The association between safety climate and noncombat injury events among United States Air Force workers.

INTRODUCTION: Work-related injuries are a common lagging safety indicator whereas safety climate assessments can help identify constructs serving as leading indicators. The National Institute for Occupational Safety and Health (NIOSH) partnered with the U.S. Department of the Air Force (DAF) Safety Center to examine the association between perceptions of safety climate survey constructs and the number of injury events within the DAF workforce. METHODS: The DAF administers voluntary, anonymous, occupation-specific safety climate surveys to DAF workers using the internal Air Force Combined Mishap Reduction System (AFCMRS). Survey responses from 2014 to 2018 provided by DAF workers and injury events in maintenance, support, and operations occupations were shared with NIOSH. Exploratory Factor Analysis revealed five constructs: Leadership and Communication; Organizational Safety Priority; Error Management; Resource Adequacy; and Deployment/Official Travel Impact. Squadron-level analysis included bivariate correlations and estimated Rate Ratios (RRs). RESULTS: 1,547 squadrons administered the survey, averaging 144 workers and 15.8 reportable injuries per squadron. Higher (more favorable) squadron-level construct scores were consistently correlated with fewer reported injuries (p < 0.001). Controlling for the number of workers, RRs revealed significant reductions in injury rates with each one-unit increase in responses: Leadership and Communication RR = 0.40 (95%CI: 0.32-0.48); Organizational Safety Priority RR = 0.50 (95%CI: 0.40-0.64); Error Management RR = 0.37 (95%CI: 0.30-0.47); Deployment/Official Travel Impact RR = 0.36 (95%CI: 0.29-0.45). Resource Adequacy revealed a non-significant lower injury rate RR = 0.87 (95%CI: 0.73-1.04). CONCLUSIONS: This unique study quantified safety climate and the association with injuries across a multi-year period. While safety climate measurements may be limited by frequent turnover and the self-reported, voluntary, anonymous nature of AFCMRS, the strength of this study is in the census of injuries. PRACTICAL APPLICATIONS: Future research should include longitudinal analyses to examine the impact on injuries when squadron leaders are provided feedback on safety climate survey results.

Severe Work-Related Injuries in the Oil and Gas Extraction Industry - 32 Federal Occupational Safety and Health Administration Jurisdictions, United States, January 2015-July 2022.

The Occupational Safety and Health Administration (OSHA) severe injuries reports include work-related injuries from establishments under federal OSHA jurisdiction that result in an amputation, loss of an eye, or inpatient hospitalization. Data from 32 jurisdictions were examined to determine oil and gas extraction industry-specific severe industry trends during January 2015-July 2022, using the 2012 North American Industry Classification System (NAICS) codes for oil and gas extraction. During this period, a total of 2,101 severe work-related injuries were reported in this sector. Among these severe work-related injuries, well service contract workers' injuries included the highest number of amputations (417) and hospitalizations (1,194), accounting for 20% and 57%, respectively, of all severe injuries reported. Overall, 895 (43%) of all severe injuries reported involved upper extremities. Contract workers in the service and drilling subindustries (NAICS codes 213112 and 213111, respectively) experienced disproportionately more work-related injuries compared with those in the operation subindustry (NAICS code 211). These injuries could be preventable by including contractors in worksite safety plans that administer the hierarchy of controls, are within an effective safety management system, and provide consistent safety training on work equipment, personal protective equipment, and daily site safety meetings that increase safety culture.

Implementation of California COVIDNet - a multi-sector collaboration for statewide SARS-CoV-2 genomic surveillance.

