Both biofilm cytotoxicity and monocytes' adhesion may be used as estimators of enterococcal virulence.

Our study aimed to identify markers of enterococci's virulence potential by evaluating the properties of strains of different sites of isolation. Enterococcal strains were isolated as commensals from faeces and as invasive strains from the urine and blood of patients from the University Clinical Centre, Gdansk, Poland. Changes in monocytes' susceptibility to the cytotoxic activity of isolates of different origins and their adherence to biofilm were evaluated using a flow cytometer. The bacterial protein profile was estimated by matrix assisted laser desorption ionization-time of flight mass spectrometer. The cytotoxicity of biofilm and monocytes' adherence to it were the most accurate factors in predicting the prevalence of the strain in the specific niche. Additionally, a bacterial protein with mass-to-charge ratio (m/z) 5000 was found to be responsible for the increased bacterial cytotoxicity, while monocytes' decreased adherence to biofilm was linked with the presence of proteins either with m/z 3330 or 2435. The results illustrate that monocytes' reaction when exposed to the bacterial biofilm can be used as an estimator of pathogens' virulence potential. The observed differences in monocytes' response are explainable by the bacterial proteins' profile. Additionally, the results indicate that the features of both bacteria and monocytes impact the outcome of the infection.

Work-related asthma prevalence among US employed adults.

BACKGROUND: Work-related asthma (WRA), a preventable occupational disease, can result in adverse health outcomes and employment disability, including decreased productivity, lost workdays, and job loss. Early identification of WRA cases and avoidance of further exposures is crucial for optimal management. OBJECTIVE: We estimate WRA prevalence among US workers by selected sociodemographic characteristics, industry, and occupation groups and assess the differences in adverse health outcomes, preventive care, and lost workdays between persons with WRA and those with non-WRA. METHODS: The 2020 National Health Interview Survey (NHIS) data for working adults aged ≥18 years employed in the 12 months before the survey were analyzed. Prevalence, and adjusted prevalence ratios with 95% confidence intervals were estimated using multivariate logistic regression. RESULTS: Of the estimated 170 million US adults working in the past year, 13.0 million (7.6%) had asthma. Among workers with asthma, an estimated 896,000 (6.9%) had WRA. WRA prevalence was highest among males, workers aged ≥55 years, those with no health insurance, those living in the Midwest, and those employed in the accommodation, food, and other services industry, and in production, installation, transportation, and material moving occupations. Workers with WRA were significantly more likely to use preventive medication and rescue inhalers, and to experience adverse health outcomes and lost workdays than workers with non-WRA. CONCLUSION: Early identification of WRA cases, assessment of workplace exposures, and implementation of targeted interventions that consider the hierarchy of controls are critical to preventing future WRA cases and associated adverse health consequences.

Proposal and practicality of an alternative blue-light hazard risk assessment method for high-intensity white-light sources at workplaces.

Objectives. It is prescribed to determine blue-light hazard (BLH) weighted radiances, LB, for an assessment of spotlights with an angular subtense α≥11mrad. The BLH weighted irradiance, EB, can be used alternatively for smaller sources. Appropriate instruments are not common among persons commissioned with risk assessment (RA), and especially LB measurements may be challenging. Therefore, a practical BLH RA approach is proposed that is based on illuminance, Ev, pre-calculated blackbody BLH efficacies of luminous radiation, KB,vPlanck, and solid angle considerations. Methods. The practicality of this method was examined and compared against other RA approaches. Results. To ensure comparability of the applied instruments, measurements were performed close to a radiance standard, showing deviations within the lamp's expanded uncertainties (<4%), whereas the deviations were ±15% for longer distances. Focusing on a complex light-emitting diode (LED) spotlight, all detected values could be converted to LB by means of the RA methods within ±20%. Two field tests with several spotlights yielded maximum permissible exposure durations (MPED) obtained from the different RA approaches that agreed among each other within uncertainties largely below ±30%. Conclusion. The general practicality of the proposed Ev method can be concluded for a workplace BLH RA of white-light sources.

Environmental management of asthma in clinical practice: Results from the 2012 National Ambulatory Medical Care Survey.

