American journal of industrial medicine最新文献

{"title":"California Warehouse Industry Worker Injury Rates in the Occupational Health and Safety Administration's Injury Tracking Application, 2018–2023","authors":"Stella Beckman,&nbsp;Naissem Andamel,&nbsp;Robert Harrison","doi":"10.1002/ajim.23697","DOIUrl":"10.1002/ajim.23697","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Occupational health and safety surveillance in the US relies primarily on federal and state administrative data sources which all have limitations created by underreporting and different sampling frames. To begin closing data gaps, in 2019 the federal Occupational Health and Safety Administration began requiring many US business establishments to submit injury and illness data to the Injury Tracking Application (ITA). We present an example use of these data by characterizing injuries in the California warehousing industry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Yearly ITA data for 2018–2023 were obtained and cleaned to exclude invalid records, resulting in 3717 records from California General Warehousing and Storage (GWS, NAICS 493110) establishments. Annual rates of total reportable injuries and cases of injuries requiring days of job transfer or restriction (DJTR) were calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Total injury rates peaked in 2021, with 5.87 injuries per 100 workers. While total injury rates subsequently declined, 2023 DJTR rates remained elevated over 2018 rates (3.21 vs. 1.84 per 100 workers). The primary analytical limitations were potential bias due to underreporting, and difficulty in identifying warehouse establishments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The ITA data are a valuable addition to existing administrative data sources, with several limitations similar to those in other administrative datasets. The findings of consistently elevated total and DJTR injury rates in California's warehousing industry are consistent with previous research and indicate that outreach and enforcement efforts should be expanded to protect the health and safety of warehouse workers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 3","pages":"295-303"},"PeriodicalIF":2.7,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dermal Exposure to Agrochemicals as Risk Factor for Skin Cancer in Farmers and Ranchers in the US Central States","authors":"Sarah Tucker,&nbsp;Yi Du,&nbsp;Rishad Ahmed,&nbsp;Gleb Haynatzki,&nbsp;Suraj Adhikari,&nbsp;Risto H. Rautiainen","doi":"10.1002/ajim.23696","DOIUrl":"10.1002/ajim.23696","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Farm operators are at a high risk of developing skin cancer due to their occupational sun exposure. With the growing incidence of skin cancer, it is also important to evaluate other occupational risk factors. Farm operators confront numerous physical, chemical, and biological hazards in their work environment. This study investigated whether dermal exposures to pesticides/fertilizers, animals/livestock, detergents/disinfectants, and fuels/solvents/paints were associated with the risk of skin cancer in farm and ranch operators.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Surveillance data from the Central States Center for Agricultural Safety and Health (CS-CASH) Farm and Ranch Health and Safety Surveys in 2018 and 2020 were used to explore the risk of skin cancer in farm operators in seven US central states. Farm production variables from the DTN Farm Market database were merged with survey responses. The associations of skin cancer and exposure variables were analyzed using descriptive statistics and regression modeling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of skin cancer was 10% among 7943 operators. Univariable analyses showed that men had 1.62 times higher odds of skin cancer compared to women. The odds of skin cancer increased significantly with age. Livestock, fed cattle, cow-calf, and beef production increased the odds of skin cancer. Exposure to pesticides/fertilizers and fuels/solvents/paints also increased the odds of skin cancer compared to unexposed operators. In the final multivariable model, the associations of skin exposure to pesticides/fertilizers (odds ratio (OR) = 1.30, 95% CI: 1.08–1.56) and to fuels/solvents/paints (OR = 1.21, 95% CI: 1.01–1.45) remained statistically significant after adjusting for sex, age, and state. Having livestock also increased the odds of skin cancer (OR = 1.18, 95% CI: 1.00–1.38).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Skin is a critical source of occupational exposures among farm operators. Increased odds of skin cancer in this study emphasizes the need for better protection against exposures to chemicals including pesticides/fertilizers, and fuels/solvents/paints.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 3","pages":"286-294"},"PeriodicalIF":2.7,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajim.23696","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reviewers for the American Journal of Industrial Medicine 2024","authors":"John D. Meyer","doi":"10.1002/ajim.23699","DOIUrl":"10.1002/ajim.23699","url":null,"abstract":"","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 2","pages":"210-213"},"PeriodicalIF":2.7,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Psychosocial Hierarchy of Controls: Effectively Reducing Psychosocial Hazards at Work","authors":"Asta Kjærgaard,&nbsp;Emilie Marie Rudolf,&nbsp;Julie Palmqvist,&nbsp;Mikala Ernebjerg Jakobsen,&nbsp;Jeppe Zielinski Nguyen Ajslev","doi":"10.1002/ajim.23694","DOIUrl":"10.1002/ajim.23694","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Psychosocial hazards in the workplace contribute to mental disorders, cardiovascular diseases, and