TP63. TP063 COVID-19 IN ENVIRONMENTAL, OCCUPATIONAL, AND POPULATION HEALTH最新文献

{"title":"Occupational Stress and Moral Injury in US Healthcare Workers (HCW) with Caregiving Duties During the COVID-19 Pandemic","authors":"K. Chin, E. Wickwire, D. Glick, S. E. Hines","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3084","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3084","url":null,"abstract":"Rationale: The advent of the global pandemic due to SARS-CoV-2 infections resulting in COVID-19 disease resulted in increased demands on HCWs for professional services. In concert, many pre-school, primary, and secondary schools closed physical facilities and initiated virtual curricula, requiring the presence of caregivers at home for younger children during typical working hours. The tension of increased job responsibilities and home caregiving responsibilities with limited remedies in HCWs during the COVID-19 pandemic may result in increased stress and possible moral injury. Methods: We surveyed HCWs at a single large tertiary academic hospital in June 2020. Participants were part of a larger study examining occupational distress, resilience, and moral injury. Status as a caregiver to children <18 years old, partnership status, changes in caregiving responsibilities, work patterns, and difficulties in work due to caregiving were evaluated using a subset of items from the University of Washington Caregiver Stress Scale. Symptoms of occupational stress were evaluated with the Impact of Event Scale - Revised (IES-R), and signs of potential moral injury were evaluated with the Moral Injury Event Scale (MIES). Results: Out of 96 respondents, 38 HCW self-identified as caregivers to children. The majority of caregiving HCW (73%) spent >50% of their professional time in clinical work. Caregivers were principally married (82%) or partnered (2.6%). Approximately 60% of caregivers reported increased caregiving responsibility for themselves as well as their spouse or partner. Few HCWs reported missing work due to childcare responsibilities. Mean IES-R scores were similar in caregivers and non-caregivers (14.8 ± 10.7 v. 14.2 ± 10.6, p=0.78) demonstrating moderate occupational stress. Mean MIES scores were similar in caregivers and noncaregivers (13.3 ± 9.1 v. 15.0 ± 7.6, p=0.33) and demonstrated low levels of potentially morally injurious events. Conclusions: While HCWs experienced an increase in childcare responsibilities during the COVID-19 pandemic, levels of occupational stress and possible moral injury were low to moderate when assessed in June 2020. Few HCWs reported work absence due to childcare needs, suggesting that these HCWs accessed alternative means of childcare to allow them to continue clinical work. Presence of a partnered marital status and concomitant increase in the partner's childcare responsibilities, in addition to high socioeconomic status, might have facilitated these arrangements. Other unmeasured resilience factors may also have contributed to low levels of occupational stress and moral injury, such as employer expectations on work tasks or expanded resources for childcare.","PeriodicalId":375809,"journal":{"name":"TP63. TP063 COVID-19 IN ENVIRONMENTAL, OCCUPATIONAL, AND POPULATION HEALTH","volume":"291 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134576018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between History of Obesity, Hypertension, Diabetes and COVID-19 Requiring Hospitalization with the Presence of Persistent Dyspnea on Exertion and Abnormal Lung Imaging in Convalescent Patients Recovering from COVID-19","authors":"X. Blanco, D. Carreras, A.R. Arauco Brown","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3093","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3093","url":null,"abstract":"Rationale On a previous exploratory analysis, a sample of 150 convalescent patients recovering from COVID-19, we found that a subgroup of our patients continues experiencing persistent dyspnea on exertion (DOE) associated with radiographic abnormalities on chest images (CT chest and chest - x rays). Patients shared the following clinical variables in their medical history: obesity, hypertension, diabetes, and history of hospitalization due to COVID-19. Objective To examine the potential relationship between comorbidities such as obesity, hypertension, and diabetes with the presence of persistent dyspnea and abnormal lung imaging in convalescent patients recovering from COVID-19. Also, we examined if history of COVID-19 requiring hospitalization was related to the dependent variables mentioned above. Methods A chi-square test of independence was performed to examine the relation between the clinical variables in the study. The sample of one hundred fifty patients