Our aim was to investigate the impact of shiftwork on changes in central retinal arteriolar equivalent (CRAE), a measure of arteriolar width, and central retinal venular equivalent (CRVE), a measure of venular width, over five years. The participants were 117 officers (72.7% men) examined at the first (2011-2014) and second (2015-2019) follow-up examinations in the Buffalo Cardio-Metabolic Occupational Police Stress study. Shiftwork data were obtained from the City of Buffalo, NY payroll records. Retinal diameters were measured using a standardized protocol. ANCOVA was used to compare mean change in CRAE and CRVE between the two examinations across shiftwork categories. Among men only, those who worked ≥70% hours on day shifts had a larger decrease in mean CRAE (-7.13 µm ± 2.51) compared to those who worked <70% day (-0.08 ± 0.96; p = 0.011). Among patrol officers, those who worked ≥70% day had a larger decrease in CRAE compared to those who worked <70% day (p = 0.015). Also, officers who worked ≥70% day had an increase in mean CRVE (µm) (4.56 ± 2.56) compared to those who worked <70% (-2.32 ± 1.32; p = 0.027). Over the five-year period, we observed adverse changes in arteriolar and venular diameters among officers who worked ≥70% on day shifts. The results should be interpreted with caution due to the small sample sizes.

PURPOSE –: This study is a mortality assessment on police officers (68-years, 1950-2018) and includes all causes of death. DESIGN/METHODOLOGY/APPROACH –: The authors investigated 1,853 police deaths (1950-2018) using sources of mortality that included the National Death Index, NY State, and available records from the Buffalo NY police department. Standardized Mortality Ratios were calculated. Death codes were obtained from 8th and 9th International Classification of Disease revisions in accordance with the year of death. FINDINGS –: Compared to the US general population, white male police officers from 1950-2018 had elevated mortality rates for some causes of death, including diseases of the circulatory system, malignant neoplasms, cirrhosis of the liver, and mental disorders. Black and female officers had lower mortality rates for all causes of death compared to the general population. RESEARCH LIMITATIONS/IMPLICATIONS –: The findings of elevated risk for chronic disease among police need to be studied in relation to stress, lifestyle, and exposure to chemical and physical agents. There is a special need to further study officers from minority populations as larger samples become available. PRACTICAL IMPLICATIONS –: The results of this study will provide police and occupational health practitioners with objective evidence to determine the health impact of work on law enforcement officers. ORIGINALITY/VALUE –: This study is longest running mortality assessment on police officers ever conducted (1950-2018) and includes white, black, and female officers.

Few studies have evaluated gene-environment interaction in the risk of autism spectrum disorder (ASD). | | • | Single nucleotide polymorphism (SNPs) in relevant genes (e.g. immune, inflammatory, serotonin) were analyzed. | | • | Two experienced industrial hygienists estimated parental occupational exposure to solvents. | | • | Additive and multiplicative gene-environment interactions between SNPs and parental solventexposure were evaluated. | | • | SNP x solvent interaction is associated with higher rates of ASD compared to the SNP alone or solvent exposure alone.

The COVID-19 pandemic introduced a significant and unprecedented exacerbation of community mental health challenges. We compared the prevalence of mental health treatment (MHT) before and during the COVID-19 pandemic among US workers. Self-reported MHT data (N = 30,680) were obtained from the Sample Adult data of the National Health Interview Survey (2019 and 2020). MHT was defined as having taken prescription medications for mental health issues or receiving counseling from a mental health professional in the past 12 months. We calculated age-adjusted prevalence estimates and employed t-tests to compare MHT in 2019 and 2020 using SAS-callable SUDAAN 11.0. The prevalence of MHT significantly increased from 16.3% in 2019 to 17.6% in 2020 (difference = 1.3, p = 0.030). The prevalence of taking prescription medications for mental health issues significantly increased in 2020 compared to 2019 (12.5% to 13.6%, difference = 1.1, p = 0.037). The prevalence of receiving counseling significantly increased but only among those who worked 30-49 h/week, difference = 1.2, p = 0.022. US workers, especially those with typical work hours, appeared to experience higher mental distress during the first year of the pandemic compared to the year prior to the pandemic period. These findings highlight the need for targeted interventions to address mental health issues in these workers.

Previous research has established the role of resistance training (RT) on muscle function in adolescents, but a lack of evidence to optimize RT for enhancing muscle quality (MQ) exists. This study examined whether RT frequency is associated with MQ in a nationally representative adolescent cohort. A total of 605 adolescents (12-15 year) in NHANES were stratified based on RT frequency. MQ was calculated as combined handgrip strength divided by arm lean mass (via dual-energy X-ray absorptiometry). Analysis of covariance was adjusted for sex, race/ethnicity, and arm fat percentage; p &lt; 0.05 was considered significant. RT frequency was associated with MQ for 2-7 day/week but not 1 day/week. When no RT was compared to 1-2 and 3-7 day/week, associations were present for 3-7 day/week but not 1-2 day/week. When comparing no RT to 1-4 and 5-7 day/week, associations existed for 5-7 day/week but not 1-4 day/week. Next, no RT was compared to 1, 2-3, and 4-7 day/week; associations were found for 4-7 day/week, while 2-3 day/week had a borderline association (p = 0.06); there were no associations for 1 day/week. Finally, no RT was compared to 1, 2, 3, 4, and 5-7 day/week; associations were present for all except 1 and 3 day/week. These prospective data suggest a minimum RT frequency of 2 day/week is associated with MQ in adolescents as indicated by the lack of differences in MQ between 1 day/week RT versus no RT.

