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This article compares the occupational safety and health systems of Switzerland, the United Kingdom, and the United States, looking at the origins of their legislation and its effects on occupational safety and health, with a view to determining what lessons may emerge, particularly for developing countries. (Author/SSH)

The majority of occupational lung diseases have long latency periods, with disease manifesting at an older age. We conducted an extensive literature review and analyzed data for age-related mortality, the impact of age on the lungs and occupational lung diseases, changes in the workforce, and considerations for surveillance to maintain a healthy workforce. Age is a major factor in occupational lung diseases, which in turn predisposes older adults to other health conditions and reduces their quality of life and life expectancy. More specifically, age-related changes in the lungs increase the susceptibility to environmental exposure-induced lung injuries and are linked to poor prognosis. Data from the Work-Related Lung Disease Surveillance Report published by the National Institute for Occupational Safety and Health (NIOSH, 2008) indicated that death from occupational lung diseases among U.S. residents peaked in the age group 75--84 years. Interestingly, the age group 65--74 years recorded a substantial number of deaths, second to the age group 75--84 years. This trend represents a shift in U.S. mortality for all diseases, which peaks at ≥85 years. Improved surveillance and early detection will be instrumental in reducing the burden of occupational lung injury in older adults, many of whom are staying in the workforce longer. [ABSTRACT FROM AUTHOR]

Operator syndrome is a common and predictable constellation of interrelated medical and psychiatric conditions and social and functional impairments experienced by special operations forces. Nurses in all settings should be aware of this emerging trend among veterans they encounter in practice so they may identify and intervene using evidence-based approaches and effect a positive outcome. [ABSTRACT FROM AUTHOR]

Background: Literature supports including occupational therapists on primary care teams. Few occupational therapists practice in this setting. The health care community needs more information regarding the benefits of occupational therapists on the team. Method: We completed an 18-month pilot integrating an occupational therapist in a primary care team, tracking conditions treated by the occupational therapist, visit duration, reimbursement, and level of primary care providers’ (PCP) satisfaction. We then evaluated outcomes via a retrospective chart review. Results: Visits were brief, averaging 35 min. Longer visits did not improve outcomes. Occupational therapists were reimbursed by Medicare (47%), commercial (47%), both (6%). PCPs referred numerous conditions, and > 50% related to musculoskeletal pain. Most of the patients, 84%, reported partial (30%) or complete (54%) improvement; 60% required one-time treatment; and 40% were referred for further treatment on-site or outside the department for additional or specialty treatment. After the pilot, most of the PCPs felt an occupational therapist on the team was absolutely essential (n = 14; 61%), or very important (n = 7; 30%). Conclusion: Embedded occupational therapy treatment resulted in symptom improvement in 84% of patients across a variety of conditions, and brief visits were effective. Occupational therapist services were reimbursed across insurance plans. After working with an occupational therapist, 91% of the PCPs viewed the occupational therapist as a very important or essential team member. [ABSTRACT FROM AUTHOR]

Studies have revealed that physical and mental demands, psychosocial factors, and individual factors can contribute to the development of WMSDs. Yet, much is still unknown regarding the effects of individual characteristics on WMSDs susceptibility. Previous studies discovered people assumed more awkward body postures to perform an activity when the perception of mental workload is higher. This research study explored if individual characteristics such as age, sex, personality, and anxiety help explain changes or differences in the perception of mental workload and body postures assume when performing activities. The study provided evidence that these individual characteristics have a modifying role on perceived mental workload and body postures. The results suggest that perceived mental workload is influenced to a higher extent by individual characteristics such as anxiety, sex, and personality traits. Women have a higher (18.7%) mental workload perception than men. Likewise, NASA-TLX scores are 22% higher for feelers than thinkers. In general, higher perceptions of mental workload were observed in participants with higher anxiety levels. On the other hand, body postures seem to be influenced by different individual factors depending on the nature of the activity. RULA scores increased on average by 13.1% between baseline and time constraint conditions. Larger differences were observed in certain individuals (e.g. introverts (19.7%) and intuitors (13.8%)) across conditions. This study looked to explore if individual factors such as age, sex, personality, and anxiety have any effect in perceived mental workload and body postures. Participants performed two physical activities under four levels of mental workload. Results indicated that personality traits (sensors/intuitors), anxiety, and sex exhibited the higher contributions. [ABSTRACT FROM AUTHOR]

This analysis examined correlates of HIV testing among Asian immigrant female sex workers in massage parlors. We interviewed 69 Chinese and Korean immigrant women who provided sexual services in massage parlors in New York City or Los Angeles County (2014–2016). Multivariable logistic regression results showed that participants who were younger, have lived in the U.S. for a longer period of time, had greater English proficiency, perceived higher HIV risk, or were living with an intimate partner were more likely to have had an HIV test. Disclosing sex work to a close friend was also positively associated with HIV testing at p <.1. These correlates may reflect differential access to information, systems, and social networks that would facilitate HIV testing, highlighting the importance of reducing social isolation and increasing HIV education, especially for older women who have come to the U.S. more recently. As the literature has indicated that Asian immigrant female sex workers experience high rates of intersectional stigma, efforts to mitigate these intersecting stigmas could further these objectives. [ABSTRACT FROM AUTHOR]

Background: Working in the nursing profession is hazardous, and nurses report poor health. Risk factors associated with poor health outcomes have been documented. However, the extent of literature exploring the prevalence of health conditions among American nurses that may be attributable to their work has not been examined. Method: A scoping review following the Joanna Briggs Institute recommendations was conducted of peer-reviewed quantitative studies to answer the question: What are health conditions experienced by American nurses that may be attributable to their work as nurses? Results: Thirty articles met the inclusion criteria. Due to the methods used in many articles, studies of the prevalence of health conditions among the nursing population were lacking. Health conditions studied broke into six categories: (a) work-related injuries and hazards; (b) unhealthy lifestyles; (c) mental health conditions; (d) burnout; (e) fatigue, sleep, and migraines; and (f) reproductive health. The role of work in the health conditions studied varied from an immediate impact on health (e.g., a needlestick or injury) to a cumulative impact (e.g., scheduling or workplace demands). Within the work demands, the physical environment; physical, emotional, and cognitive demands of work; and shiftwork were all frequently identified as antecedents that could be further explored and addressed to improve nurse health. Conclusions: Healthcare systems should seek to address the hazards and exposures that may be linked to health conditions in the nursing workforce. Understanding and mitigating the impact of the pandemic and nursing work on the workforce's health is crucial to the solvency of the workforce. Occupational health practitioners should assess for workplace hazards and exposures. [ABSTRACT FROM AUTHOR]

