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Occupational Exposure Patterns to Disinfectants and Cleaning Products and Its Association With Asthma Among French Healthcare Workers 法国卫生保健工作者对消毒剂和清洁产品的职业暴露模式及其与哮喘的关系
IF 2.7 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-04-23 DOI: 10.1002/ajim.23725
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.

背景消毒剂和清洁产品(dcp)是卫生保健工作者中重要的哮喘危险因素。然而,医疗保健工作涉及不同的清洁任务和共同暴露于许多化学品。这些多维方面很少被考虑。我们的目的是确定职业暴露于dcp的模式,并研究它们与哮喘的关系。contes是一项以法国人口为基础的约22万成年人队列研究。纳入时(2012-2021)通过问卷确定当前哮喘和哮喘症状评分。医护人员完成了一份关于他们当前/上次从事的职业、工作场所和清洁活动的补充问卷,这些问卷用于无监督学习算法来识别职业暴露模式。采用逻辑回归模型和负二项回归模型,对潜在混杂因素进行校正,以评估与哮喘结局的关联。结果5512名医护人员共分为4个职业暴露聚类:第1类(C1, 42%,参考),以低暴露护士和医生为主;C2(7%),中等暴露于常见dcp(氯/漂白剂、酒精)的医务实验室工作人员;C3(41%),护理员和护士高度暴露于少数dcp(主要是季铵类化合物);和C4(10%),护士和护理助理高度暴露于多种dcp(如戊二醛、过氧化氢和酸)。女性(n = 3734), C2(平均评分比[95% CI]: 1.31 [1.02;1.68])和C3 (1.18 [1.03;1.36])与较高的哮喘症状评分相关,C3与当前哮喘存在关联(优势比1.22 [0.99;1.51])。结论在大量的卫生保健工作者中,确定了四种DCP暴露模式,反映了卫生保健工作的异质性。两种模式,包括一种以实验室工作人员为特征的模式,与女性更严重的哮喘症状有关。
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引用次数: 0
Work Stressors and Asthma in Female and Male US Workers: Findings From the National Health Interview Survey 美国女性和男性工人的工作压力和哮喘:来自全国健康访谈调查的结果
IF 2.7 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-04-13 DOI: 10.1002/ajim.23722
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.

先前的研究已经将工作压力源与哮喘联系起来。然而,与性别相关的研究仍然很少,结果好坏参半。我们的目标是解决这一差距。方法采用2015年全国健康访谈调查的横断面数据(个人回复率为79.7%)。纳入年龄在18-70岁的就业参与者(n = 18,701)。工作与家庭冲突、职场欺凌和工作不安全感被评估为工作压力源。哮喘的定义是基于医生或其他健康专业人员的终身诊断的自我报告。为了解释复杂的抽样设计,使用方差估计来计算加权描述性统计和比值比(or),并使用多变量逻辑回归计算相应的95%置信区间(ci)。为了检验相互作用,在附加模型中加入了工作压力源和性别的相互作用术语。结果在全样本中,工作-家庭冲突、职场欺凌和工作不安全感与哮喘呈正相关(OR = 1.20, 95%CI = 1.03-1.40;Or = 1.45, 95%ci = 1.17-1.80;OR = 1.20, 95%CI = 0.99-1.45)。我们没有观察到在ORs的大小上有意义的性别差异。所有相互作用项均无统计学意义。结论工作压力源与哮喘呈正相关,但无性别差异。需要前瞻性研究来确定这些关联的潜在时间关系。
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引用次数: 0
Exposure to Psychosocial Work Factors and Occupational Injury and Its Severity: Prospective Associations Among Employees in the French National Working Conditions Survey 暴露于社会心理工作因素和职业伤害及其严重程度:在法国国家工作条件调查中雇员的前瞻性关联
IF 2.7 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-04-11 DOI: 10.1002/ajim.23723
Sandrine Bertrais, Isabelle Niedhammer

Background

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.

