Last data update: Apr 22, 2024. (Total: 46599 publications since 2009)
Records 1-30 (of 60 Records) |
Query Trace: Lincoln J [original query] |
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Disparities in COVID-19 vaccine uptake, attitudes, and experiences between food system and non–food system essential workers
Smarsh BL , Yankey D , Hung MC , Blanck HM , Kriss JL , Flynn MA , Lu PJ , McGarry S , Eastlake AC , Lainz AR , Singleton JA , Lincoln JM . J Agric Food Syst Community Dev 2024 13 (2) The COVID-19 pandemic has disproportionately affected the health of food system (FS) essential workers compared with other essential and non-essential workers. Even greater disparity exists for workers in certain FS work settings and for certain FS worker subpopulations. We analyzed essential worker respondents (n = 151,789) in May–Novem-ber 2021 data from the National Immunization Survey Adult COVID Module (NIS-ACM) to assess and characterize COVID-19 vaccination uptake (≥1 dose) and intent (reachable, reluctant), attitudes about COVID-19 and the vaccine, and experiences and difficulties getting the vaccine. We compared rates, overall and by certain characteristics, between workers of the same group, and between FS (n = 17,414) and non–food system (NFS) worker groups (n = 134,375), to determine if differences exist. FS worker groups were classified as “agriculture, forestry, fishing, or hunting” (AFFH; n = 2,730); “food manufacturing facility” (FMF; n = 3,495); and “food and beverage store” (FBS; n = 11,189). Compared with NFS workers, significantly lower percentages of FS workers reported >1 dose of COVID-19 vaccine or vaccine requirements at work or school, but overall vaccine experiences and difficulties among vaccinated FS workers were statistically similar to NFS workers. When we examined intent regarding COVID-19 vaccination among unvaccinated FS workers compared with NFS counterparts, we found a higher percentage of FMF and FBS workers were reachable whereas a higher percentage of AFFH workers were reluctant about vaccination, with differences by sociodemographic characteristics. Overall, results showed differences in uptake, intent, and attitudes between worker groups and by some sociodemographic characteristics. The findings reflect the diversity of FS workers and underscore the importance of collecting occupational data to assess health inequalities and of tailoring efforts to worker groups to improve confidence and uptake of vaccinations for infectious diseases such as COVID-19. The findings can inform future research, adult infectious disease interventions, and emergency management planning. © 2024 by the Authors. |
Journal of Agromedicine special issue on surveillance
Scott E , Weichelt B , Lincoln J . J Agromedicine 2024 1-3 |
Prevalence of COVID-19 and long COVID in collegiate student athletes from Spring 2020 to Fall 2021: A retrospective survey
Massey D , Saydah S , Adamson B , Lincoln A , Aukerman DF , Berke EM , Sikka R , Krumholz HM . BMC Infect Dis 2023 23 (1) 876 BACKGROUND: Symptomatic COVID-19 and Long COVID, also referred to as post-acute sequelae of SARS-CoV-2 (PASC) or post-COVID conditions, have been widely reported in young, healthy people, but their prevalence has not yet been determined in student athletes. We sought to estimate the prevalence of reported COVID-19, symptomatic COVID-19, and Long COVID in college athletes in the United States attending 18 schools from spring 2020 to fall 2021. METHODS: We developed an online survey to measure the prevalence of student athletes who tested positive for COVID-19, developed Long COVID, and did not return to their sport during the relevant time period. We surveyed a convenience sample of 18 collegiate school administrators, representing about 7,000 student athletes. Of those schools surveyed, 16 responded regarding the spring 2020 semester, and 18 responded regarding the full academic year of fall 2020 to spring 2021 (both semesters). RESULTS: According to the survey responses, there were 9.8% of student athletes who tested positive for COVID-19 in spring 2020 and 25.4% who tested positive in the academic year of fall 2020 to spring 2021. About 4% of student athletes who tested positive from spring 2020 to spring 2021 developed Long COVID, defined as new, recurring, or ongoing physical or mental health consequences occurring 4 or more weeks after SARS-CoV-2 infection. CONCLUSIONS: This study highlights that Long COVID occurs among young, healthy athletes and is a real consequence of COVID-19. Understanding the prevalence of Long COVID in this population requires longer follow-up and further study. |
Rural health and rural industries: Opportunities for partnership and action
Scott KA , Elliott KC , Lincoln J , Flynn MA , Hill R , Hall DM . J Rural Health 2023 A recent article in Morbidity and Mortality Weekly Report1 describes the Fatalities in Oil and Gas Extraction (FOG) database—an industry-specific database created to help researchers understand patterns of deaths among US oil and gas extraction (OGE) workers. Among other strengths, the database includes detailed geographic data on fatal incidents–a feature lacking in other systems that track workplace fatalities. It is clear that the majority of OGE worker fatalities occurred in rural micropolitan and noncore counties (Figure 1). This finding may not be surprising to people in the industry. However, it does raise questions about relationships between work, health, and rurality that are rarely explored explicitly or systematically. |
Demographic disparities in mpox vaccination series completion, by route of vaccine administration - California, August 9, 2022-March 31, 2023
Salih T , Vance J , Quint J , Meza B , McNitt L , Lincoln WU , Schechter R . MMWR Morb Mortal Wkly Rep 2023 72 (30) 827-832 In August 2022, the Food and Drug Administration authorized JYNNEOS vaccine (modified vaccinia Ankara vaccine, Bavarian Nordic), a 2-dose series used for the prevention of Monkeypox virus infection, to be administered via a dose-sparing intradermal route, in addition to the previously authorized subcutaneous route. The California Department of Public Health investigated whether demographic disparities in vaccination series completion varied by route of administration of the recipient's first dose. Among California residents who received their first dose during August 9, 2022-March 31, 2023, a total of 59.8% received a second dose. Series completion was highest among non-Hispanic White persons (64.1%), persons aged ≥65 years (72.6%), and adults with male sex assignment at birth (62.1%); series completion was lowest among non-Hispanic Black or African American persons (51.3%), persons aged 18-24 years (42.9%), and adults assigned female sex at birth (42.8%). When the first dose was received by subcutaneous administration, overall series completion was 58.8% compared with 60.2% when the first dose was administered intradermally. Odds of series completion across all race and ethnicity groups, persons aged 18-64 years, community health conditions, and persons assigned male sex at birth were not greater when the first dose was administered subcutaneously compared with intradermally. Intradermal use of JYNNEOS vaccine did not lower overall 2-dose series completion rates. Continued efforts are needed to ensure persons at risk for Monkeypox virus infection receive both recommended doses. |
Prevalence of COVID-19 and Long COVID in Collegiate Student Athletes from Spring 2020 to Fall 2021: A Retrospective Survey (preprint)
