Scott A. Hendricks MS, Kitty J. Hendricks MA, Hope M. Tiesman PhD, Harold L. Gomes PStat, CStat, James W. Collins PhD, MSME, Dan Hartley EdD
Workplace and non-workplace homicides in the United States (U.S.) have declined for over 30 years until recently. This study was conducted to address the change in trends for both workplace and non-workplace homicides and to evaluate the homogeneity of the change in workplace homicides by specified categories. Joinpoint and autoregressive models were used to assess trends of U.S. workplace and non-workplace homicides utilizing surveillance data collected by the Bureau of Labor Statistics and the Federal Bureau of Investigation from 1994 through 2021. Both workplace and non-workplace homicides decreased significantly from 1994 through 2014. Workplace homicides showed no significant trend from 2014 through 2021 (p = 0.79), while non-workplace homicides showed a significant average annual increase of 4.1% from 2014 through 2020 (p = 0.0013). The large decreases in the trend of workplace homicides occurring during a criminal act, such as robbery, leveled off and started to increase by the end of the study period (p < 0.0001). Declines in workplace homicides due to shootings also leveled off and started to increase by the end of the study period (p < 0.0001). U.S. workplace and non-workplace homicide rates declined from the 1990s until around 2014. Trends in workplace homicides varied by the types of the homicide committed and by the type of employee that was the victim. Criminal-intent-related events, such as robbery, appear to be the largest contributor to changes in workplace homicides. Researchers and industry leaders could develop and evaluate interventions that further address criminal-intent-related workplace homicides.
{"title":"Trends in workplace homicides in the U.S., 1994–2021: An end to years of decline","authors":"Scott A. Hendricks MS, Kitty J. Hendricks MA, Hope M. Tiesman PhD, Harold L. Gomes PStat, CStat, James W. Collins PhD, MSME, Dan Hartley EdD","doi":"10.1002/ajim.23584","DOIUrl":"10.1002/ajim.23584","url":null,"abstract":"<p>Workplace and non-workplace homicides in the United States (U.S.) have declined for over 30 years until recently. This study was conducted to address the change in trends for both workplace and non-workplace homicides and to evaluate the homogeneity of the change in workplace homicides by specified categories. Joinpoint and autoregressive models were used to assess trends of U.S. workplace and non-workplace homicides utilizing surveillance data collected by the Bureau of Labor Statistics and the Federal Bureau of Investigation from 1994 through 2021. Both workplace and non-workplace homicides decreased significantly from 1994 through 2014. Workplace homicides showed no significant trend from 2014 through 2021 (<i>p</i> = 0.79), while non-workplace homicides showed a significant average annual increase of 4.1% from 2014 through 2020 (<i>p</i> = 0.0013). The large decreases in the trend of workplace homicides occurring during a criminal act, such as robbery, leveled off and started to increase by the end of the study period (<i>p</i> < 0.0001). Declines in workplace homicides due to shootings also leveled off and started to increase by the end of the study period (<i>p</i> < 0.0001). U.S. workplace and non-workplace homicide rates declined from the 1990s until around 2014. Trends in workplace homicides varied by the types of the homicide committed and by the type of employee that was the victim. Criminal-intent-related events, such as robbery, appear to be the largest contributor to changes in workplace homicides. Researchers and industry leaders could develop and evaluate interventions that further address criminal-intent-related workplace homicides.</p>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140600905","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}
Nimit N. Shah MPH, Michael B. Steinberg MD, MPH, Miriam M. Calkins PhD, MS, Alberto J. Caban-Martinez PhD, DO, MPH, Jefferey L. Burgess MD, MS, MPH, Elena Austin ScD, MS, Brittany S. Hollerbach PhD, MS, Derrick L. Edwards PhD, Taylor M. Black MPH, Kathleen Black PhD, MPH, Kaleigh M. Hinton MPH, Brian S. Kubiel, Judith M. Graber PhD, MS
Background
Although firefighters have increased risk for colon and prostate cancer, limited information exists on screening practices for these cancers in volunteer firefighters who compose two-thirds of the US fire service. We estimated the prevalence of colon and prostate cancer screening among volunteer firefighters using eligibility criteria from 4 evidence-based screening recommendations and evaluated factors influencing screening.
Methods
We evaluated colon (n = 569) and prostate (n = 498) cancer screening prevalence in a sample of US volunteer firefighters using eligibility criteria from the US Preventive Services Taskforce (USPSTF), National Fire Protection Association, American Cancer Society, and National Comprehensive Cancer Network. We assessed associations with fire service experience, demographics, and cancer risk perception based on USPSTF guidelines.
