Work-related factors of mental health among Chicago residents two years into the COVID-19 pandemic.

The COVID-19 pandemic led to widespread consequences for economic, social, and general wellbeing with rates of anxiety and depression increasing across the population and disproportionately for some workers. This study explored which factors were the most salient contributors to mental health through a cross-sectional 68-item questionnaire that addressed topics related to the pandemic. Data were collected through an address-based sampling frame over the two months from April 2022 to June 2022. A total of 2,049 completed surveys were collected throughout Chicago's 77 Community Areas. Descriptive statistics including frequency and percentages were generated to describe workplace characteristics, work-related stress, and sample demographics and their relationship to psychological distress. Independent participant and workplace factors associated with the outcomes were identified using multivariable logistic regression. The weighted prevalence of persons experiencing some form of psychological distress from mild to serious was 32%. After adjusting for potential confounding factors, certain marginalized communities experienced psychological distress more than others including females, adults over the age of 25 years of age, and people with higher income levels. Those who had been laid off, lost pay, or had reduced hours had increased odds of psychological distress (aOR = 1.71, CI95% 1.14-2.56; p = 0.009) as did people that reported that their work-related stress was somewhat or much worse as compared to before the COVID-19 pandemic (aOR = 2.22, CI95% 1.02-4.82; p = 0.04, aOR = 11.0, CI95% 4.65-26.1; p < 0.001, respectively). These results warrant further investigation and consideration in developing workplace and mental health interventions.

The Effects of Interpersonal Violence on Sleep Following the COVID-19 Stay-at-Home Order.

PURPOSE: Lack of sleep is a harm that can lead to chronic diseases ranging from diabetes to heart disease. We examined the exposure to interpersonal violence and its association with sleep, following the COVID-19 stay-at-home order. DESIGN: Cross-sectional. SETTING: Surveys were completed online and via paper-and-pencil in English and Spanish (N = 2049; RR = 68.4%). SUBJECTS: Respondents were 18+ and residing in Chicago. MEASURES: The Chicago Department of Public Health's "2022 Healthy Chicago Survey COVID-19 Social Impact Survey". ANALYSIS: We developed two weighted models. Model 1 examined the effects of neighborhood violence on meeting the national sleep recommendation. Model 2 examined the effects of violence in the home among friends or family on meeting the sleep recommendation, incorporating additional predictors: victimization, stress, gender, race/ethnicity, household income, and general health. Odds ratios were estimated using multivariate logistic regression. RESULTS: Exposure to neighborhood violence and sleep was not significant, but knowing a friend or family member who experienced violence or mistreatment in their home affected the odds of meeting the sleep recommendation (OR = .61, 95% CI = .44-.84). Non-Hispanic Blacks had 52% lower odds of meeting sleep recommendations (OR = .48, 95% CI = .37-.63). CONCLUSION: Addressing the harms to sleep that followed COVID-19 should engage diverse stakeholders in implementing culturally responsive interventions to promote adequate sleep and prevent chronic disease.

Influenza and Pneumonia Mortality Across the 30 Biggest U.S. Cities: Assessment of Overall Trends and Racial Inequities.

Influenza and pneumonia account for substantial morbidity in the United States and show a demonstrated racial inequity. Detailed race-specific analysis at the city level can be used to guide targeted prevention efforts within the most at-risk communities. The purpose of this study is to analyze city-level data of influenza/pneumonia mortality rates and racial disparities across the 30 biggest U.S. cities over time. We assess racial inequities in influenza/pneumonia mortality in the 30 biggest cities and compare city-level trends overtime through age-adjusted overall and race-specific mortality rates calculated from public death records for the years 2008-2017. The national influenza/pneumonia mortality rate significantly decreased as did 45% of the cities included in the study. Nationally, the Black mortality rate was 16% higher than White mortality rate, and a significant disparity was seen within about one-third of the biggest cities. Over half (56%) of the cities showed reductions in both Black and White mortality; however, there was no overall trend in racial equity with some cities reducing the inequities between the Blacks and Whites and others increasing the inequities. Elevated mortality rates in communities of color can be traced to structural racism, social factors, and access to treatment and prevention services. We recommend an approach utilizing community outreach administered through localized public health organizations and supported by data at the city level.

Assessing Occupational Stressors in Restaurant Work Prior to and During the COVID-19 Pandemic: An Exploratory Analysis.