背景:在一般工作人群中,关于社会心理工作因素与职业伤害之间关系的前瞻性研究很少提供关于多重暴露、伤害严重程度和性别差异的信息。本研究旨在解决这些问题。方法本研究基于法国全国工作条件调查的前瞻性数据,调查对象为具有代表性的工作人口样本。从2013年到2019年,共有17486名员工(7302名男性,10184名女性)在一到两个三年的时间里接受了跟踪调查。在每个时期开始测量职业暴露,包括20个心理社会工作因素、4个工作时间/小时因素和4个体力工作因素。使用Logistic和障碍模型来研究他们与职业伤害及其严重程度的潜在关联,评估工伤缺勤及其持续时间。结果社会心理因素对职业伤害的预测作用较大。在调整后的模型中,也就是说,在控制了协变量和其他也能预测职业伤害的职业因素之后,几乎所有的关联都存在。这些前瞻性关联没有发现性别差异。对于所有类型的职业因素,在暴露次数和伤害之间发现了剂量-反应关联。然而,大多数职业因素不能预测损伤严重程度。结论职业暴露尤其是心理社会因素对职业伤害发生的预测作用大于其严重程度。职业伤害预防规划应侧重于工作环境的各个方面,包括社会心理工作因素,并应特别针对多重暴露。
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引用次数: 0
Determining Thresholds for Computer-Aided Detection for Silicosis—An Analytic Approach 确定计算机辅助检测矽肺病的阈值-一种分析方法。
IF 2.7 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-04-06 DOI: 10.1002/ajim.23720
Stephen Barker, Annalee Yassi, Jerry Spiegel, Barry Kistnasamy, Rodney Ehrlich

Background

Computer-aided detection (CAD) is emerging as an adjunct to the use of the chest X-ray (CXR) in screening for pulmonary tuberculosis (TB). CAD for silicosis, a fibrotic lung disease due to silica dust and a strong risk factor for TB, is at an earlier stage of development and, unlike TB, depends on expert human reading for validation. For all CAD systems, an important step is the choice of threshold for classifying images as positive or negative for the disease in question. The objective of this article is to present an analytic approach to the choice of threshold in using CAD systems for silicosis.

Methods

Drawing on receiver operating curve data from a published study on agreement between CAD and two expert readings of silicosis, two criteria for choosing the sensitivity/specificity combination were compared—the Youden Index and a minimum sensitivity of 90%. We explore the impact of criterion selection, silicosis definition, and reader on the choice and interpretation of threshold, as well as the influence of positive predictive value (PPV) derived from screen prevalence. We present a novel technique for using two CAD thresholds to distinguish images with a high likelihood of being of positive or negative from those characterized by uncertainty.

Results

The sample was 501 CXR images from ex-gold miners. Derived thresholds varied across the two criteria, as well as across silicosis definition and expert reader. Varying the notional disease prevalence produced large differences in PPV and, therefore, proportions of false positives. The implications of these variations affecting threshold choice are described for three use cases—annual screening of active miners, outreach screening of former miners, and adjudication of claims for silicosis compensation.

Conclusion

In applying CAD to silicosis, users need to establish the use case, their preference for the sensitivity/specificity trade-off, and the silicosis definition, as well as considering the effect of disease prevalence. System developers need to take inter-reader variation in validation exercises into account and present this information transparently. A two-threshold model has potential utility in situations of high screening volume where there is a significant cost associated with referral for confirmation of diagnosis.