OBJECTIVES: We examined associations of the metabolic syndrome severity score (MSSS) and the metabolic syndrome (MetSyn) components with central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE). METHODS: Participants in this cross-sectional study were 253 officers from the Buffalo Cardio-Metabolic Occupational Police Stress study (2011-2014). The MSSS is a z-score that represents the severity of MetSyn and was estimated using a sex-race-specific equation and the five MetSyn components. Associations of MSSS and the MetSyn with CRAE/CRVE were obtained using linear regression models or Analysis of Covariance. RESULTS: For every 1-standard deviation of MSSS, CRAE decreased by 2.3 m (SE = 1.2, p = 0.0262) and CRVE increased by 3.4 m (SE = 1.6, p = 0.0308) after adjusting for confounders. CONCLUSIONS: Officers with higher MSSS had narrower (i.e., worse) arteriolar diameters and wider (i.e., worse) venular diameters.

BACKGROUND: Adverse Childhood Experiences (ACEs) are associated with numerous adverse health outcomes in adulthood. Our objective was to investigate associations between ACEs and sleep measures among 206 police officers from the Buffalo Cardio-Metabolic Occupational Police Stress study. METHODS: ACEs (independent variable) was assessed using the ACE questionnaire. Sleep measures were assessed using the Pittsburgh Sleep Quality Index and actigraphy. ANOVA/ANCOVA were used to investigate associations between ACEs and sleep measures. RESULTS: The mean self-reported sleep duration was significantly lower among participants who reported ≥1 ACEs compared to those who reported no ACEs (6.0 ± 0.11 vs. 6.4 ± 0.14 h; multivariate-adjusted p = 0.035). Sleep efficiency was significantly lower among participants who reported ≥1 ACEs compared to those who reported none (mean = 88.7%, 95% CI = 87.7-89.6 vs. 90.2%, 89.2-91.2; unadjusted p = 0.031) but was slightly attenuated and lost statistical significance after multivariate-adjustment (88.8%, 87.8-89.7 vs. 90.1%, 88.9-91.1; p = 0.094). Compared to participants who reported no ACEs, those who reported ≥1 ACEs had a higher mean activity index score (36.9 ± 0.96 vs. 31.2 ± 1.25; multivariate-adjusted p = 0.001); a higher mean wake after sleep onset (WASO) (44.3 ± 2.24 vs. 35.3 ± 2.92 min; multivariate-adjusted p = 0.019); and a higher sleep fragmentation index (3.8 ± 1.65 vs. 3.3 ± 1.20 unadjusted p = 0.044 and 3.8 ± 0.13 vs. 3.3 ± 0.18; multivariate-adjusted p = 0.062). Among men (but not women) who reported ≥1 ACEs, self-reported sleep duration was significantly lower (5.9 ± 0.13 vs. 6.4 ± 0.15 h; multivariate-adjusted p = 0.025) and activity index was significantly higher (39.1 ± 1.3 vs. 33.2 ± 1.51; multivariate-adjusted p = 0.004) compared to those who reported no ACEs. CONCLUSION: Exposure to ≥1 ACE was associated with worse sleep measures.

Purpose: The purpose of this study is to examine cross-sectional associations between adverse childhood experiences (ACEs) and mental health among police officers. Design/methodology/approach: The sample was from the Buffalo Cardio-Metabolic Occupational Police Stress study data (132 male and 51 female officers). Standardized surveys were administered to participants. Regression coefficients were obtained from models adjusted for age, sex, race and alcohol intake. All statistical tests were performed using a statistical significance level at p < 0.05. Findings: Regression analyses showed significant positive associations between ACEs and mental health (Posttraumatic Stress Disorder [PTSD]: β = 1.70, p < 0.001 and depressive symptoms: β = 1.29, p < 0.001). Resiliency significantly modified the association between ACEs and PTSD. A positive and significant association was observed among officers with lower resiliency (β = 2.65, p < 0.001). The association between ACEs and PTSD was stronger among male officers compared to females (β = 2.66, p < 0.001 vs. β = 0.59, p ≤ 0.248, respectively). Research limitations/implications: Child abuse and development of PTSD or depression could not be traced through time as this was a cross-sectional study. Recall bias may affect results. Practical implications: PTSD and depression associated with ACEs can affect the interpretation of threat and can exacerbate emotional regulation in officers. An inquiry should be expanded regarding work assignments of victimized officers, such as child exploitation and pornography investigation. Originality/value: There are few studies on ACEs and the mental health of police officers. The present study is among the first to associate multiple police mental health issues with ACEs. © 2021, Emerald Publishing Limited.