OBJECTIVE: This exploratory study investigated occupational stress in restaurant work prior to and during the COVID-19 pandemic. METHODS: The study was a mixed methods design conducted in two phases with biomarker data for stress, questionnaire data, and semi-structured interviews. RESULTS: Results indicated elevated stressors elevated stress during normal shift conditions (P < 0.05), low job satisfaction, an effort to reward imbalance (P < 0.05), and the majority (72%, n = 28) of participants reporting discrimination at least a "few times a year." Interview data revealed four interrelated occupational stressors including: (1) financial hardships; (2) increased exposure to occupational health risks during the reopening phases; (3) increased workloads due to inadequate staffing and fewer hours; and (4) social and psychological pressures and ill treatment. CONCLUSION: These elements were reported prior to the COVID-19 pandemic and have persisted throughout with heightened impacts.

The Impact of the COVID-19 Pandemic on Occupational Stress in Restaurant Work: A Qualitative Study.

The economic downturn due to the COVID-19 pandemic disproportionately impacted the food service industry-one of the largest workforce sectors in the United States. The purpose of this qualitative study was to explore the occupational stressors experienced by restaurant and food service workers during the COVID-19 pandemic through a detailed assessment of their lived experiences. Thematic analysis was used to identify patterns within data from sixteen semi-structured interviews with people employed or recently employed in the restaurant industry during July of 2020. Five themes were highlighted including fear of being exposed to the COVID-19 virus while working under inadequate safety policies, job insecurity, inconsistent pay and hours and a lack of health benefits and paid time off, all of which increased occupational stress and led to uncertainty if respondents would return to the restaurant industry. Hardships associated with the pandemic were mitigated by the support and connections fostered by the communities built within the restaurants. Results led to several recommendations to address the social and economic contributors to occupational stress at the structural and population levels which can be used in the current and post-pandemic workplace.

Characterization of size-specific particulate matter emission rates for a simulated medical laser procedure--a pilot study.

Prior investigation on medical laser interaction with tissue has suggested device operational parameter settings influence laser generated air contaminant emission, but this has not been systematically explored. A laboratory-based simulated medical laser procedure was designed and pilot tested to determine the effect of laser operational parameters on the size-specific mass emission rate of laser generated particulate matter. Porcine tissue was lased in an emission chamber using two medical laser systems (CO2, λ = 10,600 nm; Ho:YAG, λ = 2100 nm) in a fractional factorial study design by varying three operational parameters (beam diameter, pulse repetition frequency, and power) between two levels (high and low) and the resultant plume was measured using two real-time size-selective particle counters. Particle count concentrations were converted to mass emission rates before an analysis of variance was used to determine the influence of operational parameter settings on size-specific mass emission rate. Particle shape and diameter were described for a limited number of samples by collecting particles on polycarbonate filters, and photographed using a scanning electron microscope (SEM) to examine method of particle formation. An increase in power and decrease in beam diameter led to an increase in mass emission for the Ho:YAG laser at all size ranges. For the CO2 laser, emission rates were dependent on particle size and were not statistically significant for particle ranges between 5 and 10 µm. When any parameter level was increased, emission rate of the smallest particle size range also increased. Beam diameter was the most influential variable for both lasers, and the operational parameters tested explained the most variability at the smallest particle size range. Particle shape was variable and some particles observed by SEM were likely created from mechanical methods. This study provides a foundation for future investigations to better estimate size-specific mass emission rates and particle characteristics for additional laser operational parameters in order to estimate occupational exposure, and to inform control strategies.

Modeled occupational exposures to gas-phase medical laser-generated air contaminants.

Exposure monitoring data indicate the potential for substantive exposure to laser-generated air contaminants (LGAC); however the diversity of medical lasers and their applications limit generalization from direct workplace monitoring. Emission rates of seven previously reported gas-phase constituents of medical laser-generated air contaminants (LGAC) were determined experimentally and used in a semi-empirical two-zone model to estimate a range of plausible occupational exposures to health care staff. Single-source emission rates were generated in an emission chamber as a one-compartment mass balance model at steady-state. Clinical facility parameters such as room size and ventilation rate were based on standard ventilation and environmental conditions required for a laser surgical facility in compliance with regulatory agencies. All input variables in the model including point source emission rates were varied over an appropriate distribution in a Monte Carlo simulation to generate a range of time-weighted average (TWA) concentrations in the near and far field zones of the room in a conservative approach inclusive of all contributing factors to inform future predictive models. The concentrations were assessed for risk and the highest values were shown to be at least three orders of magnitude lower than the relevant occupational exposure limits (OELs). Estimated values do not appear to present a significant exposure hazard within the conditions of our emission rate estimates.