背景:计算机辅助检测(CAD)作为胸部x线(CXR)筛查肺结核(TB)的辅助手段正在兴起。矽肺病是一种由二氧化硅粉尘引起的纤维化肺病,是结核病的一个强大危险因素,其CAD尚处于早期发展阶段,与结核病不同,它依赖于专家的人类阅读来验证。对于所有CAD系统,一个重要的步骤是选择阈值,将图像分类为阳性或阴性的疾病。本文的目的是提出一种分析方法,以选择阈值在使用CAD系统的矽肺。方法:根据已发表的一项关于CAD与两份矽肺专家读数的一致性研究的受试者工作曲线数据,比较两种选择敏感性/特异性组合的标准——约登指数和最小灵敏度为90%。我们探讨了标准选择、矽肺定义和读者对阈值的选择和解释的影响,以及来自筛查患病率的阳性预测值(PPV)的影响。我们提出了一种新的技术,使用两个CAD阈值来区分具有高可能性的图像,从那些以不确定性为特征的阳性或阴性。结果:样本为前金矿工人的501张CXR图像。得出的阈值在两个标准之间,以及在矽肺定义和专家读者之间有所不同。不同的名义疾病流行率产生了PPV的巨大差异,因此,假阳性的比例。这些变化影响阈值选择的含义被描述为三个用例——在职矿工的年度筛选,前矿工的外联筛选,以及矽肺赔偿索赔的裁决。结论:在将CAD应用于矽肺病时,用户需要建立用例、对敏感性/特异性权衡的偏好、矽肺病的定义,并考虑疾病流行的影响。系统开发人员需要考虑验证练习中阅读器之间的差异,并透明地呈现这些信息。双阈值模型在高筛查量的情况下具有潜在的效用,其中转诊确认诊断的成本很高。
{"title":"Determining Thresholds for Computer-Aided Detection for Silicosis—An Analytic Approach","authors":"Stephen Barker,&nbsp;Annalee Yassi,&nbsp;Jerry Spiegel,&nbsp;Barry Kistnasamy,&nbsp;Rodney Ehrlich","doi":"10.1002/ajim.23720","DOIUrl":"10.1002/ajim.23720","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Computer-aided detection (CAD) is emerging as an adjunct to the use of the chest X-ray (CXR) in screening for pulmonary tuberculosis (TB). CAD for silicosis, a fibrotic lung disease due to silica dust and a strong risk factor for TB, is at an earlier stage of development and, unlike TB, depends on expert human reading for validation. For all CAD systems, an important step is the choice of threshold for classifying images as positive or negative for the disease in question. The objective of this article is to present an analytic approach to the choice of threshold in using CAD systems for silicosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Drawing on receiver operating curve data from a published study on agreement between CAD and two expert readings of silicosis, two criteria for choosing the sensitivity/specificity combination were compared—the Youden Index and a minimum sensitivity of 90%. We explore the impact of criterion selection, silicosis definition, and reader on the choice and interpretation of threshold, as well as the influence of positive predictive value (PPV) derived from screen prevalence. We present a novel technique for using two CAD thresholds to distinguish images with a high likelihood of being of positive or negative from those characterized by uncertainty.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The sample was 501 CXR images from ex-gold miners. Derived thresholds varied across the two criteria, as well as across silicosis definition and expert reader. Varying the notional disease prevalence produced large differences in PPV and, therefore, proportions of false positives. The implications of these variations affecting threshold choice are described for three use cases—annual screening of active miners, outreach screening of former miners, and adjudication of claims for silicosis compensation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In applying CAD to silicosis, users need to establish the use case, their preference for the sensitivity/specificity trade-off, and the silicosis definition, as well as considering the effect of disease prevalence. System developers need to take inter-reader variation in validation exercises into account and present this information transparently. A two-threshold model has potential utility in situations of high screening volume where there is a significant cost associated with referral for confirmation of diagnosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 5","pages":"464-472"},"PeriodicalIF":2.7,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajim.23720","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794472","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}
引用次数: 0
Differences in the Effectiveness of Three OHS Training Delivery Methods 三种职业健康安全培训实施方式的有效性差异。
IF 2.7 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-04-04 DOI: 10.1002/ajim.23719
Lynda S. Robson, Cynthia Chen, Cameron A. Mustard, Faraz Vahid Shahidi, Victoria Landsman, Peter M. Smith, Aviroop Biswas

Background

Methods of delivering occupational safety and health (OSH) training have shifted from in-person to online. Widespread delivery of a standardized OSH training course in three modalities in the province of Ontario, Canada allowed measurement of differences in their effectiveness.

Methods

Learners (N = 899) self-selected into face-to-face (F2F) instructor-led learning, online instructor-led synchronous distance learning, or online self-paced e-learning. Pre- and post-training surveys collected information on knowledge and other measures. Multiple regression analyses compared modalities on knowledge achievement (0%–100% scale; the primary outcome), engagement, perceived utility, perceived applicability, self-efficacy, and intention-to-use.

Results

F2F learners achieved a statistically significant 2.5% (95% CI: 0.3%, 4.7%) higher post-training knowledge score than distance learners (Cohen's d = 0.23, which is considered small). A statistically insignificant difference of 0.4% (95%: −1.4%, 2.3%) was seen between e-learners and distance learners. Collaborating training providers regarded these differences as not meaningful in practice. Statistically significant differences between modalities were seen for engagement, perceived utility, and self-efficacy. Scores of F2F learners were more favorable than scores of distance learners, which were, in turn, more favorable than scores of e-learners.

Conclusions

This study provides evidence that there are small to no differences among F2F, distance and e-learning in their ability to ensure knowledge achievement among learners. This finding is likely generalizable to other well-designed short-term OSH training aimed at acquiring new knowledge. More research is needed to understand whether there are important differences across these modalities in basic OHS skill acquisition and transfer of learning to the workplace.

