Characterizing the Burden of Occupational Chemical Exposures by Sociodemographic Groups in the United States, 2021.

Objectives. To estimate the number and prevalence of workers in the United States exposed to chemical hazards available in the Canadian job-exposure matrix (CANJEM) database and examine exposure disparities across sociodemographic groups. Methods. We merged US worker demographic data from the Current Population Survey with CANJEM to characterize the burden and sociodemographic distribution of 244 chemical exposures in the United States in 2021. An interactive version of the full data set is available online (https://deohs.washington.edu/us-exposure-burden). Results. Of the chemical exposures examined, the most prevalent were cleaning and antimicrobial agents (14.7% of workforce estimated exposed), engine emissions (12.8%), organic solvents (12.1%), polycyclic aromatic hydrocarbons (10.1%), and diesel engine emissions (8.3%). Racial and ethnic minoritized groups, persons with lower educational attainment, foreign-born noncitizens, and males were generally overrepresented in exposure to work-related chemical hazards. Conclusions. In the United States, marginalized sociodemographic groups are estimated to experience an inequitable burden to many chemical exposures because of occupational segregation. Data from this analysis can inform occupational and public health research, policy, and interventions aimed at reducing the burden of disease and health inequities in the United States. (Am J Public Health. 2024;114(1):57-67. https://doi.org/10.2105/AJPH.2023.307461).

Health and safety risk perceptions and needs of app-based drivers during COVID-19.

BACKGROUND: App-based drivers face work disruptions and infection risk during a pandemic due to the nature of their work, interactions with the public, and lack of workplace protections. Limited occupational health research has focused on their experiences. METHODS: We surveyed 100 app-based drivers in Seattle, WA to assess risk perceptions, supports, and controls received from the company that employs them, sources of trust, stress, job satisfaction, COVID-19 infection status, and how the pandemic had changed their work hours. Data were summarized descriptively and with simple regression models. We complemented this with qualitative interviews to better understand controls and policies enacted during COVID-19, and barriers and facilitators to their implementation. RESULTS: Drivers expressed very high levels of concern for exposure and infection (86%-97% were "very concerned" for all scenarios). Only 31% of drivers reported receiving an appropriate mask from the company for which they drive. Stress (assessed via PSS-4) was significantly higher in drivers who reported having had COVID-19, and also significantly higher in respondents with lower reported job satisfaction. Informants frequently identified supports such as unemployment benefits and peer outreach among the driver community as ways to ensure that drivers could access available benefits during COVID-19. CONCLUSIONS: App-based drivers received few protections from the company that employed them, and had high fear of exposure and infection at work. There is increased need for health-supportive policies and protections for app-based drivers. The most effective occupational and public health regulations would cover employees who may not have a traditional employer-employee relationship.

Climate Change Impacts and Workforce Development Needs in Federal Region X: A Qualitative Study of Occupational Health and Safety Professionals' Perceptions.

Climate change is considered one of the top health threats in the United States. This research sought to (1) to understand the perceptions of occupational health and safety (OHS) professionals regarding the impacts of climate-related hazards on OHS in Region X, and (2) to explore the ideas of these OHS professionals regarding the content of future training programs that would better prepare OHS professionals to identify and mitigate climate-related hazards in Region X. Key informant (KI) interviews with 17 OHS professionals familiar with the climate-related hazards and impacts to OHS in Region X were coded and thematically analyzed. Climate hazards, social and economic impacts from climate-related hazards, and sector-specific worker and workplace impacts from climate-related hazards were described as having interacting relationships that influenced worker health and safety impacts. KIs further described how workplace controls could be used to mitigate OHS impacts of climate-related hazards, and how training of the OHS workforce could influence the ability to successfully implement such controls. Our findings suggest that OHS impacts are sector-specific, influenced by social and economic factors, and can be mitigated through workplace controls designed and implemented by a trained OHS workforce. The findings from this work should inform future educational and training programming and additional research and translation activities in the region, while our approach can inform other regions as they develop regionally specific OHS climate change training and programming.

Nonrelocatable Occupations at Increased Risk During Pandemics: United States, 2018.

