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Le AB, Urban-Wojcik E, Seewald M, Mezuk BR. The Relationship Between Workplace Drug Policies, Opioid Misuse, and Psychological Distress: Evidence From the 2020 National Survey on Drug Use and Health. New Solut 2024; 34:22-37. [PMID: 38332622 PMCID: PMC11003197 DOI: 10.1177/10482911241231523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
Background: This study, using a nationally representative dataset of the U.S. workforce, examines how punitive workplace drug policies relate to opioid use/misuse and psychological distress. Methods: The sample included adults aged ≥18 years who participated in the National Survey on Drug Use and Health and were employed in 2020. Hierarchical multivariate logistical models were constructed to address the research questions. Results: The weighted, design-based estimates indicate that of 147 831 081 workers, 3.38% reported misusing opioids in the last 12 months. Having a punitive workplace policy was associated with higher rates of opioid use/misuse among workers aged ≤ 34 compared to their same-aged counterparts in nonpunitive workplaces, and among workers identifying as Black, Indigenous, or Person of Color who also experienced severe psychological distress the past year. Conclusion: Some employers may think drug testing policies are net-beneficial to worker well-being; these findings indicate such policies may interact in harmful ways with psychological distress.
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Affiliation(s)
- Aurora B. Le
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Emily Urban-Wojcik
- Eisenberg Family Depression Center, University of Michigan, Ann Arbor, MI, USA
| | - Meghan Seewald
- Eisenberg Family Depression Center, University of Michigan, Ann Arbor, MI, USA
| | - Briana R. Mezuk
- Eisenberg Family Depression Center, University of Michigan, Ann Arbor, MI, USA
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Le AB, Shkembi A, Gibbs SG, Neitzel RL. A pilot study on psychosocial factors and perceptions of organizational health among a sample of U.S. waste workers. Sci Rep 2024; 14:9185. [PMID: 38649762 PMCID: PMC11035587 DOI: 10.1038/s41598-024-59912-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 04/16/2024] [Indexed: 04/25/2024] Open
Abstract
Solid waste workers encounter a number of occupational hazards that are likely to induce stress. Thus, there are likely to be psychosocial factors that also contribute to their overall perceptions of organizational health. However, attitudes regarding the aforementioned among solid waste workers' have not been assessed. This descriptive, cross-sectional pilot study operationalized the INPUTS Survey to determine workers' perceptions of organizational health and other psychosocial factors of work. Percentage and mean responses to each INPUTS domain are presented in accordance with their survey manual. Pearson's chi-squared tests were run on count data; Fisher's exact tests were run for count data with fewer than five samples. ANOVAs were run on the continuous items. Due to a relatively low sample size (N = 68), two-sided p values < 0.1 were considered statistically significant. Most solid waste worker participants reported high decision authority, that they perceived their management to prioritize workplace health and safety, and had high job satisfaction. However, perceptions of support for health outside of the realm of occupational safety and health was lower. Addressing traditional occupational health hazards continues to take precedence in this industry, with less of a focus on how the social determinants of health may impact workplace health.
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Affiliation(s)
- Aurora B Le
- Department of Health Behavior, School of Public Health, Texas A&M University, 212 Adriance Lab Road (TAMU 1266), College Station, TX, 77843, USA.
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
| | - Abas Shkembi
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Shawn G Gibbs
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Richard L Neitzel
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Le AB, Figi CE, Herstein JJ, Iwen PC, Buehler SA, Lowe JJ, Gibbs SG. Clinical laboratory equipment manufacturers' lack of guidance for high consequence pathogen response is a critical weakness. Infect Control Hosp Epidemiol 2024:1-3. [PMID: 38525674 DOI: 10.1017/ice.2024.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Affiliation(s)
- Aurora B Le
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Claire E Figi
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Jocelyn J Herstein
- University of Nebraska Medical Center, Global Center for Health Security, Omaha, NE, USA
- Department of Environmental, Agricultural, and Occupational Health, University of Nebraska Medical Center, College of Public Health, Omaha, NE, USA
| | - Peter C Iwen
- Department of Pathology and Microbiology, University of Nebraska Medical Center, College of Medicine, Omaha, NE, USA
| | - Sean A Buehler
- Department of Emergency Medicine, University of New Mexico, School of Medicine, Albuquerque, New Mexico
| | - John J Lowe
- University of Nebraska Medical Center, Global Center for Health Security, Omaha, NE, USA
- Department of Environmental, Agricultural, and Occupational Health, University of Nebraska Medical Center, College of Public Health, Omaha, NE, USA
| | - Shawn G Gibbs
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, USA
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Donovan SK, Herstein JJ, Le AB, Gibbs SG, Beam EL, Brown CK, Lowe AE, Lowe JJ, Lawler JV. The cardinal rules: Principles of personal protective equipment for high-consequence infectious disease events. Infect Control Hosp Epidemiol 2024:1-3. [PMID: 38329022 DOI: 10.1017/ice.2023.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
In recognition of an increasing number of high-consequence infectious disease events, a group of subject-matter experts identified core safety principles that can be applied across all donning and doffing protocols for personal protective equipment.
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Affiliation(s)
- Sara K Donovan
- Global Center for Health Security, University of Nebraska Medical Center, Omaha, Nebraska
| | - Jocelyn J Herstein
- Global Center for Health Security, University of Nebraska Medical Center, Omaha, Nebraska
- Department of Environmental, Agricultural, and Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska
| | - Aurora B Le
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, Texas
| | - Shawn G Gibbs
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, Texas
| | - Elizabeth L Beam
- College of Nursing, University of Nebraska Medical Center, Omaha, Nebraska
| | - Christopher K Brown
- Division of Emergency Operations, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Abigail E Lowe
- Global Center for Health Security, University of Nebraska Medical Center, Omaha, Nebraska
- Department of Allied Health Professions Education, Research, and Practice, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, Nebraska
| | - John J Lowe
- Global Center for Health Security, University of Nebraska Medical Center, Omaha, Nebraska
- Department of Environmental, Agricultural, and Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska
| | - James V Lawler
- Global Center for Health Security, University of Nebraska Medical Center, Omaha, Nebraska
- Department of Internal Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska
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Figi CE, Herstein JJ, Beam EL, Le AB, Hewlett AL, Lawler JV, Lowe JJ, Gibbs SG. Literature review of physiological strain of personal protective equipment on personnel in the high-consequence infectious disease isolation environment. Am J Infect Control 2023; 51:1384-1391. [PMID: 37182761 DOI: 10.1016/j.ajic.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 05/08/2023] [Accepted: 05/09/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Heat strain and dehydration can affect an individual's physical and mental performance. The purpose of this review was to examine the literature for the impact of heat strain on health care workers (HCWs) who care for patients with high-consequence infectious diseases (HCIDs) while wearing personal protective equipment (PPE), discuss the risks of impaired safety caused by heat strain and dehydration in HCID environments, identify attempts to combat PPE-related heat strain, recognize limitations, and provide suggestions for further research. METHODS A literature search was performed in PubMed or MEDLINE and Google Scholar. Authors screened abstracts for inclusion criteria and reviewed articles if the abstracts were considered to include information relevant to the aim. RESULTS The search terms yielded 30 articles that were sorted based on environment setting, physiological impact, and interventions. DISCUSSION The safety of the HCWs and patients can be enhanced through the development and usage of cooler, more comfortable PPE materials and ensembles to help slow the rate of dehydration and support the regulation of core body temperature. CONCLUSIONS Heat strain caused by wearing PPE is an occupational health concern for HCWs in the high-risk environment, that is, HCID care. Future studies are needed to develop innovative PPE ensembles that can reduce heat strain and improve well-being.
