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INTRODUCTION: This study aimed to investigate occupational factors associated with burnout among a sample of 9-1-1 public safety telecommunicators (PSTs). METHODS: An online survey measuring organizational factors (ie, perceived visibility and inclusion in the agency, respectful culture, leadership support, perceived gratitude, and coworker conflict); job characteristic s (ie, work-life integration, overtime, salary satisfaction, and job meaningfulness); and burnout, demographic, and call center characteristics was emailed to a sample of PSTs. ANALYSIS: Descriptive, bivariate, and multiple linear regression analyses were used to characterize the sample and investigate relationships among variables. RESULTS: PSTs (N = 324) completed the survey. Multivariate analysis showed that poor work-life integration and coworker conflict were associated with greater PST burnout, while job meaningfulness and perceptions of greater visibility and inclusion were linked to decreased levels of burnout. CONCLUSION: Occupational factors were associated with burnout among PSTs.

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OBJECTIVE: We assessed and examined relationships between the health and working conditions of early care and education workers. METHODS: We surveyed early care and education workers ( n = 2242) about their socioeconomic characteristics; work organization; psychosocial, physical, and ergonomic exposures; coping behaviors; and health. RESULTS: Nearly half of respondents reported chronic health conditions. Most worked full time, half earned less than $30,000 a year, and many reported unpaid hours or inability to take breaks. One-quarter reported economic strain. Numerous exposures were prevalent. Workers' general health was poorer than normed averages, although their physical functioning was slightly better. Sixteen percent of workers reported work-related injuries, and 43% reported depressive symptoms. Factors associated with health included socioeconomic characteristics, having a chronic condition, job type, access to benefits, eight psychosocial stressors, four physical exposures, sleep, and alcohol consumption. CONCLUSIONS: Findings support the need for attention to this workforce's health.

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BACKGROUND: Construction work offers women economic advancement and self-fulfillment opportunities, but multiple barriers prevent their increased representation in the industry. This study used qualitative methods to identity key physical and psychosocial safety hazards affecting tradeswomen. METHODS: Three focus groups were held in 2015 with 19 tradeswomen in Washington State. Groups discussed workplace hazards and solutions to make the trades safer for women. Discussions were recorded, transcribed, and two independent reviewers analyzed themes. RESULTS: Participants identified myriad physical and psychosocial hazards including a dangerous work environment, inadequate personal protective equipment, gender discrimination, and fear of layoff for reporting concerns. Participants identified mentorship as a potential intervention to overcome some of these barriers. CONCLUSION: Findings suggest that the industry's work environment can be hostile and unsupportive for women, contributing to tradeswomen's injury risk and psychological distress. Future research and interventions should focus on understanding the relationships between and mediating the negative impact of women's physical and psychosocial workplace hazards. Results from these focus groups inspired a randomized control trial to study the impact mentorship has on decreasing physical and psychosocial hazards for women in construction, and improving retention.

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INTRODUCTION: With the global spread of COVID-19, there is a compelling public health interest in quantifying who is at increased risk of contracting disease. Occupational characteristics, such as interfacing with the public and being in close quarters with other workers, not only put workers at high risk for disease, but also make them a nexus of disease transmission to the community. This can further be exacerbated through presenteeism, the term used to describe the act of coming to work despite being symptomatic for disease. Quantifying the number of workers who are frequently exposed to infection and disease in the workplace, and understanding which occupational groups they represent, can help to prompt public health risk response and management for COVID-19 in the workplace, and subsequent infectious disease outbreaks. METHODS: To estimate the number of United States workers frequently exposed to infection and disease in the workplace, national employment data (by Standard Occupational Classification) maintained by the Bureau of Labor Statistics (BLS) was merged with a BLS O*NET survey measure reporting how frequently workers in each occupation are exposed to infection or disease at work. This allowed us to estimate the number of United States workers, across all occupations, exposed to disease or infection at work more than once a month. RESULTS: Based on our analyses, approximately 10% (14.4 M) of United States workers are employed in occupations where exposure to disease or infection occurs at least once per week. Approximately 18.4% (26.7 M) of all United States workers are employed in occupations where exposure to disease or infection occurs at least once per month. While the majority of exposed workers are employed in healthcare sectors, other occupational sectors also have high proportions of exposed workers. These include protective service occupations (e.g. police officers, correctional officers, firefighters), office and administrative support occupations (e.g. couriers and messengers, patient service representatives), education occupations (e.g. preschool and daycare teachers), community and social services occupations (community health workers, social workers, counselors), and even construction and extraction occupations (e.g. plumbers, septic tank installers, elevator repair). CONCLUSIONS: The large number of persons employed in occupations with frequent exposure to infection and disease underscore the importance of all workplaces developing risk response plans for COVID-19. Given the proportion of the United States workforce exposed to disease or infection at work, this analysis also serves as an important reminder that the workplace is a key locus for public health interventions, which could protect both workers and the communities they serve.

