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Background: Studies have shown a knowledge deficit of appropriate initial burn treatment. There is a need for evidence-based wound care education rooted in new recommendations for providers to promote better patient outcomes. Objectives: To determine if an education module on burn wound management can improve Urgent Care providers’ knowledge and confidence in burn care, a pre-post intervention quality improvement project was implemented in three Urgent Care locations in Orange County from February 2024 to March 2024. Methods: All participants engaged in a 30-minute in-person wound care education intervention and completed the pre-and post-test the same day. There was a 4-week follow-up post-test to assess for retention. Participants’ demographics, burn care knowledge, and confidence in burn care were collected using pre- and post-test surveys. Data was analyzed using descriptive statistics and the Wilcoxon test. Results: Of the 19 participants, 2% had 1-5 years, 53% had 6-10 years, 37% had 11-15 years of experience in UC practice, and 21% of participants completed a CME course concerning burn care within the past two years. Participants were 16% MD, 10% DO, 32% NP, 42% PA. Of the 19 participants, 58% were between age group 30-39 years and 42% were between 40-49 years. There was a statistically significant increase in mean knowledge and confidence scores. Mean wound care knowledge score (4.2, SD 1.9 vs. 6.6, SD 1.5; p=.001) and mean confidence score (2.5, SD 0.7 vs. 3.4, SD 0.6; p=.001) from pre- to post-test, respectively. There was also a significant increase in mean wound care knowledge score (4.2, SD 1.9 vs. 6.7, SD 1.2; p<.001) from the pre-test to the 4-week follow-up post-test. Conclusion: An education intervention improved providers’ immediate and follow-up knowledge and confidence in burn care practice among urgent care providers. This study provides an effective burn wound education model for UC providers. Future studies are needed to assess the effectiv

Background: An estimated 750,000 to 1 million people live with an ostomy, and approximately 100,000 – 120,000 people undergo the creation of a new ostomy surgery every year. Faster recovery times have decreased ostomy patients’ post-operative hospital length of stay (LOS). As a result, patients have limited time to receive adequate ostomy education and training during hospitalization. Because the LOS is short, providing necessary patient education, training, and stoma site marking (SSM) before ostomy surgery as an outpatient can impact patients’ well-being, decreasing ostomy-related complications and reducing financial burden. Objectives: This preoperative ostomy care quality improvement (QI) pilot project aimed to evaluate the impact of providing preoperative ostomy education, care training, and stoma site marking (SSM) on patients undergoing scheduled fecal ostomy creation surgery, including length of stay (LOS), emergency department (ED) visitation, and readmission occurrences associated with ostomy issues including dehydration and acute renal insufficiency. Methods: This QI project was a single-site project at a large community hospital in Los Angeles County. The project's subjects included two groups of adult patients who had undergone scheduled colorectal surgery for new fecal ostomy creation: those who had surgery prior to initiation of the QI project (non-intervention group); and those who had surgery after initiation of the intervention for the QI project (intervention group). The QI project used a pre-and post-intervention design and was guided by the Plan-Do-Study-Act (PDSA) cycle. The intervention implementation was for four months, and the data collection was for a total of five months. Due to the small sample size, a descriptive statistical analysis was used. Results: The control group had 26 participants, and the intervention group had five participants. The average LOS in the control group was 7.2 days, and 3.8 days in the intervention group. The tot

The psychological health and work challenges of nurses working in prisons during the COVID-19 pandemic are understudied. We evaluated the work and wellbeing characteristics of a California prison nurse group, with a comparison to those of a community nurse group. From May to November 2020, an online survey measured psychosocial and organizational work factors, sleep habits, psychological characteristics, COVID-19 impacts, and pre-pandemic recall among 62 prison nurses and 47 community nurses. Prison nurses had significantly longer work hours (54.73 ± 14.52, p < 0.0001), higher pandemic-related work demands, and less sleep hours (5.36 ± 1.30, p < 0.0001) than community nurses. Community nurses had significantly higher pandemic-related fear levels (work infection: p = 0.0115, general: p = 0.0025) and lower perceived personal protective equipment (PPE) supply (p = 0.0103). Between pre-pandemic and pandemic periods, both groups had significantly increased night shift assignments and decreased sleep hours, but the prison group had increased work hours. Although not statistically significant, both groups had high occupational stress and prevalence of post-traumatic stress symptoms. Our results indicate that prison nurses experienced work and wellbeing challenges during the pandemic. Future research and practice ought to address nurses' workload, PPE, and psychological resources in correctional facilities and healthcare organizations.

Hypertension is a key driver of cardiovascular diseases. However, how stressors contribute to the development of hypertension remains unclear. The objective of this study was to examine prospective associations of adverse childhood experiences (ACEs) and adulthood psychosocial disadvantages (APDs) with incident hypertension. Data were from the Mid-life in the United States (MIDUS) study, a national, population-based, prospective cohort study. ACEs were examined via retrospective reports, and APDs including work stress and social isolation were assessed using survey measures. Incident hypertension was defined based on self-reported physician diagnosis. Baseline data were collected in 1995, with follow-up in 2004-2006 and 2013-2014. Cox proportional hazards regression was applied to assess prospective associations of ACEs and APDs with incident hypertension in 2568 workers free from hypertension at baseline. After adjustment for covariates, baseline APDs were associated with increased incident hypertension (aHR and 95% CI = 1.48 [1.09, 2.01]) during a 20-year follow-up, whereas ACEs showed null associations. Moreover, a moderating effect by ACEs was observed-the effect of APDs on risk of hypertension was stronger when ACEs were present (aHR and 95% CI = 1.83 [1.17, 2.86]). These findings underscore the importance of psychosocial stressors as nontraditional risk factors of cardiometabolic disorders.