Introduction: The SARS-CoV-2 pandemic represented a formidable scientific and technological challenge to public health due to its rapid spread and evolution. To meet these challenges and to characterize the virus over time, the State of California established the California SARS-CoV-2 Whole Genome Sequencing (WGS) Initiative, or "California COVIDNet". This initiative constituted an unprecedented multi-sector collaborative effort to achieve large-scale genomic surveillance of SARS-CoV-2 across California to monitor the spread of variants within the state, to detect new and emerging variants, and to characterize outbreaks in congregate, workplace, and other settings. Methods: California COVIDNet consists of 50 laboratory partners that include public health laboratories, private clinical diagnostic laboratories, and academic sequencing facilities as well as expert advisors, scientists, consultants, and contractors. Data management, sample sourcing and processing, and computational infrastructure were major challenges that had to be resolved in the midst of the pandemic chaos in order to conduct SARS-CoV-2 genomic surveillance. Data management, storage, and analytics needs were addressed with both conventional database applications and newer cloud-based data solutions, which also fulfilled computational requirements. Results: Representative and randomly selected samples were sourced from state-sponsored community testing sites. Since March of 2021, California COVIDNet partners have contributed more than 450,000 SARS-CoV-2 genomes sequenced from remnant samples from both molecular and antigen tests. Combined with genomes from CDC-contracted WGS labs, there are currently nearly 800,000 genomes from all 61 local health jurisdictions (LHJs) in California in the COVIDNet sequence database. More than 5% of all reported positive tests in the state have been sequenced, with similar rates of sequencing across 5 major geographic regions in the state. Discussion: Implementation of California COVIDNet revealed challenges and limitations in the public health system. These were overcome by engaging in novel partnerships that established a successful genomic surveillance program which provided valuable data to inform the COVID-19 public health response in California. Significantly, California COVIDNet has provided a foundational data framework and computational infrastructure needed to respond to future public health crises.

Trends of Enterovirus D68 Concentrations in Wastewater, California, USA, February 2021-April 2023.

In this retrospective study, we measured enterovirus D68 (EV-D68) genomic RNA in wastewater solids longitudinally at 2 California, USA, wastewater treatment plants twice per week for 26 months. EV-D68 RNA was undetectable except when concentrations increased from mid-July to mid-December 2022, which coincided with a peak in confirmed EV-D68 cases.

2022 National Occupational Injury Research Symposium (NOIRS): Preventing workplace injuries in a changing world.

About NOIRS: The National Occupational Injury Research Symposium (NOIRS) is the only conference solely dedicated to occupational injury research and prevention. The 8th NOIRS, sponsored by the National Institute for Occupational Safety and Health (NIOSH) and several partners, was held on May 10-12, 2022. NOIRS was held entirely virtually in response to concerns of the COVID-19 pandemic and honoring the symposium theme "Preventing Workplace Injuries in a Changing World." About this Special Issue: The intent of this issue is to highlight the breadth of high-quality presentations at NOIRS, and to make them available to those who did not participate in the conference. This issue includes three short communication articles and nine research articles. Featured research articles in this special issue span a wide variety of methods, data sources, and worker populations. They address leading and emerging causes and contributors to occupational injury in a range of industries and occupations. Concluding Remarks: We hope that this special issue provides readers with a view into some of the research presented at the 2022 NOIRS. We also hope the articles are useful for research and practice, and thinking toward the future.

Time series, seasonality and trend evaluation of 7 years (2015-2021) of OSHA severe injury data.

PROBLEM: Employers are required to report severe work-related injuries (e.g., amputation, inpatient hospitalization, or loss of an eye), to the Occupational Safety and Health Administration (OSHA). This study examined the OSHA severe injury reports (SIRs) public microdata to understand time-related trends and patterns. METHODS: This study included all SIRs from January 2015 to December 2021 (84 months). We employed time series decomposition models (classical additive and multiplicative, X-11, and X-13ARIMA-SEATS) to evaluate monthly seasonal effect and seasonally adjusted trend of SIRs. We developed data visuals to display trends from different models with the original data series. We compared number of daily SIRs by day of the week, and yearly trends by 2-digit NAICS and separately by 1-digit OIICS injury event. RESULTS: There were a total of 70,241 SIRs in this 7 year period; ranging from 8,704 to 11,156 per year, and 600 to 1,100 per month. Seasonally adjusted trend indicated a gradual increase of SIRs over time until October 2018, then a steeper decrease until August 2020, and staying somewhat flat for the rest of the months. Seasonality indicated more SIRs were reported in the summer months (June, July, August). Daily SIRs indicated a weekday average of 34 (SD = 9) and weekend average of 11 (SD = 5). The Manufacturing and Construction industries reported the highest yearly SIRs. Contact with objects and equipment, and falls, slips, trips were the most numerous injury events associated with SIRs. DISCUSSION: Although Federal OSHA SIR data do not include SIRs from state-plan jurisdictions, the data provide a timely national trend of SIR. This is the first known time series analysis of SIRs. PRACTICAL APPLICATIONS: The findings of this study highlight the ability of researchers to use the SIRs as a timely indicator to understand occupational injury trends by specific industries and injury events.

