Statin Use in Relation to COVID-19 and Other Respiratory Infections: Muscle and Other Considerations.

Statins have been widely advocated for use in COVID-19 based on large favorable observational associations buttressed by theoretical expected benefits. However, past favorable associations of statins to pre-COVID-19 infection outcomes (also buttressed by theoretical benefits) were unsupported in meta-analysis of RCTs, RR = 1.00. Initial RCTs in COVID-19 appear to follow this trajectory. Healthy-user/tolerator effects and indication bias may explain these disparities. Moreover, cholesterol drops in proportion to infection severity, so less severely affected individuals may be selected for statin use, contributing to apparent favorable statin associations to outcomes. Cholesterol transports fat-soluble antioxidants and immune-protective vitamins. Statins impair mitochondrial function in those most reliant on coenzyme Q10 (a mevalonate pathway product also transported on cholesterol)-i.e., those with existing mitochondrial compromise, whom data suggest bear increased risks from both COVID-19 and from statins. Thus, statin risks of adverse outcomes are amplified in those patients at risk of poor COVID-19 outcomes-i.e., those in whom adjunctive statin therapy may most likely be given. High reported rates of rhabdomyolysis in hospitalized COVID-19 patients underscore the notion that statin-related risks as well as benefits must be considered. Advocacy for statins in COVID-19 should be suspended pending clear evidence of RCT benefits, with careful attention to risk modifiers.

Emergency Mental Health Care Utilization and the COVID-19 Pandemic Among U.S. Armed Forces and Dependents, 1 January 2017 to 31 March 2021.

The COVID-19 pandemic brought with it concerns for the effects on mental health, from both the disease itself and the steps taken to combat it. Given the readiness ramifications of those effects, it is necessary to understand them as they apply to members of the U.S. Armed Forces and their families. This study aimed to analyze temporal trends in mental health-related emergency room (ER) visits before and during the COVID-19 pandemic among active duty service members (ADSMs) and dependents. A total of 5,205,259 health care visits in an ER setting between 1 January 2017 to 31 March 2021 were included. Multivariate logistic regressions showed significantly increased odds of ER visits related to mental health during the COVID-19 pandemic when compared to a 3 year period before, both among active duty service members and adult dependents (adjusted odds ratio, AOR: 1.13, 95%CI: 1.12, 1.14), and dependents under 18 years of age (AOR: 1.44, 95%CI: 1.42,1.48). These findings document significant increases in demand for emergency mental health services during the COVID-19 pandemic, especially within younger cohorts.

Radiation Exposure Predicts Reported Vaccine Adverse Effects in Veterans with Gulf War Illness.

Most people have no problems when administered vaccines; however, as with all drugs, reported adverse effects (rAEs) do occur. There is a need to better understand the potential predictors of reported vaccine AEs (rVaxAEs), including modifiable (environmental) predictors. Gulf War Veterans (GWV) who have Gulf War illness (GWI) report increased experiences of drug and chemical rAEs, extending to rVaxAEs. GWV provide an opportunity to examine the relationship between their reported exposures and rAEs. Forty one GWV with GWI and 40 healthy controls reported exposure and rAEs to exposure, including for 14 vaccines. Individual and summed vaccine exposures, rVaxAEs, and reported Vaccine AE Propensity (summed rVaxAEs/summed vaccines exposures) were compared in cases vs. controls. Exposure-outcome assessments focused on GWV, using a multivariable regression with robust standard error. More designated vaccines were reported in cases than in controls: 9.0 (2.3) vs. 3.8 (2.3), p < 0.0001. The fraction of vaccines received that led to rAEs was ten-fold higher in cases: 0.24 (0.21), vs. 0.023 (0.081), p < 0.0001. Multivariable assessment confirmed that radiation and pesticides remained significant statistical predictors of reported Vaccine AE Propensity. Exposure tied to excess rVaxAEs in GWV may contribute to, or underlie, the reported link between rVaxAEs in GWV and later ill health.

Sleep duration and musculoskeletal injury incidence in physically active men and women: A study of U.S. Army Special Operation Forces soldiers.