Background: More than half of women return to the workforce within one year following the birth of their child. To continue offering breast milk to their infants and follow AAP and WHO recommendations for breastfeeding, these women often need to express breast milk in the workplace. Registered Nurses who work in bedside roles do not traditionally have access to private office spaces or personal control over their work schedule, making them uniquely susceptible to workplace barriers for expression of breast milk. Currently, the CDC recommends cleaning a breast pump with soap and water and leaving it to air dry after each use. It is unknown what the current knowledge and adherence levels to these recommendations are within a working population or how knowledge and adherence may affect breastfeeding practice outcomes.Objectives: The study was conducted: 1) To determine relationships between employee perceptions of workplace support for expression of breast milk in the workplace (EBMW) and duration of breastfeeding, duration of EBMW, and other infant feeding practices, 2) To describe knowledge of CDC recommendations for cleaning of a breast pump across Registered Nurse (RN), Nurse Manager (NM), and Hospital Representative (HR) groups, 3) To determine if RN knowledge was associated with RN adherence to CDC recommendations for cleaning of a breast pump, 4) To describe relationships between RN breastfeeding practices and: RN knowledge and adherence, NM knowledge, and HR Knowledge, and 5) To learn about the experiences of working RNs who have expressed breast milk in the workplace and provide recommendations to employers for improving employee lactation experiences. Methods: This was a cross sectional research study. Registered Nurse participants who had given birth within the past three years (n=199), Nurse Managers (n = 36), and Hospital Representatives (n = 6) were recruited from 10 hospitals within the county of Los Angeles. Registered Nurses completed four questionnair

Background: More than half of women return to the workforce within one year following the birth of their child. To continue offering breast milk to their infants and follow AAP and WHO recommendations for breastfeeding, these women often need to express breast milk in the workplace. Registered Nurses who work in bedside roles do not traditionally have access to private office spaces or personal control over their work schedule, making them uniquely susceptible to workplace barriers for expression of breast milk. Currently, the CDC recommends cleaning a breast pump with soap and water and leaving it to air dry after each use. It is unknown what the current knowledge and adherence levels to these recommendations are within a working population or how knowledge and adherence may affect breastfeeding practice outcomes.Objectives: The study was conducted: 1) To determine relationships between employee perceptions of workplace support for expression of breast milk in the workplace (EBMW) and duration of breastfeeding, duration of EBMW, and other infant feeding practices, 2) To describe knowledge of CDC recommendations for cleaning of a breast pump across Registered Nurse (RN), Nurse Manager (NM), and Hospital Representative (HR) groups, 3) To determine if RN knowledge was associated with RN adherence to CDC recommendations for cleaning of a breast pump, 4) To describe relationships between RN breastfeeding practices and: RN knowledge and adherence, NM knowledge, and HR Knowledge, and 5) To learn about the experiences of working RNs who have expressed breast milk in the workplace and provide recommendations to employers for improving employee lactation experiences. Methods: This was a cross sectional research study. Registered Nurse participants who had given birth within the past three years (n=199), Nurse Managers (n = 36), and Hospital Representatives (n = 6) were recruited from 10 hospitals within the county of Los Angeles. Registered Nurses completed four questionnair

Background: Code Stroke Teams in hospitals provide emergency deployment of stroke clinical care experts for treatment of an acute stroke. Code Stroke Teams monitor their effectiveness using standards for stroke patient outcomes provided by the American Heart Association (AHA) and American Stroke Association (ASA) Stroke measures. This project was conducted in a Southern California suburban hospital where changes in leadership and high turnover rates had led to Code Stroke Team members experiencing decreased motivation, job satisfaction and low morale leading to substandard stroke patient outcomes. Aim: This quality improvement project aimed to empower staff, improve performance and stroke outcomes by giving monthly presentations of successful Code Stroke cases to the Stroke Performance Improvement Committee leaders and stroke team staff. Methods: Stroke Performance Improvement Committee leaders and stroke team staff participated monthly in an empowerment intervention through presentation of a stroke case on a “Code Stroke Spotlight” handout (Educational Empowerment Tool) over a 3 month period. Using a repeated measures, pre- post design, staff empowerment (measured by the Psychological Empowerment Instrument) and American Heart Association (AHA) Core Emergency Department Stroke Measures were collected prior to the intervention at baseline and post empowerment intervention following monthly implementation over 3 months.Results: Results showed statistically significant improvement in all items on the Psychological Empowerment (PE) Instrument using Wilcoxon signed-rank test (p<0.05) (N = 32). Door to neuro MD (neurologic expertise consult) <15 minutes showed significant improvement post intervention (z =-2.285, p = 0.023). Door to PT/INR result <45 minutes showed statistical significance (z =-2.931, p = 0.003). Door to CT film <20 minutes showed no change (z=0.000, p = 1.000). For the remaining goals there was improvement in right direction, demonstrating d

Background: Documentation practices in an outpatient migraine clinic describe migraine and headache days (MHD) experienced per month in narrative form within an electronic health record (EHR). Narrative data is time consuming to use in clinic-based research (Meyers et al., 2018). The Model of Improvement’s Plan-Study-Do-Act (PDSA) and the Chronic Care Model (CCM) guided the methodology of this QI project aiming to 1). build a structured field (SF) within an EHR clinical note, and 2). to describe the characteristics of patients who self-record and track their migraine days compared to those who do not. This work includes the first PDSA cycle. Methods: A MHD SF for the EHR clinical note was developed based on the literature review, clinical practice guidelines and informaticists consultation. Migraine clinical patients were recruited and divided into two groups based on whether they kept a record of MHD in a diary or not. Participants completed a questionnaire assessing education level, income, and marital status. A chart review then quantified additional characteristics including age, sex, history of migraine medication use, MHD frequency and severity, age of migraine onset, and zip code. The documented migraine data will be input into the MHD SF once the SF is built. Results: The MHD SF is currently being built. A total of 52 patients have been enrolled for the feasibility portion of the project, 28 tracked MHDs and 24 did not. Migraine characteristics and demographic data were compared between the two groups. There were no statistically significant differences between the groups (p > 0.05) except for the number of preventives tried, which was higher in the documented MHD group (M = 8.89, SD = 5.32) compared to the group that did not keep a diary (M = 5.92, SD = 3.50), p=0.03. Conclusion: The COVID-19 pandemic delayed the construction of the MHD SF. Changes in clinic dynamics and patient access changed with COVID-19 which impacted the original feasibility portion

Background: Code Stroke Teams in hospitals provide emergency deployment of stroke clinical care experts for treatment of an acute stroke. Code Stroke Teams monitor their effectiveness using standards for stroke patient outcomes provided by the American Heart Association (AHA) and American Stroke Association (ASA) Stroke measures. This project was conducted in a Southern California suburban hospital where changes in leadership and high turnover rates had led to Code Stroke Team members experiencing decreased motivation, job satisfaction and low morale leading to substandard stroke patient outcomes. Aim: This quality improvement project aimed to empower staff, improve performance and stroke outcomes by giving monthly presentations of successful Code Stroke cases to the Stroke Performance Improvement Committee leaders and stroke team staff. Methods: Stroke Performance Improvement Committee leaders and stroke team staff participated monthly in an empowerment intervention through presentation of a stroke case on a “Code Stroke Spotlight” handout (Educational Empowerment Tool) over a 3 month period. Using a repeated measures, pre- post design, staff empowerment (measured by the Psychological Empowerment Instrument) and American Heart Association (AHA) Core Emergency Department Stroke Measures were collected prior to the intervention at baseline and post empowerment intervention following monthly implementation over 3 months.Results: Results showed statistically significant improvement in all items on the Psychological Empowerment (PE) Instrument using Wilcoxon signed-rank test (p<0.05) (N = 32). Door to neuro MD (neurologic expertise consult) <15 minutes showed significant improvement post intervention (z =-2.285, p = 0.023). Door to PT/INR result <45 minutes showed statistical significance (z =-2.931, p = 0.003). Door to CT film <20 minutes showed no change (z=0.000, p = 1.000). For the remaining goals there was improvement in right direction, demonstrating d