Construction industry workers' compensation injury claims due to slips, trips, and falls - Ohio, 2010-2017.

PROBLEM: Compared to other industries, construction workers have higher risks for serious fall injuries. This study describes the burden and circumstances surrounding injuries related to compensable slip, trip, and fall (STF) claims from private construction industries covered by the Ohio Bureau of Workers' Compensation. METHODS: STF injury claims in the Ohio construction industry from 2010-2017 were manually reviewed. Claims were classified as: slips or trips without a fall (STWOF), falls on the same level (FSL), falls to a lower level (FLL), and other. Claim narratives were categorized by work-related risk and contributing factors. Demographic, employer, and injury characteristics were examined by fall type and claim type (medical-only (MO, 0-7 days away from work, DAFW) or lost-time (LT, ≥8 DAFW)). Claim rates per 10,000 estimated full-time equivalent employees (FTEs) were calculated. RESULTS: 9,517 Ohio construction industry STF claims occurred during the 8-year period, with an average annual rate of 75 claims per 10,000 FTEs. The rate of STFs decreased by 37% from 2010 to 2017. About half of the claims were FLL (51%), 29% were FSL, 17% were STWOF, and 3% were "other." Nearly 40% of all STF claims were LT; mostly among males (96%). The top three contributing factors for STWOF and FSL were: slip/trip hazards, floor irregularities, and ice/snow; and ladders, vehicles, and stairs/steps for FLL. FLL injury rates per 10,000 FTE were highest in these industries: Foundation, Structure, and Building Exterior Contractors (52); Building Finishing Contractors (45); and Residential Building Construction (45). The highest rate of FLL LT claims occurred in the smallest firms, and the FLL rate decreased as construction firm size increased. Discussion and Practical Applications: STF rates declined over time, yet remain common, requiring prevention activities. Safety professionals should focus on contributing factors when developing prevention strategies, especially high-risk subsectors and small firms.

Pathogen genomics in public health laboratories: successes, challenges, and lessons learned from California's SARS-CoV-2 Whole-Genome Sequencing Initiative, California COVIDNet.

The capacity for pathogen genomics in public health expanded rapidly during the coronavirus disease 2019 (COVID-19) pandemic, but many public health laboratories did not have the infrastructure in place to handle the vast amount of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequence data generated. The California Department of Public Health, in partnership with Theiagen Genomics, was an early adopter of cloud-based resources for bioinformatics and genomic epidemiology, resulting in the creation of a SARS-CoV-2 genomic surveillance system that combined the efforts of more than 40 sequencing laboratories across government, academia and industry to form California COVIDNet, California's SARS-CoV-2 Whole-Genome Sequencing Initiative. Open-source bioinformatics workflows, ongoing training sessions for the public health workforce, and automated data transfer to visualization tools all contributed to the success of California COVIDNet. While challenges remain for public health genomic surveillance worldwide, California COVIDNet serves as a framework for a scaled and successful bioinformatics infrastructure that has expanded beyond SARS-CoV-2 to other pathogens of public health importance.

Severe Acute Respiratory Syndrome Coronavirus 2 Delta Variant Genomic Variation Associated With Breakthrough Infection in Northern California: A Retrospective Cohort Study.

BACKGROUND: The association between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genomic variation and breakthrough infection is not well defined among persons with Delta variant SARS-CoV-2 infection. METHODS: In a retrospective cohort, we assessed whether individual nonlineage defining mutations and overall genomic variation (including low-frequency alleles) were associated with breakthrough infection, defined as SARS-CoV-2 infection after coronavirus disease 2019 primary vaccine series. We identified all nonsynonymous single-nucleotide polymorphisms, insertions, and deletions in SARS-CoV-2 genomes with ≥5% allelic frequency and population frequency of ≥5% and ≤95%. Using Poisson regression, we assessed the association with breakthrough infection for each individual mutation and a viral genomic risk score. RESULTS: Thirty-six mutations met our inclusion criteria. Among 12 744 persons infected with Delta variant SARS-CoV-2, 5949 (47%) were vaccinated and 6795 (53%) were unvaccinated. Viruses with a viral genomic risk score in the highest quintile were 9% more likely to be associated with breakthrough infection than viruses in the lowest quintile, but including the risk score improved overall predictive model performance (measured by C statistic) by only +0.0006. CONCLUSIONS: Genomic variation within SARS-CoV-2 Delta variant was weakly associated with breakthrough infection, but several potential nonlineage defining mutations were identified that might contribute to immune evasion by SARS-CoV-2.