Objectives. To characterize which occupations in the United States could likely work from home during a pandemic such as COVID-19.Methods. I merged 2018 US Bureau of Labor Statistics (BLS) national employment and wage data with measures ranking the importance of computer use at work and the importance of working with or performing for the public from the BLS O*NET survey.Results. Approximately 25% (35.6 million) of US workers are employed in occupations (such as technology, administrative, financial, and engineering) that could be done from home; the remaining 75% work in occupations (including health care, manufacturing, retail, and food services) that are challenging to do from home.Conclusions. Most US workers are employed in occupations that cannot be done at home, putting 108.4 million workers at increased risk for adverse health outcomes related to working during a pandemic. These workers tend to be lower paid. The stress experienced by lower-income groups, coupled with job insecurity, could result in a large burden of mental health disorders in the United States in addition to increased cases of COVID-19 from workplace transmission.

Improving and Expanding Estimates of the Global Burden of Disease Due to Environmental Health Risk Factors.

BACKGROUND: The Global Burden of Disease (GBD) study, coordinated by the Institute for Health Metrics and Evaluation (IHME), produces influential, data-driven estimates of the burden of disease and premature death due to major risk factors. Expanded quantification of disease due to environmental health (EH) risk factors, including climate change, will enhance accuracy of GBD estimates, which will contribute to developing cost-effective policies that promote prevention and achieving Sustainable Development Goals. OBJECTIVES: We review key aspects of the GBD for the EH community and introduce the Global Burden of Disease-Pollution and Health Initiative (GBD-PHI), which aims to work with IHME and the GBD study to improve estimates of disease burden attributable to EH risk factors and to develop an innovative approach to estimating climate-related disease burden-both current and projected. METHODS: We discuss strategies for improving GBD quantification of specific EH risk factors, including air pollution, lead, and climate change. We highlight key methodological challenges, including new EH risk factors, notably evidence rating and global exposure assessment. DISCUSSION: A number of issues present challenges to the scope and accuracy of current GBD estimates for EH risk factors. For air pollution, minimal data exist on the exposure-risk relationships associated with high levels of pollution; epidemiological studies in high pollution regions should be a research priority. For lead, the GBD's current methods do not fully account for lead's impact on neurodevelopment; innovative methods to account for subclinical effects are needed. Decisions on inclusion of additional EH risk-outcome pairs need to be guided by findings of systematic reviews, the size of exposed populations, feasibility of global exposure estimates, and predicted trends in exposures and diseases. Neurotoxicants, endocrine-disrupting chemicals, and climate-related factors should be high priorities for incorporation into upcoming iterations of the GBD study. Enhancing the scope and methods will improve the GBD's estimates and better guide prevention policy. https://doi.org/10.1289/EHP5496.

Creating a Future for Occupational Health.

Objectives: Economic, social, technical, and political drivers are fundamentally changing the nature of work and work environments, with profound implications for the field of occupational health. Nevertheless, researchers and practitioners entering the field are largely being trained to assess and control exposures using approaches developed under old models of work and risks. Methods: A speaker series and symposium were organized to broadly explore current challenges and future directions for the occupational health field. Broad themes identified throughout these discussions are characterized and discussed to highlight important future directions of occupational health. Findings: Despite the relatively diverse group of presenters and topics addressed, some important cross-cutting themes emerged. Changes in work organization and the resulting insecurity and precarious employment arrangements change the nature of risk to a large fraction of the workforce. Workforce demographics are changing, and economic disparities among working groups are growing. Globalization exacerbates the 'race to the bottom' for cheap labor, poor regulatory oversight, and limited labor rights. Largely, as a result of these phenomena, the historical distinction between work and non-work exposures has become largely artificial and less useful in understanding risks and developing effective public health intervention models. Additional changes related to climate change, governmental and regulatory limitations, and inadequate surveillance systems challenge and frustrate occupational health progress, while new biomedical and information technologies expand the opportunities for understanding and intervening to improve worker health. Conclusion: The ideas and evidences discussed during this project suggest that occupational health training, professional practice, and research evolve towards a more holistic, public health-oriented model of worker health. This will require engagement with a wide network of stakeholders. Research and training portfolios need to be broadened to better align with the current realities of work and health and to prepare practitioners for the changing array of occupational health challenges.