was obtained using the pulmonary office electronic medical record system. The data was collected and analyzed using SPSS Statistics software. Results Based on the data analyzed we found that there is no significant relationship between obesity and persistent DOE nor persistent radiographic abnormalities. At the same time, the test of independence showed that there was no significant association between hypertension and persistent DOE nor persistent radiographic abnormalities. Furthermore, the presence of persistent DOE with or without persistent radiographic abnormalities was not associated with past history of diabetes in convalescent patients recovering from COVID-19. We found that there was a significant statistical relation between the presence of severe COVID-19 requiring hospitalization with persistent dyspnea on exertion and persistent radiographic abnormalities. Conclusions This small retrospective analysis revealed a possible relation between history of severe SARS-CoV-2 pneumonia requiring hospitalization and persistent dyspnea on exertion in convalescent patients recovering from COVID-19 at least thirty days after initial diagnosis. There is also a potential relation between this same variable with the presence of persistent radiographic abnormalities. Further research would be required to investigate if other clinical variables or the concomitant presence of multiple of them may be associated with COVID-19 post inflammatory sequelae.","PeriodicalId":375809,"journal":{"name":"TP63. TP063 COVID-19 IN ENVIRONMENTAL, OCCUPATIONAL, AND POPULATION HEALTH","volume":"60 7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116436032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physiologic Effects of Elastomeric Half-Mask Respirator Use with or Without a Surgical Mask in Healthcare Workers","authors":"E. Zhuang, P. Thurman, O. Kolesnik, S. E. Hines","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3083","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3083","url":null,"abstract":"RATIONALE: Elastomeric half-mask respirators (EHMRs) have seen expanded use during the COVID-19 pandemic. Due to concern that persons with asymptomatic COVID-19 infection could potentially transmit infectious respiratory droplets via the exhalation port of an EHMR, some propose placing a surgical mask (SM) over the exhalation port. The physiologic effects of wearing a SM over the exhalation port of an EHMR are unknown. METHODS: We recruited 12 healthy healthcare worker volunteers (92% female, mean age 34.1 years, mean BMI 24.3 kg/m2). Subjects completed a series of simulated healthcare-related activities, including resting, talking, walking and bending, proning and supinating a 172-pound manikin, and performing cardiopulmonary resuscitation (CPR). This 30-minute series was repeated three times, each with a different mask configuration: SM only, EHMR only, or EHMR with SM covering the exhalation port. Each subject's transcutaneous carbon dioxide (tcPCO2), oxygen saturation (SpO2), and heart rate (HR) were measured continuously using a noninvasive transcutaneous sensor (Sentec Inc.). Subjects rated their rate of perceived exertion (RPE) and level of discomfort after each round. Results were analyzed using mixed linear models with a fixed effect for mask type, activity, age, BMI, and gender. A random intercept was included to account for dependency in observations. Testing also included an interaction between mask type and activity. RESULTS: Mean tcPCO2, SpO2, and HR values fell in the normal range for all activities and all mask configurations (Figure). We found statistically but not clinically significant differences in tcPCO2, SpO2, and HR between EHMR with SM and EHMR only. There were decreases in mean tcPCO2 (-0.63, p < 0.001) and SpO2 % (-0.22, p = 0.002), and an increase in HR (+1.51 bpm, p < 0.001) when using EHMR with SM compared to EHMR only. There were similar decreases in mean tcPCO2 (-0.61, p < 0.001) and SpO2 % (-0.27, p < 0.001), and an increase in mean HR (+1.00 bpm, p = 0.018) when comparing EHMR with SM and SM only. Age, BMI, and gender had no significant effect. RPE and discomfort scores were higher with either EHMR configuration compared to SM only. CONCLUSION: Wearing a SM over an EHMR did not produce clinically significant changes in tcPCO2, SpO2, and HR compared to uncovered EHMR during healthcare-related tasks, including patient proning and CPR. Despite higher exertion and discomfort scores with either EHMR configuration, clinically significant changes in tcPCO2, SpO2, and HR were not observed.","PeriodicalId":375809,"journal":{"name":"TP63. TP063 COVID-19 IN ENVIRONMENTAL, OCCUPATIONAL, AND POPULATION HEALTH","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129644075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SF-36 