Showing papers in "Journal of Occupational and Environmental Medicine in 2020"

Job Insecurity and Financial Concern During the COVID-19 Pandemic Are Associated With Worse Mental Health.

Abstract: OBJECTIVE: To determine whether job insecurity due to COVID-19 and financial concern were associated with worse mental health during the COVID-19 pandemic. METHOD: Participants (N = 474 employed U.S. individuals) completed an online survey from April 6 to 12, 2020. Linear regressions were used to examine factors associated with mental health. RESULTS: After accounting for demographic characteristics, health status, other COVID-19 experiences, and anxiety symptoms, greater job insecurity due to COVID-19 was related to greater depressive symptoms. Conversely, after accounting for covariates and depressive symptoms, greater financial concern was related to greater anxiety symptoms. Further, greater job insecurity was indirectly related to greater anxiety symptoms due to greater financial concern. CONCLUSIONS: Findings suggest that employers should aim to reduce job insecurity and financial concern among employees during the COVID-19 pandemic to address the associated mental health consequences.

Nurses' Mental Health During the Covid-19 Outbreak: A Cross-Sectional Study.

Abstract: OBJECTIVE: To describe nurses' mental health status during the Covid-19 outbreak and to explore the factors that might accentuate the negative consequences on their mental health. METHODS: We conducted an online survey to evaluate demographic variables, working conditions, family dynamics, and mental health variables in nurses working in healthcare settings, in Portugal, during the Covid-19 outbreak. RESULTS: Portuguese nurses presented higher depression, anxiety and stress levels, when compared to the Portuguese general population, during the outbreak. Overall, nurses who did not consider the quantity and quality of personal protective equipment as adequate presented significantly higher levels of depression, anxiety, and stress. CONCLUSIONS: Our results suggest that nurses' mental health status seems to be particularly affected by the Covid-19 outbreak and that some modifiable elements might accentuate the impacts on their mental health.

Personal Protective Equipment and Mental Health Symptoms Among Nurses During the COVID-19 Pandemic.

Abstract: OBJECTIVE: To determine the association between access to adequate personal protective equipment (PPE) and mental health outcomes among a sample of U.S. nurses. METHODS: An online questionnaire was administered in May 2020 to Michigan nurses via three statewide nursing organizations (n = 695 respondents). Multivariable logistic regression analysis was used to identify factors associated with mental health symptoms. RESULTS: Nurses lacking access to adequate PPE (24.9%, n = 163) were more likely to report symptoms of depression (OR 1.96, 95% CI 1.31, 2.94; P = 0.001), anxiety (OR 1.64, 95% CI 1.12, 2.40; P = 0.01) and post-traumatic stress disorder (OR 1.83, 95% CI 1.22, 2.74; P = 0.003). CONCLUSIONS: Healthcare organizations should be aware of the magnitude of mental health problems among nurses and vigilant in providing them with adequate PPE as the pandemic continues.

Covid-19 Pandemic: Looking after the Mental Health of our Healthcare Workers.

Abstract: ht © 2020 American Colle T.C. and M.D. are joint first auth Funding: None. Conflict of Interest: None to dec Supplemental digital contents are article. Direct URL citatio printed text and is provided PDF versions of this article on site (www.joem.org). Address correspondence to: Ta MD(Res), MRCP, Consulta Cardiologist, Blackpool V Whinney Heys Road, Blac United Kingdom (tawfiqc@h Copyright 2020 American C tional and Environmental Me DOI: 10.1097/JOM.00000000000

Home-Based Telework and Presenteeism Across Europe.

Abstract: Objective Flexible work arrangements such as telework are gaining importance. Although telework is accompanied by advantages for employees such as increased flexibility, current research reveals associations between home-based telework and self-endangering behavior such as sickness presenteeism. As empirical evidence is still scarce, we explore the relationship between home-based telework and sickness presenteeism across Europe. Methods We perform multilevel analyses including 25,465 individuals who responded to the 6th wave of the European Working Conditions Survey 2015. Results Home-based telework is positively related to sickness presenteeism. The results are quite robust across different measures of sickness presenteeism and to several sensitivity analyses. Conclusion Although sickness presenteeism can be functional for specific illnesses, organizations should be aware of possible risks related to home-based telework. They should design telework in a way that it reduces triggers for self-endangering behavior.