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Affiliation(s)
- Claire E Figi
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX.
| | - Jocelyn J Herstein
- Department of Environmental, Agricultural, and Occupational Health, University of Nebraska Medical Center, College of Public Health, 985110 Nebraska Medical Center, Omaha, NE.
| | - Elizabeth L Beam
- College of Nursing, University of Nebraska Medical Center, 985330 Nebraska Medical Center, Omaha, NE.
| | - Aurora B Le
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI.
| | - Angela L Hewlett
- Global Center for Health Security, University of Nebraska Medical Center, 986161 Nebraska Medical Center, Omaha, NE; Department of Internal Medicine, Division of Infectious Diseases, University of Nebraska Medical Center, 983332 Nebraska Medical Center, Omaha, NE.
| | - James V Lawler
- Global Center for Health Security, University of Nebraska Medical Center, 986161 Nebraska Medical Center, Omaha, NE.
| | - John J Lowe
- Department of Environmental, Agricultural, and Occupational Health, University of Nebraska Medical Center, College of Public Health, 985110 Nebraska Medical Center, Omaha, NE; Global Center for Health Security, University of Nebraska Medical Center, 986161 Nebraska Medical Center, Omaha, NE.
| | - Shawn G Gibbs
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX.
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Herstein JJ, Figi CE, Le AB, Beam EL, Lawler JV, Schnaubelt ER, Carter GW, Lowe JJ, Gibbs SG. An Updated Review of Literature for Air Medical Evacuation High-Level Containment Transport During the Coronavirus Disease 2019 Pandemic. Air Med J 2023; 42:201-209. [PMID: 37150575 PMCID: PMC9808413 DOI: 10.1016/j.amj.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 12/27/2022] [Indexed: 05/09/2023]
Abstract
OBJECTIVE In 2019, our team conducted a literature review of air medical evacuation high-level containment transport (AE-HLCT) of patients infected with high-consequence pathogens. Since that publication, the coronavirus disease 2019 (COVID-19) pandemic has resulted in numerous air medical evacuations. We re-examined the new literature associated with AE-HLCTs to determine new innovations developed as a result of the pandemic. METHODS A literature search was performed in PubMed/MEDLINE from February 2019 to October 2021. The authors screened abstracts for the inclusion criteria and reviewed full articles if the abstract was relevant to the aim. RESULTS Our search criteria yielded 19 publications. Many of the early transports of patients with COVID-19 used established protocols for AE-HLCT, which were built from the most recent transports of patients with Ebola virus disease. Innovations from the identified articles are subdivided into preflight considerations, in-flight operations, and postflight operations. CONCLUSION Lessons gleaned from AE-HLCTs of patients with COVID-19 in the early weeks of the pandemic, when little was known about transmission or the severity of the novel disease, have advanced the field of AE-HLCT. Teams that had never conducted such transports now have experience and processes. However, more research into AE-HLCT is needed, including research related to single-patient portable isolation units as well as containerized/multipatient transportation systems.
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Affiliation(s)
- Jocelyn J Herstein
- Department of Environmental, Agricultural, and Occupational Health, University of Nebraska Medical Center, College of Public Health, Omaha, NE; Global Center for Health Security, Omaha, NE.
| | - Claire E Figi
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX
| | - Aurora B Le
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Elizabeth L Beam
- Global Center for Health Security, Omaha, NE; College of Nursing, University of Nebraska Medical Center, Omaha, NE
| | - James V Lawler
- Global Center for Health Security, Omaha, NE; Department of Internal Medicine, University of Nebraska Medical Center College of Medicine, Omaha, NE
| | - Elizabeth R Schnaubelt
- Global Center for Health Security, Omaha, NE; Department of Internal Medicine, University of Nebraska Medical Center College of Medicine, Omaha, NE; United States Air Force School of Aerospace Medicine, Dayton, OH
| | | | - John J Lowe
- Department of Environmental, Agricultural, and Occupational Health, University of Nebraska Medical Center, College of Public Health, Omaha, NE; Global Center for Health Security, Omaha, NE
| | - Shawn G Gibbs
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX
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Le AB, Shkembi A, Tadee A, Sturgis AC, Gibbs SG, Neitzel RL. Characterization of perceived biohazard exposures, personal protective equipment, and training resources among a sample of formal U.S. solid waste workers: A pilot study. J Occup Environ Hyg 2023; 20:129-135. [PMID: 36786831 DOI: 10.1080/15459624.2023.2179060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
In the United States, the majority of waste workers work with solid waste. In solid waste operations, collection, sorting, and disposal can lead to elevated biohazard exposures (e.g., bioaerosols, bloodborne and other pathogens, human and animal excreta). This cross-sectional pilot study aimed to characterize solid waste worker perception of biohazard exposures, as well as worker preparedness and available resources (e.g., access to personal protective equipment, level of training) to address potential biohazard exposures. Three sites were surveyed: (1) a family-owned, small-scale waste disposal facility, (2) a county-level, recycling-only facility, and (3) an industrial-sized, large-scale facility that contains a hauling and landfill division. Survey items characterized occupational biohazards, resources to mitigate and manage those biohazards, and worker perceptions of biohazard exposures. Descriptive statistics were generated. The majority of workers did not report regularly coming into contact with blood, feces, and bodily fluids (79%). As such, less than one-fifth were extremely concerned about potential illness from biological exposures (19%). Yet, most workers surveyed (71%) reported an accidental laceration/cut that would potentially expose workers to biohazards. This study highlights the need for additional research on knowledge of exposure pathways and perceptions of the severity of exposure among this occupational group.
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Affiliation(s)
- Aurora B Le
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Abas Shkembi
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Anupon Tadee
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Anna C Sturgis
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Shawn G Gibbs
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, Texas
| | - Richard L Neitzel
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan
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Owens C, Le AB, Smith TD, Middlestadt SE. Beliefs of university employees leaving during a fire alarm: A theory-based belief elicitation. Saf Health Work 2023. [DOI: 10.1016/j.shaw.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
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Shkembi A, Le AB, Neitzel RL. Associations between Poorer Mental Health with Work-Related Effort, Reward, and Overcommitment among a Sample of Formal US Solid Waste Workers during the COVID-19 Pandemic. Saf Health Work 2023; 14:93-99. [PMID: 36777106 PMCID: PMC9897872 DOI: 10.1016/j.shaw.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 12/01/2022] [Accepted: 01/29/2023] [Indexed: 02/05/2023] Open
Abstract
Background Effort-reward imbalance (ERI) and overcommitment at work have been associated poorer mental health. However, nonlinear and nonadditive effects have not been investigated previously. Methods The association between effort, reward, and overcommitment with odds of poorer mental health was examined among a sample of 68 formal United States waste workers (87% male). Traditional, logistic regression and Bayesian Kernel machine regression (BKMR) modeling was conducted. Models controlled for age, education level, race, gender, union status, and physical health status. Results The traditional, logistic regression found only overcommitment was significantly associated with poorer mental health (IQR increase: OR = 6.7; 95% CI: 1.7 to 25.5) when controlling for effort and reward (or ERI alone). Results from the BKMR showed that a simultaneous IQR increase in higher effort, lower reward, and higher overcommitment was associated with 6.6 (95% CI: 1.7 to 33.4) times significantly higher odds of poorer mental health. An IQR increase in overcommitment was associated with 5.6 (95% CI: 1.6 to 24.9) times significantly higher odds of poorer mental health when controlling for effort and reward. Higher effort and lower reward at work may not always be associated with poorer mental health but rather they may have an inverse, U-shaped relationship with mental health. No interaction between effort, reward, or overcommitment was observed. Conclusion When taking into the consideration the relationship between effort, reward, and overcommitment, overcommitment may be most indicative of poorer mental health. Organizations should assess their workers' perceptions of overcommitment to target potential areas of improvement to enhance mental health outcomes.
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Affiliation(s)
- Abas Shkembi
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Aurora B Le
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Richard L Neitzel
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
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Lowe AE, Le AB, Gibbs SG. How Should Biocontainment Balance Infection Control With Practice Sustainability? AMA J Ethics 2022; 24:E944-E950. [PMID: 36215186 DOI: 10.1001/amajethics.2022.944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
This case and commentary canvasses clinical, ethical, and public health considerations about integrated infection control and sustainability efforts of biocontainment units (BCUs). BCUs protect the public's health during infectious disease outbreaks, including accounting for downstream health costs of byproducts of patient care that leave a system as waste. However, environmental costs of BCUs' operations tend to get less attention than BCUs' specialized design to contain and control highly infectious pathogens. Human health promotion and environmental protection are values that sometimes complement each other but sometimes conflict in BCU management. When these values conflict, stakeholders must mediate and balance their implications in terms of individuals' immediate short' and long'term needs for health care, public interest in pathogen control and containment, and environmental impact.