musculoskeletal ill-health. The Hierarchy of Controls applied to NIOSH <i>Total Worker Health</i> (TWH HOC) aims to mitigate these hazards through effective interventions. This study proposes a revision of the model resulting in a HOC for psychosocial hazards (P-HOC) and explores its application in improving the working environment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We reviewed recent literature on organizational and individual interventions to revise the TWH HOC to a psychosocial HOC framework. Subsequently, the modified P-HOC was applied to a qualitative case study of nine Danish companies participating in the Danish “Agreement to problem-solve” labor inspection strategy. We analyzed the types of initiatives implemented and gathered qualitative data on employee and management perspectives on their effectiveness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study led to a revision of the TWH HOC resulting in a P-HOC prioritizing organizational measures with documented effect, and indicating the importance of comprehensive measures. Findings from the qualitative study indicate a predominant contemporary focus on lower-level P-HOC initiatives, such as individual-based approaches and administrative controls. While these interventions show some improvements in mental well-being and work culture, they seem insufficient to enhance the comprehensive psychosocial environment. Companies implementing higher-level interventions experienced greater efficacy, particularly when employing multifaceted approaches.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The study emphasizes the need for a more robust application of higher-level measures and multifaceted interventions to better improve the psychosocial working environment. Future research should investigate the P-HOC's varying impact and explore alternative frameworks for better intervention outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 3","pages":"250-263"},"PeriodicalIF":2.7,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajim.23694","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hearing Loss Is Associated With Increased Mortality in a Cohort of Older Construction Trades Workers","authors":"John Dement,&nbsp;Knut Ringen,&nbsp;Marianne Cloeren,&nbsp;Sammy Almashat,&nbsp;William Grier,&nbsp;Patricia Quinn,&nbsp;Kim Cranford,&nbsp;Anna Chen,&nbsp;Scott Haas","doi":"10.1002/ajim.23693","DOIUrl":"10.1002/ajim.23693","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hearing loss has been associated with increased mortality, and there is evidence that regular use of hearing aids reduces the mortality risk. However, these associations have not been sufficiently studied in worker populations at high risk for noise-induced hearing loss.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Medical examination data for 19,379 workers employed in US Department of Energy (DOE) facilities were used. Speech-frequency pure-tone average hearing loss and hearing aid use were ascertained. Mortality status through 2021 was obtained from the National Death Index. Cox regression examined the association between hearing loss and mortality and the impact of hearing aid use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eight thousand eighty-one workers (41.3%) had speech-frequency hearing loss and 2228 (15.3%) of these workers reported use of hearing aids. A total of 5398 deaths occurred over a median follow-up of 11.1 years. Hearing loss was an independent risk factor for higher mortality with an adjusted hazard ratio (HR) of 1.10 (95% CI = 1.03−1.17). The HR increased with hearing loss severity but the relationship was non-linear. Hearing aid users were at 30% reduced risk of mortality compared to those not using hearing aids (HR = 0.70, 95% CI = 0.63−0.77).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Results are consistent with research linking hearing loss with increased mortality and the preventive impact of hearing aid use. These findings should inform workers' compensation programs in favor of: (1) better coverage of hearing loss for noise-exposed workers, and (2) inclusion of hearing aids in medical benefits. Reduction in noise exposures is a priority and workers with hearing loss should be encouraged to use hearing aids.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 3","pages":"273-285"},"PeriodicalIF":2.7,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Kidney Injury Among Florida Construction Workers: A Pilot Study","authors":"Roxana C. Chicas,&nbsp;Cathy Zhuang,&nbsp;Andrea Castellano,&nbsp;Leslie Trejo,&nbsp;Ernesto Ruiz,&nbsp;Vicki Hertzberg","doi":"10.1002/ajim.23692","DOIUrl":"10.1002/ajim.23692","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>While construction workers have the second highest rate of heat-related mortality, less is known about the prevelance of heat-related illness (HRI) symptoms, dehydration and kidney dysfunction. The aim of this study was to conduct a biomedical field-based study with construction workers to characterize HRI symptoms, dehydration, and kidney dysfunction, and analyze relationships between post-work urine specific gravity (USG) percentiles and predictors such as work hours, water consumption, and sugary beverage consumption.