Background: The National Asthma Education and Prevention Program guidelines emphasize environmental control as an integral part of asthma management; however, limited national-level data exist on how clinicians implement environmental control recommendations. Objective: We analyzed data on clinicians' self-reported use of recommended environmental control practices in a nationally representative sample (n = 1645) of primary care physicians, asthma specialists, and advanced practice providers from the National Asthma Survey of Physicians, a supplemental questionnaire to the 2012 National Ambulatory Medical Care Survey. Methods: We examined clinician and practice characteristics as well as clinicians' decisions and strategies regarding environmental trigger assessment and environmental control across provider groups. Regression modeling was used to identify clinician and practice characteristics associated with implementation of guideline recommendations. Results: A higher percentage of specialists assessed asthma triggers at home, school, and/or work than primary care or advanced practice providers (almost always: 53.6% vs 29.4% and 23.7%, respectively, P < .001). Almost all clinicians (>93%) recommended avoidance of secondhand tobacco smoke, whereas recommendations regarding cooking appliances (eg, proper ventilation) were infrequent. Although assessment and recommendation practices differed between clinician groups, modeling results showed that clinicians who reported almost always assessing asthma control were 5- to 6-fold more likely to assess environmental asthma triggers. Use of asthma action plans was also strongly associated with implementation of environmental control recommendations. Conclusions: Environmental assessment and recommendations to patients varied among asthma care providers. High adherence to other key guideline components, such as assessing asthma control, was associated with environmental assessment and recommendation practices on environmental control.

Sex Differences in COVID-19 Deaths, by Industry and Occupation, 2021.

INTRODUCTION: The COVID-19 pandemic has disproportionately impacted workers in certain industries and occupations. The infection risk for SARS-CoV-2 and future respiratory viruses in the workplace is a significant concern for workers, employers, and policymakers. This study describes the differences in COVID-19 mortality by sex and industry/occupation among working-age U.S. residents in 49 states and New York City. METHODS: The 2021 National Vital Statistics System public use multiple-cause-of-death data for U.S. decedents aged 15-64 years (working age) with information on usual industry and occupation were analyzed in 2022. Age-standardized COVID-19 death rates for selected demographic characteristics and adjusted proportional mortality ratios were estimated by sex and usual industry and occupation. RESULTS: In 2021, 133,596 (14.3%) U.S. decedents aged 15-64 years had COVID-19 listed as the underlying cause of death; the highest COVID-19 death rate was among persons aged 55-64 years (172.4 of 100,000 population) and males (65.5 of 100,000 population). Among males and females, American Indian or Alaskan Native and Black or African American, respectively, had the highest death rates. Hispanic males had higher age-adjusted death rates than Hispanic females. Working-age male decedents in the public administration (proportional mortality ratio=1.39) and management of companies and enterprises industries (proportional mortality ratio=1.39) and community and social services occupations (proportional mortality ratio=1.68) and female decedents in the utilities industry (proportional mortality ratio=1.20) and protective services occupation (proportional mortality ratio=1.18) had the highest proportional mortality ratios. CONCLUSIONS: COVID-19 death rates and proportional mortality ratios varied by sex, industry, and occupation groups. These findings underscore the importance of workplace public health interventions, which could protect workers and their communities.

Intratumoral Delivery of Chimeric Antigen Receptor T Cells Targeting CD133 Effectively Treats Brain Metastases.

PURPOSE: Brain metastases (BM) are mainly treated palliatively with an expected survival of less than 12 months after diagnosis. In many solid tumors, the human neural stem cell marker glycoprotein CD133 is a marker of a tumor-initiating cell population that contributes to therapy resistance, relapse, and metastasis. EXPERIMENTAL DESIGN: Here, we use a variant of our previously described CD133 binder to generate second-generation CD133-specific chimeric antigen receptor T cells (CAR-T) to demonstrate its specificity and efficacy against multiple patient-derived BM cell lines with variable CD133 antigen expression. RESULTS: Using both lung- and colon-BM patient-derived xenograft models, we show that a CD133-targeting CAR-T cell therapy can evoke significant tumor reduction and survival advantage after a single dose, with complete remission observed in the colon-BM model. CONCLUSIONS: In summary, these data suggest that CD133 plays a critical role in fueling the growth of BM, and immunotherapeutic targeting of this cell population is a feasible strategy to control the outgrowth of BM tumors that are otherwise limited to palliative care. See related commentary by Sloan et al., p. 477.

Patient-Specific Modeling and Model Predictive Control Approach to Personalized Optimal Anemia Management.