Massey D , Saydah S , Adamson B , Lincoln A , Aukerman DF , Berke EM , Sikka R , Krumholz HM . medRxiv 2022 16 Symptomatic COVID-19 and post-COVID conditions, also referred to as post-acute sequelae of SARS-CoV-2 (PASC) or Long COVID, have been widely reported in young, healthy people, but their prevalence has not yet been determined in student athletes. We surveyed a convenience sample of 18 collegiate school administrators, representing about 7,000 student athletes. According to their survey responses, 9.8% of student athletes tested positive for COVID-19 in spring 2020 and 25.4% tested positive in the academic year of fall 2020 to spring 2021. About 4% of student athletes who tested positive from spring 2020 to spring 2021 developed Long COVID, defined as new, recurring, or ongoing physical or mental health consequences occurring 4 or more weeks after SARS-CoV-2 infection. This study highlights that Long COVID occurs in healthy collegiate athletes and merits a larger study to determine population-wide prevalence. Copyright The copyright holder for this preprint is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. All rights reserved. No reuse allowed without permission. |
Emerging technology in agriculture: opportunities and considerations for occupational safety and health researchers
Lincoln JM , Elliott KC . J Safety Res 2023 86 [Epub ahead of print] Introduction: A variety of factors are driving the development of robotics and automation in the agriculture industry including the nature of work, workforce shortages, and a variety of economic, climatic, technologic, political, and social factors. While some new robotics and automated machines are available commercially, most are still being developed. This provides occupational safety and health researchers an unprecedented opportunity to mitigate risks and benefits to the health and safety of agriculture workers. Method: The NIOSH Office of Agriculture Safety and Health (OASH) is working to better understand how the advancements in automation and robotics is affecting workers. OASH is coordinating with the NIOSH Center of Occupational Robotics Research (CORR) to help to increase the understanding of human/machine interactions; improve the ability to identify injuries and fatalities involving automation/ robotics; and provide guidance on working safely with automation/ robotics. OASH also joined a small team of academics and industry to organize the SAfety For Emerging Robotics and Autonomous aGriculture or (SAFER AG) Workshop to identify gaps in knowledge and research needs that connect to issues related to risks and regulations/standards, occupational safety research, and impacts on workforce and society. This workshop was sponsored by USDA NIFA. Practical Applications: Occupational safety and health experts need to engage and collaborate with developers of technology. It is also increasingly important for occupational safety and health researchers and practitioners to not only become familiar with existing manufacturing safety standards, but also the lengthy standards development process. Joining consensus standards groups to help shape new standards for emerging technologies may help to mitigate adverse worker impacts. NIOSH's Office of Agriculture Safety and Health will continue to identify research gaps, support new research projects, education, outreach efforts and the development of best practices with our partners. |
Updated assessment of occupational safety and health hazards of climate change
Schulte PA , Jacklitsch BL , Bhattacharya A , Chun H , Edwards N , Elliott KC , Flynn MA , Guerin R , Hodson L , Lincoln JM , MacMahon KL , Pendergrass S , Siven J , Vietas J . J Occup Environ Hyg 2023 20 1-36 Workers, particularly outdoor workers, are among the populations most disproportionately affected by climate-related hazards. However, scientific research and control actions to comprehensively address these hazards are notably absent. To assess this absence, a seven-category framework was developed in 2009 to characterize the scientific literature published from 1988 through 2008. Using this framework, a second assessment examined the literature published through 2014, and the current one examines literature from 2014 through 2021. The objectives were to present literature that updates the framework and related topics and increases awareness of the role of climate change in occupational safety and health. In general, there is substantial literature on worker hazards related to ambient temperatures, biological hazards, and extreme weather but less on air pollution, ultraviolet radiation, industrial transitions, and the built environment. There is growing literature on mental health and health equity issues related to climate change, but much more research is needed. The socioeconomic impacts of climate change also require more research. This study illustrates that workers are experiencing increased morbidity and mortality related to climate change. In all areas of climate-related worker risk, including geoengineering, research is needed on the causality and prevalence of hazards, along with surveillance to identify, and interventions for hazard prevention and control. |
CDC-supported National Network of Farmworker-serving organizations to mitigate COVID-19
Boggess B , Prager S , Lincoln JM , Foss NE , Kissam E , Partida S , Lainz AR . Am J Public Health 2023 113 (2) 166-169 The Centers for Disease Control and Prevention has partnered with the National Center for Farmworker Health to respond to the impact of COVID-19 on US farmworker communities. Immigrant farmworkers are often isolated from public health infrastructure. This partnership built the capacity of a national network of organizations to connect farmworkers to COVID-19 education and vaccinations in 20 states through training and resource sharing. The partnership funded 194 network member staff, trained 1130 individuals, and supported COVID-19 outreach to more than 600 000 farmworkers. (Am J Public Health. 2023;113(2):166-169. https://doi.org/10.2105/AJPH.2022.307159). |
The future of U.S. Agricultural injury surveillance needs collaboration
Scott E , Weichelt B , Lincoln J . J Agromedicine 2023 28 (1) 11-13 For injury epidemiologists, the hunt for data is an | ongoing detective story. While there is a thrill in the | chase, there is even more satisfaction in using those | data to drive important public health research and | programming. The size of the U.S. agriculture workforce and the declining number of work-related agricultural injuries made annual data collection costly. | Therefore, in 2015, the National Institute for | Occupational Safety and Health (NIOSH) discontinued | interagency agreements with Department of Labor | (DOL) and United States Department of Agriculture | (USDA) to collect national agricultural worker injury | data and developed a plan to seek alternative methods | to obtain quality agricultural injury surveillance data. | However, those means were not the only tool to gather | agricultural injury data, and many alternative efforts | persisted.1 The ethos of the new model seeks to engage | with extramural partners to fill the many identified | gaps in agricultural injury data. While some may long | for the “good old days” of the national injury surveys, | we recognize several factors make such endeavors | impractical. |
Occupational safety and health with technological developments in livestock farms: A literature review
