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1.
Am J Ind Med ; 66(11): 996-1008, 2023 Nov.
Article in English | MEDLINE | ID: mdl-37635638

ABSTRACT

Work is an important social determinant of health; unfortunately, work-related injuries remain prevalent, can have devastating impact on worker health, and can impose heavy economic burdens on workers and society. Occupational health services research (OHSR) underpins occupational health services policy and practice, focusing on health determinants, health services, healthcare delivery, and health systems affecting workers. The field of OHSR has undergone tremendous expansion in both definition and scope over the past 25 years. In this commentary, focusing on the US, we document the historical development and evolution of OHSR as a research field, describe current doctoral-level OHSR training, and discuss challenges and opportunities for the OHSR field. We also propose an updated definition for the OHSR field: Research and evaluation related to the determinants of worker health and well-being; to occupational injury and illness prevention and surveillance; to healthcare, health programs, and health policy affecting workers; and to the organization, access, quality, outcomes, and costs of occupational health services and related health systems. Researchers trained in OHSR are essential contributors to improvements in healthcare, health systems, and policy and programs to improve worker health and productivity, as well as equity and justice in job and employment conditions. We look forward to the continued growth of OHSR as a field and to the expansion of OHSR academic training opportunities.


Subject(s)
Occupational Health Services , Occupational Health , Occupational Injuries , United States , Humans , Health Services Research , Delivery of Health Care , Employment , Workers' Compensation
2.
J Sch Nurs ; 39(3): 219-228, 2023 Jun.
Article in English | MEDLINE | ID: mdl-33292067

ABSTRACT

The study purpose was to identify associations between assault deterrent presence in kindergarten through 12th (K-12) grade schools and physical assaults (PAs) against educators. Data collected through a two-phase study identified physical and nonphysical violent events and utilized a nested case-control study to identify PA risk/protective factors. Analyses included multivariable modeling. Adjusted analyses demonstrated a significant decreased risk of PA with routine locker searches (odds ratio [OR] = 0.49, 95% confidence interval [CI] [0.29, 0.82]). Also important, although not statistically significant, were presence of video monitors (OR = 0.72, 95% CI [0.50, 1.03]), intercoms (OR = 0.77, 95% CI [0.55, 1.06]), and required school uniforms/dress codes (OR = 0.74, 95% CI [0.52, 1.07]). These findings are integral to school nursing practice in which there is opportunity to influence application of relevant pilot intervention efforts as a first step in determining the potential efficacy of broad-based interventions that can positively impact the problem of school-related violence.


Subject(s)
School Teachers , Workplace Violence , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Case-Control Studies , Minnesota , Multivariate Analysis , Protective Factors , Risk Factors , School Teachers/statistics & numerical data , Schools/statistics & numerical data , Workplace Violence/prevention & control , Workplace Violence/statistics & numerical data , School Nursing
3.
J Hum Hypertens ; 37(3): 220-226, 2023 03.
Article in English | MEDLINE | ID: mdl-35277589

ABSTRACT

Despite extensive evidence of work as a key social determinant of hypertension, risk prediction equations incorporating this information are lacking. Such limitations hinder clinicians' ability to tailor patient care and comprehensively address hypertension risk factors. This study examined whether including work characteristics in hypertension risk equations improves their predictive accuracy. Using occupation ratings from the Occupational Information Network database, we measured job demand, job control, and supportiveness of supervisors and coworkers for occupations in the United States economy. We linked these occupation-based measures with the employment status and health data of participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study. We fit logistic regression equations to estimate the probability of hypertension onset in five years among CARDIA participants with and without variables reflecting work characteristics. Based on the Harrell's c- and Hosmer-Lemeshow's goodness-of-fit statistics, we found that our logistic regression models that include work characteristics predict hypertension onset more accurately than those that do not incorporate these variables. We also found that the models that rely on occupation-based measures predict hypertension onset more accurately for White than Black participants, even after accounting for a sample size difference. Including other aspects of work, such as workers' experience in the workplace, and other social determinants of health in risk equations may eliminate this discrepancy. Overall, our study showed that clinicians should examine workers' work-related characteristics to tailor hypertension care plans appropriately.