Background: Documentation practices in an outpatient migraine clinic describe migraine and headache days (MHD) experienced per month in narrative form within an electronic health record (EHR). Narrative data is time consuming to use in clinic-based research (Meyers et al., 2018). The Model of Improvement’s Plan-Study-Do-Act (PDSA) and the Chronic Care Model (CCM) guided the methodology of this QI project aiming to 1). build a structured field (SF) within an EHR clinical note, and 2). to describe the characteristics of patients who self-record and track their migraine days compared to those who do not. This work includes the first PDSA cycle. Methods: A MHD SF for the EHR clinical note was developed based on the literature review, clinical practice guidelines and informaticists consultation. Migraine clinical patients were recruited and divided into two groups based on whether they kept a record of MHD in a diary or not. Participants completed a questionnaire assessing education level, income, and marital status. A chart review then quantified additional characteristics including age, sex, history of migraine medication use, MHD frequency and severity, age of migraine onset, and zip code. The documented migraine data will be input into the MHD SF once the SF is built. Results: The MHD SF is currently being built. A total of 52 patients have been enrolled for the feasibility portion of the project, 28 tracked MHDs and 24 did not. Migraine characteristics and demographic data were compared between the two groups. There were no statistically significant differences between the groups (p > 0.05) except for the number of preventives tried, which was higher in the documented MHD group (M = 8.89, SD = 5.32) compared to the group that did not keep a diary (M = 5.92, SD = 3.50), p=0.03. Conclusion: The COVID-19 pandemic delayed the construction of the MHD SF. Changes in clinic dynamics and patient access changed with COVID-19 which impacted the original feasibility portion

BackgroundHookah smoking is marketed to youth as a harmless alternative to cigarettes. Although cigarette smoking acutely impairs endothelial function, the effect of smoking fruit-flavored hookah tobacco is unknown. Because charcoal traditionally is used to heat the hookah tobacco in the waterpipe, hookah smoke delivers tobacco toxicants and nicotine plus charcoal combustion products: not only carbon-rich nanoparticles, oxidants that may destroy nitric oxide and impair endothelial function, but also large amounts of carbon monoxide (CO), a putative vasodilator molecule.MethodsTo test the acute effect of hookah smoking on endothelial function, in young adult hookah smokers (n=30, age 26±1 years, mean±SE), we measured plasma nicotine, exhaled CO, and brachial artery flow-mediated dilation (FMD) before and after charcoal-heated hookah smoking. To remove the effect of charcoal combustion, the same measurements were performed when the same flavored hookah tobacco product was heated electrically (n=20). As a positive internal control, we studied age-matched cigarette smokers (n=15) who smoked 1 cigarette. To isolate the effect of the CO boost on FMD, hookah smokers (n=8) inhaled a 0.1% CO gas mixture to approximate their CO boost achieved with charcoal-heated hookah smoking.ResultsNicotine levels increased similarly with all types of smoking, whereas exhaled CO increased 9- to 10-fold more after charcoal-heated hookah than after either electrically heated hookah or cigarette smoking. FMD did not decrease after smoking charcoal-heated hookah but instead increased by +43±7% ( P<0.001). In contrast, FMD decreased by -27±4% ( P<0.001) after smoking electrically heated hookah, comparable to the decrease after cigarette smoking. FMD increased markedly by 138±71% ( P<0.001) after breathing CO gas, 2.8 times more than the increase induced in the same subjects after smoking charcoal-heated hookah ( P<0.001), despite comparable increases in exhaled CO (24±1 versus 28±3

Health effects at work from exposures to biological, chemical, physical, mechanical, and psychosocial hazards have often been subjects of company safety programs. Nutrition contributes to health, well-being, and productivity at work. Eating a well-balanced diet allows for the body to process nutrients and to maximize them for optimal energy. Poor dietary habits lead to fatigue, decreased mental ineffectiveness, and decreased the ability to perform the job effectively. Nutrition is a function of dietary behaviors and physiological processes that are influenced by the environment, including the work environment. Effects of work on dietary behaviors have been studied in a limited number of occupations, for example, professional drivers and airport personnel. Each individual industry deals with its work environment having different food options that can influence eating behaviors. Characteristics of work such as shift work, have also been studied and shown to influence the attainment of nutritional goals. A cross-sectional, descriptive, pilot study was conducted to explore work in relation to patterns of eating and nutritional intake. The aim was to explore work characteristics (hours worked, work setting and job category) in relationship to when, where, and with whom workers ate and to determine whether this was associated with nutritional guideline targets. It was hypothesized that work characteristics would be associated with when, where, and with whom workers ate, and this would influence the attainment of nutritional guideline targets. The goal was to gather information that could provide guidance to employers about work characteristics that facilitate nutritional adequacy and also guide nutrition education for workers to equip them to achieve healthy nutrition. This explorative, descriptive, pilot study utilized a research data set obtained from 51 healthy, employed men. Work characteristics (hours worked per week, work setting, and the North American Industry Cla

More than 500 unreclaimed mines and associated waste sites exist on the Navajo Nation reservation as a result of uranium (U) mining from the 1940s through the 1980s. For this study, the impact of U-mine waste on a common, locally grown crop food was examined. The goal of this site-specific study was to determine metal(loid) concentration levels of arsenic (As), cadmium (Cd), cesium (Cs), molybdenum (Mo), lead (Pb), thorium (Th), U, vanadium (V) and selenium (Se) in Cucurbita pepo Linnaeus (squash), irrigation water, and soil using inductively coupled plasma-mass spectrometry. The concentrations of metal(loid)s were greatest in roots > leaves > edible fruit (p < 0.05), respectively. There were significant differences between metal(loid)s in squash crop plot usage (<5 years versus >30 years) for V (p = 0.001), As (p < 0.001), U (p = 0.002), Cs (p = 0.012), Th (p = 0.040), Mo (p = 0.047), and Cd (p = 0.042). Lead and Cd crop irrigation water concentrations exceeded the United States Environmental Protection Agency (USEPA) Maximum Contaminant Levels for drinking water for those metals. Edible squash concentration levels were 0.116 mg/kg of As, 0.248 mg/kg of Pb, 0.020 mg/kg of Cd, and 0.006 mg/kg of U. Calculated human ingestion of edible squash did not exceed Provisional Tolerable Weekly Intake or Tolerable Upper Limit levels from intake based solely on squash consumption. There does not appear to be a food-ingestion risk from metal(loid)s solely from consumption of squash. Safer access and emphasis on consuming regulated water was highlighted. Food intake recommendations were provided. Continued monitoring, surveillance, and further research are recommended.

