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The COVID-19 pandemic continues to exert immense societal impacts, with recent data showing inequitable distribution of consequences among racial and ethnic groups. The objective of this study was to assess associations between COVID-related work stressors and psychological distress, with special emphasis on differences by race and ethnicity. Data were from the population-based California Health Interview Survey (CHIS) 2020. Associations of individual and cumulative work stressors, including job loss, reduced work hours, and working from home, with psychological distress in 12,113 workers were examined via multivariable linear regression, and stratified analyses were conducted for racial and ethnic subgroups. After adjustment for covariates, compared to workers with no work stressors, those who experienced either one or two/more work stressors had higher psychological distress (βs and 95% CIs were 0.80 [0.51, 1.09] and 1.98 [1.41, 2.56], respectively). Notably, experiencing cumulative (two/more) work stressors had much stronger effects on psychological distress among participants who were Black (β and 95% CI were 3.51 [1.09, 5.93]) or racial minorities (β and 95% CI were 3.57 [1.10, 6.05]). Occupational consequences of the COVID-19 pandemic were associated with increased psychological distress in Californian workers and inequitably distributed, with racial and ethnic minorities suffering the greatest burden.

BackgroundNovel interventions tailored to blue collar workers are needed to reduce the disparities in smoking rates among occupational groups. ObjectiveThe main objective of this study was to evaluate the efficacy and usage of the Web-enhanced “Tobacco Tactics” intervention targeting operating engineers (heavy equipment operators) compared to the “1-800-QUIT-NOW” telephone line. MethodsOperating engineers (N=145) attending one of 25 safety training sessions from 2010 through 2012 were randomized to either the Tobacco Tactics website with nurse counseling by phone and access to nicotine replacement therapy (NRT) or to the 1-800-QUIT-NOW telephone line, which provided an equal number of phone calls and NRT. The primary outcome was self-reported 7-day abstinence at 30-day and 6-month follow-up. The outcomes were compared using chi-square tests, t tests, generalized mixed models, and logistic regression models. ResultsThe average age was 42 years and most were male (115/145, 79.3%) and white (125/145, 86.2%). Using an intent-to-treat analysis, the Tobacco Tactics website group showed significantly higher quit rates (18/67, 27%) than the 1-800-QUIT NOW group (6/78, 8%) at 30-day follow-up (P=.003), but this difference was no longer significant at 6-month follow-up. There were significantly more positive changes in harm reduction measures (quit attempts, number of cigarettes smoked per day, and nicotine dependence) at both 30-day and 6-month follow-up in the Tobacco Tactics group compared to the 1-800-QUIT-NOW group. Compared to participants in the 1-800-QUIT NOW group, significantly more of those in the Tobacco Tactics website group participated in the interventions, received phone calls and NRT, and found the intervention helpful. ConclusionsThe Web-enhanced Tobacco Tactics website with telephone support showed higher efficacy and reach than the 1-800-QUIT-NOW intervention. Longer counseling sessions may be needed to improve 6-month cessation rates. Trial RegistrationClinicaltrials.gov NCT01124110; http://clinicaltrials.gov/ct2/show/NCT01124110 (Archived by WebCite at http://www.webcitation.org/6TfKN5iNL).

This study explored racial and ethnic differences in perception of work environment, safe work practices, general health status, experience of work-related injury or illness and subsequent symptom reporting and health care seeking behaviors among cleaning workers. This study analyzed cross-sectional data obtained from 183 cleaning workers employed in a university hospital or a health sciences campus in Northern California. The sample included 120 Asians (65.6%), 37 Hispanics (20.2%), and 27 other ethnicities (14.2%); 85.7% were foreign-born. Asian workers perceived lower job control and supervisor support and higher job strain than other workers. The odds of perceiving general health as excellent or very good were lower among Asians compared to Hispanics and Others. Asians who experienced chemical-related symptoms were less likely than Hispanics and others to report the symptoms to their supervisor or seek healthcare. Our study findings indicated racial/ethnic differences in perceptions of work and general health, seeking healthcare, and reporting behaviors among cleaning workers. Asian workers, specifically, may need special attention to improve their experiences of work environments and health in the workplace.