Subject(s)
Hypertension , Occupations , Young Adult , Humans , United States/epidemiology , Workplace , Risk Factors , Hypertension/diagnosis , Hypertension/epidemiology
4.
J Econ Race Policy ; 5(4): 267-282, 2022.
Article in English | MEDLINE | ID: mdl-35341024

ABSTRACT

In the United States (US), Black-particularly Black female-healthcare workers are more likely to hold occupations with high job demand, low job control with limited support from supervisors or coworkers and are more vulnerable to job loss than their white counterparts. These work-related factors increase the risk of hypertension. This study examines the extent to which occupational segregation explains the persistent racial inequity in hypertension in the healthcare workforce and the potential health impact of workforce desegregation policies. We simulated a US healthcare workforce with four occupational classes: health diagnosing professionals (i.e., highest status), health treating professionals, healthcare technicians, and healthcare aides (i.e., lowest status). We simulated occupational segregation by allocating 25-year-old workers to occupational classes with the race- and gender-specific probabilities estimated from the American Community Survey data. Our model used occupational class attributes and workers' health behaviors to predict hypertension over a 40-year career. We tracked the hypertension prevalence and the Black-white prevalence gap among the simulated workers under the staus quo condition (occupational segregation) and the experimental conditions in which occupational segregation was eliminated. We found that the Black-white hypertension prevalence gap became approximately one percentage point smaller in the experimental than in the status quo conditions. These findings suggest that policies designed to desegregate the healthcare workforce may reduce racial health inequities in this population. Our microsimulation may be used in future research to compare various desegregation policies as they may affect workers' health differently. Supplementary Information: The online version contains supplementary material available at 10.1007/s41996-022-00098-5.

5.
Am J Ind Med ; 65(2): 105-116, 2022 02.
Article in English | MEDLINE | ID: mdl-34775629

ABSTRACT

BACKGROUND: The Minnesota Safe Patient Handling (MN SPH) Act requires health care facilities to implement comprehensive programs to protect their workers from musculoskeletal injuries caused by lifting and transferring patients. Nursing homes, hospitals, and outpatient facilities each face unique challenges implementing and maintaining SPH programs. The objective of the study was to compare patient handling injuries in these three health care settings and determine whether change in injury rate over time differed by setting following enactment of the law. METHODS: Workers' compensation data from a Minnesota-based insurer were used to describe worker and claim characteristics in nursing homes, hospitals, and outpatient facilities. Negative binomial models were used to compare claims and estimate mean annual patient handling claim rates by health care setting and time period following enactment of the law. RESULTS: Consistent with national data, the patient handling claim rate was highest in Minnesota nursing homes (168 claims/$100 million payroll [95% confidence interval: 163-174]) followed by hospitals (35/$100 million payroll [34-37]) and outpatient facilities (2/$100 million payroll [1.8-2.2]). Patient handling claims declined by 38% over 10 years following enactment of the law (vs. 27% for all other claims). The change in claims over time did not differ by health care setting. CONCLUSIONS: In this single-insurer sample, declines in workers' compensation claims for patient handling injuries were consistent across health care settings following enactment of a state SPH law. Though nursing homes experienced elevated claim rates overall, results suggest they are not lagging hospitals and outpatient facilities in reducing patient handling injuries.