Mental Component Score Trajectories Do Not Show a Strong Impact of the COVID-19 Pandemic in Current and Former Smokers","authors":"G. Kinney, J. Bon, K. Hoth, K. Young, B. Make, R. Wise, J. Hokanson, E. Regan, for the COPDGene Investigators","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3089","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3089","url":null,"abstract":"Background: CDC recommended increased social distancing in order to reduce virus transmission during the COVID-19 pandemic. This included physical isolation for older adults at elevated risk for COVID-19 due to age and chronic medical conditions such as lung disease. While social distancing is effective at reducing the spread of COVID-19, the secondary negative impact of isolation and reduction in social resources is likely to impact vulnerable older adults with medical risk factors such as a history of heavy smoking and chronic lung disease. In this study we will examine the impact of pandemic on longitudinal change in SF-36 Mental Component Score. Methods: COPDGene is a longitudinal study of current and former smokers with at least a 10 pack-year smoking history. The study has included 3 visits (Baseline, Phase 2 at 5-years, and Phase 3 at 10-years), during which quality of life was assessed using the SF-36. Phase 3 in-person visits were interrupted by COVID-19 in March 2020. SF-36 was included in virtual visits conducted from March-October of 2020 using telephony and online surveys. We examined vectors of change in MCS across the 3 timepoints employing group-based trajectory models (SAS Proc Traj) to identify group membership and the probability of the observed MCS given group memberships. Each model used baseline and 5-year data in the same way. The first model used phase 3 data collected in-person (PRE) and the second used phase 3 data collected during the pandemic (DURING). Trajectory membership was compared using demographic profiles of participants pre- vs post-pandemic. Results: Figure 1 shows the trajectories identified for each group. The PRE group (n=2,242) included 4 trajectories: 1) 68% began high (MCS=56.1) and continued to be high across 10 years, 2) 15% began low (MCS=38.8) and improved, 3) 11.0% began high (MCS=51.4) and decreased and 4) 6.4% began low (MCS=30.0%) and remained low. The DURING group included three trajectories with the majority of observations beginning high (MCS=54.5) and remaining high, and two other groups that duplicated the pattern of PRE groups 2 and 3. The most consistent predictors of group membership in both PRE and DURING were age, MMRC and 6 minute walk at both baseline and year 10 follow-up (p<0.0001 in all cases). Conclusions: Trajectories of change in mental-health related quality of life do not reflect a large negative impact of the COVID- 19 pandemic in this large sample of older current and former smokers with and without COPD.","PeriodicalId":375809,"journal":{"name":"TP63. TP063 COVID-19 IN ENVIRONMENTAL, OCCUPATIONAL, AND POPULATION HEALTH","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130451204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 Infection Among Airborne Hazards Open Burn Pit Registry Participants Utilizing the VA","authors":"N. Jani, M. Falvo, M. Arjomandi, S. Krefft, J. Osterholzer, S. E. Hines, E. Shuping, A. Sotolongo","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3086","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3086","url":null,"abstract":"Background: Veterans are concerned about their risk of coronavirus disease 2019 (COVID-19) and whether their deployment experience and/or exposures increase their risk of infection as well as associated morbidity and mortality. This is particularly important for members of armed services and Veterans who have sustained both civilian- and deployment-related occupational and environmental exposures and may potentially be at higher risk. Here, we describe the number of cases and patient characteristics among deployed Veterans who have participated in the Airborne Hazards and Open Burn Pit Registry (AHOBPR) utilizing the Veterans Health Administration (VHA). Methods: To explore the number of potential COVID-19 cases within the AHOBPR, we cross-referenced VHA medical records from March - November 2020 with the prospectively maintained AHOBPR database. As of November 25, 2020, there were 221,124 AHOBPR participants who were deployed to the Southwest Asia theater of operations on or after August 2, 1990, or deployed to Afghanistan or Djibouti after September 11, 2001. Data sources for the descriptive data analysis included the AHOBPR self-administered questionnaire and VHA medical records. Results: 89,318 VHA enrollees tested positive