In the United States, whole body vibration (WBV) affects approximately 6 million workers who regularly operate trucks, buses, heavy equipment, forklifts, planes, helicopters, small marine craft, high-speed crafts, and ships. Continuous exposure to excessive levels of vibration can cause irreversible damage to the human body. Prolonged exposure to whole body vibration has been linked to various adverse health outcomes including physiological effects, musculoskeletal disorders, as well as diseases of the nervous, digestive, and circulatory systems (Byeon et al., 2013). There is a high prevalence of back pain among aircrew in the MH-60S community that can potentially jeopardize operational readiness and safety in the military. Questionnaire data for 884 aircrew personnel sitting on the left and right gunner seats of the MH-60S helicopter were collected from 11 September 2017 to 11 September 2018. 854 of the 884 aircrew (96.6%) responded that they experienced back pain. The average pain reported by aircrew personnel experiencing pain on a scale from 0 to 9 was 4.79 with a standard deviation of 1.84. Vibration data collected, using tri-axial seat pad accelerometers, showed that 89% of the flying events that were evaluated exceeded the American Conference of Governmental Industrial Hygienist (ACGIH) action level, defined as half of the threshold limit value, with 22% of the events exceeding the threshold limit value. The threshold limit value is the maximum level to which a healthy worker can be exposed day after day for a working lifetime without adverse effects.Per the ISO 2631-1 standard, since each of the flying events had crest values greater than nine, the vibration dose value was calculated for this study. After calculating the vibration dose value for each of the flying events it was found that all 18 (100%) of the flying events exceeded the action limit and of those 44% of the flying events exceeded the limit value. Aircrew sitting in the current gunner seats hav

In the United States, whole body vibration (WBV) affects approximately 6 million workers who regularly operate trucks, buses, heavy equipment, forklifts, planes, helicopters, small marine craft, high-speed crafts, and ships. Continuous exposure to excessive levels of vibration can cause irreversible damage to the human body. Prolonged exposure to whole body vibration has been linked to various adverse health outcomes including physiological effects, musculoskeletal disorders, as well as diseases of the nervous, digestive, and circulatory systems (Byeon et al., 2013). There is a high prevalence of back pain among aircrew in the MH-60S community that can potentially jeopardize operational readiness and safety in the military. Questionnaire data for 884 aircrew personnel sitting on the left and right gunner seats of the MH-60S helicopter were collected from 11 September 2017 to 11 September 2018. 854 of the 884 aircrew (96.6%) responded that they experienced back pain. The average pain reported by aircrew personnel experiencing pain on a scale from 0 to 9 was 4.79 with a standard deviation of 1.84. Vibration data collected, using tri-axial seat pad accelerometers, showed that 89% of the flying events that were evaluated exceeded the American Conference of Governmental Industrial Hygienist (ACGIH) action level, defined as half of the threshold limit value, with 22% of the events exceeding the threshold limit value. The threshold limit value is the maximum level to which a healthy worker can be exposed day after day for a working lifetime without adverse effects.Per the ISO 2631-1 standard, since each of the flying events had crest values greater than nine, the vibration dose value was calculated for this study. After calculating the vibration dose value for each of the flying events it was found that all 18 (100%) of the flying events exceeded the action limit and of those 44% of the flying events exceeded the limit value. Aircrew sitting in the current gunner seats hav

BackgroundHookah smoking is marketed to youth as a harmless alternative to cigarettes. Although cigarette smoking acutely impairs endothelial function, the effect of smoking fruit-flavored hookah tobacco is unknown. Because charcoal traditionally is used to heat the hookah tobacco in the waterpipe, hookah smoke delivers tobacco toxicants and nicotine plus charcoal combustion products: not only carbon-rich nanoparticles, oxidants that may destroy nitric oxide and impair endothelial function, but also large amounts of carbon monoxide (CO), a putative vasodilator molecule.MethodsTo test the acute effect of hookah smoking on endothelial function, in young adult hookah smokers (n=30, age 26±1 years, mean±SE), we measured plasma nicotine, exhaled CO, and brachial artery flow-mediated dilation (FMD) before and after charcoal-heated hookah smoking. To remove the effect of charcoal combustion, the same measurements were performed when the same flavored hookah tobacco product was heated electrically (n=20). As a positive internal control, we studied age-matched cigarette smokers (n=15) who smoked 1 cigarette. To isolate the effect of the CO boost on FMD, hookah smokers (n=8) inhaled a 0.1% CO gas mixture to approximate their CO boost achieved with charcoal-heated hookah smoking.ResultsNicotine levels increased similarly with all types of smoking, whereas exhaled CO increased 9- to 10-fold more after charcoal-heated hookah than after either electrically heated hookah or cigarette smoking. FMD did not decrease after smoking charcoal-heated hookah but instead increased by +43±7% ( P<0.001). In contrast, FMD decreased by -27±4% ( P<0.001) after smoking electrically heated hookah, comparable to the decrease after cigarette smoking. FMD increased markedly by 138±71% ( P<0.001) after breathing CO gas, 2.8 times more than the increase induced in the same subjects after smoking charcoal-heated hookah ( P<0.001), despite comparable increases in exhaled CO (24±1 versus 28±3

Health effects at work from exposures to biological, chemical, physical, mechanical, and psychosocial hazards have often been subjects of company safety programs. Nutrition contributes to health, well-being, and productivity at work. Eating a well-balanced diet allows for the body to process nutrients and to maximize them for optimal energy. Poor dietary habits lead to fatigue, decreased mental ineffectiveness, and decreased the ability to perform the job effectively. Nutrition is a function of dietary behaviors and physiological processes that are influenced by the environment, including the work environment. Effects of work on dietary behaviors have been studied in a limited number of occupations, for example, professional drivers and airport personnel. Each individual industry deals with its work environment having different food options that can influence eating behaviors. Characteristics of work such as shift work, have also been studied and shown to influence the attainment of nutritional goals. A cross-sectional, descriptive, pilot study was conducted to explore work in relation to patterns of eating and nutritional intake. The aim was to explore work characteristics (hours worked, work setting and job category) in relationship to when, where, and with whom workers ate and to determine whether this was associated with nutritional guideline targets. It was hypothesized that work characteristics would be associated with when, where, and with whom workers ate, and this would influence the attainment of nutritional guideline targets. The goal was to gather information that could provide guidance to employers about work characteristics that facilitate nutritional adequacy and also guide nutrition education for workers to equip them to achieve healthy nutrition. This explorative, descriptive, pilot study utilized a research data set obtained from 51 healthy, employed men. Work characteristics (hours worked per week, work setting, and the North American Industry Cla