Subject(s)
Moving and Lifting Patients , Musculoskeletal Diseases , Occupational Injuries , Delivery of Health Care , Humans , Minnesota , Occupational Injuries/epidemiology , Occupational Injuries/prevention & control , Workers' Compensation
6.
Clin Transplant ; 35(11): e14444, 2021 11.
Article in English | MEDLINE | ID: mdl-34318522

ABSTRACT

BACKGROUND: The Kidney Allocation System (KAS) includes a scoring system to match transplant candidate life expectancy with expected longevity of the donor kidney, and a backdating policy that gives waitlist time credit to patients waitlisted after starting dialysis treatment (post-dialysis). We estimated the effect of the KAS on employment among patient subgroups targeted by the policy. METHODS: We used a sample selection model to compare employment after transplant before and after KAS implementation among patients on the kidney-only transplant waitlist between December 4, 2011 and December 31, 2017. RESULTS: Post-dialysis transplant recipients aged 18-49 were significantly more likely to be employed 1-year post transplant in the post-KAS era compared to the pre-KAS era. Transplant recipients aged 35-64 with no dialysis treatment were significantly less likely to be employed 1 year after transplant in the post-KAS era compared to the pre-KAS era. CONCLUSIONS: This study provides the first assessment of employment after DDKT under the KAS and provides important information about both the methods used to measure employment after transplant and the outcome under the KAS. Changes in employment after DDKT among various patient subgroups have important implications for assessing long-term patient and societal effects of the KAS and organ allocation policy.


Subject(s)
Kidney Transplantation , Tissue and Organ Procurement , Humans , Kidney , Return to Work , Tissue Donors , Transplant Recipients
7.
Occup Environ Med ; 78(1): 22-28, 2021 01.
Article in English | MEDLINE | ID: mdl-32895318

ABSTRACT

OBJECTIVES: The 2007 Minnesota Safe Patient Handling Act aims to protect healthcare workers from injuries caused by lifting and transferring patients. The effectiveness of the law in nursing homes is unknown. This policy evaluation measured changes in patient handling injuries before and after the law was enacted. Additionally, it assessed whether effects of the law were modified by facility levels of staffing and retention. METHODS: Workers' compensation indemnity claims for years 2005-2016 were matched to annual direct care productive hours and facility characteristics (eg, profit status, hospital affiliation and region) for all Medicaid-certified nursing homes in Minnesota. Trends in patient handling claims were analysed using negative binomial regression with generalised estimating equations. The primary predictors were time period, staff hours per resident day and staff retention. RESULTS: The patient handling indemnity claim rate declined by 25% in years 4-6 and 38% in years 7-9 following enactment of the law. Claims for all other injuries and illnesses declined by 20% in years 7-9 only. Associations between time period and patient handling claims did not vary by levels of staffing or retention. However, independent of time, facilities with annual retention ≥75% (vs <65%) had a 17% lower patient handling claim rate. CONCLUSIONS: Results suggest the law reduced patient handling claims in nursing homes. However, claim rates were elevated in facilities with low worker retention and those that were non-profit, not hospital-affiliated or in a non-metro area. Facilities with these characteristics may benefit from targeted state grants and consultation efforts.


Subject(s)
Moving and Lifting Patients/adverse effects , Nursing Homes/statistics & numerical data , Occupational Injuries/prevention & control , Workers' Compensation/statistics & numerical data , Humans , Minnesota , Nursing Staff/statistics & numerical data , Occupational Injuries/epidemiology , Personnel Turnover/statistics & numerical data , Workers' Compensation/legislation & jurisprudence
8.
Work ; 65(4): 837-846, 2020.
Article in English | MEDLINE | ID: mdl-32310213