Results
For those eligible based on USPSTF guidelines, colon and prostate cancer screening prevalence was 51.7% (95% CI: 45.7, 57.8) and 48.8% (95% CI: 40.0, 57.6), respectively. Higher odds of colon and prostate cancer screening were observed with older age and with some college education compared to those with less education. Fire service experience and cancer risk perception were not associated with screening practices.
Conclusion
This is the first large study to assess colon and prostate cancer screening among US volunteer firefighters based on different screening guidelines. Our findings suggest gaps in cancer prevention efforts in the US volunteer fire service. Promoting cancer screening education and opportunities for volunteer firefighters by their fire departments, healthcare professionals, and public health practitioners, may help to address the gaps.
{"title":"Prevalence and predictors of colon and prostate cancer screening among volunteer firefighters: The United States Firefighter Cancer Assessment and Prevention Study","authors":"Nimit N. Shah MPH, Michael B. Steinberg MD, MPH, Miriam M. Calkins PhD, MS, Alberto J. Caban-Martinez PhD, DO, MPH, Jefferey L. Burgess MD, MS, MPH, Elena Austin ScD, MS, Brittany S. Hollerbach PhD, MS, Derrick L. Edwards PhD, Taylor M. Black MPH, Kathleen Black PhD, MPH, Kaleigh M. Hinton MPH, Brian S. Kubiel, Judith M. Graber PhD, MS","doi":"10.1002/ajim.23582","DOIUrl":"10.1002/ajim.23582","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although firefighters have increased risk for colon and prostate cancer, limited information exists on screening practices for these cancers in volunteer firefighters who compose two-thirds of the US fire service. We estimated the prevalence of colon and prostate cancer screening among volunteer firefighters using eligibility criteria from 4 evidence-based screening recommendations and evaluated factors influencing screening.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We evaluated colon (<i>n</i> = 569) and prostate (<i>n</i> = 498) cancer screening prevalence in a sample of US volunteer firefighters using eligibility criteria from the US Preventive Services Taskforce (USPSTF), National Fire Protection Association, American Cancer Society, and National Comprehensive Cancer Network. We assessed associations with fire service experience, demographics, and cancer risk perception based on USPSTF guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>For those eligible based on USPSTF guidelines, colon and prostate cancer screening prevalence was 51.7% (95% CI: 45.7, 57.8) and 48.8% (95% CI: 40.0, 57.6), respectively. Higher odds of colon and prostate cancer screening were observed with older age and with some college education compared to those with less education. Fire service experience and cancer risk perception were not associated with screening practices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This is the first large study to assess colon and prostate cancer screening among US volunteer firefighters based on different screening guidelines. Our findings suggest gaps in cancer prevention efforts in the US volunteer fire service. Promoting cancer screening education and opportunities for volunteer firefighters by their fire departments, healthcare professionals, and public health practitioners, may help to address the gaps.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajim.23582","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140288008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fergus K. O'Connor, Robert D. Meade, Sean R. Notley, Leonidas G. Ioannou, Andreas D. Flouris, Glen P. Kenny
Rationale
Monitoring physiological strain is recommended to safeguard workers during heat exposure, but is logistically challenging. The perceptual strain index (PeSI) is a subjective estimate thought to reflect the physiological strain index (PSI) that requires no physiological monitoring. However, sex is known to influence perceptions of heat stress, potentially limiting the utility of the PeSI.
Objectives
The objective of this study was to assess whether sex modifies the relationship between PeSI and PSI.
Methods
Thirty-four adults (15 females) walked on a treadmill (moderate intensity; ~200 W/m2) for 180 min or until termination (volitional fatigue, rectal temperature ≥39.5°C) in 16°C, 24°C, 28°C, and 32°C wet-bulb globe temperatures. Rectal temperature and heart rate were recorded to calculate PSI (0–10 scale). Rating of perceived exertion and thermal sensation were recorded to calculate PeSI (0–10 scale). Relationships between PSI and PeSI were evaluated via linear mixed models. Mean bias (95% limits of agreement [LoA]) between PSI and PeSI was assessed via Bland–Altman analysis. Mean absolute error between measures was calculated by summing absolute errors between the PeSI and the PSI and dividing by the sample size.
Findings
PSI increased with PeSI (p < 0.01) but the slope of this relation was not different between males and females (p = 0.83). Mean bias between PSI and PeSI was small (−0.4 points), but the 95% LoA (−3.5 to 2.7 points) and mean absolute error were wide (1.3 points).
Impact
Our findings indicate that sex does not appreciably impact the agreement between the PeSI and PSI during simulated occupational heat stress. The PeSI is not a suitable surrogate for the PSI in either male or female workers.
