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Objective To identify latent components from among 13 work and non-work stressors and to examine whether the accumulation of stress factors within these components was associated with sleep problems. Methods A cohort of older employees (n = 2771 individuals, n = 3921 person-observations) responded to at least two surveys. Principal Component Analysis (PCA) was used to identify latent components. Analysis of variance was used to examine their associations with sleep. Results The components were: 'Physical workload and shift work', 'Psychosocial workload', 'Social and environmental non-work adversity' and 'Life event- and health-related non-work adversity'. They were consistently associated with sleep problems, except for 'Physical workload and shift work'. 'Social and environmental non-work adversity' was associated with sleep problems at follow-up. Conclusions Clusters of work- and non-work-related stressors were identified, and their accumulation was associated with sleep problems among older employees.

Objective To predict the future incidence trend of pneumoconiosis in China, and to evaluate three predictive models. Methods We selected pneumoconiosis cases (2000-2019) to fit Generalized Additive Model (GAM), Curve Fitting Method, and GM (1,1) Model, chosen average fitting relative error, relative error of prediction, and coefficient of determination to evaluate models. Results Chinese incidence trend of pneumoconiosis would decrease in the future. Predicted value of GAM (14,566) and Curve Fitting Method (15,781) in 2019 was close to the actual value (15,898). Relative error of prediction of GAM and Curve Fitting Method was -8.38% and -0.73%, respectively. Conclusions The government needs to strengthen prevention and control since pneumoconiosis cases might remain huge in the future. Besides, we advise that GAM and Curve Fitting Method can be used to predict Chinese incidence trend of pneumoconiosis.

Objective Investigating the relationship between exposure to chemical and biological agents at work and the occurrence of cardiovascular diseases in a Brazilian national health survey. Methods A cross-sectional study using the database of 36.442 participants from the Brazilian National Health Survey. Logistic Regression analysis was performed for multivariable models. Results After adjustments for key confounders, we observed that those individuals exposed to chemical agents and biological materials at work had 62% (95% CI: 1.20; 2.20) and 66% (95% CI: 1.03; 2.65), respectively, higher odds of having cardiovascular disease compared to employed individuals who did not report exposure to biological materials/chemical agents at work. Conclusion This study draws attention to the role of chemical and biological risks in the occurrence of cardiovascular diseases. In this sense, it is necessary developing systematic and intersectoral actions for Workers' Health Surveillance to promote health and prevent chronic non-communicable diseases.

Objectives: Clinical case complexity is an inherent factor in occupational health (OH), yet it is poorly defined and understood. Our aim was to identify the multiple sources of complexity in OH and propose a conceptual complexity framework model for clinical OH practice. Methods: Through a scoping review, expert panel consensus, and content analysis of OH clinical case reports, we identified relevant complexity-contributing factors (CCFs) specifically tailored to the OH setting, which we defined and validated. Results: The proposed model consists of three primary domains (PDs); health factors, workplace factors and biopsychosocial factors. Twenty-seven CCFs are described and defined within these PDs. Conclusions: This work lays the foundation for improved understanding, identification, and assessment of complexity in OH. This is imperative for ensuring high quality clinical practice standards, identifying training needs and appropriate triaging/resource allocation.

OBJECTIVES To identify differences in risk of ill-health retirement (IHR) between groups with different levels of education and examine this difference with respect to working conditions and health-related factors. METHODS This study analysed the longitudinal data of 1691 paid workers aged 45 to 79 years from the Korean Longitudinal Study of Aging. Multivariate Cox regression analyses were conducted to identify the predictors and build a prediction model for IHR according to different final education levels. RESULTS Over the 10-year follow-up, 208 workers exited work because of poor health. Clear educational inequalities in reason of retirement and increased risk of IHR in low, intermediate, and high educational groups were observed. CONCLUSIONS Our results suggest an educational gradient for IHR among Korean male workers and revealed gender differences in the risk of IHR.

Supplemental Digital Content is available in the text, Objective: To describe the mental health situation and job stress levels of Funeral Service Workers (FSW) during the first months of the pandemic. Methods: We conducted a cross-sectional study in Canada between May and July 2020. Funeral service professional organizations were asked to spread a questionnaire to their members including job description, assessment of anxiety (GAD-7), depression (PHQ-8), and job stress (effort-reward imbalance questionnaire). Results: Fifty-eight FSW completed a questionnaire, 32% reported anxiety symptoms (GAD-7 > 10), 29% reported depressive symptoms (PHQ-8 > 10), 31% reported job stress. Women were more likely to report overcommitment (66.7% vs. 31.8%, P = 0.015). Conclusions: Levels of anxiety and depression identified in Canadian FSW were higher than those identified in other occupational groups during the first few months of the pandemic.