Rationale: Indigenous populations in the United States face numerous health disparities, but the health of Indigenous workers is less well understood. In a recent surveillance study of active Indigenous coal miners, 3% had coal workers' pneumoconiosis/black lung, and 9% had respiratory impairment. However, occupational lung disease prevalence among Indigenous coal miners has not been directly compared with that among other race/ethnicity groups. Coal miners who are totally disabled from black lung may qualify for U.S. Department of Labor (DOL) compensation benefits, but it is unclear how current federal spirometry criteria affect qualification for Indigenous coal miners. Objectives: To compare findings of pneumoconiosis and respiratory impairment in Indigenous and non-Indigenous coal miners in the western United States and assess federal compensation qualification for Indigenous miners using different spirometry standards. Methods: We used voluntary medical surveillance data from 2002 to 2023 to compare the adjusted odds of pneumoconiosis and respiratory impairment between Indigenous/non-Indigenous coal miners. We examined the proportion of Indigenous miners meeting DOL criteria for federal compensation using different spirometry standards. Results: We identified 691 western U.S. coal miners with at least one year of coal mining employment, 289 Indigenous and 402 non-Indigenous (96% White/Hispanic). Indigenous miners had a greater odds ratio for pneumoconiosis for each additional decade of life (2.47 [95% confidence interval (CI), 1.66–3.68]) compared with non-Indigenous coal miners (1.48 [95% CI, 1.19–1.85]). For each decade, Indigenous coal miners also had a greater adjusted odds ratio for respiratory impairment (1.67 [95% CI, 1.25–2.24]) than non-Indigenous miners (1.06 [95% CI, 0.90–1.25]). Indigenous miners had an additional decline of 71 ml (95% CI, 6–136 ml) in forced expiratory volume in 1 second for each decade of life compared with non-Indigenous coal miners. Using the DOL-mandated Knudson (1976) spirometry standard rather than an Indigenous-specific standard, 6 of 18 (33%) Indigenous miners would not qualify for federal compensation. Conclusions: Indigenous coal miners experience greater adjusted odds for pneumoconiosis and respiratory impairment per decade of life and greater decline in forced expiratory volume in 1 second despite lower smoking rates. Structural inequities exist in federal spirometry requirements for Indigenous miners seeking DOL black lung benefits. Regulatory reform is needed to address barriers to compensation for these underrepresented workers. [ABSTRACT FROM AUTHOR]

Objectives. To estimate the number and prevalence of workers in the United States exposed to chemical hazards available in the Canadian job-exposure matrix (CANJEM) database and examine exposure disparities across sociodemographic groups. Methods. We merged US worker demographic data from the Current Population Survey with CANJEM to characterize the burden and sociodemographic distribution of 244 chemical exposures in the United States in 2021. An interactive version of the full data set is available online (https://deohs.washington.edu/us-exposure-burden). Results. Of the chemical exposures examined, the most prevalent were cleaning and antimicrobial agents (14.7% of workforce estimated exposed), engine emissions (12.8%), organic solvents (12.1%), polycyclic aromatic hydrocarbons (10.1%), and diesel engine emissions (8.3%). Racial and ethnic minoritized groups, persons with lower educational attainment, foreign-born noncitizens, and males were generally overrepresented in exposure to work-related chemical hazards. Conclusions. In the United States, marginalized sociodemographic groups are estimated to experience an inequitable burden to many chemical exposures because of occupational segregation. Data from this analysis can inform occupational and public health research, policy, and interventions aimed at reducing the burden of disease and health inequities in the United States. (Am J Public Health. 2024;114(1):57–67. https://doi.org/10.2105/AJPH.2023.307461) [ABSTRACT FROM AUTHOR]

Occupational exposure to ototoxicants, substances that can cause hearing loss alone or exacerbate hearing loss when exposure occurs in combination with noise, is a workplace hazard that is poorly understood. A review of existing research indicates that some solvents and heavy metals may be ototoxic, but few studies have attempted to estimate the impact of ototoxicant exposure on the United States worker population. Researchers examined trends in workplace exposure to ototoxicants among workers in the United States by comparing exposure data collected by the Occupational Safety and Health Administration against worker hearing loss data provided by the Bureau of Labor Statistics (BLS) for 2012–2019. The study found that the noise exposure data was strongly correlated to the hearing loss data using Pearson's correlation (p <.001), confirming that the exposure data collected by OSHA is predictive of the risk of occupational illness as reported by BLS. Chi-square analysis indicates that reported hearing loss was more common among industry subsectors with exposure to ototoxicants than those without exposure to ototoxicants. These findings suggest that workers with coexposure to ototoxicants and noise may be at a higher risk of experiencing hearing loss than those exposed to noise alone, and action should be taken to minimize this risk. [ABSTRACT FROM AUTHOR]

The author explores the extensive health impacts of nuclear weapons beyond their immediate use in warfare. He discusses the film "Oppenheimer," about J. Robert Oppenheimer who led the Manhattan Project as it developed the first atomic bombs and launched the atomic age, points for radiation exposure in the cycle of producing and testing nuclear weapons, and diverse groups in the U.S. harmed by nuclear weapons.

The future of agricultural work in the United States (U.S.) must account for at least two important trends: 1) the persistence of the industry being riddled with high rates of injury and illness and 2) the growing proportion of hired farmworkers compared to family farmworkers working in these dangerous environments. These workers confront structural disadvantages that impede social justice and prosperity. Social structures like policies, economic systems, institutions, and social hierarchies create health disparities, often along the lines of social categories. The result is an already dangerous industry with vulnerable workers facing unjust risks, especially those that are undocumented. Agricultural health and safety professionals and other stakeholders should engage structural competency curricula in order to increase awareness of impact of structures and be better positioned to improve farmworker health and wellbeing. Similar work has been successful in the training healthcare professionals, e.g. the Structural Competency Working Group (SCWG). New strategies are needed to improve farmworker wellbeing and retain an adequate agricultural workforce. A greater understanding of the social and structural concerns that farmworkers face is an important step towards occupational and social justice. It is also clear that it will require collaboration and community-based efforts creating a larger team of people using similar concepts related to the structural influences on whether health and wellbeing are distributed equitably. This work is being moved forward in healthcare, social work, worker organizations, and community-based initiatives. Agricultural health and safety professionals have a vital contribution to make if they join the ranks. [ABSTRACT FROM AUTHOR]