{"title":"Agreement between measured and self-reported physiological strain in males and females during simulated occupational heat stress","authors":"Fergus K. O'Connor, Robert D. Meade, Sean R. Notley, Leonidas G. Ioannou, Andreas D. Flouris, Glen P. Kenny","doi":"10.1002/ajim.23580","DOIUrl":"10.1002/ajim.23580","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Monitoring physiological strain is recommended to safeguard workers during heat exposure, but is logistically challenging. The perceptual strain index (PeSI) is a subjective estimate thought to reflect the physiological strain index (PSI) that requires no physiological monitoring. However, sex is known to influence perceptions of heat stress, potentially limiting the utility of the PeSI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The objective of this study was to assess whether sex modifies the relationship between PeSI and PSI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Thirty-four adults (15 females) walked on a treadmill (moderate intensity; ~200 W/m<sup>2</sup>) for 180 min or until termination (volitional fatigue, rectal temperature ≥39.5°C) in 16°C, 24°C, 28°C, and 32°C wet-bulb globe temperatures. Rectal temperature and heart rate were recorded to calculate PSI (0–10 scale). Rating of perceived exertion and thermal sensation were recorded to calculate PeSI (0–10 scale). Relationships between PSI and PeSI were evaluated via linear mixed models. Mean bias (95% limits of agreement [LoA]) between PSI and PeSI was assessed via Bland–Altman analysis. Mean absolute error between measures was calculated by summing absolute errors between the PeSI and the PSI and dividing by the sample size.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>PSI increased with PeSI (<i>p</i> < 0.01) but the slope of this relation was not different between males and females (<i>p</i> = 0.83). Mean bias between PSI and PeSI was small (−0.4 points), but the 95% LoA (−3.5 to 2.7 points) and mean absolute error were wide (1.3 points).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Impact</h3>\u0000 \u0000 <p>Our findings indicate that sex does not appreciably impact the agreement between the PeSI and PSI during simulated occupational heat stress. The PeSI is not a suitable surrogate for the PSI in either male or female workers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajim.23580","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140139809","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}
Hannah M. Thompson MD, Usha Govindarajulu PhD, John Doucette PhD, Ismail Nabeel MD, MPH, MS
Background
Short-acting opioids have been utilized for pain management with little known about their use in patients on Workers' Compensation (WC) insurance. Our goal was to investigate this association in the ambulatory care setting.
Methods
Using the National Ambulatory Medical Care Survey, visits from patients aged 18–64 during the years 2010 until 2018 were evaluated (excluding 2017 due to data availability). Demographic and co-morbidity data from each visit was obtained along with the visit year. The first short-acting opioid medication prescribed in the database was considered. Survey-weighted frequencies were evaluated. Logistic regression estimated the crude and adjusted odds ratios (OR) with 95% confidence intervals for the use of short-acting opioid prescription.
Results
There were 155,947 included visits with 62.5% for female patients. Most patients were White with 11.7% identifying as Black, and 6% identifying as another race. Over 13% of the sample was of Hispanic descent. WC was the identified insurance type in 1.6% of the sample population. Of these patients, 25.6% were prescribed a short-acting opioid, compared with 10.1% of those with another identified insurance. On multivariable regression, Black patients had increased odds of being prescribed a short-acting opioid compared to white patients (OR: 1.22, 95% CI: 1.11–1.34). Those on WC had 1.7-fold higher odds of being prescribed short-acting opioids (95% CI: 1.46–2.06).
Conclusion
Certain patient characteristics, including having WC insurance, increased the odds of a short-acting opioid prescription. Further work is needed to identify prescribing patterns in specific high-risk occupational groups, as well as to elicit potential associated health outcomes.