International audience; Aims: We conducted a cross-sectional study on healthcare workers from the University Hospital in Clermont-Ferrand. They received a self-report questionnaire consisting of the Maslach Burnout Inventory, Job Demand Control Support, Effort-Reward Imbalance model, and questions about ethical conflict in order to investigate on burnout.Results: We included 1774 workers. Overinvestment was the only factor explaining the increase in emotional exhaustion, depersonalization, and the decrease in personal accomplishment. Taking into account the absence of burnout as a reference, overinvestment multiplied the risk of high burnout by 22.0 (5.10 to 94.7).Conclusion: Some “forgotten” occupations among healthcare workers are at risk of burnout. Overinvestment was the main factor explaining the increase in the tree dimensions of burnout. Moreover, the two main models of stress at work were highly predictive of burnout.

Objective To assess health care utilization, lost work days, and bed days among workers with chronic obstructive pulmonary disease (COPD) by industry and occupation. Methods The 2014 to 2018 National Health Interview Survey data were analyzed. Results Among workers with COPD the highest odds of reporting an emergency room (ER) visit and lost work days were observed among workers aged ≥65 years, females, those with no health insurance, and current combustible tobacco users. Workers with COPD in the information industry and computer and mathematical occupation reported highest odds of an ER visit and utilities industry workers reported highest odds for lost work days. Conclusions The high health care utilization and lost work days among workers with COPD in certain industries and occupations underscores the importance of continued surveillance and tailored interventions to reduce disease burden and improve worker health.

Objective This study examined office workstation types' impact on the relationship between fatigue and three health metrics: physical activity, stress, and sleep quality. Methods Data from 225 office workers were collected for perceived fatigue, perceived sleep quality (Pittsburgh Sleep Quality Index [PSQI]), physiological stress response (standard deviation of heart rate variability [HRV]), and physical activity (total activity in minutes) during three consecutive workdays. Stress and physical activity were measured using chest-worn sensors. Workers were then categorized as tired or not-tired based on the median of the fatigue rating. Results Among tired workers, open-bench seating workers had increased physical activity, improved sleep quality, and reduced stress compared with workers in private offices and cubicles. Conclusions Office workstation types influence physical activity and levels of stress during work hours, which in turn affect sleep quality.

OBJECTIVE To evaluate impact of directing patients with back pain for first visit to a physiotherapist on sick leaves, healthcare utilization, and patient satisfaction. METHODS Pre-post intervention study of 70,138 patients treated in Poland for back pain: 27,034 before the care pathway redesign and 43,104 after. RESULTS After the redesign, all per-patient measures (mean ± SD) significantly decreased over the 12-month follow-up: sick leaves number from 0.32 ± 0.87 to 0.29 ± 0.86, sick leaves days from 2.78 ± 11.56 to 2.56 ± 11.25, doctors' visits from 2.02 ± 1.70 to 1.51 ± 1.63, diagnostic imaging services from 0.63 ± 0.79 to 0.43 ± 0.71 and rehabilitation services from 7.55 ± 14.90 to 4.70 ± 12.61.The Net Promoter Score was higher for physiotherapist (83), than for orthopedists (59), primary care (74), or neurologists (67). CONCLUSIONS Involving physiotherapists early in the back pain care may result in benefits for patients and healthcare organizations.

Objective We tested the construct validity and responsiveness of a single-item instrument for measuring absolute presenteeism-the single-item presenteeism question (SPQ). Methods Two self-report questionnaire surveys were conducted among employees of 24 small- or medium-sized companies (N = 1021) concerning the recognized predictors of presenteeism-absenteeism, subjective health risks, work engagement, and workplace social capital. Responsiveness was measured by determining whether changes in the presence of predictors between the surveys were accompanied by commensurate changes in SPQ presenteeism. Results SPQ presenteeism exhibited significant associations with the predictors, denoting adequate construct validity. Regarding responsiveness, unfavorable changes in most predictors were associated with increased SPQ presenteeism, as expected. Conclusions We confirmed the construct validity and responsiveness of the SPQ-an instrument that can be employed to promote workplace health and productivity management.

INTRODUCTION Welding fume exposure of welders occurs either directly from the welding process and sputters or from the fume background within the workshop. In this study the contribution of fume originating directly from the welding process was assessed. METHODS Exposure was quantified by measuring the time integral of fume mass concentration using a tapered element oscillating micro balance connected to a welder dummy. RESULTS Direct fume exposure was highest for welding processes with low fume emission rates and lowest for processes with high fume emission rates. CONCLUSIONS This finding is supposed to be due to the higher energy input of high emitting processes which stabilizes the thermic column and therefore eliminates fume particles from the welder's breathing zone. Exposure can be minimized by additionally optimizing workshop ventilation.