Commercial fishing is a high-risk occupation, yet there is a lack of surveillance documenting health conditions, health behaviors, and health care coverage among US fishermen. We used publicly available data sources to identify exposures and health outcomes common among fishermen. We utilized the National Institute for Occupational Safety and Health–Worker Health Charts to estimate the prevalence of general exposures, psychosocial exposures, health behaviors, and health conditions from the national surveys National Health Interview Survey – Occupational Health Supplement (NHIS-OHS, 2015) and Behavioral Risk Factor Surveillance System (BRFSS) (2013–2015). We compared fishing workers with both agricultural workers and all-workers. Fishermen commonly reported general exposures, psychosocial exposures, non-standard work arrangements, frequent night shifts, and shift work. The prevalence of musculoskeletal conditions such as carpal tunnel syndrome (33%) and severe low-back pain (27%) was also high. Smoking (45%) and second-hand smoke exposure (25%) were widespread, and 21% reported no health care coverage. National household surveys such as NHIS-OHS, and BRFSS can be utilized to describe the health status of fishermen. This workforce would benefit from increased access to health care and health promotion programs. More comprehensive evaluations of existing data can help to identify occupation-specific health challenges. [ABSTRACT FROM AUTHOR]

Objectives: The use of conventional treatment for work‐related musculoskeletal disorders (WRMSDs) reduces the prevalence of pain, but with popularity of complementary alternative medicine (CAM) therapies for treatment, it is important to explore their use and impact on dental hygienists (DHs) quality of life (QoL). Methods: A cross‐sectional survey research design was used with a non‐probability sample of dental hygienists (n = 85) with WRMSDs who used CAM therapies. The WHOQOL‐BREF was used to assess quality of life and compared with CAM use and frequency. Analysis included descriptive, t‐tests, correlation and chi‐square tests of independence. Results: The most commonly used CAM types were massage (81%) and chiropractic manipulation (67%) with 66% of respondents using two or more CAM therapies. Participants using five or less different CAMs (n = 46), compared with those using more than five CAM types (n = 35, M = 2.3, SD = 1.5), t (79) = 2.7, p = 0.01, had a higher average number of years before they noticed their WRMSD (M = 3.3, SD = 1.9). Participants reporting use of a higher number of CAM types also had lower QoL physical health domain scores (rho = −0.2, p = 0.03). Conclusions: Dental hygienists used a variety of CAM approaches to manage WRMSDs and had a lower QoL across all domains (physical health, psychological health, social relationships and environment) than the normative mean. More research is needed to explore the use of CAM approaches, such as yoga, for prevention and management of WRMSDs to improve QoL. [ABSTRACT FROM AUTHOR]

This is a follow-up study of 54 years on disease risks to United States Shipyard Radiation Workers using the Standardized Mortality Ratio method, answering a simple but important question: if US shipyard workers have had any mortality risk associated with occupational radiation exposures compared to US general population. Objective: To examine the risk of diseases among industrial workers with low and fractionated radiation exposures. Method: The 372,047 US male shipyard radiation and non-radiation workers were followed for 54 years and compared with US men using standardized mortality ratio (SMR) method. Results: SMRs for both radiation and non-radiation workers had lower risks of death from all causes (0.74; 95% confidence interval [CI] 0.74 to 0.75 and 0.77; 95% Cl 0.77 to 0.78, respectively) and from all cancers (0.92; 95% CI 0.91 to 0.93 and 0.90; 95% CI 0.89 to 0.91, respectively) compared with US men. Asbestos-related diseases including pleural cancers, mesothelioma, and asbestosis, but not lung cancers, were statistically higher in both radiation and non-radiation workers compared with the US men. Conclusion: US shipyard male radiation and non-radiation workers did not show any elevated mortality risks that might be associated with radiation exposure. [ABSTRACT FROM AUTHOR]

These findings document occupational differences in mortality due to the deaths of despair. They can be useful for intervening with high risk occupations and identifying workplace factors that may contribute to these deaths. Objective: To assess occupational differences in proportional mortality ratios (PMRs) and trends in these PMRs due to the deaths of despair in the United States. Methods: PMRs for deaths due to drug overdoses, suicide, and alcoholic liver disease were obtained from the National Occupational Mortality Surveillance system. Data came from various states for the years 1985 to 1998, 1999, 2003 to 2004, and 2007 to 2014. Results: Occupations with the highest risk for deaths of despair included construction; architects; and food preparation and service. Occupations with the highest increases in deaths due to deaths of despair included personal care and service and home aides. Conclusions: Identifying occupations with elevated risk factors for deaths of despair makes it possible to focus interventions on these occupations. Occupational hazards and exposures may increase risk to deaths of despair for specific workers. [ABSTRACT FROM AUTHOR]

Agricultural work involves ergonomic and psychosocial strain, which contribute to musculoskeletal conditions. The aim of this study was to assess if specific ergonomic, psychosocial, and preventive factors are linked to musculoskeletal pain or discomfort symptoms (MSS) in farmers and ranchers. We analyzed data from the Central States Center for Agricultural Safety and Health survey that was conducted in 2018 in a seven-state region of the central United States. MSS were assessed with questions from the Standardized Nordic Questionnaire. The survey included questions on demographic, ergonomic, psychosocial and preventive factors. Farm production variables were added from the Farm Market iD database. We analyzed the data using Generalized Estimating Equations. The overall prevalence of MSS for all body sites combined was 59% among 4,354 farmers and ranchers who responded (19% response rate). After controlling for age, sex, and operator status, three factors (high stress level, sleep deprivation, and exhaustion/fatigue) showed the strongest associations with MSS in any body site, with adjusted odds ratios (OR) ranging from 4.8 to 5.6. Forceful exertions, repetitive tasks, awkward postures, frequent manual labor, and vibration were also significantly associated with MSS, with adjusted ORs ranging from 1.8 to 3.3. Recommended preventive techniques were not protective for MSS. New effective strategies are needed to reduce the high burden of musculoskeletal outcomes among farmers and agricultural workers. [ABSTRACT FROM AUTHOR]

This Article performs a close analysis of workers' compensation coverage of COVID-19 and arrives at the conclusion that it should not be "impossible" to prove in a legal sense that an employee's COVID- 19 was caused by work Scientific proof is not the same as legal proof: Workers' compensation law has never required that claims must be supported by irrefutable scientific proof of workplace causation. Yet repeatedly one heard this suggestion during public discussion on workers ' compensation coverage Of employees. Still, there is good evidence that even when workers' compensation undisputedly covers work-related disease, employers seldom pay benefits and states do not compel them to do so. This is one reality that COVID-19 laid bare: The workers' compensation system rigidly resists paying occupational disease claims. This Article also explores a news account from Minnesota stating that 935 of 935 workers' compensation COVID-19-related claims from meatpacking employees had not been paid as of February 2021. There was no shortage of other stories during the pandemic of mass denial of workers' compensation claims in the meatpacking industry, a development having a disparate impact on communities of color, where more than half of all meatpacking employees are Latinx. These unpaid claim numbers suggest that something was wrong" with causation analyses at the lower levels of the administrative system. Another truth COVID-19 laid bare is that, aside. from workers' compensation, there is no nationwide short-term disability program in the United States. This leads to the conclusion that, if workers' compensation insists upon super-strict versions of causation to cover claims, a different method of compensating short-term disability during pandemics or other "environmental" crises may become necessary. The conclusion seems almost inescapable because public health experts like Dr. Anthony Fauci are warning that we remain at risk for "new disease emergences" for the "foreseeable. future. "' [ABSTRACT FROM AUTHOR]