In the condition of anemia, kidneys produce less erythropoietin hormone to stimulate the bone marrow to make red blood cells (RBC) leading to a reduced hemoglobin (Hgb) level, also known as chronic kidney disease (CKD). External recombinant human erythropoietin (EPO) is administrated to maintain a healthy level of Hgb, i.e., 10 - 12 g/dl. The semi-blind robust model identification method is used to obtain a personalized patient model using minimum dose-response data points. The identified patient models are used as predictive models in the model predictive control (MPC) framework. The simulation results of MPC for different CKD patients are compared with those obtained from the existing clinical method, known as anemia management protocol (AMP), used in hospitals. The in-silico results show that MPC outperforms AMP to maintain healthy levels of Hgb without over-or-under- shoots. This offers a considerable performance improvement compared to AMP which is unable to stabilize EPO dosage and shows oscillations in Hgb levels throughout the treatment.Clinical Relevance-This research work provides a framework to help clinicians in decision-making for personalized EPO dose guidance using MPC with semi-blind robust model identification using minimum clinical patient dose-response data.

Convergence Analysis of Online Gradient Method for High-Order Neural Networks and Their Sparse Optimization.

In this article, we investigate the boundedness and convergence of the online gradient method with the smoothing group L1/2 regularization for the sigma-pi-sigma neural network (SPSNN). This enhances the sparseness of the network and improves its generalization ability. For the original group L1/2 regularization, the error function is nonconvex and nonsmooth, which can cause oscillation of the error function. To ameliorate this drawback, we propose a simple and effective smoothing technique, which can effectively eliminate the deficiency of the original group L1/2 regularization. The group L1/2 regularization effectively optimizes the network structure from two aspects redundant hidden nodes tending to zero and redundant weights of surviving hidden nodes in the network tending to zero. This article shows the strong and weak convergence results for the proposed method and proves the boundedness of weights. Experiment results clearly demonstrate the capability of the proposed method and the effectiveness of redundancy control. The simulation results are observed to support the theoretical results.

Functional dissection and assembly of a small, newly evolved, W chromosome-specific genomic region of the African clawed frog Xenopus laevis.

Genetic triggers for sex determination are frequently co-inherited with other linked genes that may also influence one or more sex-specific phenotypes. To better understand how sex-limited regions evolve and function, we studied a small W chromosome-specific region of the frog Xenopus laevis that contains only three genes (dm-w, scan-w, ccdc69-w) and that drives female differentiation. Using gene editing, we found that the sex-determining function of this region requires dm-w but that scan-w and ccdc69-w are not essential for viability, female development, or fertility. Analysis of mesonephros+gonad transcriptomes during sexual differentiation illustrates masculinization of the dm-w knockout transcriptome, and identifies mostly non-overlapping sets of differentially expressed genes in separate knockout lines for each of these three W-specific gene compared to wildtype sisters. Capture sequencing of almost all Xenopus species and PCR surveys indicate that the female-determining function of dm-w is present in only a subset of species that carry this gene. These findings map out a dynamic evolutionary history of a newly evolved W chromosome-specific genomic region, whose components have distinctive functions that frequently degraded during Xenopus diversification, and evidence the evolutionary consequences of recombination suppression.

Rapid Identification of Material Defects Based on Pulsed Multifrequency Eddy Current Testing and the k-Nearest Neighbor Method.

The article discusses the utilization of Pulsed Multifrequency Excitation and Spectrogram Eddy Current Testing (PMFES-ECT) in conjunction with the supervised learning method for the purpose of estimating defect parameters in conductive materials. To obtain estimates for these parameters, a three-dimensional finite element method model was developed for the sensor and specimen containing defects. The outcomes obtained from the simulation were employed as training data for the k-Nearest Neighbors (k-NN) algorithm. Subsequently, the k-NN algorithm was employed to determine the defect parameters by leveraging the available measurement outcomes. The evaluation of classification accuracy for different combinations of predictors derived from measured data is also presented in this study.

Combination of an ACLY inhibitor with a GLP-1R agonist exerts additive benefits on nonalcoholic steatohepatitis and hepatic fibrosis in mice.

Increased liver de novo lipogenesis (DNL) is a hallmark of nonalcoholic steatohepatitis (NASH). A key enzyme controlling DNL upregulated in NASH is ATP citrate lyase (ACLY). In mice, inhibition of ACLY reduces liver steatosis, ballooning, and fibrosis and inhibits activation of hepatic stellate cells. Glucagon-like peptide-1 receptor (GLP-1R) agonists lower body mass, insulin resistance, and steatosis without improving fibrosis. Here, we find that combining an inhibitor of liver ACLY, bempedoic acid, and the GLP-1R agonist liraglutide reduces liver steatosis, hepatocellular ballooning, and hepatic fibrosis in a mouse model of NASH. Liver RNA analyses revealed additive downregulation of pathways that are predictive of NASH resolution, reductions in the expression of prognostically significant genes compared with clinical NASH samples, and a predicted gene signature profile that supports fibrosis resolution. These findings support further investigation of this combinatorial therapy to treat obesity, insulin resistance, hypercholesterolemia, steatohepatitis, and fibrosis in people with NASH.