背景:提供职业安全与健康(OSH)培训的方法已经从面对面转向在线。在加拿大安大略省以三种方式广泛提供标准化职业安全与卫生培训课程,可以衡量其有效性的差异。方法:学习者(N = 899)自行选择参加面对面(F2F)教师主导的学习,在线教师主导的同步远程学习或在线自定进度的电子学习。培训前后的调查收集了有关知识和其他措施的信息。多元回归分析比较知识成就的模式(0%-100%量表;主要结果)、参与、感知效用、感知适用性、自我效能和使用意图。结果:F2F学习者的培训后知识得分比远程学习者高2.5% (95% CI: 0.3%, 4.7%),具有统计学意义(Cohen’s d = 0.23,这被认为是小的)。在线学习者和远程学习者之间的差异在统计学上不显著,仅为0.4%(95%:-1.4%,2.3%)。合作培训提供者认为这些差异在实践中没有意义。在参与、感知效用和自我效能方面,不同模式之间存在统计学上的显著差异。F2F学习者的分数比远程学习者的分数更有利,而远程学习者的分数又比电子学习者的分数更有利。结论:本研究提供的证据表明,F2F、远程学习和电子学习在确保学习者知识成就的能力方面存在很小甚至没有差异。这一发现很可能推广到其他旨在获取新知识的精心设计的短期职业安全与健康培训。需要更多的研究来了解这些模式在职业健康安全基本技能获得和学习转移到工作场所方面是否存在重要差异。
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引用次数: 0
Gastroesophageal Reflux Disease in the World Trade Center Health Program General Responder Cohort 世界贸易中心健康计划一般应答者队列中的胃食管反流病
IF 2.7 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-04-02 DOI: 10.1002/ajim.23721
Christopher R. Dasaro, Ahmad Sabra, Henry S. Sacks, Benjamin J. Luft, Denise J. Harrison, Iris G. Udasin, Michael A. Crane, Jacqueline M. Moline, Winston Kwa, Andrew C. Todd, Nancy L. Sloan, Susan L. Teitelbaum

Background

People participating in the rescue, recovery, and clean-up effort after the September 11, 2001 attack on the World Trade Center (WTC) were exposed to a complex mix of noxious substances and subsequently experienced elevated gastroesophageal reflux disease (GERD) incidence, the second-most-common WTC-related condition.

Methods

Longitudinal WTC Health Program data, collected between July 2002 and December 2022, were used to describe the sample characteristics, diagnostic procedures, and treatment of consenting cohort members with self-reported GERD who reported incident GERD for a year or longer (n = 19,067). Cross-tabulations and binomial logistic regression, adjusted for confounders including comorbidities, assessed the associations with intermittent and resolved, compared with unresolved, GERD.

Results

12.6% of the study cohort reported intermittent GERD; 5.5% reported GERD resolution. Analyses indicated that most GERD resolution was reported by people of color and those with body mass index <25, and by cohort members who had longer postdiagnosis follow-up and implemented dietary modifications together with proton pump inhibitors or Program-approved antacids. GERD-certified members who underwent endoscopy, used medications without dietary modifications, or used bed head-elevation, and those with Barrett's disease (5.8%) or esophageal cancer (0.1%) may have had more severe GERD and reported little resolution.

Conclusions

The use of GERD services was consistent with clinical guidelines. Members' implementing dietary modifications in conjunction with proton pump inhibitors or Program-approved antacids reported more resolution and may have had less severe GERD. Earlier diagnosis and intervention might increase earlier therapeutic resolution.