ABSTRACT

BACKGROUND: Approximately 2.38 million janitors are employed in the U.S. While high physical workload may explain a lost-work days rate 2.7 times greater than other occupations, little is known about the association between janitors' physical workload, mental workload, and stress. OBJECTIVE: The objective of this study was to assess the associations between physical (ergonomic) and mental workload exposures and stress outcomes among janitors. METHODS: Questionnaire data, focused on ergonomic workload, mental workload and stress, were collected from Minnesota janitors for a one-year period. Physical workload was assessed with Borg Scales and Rapid Entire Body Assessments (REBA). Mental workload assessment utilized the NASA Task Load Index (TLX). Stress assessments utilized single-item ordinal stress scale (SISS) and Perceived Stress Scale-4 (PSS-4) measures. Descriptive and multivariable analyses, including bias adjustment, were conducted. RESULTS: Odds ratios (OR) and 95% confidence intervals (CI) for ergonomic workload (task frequency) effects on SISS were: REBA (1.18 OR, 1.02-1.37 CI); Borg (1.25 OR, 1.00-1.56 CI); combined REBA and Borg (1.10 OR, 1.01-1.20 CI). Mental workload was associated with higher PSS-4 levels (0.15 Mean Difference, 0.08-0.22 CI) and a 3% increased risk for each one-unit increase in the SISS scale (1.03 OR, 1.02-1.05 CI). CONCLUSIONS: This research demonstrated a moderate effect of physical and mental workloads on stress among janitors.


Subject(s)
Household Work/methods , Physical Exertion/physiology , Stress, Psychological/complications , Workload/standards , Adult , Ergonomics/methods , Ergonomics/standards , Ergonomics/statistics & numerical data , Female , Focus Groups/methods , Household Work/statistics & numerical data , Humans , Male , Middle Aged , Minnesota/epidemiology , Stress, Psychological/psychology , Surveys and Questionnaires , Task Performance and Analysis , Workload/psychology , Workload/statistics & numerical data
9.
Am J Ind Med ; 63(6): 517-526, 2020 06.
Article in English | MEDLINE | ID: mdl-32166773

ABSTRACT

BACKGROUND: Nursing assistants have one of the highest injury rates in the U.S., but few population-based studies assess differential injury risk by occupation in nursing homes. This statewide study assessed differences in musculoskeletal disorders (MSDs) and patient handling injuries among direct care workers in Minnesota nursing homes. METHODS: Indemnity claims from the Minnesota workers' compensation database were matched to time at risk from the Minnesota Nursing Home Report Card to estimate 2005 to 2016 injury and illness claim rates for certified nursing assistants (CNAs), licensed practical nurses (LPNs), and registered nurses (RNs). Associations between occupation and claim characteristics were assessed using multivariable regression modeling. RESULTS: Indemnity claim rates were 3.68, 1.38, and 0.69 per 100 full-time equivalent workers for CNAs, LPNs, and RNs, respectively. Patient handling injuries comprised 62% of claims. Compared to RNs, CNAs had higher odds of an indemnity claim resulting from an MSD (odds ratio [OR] = 1.67; 95% confidence interval [CI], 1.31-2.14) or patient handling injury (OR = 1.89; 95% CI, 1.47-2.45) as opposed to another type of injury or illness. CNAs had lower odds of receiving temporary and permanent partial disability benefits and higher odds of receiving a stipulation settlement. CONCLUSIONS: CNAs in Minnesota nursing homes are at heightened risk for lost time MSDs and patient handling injuries. Claims filed by CNAs are more frequently settled outside the regular workers' compensation benefit structure, an indication that the workers' compensation system is not providing adequate and timely benefits to these workers.


Subject(s)
Musculoskeletal Diseases/epidemiology , Nursing Homes/statistics & numerical data , Nursing Staff/statistics & numerical data , Occupational Diseases/epidemiology , Occupational Injuries/epidemiology , Workers' Compensation/statistics & numerical data , Adolescent , Adult , Female , Humans , Licensed Practical Nurses/statistics & numerical data , Male , Middle Aged , Minnesota/epidemiology , Moving and Lifting Patients/adverse effects , Moving and Lifting Patients/statistics & numerical data , Musculoskeletal Diseases/etiology , Nurses/statistics & numerical data , Nursing Assistants/statistics & numerical data , Occupational Diseases/etiology , Occupational Injuries/etiology , Young Adult
11.
Appl Ergon ; 81: 102874, 2019 Nov.
Article in English | MEDLINE | ID: mdl-31422267