OBJECTIVE: To estimate the self-reported prevalence of prescription opioid use and illicit drug use in the U.S. METHODS: Self-reported prescription opioid use and illicit drug use (mostly non-opioid) were obtained for adults and adult workers (NHANES 2005-2016). RESULTS: Prevalence (95% CI) of prescription opioid use was 6.5% (6.0-7.0) (adults) and 4.1% (3.7-4.5) (workers). Prevalence of illicit drug use was 9.5% (8.8-10.1) (adults) and 10.2% (9.4-11.1) (workers). Among occupations, prevalence of prescription opioid use was highest in personal care (6.5%; 4.1-10.4) and healthcare practitioners (5.9%; 3.8-9.0); for illicit drug use, construction/extraction (18.0%; 15.1-21.3) and food preparation (15.8%; 12.5-19.7). CONCLUSION: The prevalence of prescription opioid use was elevated among some occupations. Judicious prescription strategies and targeted interventions are both needed. The prevalence of illicit drug use among certain occupational groups suggests the need to ensure access to therapy.

We examined the association between self-reported sleep quality, sleep duration, and dietary patterns among police officers in the Buffalo Cardio-Metabolic Occupational Stress (BCOPS) study.422 police officers aged 21-74 (2004-2009).We used a cross-sectional study design and obtained sleep quality and duration from responses to the 19-item Pittsburgh Sleep Quality Index. Using 46 energy-adjusted food groups derived from a 125-item food frequency questionnaire, we identified dietary patterns using exploratory factor analysis. Multiple linear regression analysis was used to examine the associations of sleep quality and duration with the derived dietary patterns.We identified major dietary patterns: fruits and vegetables (FV), dairy products, starches and fried foods, and meat and eggs. Individuals with poor sleep quality had a lower average FV score than those with optimal sleep (β [SE] = -0.32 [0.13]; p = .01). Significant interactions were observed between sex and the FV and dairy products dietary patterns, where women with poor sleep quality had a lower mean FV score compared to women with optimal sleep quality (β [SE] = -0.81 [0.29]; p = .01). Women with < 6 hours sleep duration had a lower mean dairy score compared to women with ≥ 7 hours sleep duration (β [SE] = -0.69 [0.29]; p = .02). We did not observe these associations among men.Among women, good sleep quality and long sleep duration were associated with a dietary pattern high in consumption of both fruits and vegetables and dairy products.Abbreviations: BCOPS: Buffalo Cardio-Metabolic Occupational Stress study; BMI: body mass index; FFQ: food frequency questionnaire; FV: fruits and vegetables; KMO: Kaiser-Meyer-Olkin test; MET: metabolic equivalent of task score; PSQI: Pittsburgh Sleep Quality Index questionnaire.

PURPOSE: This study examined trends in the prevalence of cardiovascular disease (CVD) and CVD risk factors among U.S. older adults and workers. We also investigated correlations between the temporal prevalence of CVD and selected risk factors (hypertension, obesity, physical inactivity, smoking, and treated diabetes) among participants. METHODS: Data were obtained from the National Health Interview Survey (2004-2018) for U.S. adults aged ≥50 years (N=207,539), of which 84,180 were employed. Temporal trends in prevalence were assessed by fitting weighted regression models to the age-standardized prevalence to the 2010 U.S. POPULATION: The relationship between temporal prevalence of CVD with each risk factor was assessed using Spearman's correlation coefficient. RESULTS: Among all older adults, the prevalence of CVD significantly declined (β=-0.16, p<0.001) during 2004-2018; similar decline was observed among employed adults (β=-0.16, p=0.001). Temporal prevalence in CVD was positively correlated to physical inactivity (r=0.73, p=0.002) and smoking (r=0.81, p<0.001), but not to any of the other risk factors. CONCLUSION: Among employed adults aged ≥50 years, the prevalence of CVD, physical inactivity, and smoking dramatically declined over the past 15 years. The temporal decline in prevalence of CVD was significantly associated with decline prevalence of physical inactivity and smoking.