Workplace violence (WV) is a significant and growing problem for health care workers. Increased recognition of the need for improved protections has led to policy initiatives at the state and federal levels, including national Joint Commission requirements that went into effect January 2022. California's WV prevention legislation was phased in during 2017-2018 and requires hospitals to use a new incident reporting system, the Workplace Violent Incident Reporting System (WVIRS) for Hospitals. We analyzed WVIRS data collected during the first three years of its implementation, July 1, 2017 - June 30, 2020. In addition, we collected qualitative data from six California hospitals/hospital systems during 2019-2020 to better understand reporting practices. Over the three-year period, the 413 hospitals using the WVIRS reported between zero and six incidents per staffed bed. Sixteen hospitals (3.9%) reported two or more incidents per staffed bed while the rest reported fewer than two incidents. Qualitative analysis identified that reporting procedures vary considerably among hospitals. Several organizations rely on workers to complete incident reports electronically while others assign managers or security personnel to data collection. Some hospitals appear to report only those incidents involving physical harm to the worker. Regulatory guidance for reporting practices and hospitals' commitment to thorough data collection may improve consistency. As hospitals throughout the U.S. consider practice changes to comply with new WV standards, those engaged in implementation efforts should look closely at reporting practices. Greater consistency in reporting across facilities can help to build evidence for best practices and lead to safety improvements.

Background: Workers' reporting of work-related injuries or illnesses is important for treatment and prevention, yet research often focuses on reporting barriers. This study aimed to identify factors related to work-related musculoskeletal disorder (WRMSD) reporting attitudes and their connection to reporting intention and behavior. Methods: We analyzed data from 377 direct care workers employed in 19 long-term care facilities in South Korea. A self-administered questionnaire collected demographics, job characteristics, physical and psychosocial factors, musculoskeletal symptoms, reporting attitudes, and WRMSD reporting intentions and behavior between May and August 2022. We used a generalized linear mixed model with a random intercept by employers to identify factors influencing reporting attitudes. To explore the relationship between reporting attitude and reporting intention and behavior, simple logistic regression was also conducted. Results: We achieved an 86% response rate. The majority of the study participants were female (87.2%), married (95.9%), and non-immigrant (72.8%). Of the study participants, 48.9% had no intention to report WRMSDs, and 44.3% held negative reporting attitudes. Among 200 workers with WRMSDs, 86.5% did not report them. Attitudes were associated with work duration, safety training, management safety priority, WRMSD experience, and symptom severity and frequency. Management safety priority did not moderate this relationship. Significant links existed between attitudes and reporting intention and behavior. Conclusions/Applications to Practice: This study highlights the vital influence of workers' attitudes on reporting work-related injuries and illnesses. Occupational health providers should employ strategies, such as tailored safety training and management commitment, with a focus on addressing the unique needs of long-tenured and musculoskeletal-exposed workers. Fostering a safety culture that promotes open and timely reporting is crucial, and implementing these strategies can significantly enhance workplace safety and health. [ABSTRACT FROM AUTHOR]

Low health literacy is closely related to a higher rate of hospitalization and of emergency services usage, leading to billions of dollars in avoidable health care costs and contributing to individuals' poor physical and mental health. While Korean Americans (KAs) have a high prevalence of general health and mental health problems, relatively little is known about their health and mental health literacy, specifically their depression literacy. This study aims to evaluate KAs' health literacy and depression literacy, as related to sociodemographic characteristics. An exploratory study was conducted with 681 community-residing adult KAs using the Center for Epidemiologic Studies Depression (CES-D) Scale, the Depression Literacy Questionnaire (D-Lit), and the One-Question Health Literacy Scale. Data analyses were performed using one-way analysis of variance and ordinal logistic regression of health literacy, a multiple linear regression model of depression literacy. Findings indicate a positive correlation between depression literacy and health literacy. Health literacy was also significantly related to religion, English language proficiency, income, education, and perceived physical health. Additionally, depression literacy was significantly related to age, Korean language preference over English, and education. Health literacy and depression literacy education are warranted to address low health literacy and depression literacy among KAs to reduce their health and mental health disparities.

