Shift Work Predicts Increases in Lipopolysaccharide-Binding Protein, Interleukin-10, and Leukocyte Counts in a Cross-Sectional Study of Healthy Volunteers Carrying Low-Grade Systemic Inflammation

The disruption of inflammatory responses is a potential mechanism behind the harmful effects of shift work and is associated with increased risk of hypertension, stroke, obesity, diabetes, and cancer. These responses are linked to the proliferation of leukocytes in shift workers, suggesting a systemic signal as a potential mediator. The purpose of this study was to assess the relationship between systemic inflammation, leukocyte counts, and systemic endotoxemia in samples from a diverse cohort of day workers and shift workers. Participants (normothermic and normotensive) were healthy volunteers, non-smoking, and drug- and medication-free. The following outcomes were measured: C-reactive protein, TNF-α, IL-6, IL-1β, IL-10, leukocyte counts (monocytes, lymphocytes, and neutrophils), and lipopolysaccharide-binding protein (LBP). Risk factors that increase systemic inflammation, such as blood pressure, sleep loss, and cortisol, were also assessed. The results indicated that shift workers slept significantly less than day workers and had significantly increased concentrations of all of the cytokines measured as well as plasma cortisol. Regression models found that after controlling for covariates, shift-work exposure predicted the significant increase observed in IL-10, leukocyte counts, and LBP. Our results suggest that acute increases in low-grade systemic endotoxemia are unresolved during chronic shift-work exposure. This ongoing immune challenge may underlie the disrupted inflammatory responses characteristic of shift-work-related pathologies. Systemic endotoxemia may represent a novel target to investigate the early effects of exposure to shift-work schedules.

NanoSafe III: A User Friendly Safety Management System for Nanomaterials in Laboratories and Small Facilities

Research in nanoscience continues to bring forward a steady stream of new nanomaterials and processes that are being developed and marketed. While scientific committees and expert groups deal with the harmonization of terminology and legal challenges, risk assessors in research labs continue to have to deal with the gap between regulations and rapidly developing information. The risk assessment of nanomaterial processes is currently slow and tedious because it is performed on a material-by-material basis. Safety data sheets are rarely available for (new) nanomaterials, and even when they are, they often lack nano-specific information. Exposure estimations or measurements are difficult to perform and require sophisticated and expensive equipment and personal expertise. The use of banding-based risk assessment tools for laboratory environments is an efficient way to evaluate the occupational risks associated with nanomaterials. Herein, we present an updated version of our risk assessment tool for working with nanomaterials based on a three-step control banding approach and the precautionary principle. The first step is to determine the hazard band of the nanomaterial. A decision tree allows the assignment of the material to one of three bands based on known or expected effects on human health. In the second step, the work exposure is evaluated and the processes are classified into three “nano” levels for each specific hazard band. The work exposure is estimated using a laboratory exposure model. The result of this calculation in combination with recommended occupational exposure limits (rOEL) for nanomaterials and an additional safety factor gives the final “nano” level. Finally, we update the technical, organizational, and personal protective measures to allow nanomaterial processes to be established in research environments.

Assessment of One Health Knowledge, Animal Welfare Implications, and Emergency Preparedness Considerations for Effective Public Health Response

Objectives Information on knowledge of public health professionals about health aspects of the human–animal interface, referred to as One Health, is limited. The objective of this study was to identify factors associated with animal welfare attitudes, practices, and One Health awareness among US Public Health Service (USPHS) officers to assess preparedness for public health response. Methods USPHS officers participated in an online, self-administered survey from February 15 through March 2, 2018. A total of 1133 of 6474 (17.5%) USPHS officers responded. We collected information on officers’ demographic characteristics, animal welfare attitudes and practices, volunteer and work exposure to animals, and One Health knowledge. We compared (1) One Health knowledge and animal work exposure (deployment, regular assignment, or none) and (2) animal welfare importance and animal work exposure. To adjust for demographic characteristics associated with One Health knowledge, we used multivariable logistic regression. Results One-third of nonveterinary officers reported encountering animals during deployment, and 65% reported that animal welfare was very or extremely important. We found no difference in One Health knowledge between nonveterinary officers who participated in deployments involving animals and nonveterinary officers who had no work exposure to animals (adjusted odds ratio [aOR] = 1.11; 95% CI, 0.71-1.75). Nonveterinary officers who participated in animal-related public health activities during regular assignment were more likely to have One Health knowledge than nonveterinary officers who had no work exposure to animals (aOR = 7.88; 95% CI, 5.36-11.59). Conclusions One Health knowledge and awareness should be further explored in the current US public health workforce to identify training needs for emergency preparedness and other collaborative opportunities.

