Journal of Occupational and Environmental Medicine - Published Ahead-of-Print

A Men's Workplace Health Intervention: Results of the POWERPLAY Program Pilot Study. Objective: To explore physical activity and eating behaviors among men following the implementation of a gender-sensitive, workplace health promotion program. Methods: Using a pre-post within-subjects design, computer-assisted telephone interviewing (CATI) was used to collect health-related information along with physical activity and fruit/vegetable intake at baseline and after 6 months. Results: At baseline, participants (N = 139) consumed 3.58 servings of fruit and vegetables/day and engaged in an average of 229.77 min/week moderate-vigorous physical activity (MVPA). At 6 months, daily fruit/vegetable intake did not increase, whereas MVPA increased by 112.3 min/week. Conclusions: The POWERPLAY program successfully increased weekly MVPA. Engaging men in health promotion can be a challenge; here, the workplace served as a valuable environment for achieving positive change. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/4.0 Copyright (C) 2016 by the American College of Occupational and Environmental Medicine

Use of Framingham Risk Score as a Clinical Tool for the Assessment of Fitness for Work: Results From a Cohort Study. Objective: The aim of this study is to validate the use of the Framingham Risk Score (FRS) as clinical tool to predict the risk of diagnosis of unsuitability for work in a cohort of Italian workers. Methods: A cohort of workers has been observed from January 2006 to March 2014. FRS was calculated at each visit. Health surveillance diagnosis of unsuitability for work was selected as outcome. Results: Two thousand eight hundred fifty seven workers were observed, 58.9% were men, mean age was 51.6 (+/-6.7), the mean FRS was 15.1% (+/-10.7%). Increased values of FRS at baseline were associated with increased rate of diagnosis of unsuitability for work (Hazard ratio [HR], 11.2, 95%CI, 3.3 to 37.8). Conclusions: FRS is a strong predictor of diagnosis of unsuitability for work and should be used as a clinical tool for the assessment of fitness for work in health surveillance. Copyright (C) 2016 by the American College of Occupational and Environmental Medicine

Sleep and Productivity Benefits of Digital Cognitive Behavioral Therapy for Insomnia: A Randomized Controlled Trial Conducted in the Workplace Environment. Objective: Evaluating digital cognitive behavioral therapy (dCBT) for insomnia in a workplace environment. Methods: Within a randomized controlled trial in a Fortune 500 company, we randomized 270 self-identified poor sleepers [180 M/90 F: mean age 33.6 years (23 to 56 years)] to dCBT (n = 135) or waiting list (WL, n = 135). dCBT comprised six online sessions delivered by an animated therapist. Major assessments were at baseline and posttreatment. Results: Sleep Condition Indicator (SCI) scores were significantly higher for the dCBT group [interaction term: F (1,485) = 15.63, P < 0.0001], representing Cohen's d of 1.10 following dCBT (d = 0.34 for WL). On the Work Productivity and Impairment questionnaire, "presenteeism" demonstrated significant improvements following dCBT [F(1,485) = 10.99, P = 0.001: d = 0.64 for dCBT, d = 0.09 for WL]. Effects for "abseenteeism" failed to reach statistical significance (P = 0.101). Conclusions: dCBT is effective in improving sleep and work-based productivity in adults with insomnia. Copyright (C) 2016 by the American College of Occupational and Environmental Medicine

Associations Between Fish Consumption and Contaminant Biomarkers With Cardiovascular Conditions Among Older Male Anglers in Wisconsin. Objective: The aim of this study was to determine fish consumption habits and contaminant exposures associated with adverse cardiovascular outcomes among older male anglers. Methods: One hundred fifty-four men aged 50 years and older living and fishing in Wisconsin completed a detailed survey and provided hair and blood samples. Associations between fish consumption and body burdens of several contaminants, with self-reported cardiovascular outcomes, were evaluated. Results: Consuming fish species with higher methyl mercury content was positively associated with odds of angina, coronary heart disease (CHD), or heart attack, while consuming fattier species was negatively associated with high blood pressure or high cholesterol. Total mercury in blood was associated with 27% higher odds of heart attack, and certain classes of polychlorinated biphenyls were positively associated with CHD. Conclusion: Total mercury exposures may affect cardiovascular outcomes. Educational interventions promoting consumption of fish low in methyl mercury among older male anglers are needed. Copyright (C) 2016 by the American College of Occupational and Environmental Medicine