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In collaboration with the Farmworker Association of Florida, 58 construction workers in Central Florida were monitored pre- and post-work shift on one workday. Research staff used a recreational vehicle to meet workers at their worksites, collect blood and urine pre- and post-work shift, and administer a survey on HRI symptoms. Acute kidney injury (AKI) was measured using serum creatinine and dehydration with USG. Predictors were examined in single covariate linear quantile mixed models against USG percentiles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean heat index was 88.4°F. Forty-two percent reported at least one symptom of HRI. Dehydration rates were 75% pre-work shift and 78% post-work shift. Severe dehydration increased from 16% to 33%. AKI was observed in 38% of the participants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This is, to our knowledge, the first US field-based biomedical study to document AKI, dehydration, and HRI symptoms in construction workers. This study adds to the literature that supports occupational heat exposure as a risk factor for AKI and dehydration.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 3","pages":"304-310"},"PeriodicalIF":2.7,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heat-Related Illness in California Firefighters, 2001–2020","authors":"Margaret Murray,&nbsp;Stella Beckman,&nbsp;Amy Heinzerling,&nbsp;Matthew Frederick,&nbsp;Kristin J. Cummings,&nbsp;Sheiphali Gandhi,&nbsp;Robert Harrison","doi":"10.1002/ajim.23691","DOIUrl":"10.1002/ajim.23691","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Firefighters have a higher rate of heat-related illness (HRI) compared to other occupations. Given the changing climate, firefighters' risk of occupational HRI merits attention. Therefore, we aimed to identify demographic, temporal, and geographic risk factors associated with occupational HRI in California firefighters between 2001 and 2020.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Within the California Workers' Compensation Information Systems (WCIS), we identified firefighters from 2001 to 2020 using industry and class codes and assigned occupation titles using the NIOSH Industry and Occupation Computerized Coding system (NIOCCS). HRI claims among firefighters were identified using International Classification of Diseases (ICD) Ninth or Tenth revision codes, WCIS nature and cause of injury codes, and keywords. We calculated HRI incidence rates adjusted by sex, age, year, and county. Estimates of California firefighter employment were obtained from the American Community Survey.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 2185 firefighter HRI claims between 2001 and 2020 (305.5 claims/100,000 firefighters, 90% CI: 278.7–740.7). Firefighters aged 18 to 29 years had a statistically significant higher risk of HRI compared to those aged 40 to 49 years (rate ratio = 3.5, 90% CI: 3.1–3.9). The HRI rate increased over time, and the risk from 2016 to 2020 was 1.8 times higher than it was from 2001 to 2005 (90% CI: 1.7–1.9). Northern California counties, including Shasta (2313.9) and Sacramento (1772.1), had the highest HRI rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Firefighters in certain demographic groups and northern California counties were at highest risk of HRI. With rising temperatures and larger wildfires, additional prevention efforts are needed to reduce HRI in California firefighters.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 2","pages":"184-193"},"PeriodicalIF":2.7,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occupational Injury and Suicide in Washington State, Adjusting for Pre-Injury Depression","authors":"Katie M. Applebaum,&nbsp;Abay Asfaw,&nbsp;Paul K. O'Leary,&nbsp;Matthew P. Fox,&nbsp;Yorghos Tripodis,&nbsp;Andrew Busey,&nbsp;Jaimie L. Gradus,&nbsp;Leslie I. Boden","doi":"10.1002/ajim.23682","DOIUrl":"10.1002/ajim.23682","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Occupational injuries have been associated with increased suicide mortality, but prior studies have not accounted for pre-injury depression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We linked injuries that occurred from 1994 to 2000 in the Washington State workers' compensation system with Social Security Administration data on earnings and mortality through 2018. We estimated the subdistribution hazard ratio (sHR) and 95% confidence interval using competing risks regression of suicide deaths with lost time compared with medical-only injuries separately for men and women, adjusting for age, pre-injury annual earnings, and industry. We further adjusted for pre-injury diagnosis of major depressive disorder by using a quantitative bias analysis (QBA), with the prevalence of this disorder in workers derived from an external health insurance claims data set.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Elevated suicide mortality was observed following lost-time injuries compared with medical-only injuries for men (sHR = 1.49, 95% CI [1.14, 1.93]) and women (sHR = 1.30, 95% CI [1.00, 1.69]), adjusting for age, pre-injury earnings, and industry. Adjusted for pre-injury depression using a QBA, elevated suicide risk in men remained statistically significant (median sHR = 1.33, simulation interval [1.18, 1.47]) but not for women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Workplace injury requiring time off work appeared to remain influential in increasing suicide risk among men, even after controlling for pre-injury depression. The relationship between mental health before and after occupational injury is complex and studies should better integrate mental health pre-injury.