Objectives. To measure the associations between access to paid sick leave (PSL) and COVID-19 vaccination status in the United States, both overall and stratified by occupation and industry of employment. Methods. We extracted data on employed adults aged 18 to 64 years from the 2021 and 2022 US Medical Expenditure Panel Survey. We assessed associations between PSL and COVID-19 vaccination status using logistic regression. We used marginal effects analyses to estimate associations within occupation and industry groups. Results. Our analytic sample (n = 15 089) represented more than 114 million employed US adults. Access to PSL was significantly associated with receipt of a COVID-19 vaccination (adjusted odds ratio = 1.33; 95% confidence interval = 1.14, 1.55). Marginal effects analyses indicated that this association was significant within most occupation and industry groups. Conclusions. These findings suggest PSL is associated with higher COVID-19 vaccination rates among US workers. PSL remains an important tool for improving preventive health care access and reducing rates of infectious disease in the United States. (Am J Public Health. Published online ahead of print May 22, 2025:e1-e4. https://doi.org/10.2105/AJPH.2025.308095).

The proportion of synthetic opioid overdose deaths co-involving stimulants has increased in the United States in recent years. Although persons who use opioids have reported increasing stimulant co-use to maintain workplace productivity and alertness, occupational patterns of co-involvement in fatal overdose have not been systematically investigated. In an exploratory study, data on overdose deaths involving synthetic opioids (e.g., fentanyl) from the 2022 National Vital Statistics System were analyzed to characterize patterns of stimulant co-involvement among U.S. residents aged 15-64 years, stratified by decedents' usual occupation and industry. Of 69,893 fatal synthetic opioid overdoses, 53.6% involved stimulants. Occupation and industry groups with the highest percentages of synthetic opioid overdose deaths co-involving psychostimulants with abuse potential (psychostimulants) were typically physically demanding (e.g., construction and extraction occupations), whereas categories with highest percentages of cocaine co-involvement were generally less physically strenuous (e.g., business and financial occupations); these patterns might reflect differences in desired drug effects, cost, and geographic availability. Work-related interventions might be useful in preventing the development of substance use disorder by decreasing rates of occupational injuries and workplace stress, connecting workers with substance use disorder to treatment resources, and reducing fatal overdose through harm reduction.

OBJECTIVES: To measure associations between employment precarity and mental health among United States (US) workers. METHODS: This study used data from the US Medical Expenditure Panel Survey for 2008-2021. Multivariable generalized estimating equations were used to measure associations between employment precarity (operationalized as a multi-dimensional exposure) and self-rated mental health after adjusting for relevant confounders. Marginal effects analysis was used to assess potential dose-response relationships between precarity and mental health. RESULTS: Our sample (n = 57,529) was representative of >106 million US workers employed throughout 2008-2021. Compared to those with low levels of employment precarity, those with medium and high levels of precarity had an increased odds of reporting poor/fair mental health (aOR = 1.21; 95% CI = 1.11, 1.32 and 1.51; 95% CI = 1.36, 1.68, respectively). Marginal effects analysis indicated that increasing levels of precarity were associated with an increased probability of reporting poor/fair mental health. CONCLUSIONS: Increasing levels of employment precarity were associated with poor/fair self-rated mental health, findings potentially indicative of a dose-response relationship between the two. These nationally representative findings suggest employment precarity is an important social determinant of mental health. Future research could investigate how best to mitigate the negative effects of precarity on workers' lives and well-being, particularly regarding mental health.

BACKGROUND: Evidence suggests that rates of occupational injuries in the US are decreasing. As several different occupational injury surveillance systems are used in the US, more detailed investigation of this trend is merited. Furthermore, studies of this decrease remain descriptive and do not use inferential statistics. The aim of this study was to provide both descriptive and inferential statistics of temporal trends of occupational injuries treated in US emergency departments (EDs) for 2012 to 2019. METHODS: Monthly non-fatal occupational injury rates from 2012 to 2019 were estimated using the national electronic injury surveillance system-occupational supplement (NEISS-Work) dataset, a nationally representative sample of ED-treated occupational injuries. Rates were generated for all injuries and by injury event type using monthly full-time worker equivalent (FTE) data from the US Current Population Survey as a denominator. Seasonality indices were used to detect seasonal variation in monthly injury rates. Trend analysis using linear regression adjusted for seasonality was conducted to quantify changes in injury rates from 2012 to 2019. RESULTS: Occupational injuries occurred at an average rate of 176.2 (95% CI =  ± 30.9) per 10,000 FTE during the study period. Rates were highest in 2012 and declined to their lowest level in 2019. All injury event types occurred at their highest rate in summer months (July or August) apart from falls, slips, and trips, which occurred at their highest rate in January. Trend analyses indicated that total injury rates decreased significantly throughout the study period (- 18.5%; 95% CI =  ± 14.5%). Significant decreases were also detected for injuries associated with contact with foreign object and equipment (- 26.9%; 95% CI =  ± 10.5%), transportation incidents (- 23.2%; 95% CI =  ± 14.7%), and falls, slips, and trips (- 18.1%; 95% CI =  ± 8.9%). CONCLUSIONS: This study supports evidence that occupational injuries treated in US EDs have decreased since 2012. Potential contributors to this decrease include increased workplace mechanization and automation, as well as changing patterns in US employment and health insurance access.