A Quantitative Comparison of Oil Sources on Shorelines of Prince William Sound, Alaska, 17 Years After the Exxon Valdez Oil Spill.

Environmental damage caused by accidental discharges of pollutants depends in part on the degree of prior contamination, in that increased pollution of an already heavily contaminated region will usually be considered less detrimental than equivalent pollution of a pristine region. Quantitative comparisons of specific pollution events with the extent and severity of prior contamination are rare, owing to difficulties in identifying and assessing contaminants remaining from prior pollution events, and in some cases contaminants from natural sources. The 1989 Exxon Valdez oil spill (EVOS) presents an unusual opportunity to quantitatively evaluate residual contaminants from petroleum sources on shorelines of Prince William Sound (PWS), Alaska. Here, we evaluate surface oil contamination from Monterey Formation petroleum-derived residues (released into PWS from ruptured storage tanks during the 1964 earthquake) on 200 shoreline segments selected at random within the EVOS spill path. We compare these results with previously estimated contamination from the EVOS and from other human activities. Our results indicate that residual shoreline contamination from the EVOS is more than ~ 50% greater than the sum total from human activity sites, that residual contamination by Monterey Formation sources is negligible in comparison to that from the EVOS, and that most of the shorelines in PWS were as close to pristine prior to the EVOS as is likely to be found anywhere else worldwide.

Viruses - a major cause of amyloid deposition in the brain.

INTRODUCTION: Clinically, Alzheimer's disease (AD) is a syndrome with a spectrum of various cognitive disorders. There is a complete dissociation between the pathology and the clinical presentation. Therefore, we need a disruptive new approach to be able to prevent and treat AD. AREAS COVERED: In this review, the authors extensively discuss the evidence why the amyloid beta is not the pathological cause of AD which makes therefore the amyloid hypothesis not sustainable anymore. They review the experimental evidence underlying the role of microbes, especially that of viruses, as a trigger/cause for the production of amyloid beta leading to the establishment of a chronic neuroinflammation as the mediator manifesting decades later by AD as a clinical spectrum. In this context, the emergence and consequences of the infection/antimicrobial protection hypothesis are described. The epidemiological and clinical data supporting this hypothesis are also analyzed. EXPERT OPINION: For decades, we have known that viruses are involved in the pathogenesis of AD. This discovery was ignored and discarded for a long time. Now we should accept this fact, which is not a hypothesis anymore, and stimulate the research community to come up with new ideas, new treatments, and new concepts.

Pneumoconiosis incidence and prevalence among US Medicare beneficiaries, 1999-2019.

BACKGROUND: Pneumoconiosis is a group of occupational lung diseases caused by dust and fiber exposure. This study analyzes Medicare claims to estimate the burden of pneumoconiosis among fee-for-service (FFS; Medicare Parts A and B) Medicare beneficiaries during 1999-2019 in the United States. METHODS: Claim and enrollment information from 81 million continuously enrolled FFS Medicare beneficiaries were analyzed. Beneficiaries with any pneumoconiosis and cause-specific pneumoconiosis (e.g., asbestosis, silicosis) were identified using three case definitions (broad, intermediate, and narrow) with varying diagnostic criteria based on claim International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis codes and Healthcare Common Procedure Coding System codes. Results are presented as ranges of values for the three case definitions. RESULTS: The 21-year prevalence range for any pneumoconiosis was 345,383-677,361 (412-833 per 100,000 beneficiaries) using the three case definitions. The highest prevalence was among those ≥75 years of age, males, Whites, and North American Natives. Most claims (70.0%-72.5%) included an ICD-CM diagnosis code for asbestosis. The broad pneumoconiosis prevalence rate increased significantly (p < 0.001) during 2002-2009 by 3%-10% annually and declined significantly by 3%-5% annually starting in 2009. The average annual broad incidence rate declined significantly by 7% annually during 2009-2019. CONCLUSIONS: Despite the decline in rate for any pneumoconiosis among Medicare beneficiaries, which is primarily attributed to a decline in asbestosis, pneumoconiosis is prevalent among FFS Medicare beneficiaries.

Development of a new surgical technique to infuse kynurenic acid to optic nerves in chickens for studying loss of myelination.