OBJECTIVE Firefighters are at a heightened risk for developing cardiovascular disease. The purpose of this study was to determine if time restricted feeding (TRF) can improve the stress/inflammatory response to a simulated firegrounds test (FGT) in professional firefighters. METHODS Thirteen firefighters participated in an 8-week TRF intervention (14:10 [fasting:feeding]) protocol and completed a FGT before and after the intervention. Blood lactate, heart rate, salivary C-reactive protein (CRP), interleukin-6 (IL-6), interleukin 1-β (IL-1β), and cortisol were measured pre and post FGT. RESULTS Following TRF, the salivary cortisol response to the FGT was significantly (P

OBJECTIVE To assess comorbidity across five common health conditions. METHODS Surveys were collected from a probability-based sample of US law enforcement officers, and latent class models estimated for hypertension (HTN), high blood cholesterol (LDL), diabetes (DM), a gastrointestinal disorder (GI), and sleep apnea (SA). RESULTS The majority of officers (69.4%) were classified in a Healthy profile. One in four officers (23.7%) were classified in a LDL-HTN-DM profile. About 7% of officers were classified in a GI-SA-HTN profile. Age, sex, body mass index (BMI), exercise, and working a rotating shift assignment distinguished class membership. CONCLUSION Most officers reported good health. Law enforcement administrative or clinical assessments using readily accessible measures might be informative in identifying risk categories of need for more targeted prevention and treatment support.

Objectives Estimate the point prevalence of COVID-19 vaccine acceptability among US firefighters and Emergency Medical Services (EMS) workers. Methods A cross-sectional study design was used to administer an anonymous online survey to a national non-probabilistic sample of firefighter and EMS workers. Results Among the 3169 respondents, 48.2% expressed high acceptability of the COVID-19 vaccine when it becomes available, while 24.2% were unsure and 27.6% reported low acceptability. Using the "high COVID-19 vaccine acceptability" group as the reference category, the groups with greater odds of reporting low acceptability included those: 30 to 39 years of age (odds ratio = 3.62 [95% confidence interval = 2.00 to 6.55]), Black race (3.60 [1.12 to 11.53]), Hispanic/Latinx ethnicity (2.39 [1.45 to 3.92]), with some college education (2.06 [1.29 to 3.27]), married (1.65 [1.03 to 2.65]), of current rank firefighter/EMS (2.21 [1.60 to 3.08]). Conclusions Over half of US firefighters and EMS workers were uncertain or reported low acceptability of the COVID-19 vaccine when it becomes available.

Objective To explore mortality rates and trends according to the occupation of healthcare workers who died from the deaths of despair (DoD). Methods Death certificates for deaths from 2011 to 2015 due to poisonings, suicides, alcholic liver disease and cirrhosis were collected and coded based on the decedent's occupation. Mortality rates and rate ratios were calculated according to occupations for healthcare workers. Results There were 540 DoDs among Massachusetts healthcare workers, accounting for an average annual rate of 32.4 deaths per 100,000 workers. The highest mortality rate for DoDs were among medical assistants; nursing, psychiatric, and home health aides; miscellaneous; health technologists and technicians; emergency medical technicians, and paramedics. Conclusions Further research should examine factors contributing to elevated rates for DoDs among healthcare workers. Interventions targeted for these workers should be developed.

Firefighters are at an elevated risk for cardiometabolic disease and sudden cardiac death due to physiological and psychological stressors. Research suggests time restricted feeding (TRF) may improve health and performance variables. OBJECTIVE This study investigated the effects of a 7-week TRF (14-hour fasting:10-hour eating window) on fitness variables related to physical health and performance among professional, resistance-trained firefighters. METHODS Several fitness variables were assessed pre- and post-TRF intervention. RESULTS Relative and absolute ventilatory threshold (VT) increased (P

OBJECTIVE: Retinoblastoma is the most common primary intraocular tumor affecting children. We examine the role of parental occupational exposures and risk of retinoblastoma among offspring. METHODS: Our population-based case-control study linked data from four nationwide Danish registries and included all cases of retinoblastoma diagnosed in Danish children (

Law professionals are an understudied population that is integral to society. Limited research indicates lawyers experience poor mental health, decreased wellbeing, and suicidality. This cross-sectional study recruited 654 law professionals and responses to a depression scale, the patient health questionnaire 9 (PHQ-9) were compared with the general working population. Lawyers were significantly more likely to report suicidal ideation "several days" and "more than half the days" as compared with the general working population, with odds ratios (OR) of 6.54 (95% confidence interval [CI] 4.16 to 10.29) and 5.50 (95% CI 2.23 to 13.53) respectively. Lawyers were more likely reported mild (OR = 3.89, 95% CI 3.04 to 4.96), moderate (OR = 5.29, 95% CI 3.61 to 7.76), moderately severe (OR = 9.71, 95% CI 5.50 to 17.14), and severe (OR = 18.34, 95% CI 6.00 to 56.11) depressive symptoms. 17.5% of lawyers in this study were experiencing symptoms equivalent to a diagnosis of a major depressive disorder.