BACKGROUND AND PURPOSE:Drug-related ototoxicity may exacerbate presbycusis (age-related hearing loss); yet, few data are available on the prevalence of ototoxic medication use by older adults. The purposes of this study were to assess the impact of aging and ototoxicity on hearing loss, the prevalence of ototoxic medication use, and select characteristics associated with ototoxic medication use among older adults. METHODS:Cross-sectional analyses were conducted using select variables extracted from the baseline and 10-year follow-up assessments of the two population-based epidemiological studies to compare two points in time. RESULTS:Ninety-one percent of the sample was taking a medication reported to be ototoxic. Nonsteroidal anti-inflammatory drugs were the most commonly used (75.2%), followed by acetaminophen (39.9%) and diuretics (35.6%). Hypertension, diabetes, cardiovascular disease, and history of smoking were associated with ototoxic medication use. Participants with hearing loss were taking a significantly greater number of ototoxic medications than those without hearing loss. CONCLUSION:Known ototoxic medications are widely used. Any subsequent ototoxicity may interact with age changes and a more severe hearing loss than that associated with only age. IMPLICATIONS FOR PRACTICE:Nurse practitioners should inform older adults about the possibility of drug-related ototoxicity and monitor hearing acuity of all older adults taking known ototoxic medications.

ObjectiveThe purpose of this study is to determine the relationship between occupational exposures and hearing among elderly Latino Americans.DesignA descriptive, correlational design used for this secondary analysis with the data from the Sacramento Area Latino Study of Aging (SALSA).Study sampleA total of 547 older adults were included.ResultsA majority of participants (58%) reported occupational exposures to loud noise and/or ototoxic chemicals. About 65% and over 90% showed hearing loss at low and high frequencies, respectively. Participants with occupational exposure to loud noise and/or ototoxic chemicals were, significantly, two times more likely to have hearing loss at high frequencies compared to those without exposure (OR = 2.29; 95% CI: 1.17 = 4.51, p = .016), after controlling for other risk factors of hearing loss such as age, gender, household income, current smoking, and diabetes. However, lifelong occupational exposure was not significantly associated with hearing loss at low frequencies (OR = 1.43; 95% CI: 0.94 = 2.18, p = .094).ConclusionLifelong occupational exposure to loud noise and/or ototoxic chemicals was significantly associated with hearing loss among elderly Latino Americans. Healthy work life through protection from harmful auditory effects of occupational exposures to noise and chemicals will have a positive impact on better hearing in later life.

Tinnitus is a common auditory perceptual disorder whose neural substrates are under intense debate. One physiologically based model posits the dorsal striatum to play a key role in gating auditory phantoms to perceptual awareness. Here, we directly test this model along with the roles of auditory and auditory-limbic networks in tinnitus non-invasively by comparing resting-state fMRI functional connectivity patterns in chronic tinnitus patients against matched control subjects without hearing loss. We assess resting-state functional connectivity of the caudate dorsal striatum (area LC), caudate head (CH), nucleus accumbens (NA), and primary auditory cortex (A1) to determine patterns of abnormal connectivity. In chronic tinnitus, increases in ipsilateral striatal-auditory cortical connectivity are found consistently only in area LC. Other patterns of increased connectivity are as follows: (1) right striatal area LC, A1, CH, and NA with parietal cortex, (2) left and right CHs with dorsal pre-frontal cortex, (3) NA and A1 with cerebellum, hippocampus, visual and ventral pre-frontal cortex. Those findings provide further support for a striatal gating model of tinnitus, where dysfunctionally permissive area LC enables auditory phantoms to reach perceptual awareness.