Introduction: Injuries at work may negatively influence mental health due to lost or reduced working hours and financial burden of treatment. Our objective was to investigate, in U.S. workers (a) the prevalence of serious psychological distress (SPD) by injury status (occupational, non-occupational, and no injury) and injury characteristics, and (b) the association between injury status and SPD. Methods: Self-reported injuries within the previous three months were collected annually for 225,331 U.S. workers in the National Health Interview Survey (2004–2016). Psychological distress during the past 30 days was assessed using the Kessler 6 (K6) questions with Likert-type scale (0–4, total score range: 0–24). SPD was defined as K6 ≥ 13. Prevalence ratios (PR) from fitted logistic regression models were used to assess relationships between injury and SPD after controlling for covariates. Results: The prevalence of SPD was 4.74%, 3.58%, and 1.56% in workers reporting occupational injury (OI), non-occupational injury (NOI), and no injury, respectively. Workers with head and neck injury had the highest prevalence of SPD (Prevalence: OI = 7.71%, NOI = 6.17%), followed by workers with scrape/bruise/burn/bite (6.32% for those with OI). Workers reporting OI were two times more likely to have SPD compared to those without injury (PR = 2.19, 95%CI: 1.62–2.96). However, there was no significant difference in SPD between workers with OI and workers with NOI (PR = 0.98, 95%CI: 0.65–1.48). Conclusion: The prevalence of SPD varied by injury status with the highest being among workers reporting OI. We found that the workers reporting OI were significantly more likely to have SPD than those without injury, but not more than those with NOI. Practical Applications: Mental health management programs by employers are necessary for workers who are injured in the workplace.

PURPOSE: We examined cross-sectional associations of sleep measures with central retinal artery equivalent (CRAE) and central retinal vein equivalent (CRVE) and investigated whether sex and race/ethnicity modified these associations. METHODS: Participants (N = 202; 78% white; 71% men) were enrolled in the Buffalo Cardio-metabolic Occupational Police Stress study (2011-2014). Wrist actigraphy was used to assess sleep measures including sleep duration, sleep efficiency, sleep onset latency, wake after sleep onset, number of awakenings, and longest wake episode. CRAE and CRVE were obtained from fundus photography of retina and were averaged from both eyes per officer. RESULTS: We observed significant associations between sleep efficiency and CRVE (beta = -2.81 microm; P= .046), and between longest wake episode and CRVE (beta = 3.24 microm; P= .021). Adjustments for demographics, lifestyles, and physical and psychological factors attenuated these associations. Sex modified the independent associations of sleep onset latency and longest wake episode with CRVE. One standard deviation (SD) increase in sleep onset latency was associated with 4.81 microm larger CRVE (P= .028) (P-interaction = 0.098), and one SD increase in longest wake episode was associated with 4.62 microm larger CRVE (P= .032) (P-interaction = 0.115) among men. Race/ethnicity also modified the association between longest wake episode and CRVE (P-interaction = 0.088). A significant association was observed only among white officers (beta = 4.96 microm; P= .025). CONCLUSIONS: We found that poor sleep quality, measured by longest wake episode, was positively and independently associated with retinal venular diameter among white and male officers. Longitudinal studies are warranted to assess whether poor sleep quality is a risk factor for retinal diameter changes.

This study investigated the associations of baseline sleep onset latency, wake after sleep onset, longest wake episode, number of awakenings, sleep efficiency and sleep duration with incident hypertension during a 7-year follow-up (n = 161, 68% men) and the joint effect of insufficient sleep and obesity on incident hypertension. Sleep parameters were derived from 15-day actigraphy data. Relative risks and 95% confidence intervals were estimated using a robust Poisson regression model. Each 10-min increase in sleep onset latency was associated with an 89% higher risk of hypertension (95% confidence interval [CI] = 1.12-3.20). Each 10-min increase in longest wake episode was associated with a 23% higher risk of hypertension (95% CI = 1.01-1.50) and each 10% decrease in sleep efficiency was associated with a 50% higher risk of hypertension (95% CI = 1.02-2.22). These associations were independent of demographic and lifestyle characteristics, depressive symptoms, shift work, sleep duration and body mass index. Having <6 hr of sleep and a body mass index >/=30 kg/m(2) increased the risk of hypertension (relative risk = 2.81; 95% CI = 1.26-6.25) compared with having >/=6 hr of sleep and a body mass index <30 after controlling for confounders. Relative excess risk due to interaction was 3.49 (95% CI = -1.69-8.68) and ratio of relative risk was 3.21 (95% CI = 0.72-14.26). These results suggest that poor sleep quality is a risk factor for hypertension. Longitudinal studies with larger sample sizes are warranted to examine the joint effect of insufficient sleep and obesity on development of hypertension.

OBJECTIVE: Studies show that serum levels of 25-hydroxyvitamin D (25(OH)D), a biomarker for vitamin D status, are lower in persons with higher adiposity levels and that police officers have been found to have a high prevalence of obesity. The purpose of this study was to examine relationships between several adiposity measures and 25(OH)D, and also compare those measures to determine the best one that predicts insufficiency of 25(OH)D (<20 ng/mL) among police officers in the Northeast area of the United States. METHODS: Participants were 281 police officers (71.5% men) from the Buffalo Cardio-Metabolic Occupational Police Stress Study (2011-2016). Associations of body mass index (BMI), abdominal height (AbHt), waist circumference (WC), WC-to-height ratio (WCHtR), percent body fat (PBF), and fat mass index (FMI) with 25(OH)D were obtained using multiple regression models after adjustment for age, race/ethnicity, season, multivitamin supplement use, and high-density lipoprotein cholesterol. The area under the curve (AUC) was used to evaluate the predictive ability of each adiposity measure to identify insufficient 25(OH)D concentrations. RESULTS: The prevalence of obesity (BMI >/= 30) was 50.7% in men and 21.3% in women. Mean levels of 25(OH)D were 32.4 ng/mL in men and 34.4 ng/mL in women. After adjustment for covariates, PBF and FMI among men were inversely associated with 25(OH)D: PBF (beta +/- SE = -2.40 +/- 1.01, P = .018); FMI (-2.21 +/- 0.93, .018). Among women, no adiposity measure was associated with 25(OH)D. PBF was the best predictor of insufficient 25(OH)D concentrations regardless of gender (AUC = 0.878). CONCLUSION: Adiposity measures were inversely associated with 25(OH)D, but differed between female and male officers.