Health Care Acquired COVID-19 is Less Symptomatic than Community Acquired Disease Among Healthcare Workers

ABSTRACT Objective: We hypothesized healthcare workers (HCW) with high-risk exposures outside the healthcare system would have less asymptomatic coronavirus 2019 (COVID-19) disease and more symptoms than those without such exposures. Design: A longitudinal point prevalence study during August 17- September 4 2020 and December 2nd - 23rd. Setting: Community based teaching health system Participants: All HCS were invited to participate. Among HCW who acquired COVID-19, logistic regression models were used to evaluate the adjusted odds of asymptomatic disease using high-risk exposure outside the healthcare system as the explanatory variable. The number of symptoms between exposure groups was evaluated with the Wilcoxon rank-sum test. The risk of seropositivity among all HCS by work exposure was evaluated during both periods. Interventions: Survey and serological testing Result: Seroprevalence increased from 1.9% (95% CI 1.2% - 2.6%) to 13.7% (95% CI 11.9% - 15.5%) during the study. Only during Period 2 did HCW with the highest work exposure (versus low exposure) have an increased risk of seropositivity (RD 7% [95% CI 1% -13%]). Participants who had a high-risk exposure outside of work (compared to those without) had a decreased probability of asymptomatic disease (OR 0.38 [95% CI 0.16 – 0.86]) and demonstrated more symptoms (median of 3 [IQR 5] vs 1 [IQR 2]; P = 0.001). Conclusions Health care acquired COVID-19 increases the probability of asymptomatic or mild COVID-19 disease compared to community acquired disease. This suggests infection prevention strategies (including masks and eye protection) may be mitigating inoculum and supports the variolation theory in COVID-19.

Vaccine Hesitancy among Italian Patients Recovered from COVID-19 Infection towards Influenza and Sars-Cov-2 Vaccination

We aimed to assess the attitude towards influenza and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccinations among coronavirus disease 2019 (COVID-19) recovered patients. We performed a cross-sectional study consisting of a standardized telephone interview carried out between September and November 2020 targeting a cohort of adult in- and out-patients that had recovered from COVID-19 after the first wave (March–May 2020) at Udine Hospital (Italy). Overall, 599 people participated (320 female, median age 53 years) and most had experienced an acute COVID-19 with mild illness (409, 68.3%). The majority were hesitant or undecided towards influenza (327, 54.6%) and SARS-CoV-2 (353, 59.2%) vaccines. Older age, public work exposure, and previous 2019 flu shots were the main factors associated with a positive attitude toward both vaccinations (p < 0.05). Being hospitalized during the acute COVID-19 phase was associated with the willingness to get a flu shot (94/272, 34.5%) but not SARS-CoV-2 vaccine (70/244, 28.7%). Vaccine hesitancy is diffuse and multifactorial also among COVID-19 recovered.

Effect of occupational exposure to shock and vibration on health in high-performance marine craft occupants

Working conditions of High-performance Marine Craft (HPMC) occupants are inherent with shock and vibration. Therefore, HPMC occupants are usually investigated believing that their psychophysical health and performance are negatively affected by exposure to these conditions. However, the association between the regular occupational vibration exposures of HPMC occupants and the deterioration of their health and performance is disputable. Therefore, a sample of HPMC occupants are investigated in a prospective cohort study by measuring perceived work exposure, health and performance via validated web-based questionnaires and physical work exposure as vibration using measurement systems installed onboard their craft. Incidence of musculoskeletal pain (MSP) during four operational seasons is determined and presented as incidence proportion (IP). Association between accumulated vibration exposure aboard HPMC and incidence of MSP is systematically assessed using multiple logistic regression models and expressed as odds ratio (OR). Moreover, the correlation between objectively and subjectively measured vibration exposures is determined using the Spearman’s rank correlation coefficient ( rs). Incidence proportion of neck pain was 63.4% and that of lower back pain ranged from 12.5% to 87.5% over the four seasons. The accumulated vibration exposure was strongly associated with the incidence of MSP primarily with lower back pain. However, the association was not statistically significant. The objective and subjective vibration exposures of the craft drivers showed a statistically significant positive monotonic correlation. The study suggests that occupational exposure to shock and vibration aboard HPMC is a factor increasing the incidence of MSP. The HPMC occupants regularly experience attrition in their performance. The perceived vibration exposure of the drivers can be used to rank the exposure severity aboard HPMC in the absence of objective measurements. The current vibration exposure assessment methods are also recommended to be revised accounting for shock and vibration inherent in HPMC exposures.