PURPOSE: In physically demanding occupations or athletic populations, sleep has been shown to be an important factor for both performance and recovery. However, evidence is limited on sleep duration and its association with musculoskeletal injury risk in physically active populations. Therefore, the purpose of this analysis was to evaluate the relationship between sleep duration and musculoskeletal injury incidence in a population of physically active men and women. METHODS: Data were collected via electronic survey and analyzed for 7,576 soldiers from the United States Army Special Operations Command. RESULTS: This population was mostly men (95%) ≤ 35 years old (70%). The incidence of musculoskeletal injury was 53% over the twelve months before survey administration. After adjusting for other covariates, soldiers who slept ≤ 4 hours were 2.35 (95% CI: 1.89-2.93, p <0.01) times more likely to experience a musculoskeletal injury compared with those who slept eight ≥ 8 hours. When stratified by age (≤ 35 years, > 35 years), older men were found to have significantly higher risk of a musculoskeletal injury than their younger counterparts across all sleep duration groups. CONCLUSIONS: These findings suggest that sleep duration may be inversely related to risk of musculoskeletal injury. It is possible that interventions targeted at sleep may have a positive impact on prevention of musculoskeletal injuries within physically active populations.

Vaping, Smoking, and the Physical Fitness of Active Young Men.

INTRODUCTION: Adverse effects of cigarette smoking on physical performance are well studied. Because of the recent rise in popularity of vaping, it is important to evaluate its effect on fitness both independently and in conjunction with traditional cigarette use. METHODS: This was a secondary analysis performed in 2018 on data collected from U.S. Army Soldiers during 2016. All metrics were self-reported via an electronic questionnaire. Personal characteristics of current ENDS users, smokers, and dual users were compared with a reference group that reported no history of use. Adjusting for age and physical training habits, an ANCOVA was used to compare Army physical fitness test results. A Fisher's exact test determined specific mean differences between groups. RESULTS: This study population consisted of 2,854 men aged 24.6 years on average. Differences in physical training and fitness were shown between the groups. Never users averaged the most total physical training, followed by ENDS users, smokers, and then dual users. Compared with never users on the fitness tests, ENDS users had an adjusted mean difference of +27 seconds on the 2-mile run, -4.56 push-ups, and -2.01 sit-ups; smokers averaged +8 seconds, -2.15 push-ups, and -1.44 sit-ups; and dual users averaged +32 seconds, -5.17 push-ups, and -3.88 sit-ups. Dual users had significantly (p<0.05) lower scores than current smokers and never users on all 3 fitness events. CONCLUSIONS: This study suggests that individuals who use e-cigarettes and tobacco cigarettes average a lower level of fitness than individuals who abstain.

Measuring environmental noise from airports, oil and gas operations, and traffic with smartphone applications: laboratory and field trials.

Environmental noise from sources such as traffic, airports, and oil and gas (O&G) operations is associated with nuisance and health concerns. Smartphones with external microphones have been recommended for environmental noise monitoring and may be useful tools for citizen science, but are not validated against reference methods. We evaluated laboratory performance of three smartphone/application (app) configurations recommended for environmental noise measurement. Two smartphone/app configurations were also compared to a reference sampler, a type 1 sound level meter (SLM) at ten outdoor sites with traffic, airport, and O&G noise. To evaluate performance, we compared the mean squared error, variance, bias, and Krippendorff's Alpha by smartphone/app combination and testing location for both audible (A-weighted) and low-frequency (C-weighted) noise. We observed that laboratory measurements were in strong agreement with a reference sampler. The field A-weighted noise level results had strong agreement with the SLM at several outdoor sites, but our C-weighted noise results ranged from moderate to substantial agreement. For our tested configurations, we find that smartphones with external microphones are reliable proxies for measuring A- and C-weighted noise in a laboratory setting. Outdoor performance depends on noise source type, weighting, and precision and accuracy needs of the investigation.

Residential noise from nearby oil and gas well construction and drilling.

Public concern about oil and gas (O&G) operations in residential areas is substantial. Noise from construction and drilling related to O&G operations may be greater than other phases of O&G operations; yet the impacts of audible and low-frequency noise during these operations are not extensively explored nor the effects on health well understood. This study documents the noise levels at a multi-well O&G well pad during construction and drilling in a residential area in Colorado. A-weighted (dBA) and C-weighted (dBC) noise measurements were collected at four locations during development over a 3-month period. The maximum 1-min equivalent continuous sound levels over a 1-month period were 60.2 dBA and 80.0 dBC. Overall, 41.1% of daytime and 23.6% of nighttime dBA 1-min equivalent continuous noise measurements were found to exceed 50 dBA, and 97.5% of daytime and 98.3% of nighttime measurements were found to exceed 60 dBC. Noise levels exceeding 50 dBA or 60 dBC may cause annoyance and be detrimental to health; thus, these noise levels have the potential to impact health and noise levels and associated health effects warrant further investigation.