Anterior knee pain (AKP) is ubiquitous in early career military members and exacerbated during functional tasks required during military duties. Therefore, it is important to understand the risk of this condition among male and female tactical athletes in diverse military occupations. To assess sex and occupation with respect to the AKP risk in military members. Descriptive epidemiology study. United States Armed Forces. All military members diagnosed with anteropatellar or retropatellar pain, patellar instability, or knee tendinopathy on their initial encounter from 2006 to 2015. The Defense Medical Epidemiology Database was queried for the number of individuals with AKP. Relative risk (RR) and χ2 statistics were calculated in the assessment of sex and occupational category. Regressions were calculated to determine associations between service branch, sex, and AKP across time. From 2006 to 2015, a total of 151 263 enlisted and 14 335 officer service members were diagnosed with AKP. Enlisted females had an incidence rate of 16.7 per 1000 person-years compared with enlisted males' incidence rate of 12.7 per 1000 person-years (RR = 1.32; 95% CI = 1.30, 1.34; P <.001) across all AKP diagnoses. Female officers had an incidence rate of 10.7 per 1000 person-years; male officers had an incidence rate of 5.3 per 1000 person-years (RR = 2.01; 95% CI = 1.94, 2.09). Differences in risk were also noted across military occupations for both enlisted and officer service members (P values <.05). Sex and military occupation were salient factors for the AKP risk. Evaluating training requirements and developing intervention programs across military occupations could serve as a focus for future research aiming to decrease the incidence of chronic knee pain. [ABSTRACT FROM AUTHOR]

The aim of this study is to explore the current characteristics of people with chronic lower back (CLB) pain, and the sociodemographic and work-related predictors of this pain. The study design used in the study is a cross-sectional study. The 2018 National Health Interview Survey data were used. Chi-squared analysis was used to assess the sociodemographic characteristics, and logistic regression was used to analyze the risk factors after multiple imputation. Of the 72,831 respondents, 25,397 had provided data on CLB pain and were eligible for this study. People with CLB pain were more likely to be obese, white, female, older than 40 years, and did not have a college degree. They were more likely to carry out less than 150 min of moderate aerobic exercise per week. Age was the sociodemographic predictor of CLB pain (P -value <0.001). After imputation and adjusting for covariates, construction and extraction and military-specific occupational groups were associated with an increased risk of CLB pain [odds ratios (OR): 1.32, confidence interval (CI): 1.10–1.59, P -value = 0.004; OR: 2.20, CI: 1.36–3.55, P -value = 0.001]. Working between 41 and 60 h/week significantly also had an increased risk of developing CLB pain (OR: 1.13, CI: 1.01–1.27, P- value 0.043; OR: 1.23, CI: 1.10–1.37, P -value <0.001). Low socio-economic status, poor physical fitness, work-life imbalance, and the type of occupation contribute to the development of CLB pain. An improvement in preventive measures is needed to address this morbidity. More studies should be carried out to analyze the type of workplace movements that increase the risk of developing CLB. [ABSTRACT FROM AUTHOR]

The article presents the discussion on the concept of precarious employment and longstanding hazards of employment in meat packing and meat processing. Topics include characterized by low wage, poor protection from termination, absence of access to regulatory protections, and benefits associated with standard employment; and experiencing high levels of precariousness as a consequence of job insecurity and economic and political powerlessness.

The purpose of this study was to estimate the effect of past and current rotating shift assignments on U.S. law enforcement officers' health outcomes. In a nationally representative sample of 2,867 officers, with an oversample of female officers, we estimated models of sleep quality and fatigue, physical health outcomes, and psychological health outcomes. Further, we examined individual and agency-level factors associated with officers who reported currently working a rotating shift, to investigate what patterns there may be in shift assignments. A history of rotating shift assignments was positively associated with lower sleep quality, and with hypertension, diabetes, and high cholesterol, but not with gastrointestinal disorders, perceived stress, emotional well-being, or suicidality. The associations of shiftwork with health outcomes did not vary by gender. Demographic characteristics did not predict current rotating shift assignments, but a longer history of shiftwork and more working hours did predict a current shift assignment. Attention to mitigating shift system designs as well as the effect of cumulative years of working a rotating shift for the benefit of officer health outcomes is warranted. [ABSTRACT FROM AUTHOR]

Objective: Long-haul truck drivers suffer increased health risk, but how they use healthcare is unknown. The objectives of this study were to explore the health experiences of these drivers, their healthcare experiences, and their relationship with their main medical provider. Methods: In-depth semi-struc- tured interviews were conducted with 13 Canadian long-haul truck drivers. The majority (85%) were men and recruited at a truck stop on a major transport corridor between Canada and the United States. Results: Through phenomenological analysis of the transcribed interviews, themes of persever- ance, isolation, dehumanization, and working in a hidden world emerged as major influences on the health experiences of these drivers. Barriers to their medical provider were also revealed. Conclusions: Continuous exposure to a stressful work environment and inadequate access to primary care likely negatively affect the health of long-haul truck drivers. Given the experiences of this small group of drivers, improved healthcare and health resource availability might mitigate the risk of this occupational group. [ABSTRACT FROM AUTHOR]

Background: Pneumoconiosis can occur in surface coal miners. The Coal Workers' Health Surveillance Program (CWHSP) has only included surface coal miners as part of its regular disease surveillance since 2014. This analysis identifies the prevalence of pneumoconiosis among working surface coal miners participating in the CWHSP since their initial inclusion, through 2019. Methods: Working surface coal miners who had chest radiographs through the CWHSP from January 1, 2014 through December 31, 2019 were included in this analysis. Demographic information, mining tenure and occupation, and radiographic classifications according to the International Labour Office system were included from each miner's most recent encounter with the CWHSP. Prevalence ratios were calculated comparing the prevalence of the disease by region and occupation by log‐binomial regression. Results: Pneumoconiosis was present in 109 (1.6%) surface coal miners, including 12 miners with progressive massive fibrosis, the most severe form of the disease. After taking surface mining tenure into account, surface miners in Central Appalachia (prevalence ratio [PR], 3.2; 95% confidence interval [CI], 2.2–4.7) and surface miners who worked as a driller or blaster (PR, 2.1; 95% CI, 1.3–3.5) were at increased risk of pneumoconiosis. Conclusion: The occurrence of pneumoconiosis in surface coal miners supports including them within a systematic respiratory health surveillance program. The current surveillance findings are consistent with past findings of pneumoconiosis, particularly silicosis, in surface mining occupations such as drilling and blasting. [ABSTRACT FROM AUTHOR]