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Affiliation(s)
- Abigail E Lowe
- Assistant professor in the College of Allied Health Professions and co-director of the National Disaster Medical System Infectious Disease Training Program for the Global Center for Health Security at the University of Nebraska Medical Center in Omaha
| | - Aurora B Le
- John G. Searle Assistant Professor of Environmental Health Sciences at the University of Michigan School of Public Health in Ann Arbor
| | - Shawn G Gibbs
- Dean of the School of Public Health as well as the dean's chair of and a professor in the Department of Environmental and Occupational Health at Texas A&M University in College Station
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Yu Z, Le AB, Doerr A, Smith TD. Level of Concern, Spending, and External Support Related to COVID-19: A Comparison between Working and Non-Working Older Adults. Int J Environ Res Public Health 2022; 19:11375. [PMID: 36141641 PMCID: PMC9517292 DOI: 10.3390/ijerph191811375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 09/01/2022] [Accepted: 09/06/2022] [Indexed: 06/16/2023]
Abstract
This study compared levels of concern, spending, and use of external support by working status among older adults in the U.S. during the COVID-19 pandemic. It assessed whether work influences these variables related to wellness. Data from 2489 older adults from the 2020 U.S. Health and Retirement Study were analyzed using multiple linear and logistic regression. Older adults who worked had lower concerns about the pandemic (β = -0.28, p = 0.048), were less likely to increase their spending (OR = 0.74, p = 0.041), and were less likely to use external support (OR = 0.50, p < 0.001). Use of external support increased with age (OR = 1.04, p < 0.001) and increased spending (OR = 1.32, p = 0.019). Married older adults were less likely to increase spending (OR = 0.75, p = 0.007) and had lower concerns toward COVID-19 (β = -0.28, p = 0.011). Higher levels of concern were reported among women (β = 0.31, p = 0.005) and participants who had friends or family members diagnosed with COVID-19 (β = 0.51, p < 0.001). Women were more likely to use support (OR = 1.80, p < 0.001). Work appears to bolster older adult wellness outcomes.
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Affiliation(s)
- Zuojin Yu
- Department of Health Sciences, Towson University, Towson, MD 21252, USA
| | - Aurora B. Le
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Alexa Doerr
- KBR Wyle Services, LLC, NASA Johnson Space Center, Houston, TX 77058, USA
| | - Todd D. Smith
- Department of Applied Health Science, School of Public Health, Indiana University—Bloomington, Bloomington, IN 47405, USA
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Shkembi A, Smith LM, Le AB, Neitzel RL. Noise exposure and mental workload: Evaluating the role of multiple noise exposure metrics among surface miners in the US Midwest. Appl Ergon 2022; 103:103772. [PMID: 35500524 DOI: 10.1016/j.apergo.2022.103772] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/16/2022] [Accepted: 04/10/2022] [Indexed: 06/14/2023]
Abstract
This study examined associations between metrics of noise exposure and mental workload. In this cross-sectional study, five occupational noise metrics computed from full-shift dosimetry were evaluated among surface mine workers in the US Midwest. Mental workload was evaluated using a modified, raw NASA-TLX and clustered with a k-means clustering algorithm. Mixed effects logistic regression and Bayesian Kernel Machine Regression (BKMR) was utilized for analysis. Average noise exposure, the difference between peak and mean noise exposure, and the number of peaks >135 dB were each strongly associated with mental workload, while the kurtosis and standard deviation of noise throughout a shift were not. An exposure-response relationship between average noise exposure and mental workload may exist, with elevated risk of high mental workload beginning at 80 dBA. These results suggest that high noise exposure may be an independent risk factor of high mental workload, and impulse events and the difference between the peak and mean noise exposure may have interactive effects with average noise exposure.
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Affiliation(s)
- Abas Shkembi
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, United States
| | - Lauren M Smith
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, United States
| | - Aurora B Le
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, United States
| | - Richard L Neitzel
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, United States.
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13
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Le AB, Rosemberg MS, Sturgis AC, Siracuse BM. Licensure and citations among nail salons in Michigan from 2017 to 2021: A cross‐sectional study of an overlooked and vulnerable industry. Health Sci Rep 2022; 5:e730. [PMID: 35873405 PMCID: PMC9297379 DOI: 10.1002/hsr2.730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 07/04/2022] [Accepted: 07/06/2022] [Indexed: 11/21/2022] Open
Abstract
Background Nail salon workers (NSW) in the United States (U.S.) are predominantly immigrant women who face a number of occupational hazards, such as biological, ergonomic, and chronic chemical exposures. Additionally, there are challenges to keeping up with the latest practices in this evolving small business industry. Licensure requirements are intended to keep not only consumers but also workers safe, however licensure requirements vary between states creating little skill, education, and occupational health and safety knowledge and practice consistency among the nail salon workforce. The current state of nail salons and licensure of workers in the State of Michigan—an overlooked state and region (Midwest) in NSW research—was determined to better characterize this workforce. Methods A Freedom of Information Act request was submitted to the Michigan Department of Licensing and Regulatory Affairs regarding nail salon establishments and their workers, formally termed manicurists, and citation data for breaches. Data were provided on the number of licensed cosmetologists and cosmetology businesses from January 2017 to March 2021. From there, the total number of licensed manicurists was determined, and the cosmetology establishment list was analyzed to see if the businesses exclusively or predominantly provided nail services. Results As of Mach 2021, there were 1372 nail salons that exclusively provided nail services and over 12,000 licensed manicurists. Over half of the disciplinary actions cited were for salons not officially licensed. Michigan has reduced licensure requirements compared to other states and no continuing education (CE) requirements for license renewals. Conclusion There is a need for industry educational and training standardization, across the nation, as well as heightened licensure requirements for these vulnerable workers. CE not only keeps workers abreast of the latest practices in the industry, but also provides them the skills and knowledge to enhance their worker health, safety, and wellbeing.
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Affiliation(s)
- Aurora B. Le
- Department of Environmental Health Sciences, School of Public Health University of Michigan Ann Arbor Michigan USA
| | - Marie‐Anne S. Rosemberg
- Department of Systems, Population and Leadership, School of Nursing University of Michigan Ann Arbor Michigan USA
| | - Anna C. Sturgis
- Department of Environmental Health Sciences, School of Public Health University of Michigan Ann Arbor Michigan USA
| | - Brianna M. Siracuse
- Department of Environmental Health Sciences, School of Public Health University of Michigan Ann Arbor Michigan USA
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Le AB, Shkembi A, Sturgis AC, Tadee A, Gibbs SG, Neitzel RL. Effort-Reward Imbalance among a Sample of Formal US Solid Waste Workers. Int J Environ Res Public Health 2022; 19:ijerph19116791. [PMID: 35682374 PMCID: PMC9179994 DOI: 10.3390/ijerph19116791] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 02/04/2023]
Abstract
Background: Solid waste workers are exposed to a plethora of occupational hazards and may also experience work-related stress. Our study had three specific hypotheses: (1) waste workers experience effort−reward imbalance (ERI) with high self-reported effort but low reward, (2) unionized workers experience greater ERI, and (3) workers with higher income have lower ERI. Methods: Waste workers from three solid waste sites in Michigan participated in this cross-sectional study. We characterized perceived work stress using the short-version ERI questionnaire. Descriptive statistics and linear tests for trend were assessed for each scale. Linear regression models were constructed to examine the relationship between structural factors of work stress and ERI. Gradient-boosted regression trees evaluated which factors of effort or reward best characterize workers’ stress. Results: Among 68 participants, 37% of workers reported high effort and low reward from work (ERI > 1). Constant pressure due to heavy workload was most indicative of ERI among the solid waste workers. Union workers experienced 79% times higher ERI than non-unionized workers, while no significant differences were observed by income, after adjusting for confounders. Conclusions: Organizational-level interventions, such as changes related to workload, consideration of fair compensation, and increased support from supervisors, can decrease work stress.