Prolonged infusion of a high dose of kynurenic acid (KYNA) reduces the myelin content in the rat spinal cord with preservation of the axonal integrity and without inducing an inflammatory response. We hypothesized that subdural infusion of a high concentration of KYNA can induce myelin loss in the optic nerves (ONs) of chickens. However, existing methods to deliver agents to the ON are inefficient, unlocalized and provide only acute exposure. Thus, we developed a surgical approach for sustained delivery of KYNA to the chicken ON. In brief, the novel surgical technique, which does not include excision of the extraocular muscles, involves incision of the skin and underlying fascial sheath to access the optic nerve within the muscle cone, implantation of a catheter in the dura of the optic nerve, the other end of which exits the orbit under the skin. The catheter runs under the skin near the lateral canthus, over the ears to the back of the neck, where a second incision is made to both implant the osmotic pump and to attach the catheter to the osmotic pump. India ink was used to confirm prolonged sustained administration to the optic nerves and across the chiasm. This surgical model was used to investigate KYNA's effect(s) on myelin loss in the ON. ONs of 7-day old chickens were infused with 50 mM KYNA or phosphate buffered saline (PBS) for seven days. Analysis of KYNA-infused contralateral ON g-ratios and protein levels indicated a reduction in myelin. These findings demonstrate the utility of our surgical approach for sustained delivery of KYNA into the ON and suggest a role for KYNA in modulating CNS myelination.

Development of an Active Optical Lens for Arc Flashing Detection.

This paper contains the design of active optical lenses used for the detection of arc flashing emissions. The phenomenon of an arc flashing emission and its characteristics were contemplated. Methods of preventing these emissions in electric power systems were discussed as well. The article also includes a comparison of commercially available detectors. An analysis of the material properties of fluorescent optical fiber UV-VIS-detecting sensors constitutes a major part of the paper. The main purpose of the work was to make an active lens using photoluminescent materials, which can convert ultraviolet radiation into visible light. As part of the work, active lenses with materials such as Poly(methyl 2-methylpropenoate) (PMMA) and phosphate glass doped with lanthanides, such as terbium (Tb3+) and europium (Eu3+) ions, were analyzed. These lenses were used to make optical sensors, which were supported by commercially available sensors in their construction.

Industry, occupation, and exposure history of mesothelioma patients in the U.S. National Mesothelioma Virtual Bank, 2006-2022.

BACKGROUND: Malignant mesothelioma is associated with environmental and occupational exposure to certain mineral fibers, especially asbestos. This study aims to examine work histories of mesothelioma patients and their survival time. METHOD: Using the NIOSH Industry and Occupation Computerized Coding System, we mapped occupations and industries recorded for 748 of 1444 patients in the U.S. National Mesothelioma Virtual Bank (NMVB) during the period 2006-2022. Descriptive and survival analyses were conducted. RESULTS: Among the 1023 industries recorded for those having mesothelioma, the most frequent cases were found for those in manufacturing (n = 225, 22.0%), construction (138, 13.5%), and education services (66, 6.5%); among the 924 occupation records, the most frequent cases were found for those in construction and extraction (174, 18.8%), production (145, 15.7%), and management (84, 9.1%). Males (583) or persons aged >40 years (658) at the time of diagnosis tended to have worked in industries traditionally associated with mesothelioma (e.g., construction), while females (163) or persons aged 20-40 years (27) tended to have worked in industries not traditionally associated with mesothelioma (e.g., health care). Asbestos, unknown substances, and chemical solvents were the most frequently reported exposure, with females most often reporting an unknown substance. A multi-variable Cox Hazard Regression analysis showed that significant prognostic factors associated with decreased survival in mesothelioma cases are sex (male) and work experience in utility-related industry, while factor associated with increased survival are epithelial or epithelioid histological type, prior history of surgery and immunotherapy, and industry experience in accommodation and food services. CONCLUSION: The NMVB has the potential of serving as a sentinel surveillance mechanism for identifying industries and occupations not traditionally associated with mesothelioma. Results indicate the importance of considering all potential sources of asbestos exposures including occupational, environmental, and extra-occupational exposures when evaluating mesothelioma patients and advising family members.

Longevity, Centenarians and Modified Cellular Proteodynamics.