{"title":"Short-acting opioid prescriptions and Workers' Compensation using the National Ambulatory Medical Care Survey","authors":"Hannah M. Thompson MD, Usha Govindarajulu PhD, John Doucette PhD, Ismail Nabeel MD, MPH, MS","doi":"10.1002/ajim.23581","DOIUrl":"10.1002/ajim.23581","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Short-acting opioids have been utilized for pain management with little known about their use in patients on Workers' Compensation (WC) insurance. Our goal was to investigate this association in the ambulatory care setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using the National Ambulatory Medical Care Survey, visits from patients aged 18–64 during the years 2010 until 2018 were evaluated (excluding 2017 due to data availability). Demographic and co-morbidity data from each visit was obtained along with the visit year. The first short-acting opioid medication prescribed in the database was considered. Survey-weighted frequencies were evaluated. Logistic regression estimated the crude and adjusted odds ratios (OR) with 95% confidence intervals for the use of short-acting opioid prescription.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 155,947 included visits with 62.5% for female patients. Most patients were White with 11.7% identifying as Black, and 6% identifying as another race. Over 13% of the sample was of Hispanic descent. WC was the identified insurance type in 1.6% of the sample population. Of these patients, 25.6% were prescribed a short-acting opioid, compared with 10.1% of those with another identified insurance. On multivariable regression, Black patients had increased odds of being prescribed a short-acting opioid compared to white patients (OR: 1.22, 95% CI: 1.11–1.34). Those on WC had 1.7-fold higher odds of being prescribed short-acting opioids (95% CI: 1.46–2.06).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Certain patient characteristics, including having WC insurance, increased the odds of a short-acting opioid prescription. Further work is needed to identify prescribing patterns in specific high-risk occupational groups, as well as to elicit potential associated health outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140139810","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}
Emily J. Tetzlaff MHK, Casey Cassan BSc, Nicholas Goulet BSc, Melissa Gorman MPH, Brooks Hogya MA, Glen P. Kenny PhD
Background
During the summer of 2021, a deadly, unprecedented multiday Heat Dome engulfed western Canada. As a result of this extreme heat event (EHE), emergency dispatchers received an unparalleled increase in incoming 911 calls for ambulance, police, and fire (as first responders) services to attend to hundreds of heat-vulnerable community members succumbing to the heat. With 103 all-time heat records broken during this EHE and indoor temperatures of nearly 40°C, the first responders attending these calls faced extensive job demands and highly challenging operating conditions. Initial investigations have explored the health system-level impacts; however, little has been done to explore the impact on the first responders themselves. Therefore, this study aimed to improve our understanding of EHEs' impacts on the operational capabilities and health of first responders, specifically police, fire, ambulance, and dispatch services.
Methods
A systematized review and content analysis of media articles published on the 2021 Heat Dome in Canada was conducted (n = 2909), and four media-based composite narratives were developed highlighting police, fire, ambulance, and dispatch services. The Job Demands-Resources (JD-R) model was applied as a theoretical framework for occupational burnout.
Results
The media-based composite narratives highlighted that first responders faced record-breaking call volumes, increased mental-health-related claims, and exhaustive heat-related physiological stress. Using the JD-R model as a theoretical framework for occupational burnout, we identified three measures of stressful job demand: work overload (e.g., the surge in call volume, firefighters responding to medical emergencies), emotional demands (e.g., severe medical emergencies, sudden deaths, unresponsive patients, distraught family members), and physical demands (e.g., resuscitation in personal protective equipment, heat-related illness).
Conclusion
The experiences described underscore the importance of supporting first responders during work in extreme heat conditions. These findings have important implications for addressing rising rates of burnout during and following public health crises, such as EHEs, a problem that is increasingly being recognized as a threat to the Canadian public healthcare system.
{"title":"“Breaking down in tears, soaked in sweat, and sick from the heat”: Media-based composite narratives of first responders working during the 2021 Heat Dome","authors":"Emily J. Tetzlaff MHK, Casey Cassan BSc, Nicholas Goulet BSc, Melissa Gorman MPH, Brooks Hogya MA, Glen P. Kenny PhD","doi":"10.1002/ajim.23576","DOIUrl":"10.1002/ajim.23576","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>During the summer of 2021, a deadly, unprecedented multiday Heat Dome engulfed western Canada. As a result of this extreme heat event (EHE), emergency dispatchers received an unparalleled increase in incoming 911 calls for ambulance, police, and fire (as first responders) services to attend to hundreds of heat-vulnerable community members succumbing to the heat. With 103 all-time heat records broken during this EHE and indoor temperatures of nearly 40°C, the first responders attending these calls faced extensive job demands and highly challenging operating conditions. Initial investigations have explored the health system-level impacts; however, little has been done to explore the impact on the first responders themselves. Therefore, this study aimed to improve our understanding of EHEs' impacts on the operational capabilities and health of first responders, specifically police, fire, ambulance, and dispatch services.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematized review and content analysis of media articles published on the 2021 Heat Dome in Canada was conducted (<i>n</i> = 2909), and four media-based composite narratives were developed highlighting police, fire, ambulance, and dispatch services. The Job Demands-Resources (JD-R) model was applied as a theoretical framework for occupational burnout.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The media-based composite narratives highlighted that first responders faced record-breaking call volumes, increased mental-health-related claims, and exhaustive heat-related physiological stress. Using the JD-R model as a theoretical framework for occupational burnout, we identified three measures of stressful job demand: work overload (e.g., the surge in call volume, firefighters responding to medical emergencies), emotional demands (e.g., severe medical emergencies, sudden deaths, unresponsive patients, distraught family members), and physical demands (e.g., resuscitation in personal protective equipment, heat-related illness).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The experiences described underscore the importance of supporting first responders during work in extreme heat conditions. These findings have important implications for addressing rising rates of burnout during and following public health crises, such as EHEs, a problem that is increasingly being recognized as a threat to the Canadian public healthcare system.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajim.23576","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140068081","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}
Shannon L. Wagner PhD, Nicole White MA, Marc White PhD, Trina Fyfe PhD, Lynda R. Matthews PhD, Christine Randall PhD, Cheryl Regehr PhD, Lynn E. Alden PhD, Nicholas Buys PhD, Mary G. Carey PhD, RN, Wayne Corneil PhD, Elyssa Krutop MEd, Alex Fraess-Phillips PhD
Background
It is well documented that public safety personnel are exposed to potentially traumatic events (PTEs) at elevated frequency and demonstrate higher prevalence of trauma-related symptoms compared to the general population. Lesser studied to date are the organizational consequences of workplace PTE exposure and associated mental health outcomes such as acute/posttraumatic stress disorder (ASD/PTSD), depression, and anxiety.