More than 500 unreclaimed mines and associated waste sites exist on the Navajo Nation reservation as a result of uranium (U) mining from the 1940s through the 1980s. For this study, the impact of U-mine waste on a common, locally grown crop food was examined. The goal of this site-specific study was to determine metal(loid) concentration levels of arsenic (As), cadmium (Cd), cesium (Cs), molybdenum (Mo), lead (Pb), thorium (Th), U, vanadium (V) and selenium (Se) in Cucurbita pepo Linnaeus (squash), irrigation water, and soil using inductively coupled plasma-mass spectrometry. The concentrations of metal(loid)s were greatest in roots > leaves > edible fruit (p < 0.05), respectively. There were significant differences between metal(loid)s in squash crop plot usage (<5 years versus >30 years) for V (p = 0.001), As (p < 0.001), U (p = 0.002), Cs (p = 0.012), Th (p = 0.040), Mo (p = 0.047), and Cd (p = 0.042). Lead and Cd crop irrigation water concentrations exceeded the United States Environmental Protection Agency (USEPA) Maximum Contaminant Levels for drinking water for those metals. Edible squash concentration levels were 0.116 mg/kg of As, 0.248 mg/kg of Pb, 0.020 mg/kg of Cd, and 0.006 mg/kg of U. Calculated human ingestion of edible squash did not exceed Provisional Tolerable Weekly Intake or Tolerable Upper Limit levels from intake based solely on squash consumption. There does not appear to be a food-ingestion risk from metal(loid)s solely from consumption of squash. Safer access and emphasis on consuming regulated water was highlighted. Food intake recommendations were provided. Continued monitoring, surveillance, and further research are recommended.

Background: Spontaneous preterm delivery (sPTD) is associated with a twofold increased risk of future maternal cardiovascular disease. We hypothesized that women with sPTD would demonstrate greater vascular dysfunction postpartum compared to women with term delivery. Materials and Methods: In a case-controlled, matched pilot study, we enrolled 20 women with sPTD (gestation ≤34 weeks), and 20 term control women (gestation ≥39 weeks) were matched for age (±5 years), parity, ethnicity, and route of delivery. Vascular function, serum lipids, C-reactive protein, and interleukin-6 were completed within 24-72 hours postpartum. Statistical analysis included paired t-tests based on match and mixed effects linear regression models and adjusted for potential confounders. Results: The mean age for sPTD and term controls was 33 ± 6 years and 32 ± 6 years, respectively. Women with sPTD had significantly lower augmentation index-75 (24.1% ± 16.1% vs. 39.9% ± 15.2%, p = 0.001) and central pulse pressure (29.1 ± 5.4 mmHg vs. 34.6 ± 4.7 mmHg, p = 0.004), but no difference in pulse wave velocity (5.1 ± 1.6 m/s vs. 5.6 ± 1.5 m/s, p = 0.12) compared to controls. Women with sPTD had significantly lower high-density lipoprotein cholesterol (59.4 ± 12.5 mg/dL vs. 67.6 ± 13.1 mg/dL, p = 0.035) compared to controls. Analysis of chorioamnionitis and magnesium sulfate did not alter the results. Conclusions: Women with sPTD have signs of lower smooth muscle tone in the early postpartum period compared to women with term delivery. Further research is required to understand mechanistic pathways in sPTD and future maternal cardiovascular disease risk.

Objective. Work provides personal satisfaction, meaningfulness, and financial stability to adolescent and young adult (AYA) cancer survivors. However, progressive health changes because of cancer and its treatments, may compromise safety and diminish ability to work. Workplace regulations and processes also influence productivity and employment sustainability for AYA cancer survivors. This dissertation explored interactions, and factors influencing interactions, among employed AYA cancer survivors, five years or more after treatment, and occupational and environmental health professionals (OEHPs) within the workplace. Methods. Data were collected and analyzed using constructivist grounded theory. Individual interviews generated data from twelve AYA cancer survivors (age 15-39 at diagnosis). The sample of AYA cancer survivors (n = 12) was obtained from the California Surveillance Program in Los Angeles. During interviews, AYA cancer survivors identified OEHPs they encountered in the workplace. Then, twelve OEHPs were interviewed based upon the specified professional categories. Qualitative analysis developed theoretical frameworks based upon the narratives of the participants.Results. Data revealed the complexity of employment issues surrounding AYA cancer survivors during a career. Disclosure of a cancer survivor identity was central to the frameworks. Four processes were identified: Weighing the risks of revealing the survivor-self, sustaining work ability, weighing advocacy, and accessing or providing support. Additionally, employment challenges were organized into themes: Evading the cancer card, working around limitations, and powering-through for AYA survivors. On the other side of legal protection, OEHPs were becoming agents of change by discovering AYA cancer survivors, navigating systems to provide support, and identifying changes needed.Conclusion. This dissertation illuminated the unique experiences of AYA cancer survivors and OEHPs in the workplace. Avail

Despite the improvements in safety since the advent of Process Safety Management regulations in 1992, human factors still play a large role in catastrophic accidents. Worker fatigue is a significant risk in the petroleum industry, where rotating shiftwork is relied upon to staff round the clock production. Using reports of work organization factors that contributed to fatigue from the listening sessions hosted by the California Interagency Taskforce on Refinery Safety in 2013, we developed a survey for rotating shiftworkers in the refining industry. We administered the survey among hourly shift workers in the oil sector represented by the United Steelworkers union. Collecting self-reported data on sleep, mental health, job stress, quality of life, and certain health outcomes associated with shift work, we explored associations between these outcomes and participants’ work history, current work schedules and staffing allocations. Our findings revealed that the 12-hour shift, initially intended as a compressed work week, currently provides limited recovery when rest breaks are interrupted with one or more overtime shifts per week. Sleep durations were also shortest on the 12-hour shift, and averaged more than an hour shorter than previous research on 8-hour rotating shift workers. Recent work schedules reported tended to comply with the American Petroleum Institute’s (API) recommended hours of service guidelines, but despite this, more than one half of our study participants reported having trouble staying awake during engaged activities (24% monthly and 27% weekly or more), and sleep disorder prevalence approached 80% in the study population. Those who exceeded the API hours of service guidelines reported greater job demands, shorter sleep durations, and more frequent drowsiness, indicating that they were at greatest risk for fatigue. Mandatory overtime was a stressor, associated with higher job stress, lower staffing coverage, and anxiety (but not additional hours w