OBJECTIVE: To assess impact of personal protective equipment (PPE) on healthcare providers (HCPs) in caring for COVID-19 patients. METHODS: A cross-sectional survey was conducted over 50 hospitals in China. Descriptive analyses and Chi-square tests were performed on the collected data. RESULTS: All 104 frontline HCPs report negative impacts of PPE on their clinical performance, 97% of them experienced discomfort and injuries caused by wearing PPE for long hours. Frontline HCPs provided suggestions to alleviate the negative impacts and to enhance communication between healthcare staff and patients. Two hundred eighty two non-frontline HCPs also revealed similar problems; however, we recorded a few discrepancies between answers given by frontline and non-frontline HCPs. CONCLUSIONS: Wearing PPE for long hours degrades health performance. Measures were suggested to improve the design of PPE for protecting HCPs and enhancing their services to COVID patients.

Objective To investigate the efficacy of a workplace mental health awareness training program on help-seeking and mental health outcomes. Methods A cluster randomized controlled trial was conducted comparing those who received standard training (N = 210) or standard training with a mental health awareness module (N = 208). Both groups were followed up for three years with the primary outcome being likelihood to seek help. Results Rates of likely help-seeking were slightly higher in the intervention group six months after the training, but this was not maintained over time. There was no significant difference between study conditions for mental health outcomes or actual help-seeking among those with probable mental disorder at any time point. Conclusions Workplace mental health awareness training has a limited short-term impact on likelihood of help-seeking and does not appear to improve mental health outcomes.

Objective Assessment of the nasal cytology in revealing early nasal mucosa alteration of workers exposed to benzene. Methods Nasal cytology was compared among non-exposed and exposed workers to benzene. A comparison of the two groups was performed considering rhino-cytological features. Results In the exposed group neutrophils count range was 14 to 70, compared to 2 to 5 in control group. Ciliated cells ratio range was respectively 0.28 to 2.8 and 0.25 to 0.31. In subjects exposed to benzene >10 years, nasal mucosa showed an inflammatory status and an ongoing mucipar metaplasia, defined by an alteration of mucipar/ciliated cells ratio. Conclusions Nasal cytology may be a useful research tool for the health surveillance of workers exposed to benzene and may be applied to study the effects of other upper airways chemicals irritants.

Objectives: To assess prevalence of Personal Protective Equipment (PPE)-related symptoms and adverse reactions during Coronavirus Disease 2019 pandemics. Methods: We conducted an observational study among people exposed to various degree of infectious risk. Data were collected with a self-administered online questionnaire. Results: The entire cohort complained about a wide range of adverse reactions: respiratory symptoms affected 80.3% of respondents, 68.5% referred pressure-related skin lesions, fewer manifested a dermatosis of different grade or ocular symptoms. Most of the affected individuals belonged to healthcare staff and manifestations were predicted by wearing time (more than 6 h/d). Moreover, symptoms were higher in the healthcare staff wearing N95/FFP2 respirator mask. Conclusions: Given the crucial role of PPE to contain the pandemic infection, more attention has to be paid to exposed categories, establishing preventive measure of side effects to ensure total safety.

Objective Leadership styles can influence subordinates' health. We investigated how the gene encoding the Catechol-O-Methyltransferase (COMT) enzyme (i.e. COMT rs4680 Val158Met) influenced effects of abusive supervision and transformational leadership on subordinates' headache and neck pain. Methods Multiple group structural equation modeling (SEM) was employed to test associations of leadership with subordinates' pain six months after in a representative sample of the Norwegian working population (n = 996). Genotyping was performed by TaqMan technology. Results Abusive supervision was associated with increased risk, and transformational leadership with decreased risk, of headache and neck pain. Both leadership styles exhibited more pronounced effects in individuals with the Met/Met genotype. Conclusion Met/Met employees were relatively vulnerable to adversity, but also relatively responsive to constructive leadership. Many workers may benefit more from constructive leadership than population-averaged associations might suggest.