Work Exposure to VOC in Storage Areas of Retail Stores

Poor indoor air quality (IAQ) has been linked to airway disease and early deaths. The ESQUISSE study of IAQ conducted by the French Research and Safety Institute (INRS), characterized the concentrations of various volatile organic compounds (VOCs) in 10 retail stores and storage areas. The IAQ was generally better in sales areas than storage areas, which are more often unventilated and overloaded with new products. For example, in clothing stores, formaldehyde concentrations between 29.0 and 45.0 µg m−3 were measured in non-ventilated storage areas located in the basement; in sales areas, concentrations did not exceed 10.2 µg m−3. Similarly, total VOC (TVOC) concentrations in the two main storage areas were 1153 and 1223 µg m−3 toluene equivalent, whereas they were less than 77.0 µg m−3 toluene equivalent in all sales areas. Many employees work in these high-exposure areas either temporarily or for the entire day, unpacking boxes, placing products on shelves, or collecting products. Reporting primarily on formaldehyde, toluene, or TVOC concentrations, this article shows, in addition to the distinction between sales and storage areas, how an unpacking task can affect an employee’s exposure, and an example of the impact of ambient temperature on VOC concentrations. The results presented clearly highlight the issue of occupational exposure of workers in storage areas.

Work exposure and associated risk of hospitalisation with pneumonia and influenza: A nationwide study

Background: Pneumonia and influenza are major health concerns and constitute a high economic burden. However, few data are available on the associated risk of pneumonia and influenza and work exposure on a large population scale. Aim: This study aimed to examine the associated risk of pneumonia and influenza by type of work exposure. Methods: By cross-linking administrative Danish registries, we classified people in 10 different profession types. The main outcome was hospitalisation with pneumonia or influenza. A multivariable Poisson regression analysis was used to assess the associated incidence rate ratio (IRR) of being hospitalised with pneumonia or influenza by type of profession. Results: A total of 1,327,606 people added risk time to the analyses. In a multivariable model, work in day care, public transportation, sewers and nursing home care was associated with an increased risk of hospitalisation with pneumonia compared to work within public administration: IRR=1.20 (95% confidence interval (CI) 1.12–1.28), IRR=1.21 (95% CI 1.09–1.34), IRR=1.61 (95% CI 1.19–2.19) and IRR=1.10 (95% CI 1.03–1.18), respectively. In a multivariable analysis, people working within public transportation were associated with an increased risk of hospitalisation with influenza compared to people working within public administration: IRR=2.54 (95% CI 1.79–3.58). Conclusions: Working in day care, public transportation, sewers and nursing home care increased the associated risk of hospitalisation with pneumonia, and working within public transportation increased the associated risk of being hospitalised with influenza compared to working within public administration.

Work profiles of older employees in Germany-results from the lidA-cohort study

Background This study investigates whether a typology of work exposure can be established among older workers in Germany. Work exposure comprises physical work, working time quality, work intensity, skills & discretion, social environment, leadership, continued education, earnings and work prospects. Methods Latent profile analysis was conducted on a representative sample of the socially insured workforce in Germany born in 1959 or 1965 (N = 6277). Seven year-prospective associations between the typology and work-related outcomes (physical and mental health, work ability and work-privacy-conflict) were investigated to establish the distinctness of the profiles. Results Five profiles were identified: “Poor Quality” (19%), “Relaxed Manuals” (30%), “Strained non-Manuals” (16%), “Smooth Running” (33%) and “High Flying” (3%). These profiles exhibited diverging patterns of association with the selected outcomes, thus representing qualitatively distinct subgroups of older workers in Germany. Conclusions We conclude that a typological approach may broaden the understanding of the ageing work force and the complex interplay of the overall work situation with outcomes of high individual and social relevance such as health, work ability and employment. The five work profiles identified in this study may constitute crucial clusters needed to reliably mirror today’s over-all work exposure patterns in the older work force in Germany. They may allow for the comprehensible monitoring of quality of work and personal life among the older work force during their last working years and their transition to retirement in current times of extending working lives.