for COVID-19 between March and November 2020. Among all of the positive cases who underwent COVID-19 testing with VHA, 1,872 (2.0%) were AHOBPR participants. There were 5,022 known deaths of which 7 were AHOBPR participants. The majority of AHOBPR cases were men (85.9%) with a median age of 44 (range: 24 - 74 years), consistent with the demographics of the AHOBPR cohort (85.5% men, 43 median age). Eighty-nine (4.75%) of those tested positive were hospitalized in the VA and 40 (2.1%) were in the ICU. The mean ICU stay was 5.8 days (SD 7.2). The most frequently identified comorbidities among AHOBPR cases were of bronchitis (n=112, 5.9%), COPD (n=100, 5.3%), and hypertension (n=604, 32.3%). Conclusion: Approximately 13.8% of AHOBPR participants who received testing within VHA tested positive for COVID-19. Demographic characteristics of these cases reflect those of the broader AHOBPR, and comorbidity burden appears similar to the larger VHA and civilian population. Ongoing efforts are underway to investigate the role for deployment exposures and risk of COVID-19 and its associated morbidity and mortality.","PeriodicalId":375809,"journal":{"name":"TP63. TP063 COVID-19 IN ENVIRONMENTAL, OCCUPATIONAL, AND POPULATION HEALTH","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132189467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Exploratory Retrospective Study on the Clinical Progression of Predominantly Hispanic Patients with COVID 19 in a Pulmonary Clinic in the Rio Grande Valley","authors":"X. Blanco, D. Carreras, A.R. Arauco Brown","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3091","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3091","url":null,"abstract":"Rationale We observed a large number of convalescent patients recovering from COVID-19 who were referred to the pulmonary office with persistent respiratory symptoms including cough and dyspnea on exertion. A significant portion of those patients had diabetes, hypertension, and obesity as comorbidities. Objective To explore and determine which clinical variables could be associated with persistent respiratory symptoms, abnormal lung physiology, or radiographic abnormalities in patients recovering from COVID-19. Methods Using an electronic medical record, we query the pulmonary office system for patients evaluated for COVID-19 pneumonia between March and November 2020. A total of 150 patients were identified. 52% of the sample were males and 99% were Hispanics. 69% of patients (N=138) were previously hospitalized and the remaining ones were treated as ambulatory patients by their primary providers. Results From the sample, 68% (N=130) had a body mass index (BMI) greater than 30, 55% (N=150) presented hypertension and 41% (N=150) had diabetes. We observed that 68% (N=142) experienced persistent dyspnea on exertion (DOE) after 30 days of COVID-19 diagnosis. 71% (N=88) of the patients who experienced persistent DOE after 30 days had a BMI greater than 30. The 84% (N=113) showed abnormal findings on lung imaging (chest computed tomography or chest xrays). From a subgroup of 53 patients who underwent pulmonary function tests in the office, 47% showed a restrictive ventilatory defect and 68% presented a decreased diffusion capacity. Conclusions Based on the empirical evidence reported on this abstract, further research should be directed to investigate if the clinical variables delineated above (diabetes, obesity, hypertension and previous hospitalization) may increase the likelihood of persistent dyspnea, abnormal lung imaging or abnormal pulmonary function tests in convalescent patients recovering from COVID-19. At the same time, we would recommend clinicians to consider evaluating their convalescent patients with persistent respiratory symptoms for abnormal pulmonary physiology or post inflammatory radiographic changes specially if the patients presented the clinical variables delineated in this abstract.","PeriodicalId":375809,"journal":{"name":"TP63. TP063 COVID-19 IN ENVIRONMENTAL, OCCUPATIONAL, AND POPULATION HEALTH","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134368245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adult Asthma and COPD Healthcare Utilization During the COVID-19 Pandemic","authors":"S. Xie, S. Lynch, B. Himes","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3079","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3079","url":null,"abstract":"Rationale: The Coronavirus Disease 2019 (COVID-19) pandemic has greatly impacted health care delivery patterns, including for patients with asthma and chronic obstructive pulmonary disease (COPD). Patients who experience both asthma and COPD symptoms, referred to as asthma-COPD overlap (ACO), have increased morbidity and healthcare utilization