Objective: To understand impacts of social, behavioral and physical factors on well-being of office workstation users during COVID-19 work from home (WFH). Methods: A questionnaire was deployed from April 24 to June 11, 2020 and 988 responses were valid. Linear regression, multinomial logistic regression and chi-square tests were used to understand factors associated with overall physical and mental health statuses and number of new physical and mental health issues. Results: Decreased overall physical and mental well-being after WFH were associated with physical exercise, food intake, communication with coworkers, children at home, distractions while working, adjusted work hours, workstation set-up and satisfaction with workspace indoor environmental factors. Conclusion: This study highlights factors that impact workers’ physical and mental health well-being while WFH and provides a foundation for considering how to best support a positive WFH experience.

Objective Walking Meetings (WaM) have shown to be acceptable, feasible, and implementable among white-collar workers. This pilot study examines the effects of WaM on worker mood, productivity, and physical activity. Methods Eighteen white-collar workers were recruited from a university in Florida. Participants wore accelerometers for 3 consecutive weeks. During baseline week, participants continued their normal seated meetings. In weeks 2 and 3, participants conducted one walking meeting in groups of two to three people. Results Increased moderate occupational physical activity was correlated with increased productivity measured by decreased work time missed due to health reasons (r = -0.59; P = 0.03) and decreased impairment while working due to health reasons (r = -0.61; P = 0.02). In week 3, very vigorous physical activity was significantly correlated with negative mood (r = 0.69, P = 0.01). Conclusion WaM affected worker mood and productivity and increased occupational physical activity-levels.

Objective: The higher education industry in the United States is large (almost four million employees and 19 million students) with diverse hazards. Methods: We apply a novel health services research approach to systematically assess a sample of 55 institutional websites. The accessibility, content, and coverage of occupational health/safety program information were systematically coded for several domains (eg, Occupational Safety and Health Administration (OSHA)-related, specific hazards, clinical, person-oriented, COVID-19, and coverage). Results: Information was more available for programs related to OSHA mandates (eg, chemical hygiene) and specific hazards than for person-oriented programs (eg, counseling). Larger institutions provide better information and more comprehensive programs than smaller institutions. Conclusions: Higher education institutions warrant increasing attention to occupational health and safety, particularly as COVID-19 increased attention to workplace health issues.

Objectives Evidence suggests that shiftwork results in adverse occupational health outcomes. This paper contributes to the literature by estimating the separate health effects of night and irregular shiftwork on a longitudinal panel of US workers. Methods Data from a 20-year panel of worker surveys from the 1979 National Longitudinal Survey of Youth were used to predict self-reported health limitations related to night and irregular shiftwork using a series of random effects logit models. Results Separate and combined specifications of shiftwork as night and irregular effort significantly increase the odds of health limitations compared with working a regular daytime schedule, with more pronounced effects for irregular work (odds ratio [OR] = 1.09 to 1.52) over night shift (OR = 1.03 to 1.14). Conclusions The results suggest that both night and irregular shiftwork may have important negative implications on occupational health, with the deleterious effects particularly pronounced for irregularly scheduled work effort.

Objectives To assess the effect of ambient temperature, humidity and wind speed on disease occurrence in Delhi, India. Data and methods Data regarding daily corona cases, temperature, humidity, wind speed, doubling time and basic reproduction number (R0) was retrieved from online sources. Pearson's coefficient was used to assess the correlation between daily as well as weekly corona cases and various environmental factors. Results During the study period of 97 days, there was a steady rise in number of corona cases with median (interquartile range) cases per day being 224 (58 to 635). The doubling time demonstrated a strong positive correlation with temperature while R0 had strong negative correlation with temperature (correlation coefficients 0.814 and -0.78, respectively). No significant correlation with humidity or wind speed was observed. Conclusion Increasing temperature decreases COVID-19 infectivity; however, actual role of environmental factors in expansion of pandemic needs further evaluation globally.

Objective To examine the implementation of physical activity and healthy eating policies in eighteen locations of a large, public health organization. Methods We used a mixed-methods design that included a survey of employees to describe location characteristics (ie, number of employees, race/ethnicity of employees), a survey of wellness ambassadors to determine which policies were implemented, and semi-structured, telephone interviews with wellness ambassadors to examine the barriers and facilitators to policy implementation. Results Six locations implemented both policies, nine locations only implemented the physical activity policy, and two locations did not implement either policy. Structural characteristics and geographic spread impeded implementation, whereas leadership engagement and access to information about the policies facilitated implementation. Conclusions Consistent and adequate policy implementation in each location of an organization is critical to providing equity in health promotion programs for employees.