Objective. Work provides personal satisfaction, meaningfulness, and financial stability to adolescent and young adult (AYA) cancer survivors. However, progressive health changes because of cancer and its treatments, may compromise safety and diminish ability to work. Workplace regulations and processes also influence productivity and employment sustainability for AYA cancer survivors. This dissertation explored interactions, and factors influencing interactions, among employed AYA cancer survivors, five years or more after treatment, and occupational and environmental health professionals (OEHPs) within the workplace. Methods. Data were collected and analyzed using constructivist grounded theory. Individual interviews generated data from twelve AYA cancer survivors (age 15-39 at diagnosis). The sample of AYA cancer survivors (n = 12) was obtained from the California Surveillance Program in Los Angeles. During interviews, AYA cancer survivors identified OEHPs they encountered in the workplace. Then, twelve OEHPs were interviewed based upon the specified professional categories. Qualitative analysis developed theoretical frameworks based upon the narratives of the participants.Results. Data revealed the complexity of employment issues surrounding AYA cancer survivors during a career. Disclosure of a cancer survivor identity was central to the frameworks. Four processes were identified: Weighing the risks of revealing the survivor-self, sustaining work ability, weighing advocacy, and accessing or providing support. Additionally, employment challenges were organized into themes: Evading the cancer card, working around limitations, and powering-through for AYA survivors. On the other side of legal protection, OEHPs were becoming agents of change by discovering AYA cancer survivors, navigating systems to provide support, and identifying changes needed.Conclusion. This dissertation illuminated the unique experiences of AYA cancer survivors and OEHPs in the workplace. Avail

Despite the improvements in safety since the advent of Process Safety Management regulations in 1992, human factors still play a large role in catastrophic accidents. Worker fatigue is a significant risk in the petroleum industry, where rotating shiftwork is relied upon to staff round the clock production. Using reports of work organization factors that contributed to fatigue from the listening sessions hosted by the California Interagency Taskforce on Refinery Safety in 2013, we developed a survey for rotating shiftworkers in the refining industry. We administered the survey among hourly shift workers in the oil sector represented by the United Steelworkers union. Collecting self-reported data on sleep, mental health, job stress, quality of life, and certain health outcomes associated with shift work, we explored associations between these outcomes and participants’ work history, current work schedules and staffing allocations. Our findings revealed that the 12-hour shift, initially intended as a compressed work week, currently provides limited recovery when rest breaks are interrupted with one or more overtime shifts per week. Sleep durations were also shortest on the 12-hour shift, and averaged more than an hour shorter than previous research on 8-hour rotating shift workers. Recent work schedules reported tended to comply with the American Petroleum Institute’s (API) recommended hours of service guidelines, but despite this, more than one half of our study participants reported having trouble staying awake during engaged activities (24% monthly and 27% weekly or more), and sleep disorder prevalence approached 80% in the study population. Those who exceeded the API hours of service guidelines reported greater job demands, shorter sleep durations, and more frequent drowsiness, indicating that they were at greatest risk for fatigue. Mandatory overtime was a stressor, associated with higher job stress, lower staffing coverage, and anxiety (but not additional hours w

The objective of this study was to determine uranium (U) and other heavy metal (HM) concentrations (As, Cd, Pb, Mo, and Se) in tissue samples collected from sheep (Ovis aries), the primary meat staple on the Navajo reservation in northwestern New Mexico. The study setting was a prime target of U mining, where more than 1100 unreclaimed abandoned U mines and structures remain. The forage and water sources for the sheep in this study were located within 3.2 km of abandoned U mines and structures. Tissue samples from sheep (n = 3), their local forage grasses (n = 24), soil (n = 24), and drinking water (n = 14) sources were collected. The samples were analyzed using Inductively Coupled Plasma-Mass Spectrometry. Results: In general, HMs concentrated more in the roots of forage compared to the above ground parts. The sheep forage samples fell below the National Research Council maximum tolerable concentration (5 mg/kg). The bioaccumulation factor ratio was >1 in several forage samples, ranging from 1.12 to 16.86 for Mo, Cd, and Se. The study findings showed that the concentrations of HMs were greatest in the liver and kidneys. Of the calculated human intake, Se Reference Dietary Intake and Mo Recommended Dietary Allowance were exceeded, but the tolerable upper limits for both were not exceeded. Food intake recommendations informed by research are needed for individuals especially those that may be more sensitive to HMs. Further study with larger sample sizes is needed to explore other impacted communities across the reservation.

ContextSixty-three percent of cancer survivors continue to work, or return to work after treatment. Among this population, work ability and challenges encountered in the workplace by young adult cancer survivors have not been well established.PurposeThe purposes of the study are to describe what is currently known about work-related issues for young adult cancer survivors diagnosed between ages 15 and 39, to identify gaps in the research literature, and to suggest interventions or improvements in work processes and occupational settings.MethodsA narrative review of articles using PubMed, CINAHL, and PsychInfo was conducted without date limitations. Search phrases included young adult cancer survivors, long-term cancer survivors, young adults affected by cancer, further combined with key terms employment, work, and occupationally active. Inclusion criteria for publications were young adult cancer survivors initially diagnosed between the ages of 15 and 39, data about work or employment was presented, and articles written in English.ResultsTwenty-three publications met the inclusion criteria. Work-related issues included the potential for reduced work productivity from cancer-changed physical and cognitive functional ability that affected income, and resulted in distress. Coping style, support systems, and changing perspectives about work and life in general were also influential on career decisions among young adult cancer survivors.ConclusionsMore research is needed to study interventions to better manage health changes in young adult cancer survivors within the context of the workplace. Since financial hardship has been shown to be especially high among young cancer survivors, employment is essential to ensure payment of cancer-associated costs and continued medical care.Implications for cancer survivorsWhile young adult cancer survivors may initially grapple with cancer-related physical and psychosocial changes that impact work productivity or influence choice of

The objective of this study was to determine uranium (U) and other heavy metal (HM) concentrations (As, Cd, Pb, Mo, and Se) in tissue samples collected from sheep (Ovis aries), the primary meat staple on the Navajo reservation in northwestern New Mexico. The study setting was a prime target of U mining, where more than 1100 unreclaimed abandoned U mines and structures remain. The forage and water sources for the sheep in this study were located within 3.2 km of abandoned U mines and structures. Tissue samples from sheep (n = 3), their local forage grasses (n = 24), soil (n = 24), and drinking water (n = 14) sources were collected. The samples were analyzed using Inductively Coupled Plasma-Mass Spectrometry. Results: In general, HMs concentrated more in the roots of forage compared to the above ground parts. The sheep forage samples fell below the National Research Council maximum tolerable concentration (5 mg/kg). The bioaccumulation factor ratio was >1 in several forage samples, ranging from 1.12 to 16.86 for Mo, Cd, and Se. The study findings showed that the concentrations of HMs were greatest in the liver and kidneys. Of the calculated human intake, Se Reference Dietary Intake and Mo Recommended Dietary Allowance were exceeded, but the tolerable upper limits for both were not exceeded. Food intake recommendations informed by research are needed for individuals especially those that may be more sensitive to HMs. Further study with larger sample sizes is needed to explore other impacted communities across the reservation.