Fish Consumption, Levels of Nutrients and Contaminants, and Endocrine-Related Health Outcomes Among Older Male Anglers in Wisconsin. Objective: The aim of this study was to examine associations between endocrine disorders, fish consumption habits, and biomarkers of contaminants and nutrients Methods: Male anglers aged at least 50 years living in Wisconsin (n = 154) completed a questionnaire and provided biological samples. Adjusted logistic regression models were used to evaluate risk factors for endocrine outcomes. Results: Nineteen percent of anglers reported either pre-diabetes or diabetes, while 4.6% reported thyroid disease. There were few associations between endocrine disease and fish consumption, fish meal source, or species, aside from a notable increase in diabetes risk with lake trout consumption. Docosahexaenoic acid, certain polychlorinated biphenyls (PCBs), and perfluorinated compounds were associated with an increased risk of diabetes or pre-diabetes. PCBs were associated with a decreased risk of thyroid disease. Conclusion: Fish consumption patterns may affect risk for endocrine outcomes, but direction and magnitude of association may depend on the balance of the contaminants and nutrients in the individual diet. Copyright (C) 2016 by the American College of Occupational and Environmental Medicine

How Do I Diagnose and Treat Workers With Injuries From Hydrofluoric Acid?. No abstract available

Burn Pit Emissions Exposure and Respiratory and Cardiovascular Conditions Among Airborne Hazards and Open Burn Pit Registry Participants. Objective: The aim of this study was to determine how burn pit emissions exposure is associated with the incidence of respiratory and cardiovascular conditions. Methods: We examined the associations between assumed geographic and self-reported burn pit emissions exposure and respiratory and cardiovascular outcomes in participants of the Airborne Hazards and Open Burn Pit Registry. Results: We found significant dose-response associations for higher risk of self-reported emphysema, chronic bronchitis, or chronic obstructive pulmonary disease with increased days of deployment within 2 miles of selected burn pits (P-trend = 0.01) and self-reported burn pit smoke exposure (P-trend = 0.0005). Conclusions: We found associations between burn pit emissions exposure and higher incidence of post-deployment self-reported respiratory and cardiovascular conditions, but these findings should be interpreted with caution because the surrogate measurements of burn pit emissions exposure in this analysis may not reflect individual exposure levels. Copyright (C) 2016 by the American College of Occupational and Environmental Medicine

Characteristics of Cardiac Arrest Occurring in the Workplace: A Post Hoc Analysis of the Paris Area Fire Brigade Registry. Objectives: The aim of this study was to describe the characteristics of out-of-hospital cardiac arrest (OHCA) in different workplaces, their management, and the survival rate. Methods: A post hoc analysis included all the OHCA cases that occurred at the workplace and were listed in the Fire Brigade of Paris database registry (2010 to 2014). Utstein-style variables, survival, and types of workplace were analyzed. Results: The study included 298 OHCA cases, mostly young (44% between 18 and 50 years), male (86%), and nontraumatic (86%). Differences in the survival chain were found to be related to the types of work location: bystander cardiopulmonary resuscitation was performed in 0% to 55% of cases, and workplace-automated external defibrillators were used in 0% to 20% of cases. Long-term survival without major incapacity was 0% to 23%. Conclusions: The characteristics of OHCA differ as a function of the type of workplace. Copyright (C) 2016 by the American College of Occupational and Environmental Medicine

Diurnal and Reactivity Measures of Cortisol in Response to Intensive Resilience and Tactical Training Among Special Forces Police. Special Forces Police are called to the most dangerous situations that require skills and equipment beyond the training available to a patrol officer. We recruited a platoon of special forces (n = 18) and examined their basal and reactivity levels of cortisol in relation to occupational duties. Moreover, we measured the impact of a multiday program of intensive resilience and tactical training in improving cortisol responses to stressful situations. Participants were significantly more likely to exhibit basal cortisol levels higher than the civilian norms across all of the 5 days of intensive training. However, anticipatory cortisol, measured directly before exposure to critical incident scenarios, was significantly lower in Day 5 than in Day 1 of the training period. This study demonstrates that measuring cortisol is an objective method of examining training effects and possible long-term occupational health outcomes. Copyright (C) 2016 by the American College of Occupational and Environmental Medicine

Psychosocial Working Conditions and Suicide Ideation: Evidence From a Cross-Sectional Survey of Working Australians. Objectives: This study examined the relationship between psychosocial working factors such as job control, job demands, job insecurity, supervisor support, and workplace bullying as risk factors for suicide ideation. Methods: We used a logistic analytic approach to assess risk factors for thoughts of suicide in a cross-sectional sample of working Australians. Potential predictors included psychosocial job stressors (described above); we also controlled for age, gender, occupational skill level, and psychological distress. Results: We found that workplace bullying or harassment was associated with 1.54 greater odds of suicide ideation (95% confidence interval 1.64 to 2.05) in the model including psychological distress. Results also suggest that higher job control and security were associated with lower odds of suicide ideation. Conclusions: These results suggest the need for organizational level intervention to address psychosocial job stressors, including bullying. Copyright (C) 2016 by the American College of Occupational and Environmental Medicine