Comparison of Finger, Hand, and Wrist Injuries in the US Air Force to US Workers.

OBJECTIVE: Fingers, hands, and wrists (FHW) are the most frequently injured body parts in work-related injuries. This study described and compared FHW injuries among enlisted, officer, and civilian US Air Force (USAF) personnel to those in the US workforce. METHODS: All work-related, noncombat FHW injuries (≥1 lost workday) and demographics among USAF personnel and US workforce (2008-2018) were included. The USAF FHW injury rates were age adjusted to the US employment and compared by sex, source, event, and nature of the injuries. RESULTS: Finger, hand, and wrist injuries were significantly lower among the USAF personnel and among females. In both populations, FHW injuries from falls were higher and increased with age group among females. Males had higher overall FHW injuries from contact with objects and equipment. CONCLUSIONS: Prevention efforts should focus on understanding risk factors and sharing successful prevention activities.

Adeno-associated virus type 2 in US children with acute severe hepatitis.

As of August 2022, clusters of acute severe hepatitis of unknown aetiology in children have been reported from 35 countries, including the USA1,2. Previous studies have found human adenoviruses (HAdVs) in the blood from patients in Europe and the USA3-7, although it is unclear whether this virus is causative. Here we used PCR testing, viral enrichment-based sequencing and agnostic metagenomic sequencing to analyse samples from 16 HAdV-positive cases from 1 October 2021 to 22 May 2022, in parallel with 113 controls. In blood from 14 cases, adeno-associated virus type 2 (AAV2) sequences were detected in 93% (13 of 14), compared to 4 (3.5%) of 113 controls (P < 0.001) and to 0 of 30 patients with hepatitis of defined aetiology (P < 0.001). In controls, HAdV type 41 was detected in blood from 9 (39.1%) of the 23 patients with acute gastroenteritis (without hepatitis), including 8 of 9 patients with positive stool HAdV testing, but co-infection with AAV2 was observed in only 3 (13.0%) of these 23 patients versus 93% of cases (P < 0.001). Co-infections by Epstein-Barr virus, human herpesvirus 6 and/or enterovirus A71 were also detected in 12 (85.7%) of 14 cases, with higher herpesvirus detection in cases versus controls (P < 0.001). Our findings suggest that the severity of the disease is related to co-infections involving AAV2 and one or more helper viruses.

Cluster of Norovirus Genogroup IX Outbreaks in Long-Term Care Facilities, Utah, USA, 2021.

We report 5 clustered acute gastroenteritis outbreaks in long-term care facilities in Utah, USA, that were linked to healthcare employees working at multiple facilities. Four outbreaks were caused by norovirus genotype GIX. We recommend continued norovirus surveillance and genotyping to determine contributions of this genotype to norovirus outbreaks.

Severe Acute Respiratory Syndrome Coronavirus 2 and Respiratory Virus Sentinel Surveillance, California, USA, May 10, 2020-June 12, 2021.

State and local health departments established the California Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and Respiratory Virus Sentinel Surveillance System to conduct enhanced surveillance for SARS-CoV-2 and other respiratory pathogens at sentinel outpatient testing sites in 10 counties throughout California, USA. We describe results obtained during May 10, 2020‒June 12, 2021, and compare persons with positive and negative SARS-CoV-2 PCR results by using Poisson regression. We detected SARS-CoV-2 in 1,696 (19.6%) of 8,662 specimens. Among 7,851 specimens tested by respiratory panel, rhinovirus/enterovirus was detected in 906 (11.5%) specimens and other respiratory pathogens in 136 (1.7%) specimens. We also detected 23 co-infections with SARS-CoV-2 and another pathogen. SARS-CoV-2 positivity was associated with male participants, an age of 35-49 years, Latino race/ethnicity, obesity, and work in transportation occupations. Sentinel surveillance can provide useful virologic and epidemiologic data to supplement other disease monitoring activities and might become increasingly useful as routine testing decreases.