Methods
The present review synthesizes international literature on work outcomes in public safety personnel (PSP) to explore whether and how PTE and trauma-related symptoms relate to workplace outcomes. A total of N = 55 eligible articles examining PTE or trauma-related symptoms in relation to work outcomes were systematically reviewed using best-evidence narrative synthesis.
Results
Three primary work outcomes emerged across the literature: absenteeism, productivity/performance, and costs to organization. Across n = 21 studies of absenteeism, there was strong evidence that PTE or trauma-related symptoms are associated with increased sickness absence. N = 27 studies on productivity/performance demonstrated overall strong evidence of negative impacts in the workplace. N = 7 studies on cost to organizations demonstrated weak evidence that PTE exposure or trauma-related mental health outcomes are associated with increased cost to organization.
Conclusions
Based on available evidence, the experience of workplace PTE or trauma-related symptoms is associated with negative impact on PSP occupational functioning, though important potential confounds (e.g., organizational strain and individual risk factors) remain to be more extensively investigated.
{"title":"Work outcomes in public safety personnel after potentially traumatic events: A systematic review","authors":"Shannon L. Wagner PhD, Nicole White MA, Marc White PhD, Trina Fyfe PhD, Lynda R. Matthews PhD, Christine Randall PhD, Cheryl Regehr PhD, Lynn E. Alden PhD, Nicholas Buys PhD, Mary G. Carey PhD, RN, Wayne Corneil PhD, Elyssa Krutop MEd, Alex Fraess-Phillips PhD","doi":"10.1002/ajim.23577","DOIUrl":"10.1002/ajim.23577","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>It is well documented that public safety personnel are exposed to potentially traumatic events (PTEs) at elevated frequency and demonstrate higher prevalence of trauma-related symptoms compared to the general population. Lesser studied to date are the organizational consequences of workplace PTE exposure and associated mental health outcomes such as acute/posttraumatic stress disorder (ASD/PTSD), depression, and anxiety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The present review synthesizes international literature on work outcomes in public safety personnel (PSP) to explore whether and how PTE and trauma-related symptoms relate to workplace outcomes. A total of <i>N</i> = 55 eligible articles examining PTE or trauma-related symptoms in relation to work outcomes were systematically reviewed using best-evidence narrative synthesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three primary work outcomes emerged across the literature: absenteeism, productivity/performance, and costs to organization. Across <i>n</i> = 21 studies of absenteeism, there was strong evidence that PTE or trauma-related symptoms are associated with increased sickness absence. <i>N</i> = 27 studies on productivity/performance demonstrated overall strong evidence of negative impacts in the workplace. <i>N</i> = 7 studies on cost to organizations demonstrated weak evidence that PTE exposure or trauma-related mental health outcomes are associated with increased cost to organization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Based on available evidence, the experience of workplace PTE or trauma-related symptoms is associated with negative impact on PSP occupational functioning, though important potential confounds (e.g., organizational strain and individual risk factors) remain to be more extensively investigated.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajim.23577","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140064687","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}
Laia Ollé-Espluga PhD, Raúl Payá Castiblanque PhD, Clara Llorens-Serrano PhD, Laura Esteve-Matalí PhD, Albert Navarro-Giné PhD
Background
This study addresses the contribution of worker representation to health and safety in the pandemic context. To do so, we examine whether the self-reported presence of representatives in workplaces is associated with the implementation of anti-COVID-19 protective action and with which type of measures their existence is most strongly associated (individual, collective or organizational). The article also explores how the presence of worker representatives and anti-COVID-19 protective measures are distributed according to workers' socio-professional characteristics and company features.