ABSTRACT

INTRODUCTION: A Minnesota union identified to researchers at the University of Minnesota a concern relevant to a possible relation between their daily workload and outcome of occupational injuries among a population of janitors. OBJECTIVE: To assess if the ergonomic workload is related to injuries among janitors. METHODS: Following an initial group discussion among janitors, which identified common and hazardous tasks potentially leading to occupational injuries, a questionnaire was developed, pre-tested, and distributed to the janitors. Questions addressed various exposures, including workload, and comprehensive information regarding injury occurrence over two six-month sequential periods (May 2016-October 2016, November 2016-April 2017). Quantitative ergonomic analyses were performed on a sub-group of janitors (n = 30); these included data collection to identify Borg Perceived Exertion (Borg) and Rapid Entire Body Assessment (REBA) scores. Descriptive, multivariable with bias adjustment analyses were conducted on the resulting data. RESULTS: Eight tasks were found to be common for janitors. All average REBA scores for the tasks were identified in the high-risk category. The task of repeatedly emptying small trash cans (<25lb) was significantly related to injuries. Average Borg scores fell between the very light perceived exertion and somewhat difficult perceived exertion categories. Multivariable regression analyses indicated that age-sex-standardized ergonomic workload, measured by task frequencies and REBA or Borg scores, was positively related to injury occurrence. CONCLUSIONS: Standardized ergonomic workload was positively related to injury occurrence. This information serves as a basis for further research and potential intervention efforts.


Subject(s)
Ergonomics , Household Work , Occupational Injuries/etiology , Work/physiology , Workload/statistics & numerical data , Adolescent , Adult , Female , Humans , Male , Middle Aged , Multivariate Analysis , Risk Factors , Surveys and Questionnaires , Task Performance and Analysis , Young Adult
12.
J Safety Res ; 69: 1-10, 2019 06.
Article in English | MEDLINE | ID: mdl-31235219

ABSTRACT

INTRODUCTION: The goal of this study was to evaluate and improve janitors' knowledge of workers' rights and responsibilities for assessing and reporting work-related injuries, and to determine the barriers for reporting occupational injuries. METHODS: Questionnaires, designed to collect data retrospectively for two, sequential six-month periods, were disseminated to 1200 full-time unionized janitors in the Twin Cities. Immediately following the baseline questionnaire administration, a randomly selected sub-group of janitors (~600) received information on workers' rights and responsibilities for reporting injuries; six-months later a questionnaire comparable to the baseline questionnaire was disseminated to the 1200 janitors. Analyses included basic descriptive analyses and identification of potential differences in proportions of job-specific reporting barriers pre-post-intervention. RESULTS: Among the participating janitors (n = 390), approximately half (53%) were initially unsure of what an OSHA 300 Log was; 56% reported not knowing what workers' compensation was. At baseline, in both intervention and non-intervention groups, approximately 25% reported having a perceived barrier to reporting an injury to their employer. Reported barriers included "fear," "reporting takes too long," "being unsure of the reporting process," and an "understanding that injuries are a part of the job." At follow-up, among the intervention group, there was an important reduction (24%-12%) in having a perceived barrier for reporting a work-related injury. CONCLUSIONS: A majority of janitors lacked knowledge and awareness of OSHA injury reporting and Workers' Compensation. In order to improve reporting, it is essential to educate employees on OSHA and Workers' Compensation and inform janitors of the injury reporting process through training. Practical applications: Future intervention efforts must focus on the specific barriers for reporting occupational injuries and be tailored specifically to the janitor population. To reduce underreporting of injuries, they must be encouraged to report their occupational injuries. Barriers to reporting these injuries must be eliminated.