OBJECTIVES: The aim of this study is to determine if parental occupational exposure to 16 agents is associated with autism spectrum disorder (ASD). METHODS: Demographic, health and parental occupational data were collected as part of the CHildhood Autism Risks from Genetics and Environment study. The workplace exposure assessment was conducted by two experienced industrial hygienists for the parents of 537 children with ASD and 414 typically developing (TD) children. For each job, frequency and intensity of 16 agents were assessed and both binary and semi-quantitative cumulative exposure variables were derived. Logistic regression models were used to calculate adjusted odds ratios (OR) and 95% confidence intervals (CI) to assess associations between parental occupational exposures 3 months pre-pregnancy until birth. RESULTS: The OR of ASD in the children of mothers exposed to any solvents was 1.5 times higher than the mothers of TD children (95% CI=1.01-2.23). Cumulative exposure indicated that the OR associated with a moderate level of solvent exposure in mothers was 1.85 (95% CI=1.09, 3.15) for children with ASD compared with TD children. No other exposures were associated with ASD in mothers, fathers or the parents combined. CONCLUSION: Maternal occupational exposure to solvents may increase the risk for ASD. These results are consistent with a growing body of evidence indicating that environmental and occupational exposures may be associated with ASD. Future research should consider specific types of solvents, larger samples and/or different study designs to evaluate other exposures for potential associations with ASD.

The present study examined associations of effort-reward imbalance (ERI) and over-commitment at work with burnout among police officers using data from 200 (mean age = 46 years, 29% women) officers enrolled in the Buffalo Cardio-Metabolic Occupational Police Stress Study. ERI and overcommitment were assessed using Siegrist's "effort/reward" questionnaire. The Maslach Burnout Inventory-General Survey was used to assess burnout and its three subscales (exhaustion, cynicism, and professional efficacy). Analysis of covariance was used to examine mean values of burnout scores across quartiles of ERI and overcommitment. Linear regression was used to test for linear trend. ERI and overcommitment were positively and significantly associated with cynicism and exhaustion (trend p value < .001), while professional efficacy showed an inverse association with overcommitment (p = .026). Cynicism and exhaustion scores were significantly higher in officers who reported both overcommitment and ERI compared with their counterparts (p < .001). The results suggest that ERI and overcommitment at work are determinants of higher cynicism and exhaustion. The inverse association of overcommitment with professional efficacy (an indicator of engagement at work) suggests that extreme involvement in work may negatively affect efficacy. Overcommitment may be related to a need for approval and inability of officers to withdraw from work, even in an off-duty status. Police agencies should consider organizational remedies to maintain acceptable levels of commitment by officers. In addition, there is a need to monitor and improve effort-reward imbalance experienced by officers.

Background: Police officers’ stress perception, frequency of stressful events (stressors), and police work characteristics may contribute to poor sleep quality through different mechanisms. Methods: We investigated associations of stress severity (measured by stress rating score) and frequency of stressors with sleep quality and examined the influence of police work characteristics including workload, police rank, prior military experience, and shift work on the associations. Participants were 356 police officers (256 men and 100 women) enrolled in the Buffalo Cardio-Metabolic Occupational Police Stress Study from 2004 to 2009. A mean stress rating score and mean frequency of stressors occurring in the past month were computed for each participant from the Spielberger Police Stress Survey data. Sleep quality was assessed using the global score derived from the Pittsburgh Sleep Quality Index survey. Linear associations of the stress rating score and frequency of stressors with sleep quality (Pittsburgh Sleep Quality Index global score) were tested. Age, sex, race/ethnicity, and smoking status were selected as potential confounders. Results: The stress rating score was positively and independently associated with poor sleep quality (beta = 0.17, p = 0.002). Only workload significantly modified this association (beta = 0.23, p = 0.001 for high workload group; p-interaction = 0.109). The frequency of stressors was positively and independently associated with poor sleep quality (beta = 0.13, p = 0.025). Only police rank significantly modified the association (beta = 0.007, p = 0.004 for detectives/other executives; p-interaction = 0.076). Conclusion: Both police officers’ perception of stress severity and the frequency of stressors are associated with poor sleep quality. Stress coping or sleep promotion regimens may be more beneficial among police officers reporting high workloads.