Methods
This is a cross-sectional study based on an online survey conducted in Spain (n = 19,452 workers). Multiple Correspondence Analysis was used for the multivariate description while the association between worker representation and protective measures was assessed by robust Poisson regressions.
Results
The maps resulting from the Multiple Correspondence Analysis allow for the identification of patterns of inequalities in protection, with a clear occupational social class divide. The regression models show that protective measures are applied more frequently where worker representatives exist, this association being particularly strong in relation to organizational measures.
Conclusions
The presence of worker representation is systematically associated with a greater presence of protective measures, which could have implications for the reduction of social inequalities resulting from labor-management practices.
{"title":"Protective action in the workplace in the time of COVID-19: The role of worker representation","authors":"Laia Ollé-Espluga PhD, Raúl Payá Castiblanque PhD, Clara Llorens-Serrano PhD, Laura Esteve-Matalí PhD, Albert Navarro-Giné PhD","doi":"10.1002/ajim.23578","DOIUrl":"10.1002/ajim.23578","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study addresses the contribution of worker representation to health and safety in the pandemic context. To do so, we examine whether the self-reported presence of representatives in workplaces is associated with the implementation of anti-COVID-19 protective action and with which type of measures their existence is most strongly associated (individual, collective or organizational). The article also explores how the presence of worker representatives and anti-COVID-19 protective measures are distributed according to workers' socio-professional characteristics and company features.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a cross-sectional study based on an online survey conducted in Spain (n = 19,452 workers). Multiple Correspondence Analysis was used for the multivariate description while the association between worker representation and protective measures was assessed by robust Poisson regressions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The maps resulting from the Multiple Correspondence Analysis allow for the identification of patterns of inequalities in protection, with a clear occupational social class divide. The regression models show that protective measures are applied more frequently where worker representatives exist, this association being particularly strong in relation to organizational measures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The presence of worker representation is systematically associated with a greater presence of protective measures, which could have implications for the reduction of social inequalities resulting from labor-management practices.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140058553","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 Markowitz MD, DrPH, Knut Ringen DrPH, MHA, MPH, John M. Dement PhD, Kurt Straif MD, PhD, MPH, L. Christine Oliver MD, MPH, MS, Eduardo Algranti MD, MSc, PhD, Dennis Nowak MD, Rodney Ehrlich MBCHB, DOH, FCPHM(SA)(Occ Med), PhD, Melissa A. McDiarmid MD, MPH, DABT, Albert Miller MD, Collegium Ramazzini
Lung cancer is the most common cause of death from cancer in the world. It is also the most common lethal work-related cancer. After tobacco smoking, occupational exposures present the most frequent specific cause of lung cancer that is amenable to intervention.
Early detection and treatment can identify and cure primary lung cancer. Randomized controlled trials have demonstrated the efficacy of low dose computed tomography (LDCT) screening among persons at high risk of lung cancer. Guidelines for determining eligibility for LDCT screening have been established for the general population but have largely neglected those for whom occupational exposure to lung carcinogens is a risk factor.
The Collegium recommends that persons at risk for lung cancer from occupational exposures be offered annual LDCT if their cumulative risk of lung cancer approximates the level of risk endorsed by the guidelines promulgated by the United States Preventive Services Task Force (USPSTF) in 2021 and the National Comprehensive Cancer Network (NCCN) in the United States in 2021. At present, these agencies recommend screening for people aged 50 and over who have smoked at least 20 pack-years of cigarettes. The Collegium recommends that additional lung cancer risk factors, including exposure to known or suspected occupational and environmental lung carcinogens; family history of lung cancer (especially among first degree relatives and relatives <60 years of age); a personal history of chronic obstructive lung disease, pneumoconiosis, or pulmonary fibrosis; or a personal history of cancer (excluding skin cancer) be considered as part of the risk assessment for eligibility determination for lung cancer screening. Latency, or the period of time since initial occupational exposure (e.g., >15 years) is another factor that should be considered. If the presence of these additional risk factors, in combination with age and smoking history, is associated with a level of risk that meets or exceeds the level of risk identified by the USPSTF and NCCN, then an annual low dose chest CT for lung cancer screening should be offered. We do not favor a specific age cut-off at which to end screening, but we recognize that only persons who are sufficiently healthy and have sufficient life expectancy to undergo diagnostic work-up and potentially curative treatment should be offered screening for lung cancer. In view of the rising risk of occupational lung cancer over time and the potential or actual interaction between occupational lung carcinogens and cigarette smoking even after quitting, screening programs may choose to screen workers with occupational lung cancer risk for prolonged periods after they have quit smoking cigarettes. The Collegium acknowledges that there are uncertainties and assumptions entailed in this approach and that risk assessment for individual workers necessitates application of significant professional judgement. We encourage the implementation o