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Affiliation(s)
- Aurora B. Le
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (A.S.); (A.C.S.); (A.T.); (R.L.N.)
- Correspondence: ; Tel.: +1-734-615-7105
| | - Abas Shkembi
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (A.S.); (A.C.S.); (A.T.); (R.L.N.)
| | - Anna C. Sturgis
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (A.S.); (A.C.S.); (A.T.); (R.L.N.)
| | - Anupon Tadee
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (A.S.); (A.C.S.); (A.T.); (R.L.N.)
| | - Shawn G. Gibbs
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX 77843, USA;
| | - Richard L. Neitzel
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (A.S.); (A.C.S.); (A.T.); (R.L.N.)
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15
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Le AB, Middlestadt SE, Lin HC, Docherty CL, Smith TD. Belief Factors Associated With Employees' Intention to Evacuate During a Fire Alarm. Workplace Health Saf 2022; 70:21650799221093773. [PMID: 35611395 DOI: 10.1177/21650799221093773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Nonresidential fires and resultant injuries and deaths have been on the rise the last decade in the United States. Although evacuation is a primary prevention method, people in the workplace still fail to evacuate when they hear a fire alarm. The current formative study applied the Reasoned Action Approach (RAA) to identify belief factors associated with university employees' intention evacuate. METHODS Data were collected from employees at a large public university (N = 490) through an online survey. Multiple linear regression quantified the relative contribution of six RAA constructs that represent belief factors underlying employees' intention to leave the office building immediately the next time they hear a fire alarm. FINDINGS Nearly 60% of the variation in employees' intention to leave was predicted from the belief factors, adjusted R2 = 0.598, F(17, 472) = 43.80, p < .001. Controlling for demographic characteristics, five of the six RAA global constructs showed statistically significant independent associations with intention: instrumental attitude (B = .272, SE = .026, p < .001), experiential attitude (B = -.073, SE = .026, p = .024), injunctive norm (B = .210, SE = .075, p < .001), descriptive norm (B = .347, SE = .070, p < .001), and capacity (B = .178, SE = .077, p < .001). CONCLUSIONS/APPLICATIONS TO PRACTICE These findings show the RAA can be successfully applied to provide employees' perspective on safety decisions like evacuation. The belief factors' relative contributions can help safety professionals prioritize interventions to facilitate leaving immediately. Here the high weights for the two normative factors suggest addressing employees' descriptive beliefs that others like them leave and their injunctive beliefs that significant others, like supervisors and safety personnel, approve of their leaving.
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Affiliation(s)
- Aurora B Le
- Department of Environmental Health Sciences, University of Michigan School of Public Health
- Department of Applied Health Science
| | | | | | - Carrie L Docherty
- Department of Kinesiology, Indiana University School of Public Health-Bloomington
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16
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Le AB, Perez-Patron M, Ward LM, Comai A, Beam EL, Gibbs SG. Characteristics Associated With Consistent Handwashing and Satisfaction in the Workplace: A Pilot Survey of U.S. Workers. Workplace Health Saf 2022; 70:21650799221082305. [PMID: 35491860 DOI: 10.1177/21650799221082305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND This study seeks to determine what handwashing facilities are available to workers, predominantly in the manufacturing and service industries, to find out if their workplace has the appropriate resources to conduct proper handwashing and how that affects handwashing satisfaction. METHODS This cross-sectional study surveyed U.S. adult workers (N = 241) on their workplace handwashing equipment and facilities. The associations between demographic characteristics, consistent handwashing, and handwashing satisfaction were evaluated using Fisher's exact test. FINDINGS Eighty-eight percent of respondents reported consistent handwashing. Pulling a handle to exit the restroom was negatively associated with handwashing satisfaction (p = .004) and having difficulty with an automatic faucet or dispenser was negatively marginally significant in its association with handwashing consistency (p = .10). CONCLUSION/APPLICATIONS TO PRACTICE Greater understanding of the available equipment in workplace restroom facilities and how to improve selection and use of that equipment may improve workers' handwashing experiences.
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Affiliation(s)
- Aurora B Le
- Department of Environmental Health Sciences, School of Public Health, University of Michigan
| | - Maria Perez-Patron
- Department of Epidemiology and Biostatics, School of Public Health, Texas A&M University
| | - Lauren M Ward
- Department of Environmental Health Sciences, School of Public Health, University of Michigan
| | - Andrew Comai
- College of Nursing, University of Nebraska Medical Center
| | - Elizabeth L Beam
- Health and Safety Department, International Union, United Automobile, Aerospace and Agricultural Implement Workers of America
| | - Shawn G Gibbs
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University
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17
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Le AB, Brown CK, Gibbs SG, Uhrig A, Green AD, Broch Brantsæter A, Herstein JJ, Vasa A, Shugart J, Wilson Egbe W, Lowe JJ. Best practices of highly infectious decedent management: Consensus recommendations from an international expert workshop. J Occup Environ Hyg 2022; 19:129-138. [PMID: 35025726 DOI: 10.1080/15459624.2022.2027427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
With the increasing number of highly infectious disease incidents, outbreaks, and pandemics in our society (e.g., Ebola virus disease, Lassa fever, coronavirus diseases), the need for consensus and best practices on highly infectious decedent management is critical. In January 2020, a workshop of subject matter experts from across the world convened to discuss highly infectious live patient transport and highly infectious decedent management best practices. This commentary focuses on the highly infectious decedent management component of the workshop. The absence of guidance or disparate guidance on highly infectious decedent management can increase occupational safety and health risks for death care sector workers. To address this issue, the authorship presents these consensus recommendations on best practices in highly infectious decedent management, including discussion of what is considered a highly infectious decedent; scalability and storage for casualty events; integration of key stakeholders; infection control and facility considerations; transport; care and autopsy; psychological, ethical, and cultural considerations as well as multi-national care perspectives. These consensus recommendations are not intended to be exhaustive but rather to underscore this overlooked area and serve as a starting point for much-needed conversations.
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Affiliation(s)
- Aurora B Le
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Christopher K Brown
- Division of Emergency Operations, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Shawn G Gibbs
- Department of Environmental and Occupational Health, Texas A&M University School of Public Health, College Station, Texas
| | - Alexander Uhrig
- Department of Infectious Diseases, Pulmonary and Critical Care Medicine, Charité University Medical Center, Berlin, Germany
| | | | - Arne Broch Brantsæter
- Department of Infectious Diseases and Department of Acute Medicine, Oslo University Hospital, Oslo, Norway
| | - Jocelyn J Herstein
- Department of Environmental, Agricultural and Occupational Health, University of Nebraska Medical Center College of Public Health, Omaha, Nebraska
| | | | - Jill Shugart
- Center for State, Tribal, Local and Territorial Support, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Wanda Wilson Egbe
- Department of Health and Human Services, Assistant Secretary for Preparedness and Response, Washington, DC
| | - John J Lowe
- Department of Environmental, Agricultural and Occupational Health, University of Nebraska Medical Center College of Public Health, Omaha, Nebraska
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Abstract
The United States' opioid public health crisis continues having disastrous consequences on communities, including workers and employers. From May 2019 to May 2020, the largest number of drug overdose deaths was recorded over a twelve-month period. The "twindemics" of COVID-19 and opioids underscore the urgent need to address workers' physical and mental health. Although much has been written about the negative impacts of the opioid epidemic on the workplace, few initiatives have focused on primary prevention, addressing work-related root causes of opioid use disorders (e.g., injury, stress) that may lead to prescription or illicit opioid use. We suggest primary prevention efforts to address the connection between workplace hazards and opioid misuse, dependence, and addiction such as examining patterns of work injury and stress with records of opioid prescription. Government funding should be expanded to support primary prevention and research efforts to strengthen the evidence-base to support workplace primary prevention endeavors.