BACKGROUND: The annual incidence rate of work-related upper extremity musculoskeletal disorders (WUEMSDs) is increasing in US workers according to the United States Bureau of Labor Statistics (BLS). However, the prevalence of WUEMSDs among US total workers has not been estimated. OBJECTIVE: We aimed to estimate the prevalence of WUEMSDs among US total workers and among each of major occupations and industries. METHODS: We analyzed data from the National Health Interview Survey Arthritis supplements (2006, 2009, and 2014) among 50,218 current workers (age >/=18 years) to estimate the 30-day prevalence of WUEMSDs and of WUEMSDs affecting work using the SAS-callable SUDAAN software. RESULTS: About 11.2 million workers reported WUEMSDs based on three surveys (2006, 2009, and 2014). The 30-day prevalence of WUEMSDs was 8.23% the prevalence of WUEMSDs affecting work was 1.24%. The Construction occupation and industry had the highest age- and sex-adjusted 30-day prevalence of WUEMSDs (10.98% for Construction occupation; 9.94% for Construction industry) and WUEMSDs affecting work (3.32% for Construction occupation; 2.31% Construction industry). CONCLUSIONS: Our results show that construction workers had the highest prevalence of both WUEMSDs and WUEMSDs affecting work. They may be a priority group for interventions to reduce upper extremity musculoskeletal disorders.

The role of coping in the association between stress and posttraumatic stress disorder (PTSD) is not clear. We investigated the effects of active and passive coping strategies on the associations between police stress (administrative and organization pressure, physical and psychological threats, and lack of support) and PTSD symptoms in 342 police officers. Linear regression model was used in the analyses. The association between physical and psychological stress and PTSD symptoms was stronger in officers who used lower active coping (B = 4.34, p &lt; 0.001) compared to those who utilized higher active coping (p-interaction = 0.027) (B = 1.79, p ≤ 0.003). A similar result was found between lack of support and PTSD symptoms (p-interaction = 0.016) (lower active coping, B = 5.70, p &lt; 0.001; higher active coping, B = 3.33, p &lt; 0.001), but was not significantly different comparing the two groups regarding the association between administrative and organizational pressure and PTSD symptoms (p-interaction = 0.376). Associations of total stress, administrative and organizational pressure, and physical and psychological stressors with PTSD symptoms were significantly stronger in officers who utilized higher passive coping (p-interaction = 0.011, 0.030, and 0.023, respectively). In conclusion, low active or high passive coping methods may exacerbate the effect of work stress on PTSD symptoms. © 2018, This is a U.S. government work and its text is not subject to copyright protection in the United States; however, its text may be subject to foreign copyright protection.

OBJECTIVE: To examine the association of the cortisol awakening response (CAR) with change in brachial artery flow-mediated dilation (FMD%) in police officers over a seven-year period. METHODS: Baseline CAR was obtained from four saliva samples taken fifteen minutes apart immediately after awakening. Analysis of covariance was used to compare the change in FMD% (FMD%Follow-up-FMD%Baseline) across tertiles of area under the cortisol curve with respect to increase (AUCI). Regression analysis was use to assess trend. RESULTS: Officers (n = 172; 81% men) had a mean +/- SD age of 41 +/- 7.6 years. Men in the lowest AUCI tertile (i.e., atypical waking cortisol pattern) had a significantly larger seven-year mean decline in FMD% (mean +/- SE: -2.56 +/- 0.64) compared to men in the highest tertile (-0.89 +/- 0.69) (p = 0.0087). CONCLUSION: An awakening cortisol AUCI predicted worsening of FMD% approximately seven years later among male officers.

Purpose: The purpose of this paper is to examine the association of social avoidance among police, cardiovascular disease (CVD) (metabolic syndrome (MetSyn)), and social support. Design/methodology/approach: Participants were officers from the Buffalo Cardio-Metabolic Occupational Police Stress study (n=289). Social avoidance (defined as the tendency to avoid social contact) and other subscales from the Cook-Medley Hostility Scale were analyzed. The mean number of MetSyn components across tertiles of the Cook-Medley scales was computed using analysis of variance and analysis of covariance. Social support was measured with the Social Provisions Scale, categorized as high or low based on the median. Findings: The mean number of MetSyn components increased significantly across tertiles of social avoidance (1.51±0.18, 1.52±0.12, and 1.81±0.12); the only Cook-Medley subscale that remained significantly associated with MetSyn following adjustment for age and gender. Participants high in social avoidance reported significantly lower social support (79.9±8.5 vs 85.8±8.6; p=0.001). Research limitations/implications: The study is cross-sectional and therefore precludes causality. The authors were unable to determine the direction of associations between social avoidance and MetSyn. The measure of social support was unidimensional, including only perceived support; additional types of social support measures would be helpful. Practical implications: This study suggests that occupational-based police social isolation is associated with health outcomes and lower support. Several suggestions are made which will help to improve communication between the police and public. Examples are the use of social media, training in communication techniques, and changing the police role to one of public guardians. Originality/value: Social avoidance is the least studied the Cook-Medley subscale associated with CVD. It is important for the health of officers to maintain a social connection with others.