Mesothelioma Associated With the Use of Cosmetic Talc.

Abstract: Objective:To describe 33 cases of malignant mesothelioma among individuals with no known asbestos exposure other than cosmetic talcum powder.Methods:Cases were referred for medico-legal evaluation, and tissue digestions were performed in some cases. Tissue digestion for the six cases described was d

Impact of a Mindfulness-Based, Workplace Group Yoga Intervention on Burnout, Self-Care, and Compassion in Health Care Professionals: A Pilot Study.

Abstract: Objective To investigate whether a workplace, group mindfulness-based yoga intervention could help manage burnout and improve wellbeing among health care professionals. Methods A total of 43 health care professionals participated in 8-week supervised workplace, group mindfulness-based yoga activities. The authors used a single-sample, pre-post design. At two points in time (baseline and postintervention), participants completed a set of online measures assessing burnout, depression, anxiety, stress, resilience, and compassion. The authors used linear mixed model analysis to assess changes in outcome measures. Results Participants had improvements after the 8-week intervention. At postintervention, they had significantly better scores on personal accomplishment, depression, anxiety, stress, perceived resilience, and compassion. Participants had a positive perception of the yoga intervention. Conclusion Group mindfulness-based yoga program may be convenient and low-cost approach to support health and wellbeing among health care professionals.

Perfluoroalkyl Substances and Metabolic Syndrome in Firefighters: A Pilot Study.

Abstract: Objective To compare association of perfluoroalkyl substances (PFASs) with metabolic syndrome (MetS) profile among firefighters (FF) at airport to suburban FF. Methods Cross-sectional exploratory study, 47 men FF aged 18 to 62 years were enrolled from two fire departments in Ohio. Association between MetS outcome and log transformed serum concentrations of four PFASs was evaluated using multivariable logistic regression. Results PFASs serum concentrations were 18% to 74% higher in FF than the general population, and 21% to 62% higher in airport FF than suburban FF. Compared with US general population, an elevated risk of hypertension was noted in FF, but no significant association between PFASs and MetS was found. Conclusions Current serum PFASs in FF are not associated with MetS risk.

Respiratory Diseases in Post-9/11 Military Personnel Following Southwest Asia Deployment.

Abstract: Objective Persistent respiratory symptoms following post-9/11 military deployment to Iraq and Afghanistan are well-recognized, but the spectrum of respiratory diseases remains poorly characterized. This study describes deployment-related respiratory diseases and the diagnostic utility of resting and exercise pulmonary function testing. Methods Between 2009 and 2017, 127 consecutive military workers ("deployers") with new-onset respiratory symptoms underwent clinical evaluation. Deployment-related respiratory diseases were classified as proximal and/or distal. Using descriptive statistics and logistic regression, we analyzed lung function parameters associated with deployment-related distal lung disease (DDLD). Results Common deployment-related respiratory diseases included asthma (31.5%), intermittent laryngeal obstruction (14.2%), rhinosinusitis (15%), and DDLD (68.5%). Decreased diffusion capacity (odds ratio [OR] = 4.6, 95% confidence interval [CI]: 1.4 to 15.1, P = 0.01) was significantly associated with DDLD. Conclusions A comprehensive diagnostic approach may identify a spectrum of proximal and distal respiratory diseases that can occur in symptomatic post-9/11 deployers, requiring a personalized approach to care.

Cardiovascular Disease Risk Factor Changes Over 5 Years Among Male and Female US Firefighters.

Abstract: OBJECTIVE To examine changes in measures of cardiovascular health in male and female firefighters over 5 years. METHODS Anthropometrics and biomarkers of cardiovascular health from two occupational medical exams separated by 5 years (2009 to 2016) were examined from a cohort of US career firefighters in Virginia (males, n = 603; females, n = 69). Changes over time were tested using paired t-tests and McNemar's tests. RESULTS At baseline, 29% of males and 10% of females were obese. Body weight and body mass index significantly increased (P < 0.05) in males (2.5 ± 0.2 kg) (0.8 ± 0.1 kg·m) and females (2.5 ± 0.8 kg) (1.0 ± 0.3 kg·m) over the 5-year period. The prevalence of obesity, hypercholesterolemia, hypertensive medication usage, and high blood glucose significantly increased in males over the 5-year period. CONCLUSIONS While improvements in blood pressure were observed, large percentages of firefighters, particularly males, had cardiovascular disease risk factors that increased over time.