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Affiliation(s)
- Aurora B. Le
- University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Jonathan D. Rosen
- National Clearinghouse for Worker Safety and Health Training, Schenectady, NY, USA
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19
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Herstein JJ, Abdoulaye AA, Jelden KC, Le AB, Beam EL, Gibbs SG, Hewlett AL, Vasa A, Boulter KC, Stentz TL, Kopocis-Herstein KR, ElRayes W, Wichman C, Lowe JJ. A pilot study of core body temperatures in healthcare workers wearing personal protective equipment in a high-level isolation unit. J Occup Environ Hyg 2021; 18:430-435. [PMID: 34383620 DOI: 10.1080/15459624.2021.1949459] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Personal protective equipment used by healthcare workers to mitigate disease transmission risks while caring for patients with high-consequence infectious diseases can impair normal body cooling mechanisms and exacerbate physiological strain. Symptoms of heat strain (e.g., cognitive impairment, confusion, muscle cramping) are especially harmful in the high-risk environment of high-consequence infectious disease care. In this pilot study, the core body temperatures of healthcare workers were assessed using an ingestible, wireless-transmission thermometer while performing patient care tasks common to a high-level isolation unit setting in powered air purifying respirator (PAPR)-level. The objective was to determine the potential for occupational health hazard due to heat stress in an environmentally controlled unit. Maximum core temperatures of the six participants ranged from 37.4 °C (99.3 °F) to 39.9 °C (103.8°F) during the 4-hr shift; core temperatures of half (n = 3) of the participants exceeded 38.5 °C (101.3 °F), the upper core temperature limit. Future investigations are needed to identify other heat stress risks both in and outside of controlled units. The ongoing COVID-19 pandemic offers unique opportunities for field-based research on risks of heat stress related to personal protective equipment in healthcare workers that can lead to both short- and long-term innovations in this field.
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Affiliation(s)
- Jocelyn J Herstein
- College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska
| | | | | | - Aurora B Le
- School of Public Health, University of Michigan, Ann Arbor, Ann Arbor, Michigan
| | - Elizabeth L Beam
- College of Nursing, University of Nebraska Medical Center, Omaha, Nebraska
| | - Shawn G Gibbs
- School of Public Health, Texas A&M University, College Station, Texas
| | - Angela L Hewlett
- College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska
| | | | | | - Terry L Stentz
- College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska
- College of Engineering, University of Nebraska-Lincoln, Lincoln, Nebraska
| | - Kelli R Kopocis-Herstein
- College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska
- College of Engineering, University of Nebraska-Lincoln, Lincoln, Nebraska
| | - Wael ElRayes
- College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska
| | - Chris Wichman
- College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska
| | - John J Lowe
- College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska
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20
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Affiliation(s)
- Aurora B Le
- Aurora B. Le is with the Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor
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21
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Le AB, Herstein JJ. Revisiting the Need for an Infectious Disease Care Network in the United States. Health Secur 2021; 19:240-241. [PMID: 33719548 DOI: 10.1089/hs.2021.0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Aurora B Le
- Aurora B. Le, PhD, MPH, CPH, CSP, is an Assistant Professor, Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI. Jocelyn J. Herstein, PhD, MPH, is Director, Sub-Sahara Africa Region, Global Center for Health Security, and a Research Assistant Professor, Department of Environmental, Agricultural and Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE
| | - Jocelyn J Herstein
- Aurora B. Le, PhD, MPH, CPH, CSP, is an Assistant Professor, Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI. Jocelyn J. Herstein, PhD, MPH, is Director, Sub-Sahara Africa Region, Global Center for Health Security, and a Research Assistant Professor, Department of Environmental, Agricultural and Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE
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22
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Le AB, Wong SW, Lin HC, Smith TD. The association between union membership and perceptions of safety climate among US adult workers. Saf Sci 2021; 133:105024. [PMID: 33052171 PMCID: PMC7544701 DOI: 10.1016/j.ssci.2020.105024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 08/07/2020] [Accepted: 09/28/2020] [Indexed: 05/27/2023]
Abstract
OBJECTIVES An individual's perceptions of their workplace safety climate can influence their health and safety outcomes in the workplace. Even though union membership has been declining in the US, union members still comprise 10% of the working population and have higher-than-industry average non-fatal illness and injury rates. Due to limited research focused in this area, this study examined whether union membership was associated with worker perceptions of safety climate. METHODS This was a secondary data analysis study utilizing data from the Quality Work Life module from the General Social Survey centered on US workers aged 18 and above. Propensity-score matching was implemented to reduce potential selection bias between unionized and non-unionized workers. Linear regression explored the association between union membership and perceptions of safety climate, controlling for age, sex, education, industry, resource adequacy, supervisor support, co-worker support, and workload. RESULTS For perceived safety climate (on a 0-16 scale, the higher the more positive), those in union had a lower mean of perceived safety climate (12.44) compared to those not in a union (13.20). Based on the regression results, those who were in a union reported more negative perceptions of their workplace safety climate in a 12-month period (β = -0.61, p < .001). CONCLUSIONS By demonstrating a commitment to proactive injury prevention and bolstering the business's overall safety performance indicators, businesses who are open to collaborations with unions may see some long-term benefits (e.g. return on investment, increased job satisfaction) and enhance union workers' perceptions of safety climate.
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Affiliation(s)
- Aurora B Le
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA
- Department of Applied Health Science, Indiana University School of Public Health, Bloomington, IN, USA
| | - Su-Wei Wong
- Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center, Houston, TX, USA
| | - Hsien-Chang Lin
- Department of Applied Health Science, Indiana University School of Public Health, Bloomington, IN, USA
| | - Todd D Smith
- Department of Applied Health Science, Indiana University School of Public Health, Bloomington, IN, USA
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23
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B. Le A, McNulty LA, Dyal MA, DeJoy DM, Smith TD. Firefighter Overexertion: A Continuing Problem Found in an Analysis of Non-Fatal Injury Among Career Firefighters. Int J Environ Res Public Health 2020; 17:ijerph17217906. [PMID: 33126593 PMCID: PMC7663299 DOI: 10.3390/ijerph17217906] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 10/19/2020] [Accepted: 10/26/2020] [Indexed: 11/25/2022]
Abstract
Traditionally, safety-related research on firefighting has focused on fires and fireground smoke as the primary source of non-fatal firefighter injury. However, recent research has found that overexertion and musculoskeletal disorders may be the primary source of firefighter injury. This study aimed to provide an update on injury occurrence among career firefighters. Injury data were collected over a two-year period from two large metropolitan fire departments in the U.S. Injury data were categorized based on the Bureau of Labor Statistics’ Occupational Injury and Illness Classification System. Cross-tabulations and Chi-square tests were used to determine the primary causes of injury, as well as the injury region. Between the two fire departments, there were 914 firefighters included in the analysis. The median age was 40.7 years old with those aged 40–49 as the largest age group for injury cases (38.3%). The most frequently reported cause of injury was ‘overexertion and bodily reaction’ (n = 494; 54.1%). The most reported injury region was in ‘multiple body parts’ (n = 331; 36.3%). To prevent subsequent musculoskeletal disorders that may arise due to overexertion, initiatives that promote enhanced fitness and ergonomics based on an analysis of the physical demands of firefighting are suggested.
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Affiliation(s)
- Aurora B. Le
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
- Correspondence: ; Tel.: +1-(734)-615-7105
| | - Lily A. McNulty
- Department of Applied Health Science, Indiana University School of Public Health–Bloomington, Bloomington, IN 47405, USA; (L.A.M.); (T.D.S.)
| | - Mari-Amanda Dyal
- Department of Health Promotion & Physical Education, Kennesaw State University, Kennesaw, GA 30144, USA;
| | - David M. DeJoy
- Department of Health Promotion & Behavior, University of Georgia College of Public Health, Athens, GA 30602, USA;
| | - Todd D. Smith
- Department of Applied Health Science, Indiana University School of Public Health–Bloomington, Bloomington, IN 47405, USA; (L.A.M.); (T.D.S.)