Objective Supporting employees with health impairments to stay at work through workplace accommodation is a well-researched topic. However, research on workplace accommodations for older employees is lacking. Methods Cross-sectional data from the German lidA cohort study in 2018 focusing on older employees who reported poor health (n = 421) was analyzed. A multiple logistic regression analysis was conducted to asses a potential association between the accommodation type and perceived helpfulness of workplace accommodations in older employees with poor health. Results Changes in working times (OR 6.59), in work tasks (OR 3.50) and in the workplace (OR 2.57) were perceived as most helpful. Conclusion The results indicate that workplace accommodations can be helpful in older employees with health impairments and that this is not by chance, but that the perceived effectiveness has determinants and can be influenced.

OBJECTIVE: To assess the effects of a multi-modal resilience program, the Stress Management and Resiliency Training (SMART) Program, on healthcare professional well-being and job satisfaction. METHODS: This pilot, mixed-methods, quality improvement, cohort study assessed perceived stress, physical and mental health, job satisfaction, burnout, and value of the curriculum to attendees. RESULTS: Participants experienced a significant reduction in perceived stress (p < 0.001) and significant improvements in global mental health (p = 0.001), physical health (p = 0.045), and job satisfaction (p = 0.047). There was no significant improvement in burnout. Qualitative analysis of free text responses revealed appreciation for the skills taught, increased resiliency, and a positive impact on relationships. CONCLUSIONS: Delivering the SMART Program to healthcare professionals is feasible and may serve as a useful tool for reducing stress and increasing resilience.

OBJECTIVE To address which body composition (BC) measures best correlate with cardiorespiratory fitness (CRF) in firefighters and develop a model for accurate CRF estimation compared with traditional methods. METHODS Career firefighters had body mass index (BMI) and waist circumference (WC) measured in addition to body fat percentage (FM%) by dual-energy x-ray absorptiometry (DXA). CRF as maximum oxygen uptake (VO2max) was estimated by rowing machine and measured by indirect calorimetry in a treadmill exercise test. RESULTS Fifty two firefighters participated (92.3% men). Univariate correlations with BMI were best with WC. Univariate correlations with VO2max were best with FM%. Obesity classifications by BC measures agreed weakly at best. Multivariate analysis of several variables yielded an improved VO2max estimate (R2 = 0.70). CONCLUSIONS Fire departments may benefit from more sophisticated measures of BC and CRF to evaluate firefighter fitness.

Objective Describe workplace vaping, prevalence of observed use, attitudes, and perceptions among US adults. Methods Employees of companies with more than 150 employees, drawn from an opt-in national online panel (N = 1607), ages 18 to 65, completed an online survey in November 2019. Results Majority (61.6%) observed coworkers vaping at work and 19.1% reported vaping at work themselves. Participants perceived workplace vaping as moderately harmful (M = 1.9 out of 3), 63.2% were bothered by workplace vaping and 52.1% thought it decreased workplace productivity among non-users. Multiple regression models found workplace vaping prevalence varied by industry and participant characteristics, and attitudes about it varied by tobacco use status. Conclusions Workplace vaping and vaping exposure is common in US workplaces. Employees, particularly non-users, hold generally negative perceptions of workplace vaping. Comprehensive policies to prevent workplace vaping are needed to protect workers.

Objective To test the feasibility, acceptability, and potential effectiveness of engineering and behavioral interventions to improve the sleep, health, and well-being of team truck drivers (dyads) who sleep in moving semi-trucks. Methods Drivers (n = 16) were exposed to Condition A: a new innerspring mattress, and Condition B: a novel therapeutic mattress. A subsample of drivers (n = 8) were also exposed to Condition C: use of their preferred mattress (all chose to keep B), switching to an active suspension driver's seat, and completing a behavioral sleep-health program. Primary outcomes were sleep duration, sleep quality, and fatigue. Behavioral program targets included physical activity and sleep hygiene. Results Self-reported sleep and fatigue improved with mattress A, and improved further with mattress B which altered vibration exposures and was universally preferred and kept by all drivers. Condition C improved additional targets and produced larger effect sizes for most outcomes. Conclusions Results support these interventions as promising for advancing team truck drivers' sleep, health, and well-being.

Objective To assess whether standardized screening and service navigation improve access to primary care in low wage workers. Methods Four rapid plan-do-study-act cycles were conducted over an 8-week period. Each cycle consisted of four core interventions. Data were collected every 2 to 3 days, then analyzed on run charts and aggregate data tables. Results Effective care was achieved by increasing the percentage of patients with a primary care provider from 52% to 79%. Patients' perception of health increased from 3.6 to 4.4 and team communication and support score increased from 3.9 to 4.2 on a 5-point Likert scale. Conclusions Patient engagement and a standardized referral process aids in the establishment of routine, effective care. Application of "smart phrases" in electronic health records provides sustainability for use in other occupational medicine practices.

