ABSTRACT
Background and Aim: The COVID-19 pandemic had multi-faceted impacts on the working population who had to adapt to working from home (WFH). WFH has been reported to increase the rate of depression and anxiety due to social isolation;however, the cardiovascular effects of WFH are not well known yet. We aimed to assess the effects of WFH on cardiovascular risk factors and health behaviors during the COVID-19 pandemic. Method(s): Companies that employ WFH were invited to study by occupational health specialists via respective human resources departments. WFH employees were sent an online self-reported questionnaire which included demographics, WFH conditions, medical history, new complaints during the pandemic, health behaviors during and before the pandemic, and COVID-19 exposure. Participants were also asked to provide data on blood pressure, blood glucose, and lipid levels before and during the pandemic. Data collection started in January 2022 and ended in July 2022. Two hundred forty- five participants were invited, 208 completed the questionnaire (response rate: 84%), and 61 provided biological data (response rate: 25%). Result(s): Demographic data are presented in Table 1. Regarding WFH, 72 (34.6%) participants had undergone training for WFH conditions, and 87 (41.8%) were able to give regular breaks. Weekly working hours have increased by 6 hours during the pandemic (49.6+/-13.8 vs. 43.8+/-12.1, p=0.001, t-test). Participants reported a median 7.5-point satisfaction regarding WFH on a 10-point scale. One hundred-twelve (53.8%) participants had a new complaint;the most common complaints were weight gain/increased appetite (73, 35.1%), insomnia/anxiety (58, 27.9%), and physical inactivity/musculoskeletal pain (38, 18.3%). One hundred-twenty (57.7%) participants had a weight increase, an increase in median BMI (p=0.001, Wilcoxon signed-rank test), and a shift toward pre-obesity was observed (p=0.001, chi-square test, Table 2). Most participants did not have changes in tobacco or alcohol consumption or exercise during the pandemic. Seventy-nine (37.9%) participants had a history of COVID-19 infection, and 165 (79.3%) had a relative infected with COVID-19. Data from the biological data subgroup did not show significant changes in blood pressure, blood glucose, or lipid levels. Conclusion(s): WFH adversely affected modifiable cardiovascular risk factors, and was associated with weight gain, increased work hours, caused a lack of workload planning, and increased anxiety. Previous observational studies have reported increased sedentary behavior, alcohol and food intake, and weight gain. This study adds to the literature that although risk factors are adversely affected by WFH conditions, workers were satisfied with WFH. The training rate regarding WFH conditions was low in our study;therefore, we believe WFH workers must be informed about WFH conditions, and occupational health specialists should focus on reducing specific risk factors that exist during WFH. (Table Presented).
ABSTRACT
Study Objectives: emergency department (ED) health care workers (HCW) have experienced extensive mental health burdens in the fight against COVID-19. This study measured depressive symptoms in ED HCW in Brooklyn, New York, at the peak 2020 COVID-19 pandemic. Methods: An email-distributed survey of ED HCW at Maimonides Medical Center was conducted September 8–December 31, 2020, with reference period March-May 2020. Depressive symptoms were measured by the 10- item depressive symptom scale, Centers for Epidemiologic Studies-Depression (CES-D). CES-D items were summed, with a possible total score of 0-30. A CES-D score >10 was deemed clinically relevant. Our main predictor was HCW status, which was dichotomized as clinical (MD/DO, nurses, ED technicians) vs non-clinical. Covariates included sex, age, race, SARS-CoV-2 testing status (not tested vs +test vs -test), social support (range: 0->=4 people to talk to), number of COVID-related home problems (range: 0-9), mental health care disruption during COVID-19 (yes/no), 3-item Loneliness Brief Survey (LBF) score (range: 3-9), and survey date. General linear regression and logistic regression analysis were used to predict CES-D score (β- coefficient, p-value) and clinically relevant depressive symptoms (Odds Ratio (OR), 95% Confidence Interval (95% CI)), respectively. A p-value<0.05 was considered significant. Results: Among 222 HCW respondents, the mean age was 38.2±10.8y;and 