BackgroundCleaning workers are regularly exposed to cleaning products containing hazardous chemicals. This study investigated acute symptoms associated with chemical exposures among cleaning workers and their safe work practices.MethodsThis cross-sectional study included 183 cleaning workers employed in an academic medical center and affiliated health sciences campuses in Northern California. Data on respiratory, eye, skin, neurological, and gastrointestinal symptoms and occupational factors were collected by in-person interviews or self-administered questionnaires.ResultsChemical-related symptoms (several times monthly or more often) were more common among workers who performed patient area cleaning (44%) than hospital custodians (36%) or campus custodians (28%). After controlling for age, sex, and job title, symptoms were associated with exposure to carpet cleaners (OR = 2.98, 95% CI 1.28-6.92), spray products (OR = 2.82, 95% CI 1.16-6.82), solvents (OR = 2.71, 95% CI 1.20-6.15), and multi-purpose cleaners (OR = 2.58, 935% CI 1.13-6.92). Except for gloves, regular use of personal protective equipment was infrequent.ConclusionsStudy findings suggest a need for additional interventions such as use of less toxic products to reduce health risks among cleaning workers.

The purpose of this study was to determine the relationship between occupational exposures and cigarette smoking among operating engineers. A cross-sectional survey was conducted with operating engineers (N = 412) from a midwestern state in the United States. The survey included validated questions on cigarette smoking, occupational exposures, demographics, comorbidities, and health behaviors. About 35% were current smokers. Those exposed to asphalt fumes, heat stress, concrete dust, and welding fumes were less likely to smoke (odds ratio [OR] = .79, 95% confidence interval [CI]: .64-.98). Other factors associated with smoking included younger age (OR = .97, 95% CI: .94-.99), problem drinking (OR = 1.07, 95% CI: 1.03-1.12), lower Body Mass Index (OR = .95, 95% CI: .90-.99), and being separated/widowed/divorced (OR = 2.24, 95% CI: 1.19-4.20). Further investigation is needed for better understanding about job-specific exposure patterns and their impact on cigarette smoking among operating engineers.

Background: Working from home (WFH) may affect health behaviors and mental health. The coronavirus disease‐2019 (COVID‐19) pandemic saw many US employees transition to WFH, which has persisted in various job sectors and significantly impacted employees. However, its effects on health outcomes have remained unclear. We aimed to explore the characteristics and health outcomes of, and health‐related differences between, WFH and not‐WFH groups. Methods: Using the 2021 California Health Interview Survey data, we analyzed health behaviors (smoking, alcohol consumption, and fruit‐related nutrition) and the mental health status of 12,438 individuals using descriptive statistics, Pearson's χ2 test, and regressions. Results: A total of 39% were WFH and 61% were not‐WFH. Overall, the WFH group had worse health behaviors and mental health than the not‐WFH group. Age was associated with smoking in both groups (WFH: b = 0.37; not‐WFH: b = 0.35), but with fruit‐related nutrition only in the WFH group. Household income and occupation were associated with alcohol consumption in both groups. Age (WFH: b = −1.58; not‐WFH: b = −1.39), household income (WFH: b = −0.75; not‐WFH: b = −0.34), and job duration (WFH: b = −0.34; not‐WFH: b = −0.40) were associated with mental health in both groups; those who were younger and had lower household incomes and job durations had worse mental health. Conclusion: Health management is a clear necessity for the WFH group. Irrespective of WFH status, young workers with shorter than 5 years' job duration reported mental distress, highlighting a need for distress assessment and management for the young workforce. [ABSTRACT FROM AUTHOR]