We have shown before that at least one intracellular proteolytic system seems to be at least as abundant in the peripheral blood lymphocytes of centenarians as in the same cells of young individuals (with the cells of the elderly population showing a significant dip compared to both young and centenarian cohorts). Despite scarce published data, in this review, we tried to answer the question how do different types of cells of longevous people-nonagenarians to (semi)supercentenarians-maintain the quality and quantity of their structural and functional proteins? Specifically, we asked if more robust proteodynamics participate in longevity. We hypothesized that at least some factors controlling the maintenance of cellular proteomes in centenarians will remain at the "young" level (just performing better than in the average elderly). In our quest, we considered multiple aspects of cellular protein maintenance (proteodynamics), including the quality of transcribed DNA, its epigenetic changes, fidelity and quantitative features of transcription of both mRNA and noncoding RNAs, the process of translation, posttranslational modifications leading to maturation and functionalization of nascent proteins, and, finally, multiple facets of the process of elimination of misfolded, aggregated, and otherwise dysfunctional proteins (autophagy). We also included the status of mitochondria, especially production of ATP necessary for protein synthesis and maintenance. We found that with the exception of the latter and of chaperone function, practically all of the considered aspects did show better performance in centenarians than in the average elderly, and most of them approached the levels/activities seen in the cells of young individuals.

Malignant mesothelioma among US Medicare beneficiaries: incidence, prevalence and therapy, 2016-2019.

OBJECTIVES: Mesothelioma is a rare, aggressive cancer caused by exposure to asbestos fibres. Mesothelioma patients who receive trimodal therapy (chemotherapy, surgical resection and radiation) survive longer than those who receive two or fewer therapy modalities. This study analyses the 2016-2019 Medicare claims data to estimate the burden of malignant mesothelioma and describe therapy patterns (when available) among continuously enrolled fee-for-service (FFS; Medicare parts A and B) beneficiaries. METHODS: We analysed claims and enrolment information from 42 529 117 FFS Medicare beneficiaries using three mesothelioma case definitions (broad, intermediate and narrow) with varying levels of diagnostic requirements. Results are presented as ranges of values for the three definitions. RESULTS: Among FFS beneficiaries, 8213-19 036 beneficiaries with mesothelioma were identified depending on the case definition. The annual prevalence per 100 000 beneficiaries ranged from 8.8 in 2016 (narrow) to 31.3 in 2019 (broad) and annual incidence per 100 000 beneficiaries ranged from 4.5 in 2019 (narrow) to 12.6 in 2017 (broad). Depending on the mesothelioma case definition, 41.8%-81.5% had available therapy claim information indicating that 7.6%-11.3% received chemotherapy alone, 1.3%-1.5% received radiation alone, and 14.3%-27.0% underwent surgery only, with 4.6%-10.5% receiving all three therapy modalities. CONCLUSIONS: Mesothelioma was a prevalent disease among FFS Medicare beneficiaries during 2016-2019, and a limited proportion of beneficiaries received all three therapy modalities. Medicare data build on findings from cancer registry data to enhance our understanding of the mesothelioma burden and therapy patterns.

Asthma, chronic obstructive pulmonary disease, and asthma-COPD overlap among US working adults.

BACKGROUND: Asthma-COPD overlap (ACO) is a respiratory condition with more severe respiratory symptoms, poorer quality of life, and increased hospital admissions compared with asthma or COPD alone. OBJECTIVES: Estimate asthma, chronic obstructive pulmonary disease (COPD), and ACO prevalence among workers by industry and occupation and assess physical and mental health status, healthcare utilization, among workers with ACO. METHODS: The 2014-2018 National Health Interview Survey (NHIS) data for working adults aged ≥18 years employed (sample n = 99,424) in the 12 months prior to the survey were analyzed. Age-adjusted ACO, COPD and asthma prevalence and prevalence ratios adjusted for age, sex, race and smoking status were estimated. RESULTS: During 2014-2018, of the estimated 166 million (annual average) US workers, age-adjusted asthma, COPD, and ACO prevalence was 6.9%, 4.0%, and 1.1%, respectively. ACO prevalence was highest among workers aged ≥65 years (2.0%), females (1.6%), current smokers (1.9%), those living below the federal poverty level (2.3%), and workers in the accommodation and food services (1.6%) industry and personal care and service (2.3%) occupations. Workers with ACO had more frequent (p < 0.05) physician office visits, emergency department visits; and were more likely to be in poorer mental health, obese, have more lost workdays, more bed days, and comorbidities compared to workers with asthma alone and workers with COPD alone.Conclusion: Higher ACO prevalence among worker groups and increased healthcare utilization underscores the need for early identification of asthma and COPD, assessment of potential workplace exposures, and implementation of tailored interventions to reduce ACO among working adults.