Serous Ovarian Cancer Caused by Exposure to Asbestos and Fibrous Talc in Cosmetic Talc Powders-A Case Series.

Abstract: Objective Asbestos is a known cause of ovarian cancer. We report 10 cases of serous ovarian cancer among users of Johnson & Johnson (J&J) asbestos-containing "cosmetic" talc products. Methods We conducted an asbestos exposure assessment during talc application and analyzed surgical tissues and talc containers for asbestos and talc. Results Talc was found in all cases and tremolite and/or anthophyllite asbestos was found in 8/10 cases. The asbestos fibers found in the "cosmetic" talc containers matched those found in tissues. We estimated inhaled asbestos dose ranged from 0.38 to 5.18 fiber years. Conclusion We provide evidence that the inhaled dose of asbestos/fibrous talc from "cosmetic" talc use causes ovarian cancer. The unique combination of the types of asbestiform minerals detected in cancerous tissue and "cosmetic" talc is a fingerprint for exposure to asbestos-containing talc.

Prevalence of Chronic Multisymptom Illness/Gulf War Illness Over Time Among Millennium Cohort Participants, 2001 to 2016.

Abstract: Objective:Chronic multisymptom illness/Gulf War illness (CMI/GWI) is the defining illness of the 1990 to 1991 Gulf War. However, few studies have examined changes over time in CMI/GWI prevalence.Methods:Prevalence of CMI/GWI over time was compared between three groups of military personnel (9110 Gul

Mental Health Stigma and Wellbeing Among Commercial Construction Workers: A Mixed Methods Study.

Abstract: Objective The aim of this study was to understand the relationship between mental health stigma and wellbeing in a sample of commercial construction workers. Methods A sequential quantitative to qualitative mixed methods study was conducted. First, 264 workers were surveyed and logistic regression examined the associations between mental health stigma and psychological distress, substance abuse, and sleep; then, data from eight key informant interviews and six focus groups with workers were analyzed thematically. Results Stigma was significantly associated with psychological distress and impaired sleep, but not with substance abuse. Key informants and workers discussed the prominence of stigma on worksites and how the masculine culture of the industry and job insecurity contributed to stigma. Conclusion Stigma poses a barrier to addressing mental health among workers; peer support and improved human resources may be promising.

Ensuring Organization-Intervention Fit for a Participatory Organizational Intervention to Improve Food Service Workers' Health and Wellbeing: Workplace Organizational Health Study.

Abstract: Objective: Food-service workers’ health and wellbeing is impacted by their jobs and work environments. Formative research methods were used to explore working conditions impacting workers’ health to inform intervention planning and implementation and to enhance the intervention’s ‘fit’ to the organization. Methods: Four qualitative methods (worker focus groups; manager interviews; worksite observations; multi-stakeholder workshop) explored in-depth and then prioritized working conditions impacting workers’ health as targets for an intervention. Results: Prioritized working conditions included: ergonomics; work intensity; career development and job enrichment. Data revealed necessary intervention mechanisms to enhance intervention implementation: worker and management communication infrastructure; employee participation in intervention planning and implementation; tailored worksite strategies; and ensuring leadership commitment. Conclusions: These targeted, comprehensive methods move away from a typical focus on generic working conditions, e.g. job demands and physical work environment, to explore those conditions unique to an organization. Thereby, enhancing ‘intervention-fit’ at multiple levels within the company context.

Non-Invasive and Minimally Invasive Management of Low Back Disorders.

Abstract: OBJECTIVE This abbreviated version of the American College of Occupational and Environmental Medicine's (ACOEM) Low Back Disorders Guideline reviews the evidence and recommendations developed for non-invasive and minimally invasive management of low back disorders. METHODS Systematic literature reviews were accomplished with article abstraction, critiquing, grading, evidence table compilation, and guideline finalization by a multidisciplinary expert panel and extensive peer-review to develop evidence-based guidance. Consensus recommendations were formulated when evidence was lacking. A total of 70 high-quality and 564 moderate-quality trials were identified for non-invasive low back disorders. Detailed algorithms were developed. RESULTS Guidance has been developed for the management of acute, subacute, and chronic low back disorders and rehabilitation. This includes 121 specific recommendations. CONCLUSION Quality evidence should guide treatment for all phases of managing low back disorders.