Purpose--To characterize the prevalence of work-related musculoskeletal disorders (MSD), symptoms, and risk factors among ophthalmologists. Methods--An online survey was distributed to ophthalmologist members of the Maryland Society of Eye Physicians and Surgeons. The survey consisted of 34 questions on respondent demographics, practice characteristics, pain, and effects of MSD on their practice patterns. Participants were excluded if they were not ophthalmologists or if they had MSD symptoms prior to the start of their ophthalmology career. Demographics and practice patterns were compared for those with or without MSD symptoms using the Welch t test and the Fisher exact test. Results--The survey was completed by 127 of 250 active members (response rate, 51%). Of the 127, 85 (66%) reported experiencing work-related pain, with an average pain level of 4/10. With regard to mean age, height, weight, years in practice, number of patients seen weekly, and hours worked weekly, there was no difference between respondents reporting pain and those without. Those reporting MSD symptoms spent significantly more time in surgery than those who did not (mean of 7.9 vs 5.3 hours/week [P < 0.01]). Fourteen percent of respondents reported plans to retire early due to their symptoms. Conclusions--A majority of respondents experienced work-related MSD symptoms, which was associated with time spent in surgery. Modifications to the workplace environment focusing on ergonomics, particularly in the operating room, may benefit ophthalmologists. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate occupational and non-occupational mortality among Mexican immigrants in the South Eastern United States. The construction industry has the highest burden of occupational fatalities in the USA of all industries, and foreign-born Hispanic workers are disproportionately affected. Design/methodology/approach: Data were obtained from 3,093 death certificates maintained by the Consulate General of Mexico in Atlanta, Georgia. Standardized mortality ratios (SMR) were used to compare occupational-related deaths among construction industry occupations, and logistic regression models were used to examine the relationship between manners of death not related to occupation and employment in the construction industry. Findings: The proportion of Mexican immigrants who died from occupational injuries is higher among all construction workers (SMR = 1.31), roofers (SMR = 2.32) and carpenters (SMR = 2.25) than other workers. Among the population in this analysis suicide [adjusted odds ratio (aOR) = 0.63] and death from natural causes (aOR = 0.70) were inversely related to work in the construction industry. Research limitations/implications: Interventions to reduce occupational fatalities among Mexican migrant construction workers should target roofers and carpenters. Future research should further investigate the industry's association with suicide and natural death. Originality/value: This is one of the first analyzes that investigated associations between construction industry employment and non-occupational fatalities among immigrants. The analysis provides evidence that a large portion of the Mexican immigrant population is used in the construction industry (38%) and face elevated risks for occupational fatalities and the results of this investigation should encourage greater surveillance of occupational illness and injury among foreign-born immigrants who work in construction, as well as other high-risk industries. [ABSTRACT FROM AUTHOR]

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Background : Analyzing health risk factors among current workers by industry and occupation (IO) provides information on disparities between worker groups, especially when comparing workers within manual labor occupations. Mining and oil and gas extraction (OGE) are unique industries with different work environments that could affect health risk factors. The study objective was to compare the prevalence of health risk factors of miners, OGE, other manual labor, and nonmanual labor workers. Methods : The Behavioral Risk Factor Surveillance System's IO module was analyzed for years 2013–2017 to compare prevalences of excessive alcohol use, smoking, smokeless tobacco use, seat belt use, inadequate sleep, and obesity among four worker groups. National Health Interview Survey IO codes were used to categorize miners, OGE, other manual labor, and nonmanual labor workers. Findings : Miners and OGE workers had higher prevalence estimates than both nonmanual and manual labor workers for all health risk factors except current smoking. Both miners and OGE workers were significantly more likely than other manual labor workers to report smokeless tobacco use and not always wearing seatbelts. Compared with other manual labor workers, OGE workers were significantly more likely to report obesity, and miners were significantly more likely to report inadequate sleep. Conclusion/Application to Practice : Prevalence of most health risk factors differed among miners, OGE, other manual labor, and nonmanual labor workers. These differences could lead to disparities in health outcomes. Occupational health professionals in mining and OGE can use this information to inform and target integrated wellness and health and safety programs. [ABSTRACT FROM AUTHOR]

Objectives: Back pain is the leading occupational health problem among agricultural workers. Current study aimed to assess the burden of farm work-related back pain and to investigate its associations with living residence location and work conditions among farmworkers. Methods: We used the National Agricultural Workers Survey (NAWS) data from 1999 to 2004, 2008–2010, and 2014. Work-related back pain was defined as a back pain that was developed when performing farm work in the 12 months prior to the interview, and it caused pain or discomfort for at least five consecutive days. To assess the associations of place of residence and working conditions (i.e. work equipment and access to toilet and water for washing hands at work) with back pain, we analyzed the data using mixed-effects logistic regression models while adjusting for age, gender, race, birthplace (US vs. foreign country), education, marital status, work authorization (yes vs. no), below poverty income, whether the worker was hired by a farm labor contractor or not, and weekly working hours. Results: The standardized annual back pain prevalence during the study period ranged from 2.6% to 11.3%. In the adjusted model, farmworkers who lived in a residence located on the farm, who did not have access to toilet at work, and who paid for work equipment had higher odds of back pain than their counterparts. Conclusion: Back pain is particularly common among farmworkers with poor working and living conditions. Interventions should target the identified high-risk groups to mitigate their burden of back pain. [ABSTRACT FROM AUTHOR]

Purpose: Little is known about the work environmental risk factors for opioid use disorder (OUD) in working populations. The purpose of this study is to examine whether adverse physical and psychosocial working conditions are associated with OUD in a working population of the United States (US). Methods: Among the participants of the National Survey of Midlife Development in the United States (MIDUS) II Study (2004–2006), 2134 workers (1059 men and 1075 women; mean age, 51 years) were chosen for this study. OUD was measured with self-administered questions in line with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSD-5). Physical demands (physical efforts, heavy lifting, and crouching/stooping/kneeling) and psychosocial work stressors (skill discretion, decision authority, job control, psychological job demands, supervisor and coworker support at work, job insecurity, and work hours) were measured with a standard questionnaire. Results: The prevalence of OUD was 3.8%. In multivariate analyses, low skill discretion, high psychological job demands, job strain (a combination of low control and high demands), and high physical job demands were significantly associated with OUD. The multivariate prevalence ratios for OUD by job strain and frequent heavy lifting were 1.98 (1.27–3.10) and 2.23 (1.22–4.10), respectively. Job strain was more strongly associated with OUD in men, while high physical job demands were more strongly associated with OUD in women. Conclusion: This study implies that adverse physical and psychosocial working conditions may be important risk factors for OUD in US working populations. Future longitudinal and mechanistic studies are urgently warranted. [ABSTRACT FROM AUTHOR]