{"title":"Occupational lung cancer screening: A Collegium Ramazzini statement","authors":"Steven Markowitz MD, DrPH, Knut Ringen DrPH, MHA, MPH, John M. Dement PhD, Kurt Straif MD, PhD, MPH, L. Christine Oliver MD, MPH, MS, Eduardo Algranti MD, MSc, PhD, Dennis Nowak MD, Rodney Ehrlich MBCHB, DOH, FCPHM(SA)(Occ Med), PhD, Melissa A. McDiarmid MD, MPH, DABT, Albert Miller MD, Collegium Ramazzini","doi":"10.1002/ajim.23572","DOIUrl":"10.1002/ajim.23572","url":null,"abstract":"<p>Lung cancer is the most common cause of death from cancer in the world. It is also the most common lethal work-related cancer. After tobacco smoking, occupational exposures present the most frequent specific cause of lung cancer that is amenable to intervention.</p><p>Early detection and treatment can identify and cure primary lung cancer. Randomized controlled trials have demonstrated the efficacy of low dose computed tomography (LDCT) screening among persons at high risk of lung cancer. Guidelines for determining eligibility for LDCT screening have been established for the general population but have largely neglected those for whom occupational exposure to lung carcinogens is a risk factor.</p><p>The Collegium recommends that persons at risk for lung cancer from occupational exposures be offered annual LDCT if their cumulative risk of lung cancer approximates the level of risk endorsed by the guidelines promulgated by the United States Preventive Services Task Force (USPSTF) in 2021 and the National Comprehensive Cancer Network (NCCN) in the United States in 2021. At present, these agencies recommend screening for people aged 50 and over who have smoked at least 20 pack-years of cigarettes. The Collegium recommends that additional lung cancer risk factors, including exposure to known or suspected occupational and environmental lung carcinogens; family history of lung cancer (especially among first degree relatives and relatives <60 years of age); a personal history of chronic obstructive lung disease, pneumoconiosis, or pulmonary fibrosis; or a personal history of cancer (excluding skin cancer) be considered as part of the risk assessment for eligibility determination for lung cancer screening. Latency, or the period of time since initial occupational exposure (e.g., >15 years) is another factor that should be considered. If the presence of these additional risk factors, in combination with age and smoking history, is associated with a level of risk that meets or exceeds the level of risk identified by the USPSTF and NCCN, then an annual low dose chest CT for lung cancer screening should be offered. We do not favor a specific age cut-off at which to end screening, but we recognize that only persons who are sufficiently healthy and have sufficient life expectancy to undergo diagnostic work-up and potentially curative treatment should be offered screening for lung cancer. In view of the rising risk of occupational lung cancer over time and the potential or actual interaction between occupational lung carcinogens and cigarette smoking even after quitting, screening programs may choose to screen workers with occupational lung cancer risk for prolonged periods after they have quit smoking cigarettes. The Collegium acknowledges that there are uncertainties and assumptions entailed in this approach and that risk assessment for individual workers necessitates application of significant professional judgement. We encourage the implementation o","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajim.23572","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140027189","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}
Kathleen Fitzsimmons PhD, MPH, Malena Hood MPH, Kathleen Grattan MPH, James Laing, Emily Sparer-Fine ScD, MS
Background
Working outside the home put some workers at risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure and might partly explain elevated coronavirus disease 2019 (COVID-19) mortality rates in the first months of the pandemic in certain groups of Massachusetts workers. To further investigate this premise, we examined COVID-19 mortality among Massachusetts workers, with a specific focus on telework ability based on occupation.
Methods
COVID-19-associated deaths between January 1 and December 31, 2020 among Massachusetts residents aged 18–64 years were analyzed. Deaths were categorized into occupation-based quadrants (Q) of telework ability. Age-adjusted rates were calculated by key demographics, industry, occupation, and telework quadrant using American Community Survey workforce estimates as denominators. Rate ratios (RRs) and 95% confidence intervals comparing rates for quadrants with workers unlikely able to telework (Q2, Q3, Q4) to that among those likely able to telework (Q1) were calculated.
Results
The overall age-adjusted COVID-19-associated mortality rate was 26.4 deaths per 100,000 workers. Workers who were male, Black non-Hispanic, Hispanic, born outside the US, and with lower than a high school education level experienced the highest rates among their respective demographic groups. The rate varied by industry, occupation and telework quadrant. RRs comparing Q2, Q3, and Q4 to Q1 were 0.99 (95% confidence interval [CI]: 0.8−1.2), 3.2 (95% CI: 2.6−3.8) and 2.5 (95% CI: 2.0−3.0), respectively.