背景:2001年9月11日世界贸易中心(WTC)遇袭后,参与救援、恢复和清理工作的人们暴露于复杂的有毒物质混合物中,随后经历了胃食管反流病(GERD)发病率升高,这是世界贸易中心(WTC)相关的第二大常见疾病。方法:从2002年7月至2022年12月收集的纵向WTC健康计划数据用于描述样本特征、诊断程序和同意自报告发生GERD一年或更长时间的GERD队列成员的治疗(n = 19,067)。交叉表和二项逻辑回归,调整混杂因素,包括合并症,评估间歇性和消退性胃食管反流与未消退性胃食管反流的关系。结果:12.6%的研究队列报告间歇性胃食管反流;5.5%报告GERD解决。分析表明,有色人种和有体重指数的人报告了大多数胃食管反流的消退。结论:使用胃食管反流服务符合临床指南。与质子泵抑制剂或项目批准的抗酸剂一起实施饮食调整的成员报告了更多的解决方案,并且可能减轻了严重的胃反流。早期诊断和干预可能会增加早期治疗效果。
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引用次数: 0
Exposure to the World Trade Center Disaster, Health, and Health-Related Quality of Life Nearly 20 Years After 9/11 9/11事件后近20年的世界贸易中心灾难、健康和与健康相关的生活质量
IF 2.7 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-04-02 DOI: 10.1002/ajim.23706
Julia S. Sisti, Ananya Dhanya, Howard E. Alper, Nicholas Millet, Ayda Ahmadi, Robert M. Brackbill

Background

Exposure to the terrorist attacks on the World Trade Center (WTC) on September 11, 2001, has been associated with several chronic physical and mental health conditions. We assessed the burden, nearly 20 years after the attacks, of several 9/11-related health conditions and indicators of poor health-related quality of life (HRQOL) among individuals exposed to the WTC disaster.

Methods

Among individuals enrolled in the longitudinal WTC Health Registry in 2020–2021 (N = 26,964), we estimated post-9/11 prevalence of: self-reported diagnosed physical health conditions known to be associated with WTC exposure; probable posttraumatic stress disorder (PTSD) and depression; and poor HRQOL indicators. We also compared lifetime prevalence of selected conditions and poor-HRQOL indicators among WTC-exposed rescue and recovery workers and community members, separately, to New York State general population estimates, using multivariable-adjusted logistic regression.

Results

Prevalence of post-9/11 physical health conditions ranged from 10.5% (chronic obstructive pulmonary disease, COPD) to 26.3% (gastroesophageal reflux disease). Prevalence of probable post-9/11 PTSD and depression were 9.6% and 12.7%, respectively. Lifetime prevalence of physician-diagnosed asthma, COPD, and depression were higher among WTC-exposed individuals compared to the general population. Indicators of poor HRQOL were higher among WTC Registry enrollees relative to the general population, and among enrollees with any physical or probable mental health conditions compared to enrollees without any conditions.

Conclusions

Nearly 20 years after 9/11, WTC-exposed populations experience a high burden of health conditions that affect their wellbeing, highlighting the need for continued monitoring of this population.

背景:暴露在2001年9月11日世界贸易中心(WTC)的恐怖袭击中,与几种慢性身心健康状况有关。我们评估了9/11事件发生近20年后,与9/11事件相关的几种健康状况和与健康相关的生活质量(HRQOL)指标在世贸中心灾难暴露人群中的负担。方法:在2020-2021年参加世贸中心纵向健康登记的个体中(N = 26,964),我们估计了911后的患病率:已知与世贸中心暴露相关的自我报告诊断的身体健康状况;可能的创伤后应激障碍(PTSD)和抑郁症;HRQOL指标差。我们还使用多变量调整logistic回归,分别比较了wtc暴露的救援和恢复工作者和社区成员中选择条件和不良hrqol指标的终生患病率与纽约州一般人群估计值。结果:9/11后身体健康状况的患病率从10.5%(慢性阻塞性肺疾病,COPD)到26.3%(胃食管反流病)不等。9/11后PTSD和抑郁症的患病率分别为9.6%和12.7%。与普通人群相比,wtc暴露个体中医生诊断的哮喘、COPD和抑郁症的终生患病率更高。WTC登记注册者的HRQOL差指标高于一般人群,有任何身体或可能的精神健康状况的注册者的HRQOL差指标高于没有任何健康状况的注册者。结论:9/11事件发生近20年后,wtc暴露人群经历了影响其健康状况的沉重负担,突出了对这一人群进行持续监测的必要性。
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引用次数: 0
Student and Parental Job Loss During the COVID-19 Public Health Emergency: Effects on Household Economic Security COVID-19突发公共卫生事件期间学生和家长失业:对家庭经济安全的影响
IF 2.7 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-03-08 DOI: 10.1002/ajim.23713
Sharon R. Silver, Taylor M. Shockey, Jonetta J. Mpofu

Background

While studies have examined effects of parental job loss early in the COVID-19 pandemic, few have assessed economic impacts of student job loss.