Progress in Corrections Worker Health: The National Corrections Collaborative Utilizing a Total Worker Health® Strategy.

Abstract: OBJECTIVE To examine National Corrections Collaborative (NCC) activities, as an outreach initiative, to advance corrections workplace health and safety research, practice, and policy through a series of applied Research to Practice (r2p) meetings informed by the Total Worker Health(Total Worker Health is a registered trademark of the U.S. Department of Health and Human Services) (TWH) strategy. METHODS We mapped the coalescence of correctional worker health concerns, federal and national professional organization initiatives, and research activities that formed the NCC in 2014. RESULTS During the NCC's 5-years of TWH activities, attendance increased, partner composition expanded, and themes of concern evolved. Partners were motivated to participate and work together towards building evidence for health and safety r2p. CONCLUSIONS A unified plea to the academic and federal research communities for assistance with better evaluation instruments, data linkages, and for adopting an integrated TWH approach to workforce health and wellbeing continue to drive NCC r2p activities.

The Economic Burden of Lost Productivity due to Presenteeism Caused by Health Conditions Among Workers in Japan.

Abstract: Objective To identify the primary health conditions that cause presenteeism, and to estimate the economic cost of lost productivity due to presenteeism in Japan. Methods We conducted an Internet survey among 10,000 Japanese workers. Participants were asked to answer the health condition most affecting their work. Presenteeism was evaluated using the Quantity and Quality methods, and we estimated an annualized cost per capita and nation. Results The common health conditions most interfering with work were neck pain or stiff shoulders, low back pain, and mental illnesses. The annualized costs of presenteeism per capita for each were $414.05, $407.59, and $469.67, respectively. The estimated national costs for each were all above $27 billion. Conclusions Mental illnesses and musculoskeletal symptoms were the leading causes of presenteeism in Japan, and the economic burden of presenteeism was considerably large.

Teleworking and Employee Well-Being in Corona Times: The Importance of Optimal Psychosocial Work Conditions.

Abstract: T he COVID-19 pandemic has led to a great acceleration of teleworking (ie, homebased working) around the world. Teleworking was imposed in organizations and jobs where it was initially considered impossible, and it is expected that also after the pandemic people will continue working from home more often. Beyond the fact that teleworking leads to physical distancing protecting workers against the virus, scholars and policy makers have also identified other advantages of teleworking for the organization (eg, less accommodation costs), for the employee (eg, less travel costs, more flexibility, and better workhome balance), and for society (eg, less traffic congestions and less pollution). However, research findings on the benefits of teleworking for employees dating from before the COVID-19 crisis are inconsistent, showing that the successfulness of teleworking in terms of productivity and well-being is far from straightforward. Scholars have therefore suggested to focus on characteristics of teleworking and the conditions under which it is implemented rather than on working from home or not. In reply, we investigated the relationship between extent of teleworking (operationalized as the number of days working from home a week) and employee well-being (ie, burnout, work engagement, and cognitive stress complaints) among 878 employees from an international telecommunication company with a long history of teleworking. Additionally, we took into account various work characteristics (ie, social support from colleagues, participation in

Professional Recognition at Work: The Protective Role of Esteem, Respect, and Care for Burnout Among Employees.

Abstract: Objective The present research systematically investigates the role of recognition experiences at work as a protective factor for burnout. Method In two cross-sectional studies (N = 328 and N = 220) with employees we measured via online questionnaires three forms of recognition (achievement-based social esteem, equality-based respect, and need-based care) from coworkers and supervisors as predictors and burnout among employees as outcome. Results Using multiple regression analyses, Study 1 provided initial evidence that both supervisor and coworker recognition were negatively associated with employees' burnout. Study 2 further demonstrated that whereas respect experiences were especially crucial for lowering emotional exhaustion, care was primarily linked to reduced depersonalization and esteem to heightened personal accomplishment. Conclusion We discuss how positive recognition experiences can be fostered in organizations in order to buffer the negative effects burnout can cause.

Spirometry in Occupational Health-2020.