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Though many questions remain on the complex relationship between work, depression, injuries, and suicide, employers should work to prevent injuries and consider implementing mental health programs, which could be helpful in reducing suicide risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 2","pages":"122-131"},"PeriodicalIF":2.7,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Effectiveness of an Occupational Health and Safety Management System Certification Program on Firm Work Injury Rates in Alberta, Canada","authors":"Christopher B. McLeod,&nbsp;Robert A. Macpherson","doi":"10.1002/ajim.23690","DOIUrl":"10.1002/ajim.23690","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Occupational health and safety management systems (OHSMS) certification programs have the potential to improve workplace health and safety. In Canada, the Certificate of Recognition (COR) program is an example of such program and has been introduced in many industries and provinces. This study's objective was to identify whether the implementation of the COR program led to greater reduction in firm work-related injuries in Alberta, Canada.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using firm- and claim-level data from the Workers' Compensation Board of Alberta and COR registration data from Government of Alberta, the effect of becoming COR-certified on firm-level injury rates was assessed using a matched difference-in-differences study design with population-averaged negative binomial regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 14,377 certified firms were matched with 11,338 non-certified firms during the years 2000 to 2015. Firms that became certified had a greater reduction in the lost-time injury rate (IRR: 0.86, 95% CI 0.83−0.88) and disabling injury rate (IRR 0.97, 95% CI 0.94−1.00) relative to the change in injury rates among similar non-certified firms. The effectiveness of OHSMS certification was strongest in the transportation, manufacturing and trade sectors, in more recent years, and among firms certified using the standard COR program as opposed to the program adapted for small employers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings suggest that COR can be an effective program, but that the effectiveness of this program is dependent on the context in which it is implemented, such as the industry sector, time period, and type of audit program.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 2","pages":"175-183"},"PeriodicalIF":2.7,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Mild and Severe Cognitive Impairment in World Trade Center Exposed Fire Department of the City of New York (FDNY) and General Emergency Responders","authors":"Frank D. Mann,&nbsp;Alexandra K. Mueller,&nbsp;Rachel Zeig-Owens,&nbsp;Jaeun Choi,&nbsp;David J. Prezant,&nbsp;Melissa M. Carr,&nbsp;Alicia M. Fels,&nbsp;Christina M. Hennington,&nbsp;Megan P. Armstrong,&nbsp;Alissa Barber,&nbsp;Ashley E. Fontana,&nbsp;Cassandra H. Kroll,&nbsp;Kevin Chow,&nbsp;Onix A. Melendez,&nbsp;Abigail J. Smith,&nbsp;Christopher Christodoulou,&nbsp;Benjamin J. Luft,&nbsp;Charles B. Hall,&nbsp;Sean A. P. Clouston","doi":"10.1002/ajim.23685","DOIUrl":"10.1002/ajim.23685","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The emergency personnel who responded to the World Trade Center (WTC) attacks endured severe occupational exposures, yet the prevalence of cognitive impairment remains unknown among WTC-exposed-FDNY-responders. The present study screened for mild and severe cognitive impairment in WTC-exposed FDNY responders using objective tests, compared prevalence rates to a cohort of non-FDNY WTC-exposed responders, and descriptively to meta-analytic estimates of MCI from global, community, and clinical populations.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A sample of WTC-exposed-FDNY responders (&lt;i&gt;n&lt;/i&gt; = 343) was recruited to complete an extensive battery of cognitive, psychological, and physical tests. The prevalences of domain-specific impairments were estimated based on the results of norm-referenced tests, and the Montreal Cognitive Assessment (MoCA), Jak/Bondi criteria, Petersen criteria, and the National Institute on Aging and Alzheimer's Association (NIA-AA) criteria were used to diagnose MCI. NIA-AA criteria were also used to diagnose severe cognitive impairment. Generalized linear models and propensity score matching were used to compare prevalence estimates of cognitive impairment to a large sample of WTC-exposed-non-FDNY responders from the General Responder Cohort (GRC; &lt;i&gt;n&lt;/i&gt; = 7102) who completed the MoCA during a similar time frame.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Result&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Among FDNY responders under 65 years, the unadjusted prevalence of MCI varied from 52.57% to 60.32% depending on the operational definition of MCI, apart from using a conservative cut-off applied to MoCA total scores (18 &lt; MoCA &lt; 23), which yielded a markedly lower crude prevalence (24.31%) compared to alternative criteria. Using propensity score matching, the prevalence of MCI was significantly higher among WTC-exposed FDNY responders, compared to WTC-exposed GRC responders (adjusted &lt;i&gt;RR&lt;/i&gt; = 1.13 (CI 95% = 1.07–1.20, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), and descriptively higher than meta-analytic estimates from different global, community, and clinical populations. Following NIA-AA diagnostic guidelines, 4.96% of WTC-exposed-FDNY-responders met the criteria for severe impairments (95% CI = 2.91–7.82), a prevalence that remained largely unchanged after excluding responders over the age of 65 years.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Discussion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;There is a high prevalence of mild and severe cognitive impairment among WTC-responders, highlighting the putative role of occupational, environmental, and disaster-related exposures in the etiology of accelerated cognitive decline.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 &lt;/di","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":"68 2","pages":"160-174"},"PeriodicalIF":2.7,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}