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OBJECTIVE: Federal Region X is an administrative region in the northwestern United States comprised of the states of Alaska (AK), Idaho (ID), Oregon (OR), and Washington (WA). Quantifying the number of workers in this region exposed to harmful circumstances in the workplace, and projected changes over time will help to inform priorities for occupational health training, risk reduction, and research. METHODS: State data for WA, ID, OR, and AK were used to estimate number of workers by occupation, in 2014 and 2024. These data were merged with a Canadian job-exposure matrix (CANJEM) which characterizes chemical exposures, and O*NET, which ranks occupations with particular physical, ergonomic, and psychosocial exposures. RESULTS: Of the exposures considered, psychosocial and ergonomic exposures were the most prevalent among the regional workforce, though traditional chemical exposures are still common and increasing. CONCLUSIONS: Exposure surveillance will inform prioritization of risk reduction strategies, ultimately leading to a decrease in occupational injury and illness. Findings from this analysis will help to prioritize occupational health training and research in the region.

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Objectives: This article examines whether the Occupational Safety and Health Administration's (OSHA) average noise level (LAVG) or the National Institute of Occupational Safety and Health's (NIOSH) equivalent continuous average (LEQ) noise measurement criteria better predict hearing loss. Methods: A cohort of construction workers was followed for 10 years (2000-2010), during which time their noise exposures and hearing threshold levels (HTLs) were repeatedly assessed. Linear mixed models were constructed with HTLs as the outcome, either the OSHA (LAVG) or NIOSH (LEQ) measurement criteria as the measure of exposure, and controlling for age, gender, duration of participation, and baseline HTLs (as both a covariate or an additional repeated measure). Model fit was compared between models for HTLs at 0.5, 1, 2, 3, 4, 6, and 8 kHz using the Akaike information criterion (AIC). The 10th, 50th, and 90th percentiles of hearing outcomes predicted by these models were then compared with the hearing outcomes predicted using the ISO 1999:2013 model. Results: The mixed models using the LEQ were found to have smaller AIC values than the corresponding LAVG models. However, only the 0.5, 3, and 4 kHz models were found to have an AIC difference greater than 2. When comparing the distribution of predicted hearing outcomes between the mixed models and their corresponding ISO outcomes, it was found that LEQ generally produced the smallest difference in predicted hearing outcomes. Conclusions: Despite the small difference and high correlation between the LEQ and LAVG, the LEQ was consistently found to better predict hearing levels in this cohort and, based on this finding, is recommended for the assessment of noise exposure in populations with similar exposure characteristics.

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Objectives: Despite women's increased representation in the overall workforce, construction remains a male-dominated industry. Prior studies have noted that the hazardous workplace environment combined with a culture that can be discriminatory and openly hostile can threaten women workers' health and safety. However, little information exists about the current physical and psychosocial hazards at work affecting tradeswomen. Methods: We examined differences in workplace exposure between women and men, and the association of these exposures with self-reported stress and work injury, in order to highlight how gendered conditions of work negatively affect tradeswomen's health. A holistic view of health that included the influence of both home and work spheres as well as hazards related to women's social experience was considered. Almost 300 workers (198 tradeswomen and 93 tradesmen) throughout Washington State completed surveys. We used descriptive statistics to compare exposures between genders, and logistic regression to model the association between psychosocial exposures and injury and stress outcomes. Results: We found that women were significantly more likely than men to report high perceived stress (31 and 18%, respectively) and being injured at work in the past year (31 and 12%, respectively). Ten of the 12 work-related psychosocial exposures were found to be associated with either stress (job strain, gender and age discrimination, bullying, work/life balance, isolation, sexual harassment, safety climate, and social support) or injury (gender discrimination, bullying, overcompensation, and sexual harassment) for women. Conclusions: The industry continues to lag in supporting tradeswomen's health and safety needs. This study suggests that multiple exposures (including discrimination, overcompensation, and work/life balance) have an important impact on worker well-being. The findings underscore the complex interaction of gender, psychosocial exposures, and occupational risks, and indicate areas for intervention.