than patients with either disease alone. Methods: We obtained de-identified encounter-level electronic health record (EHR) data for adult asthma and COPD encounters within Penn Medicine occurring between January 1, 2015 and October 31, 2020. Variables extracted included codified demographic information, ICD-10 encounter codes and encounter type (i.e., office visit, hospital encounter, telemedicine or other). Patients were included if they were aged at least 18 years at first encounter and had at least two encounters over a period of at least a year. We classified patients as having asthma, COPD or ACO based on ICD-10 diagnoses (J45∗ for asthma and J41-44∗ for COPD) and medication prescriptions (short-acting β2-agonist for asthma and either shortacting β2-agonist or short-acting muscarinic antagonist for COPD), where ACO patients were defined as those meeting asthma and COPD criteria. We compared asthma and COPD healthcare encounters before (pre-pandemic) and after (pandemic) March 17, 2020 in terms of encounter volume and type. We also tested for differences in the demographic distributions of telemedicine vs. in-person visits using t- and χ2-tests. Results: A total 66,191 patients met our inclusion criteria, of which 46,257 (70%) had asthma, 12,580 (19%) had COPD, and 7,354 (11%) had ACO. Average monthly volume of office visits and hospital encounters for asthma/COPD decreased considerably during the pandemic (>50% decrease in office visits and >25% decrease in hospital encounters across all patient groups), while the volume of telemedicine visits increased dramatically (from 0-1 to 481-1,343 average monthly telemedicine visits across all patient groups) [Figure 1]. During the pandemic, non-Hispanic Black patients were more likely to be encountered via telemedicine than in-person encounters across all patient groups (39% vs. 34% of asthma patients encountered via telemedicine and in-person visits, respectively, were non-Hispanic Black;33% vs. 26% of COPD patients, and 50% vs. 44% among ACO patients;p<0.01 for all comparisons). Telemedicine and in-person visits for asthma/COPD during the pandemic did not differ significantly by mean age or sex among any of the patient groups. Conclusions: Telemedicine visits for asthma and COPD increased dramatically during the COVID-19 pandemic, while office visits and hospital encounters decreased. Further study.","PeriodicalId":375809,"journal":{"name":"TP63. TP063 COVID-19 IN ENVIRONMENTAL, OCCUPATIONAL, AND POPULATION HEALTH","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131192436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inhalant Use Is Associated with Sleep Quality and Mental Health During the COVID-19 Pandemic","authors":"D. Gunge, I. Advani, S. Boddu, Y. Chen, S. Mehta, W. Merz, A. Lucia-Fuentes, A. Malhotra, S. Banks, L. C. Crotty Alexander","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3090","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3090","url":null,"abstract":"RATIONALE: Cigarette smoking and sleep quality are known to impact mental health considerably. As nicotine is a primary component of both cigarettes and electronic (e)-cigarettes, we launched a survey-based study in order to study the effects of e-cigarettes, conventional tobacco, and dual usage on mental health as well as sleep quality. We sent out this survey in the time of COVID-19 in order to assess the impact of nicotine-based inhalant use on sleep quality and mental health. We hypothesized that e-cigarette use impacts mental illnesses and sleep quality, which is exacerbated by the presence of additional stress such as a global pandemic. METHODS: We combined our established UCSD Inhalant Questionnaire with the Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS), and Patient Health Questionnaire (PHQ-9). Participants were recruited through online advertisements posted to social media sites including Facebook, Craigslist, Reddit, and Twitter. Participants (n=554) were recruited in April 2020, and a subset (n=217) retook the survey in June 2020. The survey was broken up into four sections - past and current type of inhalant use (UCSD Inhalant Questionnaire), PSQI, HADS, and PHQ-9. All participants were incentivized via a weekly lottery for a gift card. RESULTS: Inhalant users reported worse sleep quality (PSQI, 6.74) when compared to non-smokers/non-vapers (PSQI, 5.72, p=0.02). Higher anxiety scores were associated with worse sleep quality (linear regression, r2=0.28, p<0.001). E-cigarette users and dual users of both e-cigarettes and conventional tobacco had higher anxiety scores (HADS anxiety;12.08 and 11.37, respectively) than non-smokers/non-vapers (7.94, p=0.028). Dual users were found to have higher depression scores relative to controls as well (HADS depression;7.42 versus 4.68, p=0.017). Sleep quality improved during the COVID pandemic from April 2020 (PSQI, 7.92) to June 2020 (PSQI, 6.10, p<0.0001). Interestingly, anxiety scores increased over the same period of time (HADS anxiety, 7.51 to 8.76, p<0.01). CONCLUSION: Our finding of diminished sleep quality in inhalant users is novel. Based on these data, we speculate that inhalant users may be more susceptible to sleep disturbances in the setting of a stressor, such as a global pandemic. Higher anxiety scores in e-cigarette and dual users, and higher depression scores in dual users, imply a direct relationship between inhalant use and mental disorders. Higher anxiety scores as the pandemic progressed may in theory reflect the lack of having an end in sight, or having loved ones affected by COVID-19.","PeriodicalId":375809,"journal":{"name":"TP63. TP063 COVID-19 IN ENVIRONMENTAL, OCCUPATIONAL, AND POPULATION HEALTH","volume":"1230 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131909222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of Measurements with Ultrasonic Spirometers by Adding Different High Efficiency Filters","authors":"C. Guzman Valderrabano, I. Alvarado Amador, L. Gochicoa-Rangel","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3095","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3095","url":null,"abstract":"","PeriodicalId":375809,"journal":{"name":"TP63. TP063 COVID-19 IN ENVIRONMENTAL, OCCUPATIONAL, AND POPULATION HEALTH","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129683606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Factors Associated with COVID19 Risk in Asthma","authors":"C. Bloom, P. Cullinan, J. Wedzicha","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3077","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3077","url":null,"abstract":"RATIONALE Several factors may be associated with the apparent reduced risk of severe COVID-19 disease in asthma patients. These include a proposed protective effect from inhaled corticosteroids (ICS) or from a type-2 immune airway response. Large UK population cohorts have found conflicting results, but each had missing information on asthma phenotype, including exacerbation history or markers of type-2 inflammation. Protective factors may be determined by comparing the outcomes of asthma patients to other patients using ICS or patients that have similar inflammation. This will be done using a national primary care database linked to secondary care data and Public Health England (PHE) COVID-19 data. METHODS From a primary care database covering around 15% of the UK population, we drew three cohorts of adults (>17 years) with asthma, chronic obstructive pulmonary disease (COPD) or allergic rhinitis, and a general population cohort matched by age, gender and primary care practice. COVID-19 infection was defined using three sources: primary care records (confirmed and suspected cases), hospital admissions or PHE data from their surveillance system. Preliminary analysis calculated the proportion of patients diagnosed as suspected or confirmed COVID-19 in primary care between 1st February and 22nd June 2020. We used multivariable logistic regression to assess associations between risk factors and COVID-19. RESULTS We identified 729,045 patients with asthma, 280,892 with COPD, 137,312 with allergic rhinitis and 1,138,018 in the general population cohort. 2.2% of the asthma cohort, 3.5% the COPD cohort, 2.4% of the allergic rhinitis cohort and 1.1% of the general population, were identified as having either suspected or confirmed COVID-19 in primary care (approximately a quarter were confirmed). In the asthma cohort, the following were found to be independently significantly associated with having suspected/confirmed COVID-19;older age, being male, diabetes, cardiovascular disease, obesity, sleep apnoea, bronchiectasis, COPD, ILD, chronic renal failure, cerebrovascular disease, dementia and liver disease (all p<0.0001). A history of past or current smoking and a high eosinophil count were not significantly associated. CONCLUSIONS These preliminary findings suggest patients with asthma are more likely to consult primary care about COVID-19 than a matched general population, but less likely than COPD patients, and that type-2 inflammation may not be associated with an increased risk of COVID-19 consultation with a primary care physician. Analysis comparing to the other cohorts and the general population, and using data from secondary care and PHE, is ongoing.","PeriodicalId":375809,"journal":{"name":"TP63. TP063 COVID-19 IN ENVIRONMENTAL, OCCUPATIONAL, AND POPULATION HEALTH","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126067850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}