Objective: To describe the frequency of work-related asthma (WRA) and characteristics of individuals with exposure to cleaning products 1998 to 2012, compared with 1993 to 1997. Methods: Cases of WRA from products used for cleaning or disinfecting surfaces were identified from California, Massachusetts, Michigan (1998 to 2012), New Jersey (1998 to 2011), and New York (2009 to 2012). Results: There were 1199 (12.4%) cleaning product cases among all 9667 WRA cases; 77.8% women, 62.1 % white non-Hispanic, and average age of 43 years. The highest percentages worked in healthcare (41.1 %), and were building cleaners (20.3%), or registered nurses (14.1%). Conclusions: The percentage of WRA cases from exposure to cleaning products from 1998 to 2012 was unchanged from 1993 to 1997 indicating that continued and additional prevention efforts are needed to reduce unnecessary use, identify safer products, and implement safer work processes. [ABSTRACT FROM AUTHOR]

Background: Timely and reliable national estimates of the occurrence of occupational injury and illness are needed to monitor the burden of occupational morbidity and mortality, establish research and intervention priorities, and evaluate the progress and effectiveness of prevention efforts. Methods: We provide updated estimates of morbidity from occupational injuries and selected illnesses, using current general population incidence rates, the proportion of the general public with a particular workplace exposure, and the relative risk of illness from that exposure. We provide estimates for the total U.S. working population and for specific industry sectors. Results: We estimate that, in 2012, between 5 712 362 and 5 961 620 total occupational cases, including 0.7 to 1.0 million incident illnesses and 5.0 million injuries, occurred in the United States. Conclusion: The variety of disparate data sources and methods required to compile these estimates highlight the need for more comprehensive and compatible occupational health surveillance in the United States. [ABSTRACT FROM AUTHOR]

The primary health concerns among US firefighters are cardiovascular disease, cancer, and depression and occur in an occupational setting where dietary habits are suboptimal. To understand if a diet or lifestyle modification works in a fire academy training setting, it is important to evaluate the cultural barriers and challenges that might be faced. A semi-structured telephone interview method followed by a focus group was used to gather common themes among fire service leaders. Twelve leaders participated in the telephonic interviews and a subset of five in the subsequent group session. Five main themes were identified. The study identified a need for staff and recruits to develop a cohesive culture that facilitates long-term change. Participants reported that incentives for good choices and the elimination of certain poor choices from the food environment would promote healthier choices. The study supports an intervention using education of fire recruits and modifications of the fire academy food environment. [ABSTRACT FROM AUTHOR]

Climate-related increases in global mean temperature and the intensification of heat waves present a significant threat to outdoor workers. Limited research has been completed to assess the potential differences in heat exposures that exist between individuals within similar microenvironments. Yet, there is a paucity of individual data characterizing patterns of individually experienced temperatures in workers and the associated physiologic heat strain response. The objective of this study was to apply a wearable sensor-based approach to examine the occupational, environmental, and behavioral factors that contribute to individual-level variations in heat strain in grounds maintenance workers. Outdoor workers from three diverse climatic locations in the southeastern United States – high temperature, high temperature + high humidity, and moderate temperature environments – participated in personal heat exposure monitoring during a 5-day work period in the summer. We performed Cox proportional hazards modeling to estimate associations between multiple heat strain events per worker and changes in individually experienced temperatures. Heat strain risk was higher among workers with a place to cool-off, higher education, and who worked in hotter temperatures. A mismatch was observed between workers' perceptions of heat strain and actual heat strain prevalence across exposure groups. We also used a quasi-Poisson regression with distributed lag non-linear function to estimate the non-linear and lag effects of individually experienced temperatures on risk of heat strain. The association between increasing temperature and heat strain was nonlinear and exhibited an U-shaped relationship. Heat strain was less common during issued heat warnings demonstrating behavioral adaptive actions taken by workers. This study is one of the first temperature monitoring studies to quantify the individual-level exposure-response function in this vulnerable population and highlights the elevated risk of heat strain both immediately and several days after worker exposure to high temperatures. • Wearable sensors are feasible to continuously measure individual experienced temperature and physiologic heat strain response. • We observed a mismatch between worker perception of heat and prevalence of heat strain. • Higher risk of heat strain occurred outside of a National Weather Service heat advisory. • Heat strain risks varied across the three geographically/climatically distinct worksites. • Temperature-heat strain association followed a nonlinear, U-shaped response. [ABSTRACT FROM AUTHOR]

Background: Trauma-related diagnoses such as posttraumatic stress disorder (PTSD) are prevalent in veterans. The identification of mechanisms related to stress vulnerability and development of PTSD specifically in a veteran population may aid in the prevention of PTSD and identification of novel treatment targets.Methods: Veterans with PTSD (n = 27), trauma-exposed veterans with no PTSD (TEC, n = 18) and non-trauma-exposed controls (NTEC, n = 28) underwent single-voxel proton (1H) magnetic resonance spectroscopy (MRS) at 3 Tesla in the dorsal anterior cingulate cortex (dACC) using a two-dimensional (2D) J-resolved point spectroscopy sequence in addition to completing a clinical battery.Results: The PTSD and TEC groups demonstrated lower gamma-amino butyric acid (GABA)/H2O (p = 0.02) and glutamine (Gln)/H2O (p = 0.02) in the dACC as compared to the NTEC group. The PTSD group showed a trend towards higher Glu/GABA (p = 0.053) than the NTEC group. Further, GABA/H2O in the dACC correlated negatively with sleep symptoms in the PTSD group (p = 0.03) but not in the TEC and NTEC groups.Limitations: Cross-sectional study design, concomitant medications, single voxel measurement as opposed to global changes, absence of measure of childhood or severity of trauma and objective sleep measures, female participants not matched for menstrual cycle phase.Conclusions: Exposure to trauma in veterans may be associated with lower GABA/H2O and Gln/H2O in the dACC, suggesting disruption in the GABA-Gln-glutamate cycle. Further, altered Glu/GABA in the dACC in the PTSD group may indicate an excitatory-inhibitory imbalance. Further, lower GABA/H2O in the ACC was associated with poor sleep in the PTSD group. Treatments that restore GABAergic balance may be particularly effective in reducing sleep symptoms in PTSD. [ABSTRACT FROM AUTHOR]