ContextSixty-three percent of cancer survivors continue to work, or return to work after treatment. Among this population, work ability and challenges encountered in the workplace by young adult cancer survivors have not been well established.PurposeThe purposes of the study are to describe what is currently known about work-related issues for young adult cancer survivors diagnosed between ages 15 and 39, to identify gaps in the research literature, and to suggest interventions or improvements in work processes and occupational settings.MethodsA narrative review of articles using PubMed, CINAHL, and PsychInfo was conducted without date limitations. Search phrases included young adult cancer survivors, long-term cancer survivors, young adults affected by cancer, further combined with key terms employment, work, and occupationally active. Inclusion criteria for publications were young adult cancer survivors initially diagnosed between the ages of 15 and 39, data about work or employment was presented, and articles written in English.ResultsTwenty-three publications met the inclusion criteria. Work-related issues included the potential for reduced work productivity from cancer-changed physical and cognitive functional ability that affected income, and resulted in distress. Coping style, support systems, and changing perspectives about work and life in general were also influential on career decisions among young adult cancer survivors.ConclusionsMore research is needed to study interventions to better manage health changes in young adult cancer survivors within the context of the workplace. Since financial hardship has been shown to be especially high among young cancer survivors, employment is essential to ensure payment of cancer-associated costs and continued medical care.Implications for cancer survivorsWhile young adult cancer survivors may initially grapple with cancer-related physical and psychosocial changes that impact work productivity or influence choice of

Objective: Monosodium glutamate (MSG) is a widely used food additive with controversial side effects. Though neonatal administration of MSG has been shown to affect fertility via arcuate nucleus ablation, the body of work involving the effects of adult MSG administration on male rat fertility has yet to be collectively assessed.Design: Systematic review.Methods: A PubMed search using terms “monosodium glutamate” in addition to “male fertility” or “male reproduction” or “sperm” or “testes” was performed. Inclusion criteria included: English language, adult administration of MSG, male reproductive outcomes, and control groups. Additional studies were identified via reference lists of relevant articles.Results: Of 167 records originally identified, six studies remained after removal of duplicates and studies not meeting inclusion criteria. Data ranges included: cohort sizes of 24 – 32 animals, dosing from 0 to 4 g/kg, MSG administration duration of 10 – 56 days, and weight 75 – 200g. In MSG fed rats compared to controls: Sperm count was lower in three of four studies, serum testosterone concentration was lower in two of two studies, testicular component weights or size was decreased in two of three studies, and abnormal testicular and sperm histology was observed in five of six studies.Conclusion: Adult intake of MSG can negatively impact sperm count and serum testosterone concentrations as well as testicular morphology and histology in rats. Further investigation of this effect should be evaluated in humans for such a popular flavor enhancer.

Objective: Monosodium glutamate (MSG) is a widely used food additive with controversial side effects. Though neonatal administration of MSG has been shown to affect fertility via arcuate nucleus ablation, the body of work involving the effects of adult MSG administration on male rat fertility has yet to be collectively assessed.Design: Systematic review.Methods: A PubMed search using terms “monosodium glutamate” in addition to “male fertility” or “male reproduction” or “sperm” or “testes” was performed. Inclusion criteria included: English language, adult administration of MSG, male reproductive outcomes, and control groups. Additional studies were identified via reference lists of relevant articles.Results: Of 167 records originally identified, six studies remained after removal of duplicates and studies not meeting inclusion criteria. Data ranges included: cohort sizes of 24 – 32 animals, dosing from 0 to 4 g/kg, MSG administration duration of 10 – 56 days, and weight 75 – 200g. In MSG fed rats compared to controls: Sperm count was lower in three of four studies, serum testosterone concentration was lower in two of two studies, testicular component weights or size was decreased in two of three studies, and abnormal testicular and sperm histology was observed in five of six studies.Conclusion: Adult intake of MSG can negatively impact sperm count and serum testosterone concentrations as well as testicular morphology and histology in rats. Further investigation of this effect should be evaluated in humans for such a popular flavor enhancer.

Hexachlorobenzene (HCB) is a persistent environmental fungicide that may disrupt androgen regulation. The aim of this study was to investigate associations between HCB levels and biomarkers of male reproductive function. 589 Spouses of pregnant women from Greenland, Poland and Ukraine were enrolled between 2002 and 2004. The men provided semen and blood samples and were interviewed. HCB was measured in serum by gas chromatography. The mean serum concentrations of HCB were higher in Ukraine (182.3ng/g lipid) and Greenland (79.0ng/g lipid) compared to Poland (14.2ng/g lipid). Sex hormone binding globulin (SHBG) and free androgen index (FAI) were associated with HCB in men from Ukraine and Poland. This study spanning large differences in environmental HCB exposure levels shows a positive association for SHBG and negative association for FAI with high serum levels of HCB in fertile men, but without major consequences for semen quality and the Inuit study population.

The broad, long-term objective of this study is to identify the extent and impact of uranium (U) and other heavy metal (As, Cd, Cs, Pb, Mo, Se, Th, and V) contamination on harvested Ovis aries (sheep) and plants on the Dine (formerly known as Navajo) reservation. This study provides a food chain assessment of U exposure in an American Indian (AI) reservation in northwestern New Mexico. The study setting was a prime target of U mining for military purposes from 1945 to 1988. More than 1,100 unreclaimed abandoned U mines and structures remain. These abandoned U mines, structures, and tailings contaminate the land and vegetation that humans and livestock use for subsistence. The specific aims of the study are to: (1) describe the dietary behavior in Dine residents who grow and harvest their own food specifically related to ingestion of locally harvested O. aries and plants; (2) compare heavy metal levels in locally harvested sheep and plants in areas suspected to have high levels of environmental contamination and low environmental levels of contamination; (3) explore potential routes of heavy metal exposure for locally harvested plants and O. aries; and (4) formulate a plan to disseminate study findings to the leadership and community on the Dine reservation. This is a comparison study examining contamination levels in locally harvested animals and plants across reservation areas suspected to have high levels of environmental contamination and low levels of contamination. The DiNEH (Dine Network for Environmental Health) cohort (N=1,304) served as one of the sources from which growers and harvesters were identified who provided samples for the current research. Of the DiNEH cohort respondents, those individuals who reported positively to questionnaire items about harvesting sheep (n=280) and crops (n=180) locally were eligible for the present study. A goal was to compare current results to existing DiNEH data or background levels. New participants were recruited by va