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We investigated the viability of particle bound 1-nitropyrene (1-NP) air concentration measurements as a surrogate of diesel exhaust (DE) exposure, as compared with industry-standard elemental carbon (EC) and total carbon (TC) measurements. Personal exposures are reported for 18 employees at a large underground metal mine during four different monitoring campaigns. Full-shift personal air exposure sampling was conducted using a Mine Safety and Health Administration (MSHA) compliant diesel particulate matter (DPM) impactor cassette downstream of a GS-1 cyclone pre-selector. Each DPM filter element was analyzed for EC and organic carbon (OC) using NIOSH Method 5040. After EC and OC analysis, the remaining portion of each DPM filter was analyzed for 1-NP using liquid chromatography tandem mass spectrometry (LC/MS/MS). We observed high correlations between the quantiles of 1-NP and EC exposures across 10 different work shift task groups (r = 0.87 to 0.96), and a linear relationship with a slope between 6.0 to 6.9 pg 1-NP per µg EC. However, correlation between 1-NP and EC was weak (r =0.34) for the 91 individual sample pairs due to low EC concentrations and possible heterogeneity of DE composition. While both 1-NP and EC differentiated between high and low exposure groups categorized by job location, measurements of 1-NP, but not EC further differentiated between specific job activities. Repeated measurements on individual subjects verified the relationship between 1-NP and EC and demonstrated substantial within-subject variability in exposure. The detection limit of TC air concentration ranged between 18 and 28 µg m-3 and was limited by OC contamination of the quartz filters in the MSHA compliant DPM samplers.

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Little is known about exposure to pathogenic bacteria among industrial laundry workers who work with soiled clinical linen. To study worker exposures, an assessment of surface contamination was performed at an industrial laundry facility serving hospitals in Seattle, WA, USA. Surface swab samples (n = 240) from the environment were collected during four site visits at 3-month intervals. These samples were cultured for Clostridium difficile, methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant enterococci (VRE). Voluntary participation of 23 employees consisted of nasal swabs for detection of MRSA, observations during work, and questionnaires. Contamination with all three pathogens was observed in both dirty (laundry handling prior to washing) and clean areas (subsequent to washing). The dirty area had higher odds of overall contamination (≥1 pathogen) than the clean area (odds ratio, OR = 18.0, 95% confidence interval 8.9-36.5, P < 0.001). The odds of contamination were high for each individual pathogen: C. difficile, OR = 15.5; MRSA, OR = 14.8; and VRE, OR = 12.6 (each, P < 0.001). The highest odds of finding surface contamination occurred in the primary and secondary sort areas where soiled linens were manually sorted by employees (OR = 63.0, P < 0.001). The study substantiates that the laundry facility environment can become contaminated by soiled linens. Workers who handle soiled linen may have a higher risk of exposure to C. difficile, MRSA, and VRE than those who handle clean linens. Improved protocols for prevention and reduction of environmental contamination were implemented because of this study.

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RATIONALE: The impact of a broad range of occupational exposures on subclinical interstitial lung disease (ILD) has not been studied. OBJECTIVES: To determine whether occupational exposures to vapors, gas, dust, and fumes (VGDF) are associated with high-attenuation areas (HAA) and interstitial lung abnormalities (ILA), which are quantitative and qualitative computed tomography (CT)-based measurements of subclinical ILD, respectively. METHODS: We performed analyses of participants enrolled in MESA (Multi-Ethnic Study of Atherosclerosis), a population-based cohort aged 45-84 years at recruitment. HAA was measured at baseline and on serial cardiac CT scans in 5,702 participants. ILA was ascertained in a subset of 2,312 participants who underwent full-lung CT scanning at 10-year follow-up. Occupational exposures were assessed by self-reported VGDF exposure and by job-exposure matrix (JEM). Linear mixed models and logistic regression were used to determine whether occupational exposures were associated with log-transformed HAA and ILA. Models were adjusted for age, sex, race/ethnicity, education, employment status, tobacco use, and scanner technology. MEASUREMENTS AND MAIN RESULTS: Each JEM score increment in VGDF exposure was associated with 2.64% greater HAA (95% confidence interval [CI], 1.23-4.19%). Self-reported vapors/gas exposure was associated with an increased odds of ILA among those currently employed (1.76-fold; 95% CI, 1.09-2.84) and those less than 65 years old (1.97-fold; 95% CI, 1.16-3.35). There was no consistent evidence that occupational exposures were associated with progression of HAA over the follow-up period. CONCLUSIONS: JEM-assigned and self-reported exposures to VGDF were associated with measurements of subclinical ILD in community-dwelling adults.