Background: Previous studies have suggested an association of asthma onset and exacerbation with cleaning and disinfecting activities in a number of industries, including healthcare. The objective of the current study was to investigate the association of asthma and related outcomes with occupations and tasks in urban healthcare workers in the United States.Methods: A questionnaire was implemented in a sample of workers from nine healthcare occupations in New York City. We used regression models to examine the association of post-hire asthma, current asthma, exacerbation of asthma, a symptom algorithm for bronchial hyper-responsiveness (BHR-related symptoms), a symptom-based asthma score, and the symptom wheeze with occupation and four healthcare tasks, while adjusting for other risk factors and potential confounders.Results: A total of 2030 participants completed the questionnaire. The task of cleaning fixed surfaces was significantly associated with most outcome variables, including current asthma (odds ratio (OR) = 1.84, 95% confidence interval (CI) 1.26-2.68), moderate exacerbation (OR = 3.10, 95% CI 1.25-7.67), and BHR-related symptoms (OR = 1.38, 95% CI 1.08-1.77). In comparison to nursing assistants, the occupations environmental service workers and registered nurses were at higher risk for current asthma, and licensed practical nurses were at higher risk for moderate exacerbation. Other tasks associated with outcomes were administering aerosolized medications with current asthma and moderate exacerbation, and sterilizing medical equipment with BHR-related symptoms.Conclusions: These findings add to the growing body of evidence for the association of asthma with cleaning and other activities in healthcare. Further research is especially needed to investigate the association of asthma-related outcomes with exposure metrics based on tasks, products, and chemical exposures in healthcare. [ABSTRACT FROM AUTHOR]

Purpose: Work-related musculoskeletal disorders (WMSDs) among dental hygienists (DHs) are highly prevalent due to occupational risk factors. The purpose of this study was to evaluate prevalence of WMSDs in clinical DHs, chairside stretching exercise behavior, and readiness to implement chairside stretching exercises. Methods: Cross-sectional survey research was conducted with a non-probability sample of clinical DHs (N = 224). The survey included WMSD experience, chairside stretching exercise behavior, and University of Rhode Island Change Assessment -- Exercise 2 (URICA-E2) to assess participants stretching exercise behavior and related stage of change. Analysis included descriptive, t-tests, Spearman correlation, chi-square tests, confirmatory factor analysis, and regression modeling. Results: The findings showed 83% of participants reported WMSDs with a mean stretching frequency of 4.6 (SD=4.2) times per day for 2.2 (SD=2.9) minutes. In regression models, predictors of duration (p<.05) and frequency (p<.01) of stretching was being in the Action stage of change and being in Contemplation was negatively associated with duration (p<.01) and frequency (p<.01). The models explained 7% (R2=.07, p<.01) of variance in duration and 17% (R2=.17, p<.01) of variance in frequency. Conclusion: Findings showed a high prevalence of WMSDs with the contemplation stage being the strongest predictor for duration and frequency of stretching behavior. However, variables included in this study only accounted for 7-17% of the variance suggesting a need to explore other factors that explain duration and frequency of DHs chairside stretching behavior. [ABSTRACT FROM AUTHOR]

The article focuses on Climate Change and the Amplification of Agricultural Worker Health Risks. Topics discussed include Climate change can be seen as a process that amplifies health risks in agriculture, along with creating new hazards for certain worker populations; and Climate change is associated with higher temperatures in the Western U.S. leading to a higher frequency of extreme heat days.

Bisphenol A is a commercially important chemical used to make polycarbonate plastic, epoxy resins, and other specialty products. Despite an extensive body of in vitro, animal and human observational studies on the effects of exposure to bisphenol A, no authoritative bodies in the U.S. have adopted or recommended occupational exposure limits for bisphenol A. In 2017, the National Institute for Occupational Safety and Health published a Draft process for assigning health-protective occupational exposure bands, i.e., an airborne concentration range, to chemicals lacking an occupational exposure limit. Occupational exposure banding is a systematic process that uses both quantitative and qualitative toxicity information on selected health effect endpoints to assign an occupational exposure band for a chemical. The Draft process proposes three methodological tiers of increasing complexity for assigning an occupational exposure band. We applied Tier 1 (based on the Globally Harmonized System of Classification and Labelling) and Tier 2 (based on authoritative sources/reviews) to assign an occupational exposure band to bisphenol A. Under both Tier 1 and 2, the occupational exposure band for bisphenol A was "E" (<0.01 mg/m3), an assignment based on eye damage. "E" is the lowest exposure concentration range, reserved for chemicals with high potential toxicity. If eye damage was excluded in assigning an air concentration exposure range, then bisphenol A would band as "D" (>0.01 to 0.1 mg/m3) under Tier 1 (based on reproductive toxicity and respiratory/skin sensitization) and under Tier 2 (based on specific target organ toxicity-repeated exposure). In summary, Tiers 1 and 2 gave the same occupational exposure band for bisphenol A when eye damage was included ("E") or excluded ("D") as an endpoint. [ABSTRACT FROM AUTHOR]

Background: Unique aspects of military sexual trauma (MST) may result in specific maladaptive cognitions among survivors. Understanding which posttraumatic cognitions are particularly strong among MST survivors could help clinicians target and improve treatment for these individuals. This study explored the impact of experiencing MST on posttraumatic cognitions among veterans with posttraumatic stress disorder (PTSD).Methods: Veterans enrolled in an Intensive Outpatient Program for PTSD (N = 226) were assessed for MST, PTSD severity, depression severity, and posttraumatic cognitions as part of a standard clinical intake. Multivariate analyses examined differences in posttraumatic cognitions between veterans who did and did not experience MST.Results: MST survivors (n = 88) endorsed significantly stronger posttraumatic cognitions related to self-blame compared to non-MST counterparts (n = 138), even when accounting for current symptom severity. Specifically, MST predicted the following cognitions: "The event happened to me because of the sort of person I am," "Somebody else would have stopped the event from happening," "Somebody else would not have gotten into this situation," and "There is something about me that made the event happen," after controlling for severity of PTSD and depression.Limitations: Study population was a treatment-seeking sample of veterans diagnosed with PTSD from a non-VA clinic. Veterans in MST group endorsed either sexual harassment, sexual assault, or both. Sample size of males who endorsed MST (n = 21) may be too small to generalize to all males.Conclusions: Beliefs related to self-blame may be important treatment targets for MST survivors. [ABSTRACT FROM AUTHOR]