The broad, long-term objective of this study is to identify the extent and impact of uranium (U) and other heavy metal (As, Cd, Cs, Pb, Mo, Se, Th, and V) contamination on harvested Ovis aries (sheep) and plants on the Dine (formerly known as Navajo) reservation. This study provides a food chain assessment of U exposure in an American Indian (AI) reservation in northwestern New Mexico. The study setting was a prime target of U mining for military purposes from 1945 to 1988. More than 1,100 unreclaimed abandoned U mines and structures remain. These abandoned U mines, structures, and tailings contaminate the land and vegetation that humans and livestock use for subsistence. The specific aims of the study are to: (1) describe the dietary behavior in Dine residents who grow and harvest their own food specifically related to ingestion of locally harvested O. aries and plants; (2) compare heavy metal levels in locally harvested sheep and plants in areas suspected to have high levels of environmental contamination and low environmental levels of contamination; (3) explore potential routes of heavy metal exposure for locally harvested plants and O. aries; and (4) formulate a plan to disseminate study findings to the leadership and community on the Dine reservation. This is a comparison study examining contamination levels in locally harvested animals and plants across reservation areas suspected to have high levels of environmental contamination and low levels of contamination. The DiNEH (Dine Network for Environmental Health) cohort (N=1,304) served as one of the sources from which growers and harvesters were identified who provided samples for the current research. Of the DiNEH cohort respondents, those individuals who reported positively to questionnaire items about harvesting sheep (n=280) and crops (n=180) locally were eligible for the present study. A goal was to compare current results to existing DiNEH data or background levels. New participants were recruited by va

Although the possibility of sexual transmission of the hepatitis C virus (HCV) remains controversial, little is known of the associations ofpositive semen specimens with potential demographic and behavioral risk factors. Knowledge of these predictors may suggest factors that increase risk of HCV RNA in the semen. Semen and bloodfrom 80 HCV-infected homeless men were evaluatedfor the presence of HCVRNA by means of branch DNA and transcription-mediated amplification analyses. Associations of selected demographic and behavioral characteristics of the participants with presence or absence of HCV in their semen were also assessed. HCV RNA was detected in the semen of 36% of the sample. Associations were found with HCV RNA in semen and older age, higher viral loads of HCV in blood, current alcohol and lifetime methamphetamine use, and having been vaccinated for the hepatitis B virus. Findings suggest that sexual transmission of HCV is plausible and shed light on the need to conduct more in-depth investigations.

ObjectiveTo describe the prevalence of hepatitis C virus (HCV) infection in a sample of homeless and impoverished adults and examine risk factors for HCV infection in the overall sample and as a function of injection drug use.DesignAssays were conducted on stored sera. Sociodemographic characteristics and risky sexual activity were measured by content-specific items. Substance use was measured by a structured questionnaire. HCV antibodies were tested by enzyme-linked immunosorbent assay; a confirmatory level was defined by recombinant immunoblot assay.SettingsShelters ( N = 36) and outdoor locations in Los Angeles.ParticipantsEight hundred eighty-four homeless women and/or partners or friends.ResultsAmong this sample of 884 homeless and impoverished adults, 22% were found to be HCV infected. Lifetime injection drug users (IDUs) (cocaine, crack, and methamphetamine) and recent daily users of crack were more likely than nonusers or less-frequent users of these drugs to be HCV-infected. Similar results were found for those who had been hospitalized for a mental health problem. Among non-injection drug users and persons in the total sample, those who reported lifetime alcohol abuse were more likely than those who did not to be HCV infected. Controlling for sociodemographic characteristics, multiple logistic regression analyses revealed IDUs have over 25 times greater odds of having HCV infection than non-IDUs. HCV infection was also predicted by older age, having started living on one's own before the age of 18, and recent chronic alcohol use. Males and recent crack users had about one and a half times greater odds of HCV infection when compared to females and non-chronic crack users.ConclusionsTargeted outreach for homeless women and their partners, including HCV testing coupled with referrals to HCV and substance abuse treatments, may be helpful.

Although the possibility of sexual transmission of the hepatitis C virus (HCV) remains controversial, little is known of the associations ofpositive semen specimens with potential demographic and behavioral risk factors. Knowledge of these predictors may suggest factors that increase risk of HCV RNA in the semen. Semen and bloodfrom 80 HCV-infected homeless men were evaluatedfor the presence of HCVRNA by means of branch DNA and transcription-mediated amplification analyses. Associations of selected demographic and behavioral characteristics of the participants with presence or absence of HCV in their semen were also assessed. HCV RNA was detected in the semen of 36% of the sample. Associations were found with HCV RNA in semen and older age, higher viral loads of HCV in blood, current alcohol and lifetime methamphetamine use, and having been vaccinated for the hepatitis B virus. Findings suggest that sexual transmission of HCV is plausible and shed light on the need to conduct more in-depth investigations.

ObjectiveTo describe the prevalence of hepatitis C virus (HCV) infection in a sample of homeless and impoverished adults and examine risk factors for HCV infection in the overall sample and as a function of injection drug use.DesignAssays were conducted on stored sera. Sociodemographic characteristics and risky sexual activity were measured by content-specific items. Substance use was measured by a structured questionnaire. HCV antibodies were tested by enzyme-linked immunosorbent assay; a confirmatory level was defined by recombinant immunoblot assay.SettingsShelters ( N = 36) and outdoor locations in Los Angeles.ParticipantsEight hundred eighty-four homeless women and/or partners or friends.ResultsAmong this sample of 884 homeless and impoverished adults, 22% were found to be HCV infected. Lifetime injection drug users (IDUs) (cocaine, crack, and methamphetamine) and recent daily users of crack were more likely than nonusers or less-frequent users of these drugs to be HCV-infected. Similar results were found for those who had been hospitalized for a mental health problem. Among non-injection drug users and persons in the total sample, those who reported lifetime alcohol abuse were more likely than those who did not to be HCV infected. Controlling for sociodemographic characteristics, multiple logistic regression analyses revealed IDUs have over 25 times greater odds of having HCV infection than non-IDUs. HCV infection was also predicted by older age, having started living on one's own before the age of 18, and recent chronic alcohol use. Males and recent crack users had about one and a half times greater odds of HCV infection when compared to females and non-chronic crack users.ConclusionsTargeted outreach for homeless women and their partners, including HCV testing coupled with referrals to HCV and substance abuse treatments, may be helpful.