Hayden MA , Barim MS , Weaver DL , Elliott KC , Flynn MA , Lincoln JM . Int J Environ Res Public Health 2022 19 (24) In recent decades, there have been considerable technological developments in the agriculture sector to automate manual processes for many factors, including increased production demand and in response to labor shortages/costs. We conducted a review of the literature to summarize the key advances from installing emerging technology and studies on robotics and automation to improve agricultural practices. The main objective of this review was to survey the scientific literature to identify the uses of these new technologies in agricultural practices focusing on new or reduced occupational safety risks affecting agriculture workers. We screened 3248 articles with the following criteria: (1) relevance of the title and abstract with occupational safety and health; (2) agriculture technologies/applications that were available in the United States; (3) written in English; and (4) published 2015-2020. We found 624 articles on crops and harvesting and 80 articles on livestock farming related to robotics and automated systems. Within livestock farming, most (78%) articles identified were related to dairy farms, and 56% of the articles indicated these farms were using robotics routinely. However, our review revealed gaps in how the technology has been evaluated to show the benefits or potential hazards to the safety and well-being of livestock owners/operators and workers. |
Workplace determinants of depression, anxiety, and stress in U.S. Mariners during the COVID-19 pandemic
Yassin AH , Spector JT , Mease L , Shumate A , Hill R , Lincoln JE , Baker MG . Int J Environ Res Public Health 2022 19 (24) United States (U.S.) mariners continued sailing throughout COVID-19. Many aspects of their work could make them prone to adverse mental health outcomes but research on workplace determinants of their mental health during COVID-19 is limited. Between January and July 2021 an online survey assessed the outcomes of increased depressive symptoms, increased anxiety symptoms, and increased perceived stress in addition to concerns, worries, and experiences when sailing during COVID-19, job satisfaction, and safety climate in n = 1384 U.S. mariners. Demographic measures were also collected. Logistic regression models (for depression and anxiety) and a linear regression model (for stress) were developed. We found that increased COVID-19 concerns and poor self-reported mental health were related to increased odds of likely depression and anxiety and higher stress. Mariners who experienced more adverse experiences aboard a vessel had increased stress and increased odds of depression. Poor sleep quality was also related to increased odds of depression, and poor vessel support/safety culture was related to higher stress. Differences in outcomes were seen by vessel type, age, and credential in regression analyses. Results from this study will help to prioritize interventions to minimize the mental health impacts of COVID-19, and influence evidence-based recommendations to improve the mental health of mariners going forward. |
Future of work in agriculture
Howard J , Lincoln JM . J Agromedicine 2022 28 (1) 1-4 In 2019, the National Institute for Occupational Safety and Health (NIOSH) launched a Future of Work Initiative.Citation1 The new Initiative is organized around a series of changes affecting where work is done (workplace), how job tasks are accomplished (work), and who does work (workforce). One of the chief goals of the NIOSH Future of Work Initiative is to discover emerging workplace, work, and workforce trends in various industry sectors that may impact occupational safety, health and well-being in those sectors.Citation2 Nowhere are emerging future of work trends more apparent than in one of the oldest industry sectors – agriculture. |
Have you met Angus Development and evaluation of a social marketing intervention to improve personal flotation device use in commercial fishing
Teske TD , Case SL , Lucas DL , Forrester CL , Lincoln JM . J Safety Res 2022 83 260-268 Introduction: Drowning is the leading cause of death among commercial fishermen in the United States. Approximately 30% of all commercial fishing fatalities are attributed to falls overboard. One of the simplest and most affordable ways to prevent these fatalities is for crewmembers to wear personal flotation devices (PFDs) while on deck. An examination of over 200 fatal falls overboard in the U.S. fishing industry revealed that none of the victims were wearing PFDs when they died. PFDs are not required to be worn by commercial fishermen in the United States, so this study was designed to encourage behavior change using targeted health communication and social marketing. Methods: This study developed, implemented, and evaluated a multi-media social marketing campaign featuring a fictitious, culturally-relevant spokesman designed to look, talk, and act like the target audience. The messages were crafted to address common barriers to PFD adoption and misconceptions about fleet-specific risks for fatalities from falls overboard. The campaign was evaluated over two seasons of fishing to look at message retention and intent toward action following exposure to the campaign materials. Results: Survey respondents indicated overall positive opinions about the spokesman and the messages. Results also show a reported change in behavior related to using PFDs while working on deck. Discussion: Targeted multi-media messaging can influence behavior of workers in high-risk occupations in remote locations. Safety message development should focus on occupational culture to create valid and authentic communication products for workers in high-risk industries. © 2022 |
Working hours, sleep, and fatigue in the agriculture, forestry, and fishing sector: A scoping review
Elliott KC , Lincoln JM , Flynn MA , Levin JL , Smidt M , Dzugan J , Ramos AK . Am J Ind Med 2022 65 (11) 898-912 INTRODUCTION: Agriculture, forestry, and fishing industry (AgFF) workers often work extremely long hours during peak production seasons, resulting in sleep deprivation and fatigue. The National Occupational Research Agenda has classified fatigue as a "significant safety issue" and area of concern for many industry sectors, including AgFF. This review explores current research and practice in AgFF and proposes next steps. METHODS: We conducted a scoping literature review to examine the extent and nature of research in this area. Article inclusion criteria included peer-reviewed journal articles written in English; published after 1989; covering AgFF workers in high-income countries; with data on working hours/schedules and sleep related to safety and health. RESULTS: Limited research has addressed long hours and sleep deprivation among AgFF workers. We identified 8350 articles for title and abstract review. Among those, 407 underwent full-text review and 96 met all inclusion criteria (67% agriculture, 25% fishing/seafood processing, 8% forestry). The literature provided some evidence fatigue contributes to fatalities, injuries, and illnesses in AgFF. Older, new, young, foreign-born, and female workers, as well as those who work in small organizations or longer hours (40+) may be at higher risk for fatigue-related injury and illness. Few studies have developed or evaluated interventions to control risks. DISCUSSION: Given that fatigue is a factor in injury and illness for this sector, future AgFF surveillance and research should increase efforts to capture fatigue and sleep data, directly investigate the role of long hours and nonstandard work schedules in the sector, and most importantly, create practical interventions to manage fatigue. |
Divergent Rabies Virus Variant of Probable Bat Origin in 2 Gray Foxes, New Mexico, USA.