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24
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Herstein JJ, Le AB, McNulty LA, Buehler SA, Biddinger PD, Hewlett AL, Lowe JJ, Gibbs SG. Update on Ebola Treatment Center Costs and Sustainability, United States, 2019. Emerg Infect Dis 2020; 26:1007-1009. [PMID: 32097110 PMCID: PMC7181920 DOI: 10.3201/eid2605.191245] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We surveyed 56 Ebola treatment centers (ETCs) in the United States and identified costs incurred since 2014 ($1.76 million/ETC) and sustainability strategies. ETCs reported heavy reliance on federal funding. It is uncertain if, or for how long, ETCs can maintain capabilities should federal funding expire in 2020.
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25
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Gibbs SG, Herstein JJ, Le AB, Beam EL, Cieslak TJ, Lawler JV, Santarpia JL, Stentz TL, Kopocis-Herstein KR, Achutan C, Carter GW, Lowe JJ. Review of Literature for Air Medical Evacuation High-Level Containment Transport. Air Med J 2019; 38:359-365. [PMID: 31578975 PMCID: PMC7128392 DOI: 10.1016/j.amj.2019.06.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 05/24/2019] [Accepted: 06/13/2019] [Indexed: 05/12/2023]
Abstract
INTRODUCTION Aeromedical evacuation (AE) is a challenging process, further complicated when a patient has a highly hazardous communicable disease (HHCD). We conducted a review of the literature to evaluate the processes and procedures utilized for safe AE high-level containment transport (AE-HLCT) of patients with HHCDs. METHODS A literature search was performed in PubMed/MEDLINE (from 1966 through January 2019). Authors screened abstracts for inclusion criteria and full articles were reviewed if the abstract was deemed to contain information related to the aim. RESULTS Our search criteria yielded 14 publications and were separated based upon publication dates, with the natural break point being the beginning of the 2013-2016 Ebola virus disease epidemic. Best practices and recommendations from identified articles are subdivided into pre-flight preparations, inflight operations, and post-flight procedures. CONCLUSIONS Limited peer-reviewed literature exists on AE-HLCT, including important aspects related to healthcare worker fatigue, alertness, shift scheduling, and clinical care performance. This hinders the sharing of best practices to inform evacuations and equip teams for future outbreaks. Despite the successful use of different aircraft and technologies, the unique nature of the mission opens the opportunity for greater coordination and development of consensus standards for AE-HLCT operations.
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Affiliation(s)
- Shawn G Gibbs
- Department of Environmental and Occupational Health, Indiana University School of Public Health, Bloomington, IN
| | - Jocelyn J Herstein
- Global Center for Health Security, University of Nebraska Medical Center, Omaha, NE; Department of Environmental, Occupational and Agricultural Health, University of Nebraska Medical Center, College of Public Health, Omaha, NE.
| | - Aurora B Le
- Department of Environmental and Occupational Health, Indiana University School of Public Health, Bloomington, IN; Department of Applied Health Science, Indiana University School of Public Health, Bloomington, IN
| | - Elizabeth L Beam
- Global Center for Health Security, University of Nebraska Medical Center, Omaha, NE; Nebraska Biocontainment Unit, Omaha, NE; College of Nursing, University of Nebraska Medical Center, Omaha, NE
| | - Theodore J Cieslak
- Global Center for Health Security, University of Nebraska Medical Center, Omaha, NE; Nebraska Biocontainment Unit, Omaha, NE; Department of Epidemiology, University of Nebraska Medical Center College of Public Health, Omaha, NE
| | - James V Lawler
- Global Center for Health Security, University of Nebraska Medical Center, Omaha, NE; Nebraska Biocontainment Unit, Omaha, NE; Department of Internal Medicine, University of Nebraska Medical Center College of Medicine, Omaha, NE; National Strategic Research Institute, Omaha, NE
| | - Joshua L Santarpia
- Global Center for Health Security, University of Nebraska Medical Center, Omaha, NE; National Strategic Research Institute, Omaha, NE; Department of Microbiology and Pathology, University of Nebraska Medical Center, Omaha, NE
| | - Terry L Stentz
- Department of Environmental, Occupational and Agricultural Health, University of Nebraska Medical Center, College of Public Health, Omaha, NE; The Charles W. Durham School of Architectural Engineering and Construction, University of Nebraska-Lincoln, Lincoln, NE
| | - Kelli R Kopocis-Herstein
- The Charles W. Durham School of Architectural Engineering and Construction, University of Nebraska-Lincoln, Lincoln, NE
| | - Chandran Achutan
- Department of Environmental, Occupational and Agricultural Health, University of Nebraska Medical Center, College of Public Health, Omaha, NE
| | | | - John J Lowe
- Global Center for Health Security, University of Nebraska Medical Center, Omaha, NE; Department of Environmental, Occupational and Agricultural Health, University of Nebraska Medical Center, College of Public Health, Omaha, NE; Nebraska Biocontainment Unit, Omaha, NE
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26
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Herstein JJ, Buehler SA, Le AB, Lowe JJ, Iwen PC, Gibbs SG. Clinical Laboratory Equipment Manufacturer Policies on Highly Hazardous Communicable Diseases. Public Health Rep 2019; 134:332-337. [PMID: 31216938 DOI: 10.1177/0033354919856936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Affiliation(s)
- Jocelyn J Herstein
- 1 Department of Environmental, Agricultural and Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.,2 Global Center for Health Security, University of Nebraska Medical Center, Omaha, NE, USA
| | - Sean A Buehler
- 3 Department of Environmental and Occupational Health, Indiana University School of Public Health, Bloomington, IN, USA
| | - Aurora B Le
- 3 Department of Environmental and Occupational Health, Indiana University School of Public Health, Bloomington, IN, USA
| | - John J Lowe
- 1 Department of Environmental, Agricultural and Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.,2 Global Center for Health Security, University of Nebraska Medical Center, Omaha, NE, USA
| | - Peter C Iwen
- 4 Department of Pathology and Microbiology, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Shawn G Gibbs
- 3 Department of Environmental and Occupational Health, Indiana University School of Public Health, Bloomington, IN, USA
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Gibbs SG, Herstein JJ, Le AB, Beam EL, Cieslak TJ, Lawler JV, Santarpia JL, Stentz TL, Kopocis-Herstein KR, Achutan C, Carter GW, Lowe JJ. Need for Aeromedical Evacuation High-Level Containment Transport Guidelines. Emerg Infect Dis 2019; 25:1033-1034. [PMID: 30741629 PMCID: PMC6478225 DOI: 10.3201/eid2505.181948] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Circumstances exist that call for the aeromedical evacuation high-level containment transport (AE-HLCT) of patients with highly hazardous communicable diseases. A small number of organizations maintain AE-HLCT capabilities, and little is publicly available regarding the practices. The time is ripe for the development of standards and consensus guidelines involving AE-HLCT.
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Le AB, Brooks EG, McNulty LA, Gill JR, Herstein JJ, Rios J, Patlovich SJ, Jelden KC, Schmid KK, Lowe JJ, Gibbs SG. U.S. Medical Examiner/Coroner capability to handle highly infectious decedents. Forensic Sci Med Pathol 2018; 15:31-40. [PMID: 30402743 PMCID: PMC7090777 DOI: 10.1007/s12024-018-0043-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2018] [Indexed: 12/01/2022]
Abstract
In the United States of America, Medical Examiners and Coroners (ME/Cs) investigate approximately 20% of all deaths. Unexpected deaths, such as those occurring due to a deceased person under investigation for a highly infectious disease, are likely to fall under ME/C jurisdiction, thereby placing the ME/C and other morgue personnel at increased risk of contracting an occupationally acquired infection. This survey of U.S. ME/Cs' capabilities to address highly infectious decedents aimed to determine opportunities for improvement at ME/C facilities serving a state or metropolitan area. Data for this study was gathered via an electronic survey. Of the 177 electronic surveys that were distributed, the overall response rate was N = 108 (61%), with 99 of those 108 respondents completing all the questions within the survey. At least one ME/C responded from 47 of 50 states, and the District of Columbia. Select results were: less than half of respondents (44%) stated that their office had been involved in handling a suspected or confirmed highly infectious remains case and responses indicated medical examiners. Additionally, ME/C altered their personal protective equipment based on suspected versus confirmed highly infectious remains rather than taking an all-hazards approach. Standard operating procedures or guidelines should be updated to take an all-hazards approach, best-practices on handling highly infectious remains could be integrated into a standardized education, and evidence-based information on appropriate personal protective equipment selection could be incorporated into a widely disseminated learning module for addressing suspected or confirmed highly infectious remains, as those areas were revealed to be currently lacking.
