Impact of COVID-19 vaccine-associated side effects on health care worker absenteeism and future booster vaccination.

BACKGROUND: Short-term side effects related to mRNA vaccines against SARS-CoV-2 are frequent and bothersome, with the potential to disrupt work duties and impact future vaccine decision-making. OBJECTIVE: To identify factors more likely to lead to vaccine-associated work disruption, employee absenteeism, and future vaccine reluctance among healthcare workers (HCWs). HYPOTHESIS: Side effects related to COVID vaccination: 1- frequently disrupt HCW duties, 2- result in a significant proportion of HCW absenteeism, 3- contribute to uncertainty about future booster vaccination, 4- vary based on certain demographic, socioeconomic, occupational, and vaccine-related factors. METHODS: Using an anonymous, voluntary electronic survey, we obtained responses from a large, heterogeneous sample of COVID-19-vaccinated HCWs in two healthcare systems in Southern California. Descriptive statistics and regression models were utilized to evaluate the research questions. RESULTS: Among 2,103 vaccinated HCWs, 579 (27.5%) reported that vaccine-related symptoms disrupted their professional responsibilities, and 380 (18.1%) missed work as a result. Independent predictors for absenteeism included experiencing generalized and work-disruptive symptoms, and receiving the Moderna vaccine [OR = 1.77 (95% CI = 1.33 - 2.36), p < 0.001]. Physicians were less likely to miss work due to side effects (6.7% vs 21.2% for all other HCWs, p < 0.001). Independent predictors of reluctance toward future booster vaccination included lower education level, younger age, having received the Moderna vaccine, and missing work due to vaccine-related symptoms. CONCLUSION: Symptoms related to mRNA vaccinations against SARS-CoV-2 may frequently disrupt work duties, lead to absenteeism, and impact future vaccine decision-making. This may be more common in Moderna recipients and less likely among physicians. Accordingly, health employers should schedule future booster vaccination cycles to minimize loss of work productivity.

Assessing the validity, reliability and efficacy of the Cross-Cultural Stress Scale (CCSS) for psychosomatic studies.

OBJECTIVE: The impact of stressful life events (SLEs) on health has been empirically studied with significant correlations documented. We developed a comprehensive stress rating toolkit, the Cross-Cultural Stress Scale (CCSS) from a triangulated qualitative research study. This article describes our pilot test of the scale to explore demographic-specific patterns of SLE scores and evaluate the scale's aptitude in assessing the stress-health correlation. METHODS: The face and content-validated CCSS was shared via a web-based survey to diverse individuals grouped by: (a) gender, (b) age, (c) race and ethnicity, (d) native, foreign-born or first-generation, (e) educational attainment, and (f) income. Participants from the Amazon crowdsourcing marketplace MTurk (N = 216) first indicated perceived stress intensities assuming experiences of all the SLEs in the CCSS. They then selected SLEs they had personally experienced in the last 12 months (N = 176). Multivariable analyses were conducted on perceived intensities. Correlations of experienced SLEs with self-reported health based on the Centers for Disease Control and Prevention (CDC) Health Related Quality of Life (HRQOL) indicators measured by the Behavioral Risk Factors Surveillance System (BRFSS) were analyzed. RESULTS: We validated the CCSS and obtained a high internal reliability (Cronbach's alpha >0.9). We found significant differences in stress rating by and within demographics. We also correlated stress to perceived health using the HRQOL and presence of a chronic disease ascertaining the stress-health hypothesis. LIMITATION: Sampling limitations observed include data drawn from a convenience sample. CONCLUSION: Despite sampling limitations, our research highlights demographic-specific stressors and offers an updated methodology in the stress-health correlation.

The association between ambient fine particulate matter and incident adenocarcinoma subtype of lung cancer.

BACKGROUND: Adenocarcinoma (AC) is the most common lung cancer among non-smokers, but few studies have assessed the effect of PM2.5 on AC among never smokers. The purpose of this study was to assess the association between ambient PM2.5 and incident lung AC in the Adventist Health and Smog Study-2 (AHSMOG-2), a cohort of 80,044 non-smokers (81% never smokers) followed for 7.5 years (597,177 person-years) (2002-2011). METHODS: Incident lung AC was identified through linkage with U.S. state cancer registries. Ambient PM2.5 levels at subjects' residences were estimated for the years 2000 and 2001, immediately prior to study start. RESULTS: A total of 164 incident lung AC occurred during follow-up. Each 10 µg/m3 increment in PM2.5 was associated with an increase in the hazard rate of lung AC [HR = 1.31 (95% confidence interval (CI) 0.87-1.97)] in the single-pollutant model. Excluding those with prevalent non-melanoma skin cancer (NMSC) strengthened the association with lung AC (HR = 1.62 (95% CI, 1.11-2.36) for each 10 µg/m3 PM2.5 increment. Also, limiting the analyses to subjects who spent more than 1 h/day outdoors, increased the estimate (HR = 1.55, 95% CI: 1.05, 2.30). CONCLUSIONS: Increased risk of AC was observed for each 10 µg/m3 increment in ambient PM2.5 concentrations. The risk was higher among those without prevalent NMSC and those who spent more than 1 h/day outdoors.

Long-term inhalable particles and other air pollutants related to mortality in nonsmokers.

Long-term ambient concentrations of inhalable particles less than 10 microm in diameter (PM10) (1973- 1992) and other air pollutants-total suspended sulfates, sulfur dioxide, ozone (O3), and nitrogen dioxide-were related to 1977-1992 mortality in a cohort of 6,338 nonsmoking California Seventh-day Adventists. In both sexes, PM10 showed a strong association with mortality for any mention of nonmalignant respiratory disease on the death certificate, adjusting for a wide range of potentially confounding factors, including occupational and indoor sources of air pollutants. The adjusted relative risk (RR) for this cause of death as associated with an interquartile range (IQR) difference of 43 d/yr when PM10 exceeded 100 microg/m3 was 1.18 (95% confidence interval [CI]: 1.02, 1.36). In males, PM10 showed a strong association with lung cancer deaths-RR for an IQR was 2.38 (95% CI: 1.42, 3.97). Ozone showed an even stronger association with lung cancer mortality for males with an RR of 4.19 (95% CI: 1.81, 9.69) for the IQR difference of 551 h/yr when O3 exceeded 100 parts per billion. Sulfur dioxide showed strong associations with lung cancer mortality for both sexes. Other pollutants showed weak or no association with mortality.