Conclusion
Findings suggest a positive association between working on-site and COVID-19-associated mortality. Work-related factors likely contributed to COVID-19 among Massachusetts workers and should be considered in future studies of COVID-19 and similar diseases.
{"title":"COVID-19 mortality among Massachusetts workers and the association with telework ability, 2020","authors":"Kathleen Fitzsimmons PhD, MPH, Malena Hood MPH, Kathleen Grattan MPH, James Laing, Emily Sparer-Fine ScD, MS","doi":"10.1002/ajim.23579","DOIUrl":"10.1002/ajim.23579","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Working outside the home put some workers at risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure and might partly explain elevated coronavirus disease 2019 (COVID-19) mortality rates in the first months of the pandemic in certain groups of Massachusetts workers. To further investigate this premise, we examined COVID-19 mortality among Massachusetts workers, with a specific focus on telework ability based on occupation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>COVID-19-associated deaths between January 1 and December 31, 2020 among Massachusetts residents aged 18–64 years were analyzed. Deaths were categorized into occupation-based quadrants (Q) of telework ability. Age-adjusted rates were calculated by key demographics, industry, occupation, and telework quadrant using American Community Survey workforce estimates as denominators. Rate ratios (RRs) and 95% confidence intervals comparing rates for quadrants with workers unlikely able to telework (Q2, Q3, Q4) to that among those likely able to telework (Q1) were calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The overall age-adjusted COVID-19-associated mortality rate was 26.4 deaths per 100,000 workers. Workers who were male, Black non-Hispanic, Hispanic, born outside the US, and with lower than a high school education level experienced the highest rates among their respective demographic groups. The rate varied by industry, occupation and telework quadrant. RRs comparing Q2, Q3, and Q4 to Q1 were 0.99 (95% confidence interval [CI]: 0.8−1.2), 3.2 (95% CI: 2.6−3.8) and 2.5 (95% CI: 2.0−3.0), respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Findings suggest a positive association between working on-site and COVID-19-associated mortality. Work-related factors likely contributed to COVID-19 among Massachusetts workers and should be considered in future studies of COVID-19 and similar diseases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140012041","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}
David J. Kinitz PhD, MSW, Lori E. Ross PhD, Ellen MacEachen PhD, Charles Fehr MA, Dionne Gesink PhD
Background
This study brings lesbian, gay, bisexual, transgender (trans), and queer (LGBTQ+) populations into scholarly discourse related to precarious employment through a political economy of queer struggle.
Methods
Drawing on narrative inquiry, 20 gay, bisexual, and queer men shared stories of precarious employment that were analyzed using Polkinghorne's narrative analysis.
Results
Results tell an overarching narrative in three parts that follow the trajectory of participants' early life experiences, entering the labor market and being precariously employed. Part 1: Devaluation of LGBTQ+ identities and adverse life experiences impacted participants' abilities to plan their careers and complete postsecondary education. Part 2: Participants experienced restricted opportunities due to safety concerns and learned to navigate white, cis, straight, Canadian ideals that are valued in the labor market. Part 3: Participants were without protections to respond to hostile treatment for fear of losing their employment.
Conclusions
These stories of precarious employment illustrate unique ways that LGBTQ+ people might be particularly susceptible to exploitative labor markets.
{"title":"“…full of opportunities, but not for everyone”: A narrative inquiry into mechanisms of labor market inequity among precariously employed gay, bisexual, and queer men","authors":"David J. Kinitz PhD, MSW, Lori E. Ross PhD, Ellen MacEachen PhD, Charles Fehr MA, Dionne Gesink PhD","doi":"10.1002/ajim.23574","DOIUrl":"10.1002/ajim.23574","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study brings lesbian, gay, bisexual, transgender (trans), and queer (LGBTQ+) populations into scholarly discourse related to precarious employment through a political economy of queer struggle.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Drawing on narrative inquiry, 20 gay, bisexual, and queer men shared stories of precarious employment that were analyzed using Polkinghorne's narrative analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Results tell an overarching narrative in three parts that follow the trajectory of participants' early life experiences, entering the labor market and being precariously employed. Part 1: Devaluation of LGBTQ+ identities and adverse life experiences impacted participants' abilities to plan their careers and complete postsecondary education. Part 2: Participants experienced restricted opportunities due to safety concerns and learned to navigate white, cis, straight, Canadian ideals that are valued in the labor market. Part 3: Participants were without protections to respond to hostile treatment for fear of losing their employment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These stories of precarious employment illustrate unique ways that LGBTQ+ people might be particularly susceptible to exploitative labor markets.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajim.23574","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139904848","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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