Subject(s)
Health Knowledge, Attitudes, Practice , Occupational Diseases , Occupational Injuries , Occupations , Safety Management , Adult , Employment , Female , Humans , Male , Middle Aged , Occupational Diseases/prevention & control , Occupational Injuries/prevention & control , Records , Retrospective Studies , Surveys and Questionnaires , Work , Workers' Compensation/statistics & numerical data , Young Adult
13.
Nutrients ; 11(4)2019 Apr 25.
Article in English | MEDLINE | ID: mdl-31027268

ABSTRACT

Full breastfeeding (FBF) is promoted as effective for losing pregnancy weight during the postpartum period. This study evaluated whether longer FBF is associated with lower maternal postpartum weight retention (PPWR) as compared to a shorter FBF duration. The MILK (Mothers and Infants Linked for Healthy Growth) study is an ongoing prospective cohort of 370 mother-infant dyads, all of whom fully breastfed their infants for at least 1 month. Breastfeeding status was subsequently self-reported by mothers at 3 and 6 months postpartum. Maternal PPWR was calculated as maternal weight measured at 1, 3, and 6 months postpartum minus maternal prepregnancy weight. Using linear mixed effects models, by 6 months postpartum, adjusted means ± standard errors for weight retention among mothers who fully breastfed for 1-3 (3.40 ± 1.16 kg), 3-6 (1.41 ± 0.69 kg), and ≥6 months (0.97 ± 0.32 kg) were estimated. Compared to mothers who reported FBF for 1-3 months, those who reported FBF for 3-6 months and ≥6 months both had lower PPWR over the period from 1 to 6 months postpartum (p = 0.04 and p < 0.01, respectively). However, PPWR from 3 to 6 months was not significantly different among those who reported FBF for 3-6 versus ≥6 months (p > 0.05). Interventions to promote FBF past 3 months may increase the likelihood of postpartum return to prepregnancy weight.


Subject(s)
Body Weight , Breast Feeding , Postpartum Period , Adult , Cohort Studies , Female , Humans , Time Factors , Young Adult
14.
Obesity (Silver Spring) ; 27(4): 621-628, 2019 04.
Article in English | MEDLINE | ID: mdl-30900412

ABSTRACT

OBJECTIVE: The aim of this study was to test associations of prepregnancy BMI, gestational weight gain, oral glucose challenge test results, and postpartum weight loss as predictors of breast milk leptin, insulin, and adiponectin concentrations and whether these relationships vary over time. METHODS: Milk was collected at 1 and 3 months from 135 exclusively breastfeeding women from the longitudinal Mothers and Infants Linked for Healthy Growth (MILk) study. Hormones were assayed in skimmed samples using ELISA. Mixed-effects linear regression models were employed to assess main effects and effect-by-time interactions on hormone concentrations. RESULTS: In adjusted models, BMI was positively associated with milk leptin (P < 0.001) and insulin (P = 0.03) and negatively associated with milk adiponectin (P = 0.02); however, the association was stronger with insulin and weaker with adiponectin at 3 months than at 1 month (time interaction P = 0.017 for insulin and P = 0.045 for adiponectin). Gestational weight gain was positively associated and postpartum weight loss was negatively associated with milk leptin (both P < 0.001), independent of BMI. Oral glucose challenge test results were not associated with these milk hormone concentrations. CONCLUSIONS: Maternal weight status before, during, and after pregnancy contributes to interindividual variation in human milk composition. Continuing work will assess the role of these and other milk bioactive factors in altering infant metabolic outcomes.


Subject(s)
Adiponectin/metabolism , Body Weight/physiology , Insulin/metabolism , Leptin/metabolism , Milk, Human/metabolism , Mothers , Adiponectin/analysis , Adult , Breast Feeding , Female , Glucose Tolerance Test , Humans , Infant, Newborn , Insulin/analysis , Leptin/analysis , Longitudinal Studies , Male , Middle Aged , Milk, Human/chemistry , Postpartum Period/metabolism , Pregnancy , Young Adult
15.
Nutrients ; 11(3)2019 Mar 15.
Article in English | MEDLINE | ID: mdl-30875943