Methods

The Adolescent Behaviors and Experiences Survey (ABES) was a one-time online, nationally-representative survey administered by CDC in 2021 to understand high school students' experiences. We assessed associations between student, parent, and dyadic employment experiences and two measures of economic stress: housing instability and food insufficiency.

Results

Parental job loss was common and associated with both adverse economic outcomes. The adjusted prevalence rate (aPR) for housing instability was 2.79, 95% confidence interval (CI) = 1.73–4.51. A new finding is that student employment may also play a role in food sufficiency. Student job loss was significantly associated with both any food insufficiency and frequent food insufficiency (aPR = 1.61, 95% CI = 1.35–1.93 and aPR = 1.96, 95% CI = 1.43–2.70, respectively).

Discussion

Analysis of associations between employment status before and during the COVID-19 public health emergency and measures of household economic insecurity reveals social safety net gaps. Our finding that student employment may affect household food sufficiency highlights the need to better understand the role of student employment in household economic stress.

背景:虽然有研究调查了COVID-19大流行早期父母失业的影响,但很少有研究评估学生失业的经济影响。方法:《青少年行为与经历调查》(ABES)是CDC于2021年实施的一项具有全国代表性的一次性在线调查,旨在了解高中生的经历。我们评估了学生、家长和二元就业经历与两项经济压力指标之间的联系:住房不稳定和食物不足。结果:父母失业是常见的,并且与不利的经济结果有关。住房不稳定的调整患病率(aPR)为2.79,95%可信区间(CI) = 1.73 ~ 4.51。一项新的发现是,学生就业也可能在食物充足方面发挥作用。学生失业与任何食物不足和频繁食物不足均显著相关(aPR = 1.61, 95% CI = 1.35-1.93, aPR = 1.96, 95% CI = 1.43-2.70)。讨论:分析2019冠状病毒病突发公共卫生事件之前和期间的就业状况与家庭经济不安全措施之间的关联,揭示社会安全网缺口。我们发现学生就业可能会影响家庭食物充足,这突出了更好地理解学生就业在家庭经济压力中的作用的必要性。
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引用次数: 0
Reliability and Validity of the Japanese Version of the Four-Item Psychosocial Safety Climate Scale (PSC-4J) 日本版心理社会安全气候量表(PSC-4J)的信度和效度
IF 2.7 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-03-05 DOI: 10.1002/ajim.23715
Akiomi Inoue, Hisashi Eguchi, Yuko Kachi, Maureen F. Dollard, Akizumi Tsutsumi

Background

Short measurement scales are increasingly sought-after for reasons of efficiency and survey fatigue. A short four-item measure of an organization's climate for employee psychological health, the psychosocial safety climate (PSC-4), has gained international usage. However, the psychometric properties of its Japanese version (PSC-4J) are unknown. We examined the reliability and validity of the PSC-4J.

Methods

An online survey containing the Japanese 12-item PSC scale (PSC-12J), from which the PSC-4J derived, and relevant variables (job demands, job resources, and outcomes) was administered to 2200 employees registered with a Japanese online survey provider. Two weeks later, the PSC-12J was measured again with a follow-up survey of 1400 respondents. Internal consistency and test-retest reliability were examined by Cronbach's α and intraclass correlation (ICC). Agreement between PSC-4J and PSC-12J was examined by Spearman's correlation. Structural validity was examined by confirmatory factor analysis (CFA) and item response theory (IRT) analysis. Convergent validity was examined by Spearman's correlations of PSC-4J with relevant variables, comparing these results with the PSC-12J.

Results

Cronbach's α and ICC for PSC-4J were 0.91 and 0.68, respectively. Spearman's correlation between PSC-4J and PSC-12J was 0.97. The CFA assuming a one-factor structure showed good model fit. The IRT analysis indicated each PSC-4J item had very high discrimination and appropriate difficulty. Spearman's correlations of PSC-4J with relevant variables were slightly lower than for PSC-12J but in the theoretically expected direction.

Conclusions

The PSC-4J, while slightly inferior to the PSC-12J in psychometric properties, provides comparable measurements with fewer items while maintaining adequate reliability and validity.