AbstractBackgroundRecent research indicates that 35 percent of blue-collar workers in the US currently smoke while only 20 percent of white-collar workers smoke. Over the last year, we have been working with heavy equipment operators, specifically the Local 324 Training Center of the International Union of Operating Engineers, to study the epidemiology of smoking, which is 29% compared to 21% among the general population. For the current study funded by the National Cancer Institute (1R21CA152247-01A1), we have developed the Tobacco Tactics website which will be compared to the state supported 1-800-QUIT-NOW telephone line. Outcome evaluation will compare those randomized to the Tobacco Tactics web-based intervention to those randomized to the 1-800-QUIT-NOW control condition on: a) 30-day and 6-month quit rates; b) cotinine levels; c) cigarettes smoked/day; d) number of quit attempts; and e) nicotine addiction. Process evaluation will compare the two groups on the: a) contacts with intervention; b) medications used; c) helpfulness of the nurse/coach; and d) willingness to recommend the intervention to others.Methods/DesignThis will be a randomized controlled trial (N = 184). Both interventions will be offered during regularly scheduled safety training at Local 324 Training Center of the International Union of Operating Engineers and both will include optional provision of over-the-counter nicotine replacement therapy and the same number of telephone contacts. However, the Tobacco Tactics website has graphics tailored to Operating Engineers, tailored cessation feedback from the website, and follow up nurse counseling offered by multimedia options including phone and/or email, and/or e-community. Primary Analysis of Aim 1 will be conducted by using logistic regression to compare smoking habits (e.g., quit rates) of those in the intervention arm to those in the control arm. Primary analyses for Aim 2 will compare process measures (e.g., medications used) between the two groups by linear, logistic, and Poisson regression.DiscussionDissemination of an efficacious work-site, web-based smoking cessation intervention has the potential to substantially impact cancer rates among this population. Based on the outcome of this smaller study, wider scale testing in conjunction with the International Environment Technology Testing Center which services Operating Engineers across North America (including US, Mexico, and Canada) will be conducted.Trial registrationNCT01124110

Abstract Background Sudden cardiac death is the leading cause of on-duty death in United States firefighters. Accurately assessing cardiopulmonary capacity is critical to preventing, or reducing, cardiovascular events in this population. Methods A total of 83 male firefighters performed Wellness-Fitness Initiative (WFI) maximal exercise treadmill tests and direct peak VO2 assessments to volitional fatigue. Of the 83, 63 completed WFI sub-maximal exercise treadmill tests for comparison to directly measured peak VO2 and historical estimations. Results Maximal heart rates were overestimated by the traditional 220-age equation by about 5 beats per minute (p < .001). Peak VO2 was overestimated by the WFI maximal exercise treadmill and the historical WFI sub-maximal estimation by ~ 1MET and ~ 2 METs, respectively (p < 0.001). The revised 2008 WFI sub-maximal treadmill estimation was found to accurately estimate peak VO2 when compared to directly measured peak VO2. Conclusion Accurate assessment of cardiopulmonary capacity is critical in determining appropriate duty assignments, and identification of potential cardiovascular problems, for firefighters. Estimation of cardiopulmonary fitness improves using the revised 2008 WFI sub-maximal equation.

Aim: This study used California's unique Workplace Violent Incident Reporting System (WVIRS) to describe changes in workplace violence (WV) exposure for hospital‐based healthcare workers during the pandemic. Design: Interrupted time series analysis. Methods: We compared the linear trends in weekly WV incidents reported during the period before the COVID‐19 pandemic (7/1/2017–3/20/2020) to the period following California's shutdown (3/21/2020–6/30/2021). We created mixed effects models for incidents reported in emergency departments (EDs) and in other hospital units. We used hospital volume data from the California Department of Health Care Access and Information. Results: A total of 418 hospitals reported 37,561 incidents during the study period. For EDs, the number of reported incidents remained essentially constant, despite a 26% drop in outpatient visits between the first and second quarters of 2020. For other hospital units, weekly incidents initially dropped—parallel to a 13% decrease in inpatient days between the first and second quarters of 2020—but then continued parallel to the trend seen in the pre‐COVID period. Conclusion: WV persists steadily in California's hospitals. Despite major reductions in patient volume due to COVID‐19, weekly reported ED incidents remained essentially unchanged. Impact Surveys and media reported that WV increased during the pandemic, but it has been difficult to measure these changes using a large‐scale database. The absolute number of WV incidents did not increase during the pandemic; however, the trend in reported incidents remained constant in the context of dramatic decreases in patient volume. New federal WV prevention legislation is being considered in the U.S. California's experience of implementation should be considered to improve WV reporting and prevention. Public Contribution: There was no public contribution to this study. The goal of this analysis was to summarize findings from administrative data. The findings presented can inform future discussion of public policy and action. [ABSTRACT FROM AUTHOR]