OBJECTIVE We evaluated the efficacy of a combined short-wavelength-enriched white light and exercise fatigue countermeasure during breaks for flight controllers working overnight shifts. METHODS Twenty NASA flight controllers were studied for two blocks of nightshifts in ISS mission control, randomized to either the control or countermeasure condition. The countermeasure constituted passive exposure to blue-enriched polychromatic lighting for three 20-minute intervals, which included 10 minutes of exercise and occurred before and twice during their shifts. Alertness, performance, and mood were evaluated. RESULTS Flight controllers reported being significantly more alert (P

Objective We aimed to evaluate the relationship between job stress and subclinical cardiovascular disease at ELSA-Brasil. Methods We considered job stress domains (demand, skill discretion, decision authority, and social support) as independent variables and coronary artery calcium (CAC more than 0) and carotid intima-media thickness (CIMT more than P75% as a continuous variable) as dependent ones. Odds ratio (OR) and 95% confidence interval (95% CI) were presented crude, with further adjustments for sociodemographic, cardiovascular risk factors, and lifestyle variables. Linear regression models were built for CIMT using the same covariates. Results Although significant associations were observed in the crude models, after multivariate adjustment CAC and CIMT were not significantly associated with demand, skill discretion, decision authority, and social support. Conclusions Our results did not support an association between job stress and subclinical cardiovascular disease measured by CAC or CIMT.

Objectives To understand the relationship between job burnout and job satisfaction for medical workers and analyse the influencing factors. Methods We used two scales to examine medical workers in Hengyang mental hospitals. Multivariate logistic regression and structural equation model were used to evaluate the relevant factors of job satisfaction, and the relationship between job satisfaction and job burnout. Results The total job satisfaction was at the moderate level. For job burnout was in the middle burnout level. Job satisfaction can have a negative prediction function for job burnout (direct effect -0.684). The relevant factors of job burnout and job satisfaction was as follows: nature of the work, pay, benefits and communication impacted job satisfaction and job burnout. Conclusions The current level of job satisfaction is relatively low, job satisfaction has a negative effect on job burnout.

Industrial workers can come into contact with harmful agents that are transmitted via the eye in the form of an aerosol droplet or splash. Contact lenses do not provide ocular protection from hazards. This guidance from the American College of Occupational and Environmental Medicine addresses the use of contact lenses and personal protective equipment by the industrial worker and provides recommendations for contact lens use in an eye-hazardous environment.

Supplemental Digital Content is available in the text, Objectives: To evaluate impact of electrolyte supplementation on hydration status and health outcomes in Guatemalan agricultural workers performing heavy work under hot climatic conditions. Methods: A 3-week pragmatic trial was conducted with a group of 50 workers during the 2017 to 2018 sugarcane harvest. Workers received an electrolyte hydration intervention during 2 of the 3 weeks. Blood and urine samples were collected each week. Results: Increased electrolyte intake resulted in less muscle injury. Kidney function was maintained across the intervention period. Workers were adequately hydrated and average electrolyte levels remained in normal ranges. Mild indications of hyponatremia occurred at higher levels of fluid intake. Conclusions: This trial demonstrates the feasibility of maintaining workers’ electrolyte levels under extremely hot and humid conditions while mitigating muscle injury. Electrolyte supplementation should be added to standard workplace water, rest, and shade interventions to protect workers.

Objective To examine hospital employee perceptions of organizational safety one-year following a workplace violence intervention and to evaluate perceptions based on violence exposure status. Methods In 2014, 343 employees across 41 hospital units (N = 21 control units, N = 20 intervention units) completed a questionnaire capturing organizational safety perceptions and violence exposure. Results Intervention unit employees reported more positive perceptions of organizational safety compared to control unit employees. However, intervention group employees who experienced patient-to-worker violence (Type II) had significantly more positive perceptions than those who experienced worker-to-worker violence (Type III). Conclusions Organizational safety perceptions improved following a violence-prevention intervention, especially among employees who reported Type II violence. Certain employees report worsened safety perceptions. Hospitals and units that implement violence prevention interventions should strive to address all types of violent behavior.