Abstract: Spirometry in the occupational health setting plays a critical role in the primary, secondary, and tertiary prevention of workplace-related lung disease. Recognizing the central role of spirometry in workplace respiratory programs, the American College of Occupational and Environmental Medicine (ACOEM) developed three spirometry position statements in the past two decades, which summarized advances of particular relevance to occupational health practice. However, since these statements were published, there have been important developments in federal regulations and in official American Thoracic Society recommendations which affect occupational spirometry testing. This 2020 ACOEM guidance statement incorporates these spirometry testing changes into its recommendations to provide current information for all users of spirometry test results, from those who perform or supervise testing to those who only interpret or review results.

Metabolic Syndrome in Commercial Truck Drivers: Prevalence, Associated Factors, and Comparison With the General Population.

Abstract: Introduction Commercial motor vehicle drivers, such as truck drivers, experience unique health, lifestyle, and occupational challenges directly associated with their profession. Methods All participants in this multistate cross-sectional study completed questionnaire measurements. Participants were categorized with metabolic syndrome (MetS) if they had at least three of the five modified criteria used in the joint scientific statement on metabolic syndrome. Results Overall MetS prevalence was 52.4% (n = 428) of the 817 participants. Prevalence of MetS criteria were waist circumference (n = 634, 77.0%), low HDL cholesterol (n = 580, 71.0%), elevated triglycerides (n = 552, 67.6%), elevated blood pressure (n = 175, 21.2%), and elevated hemoglobin A1c (n = 97, 11.9%). Truck drivers were 2.7 times more likely to have MetS compared to the general working population. Conclusion Truck drivers in the United States have a high prevalence of MetS compared to the general working population.

Balancing Health and Economic Factors When Reopening Business in the Age of COVID-19.

Abstract: D isasters often stress the economy and, as in the case of the current pandemic, expose structural weaknesses that reveal significant gaps in organization, infrastructure, and capacity. From the time of its emergence in late 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) that causes coronavirus disease 2019 (COVID-19), has swept across the globe causing substantial morbidity and mortality. Without effective pharmacologic interventions, public health policy responses include social distancing, masking, stay-at-home orders, and business closures in efforts to protect lives by slowing the rate of infection. Unfortunately, these mitigation measures have come at a significant financial and economic cost. The trade-off for saving lives has been economic dislocation as many industries have been shut-down and unemployment rates have soared. As the pandemic surge wanes, attention has shifted to lifting stay-at-home measures and restarting the economy. Political debate, which often falls along partisan lines, has framed the choice as pitting pro-economy versus pro-health arguments. We contend that this is a false dichotomy. At the macro-economic level, health and wealth are not only closely related but mutually reinforcing. The economic downturn itself is expected to create secondary surges in poor health: increased severity of chronic diseases (ambulatory sensitive and prevention sensitive conditions) as people have delayed routine healthcare, increased demands on mental health, and substance-abuse related services due to the stress and isolation, and overall worsening of physical and mental

Safely Returning America to Work: Part I: General Guidance for Employers.

Abstract: Businesses are struggling to re-open as the world continues to deal with the coronavirus 2019 (COVID-19) pandemic. The reopening of businesses will require employers to implement safe return-to-work strategies through evaluation, testing, work modifications, and development of appropriate workplace policies. There will be unique challenges along the way as no one approach will be ideal for all workplaces and industries. This document is intended to provide return-to-work guidance for both employers and the occupational and environmental medicine physicians who will be supporting businesses in implementing safe return-to-work strategies.

The Impact of Challenge and Hindrance Demands on Burnout, Work Engagement, and Presenteeism. A Cross-Sectional Study Using the Job Demands-Resources Model.

Abstract: Objective The present study used the Job Demands-Resources (JD-R) model to understand how perceiving job demands as a hindrance or a challenge can influence an individual's exhaustion and motivation and its effect on presenteeism. Method A sample of 171 working Australians was used to test the relationships between job demands and job resources with presenteeism via burnout and work engagement. Findings The results suggested that challenge demands were positively related to burnout and work engagement, while hindrance demands were positively related to burnout and negatively related to work engagement. Most direct and indirect pathways predicted in earlier work incorporating the JD-R model to understand presenteeism were replicated. Conclusion Future research on larger nation-wide samples is needed to further explore the differentiating effects of job demands on presenteeism via burnout and work engagement.