Condori Rene E, Aragon Adam, Breckenridge Mike, Pesko Kendra, Mower Kerry, Ettestad Paul, Melman Sandra, Velasco-Villa Andres, Orciari Lillian A, Yager Pamela, Streicker Daniel G, Gigante Crystal M, Morgan Clint, Wallace Ryan, Li Yu. Emerging infectious diseases 2022 28(6) 1137-1145 . Emerging infectious diseases 2022 28(6) 1137-1145 Condori Rene E, Aragon Adam, Breckenridge Mike, Pesko Kendra, Mower Kerry, Ettestad Paul, Melman Sandra, Velasco-Villa Andres, Orciari Lillian A, Yager Pamela, Streicker Daniel G, Gigante Crystal M, Morgan Clint, Wallace Ryan, Li Yu. Emerging infectious diseases 2022 28(6) 1137-1145 |
Research gaps and needs for preventing worker fatigue in the transportation and utilities industries
Sieber WK , Chen GX , Krueger GP , Lincoln JE , Menéndez CC , O'Connor MB . Am J Ind Med 2022 65 (11) 857-866 BACKGROUND: The transportation and utilities industries include establishments engaged in the movement of passengers and freight, or the provision of public power, water, and other services. Along with the warehousing industry, they make up the US National Occupational Research Agenda's Transportation, Warehousing and Utilities (TWU) industry sector. In 2018 the sector composed 5% of the US workforce, with approximately 8 million workers. TWU workers experienced 19% of all fatalities among U.S. workers in 2018 and 7% of total occupational injuries and illnesses. METHODS: Around-the-clock operations, heavy workloads, long and irregular shifts, complicated schedules, and time pressures characterize work across the US TWU sector. However, there are considerable differences in worker priorities and concerns between TWU industries. Major areas of concern within the sector include disparities in work schedules; required training for employee fatigue awareness and prevention; physical and mental job demands; and safety culture. RESULTS: Strategies for fatigue mitigation are critical to reduce the prevalence of injuries, safety-critical events, and crashes in TWU workers. Further research on the incidence and characterization of fatigue among TWU workers will guide the development of effective mitigation strategies. The influence of work scheduling on missed sleep opportunities and disrupted circadian rhythms should be determined. Evaluation of fatigue mitigation strategies can lead to the adoption of the most effective ones for each TWU industry. CONCLUSION: Implementation of effective strategies is critical for the health, safety, wellbeing, and productivity of workers in the TWU sector. |
The occupational health effects of responding to a natural gas pipeline explosion among emergency first responders - Lincoln County, Kentucky, 2019
Bui DP , Kukielka EA , Blau EF , Tompkins LK , Bing KL , Edge C , Hardin R , Miller D , House J , Boehmer T , Winquist A , Orr M , Funk R , Thoroughman D . Disaster Med Public Health Prep 2021 16 (5) 1-8 OBJECTIVE: The aim of the study was to assess occupational health effects 1 month after responding to a natural gas pipeline explosion. METHODS: First responders to a pipeline explosion in Kentucky were interviewed about pre- and post-response health symptoms, post-response health care, and physical exertion and personal protective equipment (PPE) use during the response. Logistic regression was used to examine associations between several risk factors and development of post-response symptoms. RESULTS: Among 173 first responders involved, 105 (firefighters [58%], emergency medical services [19%], law enforcement [10%], and others [12%]) were interviewed. Half (53%) reported at least 1 new or worsening symptom, including upper respiratory symptoms (39%), headache (18%), eye irritation (17%), and lower respiratory symptoms (16%). The majority (79%) of symptomatic responders did not seek post-response care. Compared with light-exertion responders, hard-exertion responders (48%) had significantly greater odds of upper respiratory symptoms (aOR: 2.99, 95% CI: 1.25-7.50). Forty-four percent of responders and 77% of non-firefighter responders reported not using any PPE. CONCLUSIONS: Upper respiratory symptoms were common among first responders of a natural gas pipeline explosion and associated with hard-exertion activity. Emergency managers should ensure responders are trained in, equipped with, and properly use PPE during these incidents and encourage responders to seek post-response health care when needed. |
Multisystem Inflammatory Syndrome in Children - Initial Therapy and Outcomes.
Son MBF , Murray N , Friedman K , Young CC , Newhams MM , Feldstein LR , Loftis LL , Tarquinio KM , Singh AR , Heidemann SM , Soma VL , Riggs BJ , Fitzgerald JC , Kong M , Doymaz S , Giuliano JS Jr , Keenaghan MA , Hume JR , Hobbs CV , Schuster JE , Clouser KN , Hall MW , Smith LS , Horwitz SM , Schwartz SP , Irby K , Bradford TT , Maddux AB , Babbitt CJ , Rowan CM , McLaughlin GE , Yager PH , Maamari M , Mack EH , Carroll CL , Montgomery VL , Halasa NB , Cvijanovich NZ , Coates BM , Rose CE , Newburger JW , Patel MM , Randolph AG . N Engl J Med 2021 385 (1) 23-34 BACKGROUND: The assessment of real-world effectiveness of immunomodulatory medications for multisystem inflammatory syndrome in children (MIS-C) may guide therapy. METHODS: We analyzed surveillance data on inpatients younger than 21 years of age who had MIS-C and were admitted to 1 of 58 U.S. hospitals between March 15 and October 31, 2020. The effectiveness of initial immunomodulatory therapy (day 0, indicating the first day any such therapy for MIS-C was given) with intravenous immune globulin (IVIG) plus glucocorticoids, as compared with IVIG alone, was evaluated with propensity-score matching and inverse probability weighting, with adjustment for baseline MIS-C severity and demographic characteristics. The primary outcome was cardiovascular dysfunction (a composite of left ventricular dysfunction or shock resulting in the use of vasopressors) on or after day 2. Secondary outcomes included the components of the primary outcome, the receipt of adjunctive treatment (glucocorticoids in patients not already receiving glucocorticoids on day 0, a biologic, or a second dose of IVIG) on or after day 1, and persistent or recurrent fever on or after day 2. RESULTS: A total of 518 patients with MIS-C (median age, 8.7 years) received at least one immunomodulatory therapy; 75% had been previously healthy, and 9 died. In the propensity-score-matched analysis, initial treatment with IVIG plus glucocorticoids (103 patients) was associated with a lower risk of cardiovascular dysfunction on or after day 2 than IVIG alone (103 patients) (17% vs. 31%; risk ratio, 0.56; 95% confidence interval [CI], 0.34 to 0.94). The risks of the components of the composite outcome were also lower among those who received IVIG plus glucocorticoids: left ventricular dysfunction occurred in 8% and 17% of the patients, respectively (risk ratio, 0.46; 95% CI, 0.19 to 1.15), and shock resulting in vasopressor use in 13% and 24% (risk ratio, 0.54; 95% CI, 0.29 to 1.00). The use of adjunctive therapy was lower among patients who received IVIG plus glucocorticoids than among those who received IVIG alone (34% vs. 70%; risk ratio, 0.49; 95% CI, 0.36 to 0.65), but the risk of fever was unaffected (31% and 40%, respectively; risk ratio, 0.78; 95% CI, 0.53 to 1.13). The inverse-probability-weighted analysis confirmed the results of the propensity-score-matched analysis. CONCLUSIONS: Among children and adolescents with MIS-C, initial treatment with IVIG plus glucocorticoids was associated with a lower risk of new or persistent cardiovascular dysfunction than IVIG alone. (Funded by the Centers for Disease Control and Prevention.). |
Characteristics and Outcomes of US Children and Adolescents With Multisystem Inflammatory Syndrome in Children (MIS-C) Compared With Severe Acute COVID-19.
