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This study suggests that lack of adequate PPE can lead to HCP burnout, which may result in employees quitting. A pandemic preparedness plan for future pandemics or outbreaks that does not include adequate and appropriate PPE may increase health care personnel burnout and intention to leave post. Objective: The aim of the study is to explore associations among personal protective equipment (PPE) availability, workplace environment, and burnout among US healthcare personnel during the COVID-19 pandemic. Methods: The study used an online healthcare provider (HCP) survey (December 2020–February 2021) regarding PPE confidence, availability, burnout, and workplace environment. Results: Lack of appropriate PPE was reported by 27% of 799 US HCP surveyed. Burnout, reported by 77% of HCP, was more likely among females, those with fewer years of professional experience, and those with a higher desire to quit, and less likely for those who perceived PPE was adequate or their employer took all steps to minimize workplace risks. Conclusions: This study suggests that lack of adequate PPE can lead to HCP burnout, which may result in employees quitting. A pandemic preparedness plan that includes adequate PPE is essential for HCP well-being, patient health, and employer fiscal health. [ABSTRACT FROM AUTHOR]

Objectives: The aims of the study are to determine best practices from two large-scale, academic niedical centers' employee coronavirus 2019 (COVID-19) vaccination clinics and to apply them to create scalable modules for rapid administration of 10,000 vaccinations. Methods: The weekly number of COVID-19 vaccine doses administered was captured. Processes were compared to determine best practices, which informed the scalable financial model. Results: Within the first 3 months, more than 60,000 COVID-19 vaccine doses were administered, and 70% of employees were fully vaccinated in 4 months with more than 95% by the vaccine mandate deadline. The estimated cost of delivering one dose was $29.95 ($299,505/10.000) compared with $35-$39 per dose when delivered by an on-site retail phannacy. Conclusions: Successful, safe, and rapid delivery of more than 60,000 COVID-19 vaccine doses in 3 months is practical and scalable. Learnings go beyond COVID-19 and can be applied to fliture outbreaks/pandemics. [ABSTRACT FROM AUTHOR]

Occupational and environmental medicine (OEM) is an ACGME-accredited preventive medicine specialty focused on work as a social determinant of health and population health. OEM providers recognize and mitigate workplace and environmental hazards, treat resultant injuries and illnesses, and promote the health, wellness and resiliency of workers and communities. Multidisciplinary residency training in clinical medicine, epidemiology, public and population health, toxicology, exposure and risk assessment, and emergency preparedness equips them with the skill set needed for leadership roles in diverse settings. These include clinical practice, academia, corporate settings, and governmental agencies. Despite robust job opportunities, a shortage of formally trained OEM physicians remains and is expected to worsen given a declining number of training programs. We examine root causes of the system-level issues impacting the supply of OEM physicians and potential solutions. [ABSTRACT FROM AUTHOR]

Objective: To determine factors associated with return to work in US diplomats injured during a work assignment in Cuba. Methods: In this case series work ability was determined at each visit. Questionnaires used included the Symptom Score Questionnaire, Beck Anxiety Inventory, Beck Depression Inventory, Quality-of-Life Inventory, and Patient Health Questionnaire. Results: Of the 45 employees referred to Occupational Medicine, the mean age was 42.5 years, 60% were men, 68% were never out of work, 22% were out of work for some period, and 15% remain out of work. Vestibular, cognitive, hearing, sleep, and visual symptoms, and a higher initial symptom score were significantly associated with work inability while psychiatric symptoms were not. Conclusions: This exposure resulted in prolonged illness with cognitive impairment and other clinical manifestations associated with work inability. [ABSTRACT FROM AUTHOR]