ABSTRACT

Maternal pregnancy nutrition influences fetal growth. Evidence is limited, however, on the relationship of maternal diet during pregnancy and lactation on infant postnatal growth and adiposity. Our purpose was to examine associations between maternal diet quality during pregnancy and lactation with offspring growth and body composition from birth to six months. Maternal diet quality was serially assessed in pregnancy and at one and three months postpartum, using the Healthy Eating Index⁻2015 in a cohort of 354 fully breastfeeding mother⁻infant dyads. Infant length-for-age (LAZ), weight-for-age (WAZ), and weight-for-length (WLZ) Z-scores were assessed at birth, one, three, and six months. Infant body fat percent (BF%), fat mass (FM), and fat-free mass (FFM) were measured at six months using dual-energy X-ray absorptiometry. Higher maternal diet quality from pregnancy through three months postpartum was associated with lower infant WLZ from birth to six months (p = 0.02) and BF% at six months (p ≤ 0.05). Higher maternal diet quality at one and three months postpartum was also associated with lower infant FM at six months (p < 0.01). In summary, maternal diet quality during pregnancy and lactation was inversely associated with infant relative weight and adiposity in early postnatal life. Additional research is needed to explore whether associations persist across the life course.


Subject(s)
Body Composition/physiology , Diet/statistics & numerical data , Infant Nutritional Physiological Phenomena/physiology , Maternal Nutritional Physiological Phenomena/physiology , Adiposity/physiology , Adult , Body Mass Index , Breast Feeding/statistics & numerical data , Child Development/physiology , Diet/standards , Female , Humans , Infant , Infant, Newborn , Lactation/physiology , Male , Middle Aged , Pregnancy , Prospective Studies , Young Adult
16.
Am J Ind Med ; 62(3): 222-232, 2019 03.
Article in English | MEDLINE | ID: mdl-30675912

ABSTRACT

BACKGROUND: This study was designed to identify potential effects of workload and sleep on injury occurrence. METHODS: Questionnaires were disseminated to janitors in the SEIU Local 26 union; 390 responded and provided information on workload, sleep, and injury outcomes. Quantitative measurements of workload and sleep were collected via FitBit devices from a subset of 58 janitors. Regression techniques were implemented to determine risk. RESULTS: Thirty-seven percent reported increased workload over the study period Adjusted analyses indicated a significant effect of change in workload (RR: 1.94; 95%CI: 1.40-2.70) and sleep hours (RR: 2.21; 95%CI: 1.33-3.66) on occupational injury. Among those with sleep disturbances, injury risk was greater for those with less than five, versus more than five, days of moderate to vigorous physical activity; RR: 2.77; 95%CI: 1.16-6.59). CONCLUSIONS: Increased workload and sleep disturbances increased the risk of injury, suggesting employers should address these factors to mitigate occupational injuries.


Subject(s)
Household Work/statistics & numerical data , Occupational Injuries/epidemiology , Sleep Wake Disorders/epidemiology , Sleep , Workload/statistics & numerical data , Adult , Exercise , Female , Fitness Trackers , Humans , Male , Middle Aged , Surveys and Questionnaires , Time Factors , Young Adult
17.
J Occup Environ Med ; 61(2): 153-161, 2019 02.
Article in English | MEDLINE | ID: mdl-30507790

ABSTRACT

OBJECTIVE: Determine injury incidence and severity and potential associated risk factors for injury, among janitors. METHODS: Questionnaires were disseminated to 1200 full-time janitors in the Service Employees International Union (SEIU) Local 26 union; 390 responded and provided information on their injury experiences and exposures, based on personal characteristics and work-related activities. Multivariable analyses, including bias adjustment, were implemented using directed acyclic graphs to determine potential risk. RESULTS: Among the janitors, 34% reported experiencing at least one injury; 16% of cases resulted in hospital admittance. Significantly increased risks were identified for age, ethnicity, shift start time, and physician-diagnosed depression. CONCLUSIONS: Knowledge of specific risk and protective factors is valuable, and can serve as a basis for further in-depth studies and inform the development of targeted intervention strategies aimed to reduce occurrence of these injuries.