Feldstein LR , Tenforde MW , Friedman KG , Newhams M , Rose EB , Dapul H , Soma VL , Maddux AB , Mourani PM , Bowens C , Maamari M , Hall MW , Riggs BJ , Giuliano JSJr , Singh AR , Li S , Kong M , Schuster JE , McLaughlin GE , Schwartz SP , Walker TC , Loftis LL , Hobbs CV , Halasa NB , Doymaz S , Babbitt CJ , Hume JR , Gertz SJ , Irby K , Clouser KN , Cvijanovich NZ , Bradford TT , Smith LS , Heidemann SM , Zackai SP , Wellnitz K , Nofziger RA , Horwitz SM , Carroll RW , Rowan CM , Tarquinio KM , Mack EH , Fitzgerald JC , Coates BM , Jackson AM , Young CC , Son MBF , Patel MM , Newburger JW , Randolph AG . JAMA 2021 325 (11) 1074-1087 IMPORTANCE: Refinement of criteria for multisystem inflammatory syndrome in children (MIS-C) may inform efforts to improve health outcomes. OBJECTIVE: To compare clinical characteristics and outcomes of children and adolescents with MIS-C vs those with severe coronavirus disease 2019 (COVID-19). SETTING, DESIGN, AND PARTICIPANTS: Case series of 1116 patients aged younger than 21 years hospitalized between March 15 and October 31, 2020, at 66 US hospitals in 31 states. Final date of follow-up was January 5, 2021. Patients with MIS-C had fever, inflammation, multisystem involvement, and positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcriptase-polymerase chain reaction (RT-PCR) or antibody test results or recent exposure with no alternate diagnosis. Patients with COVID-19 had positive RT-PCR test results and severe organ system involvement. EXPOSURE: SARS-CoV-2. MAIN OUTCOMES AND MEASURES: Presenting symptoms, organ system complications, laboratory biomarkers, interventions, and clinical outcomes. Multivariable regression was used to compute adjusted risk ratios (aRRs) of factors associated with MIS-C vs COVID-19. RESULTS: Of 1116 patients (median age, 9.7 years; 45% female), 539 (48%) were diagnosed with MIS-C and 577 (52%) with COVID-19. Compared with patients with COVID-19, patients with MIS-C were more likely to be 6 to 12 years old (40.8% vs 19.4%; absolute risk difference [RD], 21.4% [95% CI, 16.1%-26.7%]; aRR, 1.51 [95% CI, 1.33-1.72] vs 0-5 years) and non-Hispanic Black (32.3% vs 21.5%; RD, 10.8% [95% CI, 5.6%-16.0%]; aRR, 1.43 [95% CI, 1.17-1.76] vs White). Compared with patients with COVID-19, patients with MIS-C were more likely to have cardiorespiratory involvement (56.0% vs 8.8%; RD, 47.2% [95% CI, 42.4%-52.0%]; aRR, 2.99 [95% CI, 2.55-3.50] vs respiratory involvement), cardiovascular without respiratory involvement (10.6% vs 2.9%; RD, 7.7% [95% CI, 4.7%-10.6%]; aRR, 2.49 [95% CI, 2.05-3.02] vs respiratory involvement), and mucocutaneous without cardiorespiratory involvement (7.1% vs 2.3%; RD, 4.8% [95% CI, 2.3%-7.3%]; aRR, 2.29 [95% CI, 1.84-2.85] vs respiratory involvement). Patients with MIS-C had higher neutrophil to lymphocyte ratio (median, 6.4 vs 2.7, P < .001), higher C-reactive protein level (median, 152 mg/L vs 33 mg/L; P < .001), and lower platelet count (<150 ×103 cells/μL [212/523 {41%} vs 84/486 {17%}, P < .001]). A total of 398 patients (73.8%) with MIS-C and 253 (43.8%) with COVID-19 were admitted to the intensive care unit, and 10 (1.9%) with MIS-C and 8 (1.4%) with COVID-19 died during hospitalization. Among patients with MIS-C with reduced left ventricular systolic function (172/503, 34.2%) and coronary artery aneurysm (57/424, 13.4%), an estimated 91.0% (95% CI, 86.0%-94.7%) and 79.1% (95% CI, 67.1%-89.1%), respectively, normalized within 30 days. CONCLUSIONS AND RELEVANCE: This case series of patients with MIS-C and with COVID-19 identified patterns of clinical presentation and organ system involvement. These patterns may help differentiate between MIS-C and COVID-19. |
Occupational health research in the commercial fishing industry
Lincoln JM , Carruth A , Cherry D , Kincl L , Syron LN . J Agromedicine 2021 26 (1) 28-30 The commercial fishing industry in the United States is one of the most hazardous work settings. Operations are characterized by hazardous machinery and equipment, strenuous labor, long work hours, harsh weather, and moving decks. Risk varies by vessel and types of gear. During 2000–2016, the fishing industry suffered a fatality rate of 115 deaths per 100,000 workers, compared with an average of 4 deaths per 100,000 workers among all U.S. workers.1 During this same time, 755 commercial fishermen died, with nearly half of these fatalities (364, 48%) occurring after a vessel disaster, 30% (227) after a fall overboard, and 13% (97) from traumatic injuries sustained onboard.1 The remaining 67 (9%) fatalities occurred either while diving or from injuries that occurred onshore or on the dock.1 Risk factors and recommendations have been made to prevent these fatalities by fishery and by region of the country.2–6 |
Truck driver reported unrealistically tight delivery schedules linked to their opinions of maximum speed limits and hours-of-service rules and their compliance with these safety laws and regulations
