Nursing Home Adoption of CDC and ASHRAE COVID-19 Built Environment Recommendations: A Characterization Study of Colorado Nursing Home Facilities.

BACKGROUND: During the COVID-19 pandemic, the Centers for Disease Control and Prevention (CDC) and ASHRAE provided infection control recommendations for the built environments and ventilation systems of nursing homes (NHs). The level of adoption of the suggested strategies is unknown, as little information has been obtained from NHs identifying the strategies that were implemented. OBJECTIVE: The primary goal of our study was to characterize the built environments of Colorado NHs during the COVID-19 pandemic to assess the level of adoption of CDC and ASHRAE recommendations. Our secondary goal was to identify opportunities and barriers that NHs face as they work to create health-protective built environments in the future. METHOD: We used the Nursing Home Built Environment survey to obtain data related to three main categories of CDC and ASHRAE recommendation for Colorado NHs: Resident Isolation, Improved Indoor Air Quality, and Staff Separation/Support. RESULTS: Key findings included: (1) On average, NHs had 34% of their beds located in single-occupancy rooms; (2) seven (9%) NHs had designated COVID-positive "neighborhoods"; (3) 14 (20%) NHs had common area ventilation systems that were utilizing filters with a minimum efficiency reporting value 13 rating, or higher. CONCLUSION: Most Colorado NHs did not fully implement the COVID-19 built environment strategies recommended by CDC and ASHRAE. While there are barriers to the adoption of many of the strategies, there are also opportunities for immediate improvements that can support the health of vulnerable NH populations as we continue to see high rates of aerosolized infectious disease spread in NH facilities.

What Factors Are Associated With Occupational Health Office Staffing, Job Stress, and Job Satisfaction?

OBJECTIVE: This study sought to identify factors associated with occupational health staffing in health care settings, provide benchmarking data, and investigate relationships between staffing and worker stress and satisfaction. METHODS: Members of the Association of Occupational Health Professionals in Healthcare were sent an online survey. Data on facility served, staffing, job attitudes, and work stress were collected and analyzed. RESULTS: Number and types of personnel served were the largest predictors of staffing, accounting for 38 and 41% of the variability seen, respectively. Number of personnel served was related to worker stress and lack of work/life balance. CONCLUSION: Offices that required a provider presence had roughly one provider, seven nurses, and three clerical staff per 8000 personnel served. Occupational health workers are generally highly satisfied, and staffing has little relation to sources of job stress and satisfaction.

Congenital anomalies identified at birth among infants born following assisted reproductive technology in Colorado.

BACKGROUND: Assisted reproductive technology (ART) has assisted many infertile couples in conceiving. Despite increasing use in the United States, the association between ART and congenital anomalies remains a highly contested subject. We conducted a study to examine the risk of congenital anomalies among infants conceived using ART. METHODS: A retrospective cohort study of 344,567 infants born in Colorado from 2007 to 2011 was conducted using data obtained from the Colorado Birth Certificate Database. The incidence of congenital anomalies identified at birth following conception with ART was assessed and compared with all naturally conceived infants born during the same time period. The odds ratio was calculated using multiple logistic regression after adjusting for multiple confounders. RESULTS: Of 2071 infants, 23 (1.11%) conceived using ART had a congenital anomaly identified at birth compared with 3826 (1.12%) of 342,496 infants conceived naturally. The adjusted odds ratio of a congenital anomaly among infants born following conception with ART was 1.01 (95% confidence interval, 0.67-1.52). The proportion of infants born following usage of ART in Colorado has not changed significantly (p = 0.20) from 2007 to 2011 with an overall proportion of 0.60% (range 0.52-0.64%), while the incidence of congenital anomalies has decreased significantly (p = 0.002) during the study years with an average of 1.12% (range, 0.92-1.25%). CONCLUSION: This study suggests that conception by means of ART is not associated with an increased risk of congenital abnormalities identified by birth certificate data in Colorado when compared with births following natural conception.