COVID-19 Exposure among First Responders in Arizona

Abstract: OBJECTIVE: There is currently over 80,000 cases of COVID-19 in Arizona, and the number is rapidly increasing, leading the country in the rate of new daily cases Exposure among first responders remains unknown METHODS: Rates of SARS-CoV-2 IgG among first responders in Arizona were determined, and attitudes / views about the impact of COVID-19 on their work life was analyzed RESULTS: Of 3,326 first responders, 50 (1 50%) tested positive for SARS-CoV-2 IgG Most first responders thought antibody testing would help ease their anxieties (62 5%) and be beneficial to their work-life (60 6%) CONCLUSION: The rate of COVID-19 exposure among first responders in Arizona is low - 1 50% COVID-19 is a concern among many of the first responders, and antibody testing was beneficial in easing their anxieties about going to work and performing work-related duties

Trends in Work-Related Musculoskeletal Disorders From the 2002 to 2014 General Social Survey, Quality of Work Life Supplement.

Abstract: Objective To update trends in prevalence of back and upper limb musculoskeletal symptoms and risk factors from the 2014 Quality of Work Life (QWL) Survey. Methods Quadrennial QWL Surveys, 2002-2014 (with N = 1455, 1537, 1019, and 1124 in 2002, 2006, 2010, and 2014 surveys respectively) were analyzed for reports of back pain and pain in arms. Results In the fourth analysis of this survey, twelve-year trends continue to show a decline in back pain and pain in arms. Key physical (heavy lifting, hand movements, very hard physical effort) and psychosocial/work organizational factors (low supervisor support, work is always stressful, not enough time to get work done) remain associated with back and arm pain, with the physical risk factors showing the strongest associations. Conclusion Physical exposure risk factors continue to be strongly associated with low back and arm pain and should be the focus of intervention strategies.

Whole-Process Emergency Training of Personal Protective Equipment Helps Healthcare Workers Against COVID-19: Design and Effect.

Abstract: OBJECTIVE: To develop an emergency training program of personal protective equipment (PPE) for general healthcare workers (HCWs) who may be under the threat of Corona Virus Disease 2019 (COVID-19) and evaluate the effect of the program. METHODS: A three-stage training program was designed. The complete clinical workflow together with infectious disease ward was simulated. To verify the effect of the program, an experimental training with pre- and post-test was conducted before large-scale training. RESULTS: Post-test scores were significantly improved when compared with the pre-test scores. Among all PPE, N95 respirator and protective coverall needed training most. Meanwhile, "proficiency level" and "mutual check & help" also needed to be strengthened as independent scoring points. CONCLUSION: This training program significantly improved the performances of participants. It may therefore be applied for general HCWs on a larger scale.

Firefighter's Acute Inflammatory Response to Wildfire Suppression.

Abstract: Objectives The purpose of this study was to determine the inflammatory response to a 12-hour wildfire suppression shift, in firefighters attending the "Black Saturday" natural disaster. Methods Thirty-eight male volunteer firefighters provided venous blood samples before and after a 12-hour firefighting shift. Pre- to post-shift changes in pro-inflammatory (Interleukin [IL]-1β, IL-2, IL-6, IL-8, IL-12P70, granulocyte macrophage-colony stimulating factor [GM-CSF], tumor necrosis factor-alpha [TNF-α], interferon-gamma [IFNγ]), and anti-inflammatory (IL-4, IL-5, IL-7, IL-10, IL-13) cytokines were measured with paired sample t tests, or Wilcoxon t tests for non-parametric data. Results Interleukin (IL)-6 (P = 0.003) and IL-8 (P = 0.017) were significantly increased following 12-hours of wildfire suppression. There was also a significant decrease in IL-10 (P = 0.021). Conclusions The observed acute inflammatory response may have resulted from multiple stressors including physical exertion, thermal strain, or smoke inhalation experienced during the shift, and may be a necessary response for the body to adapt to stressor exposure.

Night Shift Working Is Associated With an Increased Risk of Thyroid Nodules.

Abstract: Objectives:To study thyroid alterations in health care workers according to their working status.Methods:We performed a retrospective study including 299 hospital employers who underwent in 2016 a periodic health surveillance checks in the Service of Occupational Medicine. According to the working s