Objective: To determine prevalence and key drivers of burnout in Occupational and Environmental Medicine physicians in the United States. Methods: A nationwide survey of Occupational Medicine physicians was conducted using the Qualtrics® platform. Burnout, measured by the Maslach Burnout Inventory®, Social Support, and Job Satisfaction were assessed. Results: The response rate was 46%, the overall burnout prevalence 38%, and most respondents were men (69%). The mean age and mean years in practice were 56 years and 20 years respectively. Physicians working in govemment/military (48%) and private medical center group settings (46%) were significantly more likely to report burnout, with consultants (15%) reporting the lowest rate. Conclusions: Although the overall burnout prevalence is lower in Occupational Medicine physicians compared with most specialties, the rate varies significantly by practice setting (15% to 48%) affirming the impact of organizational factors. [ABSTRACT FROM AUTHOR]

Objective: Prescription opioid and benzodiazepine drug use, which has risen significantly, can affect worker health. Exploration of the scientific literature assessed (1) interrelationships of such drug use, occupational risk factors, and illness and injury, and (2) occupational and personal risk factor combinations that can affect their use. Methods: The scientific literature from 2000 to 2015 was searched to determine any interrelationships. Results: Evidence for eight conceptual models emerged based on the search yield of 133 articles. These models summarize interrelationships among prescription opioid and benzodiazepine use with occupational injury and illness. Factors associated with the use of these drugs included fatigue, impaired cognition, falls, motor vehicle crashes, and the use of multiple providers. Conclusion: Prescription opioid and benzodiazepine drugs may be both a personal risk factor for work-related injury and a consequence of workplace exposures. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Then and Now Forum: The healthy Worker Effect" by Richard R. Monson that was published in the previous issue.

The article presents the Occupational Physicians Scholarship Fund (OPSF) as a private support for postgraduate physician training entering the field of occupational and environmental medicine (OEM). The fund is responding to the shortage of physicians in OEM that specialize in the prevention, diagnosis and treatment of illnesses and injuries associated in the workplace and the environment. The success of the fund was measured based on the number of scholars who become diplomates of the American Board of Preventive Medicine, certified in Occupational Medicine (ABPM/OM), scholar performance on the ABPM/OM-certifying examination, retention of scholars and their membership in American College of Occupational and Environmental Medicine (ACOEM).

Studies the impact of a health care management initiative on reducing costs from workers' compensation. Key issues of interest; Analysis of pertinent topics and relevant issues; Implications on occupational and environmental medicine.

Focuses on the External Practicum Year Residency Training Program in Occupational and Environmental Medicine at the University of Pennsylvania Medical Center in Pennsylvania. Requirements for admission to the program; Objectives of the program; Approaches for the evaluation and improvement of the program.

Compares the status of workers' compensation costs for two sets of injured workers at the Johns Hopkins Medical Institutions (JHMI) in the United States, before and after the implementation of managed care. Description of research methods utilized; Details on the study population assessed; Analysis of statistical data on compensation costs.

The article provides information on the perceived occupational cluster. It mentions that occupational clusters were found to have been caused by polycyclic aromatics found in soot. It recounts that most of the clusters that have yielded etiologic information have been occupational and not environmental. The perceived occupational clusters require investigation through the utilization of a systematic, integrated approach and workers must be informed of the results regardless of whether or not it was confirmed as an epidemiological and statistical cluster. It presents the CDC protocol for occupational disease cluster investigation wherein a four-stage process is recommended including initial response, assessment, major feasibility study and etiologic investigation.

The article discusses whether a mobile ultraviolet (UV) room sterilizing device can produce sufficient amounts of ozone to induce symptoms in an employee. This device is used as an adjunct to standard cleaning and disinfection practices in health care settings and combat hospital-acquired infections due to bacteria lie Clostridium difficile. It cites the need for continued vigilance for environmental and other health hazards given this case of an unintentional ozone exposure.

A report on a series of six Forum Articles from the American College of Occupational and Environmental Medicine (ACOEM) Task Force on Climate Change which discusses the impact of climate change on the workplace and workers' health.

The article provides an answer to a question of what are the differences between the tuberculin skin test and the QuantiFERON-TB Gold test.