背景:由于效率和调查疲劳的原因,短测量量表越来越受欢迎。社会心理安全气候(PSC-4)是衡量组织员工心理健康气候的一个简短的四项指标,已在国际上得到使用。然而,其日文版本(PSC-4J)的心理测量特性尚不清楚。我们检查了PSC-4J的可靠性和有效性。方法:采用日语12题PSC量表(PSC- 12j)和相关变量(工作需求、工作资源和结果)对在日本在线调查提供商注册的2200名员工进行在线调查,PSC- 4j由此衍生。两周后,又对1400名受访者进行了PSC-12J测试。采用Cronbach’s α和类内相关(ICC)检验内部一致性和重测信度。PSC-4J和PSC-12J的一致性采用Spearman相关检验。采用验证性因子分析(CFA)和项目反应理论(IRT)检验结构效度。通过PSC-4J与相关变量的Spearman相关性来检验收敛效度,并将这些结果与PSC-12J进行比较。结果:PSC-4J的Cronbach’s α和ICC分别为0.91和0.68。PSC-4J与PSC-12J的Spearman相关系数为0.97。假设单因素结构的CFA显示出良好的模型拟合。IRT分析显示PSC-4J的每个条目具有很高的辨识度和适当的难度。PSC-4J与相关变量的Spearman相关性略低于PSC-12J,但符合理论预期方向。结论:PSC-4J虽然在心理测量特性上略低于PSC-12J,但在保持足够信度和效度的同时,提供了较少项目的可比较测量。
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引用次数: 0
Exposure to Per- and Polyfluoroalkyl Substances and the Risk of Prostate and Ovarian Cancer: An Epidemiologic Meta-Analysis 暴露于全氟和多氟烷基物质与前列腺癌和卵巢癌的风险:一项流行病学荟萃分析。
IF 2.7 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-03-05 DOI: 10.1002/ajim.23717
Shenglan Yang, Hui Dong, Xinyu Gou, Limei Chen, Ying Zhang, Jing Wu

Background

Per- and polyfluoroalkyl substances (PFAS) are persistent environmental contaminants. Previous research has linked PFAS exposure to prostate and ovarian cancer risk, however, the conclusions have been inconsistent. This research purpose was to determine the relationship between PFAS exposure and prostate and ovarian cancer at the population level.

Methods

We systematically reviewed three databases—PubMed, Web of Science, and Embase—for research from when these databases were established to April 15, 2024. The quality of the retrieved research was evaluated using the Newcastle-Ottawa Scale (NOS) quality measurement tool. Meta-analysis of the extracted data was conducted using Stata 18. We also conducted sensitivity and subgroup analyses, as well as Begg's and Egger's tests.

Results

Twelve publications were involved in the analysis for prostate cancer, and six were included for ovary cancer. The outcomes indicated that PFOS exposure was positively related to prostate cancer (OR: 1.13, 95% CI: 1.00–1.28), while mixed PFAS exposure was positively related to ovarian cancer (OR: 1.63, 95% CI: 1.49–1.78). The source of heterogeneity identified in the subgroup analysis was primarily attributable to variations in study design. No significant study bias was detected in the analysis.

Conclusion

The study demonstrated an association between PFAS exposure and both prostate and ovarian cancers. Further investigation is required to clarify the underlying mechanisms and potential associations.

背景:全氟和多氟烷基物质(PFAS)是持久性环境污染物。先前的研究已经将PFAS暴露与前列腺癌和卵巢癌风险联系起来,然而,结论并不一致。本研究的目的是在人群水平上确定PFAS暴露与前列腺癌和卵巢癌之间的关系。方法:系统检索pubmed、Web of Science和embase三个数据库,从这些数据库建立到2024年4月15日。使用纽卡斯尔-渥太华量表(NOS)质量测量工具对所检索研究的质量进行评估。采用Stata 18对提取的数据进行meta分析。我们还进行了敏感性和亚组分析,以及贝格和埃格的测试。结果:12篇文献纳入前列腺癌的分析,6篇文献纳入卵巢癌的分析。结果表明,全氟辛烷磺酸暴露与前列腺癌呈正相关(OR: 1.13, 95% CI: 1.00-1.28),而混合全氟辛烷磺酸暴露与卵巢癌呈正相关(OR: 1.63, 95% CI: 1.49-1.78)。亚组分析中发现的异质性来源主要归因于研究设计的差异。分析中未发现显著的研究偏倚。结论:该研究表明PFAS暴露与前列腺癌和卵巢癌之间存在关联。需要进一步的调查来阐明潜在的机制和潜在的关联。
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引用次数: 0
期刊
American journal of industrial medicine
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