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Affiliation(s)
- Aurora B Le
- Department of Environmental and Occupational Health, Indiana University School of Public Health, 1025 E. Seventh Street, PH029, Bloomington, IN, 47405, USA. .,Department of Applied Health Science, Indiana University School of Public Health, Bloomington, IN, USA.
| | - Erin G Brooks
- Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,National Association of Medical Examiners (NAME) Ad Hoc Committee for Bioterrorism and Infectious Disease, Walnut Shade, MO, USA
| | - Lily A McNulty
- Department of Applied Health Science, Indiana University School of Public Health, Bloomington, IN, USA
| | - James R Gill
- National Association of Medical Examiners (NAME) Ad Hoc Committee for Bioterrorism and Infectious Disease, Walnut Shade, MO, USA.,Department of Pathology, Yale School of Medicine, New Haven, CT, USA
| | - Jocelyn J Herstein
- Department of Environmental, Agricultural & Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.,Global Center for Health Security, University of Nebraska Medical Center, Omaha, NE, USA
| | - Janelle Rios
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Scott J Patlovich
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.,Office of Safety, Health, Environment and Risk Management, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Katelyn C Jelden
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Kendra K Schmid
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - John J Lowe
- Department of Environmental, Agricultural & Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.,Global Center for Health Security, University of Nebraska Medical Center, Omaha, NE, USA.,Nebraska Biocontainment Unit, Omaha, NE, USA
| | - Shawn G Gibbs
- Department of Environmental and Occupational Health, Indiana University School of Public Health, 1025 E. Seventh Street, PH029, Bloomington, IN, 47405, USA
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Gibbs SG, Lowe JJ, Le AB, Herstein JJ, Biddinger PD. Ebola Virus Disease Preparations Do Not Protect the United States Against Other Infectious Outbreaks. Am J Public Health 2018; 108:1327-1329. [PMID: 30207757 PMCID: PMC6137799 DOI: 10.2105/ajph.2018.304667] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2018] [Indexed: 11/04/2022]
Affiliation(s)
- Shawn G Gibbs
- Shawn Gibbs and Aurora Le are with the Department of Environmental and Occupational Health, Indiana University School of Public Health, Bloomington. John Lowe and Jocelyn Herstein are with the Department of Environmental, Agricultural, and Occupational Health, University of Nebraska Medical Center College of Public Health, and the Nebraska Biocontainment Unit, Nebraska Medicine, Omaha. Paul Biddinger is with Massachusetts General Hospital Boston, and Harvard Medical School, Boston
| | - John J Lowe
- Shawn Gibbs and Aurora Le are with the Department of Environmental and Occupational Health, Indiana University School of Public Health, Bloomington. John Lowe and Jocelyn Herstein are with the Department of Environmental, Agricultural, and Occupational Health, University of Nebraska Medical Center College of Public Health, and the Nebraska Biocontainment Unit, Nebraska Medicine, Omaha. Paul Biddinger is with Massachusetts General Hospital Boston, and Harvard Medical School, Boston
| | - Aurora B Le
- Shawn Gibbs and Aurora Le are with the Department of Environmental and Occupational Health, Indiana University School of Public Health, Bloomington. John Lowe and Jocelyn Herstein are with the Department of Environmental, Agricultural, and Occupational Health, University of Nebraska Medical Center College of Public Health, and the Nebraska Biocontainment Unit, Nebraska Medicine, Omaha. Paul Biddinger is with Massachusetts General Hospital Boston, and Harvard Medical School, Boston
| | - Jocelyn J Herstein
- Shawn Gibbs and Aurora Le are with the Department of Environmental and Occupational Health, Indiana University School of Public Health, Bloomington. John Lowe and Jocelyn Herstein are with the Department of Environmental, Agricultural, and Occupational Health, University of Nebraska Medical Center College of Public Health, and the Nebraska Biocontainment Unit, Nebraska Medicine, Omaha. Paul Biddinger is with Massachusetts General Hospital Boston, and Harvard Medical School, Boston
| | - Paul D Biddinger
- Shawn Gibbs and Aurora Le are with the Department of Environmental and Occupational Health, Indiana University School of Public Health, Bloomington. John Lowe and Jocelyn Herstein are with the Department of Environmental, Agricultural, and Occupational Health, University of Nebraska Medical Center College of Public Health, and the Nebraska Biocontainment Unit, Nebraska Medicine, Omaha. Paul Biddinger is with Massachusetts General Hospital Boston, and Harvard Medical School, Boston
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Abstract
The 2014-2016 Ebola outbreak in West Africa prompted a select group of US hospitals to establish high-level isolation units equipped with advanced engineering controls, trained staff, and stringent protocols to safely treat highly infectious disease patients. This survey details the comprehensive infection control protocols developed by these units, including for decontamination of units, post-mortem management, liquid waste disposal, and personal protective equipment (PPE) use. In spring 2016, a survey was electronically distributed to the 56 original Centers for Disease Control and Prevention (CDC)-designated high-level isolation units. Responses were collected via a fillable PDF and analyzed using descriptive statistics. Thirty-six (64%) high-level isolation units responded; 33 completed the survey, and 3 reported they no longer maintained high-level isolation unit capabilities. Nearly all responding units had written procedures for decontamination, liquid waste disposal, and PPE use; however, infection control protocols varied between units. High-level isolation units implemented multiple strategies in promoting hand hygiene among staff and in monitoring correct PPE use. Maximum time allowed in full PPE was restricted in all but 2 units (average of 3.45 hours per shift). Almost all (94%) had written procedures for the management of human remains, although only 2 units had written protocols for an autopsy of a patient with a highly infectious disease. While the vast majority of high-level isolation units reported having written protocols for infection control practices, staff compliance and procedural application are the true indicators of the state of preparedness. Therefore, rigorous training and staff adherence to infection control practices is critical to minimizing exposure risks.
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Abstract
During the 2014-15 Ebola outbreak in West Africa, the United States responded by stratifying hospitals into 1 of 3 Centers for Disease Control and Prevention (CDC)-designated categories-based on the hospital's ability to identify, isolate, assess, and provide care to patients with suspected or confirmed Ebola virus disease (EVD)-in an attempt to position the US healthcare system to safely isolate and care for potential patients. Now, with the Ebola epidemic quelled, it is crucial that we act on the lessons learned from the EVD response to broaden our national perspective on infectious disease mitigation and management, build on our newly enhanced healthcare capabilities to respond to infectious disease threats, develop a more cost-effective and sustainable model of infectious disease prevention, and continue to foster training so that the nation is not in a vulnerable position once more. We propose the formal creation of a US Highly Infectious Disease Care Network (HIDCN) modeled after 2 previous highly infectious disease consensus efforts in the United States and the European Union. A US Highly Infectious Disease Care Network can provide a common platform for the exchange of training, protocols, research, knowledge, and capability sharing among high-level isolation units. Furthermore, we envision the network will cultivate relationships among facilities and serve as a means of establishing national standards for infectious disease response, which will strengthen domestic preparedness and the nation's ability to respond to the next highly infectious disease threat.
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Le AB, Buehler SA, Maniscalco PM, Lane P, Rupp LE, Ernest E, Von Seggern D, West K, Herstein JJ, Jelden KC, Beam EL, Gibbs SG, Lowe JJ. Determining training and education needs pertaining to highly infectious disease preparedness and response: A gap analysis survey of US emergency medical services practitioners. Am J Infect Control 2018; 46:246-252. [PMID: 29499788 PMCID: PMC7132664 DOI: 10.1016/j.ajic.2017.09.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 09/21/2017] [Accepted: 09/21/2017] [Indexed: 11/19/2022]
Abstract
Gap-analysis survey concerning HID preparedness among U.S. EMS was conducted. Knowledge deficits for exposure routes of notable select HIDs were identified. Results indicate practitioners could gain from updated HID training and education.