Ambient air quality and the risk for Chronic Obstructive Pulmonary Disease among Metro Manila Development Authority traffic enforcers in Metro Manila: An exploratory study.

BACKGROUND: Air pollution and poor ambient air quality are significantly related to multiple health risks. One associated disease is chronic obstructive pulmonary disease (COPD), a preventable disease with several contributing factors and one of the leading causes of morbidity/mortality locally and globally. A potentially high-risk population are traffic enforcers who are constantly exposed to air pollution. In the Philippines, the MMDA has the widest coverage in traffic management. The study determined the risk of COPD among Metro Manila Development Authority (MMDA) traffic enforcers in relation to ambient air quality level, as well as identified other factors that increase the risk of developing COPD. METHODS: Fifty-two MMDA traffic enforcers deployed in PM2.5 air quality sensor areas in Metro Manila from 2016 to 2018 were recruited through stratified sampling. The International Primary Airways Guidelines (IPAG) questionnaire was utilized to measure risk of COPD. Respiratory health and working history were obtained through questionnaires. Department of environment and natural resources provided PM2.5 ambient air quality data which aided in the construction of the Exposure-Month Index. Ordinal logistic regression was used to examine the association of PM2.5 together with the relevant factors and the risk of COPD. RESULTS: We found statistically significant associations between PM2.5 and COPD among high risk category [odds risk (OR): 1.24, 95% confidence interval (CI): 1.07-1.44]. Age (Moderate, OR: 1.16, 95% CI: 0.98-1.38 and High, OR: 10.06, 95% CI: 4.02-25.17) and chest pain (Moderate, OR: 68.65, 95% CI: 1.71-2.75 × 103) were potential risk factors, whereas body mass index (BMI) (OR: 0.05, 95% CI: 0.01-0.53) exhibited protective effect. CONCLUSIONS: Exposure to PM2.5 was associated with an increased risk of COPD among high-risk category MMDA traffic enforcers. Age and chest pain were potential risk factors to risk of COPD, whereas BMI exhibited a potential protective effect. Results of this study can be used for clinical management of high-risk populations, such that of MMDA traffic enforcers.

Public Health Responses to COVID-19 Outbreaks on Cruise Ships - Worldwide, February-March 2020.

An estimated 30 million passengers are transported on 272 cruise ships worldwide each year* (1). Cruise ships bring diverse populations into proximity for many days, facilitating transmission of respiratory illness (2). SARS-CoV-2, the virus that causes coronavirus disease (COVID-19) was first identified in Wuhan, China, in December 2019 and has since spread worldwide to at least 187 countries and territories. Widespread COVID-19 transmission on cruise ships has been reported as well (3). Passengers on certain cruise ship voyages might be aged ≥65 years, which places them at greater risk for severe consequences of SARS-CoV-2 infection (4). During February-March 2020, COVID-19 outbreaks associated with three cruise ship voyages have caused more than 800 laboratory-confirmed cases among passengers and crew, including 10 deaths. Transmission occurred across multiple voyages of several ships. This report describes public health responses to COVID-19 outbreaks on these ships. COVID-19 on cruise ships poses a risk for rapid spread of disease, causing outbreaks in a vulnerable population, and aggressive efforts are required to contain spread. All persons should defer all cruise travel worldwide during the COVID-19 pandemic.

Individual, business-related, and work environment factors associated with driving tired among taxi drivers in two metropolitan U.S. cities.