PURPOSE: We hypothesized that effort-reward imbalance (ERI) is associated with an atypical cortisol response. ERI has been associated with higher job stress. Stress triggers cortisol secretion via the hypothalamic-pituitary-adrenal (HPA) axis, and significant deviation from a typical cortisol pattern can indicate HPA axis dysfunction. METHODS: 176 police officers participated from the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) Study. ERI was the exposure variable. Outcome variables were saliva-based peak and mean cortisol values, total area under the curve ground (AUCG) and baseline (AUCI); linear regression line fitted to log-transformed cortisol. Regression analyses were used to examine linear trend between ERI and cortisol parameters. Repeated measures analysis examined whether the pattern of cortisol over time differed between low ERI (< median) and high ERI (>/= median). RESULTS: Mean age was 46 years (SD = 6.6). After adjustment for potential confounders, there was a significant inverse association between ERI and peak cortisol (beta = - 0.20, p = 0.009), average cortisol (beta = - 0.23, p = 0.003), and total area under the curve (beta = - 0.21, p = 0.009). ERI was not significantly associated with AUCI (beta = - 0.11, p = 0.214); slope of the regression line fitted to the cortisol profile (beta = - 0.009, p = 0.908). Repeated measures analyses showed that the cortisol pattern did not vary significantly between high and low ERI using the median as a cut point (interaction p value = 0.790). CONCLUSIONS: ERI was inversely associated with the magnitude of awakening cortisol over time, indicating HPA axis dysregulation and potential future health outcomes.

BACKGROUND: Police officers in the New Orleans geographic area faced a number of challenges following Hurricane Katrina. AIM: This cross-sectional study examined the effect of social support, gratitude, resilience and satisfaction with life on symptoms of depression. METHOD: A total of 86 male and 30 female police officers from Louisiana participated in this study. Ordinary least-square (OLS) regression mediation analysis was used to estimate direct and indirect effects between social support, gratitude, resilience, satisfaction with life and symptoms of depression. All models were adjusted for age, alcohol intake, military experience and an increase in the number of sick days since Hurricane Katrina. RESULTS: Mean depressive symptom scores were 9.6 +/- 9.1 for females and 10.9 +/- 9.6 for males. Mediation analyses indicates that social support and gratitude are directly associated with fewer symptoms of depression. Social support also mediated the relationships between gratitude and depression, gratitude and satisfaction with life, and satisfaction with life and depression. Similarly, resilience mediated the relationship between social support and fewer symptoms of depression. CONCLUSION: Social support, gratitude and resilience are associated with higher satisfaction with life and fewer symptoms of depression. Targeting and building these factors may improve an officer's ability to address symptoms of depression.

OBJECTIVE: To examine relationships of blood pressure with central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) among 242 police officers. METHODS: Computerized retinal images of each eye were taken. Mean values of CRAE and CRVE were compared across hypertension status categories using ANOVA and ANCOVA. Associations of mean arterial blood pressure (MABP) with CRAE and CRVE were obtained using regression models. RESULTS: CRAE were significantly narrower in officers with uncontrolled hypertension (142.8 +/- 2.7 mum), compared to those with controlled hypertension (153.6 +/- 2.7 mum, p = 0.0013) and those with no hypertension (156.4 +/- 1.0 mum, p </= 0.0001) after covariate adjustment. CRAE decreased by 3.43 mum for each 5 mmHG increase in MABP (p </= 0.0001). CONCLUSION: Uncontrolled hypertension was significantly associated with narrower retinal arterioles. No association was observed with retinal venules.

Exposure to crystalline silica results in serious adverse health effects, most notably, silicosis. An understanding of the mechanism(s) underlying silica-induced pulmonary toxicity is critical for the intervention and/or prevention of its adverse health effects. Rats were exposed by inhalation to crystalline silica at a concentration of 15 mg/m3, 6 hr/day, 5 days/week for 3, 6 or 12 weeks. Pulmonary toxicity and global gene expression profiles were determined in lungs at the end of each exposure period. Crystalline silica was visible in lungs of rats especially in the 12-week group. Pulmonary toxicity, as evidenced by an increase in lactate dehydrogenase (LDH) activity and albumin content and accumulation of macrophages and neutrophils in the bronchoalveolar lavage (BAL), was seen in animals depending upon silica exposure duration. The most severe histological changes, noted in the 12-week exposure group, consisted of chronic active inflammation, type II pneumocyte hyperplasia, and fibrosis. Microarray analysis of lung gene expression profiles detected significant differential expression of 38, 77, and 99 genes in rats exposed to silica for 3-, 6-, or 12-weeks, respectively, compared to time-matched controls. Among the significantly differentially expressed genes (SDEG), 32 genes were common in all exposure groups. Bioinformatics analysis of the SDEG identified enrichment of functions, networks and canonical pathways related to inflammation, cancer, oxidative stress, fibrosis, and tissue remodeling in response to silica exposure. Collectively, these results provided insights into the molecular mechanisms underlying pulmonary toxicity following sub-chronic inhalation exposure to crystalline silica in rats.

