interaction terms were not statistically significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Work stressors were positively associated with asthma, but there was no evidence of gender differences. Prospective studies are needed to determine the potential temporal relation of these associations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 6","pages":"508-515"},"PeriodicalIF":2.7,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajim.23722","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143938867","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}
The few prospective studies on the associations between psychosocial work factors and occupational injury in the general working population provide little information on multiple exposures, injury severity, and gender differences. This study aimed to address these points.
Methods
The study was based on prospective data from the nationwide Working Conditions survey on a representative sample of the working population in France. A total of 17,486 employees (7302 men, 10,184 women) were followed over one or two 3-year periods from 2013 to 2019. Occupational exposures were measured at the beginning of each period and included 20 psychosocial work factors, 4 working time/hours factors, and 4 physical work factors. Logistic and Hurdle models were used to study their prospective associations with occupational injury and its severity, as assessed by work absence due to injury and its duration.
Results
Most psychosocial work factors predicted occupational injury. Almost all associations persisted in adjusted models, that is, after controlling for covariates and the other occupational factors that were also predictive of occupational injury. No gender differences were found for these prospective associations. For all types of occupational factors, dose–response associations were found between the number of exposures and injury. However, most occupational factors were not predictive of injury severity.
Conclusions
Occupational exposures, and psychosocial work factors in particular, predicted the occurrence of occupational injury more than its severity. Occupational injury prevention programmes should focus on various aspects of the work environment, including psychosocial work factors, and should particularly target multiple exposures.
{"title":"Exposure to Psychosocial Work Factors and Occupational Injury and Its Severity: Prospective Associations Among Employees in the French National Working Conditions Survey","authors":"Sandrine Bertrais, Isabelle Niedhammer","doi":"10.1002/ajim.23723","DOIUrl":"https://doi.org/10.1002/ajim.23723","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The few prospective studies on the associations between psychosocial work factors and occupational injury in the general working population provide little information on multiple exposures, injury severity, and gender differences. This study aimed to address these points.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study was based on prospective data from the nationwide Working Conditions survey on a representative sample of the working population in France. A total of 17,486 employees (7302 men, 10,184 women) were followed over one or two 3-year periods from 2013 to 2019. Occupational exposures were measured at the beginning of each period and included 20 psychosocial work factors, 4 working time/hours factors, and 4 physical work factors. Logistic and Hurdle models were used to study their prospective associations with occupational injury and its severity, as assessed by work absence due to injury and its duration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Most psychosocial work factors predicted occupational injury. Almost all associations persisted in adjusted models, that is, after controlling for covariates and the other occupational factors that were also predictive of occupational injury. No gender differences were found for these prospective associations. For all types of occupational factors, dose–response associations were found between the number of exposures and injury. However, most occupational factors were not predictive of injury severity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Occupational exposures, and psychosocial work factors in particular, predicted the occurrence of occupational injury more than its severity. Occupational injury prevention programmes should focus on various aspects of the work environment, including psychosocial work factors, and should particularly target multiple exposures.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 6","pages":"543-551"},"PeriodicalIF":2.7,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajim.23723","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143938745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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