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Objectives: Economic, social, technical, and political drivers are fundamentally changing the nature of work and work environments, with profound implications for the field of occupational health. Nevertheless, researchers and practitioners entering the field are largely being trained to assess and control exposures using approaches developed under old models of work and risks. Methods: A speaker series and symposium were organized to broadly explore current challenges and future directions for the occupational health field. Broad themes identified throughout these discussions are characterized and discussed to highlight important future directions of occupational health. Findings: Despite the relatively diverse group of presenters and topics addressed, some important cross-cutting themes emerged. Changes in work organization and the resulting insecurity and precarious employment arrangements change the nature of risk to a large fraction of the workforce. Workforce demographics are changing, and economic disparities among working groups are growing. Globalization exacerbates the 'race to the bottom' for cheap labor, poor regulatory oversight, and limited labor rights. Largely, as a result of these phenomena, the historical distinction between work and non-work exposures has become largely artificial and less useful in understanding risks and developing effective public health intervention models. Additional changes related to climate change, governmental and regulatory limitations, and inadequate surveillance systems challenge and frustrate occupational health progress, while new biomedical and information technologies expand the opportunities for understanding and intervening to improve worker health. Conclusion: The ideas and evidences discussed during this project suggest that occupational health training, professional practice, and research evolve towards a more holistic, public health-oriented model of worker health. This will require engagement with a wide network of stakeholders. Research and training portfolios need to be broadened to better align with the current realities of work and health and to prepare practitioners for the changing array of occupational health challenges.

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PURPOSE: We sought to understand the time course between exposure to manganese (Mn) and uptake into the blood, to allow a more meaningful interpretation of exposure biomarker data, and to determine the utility of blood as a biomarker of Mn exposure. METHODS: Welder trainees were monitored over the course of a five-quarter training program. Each quarter, trainees gave eight blood samples and had personal air monitoring four times. A mixed model was fit to obtain estimates of airborne exposure by welding type (fixed effect), adjusted for subject (random effect). Considering weekends and days absent as zero exposure, estimated exposures were summed over various exposure windows and related to measured blood manganese (MnB) using a mixed model. RESULTS: A relationship consistent with zero was found between MnB and modeled 1 or 7 days of exposure. After 30 days of preceding exposure, a 1 mg-days/m(3) increase in air Mn is associated with a 0.57 ng/mL increase in MnB (95% CI -0.04, 1.19). Considering a 90-day exposure window and a cumulative exposure window, a 1 mg-days/m(3) increase in air Mn is associated with a 0.26 (95% CI 0.005, 0.51) and 0.09 (95% CI 0.006, 0.17) ng/mL increase in MnB, respectively. CONCLUSIONS: From this analysis, MnB may begin to act as a biomarker of Mn exposure over longer time periods, or at higher levels of exposure. This novel study design allowed investigation of how MnB relates to different time windows of exposure, representing the most robust Mn exposure assessment in the biomarker literature.

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Quantifying exposure and dose to manganese (Mn) containing airborne particles in welding fume presents many challenges. Common biological markers such as Mn in blood or Mn in urine have not proven to be practical biomarkers even in studies where positive associations were observed. However, hair Mn (MnH) as a biomarker has the advantage over blood and urine that it is less influenced by short-term variability of Mn exposure levels because of its slow growth rate. The objective of this study was to determine whether hair can be used as a biomarker for welders exposed to manganese. Hair samples (1cm) were collected from 47 welding school students and individual air Mn (MnA) exposures were measured for each subject. MnA levels for all days were estimated with a linear mixed model using welding type as a predictor. A 30-day time-weighted average MnA (MnA30d) exposure level was calculated for each hair sample. The association between MnH and MnA30d levels was then assessed. A linear relationship was observed between log-transformed MnA30d and log-transformed MnH. Doubling MnA30d exposure levels yields a 20% (95% confidence interval: 11-29%) increase in MnH. The association was similar for hair washed following two different wash procedures designed to remove external contamination. Hair shows promise as a biomarker for inhaled Mn exposure given the presence of a significant linear association between MnH and MnA30d levels.

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