Chen GX , Sieber WK , Collins JW , Hitchcock EM , Lincoln JE , Pratt SG , Sweeney MH . Saf Sci 2021 133 Objectives: The study objectives were to examine U.S. long-haul truck drivers (LHTDs)' opinions on their safety needs and to assess the associations of driver reported unrealistically tight delivery schedules with: (1) their opinions on their compensation, maximum speed limits, and Hours-of-Service (HOS) regulations, and (2) their behaviors of noncompliance with these safety laws and regulations. Method(s): National Institute for Occupational Safety and Health analyzed data from its 2010 national survey of LHTD health and injury. A total of 1,265 drivers completed the survey. Logistic regression was used to examine the associations between driver reported unrealistically tight delivery schedule and their opinion on safety and unsafe driving behaviors. Result(s): Drivers who reported often receiving an unrealistically tight delivery schedule (an estimated 15.5% of LHTDs) were significantly more likely than drivers who reported never receiving an unrealistically tight delivery schedule to report that: (1) increasing the current maximum speed limit on interstate highways by 10 miles per hour (mph) would improve safety (odds ratio (OR) = 2.1); (2) strictly enforcing HOS rules would not improve safety (OR = 1.8); (3) they often drove 10 mph or more over the speed limit (OR = 7.5); (4) HOS regulations were often violated (OR = 10.9); (5) they often continued to drive despite fatigue, bad weather, or heavy traffic because their must delivery or pick up a load at a given time (OR = 7.5); and (6) their work was never adequately rewarded (OR = 4.5). When presented with 11 potential safety strategies, the largest percentage of LHTDs (95.4%) selected that building more truck stops/parking areas would improve truck driver safety. Conclusion(s): Driver reported unrealistically tight delivery schedules are associated with drivers' beliefs in safety laws/regulations and risk-taking behaviors. LHTDs see building more truck stops/rest areas as the most wanted safety need among the 11 potential safety strategies that were asked about in the survey. |
Geospatial analysis in responding to a nuclear detonation scenario in NYC: The Gotham Shield Exercise
Lowe L , Salame-Alfie A , Neurath B , Quinn C , Ansari A , Whitcomb R , Dopson S . J Homel Secur Emerg Manag 2020 17 (3) In April 2017, the Centers for Disease Control and Prevention (CDC) participated in the Gotham Shield Exercise, led by the Federal Emergency Management Agency (FEMA) and in collaboration with other federal agencies to test the federal, state and local government's ability to respond to an improvised nuclear device (IND). With active engagement from CDC leadership, 266 scientific and support staff from across the agency participated in the Gotham Shield exercise. The scenario involved a 10-kiloton detonation near the Lincoln Tunnel in New Jersey. This nuclear detonation scenario provided CDC with the opportunity to test some of the all-hazards tools the agency uses during response to other national or international emergencies, such as Geographic Information Systems (GIS) and mapping tools, and apply these tools to a nuclear emergency. Geospatial analysis associated with real time data can provide near real time information for individuals and entities associated with response and recovery activities. This type of analysis can provide timely data in regard to maps and information used to properly place staging areas for Community Reception Centers (CRC), mass care locations, and other medical care and countermeasure related services. Maps showing locations of power loss, such as locations of lost or inoperable main electrical grid and substations, combined with real time data on where power is available provides valuable information for first responders and emergency managers as well as responders engaged in communicating critical public messages to affected populations in these areas. By using real-time information, response officials can direct the response, allocate scarce resources, aid in coordination efforts, and provide a more efficient means of providing critical public health and medical services. The results of the exercise highlight the importance of using geospatial analysis for response planning and effect mitigation before, during, and after a public health event of this magnitude, and the value they represent in informed decision making. |
Characteristics and Outcomes of Contacts of COVID-19 Patients Monitored Using an Automated Symptom Monitoring Tool - Maine, May-June 2020.
Krueger A , Gunn JKL , Watson J , Smith AE , Lincoln R , Huston SL , Dirlikov E , Robinson S . MMWR Morb Mortal Wkly Rep 2020 69 (31) 1026-1030 SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), is spread from person to person (1-3). Quarantine of exposed persons (contacts) for 14 days following their exposure reduces transmission (4-7). Contact tracing provides an opportunity to identify contacts, inform them of quarantine recommendations, and monitor their symptoms to promptly identify secondary COVID-19 cases (7,8). On March 12, 2020, Maine Center for Disease Control and Prevention (Maine CDC) identified the first case of COVID-19 in the state. Because of resource constraints, including staffing, Maine CDC could not consistently monitor contacts, and automated technological solutions for monitoring contacts were explored. On May 14, 2020, Maine CDC began enrolling contacts of patients with reported COVID-19 into Sara Alert (MITRE Corporation, 2020),* an automated, web-based, symptom monitoring tool. After initial communication with Maine CDC staff members, enrolled contacts automatically received daily symptom questionnaires via their choice of e-mailed weblink, text message, texted weblink, or telephone call until completion of their quarantine. Epidemiologic investigations were conducted for enrollees who reported symptoms or received a positive SARS-CoV-2 test result. During May 14-June 26, Maine CDC enrolled 1,622 contacts of 614 COVID-19 patients; 190 (11.7%) eventually developed COVID-19, highlighting the importance of identifying, quarantining, and monitoring contacts of COVID-19 patients to limit spread. In Maine, symptom monitoring was not feasible without the use of an automated symptom monitoring tool. Using a tool that permitted enrollees to specify a method of symptom monitoring was well received, because the majority of persons monitored (96.4%) agreed to report using this system. |
Multisystem Inflammatory Syndrome in U.S. Children and Adolescents.