Subject(s)
Household Work/statistics & numerical data , Occupational Injuries/epidemiology , Adult , Age Factors , Female , Hospitalization/statistics & numerical data , Humans , Incidence , Injury Severity Score , Male , Middle Aged , Multivariate Analysis , Occupational Injuries/etiology , Risk Factors , Surveys and Questionnaires , Young Adult
18.
Sci Rep ; 8(1): 17034, 2018 11 19.
Article in English | MEDLINE | ID: mdl-30451873

ABSTRACT

Elevated in utero and early childhood exposure to manganese may have adverse effects on neurodevelopment. We conducted preliminary analyses to evaluate toenails as a matrix for investigating manganese exposure in infants. Infant and maternal toenail and hair samples were collected from 25 infants (7 months old) and their mothers. A subset of mothers was recruited in the third trimester of pregnancy and some also provided pre-natal toenail, hair, and blood samples, cord blood, and additional post-natal samples. Collected samples were analyzed by inductively coupled plasma mass-spectrometry. Toenail manganese levels in infants ranged from below the limit of detection (LOD) to 2.80 µg/g. Only 1 toenail sample and 4 hair samples contained levels of manganese below LOD. Associations between infant and maternal biomarkers were not statistically significant. Analysis of multiple post-natal toenail samples from a single infant-mother pair showed an increase in the infant's toenail manganese and a decrease in maternal toenail manganese over the first year of the infant's life. Overall, our findings suggest that toenails may serve as a valuable biological matrix for measuring manganese exposure in newborns and infants; however, additional studies are needed to determine the impact of the timing of toenail sample collection on its utility in assessing early life exposure and health outcomes.


Subject(s)
Environmental Exposure , Manganese/analysis , Maternal Exposure , Nails/chemistry , Adult , Biomarkers/analysis , Female , Foot , Humans , Infant , Infant, Newborn , Limit of Detection , Male , Pilot Projects , Pregnancy , Pregnancy Trimester, Third
20.
Matern Child Health J ; 22(2): 216-225, 2018 02.
Article in English | MEDLINE | ID: mdl-29098488

ABSTRACT

Objectives The United States is one of only three countries worldwide with no national policy guaranteeing paid leave to employed women who give birth. While maternity leave has been linked to improved maternal and child outcomes in international contexts, up-to-date research evidence in the U.S. context is needed to inform current policy debates on paid family leave. Methods Using data from Listening to Mothers III, a national survey of women ages 18-45 who gave birth in 2011-2012, we conducted multivariate logistic regression to predict the likelihood of outcomes related to infant health, maternal physical and mental health, and maternal health behaviors by the use and duration of paid maternity leave. Results Use of paid and unpaid leave varied significantly by race/ethnicity and household income. Women who took paid maternity leave experienced a 47% decrease in the odds of re-hospitalizing their infants (95% CI 0.3, 1.0) and a 51% decrease in the odds of being re-hospitalized themselves (95% CI 0.3, 0.9) at 21 months postpartum, compared to women taking unpaid or no leave. They also had 1.8 times the odds of doing well with exercise (95% CI 1.1, 3.0) and stress management (95% CI 1.1, 2.8), compared to women taking only unpaid leave. Conclusions for Practice Paid maternity leave significantly predicts lower odds of maternal and infant re-hospitalization and higher odds of doing well with exercise and stress management. Policies aimed at expanding access to paid maternity and family leave may contribute toward reducing socio-demographic disparities in paid leave use and its associated health benefits.


Subject(s)
Infant Health , Maternal Health , Mothers/statistics & numerical data , Parental Leave/economics , Salaries and Fringe Benefits , Women, Working/statistics & numerical data , Adolescent , Adult , Cross-Sectional Studies , Female , Health Behavior , Humans , Infant , Infant, Newborn , Mental Health , Mothers/psychology , Parental Leave/statistics & numerical data , Postpartum Period , Pregnancy , United States , Young Adult
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