A Cross-Sectional Descriptive Analysis of Diversity, Equity, and Inclusion Presence Among United States Occupational and Environmental Medicine Residency Program Websites.

OBJECTIVE: To evaluate the presence of diversity, equity, and inclusion (DEI) among US occupational and environmental medicine (OEM) residency program websites. METHODS: In January to February 2022, two independent reviewers evaluated the websites of all 24 US accredited OEM residency programs and documented the presence of 10 predetermined DEI metrics and resident/faculty photographs and biographies. RESULTS: Program websites included a median of 1 (0-3) DEI element with 46% of websites containing none of the DEI metrics. Faculty photographs and biographies were included in 83% and 75% of websites, respectively. Resident photographs and biographies were included in 50% and 25% of websites, respectively. CONCLUSIONS: Many OEM residency program websites lack DEI presence. Programs should consider presenting information relevant to DEI on their websites to help attract more diverse applicant pools.

Return to Work, Demographic Predictors, and Symptomatic Analysis Among Healthcare Workers Presenting for COVID-19 Testing: A Retrospective Cohort From a United States Academic Occupational Medicine Clinic.

Introduction We sought to determine time to return to work (RTW) among healthcare workers (HCWs) with mild/moderate coronavirus disease 2019 (COVID-19) and identify predictors of COVID-19 test positivity and illness duration.  Methods A retrospective review of HCWs presenting for COVID-19 testing/evaluation in December 2020 was performed to examine demographics, clinical characteristics, and RTW. Results Of 250 exposure incidents, 107 employees (42.80%) tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). No significant differences between COVID-19 positive and negative HCWs were noted in terms of key demographics, including age, gender, and CDC risk scores. Cough (77.57% vs 56.64%, p = 0.001), fatigue (66.36% vs 51.05%, p = 0.015), fever/chills (65.42% vs 37.06%, p < 0.001), myalgia (57.01% vs 35.66%, p = 0.008), and change in smell/taste (38.32% vs 13.29%, p < 0.001) were more prevalent among COVID-19 positive versus negative HCWs. Change in smell/taste (p < 0.001, OR 3.592), cough (p = 0.001, OR 2.966), and fever/chills (p = 0.019, OR 2.107) were independently associated with COVID-19 test positivity. Mean time to RTW from symptom onset was 13.09 days for COVID-19 positive HCWs. Female gender (p = 0.020, + 3.20 days), older age (p = 0.014, + 2.22 days), and myalgia (p = 0.021, + 2.23 days) were predictive of longer illness duration. Conclusion Change in taste/smell, cough, and fever/chills were independently associated with COVID-19 test positivity. Among HCWs with mild/moderate COVID-19 infection, the mean time to RTW was approximately 13 days with female gender, older age, and myalgia being predictive of delayed RTW.

Heart Rate Variability and Performance of Commercial Airline Pilots during Flight Simulations.

Pilots undergo a variety of stressors that may affect their performance during all phases of flight. Heart rate variability (HRV) has been considered as a reliable indicator of the parasympathetic and sympathetic activities of human autonomic nervous system, which can be used to characterize the sympathetic stress response of pilots during flight. In this study, thirty active commercial airline pilots were recruited to fly three flight segments in a Federal Aviation Administration (FAA)-certified A320 flight simulator with each segment at a different carbon dioxide (CO2) concentration on the flight deck. The pilots performed a series of maneuvers of varying difficulty, and their performance was evaluated by FAA designated pilot examiners. The HRV metrics (SDNN, RMSSD and LF/HF ratio) of each pilot both before and during flight simulations were measured with a Movisens EcgMove3 sensor. The average SDNN, RMSSD and LF/HF ratio of the pilots during flight simulations were 34.1 ± 12.7 ms, 23.8 ± 10.2 ms and 5.7 ± 2.8 respectively. Decreased HRV was associated with aging, obesity and performing difficult maneuvers. Both CO2 exposure and HRV had an independent effect on the pilot performance, while their interaction was not significant. The generalized additive mixed effect model results showed that a pilot performed better on a maneuver when his stress response was lower, as indicated by higher SDNN and RMSSD and lower LF/HF ratio. An interquartile range (IQR) increase in SDNN (21.97 ms) and RMSSD (16.00 ms) and an IQR decrease in LF/HF ratio (4.69) was associated with an increase in the odds of passing a maneuver by 37%, 22% and 20%, respectively.