Excessive ambient temperature exposure can result in significant morbidity and mortality, especially among vulnerable occupational groups like outdoor workers. Average temperatures in the USA are projected to increase in frequency and intensity, placing future worker populations at greater risk for unhealthy levels of exposure. Unlike previous research focused on aggregate-level temperature exposures from in situ weather station data, this study will measure location-based personal ambient temperatures (PAT) at the individual-level by piloting the use of wearable sensor technology. A total of 66 outdoor workers in three geographically and climatologically diverse regions in the Southeast USA were continuously sampled during the workday for a 1-week period throughout July 11 to August 8 2016. Results indicate significant worker variation in temperature exposure within and between study locations; with PAT characterized by less pronounced variability as workers moved between indoor and outdoor environments. Developed land covers, a factor often associated with higher temperatures, were poorly correlated with PAT. Future analysis should focus on a worker’s physiological response to PAT and mapping of spatial patterns of PAT for a larger worker population to produce innovative and targeted heat prevention programs. [ABSTRACT FROM AUTHOR]

Purpose: We conducted external comparisons for the prevalence of asthma, hypertension, diabetes, and cancer among World Trade Center (WTC) general responders using the National Health Interview Survey (NHIS) as the reference, along with internal comparisons for the incidence of asthma. Methods: Standardized Morbidity Ratios (SMRs) were calculated for the prevalence of the health conditions, and risk ratios (RRs) for asthma incidence. Results: Relative to the NHIS, asthma prevalence was in excess in responders over the study years (age‐adjusted SMRs = 1.3‐2.8). Hypertension prevalence began to exceed expected from 2006 while diabetes was lower than expected. An upward trend towards excess cancer prevalence was observed. Internal comparisons showed elevated asthma incidence among protective service and utility workers compared to construction workers; while those who arrived at the WTC site in the morning of 9/11 had a lower asthma risk than those who arrived in the afternoon. Conclusions: The use of NHIS data as a reference population demonstrates and reconfirms several important patterns of excess risk in WTC responders. External comparisons are an alternative for disaster cohorts without an established comparison group. [ABSTRACT FROM AUTHOR]

Background: Accuracy of the Bureau of Labor Statistics Survey of Occupational Injuries and Illnesses (SOII) data is dependent on employer compliance with workplace injury and illness recordkeeping requirements. Characterization of employer recordkeeping can inform efforts to improve the data. Methods: We interviewed representative samples of SOII respondents from four states to identify common recordkeeping errors and to assess employer characteristics associated with limited knowledge of the recordkeeping requirements and non compliant practices. Results: Less than half of the establishments required to maintain OSHA injury and illness records reported doing so. Few establishments knew to omit cases limited to diagnostic services (22%) and to count unscheduled weekend days as missed work (27%). No single state or establishment characteristic was consistently associated with better or worse record‐keeping. Conclusion: Many employers possess a limited understanding of workplace injury recordkeeping requirements, potentially leading them to over‐report minor incidents, and under‐report missed work cases. [ABSTRACT FROM AUTHOR]

Background: Recent animal studies have suggested the potential for wide-ranging health effects resulting from exposure to carbon nanotubes and nanofibers (CNT/F). To date, no studies in the US have directly examined the relationship between occupational exposure and potential human health effects.Objectives: Our goal was to measure CNT/F exposures among US workers with representative job types, from non-exposed to highly exposed, for an epidemiologic study relating exposure to early biologic effects.Methods: 108 participants were enrolled from 12 facilities across the US. Personal, full-shift exposures were assessed based on the mass of elemental carbon (EC) at the respirable and inhalable aerosol particle size fractions, along with quantitatively characterizing CNT/F and estimating particle size via transmission electron microscopy (TEM). Additionally, sputum and dermal samples were collected and analyzed to determine internal exposures and exposures to the hands/wrists.Results: The mean exposure to EC was 1.00 μg/m3 at the respirable size fraction and 6.22 μg/m3 at the inhalable fraction. Analysis by TEM found a mean exposure of 0.1275 CNT/F structures/cm3, generally to agglomerated materials between 2 and 10 μm. Internal exposures to CNT/F via sputum analysis were confirmed in 18% of participants while ∼70% had positive dermal exposures.Conclusions: We demonstrated the occurrence of a broad range of exposures to CNT/F within 12 facilities across the US. Analysis of collected sputum indicated internal exposures are currently occurring within the workplace. This is an important first step in determining if exposures in the workforce have any acute or lasting health effects. [ABSTRACT FROM AUTHOR]

Background: Previous studies have used network models to investigate how PTSD symptoms associate with each other. However, analyses examining the degree to which these networks are stable over time, which are critical to identifying symptoms that may contribute to the chronicity of this disorder, are scarce. In the current study, we evaluated the temporal stability of DSM-5 PTSD symptom networks over a three-year period in a nationally representative sample of trauma-exposed U.S. military veterans.Methods: Data were analyzed from 611 trauma-exposed U.S. military veterans who participated in the National Health and Resilience in Veterans Study (NHRVS). We estimated regularized partial correlation networks of DSM-5 PTSD symptoms at baseline (Time 1) and at three-year follow-up (Time 2), and examined their temporal stability.Results: Evaluation of the network structure of PTSD symptoms at Time 1 and Time 2 using a formal network comparison indicated that the Time 1 network did not differ significantly from the Time 2 network with regard to network structure (p = 0.12) or global strength (sum of all absolute associations, i.e. connectivity; p = 0.25). Centrality estimates of both networks (r = 0.86) and adjacency matrices (r = 0.69) were highly correlated. In both networks, avoidance, intrusive, and negative cognition and mood symptoms were among the more central nodes.Limitations: This study is limited by the use of a self-report instrument to assess PTSD symptoms and recruitment of a relatively homogeneous sample of predominantly older, Caucasian veterans.Conclusion: Results of this study demonstrate the three-year stability of DSM-5 PTSD symptom network structure in a nationally representative sample of trauma-exposed U.S. military veterans. They further suggest that trauma-related avoidance, intrusive, and dysphoric symptoms may contribute to the chronicity of PTSD symptoms in this population. [ABSTRACT FROM AUTHOR]

Globally, one in three adults has some level of measurable hearing loss, and 1.1 billion young persons are at risk for hearing loss attributable to noise exposure. Although noisy occupations such as construction, mining, and manufacturing are primary causes of hearing loss in adults, nonoccupational noise also can damage hearing. Loud noises can cause permanent hearing loss through metabolic exhaustion or mechanical destruction of the sensory cells within the cochlea. Some of the sounds of daily life, including those made by lawn mowers, recreational vehicles, power tools, and music, might play a role in the decline in hearing health. Hearing loss as a disability largely depends on a person's communication needs and how hearing loss affects the ability to function in a job. The loss of critical middle and high frequencies can significantly impair communication in hearing-critical jobs (e.g., law enforcement and air traffic control). [ABSTRACT FROM AUTHOR]