Feldstein LR , Rose EB , Horwitz SM , Collins JP , Newhams MM , Son MBF , Newburger JW , Kleinman LC , Heidemann SM , Martin AA , Singh AR , Li S , Tarquinio KM , Jaggi P , Oster ME , Zackai SP , Gillen J , Ratner AJ , Walsh RF , Fitzgerald JC , Keenaghan MA , Alharash H , Doymaz S , Clouser KN , Giuliano JS Jr , Gupta A , Parker RM , Maddux AB , Havalad V , Ramsingh S , Bukulmez H , Bradford TT , Smith LS , Tenforde MW , Carroll CL , Riggs BJ , Gertz SJ , Daube A , Lansell A , Coronado Munoz A , Hobbs CV , Marohn KL , Halasa NB , Patel MM , Randolph AG . N Engl J Med 2020 383 (4) 334-346 BACKGROUND: Understanding the epidemiology and clinical course of multisystem inflammatory syndrome in children (MIS-C) and its temporal association with coronavirus disease 2019 (Covid-19) is important, given the clinical and public health implications of the syndrome. METHODS: We conducted targeted surveillance for MIS-C from March 15 to May 20, 2020, in pediatric health centers across the United States. The case definition included six criteria: serious illness leading to hospitalization, an age of less than 21 years, fever that lasted for at least 24 hours, laboratory evidence of inflammation, multisystem organ involvement, and evidence of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) based on reverse-transcriptase polymerase chain reaction (RT-PCR), antibody testing, or exposure to persons with Covid-19 in the past month. Clinicians abstracted the data onto standardized forms. RESULTS: We report on 186 patients with MIS-C in 26 states. The median age was 8.3 years, 115 patients (62%) were male, 135 (73%) had previously been healthy, 131 (70%) were positive for SARS-CoV-2 by RT-PCR or antibody testing, and 164 (88%) were hospitalized after April 16, 2020. Organ-system involvement included the gastrointestinal system in 171 patients (92%), cardiovascular in 149 (80%), hematologic in 142 (76%), mucocutaneous in 137 (74%), and respiratory in 131 (70%). The median duration of hospitalization was 7 days (interquartile range, 4 to 10); 148 patients (80%) received intensive care, 37 (20%) received mechanical ventilation, 90 (48%) received vasoactive support, and 4 (2%) died. Coronary-artery aneurysms (z scores >/=2.5) were documented in 15 patients (8%), and Kawasaki's disease-like features were documented in 74 (40%). Most patients (171 [92%]) had elevations in at least four biomarkers indicating inflammation. The use of immunomodulating therapies was common: intravenous immune globulin was used in 144 (77%), glucocorticoids in 91 (49%), and interleukin-6 or 1RA inhibitors in 38 (20%). CONCLUSIONS: Multisystem inflammatory syndrome in children associated with SARS-CoV-2 led to serious and life-threatening illness in previously healthy children and adolescents. (Funded by the Centers for Disease Control and Prevention.). |
Mild steel and stainless steel welding fumes elicit pro-inflammatory and pro-oxidant effects in first trimester trophoblast cells
Olgun NS , Morris AM , Bowers LN , Stefaniak AB , Friend SA , Reznik SE , Leonard SS . Am J Reprod Immunol 2020 83 (4) e13221 PROBLEM: As more women join the skilled-trade workforce, the effects of workplace exposures on pregnancy need to be explored. This study aims to identify the effects of mild steel and stainless steel welding fume exposures on cultured placental trophoblast cells. METHOD OF STUDY: Welding fumes (mild steel and stainless steel) were generously donated by Lincoln Electric. Electron microscopy was used to characterize welding fume particle size and the ability of particles to enter extravillous trophoblast cells (HTR-8/SVneo). Cellular viability, free radical production, cytokine production, and ability of cells to maintain invasive properties were analyzed, respectively, by WST-1, electron paramagnetic resonance, DCFH-DA, V-plex MULTI-SPOT assay system, and a matrix gel invasion assay. RESULTS: For all three welding fume types, average particle size was < 210 nm. HTR-8/SVneo cells internalized welding particles, and nuclear condensation was observed. Cellular viability was significantly decreased at the high dose of 100 microg/ml for all three welding fumes, and stainless steel generated the greatest production of the hydroxyl radical, and intracellular reactive oxygen species. Production of the cytokines IL-1beta and TNFalpha were not observed in response to welding fume exposure, but IL-6 and IL-8 were. Finally, the invasive capability of cells was decreased upon exposure to both mild steel and stainless steel welding fumes. CONCLUSION: Welding fumes are cytotoxic to extravillous trophoblasts, as is evident by the production of free radicals, pro-inflammatory cytokines, and the observed decrease in invasive capabilities. |
The Fifth International Fishing Industry Safety and Health Conference (IFISH 5): A Gathering of International Safety and Health Experts in Commercial Fishing, Aquaculture and Seafood Processing
Lincoln J . J Agromedicine 2019 24 (4) 309-310 Few occupations are as old, or as hazardous, as commercial fishing. As the global production of seafood continues to rise, the health and safety of workers in not only fishing, but also the expanding aquaculture and seafood processing industries becomes an increasingly important area of research. Currently, the Food and Agriculture Organization (FAO) estimates the worldwide number of fishermen and fish farmers to be 59.7 million, operating a fleet comprising 4.5 million vessels. Workplace health and safety hazards vary greatly, with work settings as various as small vessels to large catcher-processors and manufactured inland ponds to large marine farms in the ocean. Seafood processing includes a variety of processes and can all be done manually or more highly automated. China, Indonesia, India, the United States, and the Russian Federation were the largest seafood producers by volume in 2017.Citation1 The top aquaculture producers were China, India, Indonesia, Viet Nam, and Bangladesh. It is estimated that 32,000 people lose their lives each year while harvesting seafood.Citation2 |
Estimating the size of key populations in Kampala, Uganda: 3-source capture-recapture study