59.4% were White, 52.5% were male, 80.1% were clinical HCW (38.5% MD/DO, 29.7% nurses, 31.8% ED technicians), and 61.6% tested for SARS-CoV-2. The mean CES-D score was 11.8±8.2. A clinically relevant depressive symptom burden was reported by 51.6% of HCW-55.4% of clinical HCW vs 36.4% of non-clinical HCW (p=0.024). There was no difference in the odds of clinically relevant depressive symptoms by type of clinical HCW (MD/DO, nurses, ED technicians) compared to non-clinical HCW;and no difference in mean CES-D score by clinical vs non-clinical HCW status. Increasing CES-D scores were also observed with increasing age (β=0.12, p=0.01), number of COVID-19-related home problems (β=0.99, p=0.035), and LBF score (β= 2.17, p<0.0001). A clinically-relevant depressive symptom burden was also observed with increasing age (OR 1.07, 95% CI 1.03-1.11), among those who reported increasing COVID-19-related home problems (OR 1.46, 95% CI 1.01-2.11), and LBF score (OR 2.08, 95% CI 1.63-2.65). Conclusions: Over half of clinical HCW experienced a clinically relevant depressive symptom burden during the peak of the COVID-19 pandemic. Age, number of COVID-19-related home problems, and loneliness were also associated with higher depressive symptom burden. To deepen our understanding of mental health outcomes, create effective interventions, and promote mental health-related policy changes, such as expanding insurance coverage for mental health care, temporal associations between mental health outcomes and associated factors must continue to be investigated.
ABSTRACT
Study Objectives: Emergency department (ED) health care workers (HCW) have experienced extensive mental health burden in the fight against COVID-19. This study measured symptoms of post-traumatic stress disorder (PTSD) in ED HCW in Brooklyn, New York, experienced during the peak of the COVID-19 pandemic. Methods: An email-distributed survey of ED HCW at Maimonides Medical Center was conducted September 8–December 31, 2020, with reference period March–May 2020. Posttraumatic stress symptoms were measured by the PTSD checklist for DSM-5 (PCL-5). A PCL-5 score >32 was deemed clinically relevant. Our main predictor was HCW status, which was dichotomized as clinical (MD/DO, nurses, ED technicians) vs non-clinical. Covariates included sex, age, race, SARS-CoV-2 testing status (not tested vs +test vs -test), social support (range: 0- >4 people to talk to), number of COVID-related home problems (range: 0-9), mental health care disruption during COVID-19 (yes/no), 3-item Loneliness Brief Survey (LBF) score (range: 3-9), and survey date. General linear regression and logistic regression analyses were used to predict PCL-5 score (β-coefficient, p-value) and clinically relevant posttraumatic stress symptoms (odds ratio (OR), 95% confidence interval (95% CI)), respectively. A p-value<0.05 was considered significant. Results: Among 247 HCW respondents, 67.1% were between 25-44 years old, 56.8% were White, 51.4% were male, 79.7% were clinical HCW (30.5% MD/DO, 22.7% nurses, 25.2% ED technicians), and 63.2% had been tested for SARS-CoV-2. The median PCL-5 score was 10. A higher mean PCL-5 score was observed for clinical vs non-clinical HCW (p<0.0001). Lower PCL-5 scores were observed for males (β=-4.31, p=0.05), while higher scores were observed in association with an increased number of COVID-19-related home problems (β=2.13, p=0.04), LBF score (β= 4.09, p<0.0001) and higher number of people to talk to (β=6.97, p=0.04). A clinically relevant PTSD symptom burden was reported by 16.6% of HCW - 18.3% of clinical HCW vs 3.6% of non-clinical HCW (p=0.0048). Higher odds of clinically relevant PTSD symptoms were observed for ED technicians compared to non-clinical HCW (OR 16.16, 95% CI 1.53-170.46). A clinically relevant PTSD symptom burden was also observed among those reporting increasing COVID-19-related home problems (OR 1.69, 95% CI 1.01-2.83) and LBF score (OR 1.83, 95% CI 1.38-2.44). Conclusions: Almost one in five clinical HCW experienced a clinically relevant PTSD symptom burden during the peak of the COVID-19 pandemic. To deepen our understanding of mental health outcomes, create effective interventions, and promote mental health-related policy changes, such as expanding insurance coverage for mental health care and developing more effective wellness programs for HCW, temporal associations between mental health outcomes and associated factors must continue to be investigated.