Objective This study aims to identify interventions to address workplace violence in the emergency department based on direct evidence from experiences of patient assault. Methods We performed de novo coding and thematic analysis of datasets from two geographically distinct institutions and five different sites that contained interviews with 80 health workers. Results We identified concepts that corresponded to the micro (workers and patients), meso (organizations and clinical units), and macro (society at large, worldviews, and values) levels of the healthcare system. Within each level, potential interventions fell into the prevention, response, and recovery phases of emergency preparedness. Conclusion Efforts to address workplace violence should consider interconnected influences from individual workers, organizations, and society at large. Comprehensive approaches at multiple phases of preparedness are needed to have sustained impact on safety.

Objectives To determine: 1) different return to work (RTW) pathways among road traffic crash (RTC) survivors; 2) RTW differences between RTC and workers' compensation schemes, and; 3) factors associated with relapse and attempting graduated RTW. Methods Administrative income support data from RTC survivors with compensated work absence in Victoria, Australia were arranged as daily income payments, pattern recognition determined RTW pathways. Multivariable logistic regression showed odds of relapse or attempting graduated RTW by covariate. Results Most had successful RTWs without relapse (66.7% full, 7.2% graduated), 22% relapsed at least once, and 17% attempted gradual RTW. Sex, injury type, length of hospital stay, road user group, and compensation scheme were associated with relapse and graduated RTW attempt likelihood. Conclusions Results help identify people likely to benefit from RTW interventions, such as programs that incentivise graduated RTW.

Objective: To evaluate the effects of participation with a novel musculoskeletal care coordination service on clinical outcomes, self-reported productivity, and satisfaction. Methods: Prospective analysis of participants using the service from January 1, 2019 to December 31, 2019. Results: One hundred eighty nine participants were enrolled; 54 participants completed their recommended clinical pathway. Low back pain was the most common musculoskeletal issue (N = 86, 46%). 88 participants (47%) were triaged to home exercise and 59 (31%) to physical therapy. Behavioral health issues were common: 47 participants (25%) were referred to their EAP. Only 30 participants (16%) required a medical referral. Engagement was associated with improvements in pain, physical function, mood, and self-reported productivity (P

OBJECTIVE Assess workplace vaping as a trigger for tobacco use; examine interest in and prevalence of vaping cessation programs; determine needs of parents whose children vape. METHODS Employees of companies with more than 150 employees, drawn from an opt-in national online panel (N = 1607), ages 18 to 65, completed an online survey in November 2019. RESULTS Among tobacco users, 46% to 48% reported workplace vaping was a trigger for smoking and vaping, respectively; 7% of former users reported it as a trigger. Quit vaping support is important to 85% of employees; 1/3 of workplaces have such programs, with industry variation. Child vaping results in presenteeism and absenteeism among roughly 1/3 of parents. CONCLUSIONS Workplace vaping is a trigger for smoking and vaping among current and former tobacco users. A gap exists between desired support for vaping cessation and current employer-sponsored cessation programs.

Objective To evaluate the relationship between burnout and professional behaviors and beliefs among US nurses. Methods We used data from 2256 nurses who completed a survey that included the Maslach Burnout Inventory and items exploring their professional conduct (documented something they had not done so they could 'close out' an encounter in the EHR or part of the assessment not completed, requested continuing education credit for an activity not attended) and beliefs about reporting impaired colleagues. Results On multivariable analysis, burnout was independently associated with higher odds of reporting 1 or more unprofessional behaviors in the last year and not believing nurses have a duty to report impairment among colleagues due to substance use or mental health problems. Conclusions Occupational burnout is associated with self-reported unprofessional behaviors and less favorable beliefs about reporting impaired colleagues among nurses.

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.

OBJECTIVES: To describe the strategies to monitor and expand access to care for a health system workers in the first 2 months of the COVID-19 epidemic in Brazil. METHODS: Description of the implemented strategy based on the guidelines developed to address the surveillance and care of a large health system's workforce in the COVID-19 epidemic. RESULTS: During phase 1, the surveillance strategy focused on monitoring suspected cases among employees. In phase 2, surveillance was restricted to employees with confirmed COVID-19, aiming at monitoring of symptoms and following hospitalizations. Access to care was expanded. A total of 1089 employees were diagnosed with COVID-19, 89 required hospitalizations and none had died. CONCLUSION: The strategies adopted were promptly implemented and could be adapted to the changing epidemic dynamics, allowing low rates of adverse outcomes in this high-risk population.

OBJECTIVE This study examined the relationship between job insecurity and presenteeism, and the role of workplace health promotion as moderator in this association. METHODS We used data from 9525 employees from the sixth BIBB/BAuA Employment Survey 2012 for the working population in Germany. Data analysis was performed with logistic regressions. RESULTS Job insecurity was associated with a higher risk of presenteeism, even after adjustment for control factors (OR = 1.25, CI: 1.01-1.53, P