Doshi RH , Apodaca K , Ogwal M , Bain R , Amene E , Kiyingi H , Aluzimbi G , Musinguzi G , Serwadda D , McIntyre AF , Hladik W . JMIR Public Health Surveill 2019 5 (3) e12118 BACKGROUND: Key populations, including people who inject drugs (PWID), men who have sex with men (MSM), and female sex workers (FSW), are disproportionately affected by the HIV epidemic. Understanding the magnitude of, and informing the public health response to, the HIV epidemic among these populations requires accurate size estimates. However, low social visibility poses challenges to these efforts. OBJECTIVE: The objective of this study was to derive population size estimates of PWID, MSM, and FSW in Kampala using capture-recapture. METHODS: Between June and October 2017, unique objects were distributed to the PWID, MSM, and FSW populations in Kampala. PWID, MSM, and FSW were each sampled during 3 independent captures; unique objects were offered in captures 1 and 2. PWID, MSM, and FSW sampled during captures 2 and 3 were asked if they had received either or both of the distributed objects. All captures were completed 1 week apart. The numbers of PWID, MSM, and FSW receiving one or both objects were determined. Population size estimates were derived using the Lincoln-Petersen method for 2-source capture-recapture (PWID) and Bayesian nonparametric latent-class model for 3-source capture-recapture (MSM and FSW). RESULTS: We sampled 467 PWID in capture 1 and 450 in capture 2; a total of 54 PWID were captured in both. We sampled 542, 574, and 598 MSM in captures 1, 2, and 3, respectively. There were 70 recaptures between captures 1 and 2, 103 recaptures between captures 2 and 3, and 155 recaptures between captures 1 and 3. There were 57 MSM captured in all 3 captures. We sampled 962, 965, and 1417 FSW in captures 1, 2, and 3, respectively. There were 316 recaptures between captures 1 and 2, 214 recaptures between captures 2 and 3, and 235 recaptures between captures 1 and 3. There were 109 FSW captured in all 3 rounds. The estimated number of PWID was 3892 (3090-5126), the estimated number of MSM was 14,019 (95% credible interval (CI) 4995-40,949), and the estimated number of FSW was 8848 (95% CI 6337-17,470). CONCLUSIONS: Our population size estimates for PWID, MSM, and FSW in Kampala provide critical population denominator data to inform HIV prevention and treatment programs. The 3-source capture-recapture is a feasible method to advance key population size estimation. |
Surveillance, epidemiology, and estimated burden of neonatal abstinence syndrome, Tennessee, 2013-2016
Brennan J , Wiedeman C , Dunn JR , Schaffner W , Jones TF . Public Health Rep 2019 134 (5) 537-541 OBJECTIVES: Between 2003 and 2013, the rate of neonatal abstinence syndrome (NAS)-a postnatal drug withdrawal syndrome-in Tennessee increased approximately 10-fold. NAS surveillance is relatively new, and underestimation associated with surveillance has not been described. We compared data from the Tennessee NAS public health surveillance system (TNSS) with a second source of NAS data, hospital discharge data system (HDDS), and estimated the true number of infants with NAS using capture-recapture methods. METHODS: We obtained NAS data on cases of NAS among Tennessee infants from TNSS and HDDS from January 1, 2013, through December 31, 2016. We matched cases of NAS identified in TNSS to cases identified in HDDS. We estimated the true number of infants with NAS by using the Lincoln-Peterson estimator capture-recapture methodology. RESULTS: During the study period, 4070 infants with NAS were reported to TNSS, and 5321 infants with NAS were identified in HDDS; 2757 were in both data sets. Using capture-recapture methods, the total estimated number of infants with NAS during the study period was 7855 (annual mean = 1972; estimated range = 1531-2427), which was 93% more than in TNSS and 48% more than in HDDS. Drugs used for the medication-assisted treatment of substance use disorder were the most commonly reported substances associated with NAS (n = 2389, 59%). CONCLUSIONS: TNSS underestimated the total burden of NAS based on the capture-recapture estimate. Case-based public health surveillance is important for monitoring the burden of and risk factors for NAS and helping guide public health interventions. |
Use of photography to identify free-roaming dogs during sight-resight surveys: Impacts on estimates of population size and vaccination coverage, Haiti 2016
Cleaton JM , Blanton JD , Dilius P , Ludder F , Crowdis K , Medley A , Chipman R , Estime F , Maciel E , Wallace RM . Vaccine: X 2019 2 100025 Background: Enumerating dog populations is essential to plan and evaluate rabies vaccination campaigns. To estimate vaccination coverage and dog population size in a Haitian commune, 15 sight-resight counts were conducted over two days following a government-sponsored vaccination campaign. Methods: Dogs received temporary laminated collars and livestock wax marks on the head and sides at the time of rabies vaccination. After the vaccination campaign, pairs of surveyors walked pre-defined routes through targeted neighborhoods, photographing and recording characteristics and location of each dog seen on a standardized data sheet. On the second survey day, surveyors retraced the prior day's track, followed the same procedure, and indicated in addition whether they believed the dogs were resighted from the prior day. After completion of the field survey, two independent evaluators reviewed photographs and characteristics of each dog to assess which had vaccination marks and which were resighted. Surveyor and photo-reviewer sight-resight decisions were compared using Cohen's kappa, and population estimates were compared using Lincoln-Petersen 95% confidence intervals. Results: Field-surveyors identified dogs consistent with the photograph evaluations in 629 out of 800 instances (78.6%, Cohen's kappa of 0.12). Despite this inconsistency, the population estimates resulting from the field and final determinations were not significantly different at 1,789 (95% CI 1,677 to 1,901) and 1,978 (95% CI 1,839 to 2,118). Vaccination coverage was also the same at 55% and 56%; however, an observed vaccination mark loss of 13.8% suggests that the true coverage may have been closer to 64%. Conclusion: Using photos improved dog identification during the sight-resight study, leading to a higher population estimate. Despite using a 2-mark system to temporarily identify vaccinated dogs, a significant proportion had lost all identifying marks by the second day of field surveys. Efforts to estimate vaccination coverage using sight-resight surveys should consider improvement of marking techniques or better accounting for potential loss of marks in their free-roaming dog vaccination coverage assessments. |
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