OBJECTIVE: Police officers in the New Orleans geographic area faced a number of challenges following Hurricane Katrina in 2005. DESIGN: This cross-sectional study examined gratitude, resilience, and satisfaction with life as mediators in the association between social support and post-traumatic stress disorder (PTSD) symptoms in 82 male and 31 female police officers. The Gratitude Questionnaire, Connor-Davidson Resilience Scale, Satisfaction with Life Scale, and the Interpersonal Support Evaluation List were used to measure gratitude, resilience, satisfaction with life, and social support, respectively. PTSD symptoms were measured using the PTSD Checklist-Civilian (PCL-C). Ordinary least square regression mediation analysis was used to estimate direct and indirect effects among gratitude, resilience, satisfaction with life, social support, and PTSD symptoms. All models were adjusted for age, alcohol, race, and previous military experience. RESULTS: Mean PCL-C symptoms were 29.1 (standard deviation [SD] = 14.4) for females and 27.9 (SD = 12.1) for males. There was no direct relationship between social support and PTSD symptoms (c9 = -0.041; 95% confidence interval [CI] = -0.199, 0.117) independent of the indirect effect through resilience (effect = -0.038; 95%CI = -0.099, -0.002). Neither gratitude (effect = -0.066; 95% CI = -0.203, 0.090) nor satisfaction with life (effect = -0.036, 95% CI = -0.131, 0.046) contribute to the indirect effect. CONCLUSIONS: These results indicate that resilience mediates the relationship between social support and symp-toms of PTSD. Targeting social support and resilience in officers may facilitate reduction of PTSD symptoms.

OBJECTIVE: To investigate associations of central retinal arteriolar equivalent (CRAE), a measure of retinal arteriolar width, and central retinal venular equivalents (CRVE), a measure of retinal venular width, with shiftwork in 199 police officers (72.9% men). METHODS: Shiftwork (day, afternoon, night) was assessed using electronic payroll records. Four digital retinal images per officer were taken. Mean diameters of the retinal vasculature were compared across shifts using analysis of variance (ANOVA)/analysis of covariance (ANCOVA). RESULTS: Among all officers (mean age = 46.6 +/- 6.8 years), shiftwork was not significantly associated with CRAE or CRVE. However, among current and former smokers, night-shift officers had a wider mean (+/-standard error [SE]) CRVE (230.0 +/- 4.5 mum) compared with day shift officers (215.1 +/- 3.5 mum); adjusted P = 0.014. CONCLUSIONS: Night shift schedule in current and former smokers is associated with wider retinal venules. Reasons for this association are not known. Longitudinal studies are warranted.

OBJECTIVES: This study examines relationships between the frequency and intensity of police work stressors and cardiac vagal control, estimated using the high frequency component of heart rate variability (HRV). METHODS: This is a cross-sectional study of 360 officers from the Buffalo New York Police Department. Police stress was measured using the Spielberger police stress survey, which includes exposure indices created as the product of the self-evaluation of how stressful certain events were and the self-reported frequency with which they occurred. Vagal control was estimated using the high frequency component of resting HRV calculated in units of milliseconds squared and reported in natural log scale. Associations between police work stressors and vagal control were examined using linear regression for significance testing and analysis of covariance for descriptive purposes, stratified by gender, and adjusted for age and race/ethnicity. RESULTS: There were no significant associations between police work stressor exposure indices and vagal control among men. Among women, the inverse associations between the lack of support stressor exposure and vagal control were statistically significant in adjusted models for indices of exposure over the past year (lowest stressor quartile: M = 5.57, 95% CI 5.07 to 6.08, and highest stressor quartile: M = 5.02, 95% CI 4.54 to 5.51, test of association from continuous linear regression of vagal control on lack of support stressor beta = -0.273, P = .04). CONCLUSIONS: This study supports an inverse association between lack of organizational support and vagal control among female but not male police officers.

Recent studies conducted in the Great Basin Desert region of the United States have shown that skin test reactivity to fungal and dust mite allergens are increased in children with asthma or allergy living in homes with evaporative coolers (EC). The objective of this study was to determine if the increased humidity previously reported in EC homes leads to varying microbial populations compared to homes with air conditioners (AC). Children with physician-diagnosed allergic rhinitis living in EC or AC environments were recruited into the study. Air samples were collected from the child's bedroom for genomic DNA extraction and metagenomic analysis of bacteria and fungi using the Illumina MiSeq sequencing platform. The analysis of bacterial populations revealed no major differences between EC and AC sampling environments. The fungal populations observed in EC homes differed from AC homes. The most prevalent species discovered in AC environments belonged to the genera Cryptococcus (20%) and Aspergillus (20%). In contrast, the most common fungi identified in EC homes belonged to the order Pleosporales and included Alternaria alternata (32%) and Phoma spp. (22%). The variations in fungal populations provide preliminary evidence of the microbial burden children may be exposed to within EC environments in this region.