Background The Ebola virus disease outbreak highlighted the lack of consistent guidelines and training for workers outside of hospital settings. Specifically, emergency medical services (EMS) workers, who are frequently the first professionals to evaluate patients, often do not have advanced notice of patient diagnosis, and have limited time in their national curricula devoted to highly infectious disease (HID) identification and containment. All of these can place them at increased risk. To explore the depth of US EMS practitioners' HID training and education, a pilot gap analysis survey was distributed to determine where the aforementioned can be bolstered to increase occupational safety. Methods Electronic surveys were distributed to EMS organization members. The survey collected respondent willingness to encounter HID scenarios; current policies and procedures; and levels of knowledge, training, and available resources to address HIDs. Results A total of 2,165 surveys were initiated and collected. Eighty percent of frontline personnel were aware that their agency had an HID standard operating guideline. Almost 85% of respondents correctly marked routes of exposure for select HIDs. More than half of respondents indicated no maximum shift times in personal protective equipment. Discussion This research suggests EMS practitioners could benefit from enhanced industry-specific education, training, and planning on HID mitigation and management. Conclusion Strengthening EMS preparedness in response to suspected or confirmed HID cases may not only improve patient outcomes, but also worker and community safety.
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Affiliation(s)
- Aurora B Le
- Department of Environmental and Occupational Health, Indiana University School of Public Health-Bloomington, Bloomington, IN; Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN.
| | - Sean A Buehler
- Department of Environmental and Occupational Health, Indiana University School of Public Health-Bloomington, Bloomington, IN; Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN
| | - Paul M Maniscalco
- International Association of Emergency Medical Services Chiefs, Washington, DC
| | - Pamela Lane
- National Association of Emergency Medical Technicians, Clinton, MS
| | - Lloyd E Rupp
- Emergency Medical Services, Omaha Fire & Rescue, Omaha, NE
| | - Eric Ernest
- Department of Emergency Medicine, University of Nebraska Medical Center, Omaha, NE
| | - Debra Von Seggern
- Center for Continuing Education, EMS and Trauma Program, University of Nebraska Center, Omaha, NE
| | - Katherine West
- Infection Control/Emerging Concepts, Inc, Alexandria, VA
| | - Jocelyn J Herstein
- Department of Environmental, Agricultural & Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE
| | - Katelyn C Jelden
- College of Medicine, University of Nebraska Medical Center, Omaha, NE
| | - Elizabeth L Beam
- College of Nursing, University of Nebraska Medical Center, Omaha, NE; Nebraska Biocontainment Unit, University of Nebraska Medical Center, Omaha, NE
| | - Shawn G Gibbs
- Department of Environmental and Occupational Health, Indiana University School of Public Health-Bloomington, Bloomington, IN
| | - John J Lowe
- Department of Environmental, Agricultural & Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE; Nebraska Biocontainment Unit, University of Nebraska Medical Center, Omaha, NE
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Herstein JJ, Biddinger PD, Gibbs SG, Le AB, Jelden KC, Hewlett AL, Lowe JJ. Sustainability of High-Level Isolation Capabilities among US Ebola Treatment Centers. Emerg Infect Dis 2018; 23:965-967. [PMID: 28518036 PMCID: PMC5443454 DOI: 10.3201/eid2306.170062] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
To identify barriers to maintaining and applying capabilities of US high-level isolation units (HLIUs) used during the Ebola virus disease outbreak, during 2016 we surveyed HLIUs. HLIUs identified sustainability challenges and reported the highly infectious diseases they would treat. HLIUs expended substantial resources in development but must strategize models of sustainability to maintain readiness.
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Le AB, Hoboy S, Germain A, Miller H, Thompson R, Herstein JJ, Jelden KC, Beam EL, Gibbs SG, Lowe JJ. A pilot survey of the U.S. medical waste industry to determine training needs for safely handling highly infectious waste. Am J Infect Control 2018; 46:133-138. [PMID: 28958444 PMCID: PMC7132720 DOI: 10.1016/j.ajic.2017.08.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 08/15/2017] [Accepted: 08/15/2017] [Indexed: 11/12/2022]
Abstract
Waste management is overlooked in the containment of highly infectious pathogens. Complexities of category A waste deter facilities' willingness to accept the waste. Enhanced training on properly handling and transporting category A waste is urged.
Background The recent Ebola outbreak led to the development of Ebola virus disease (EVD) best practices in clinical settings. However, after the care of EVD patients, proper medical waste management and disposal was identified as a crucial component to containing the virus. Category A waste—contaminated with EVD and other highly infectious pathogens—is strictly regulated by governmental agencies, and led to only several facilities willing to accept the waste. Methods A pilot survey was administered to determine if U.S. medical waste facilities are prepared to handle or transport category A waste, and to determine waste workers' current extent of training to handle highly infectious waste. Results Sixty-eight percent of survey respondents indicated they had not determined if their facility would accept category A waste. Of those that had acquired a special permit, 67% had yet to modify their permit since the EVD outbreak. This pilot survey underscores gaps in the medical waste industry to handle and respond to category A waste. Furthermore, this study affirms reports a limited number of processing facilities are capable or willing to accept category A waste. Conclusions Developing the proper management of infectious disease materials is essential to close the gaps identified so that states and governmental entities can act accordingly based on the regulations and guidance developed, and to ensure public safety.
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Le AB, Witter L, Herstein JJ, Jelden KC, Beam EL, Gibbs SG, Lowe JJ. A gap analysis of the United States death care sector to determine training and education needs pertaining to highly infectious disease mitigation and management. J Occup Environ Hyg 2017; 14:674-680. [PMID: 28609169 DOI: 10.1080/15459624.2017.1319570] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
PURPOSE A United States industry-specific gap analysis survey of the death care sector-which comprises organizations and businesses affiliated with the funeral industry and the handling of human remains- was developed, the results analyzed, and training and education needs in relation to highly infectious disease mitigation and management were explored in an effort to identify where occupational health and safety can be enhanced in this worker population. METHODS Collaborating national death care organizations distributed the 47-question electronic survey. N = 424 surveys were initiated and results recorded. The survey collected death care sector-specific information pertaining to the comfortability and willingness to handle highly infectious remains; perceptions of readiness, current policies and procedures in place to address highly infectious diseases; current highly infectious disease training levels, available resources, and personal protective equipment. RESULTS One-third of respondents have been trained on how to manage highly infectious remains. There was a discrepancy between Supervisor/Management and Employee/Worker perceptions on employees' willingness and comfortability to manage potentially highly infectious remains. More than 40% of respondents did not know the correct routes of transmission for viral hemorrhagic fevers. CONCLUSIONS Results suggest death care workers could benefit from increasing up-to-date industry-specific training and education on highly infectious disease risk mitigation and management. Professional death care sector organizations are positioned to disseminate information, training, and best practices.
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Affiliation(s)
- Aurora B Le
- a Department of Environmental Health and Occupational Health , Indiana University School of Public Health , Bloomington , Indiana
| | - Lesley Witter
- b Advocacy, National Funeral Directors Association (NFDA) , Brookfield , Wisconsin
| | - Jocelyn J Herstein
- c Department of Environmental, Occupational and Agricultural Health, College of Public Health , University of Nebraska Medical Center , Omaha , Nebraska
| | - Katelyn C Jelden
- d College of Medicine , University of Nebraska Medical Center , Omaha , Nebraska
| | - Elizabeth L Beam
- e Nebraska Biocontainment Unit , Omaha , Nebraska
- f College of Nursing , University of Nebraska Medical Center , Omaha , Nebraska
| | - Shawn G Gibbs
- a Department of Environmental Health and Occupational Health , Indiana University School of Public Health , Bloomington , Indiana
| | - John J Lowe
- c Department of Environmental, Occupational and Agricultural Health, College of Public Health , University of Nebraska Medical Center , Omaha , Nebraska
- e Nebraska Biocontainment Unit , Omaha , Nebraska
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