A pilot study to determine medical laser generated air contaminant emission rates for a simulated surgical procedure.

The U.S. Occupational Safety and Health Administration (OSHA) estimates that half a million health-care workers are exposed to laser surgical smoke each year. The purpose of this study was to establish a methodology to (1) estimate emission rates of laser-generated air contaminants (LGACs) using an emission chamber, and to (2) perform a screening study to differentiate the effects of three laser operational parameters. An emission chamber was designed, fabricated, and assessed for performance to estimate the emission rates of gases and particles associated with LGACs during a simulated surgical procedure. Two medical lasers (Holmium Yttrium Aluminum Garnet [Ho:YAG] and carbon dioxide [CO2]) were set to a range of plausible medical laser operational parameters in a simulated surgery to pyrolyze porcine skin generating plume in the emission chamber. Power, pulse repetition frequency (PRF), and beam diameter were evaluated to determine the effect of each operational parameter on emission rate using a fractional factorial design. The plume was sampled for particulate matter and seven gas phase combustion byproduct contaminants (benzene, ethylbenzene, toluene, formaldehyde, hydrogen cyanide, carbon dioxide, and carbon monoxide): the gas phase emission results are presented here. Most of the measured concentrations of gas phase contaminants were below their limit of detection (LOD), but detectable measurements enabled us to determine laser operation parameter influence on CO2 emissions. Confined to the experimental conditions of this screening study, results indicated that beam diameter was statistically significantly influential and power was marginally statistically significant to emission rates of CO2 when using the Ho:YAG laser but not with the carbon dioxide laser; PRF was not influential vis-a-vis emission rates of these gas phase contaminants.

An assessment of the occupational hazards related to medical lasers.

OBJECTIVE: Occupational hazards associated with medical laser applications remain poorly understood and uncharacterized. METHODS: A literature search was performed using PubMed, and all articles relevant to beam and nonbeam medical laser hazards were reviewed. The Rockwell Laser Industries Laser Accident Database was searched for medical laser injuries and abstracted. RESULTS: Eye injuries, skin burns, injuries related to the onset of fires, and electric shock have been reported in relation to medical laser use. It is probable that both acute and chronic health effects have been experienced by medical personnel as the result of exposure to laser generated air contaminants. CONCLUSIONS: Because of the clinical benefits they provide, the growth of laser technologies and applications are anticipated to result in an increase in the number and type of medical personnel with future exposure to laser hazards.

Laser-generated air contaminants from medical laser applications: a state-of-the-science review of exposure characterization, health effects, and control.

The clinical use of lasers in surgery began in 1973 with applications of the carbon dioxide laser in otolaryngology, and since then the use of lasers has become commonplace in many medical and surgical specialties. Nonetheless, when biological tissue is subjected to laser radiation, the target cells can be vaporized, resulting in the aerosolization of their contents and the subsequent exposure of health care workers to laser-generated air contaminants (LGACs). The purpose of our analysis was to summarize and present all of the published literature pertaining to the laser-induced plume chemical and physical composition, health effects, and methods of control. The objective was to identify knowledge gaps within exposure science to set a research agenda for the protection of health care personnel exposed to LGACs. A literature search was performed using the PubMed database using a variety of search strategies and keyword combinations. To locate additional studies, we systematically searched the reference lists of all studies identified by our search, as well as key review papers. To date, researchers have identified roughly 150 chemical constituents of plume, as well as fine and ultrafine particulate matter, which has been shown to include viable cellular material, viruses, and bacteria. However, very few studies have attempted to characterize the effects of laser system type, power, and tissue treated, as it relates to LGAC exposure. Furthermore, current control strategies do not appear to be adequate in preventing occupational exposure to LGACs.

Magnetic field exposure in a nondestructive testing operation.

Nondestructive testing is any technique used to inspect the integrity of a manufactured item without diminishing its future usefulness. Magnetic particle inspection is one type of nondestructive testing that uses electromagnetism in the inspection procedure, thus potentially exposing the operator to magnetic fields. During magnetic particle inspection, investigators took peak magnetic field measurements of 8 turbine engine shafts at a turbine engine overhaul and repair center. They recorded 95 peak magnetic field measurements, ranging from < 0.1 to 29.27 mT. The exposure values measured were among the highest reported in the occupational setting. Further work is needed to characterize magnetic field exposures in magnetic particle inspection operations--in particular, by differentiating magnetic field magnitude by current frequency--and to understand exposure as it relates to different types of magnetic particle inspection devices.