INTRODUCTION: Violence-related events and roadway incidents are the leading causes of injury among taxi drivers. Fatigue is under-recognized and prevalent in this workforce and is associated with both injury outcomes. We describe the association of individual, business-related, and work environment factors with driving tired among taxi drivers in two very different cities. METHOD: We developed a comprehensive survey for licensed taxi drivers. We trained surveyors to administer the 30-min survey using systematic sampling among taxi drivers waiting for fares in two large U.S. cities: the Southwest (City 1) and the West (City 2). A driving tired scale of the Occupational Driver Behavior Questionnaire was the outcome. Multivariate logistic models described driving tired behavior in city-specific models using adjusted Odds Ratios (ORadj). RESULTS: City 1 and City 2 had 496 and 500 participants, respectively. Each driving tired behavior was significantly more prevalent in City 2 than City 1 (p < .05). There were more variables and a greater diversity of variables in the models describing drowsy driving in City 1 than City 2. In City 1, variables describing negative safety climate (ORadj = 1.15), socio-demographic groups (identifying as Asian, educational attainment), passenger-related violence (ORadj = 1.79), and company tenure (ORadj =1.15) were associated with driving tired. In City 2, high perceived safety training usefulness (ORadj = 0.48) was associated with driving tired. A risk factor for driving tired that was common to both cities was job demands (ORadj = 1.21 in City 1; 1.43 in City 2). CONCLUSIONS: These findings represent two diverse taxi populations driving in two geographically distinct regions that differ in safety regulation. It is important that safety measures that include fatigue awareness training are reaching all drivers. Fatigue management training should be integrated into driver safety programs regardless of location. Practical applications: Fatigue management strategies that recognize individual factors, business-related characteristics, and work environment are an important component of road safety and are particularly relevant for occupational drivers.

Fatal work-related falls in the United States, 2003-2014.

BACKGROUND: Falls are the second leading cause of work-related fatalities among US workers. We describe fatal work-related falls from 2003 to 2014, including demographic, work, and injury event characteristics, and changes in rates over time. METHODS: We identified fatal falls from the Bureau of Labor Statistics (BLS), Census of Fatal Occupational Injuries and estimated rates using the BLS Current Population Survey. RESULTS: From 2003 to 2014, there were 8880 fatal work-related falls, at an annual rate of 5.5 per million FTE. Rates increased with age. Occupations with the highest rates included construction/extraction (42.2 per million FTE) and installation/maintenance/repair (12.5 per million FTE). Falls to a lower level represented the majority (n = 7521, 85%) compared to falls on the same level (n = 1128, 13%). CONCLUSIONS: Falls are a persistent source of work-related fatalities. Fall prevention should continue to focus on regulation adherence, Prevention through Design, improving fall protection, training, fostering partnerships, and increasing communication.

Work-Related Violent Deaths in the US Taxi and Limousine Industry 2003 to 2013: Disparities Within a High-Risk Working Population.

OBJECTIVE: We describe the magnitude and distribution of violent work-related deaths among taxi and limousine drivers, a high-risk population. METHODS: We analyzed rates using the Bureau of Labor Statistics Census of Fatal Occupational Injuries (CFOI) for all violent work-related deaths in the taxi and limousine industry from 2003 to 2013. We described demographics, work characteristics, and other injury details, examining temporal trends for nativity and race/ethnicity. RESULTS: Men (adjusted rate ratio [RRadj] 6.1 [95% confidence interval [CI] 2.6-14.1]), blacks (RRadj 2.3 [95% CI 1.6-3.4]), Hispanics (RRadj 2.1 [95% CI 1.3-3.4]), and drivers in the South (RRadj 2.7 [95% CI 1.9-3.9]) had significantly higher fatality rates than comparison groups. Over time, the rates remained substantially higher compared with all workers. CONCLUSIONS: The taxi and limousine industry continues to face a disproportionately dangerous working environment. Recommended safety measures implemented uniformly by cities, companies, and drivers could mitigate disparities.

Genome Sequences of Two Listeria monocytogenes Strains from Nectarines Associated with Listeriosis in 2014.

Listeria monocytogenes is an important foodborne pathogen. Here, we present the annotated whole genome of Listeria monocytogenes strains F14M01297-C2 and F14M01297-C4, isolated from nectarines distributed by a packing facility in California during an investigation of listeriosis associated with stone fruit in 2014.

Draft Genome Sequence of an ortho-Nitrophenyl-ß-d-Galactoside (ONPG)-Negative Strain of Vibrio cholerae, Isolated from Drakes Bay, California.

We present the draft whole-genome sequence of a Vibrio cholerae strain (Vc25-3) isolated from Drakes Bay, California. This environmental isolate has an atypical morphology and is ortho-nitrophenyl-ß-d-galactoside (ONPG)-negative.