Background: Rotator cuff repair (RCR) is increasingly being performed for both acute traumatic and degenerative tears of the rotator cuff, while total shoulder arthroplasty (TSA) is reserved for osteonecrosis of the humeral head, arthritis of the glenohumeral joint and failed RCR., Objective: To assess the incidence and patient characteristics of rotator cuff tears (RCTs), RCRs, and TSAs among workers' compensation (WC) claimants., Method: 8,347 RCT indemnity claims filed to Accident Fund Group from 2007 to 2022 were studied., Results: Over the study period, the percentages of RCTs increased from 41% to 65% among shoulder injury indemnity claimants, RCRs increased from 88% to 92% of RCTs and TSAs increased from 1% to 5%., Conclusion: RCT, RCR, and TSA have increased dramatically among WC claimants, age of the injured worker being the primary determinant of the increase., Competing Interests: Conflict of interest: None declared, (Copyright © 2024 American College of Occupational and Environmental Medicine.)

Introduction: The "future of work" refers to workplace modifications projected to occur following large scale events impacting workforce health and safety such as pandemics, technological advancements, or economic shifts. This paper examines the influence of the COVID-19 pandemic on the future of work., Methods: The electronic databases PubMed, Google Scholar, and Scopus were explored using search terms such as "post-pandemic," "working force," and "future of work" to retrieve papers published between 2000 and 2023., Results: The main characteristics of the future of work modification revealed are blurring of work-home boundaries, increase in telework and the gig economy, demand for artificial intelligence, smart working, quiet hiring, diversity and inclusion, and algocratic governance. Needed skills include virtual collaboration capability, cross-cultural competency, computational thinking, news media literacy, transdisciplinarity, sense making, and focusing on mental health and well-being., Conclusions: Organizations are remodeling workforces to meet employee, employer, regulatory, and market expectations to adapt to future workplace needs., Competing Interests: Conflict of interest: None declared., (Copyright © 2024 American College of Occupational and Environmental Medicine.)

Objective: The aim of the study is to determine the morphine equivalent dose in milligrams (MED)/day escalation trend after initial utilization., Methods: A total of 25,108 lost time claims filed between 1998 and 2007 were followed for 8 years from injury date. Claims were stratified by initial MED/day at 3 months after injury into four groups (0, 1 to < 15, 15 to < 30, and ≥30 MED/day). The slopes in MED/year of opioid dose escalation were determined for each initial MED/day group., Results: The slopes of MED/day escalation by initial MED categories were similar ( P ≥ 0.05) ranging from 5.38 to 7.76 MED annually. On average, MED/day increased in a liner pattern with a slope at 6.28 MED/year ( P < 0.01)., Conclusions: Opioid MED/day increased in a linear pattern, regardless of initial MED/day dose., Competing Interests: Conflicts of interest. None declared., (Copyright © 2023 American College of Occupational and Environmental Medicine.)

Competency is defined as possession of sufficient physical, intellectual, and behavioral qualifications to perform a task or serve in a role which adequately accomplishes a desired outcome. Recognizing the need for defining competencies essential to occupational and environmental medicine (OEM) physicians, the American College of Occupational and Environmental Medicine developed its first set of OEM Competencies in 1998. Later updated in 2008, and again in 2014, the increasing globalization and modernization of the workplace, along with published research on OEM practice, required an update to ensure OEM physicians stay current with the field and practice of OEM. Delineation of core competencies for the profession provides employers, government agencies, health care organizations, and other health practitioners a solid context of the role and expertise of OEM physicians., Competing Interests: The author declares no conflicts of interest., (Copyright © 2021 American College of Occupational and Environmental Medicine.)

Objective: Insomnia is often unrecognized in the workplace despite a 10% prevalence. Cognitive behavioral therapy for insomnia (CBTi) is efficacious but often not available. This study assessed the efficacy of the self-guided CBTi Coach mobile app., Methods: Using a pre/post design, the CBTi Coach was evaluated prospectively in hospital nurses with insomnia. The primary outcome measured was the Insomnia Severity Index (ISI) at 0, 3, and 6 weeks., Results: Thirteen of 17 (76%) female nurses who worked day shifts completed the study. Baseline ISI was 18.1 (range 15 to 22). After 3 and 6 weeks, ISI significantly decreased to 12 and 11, respectively. No difference in ISI score was noted between weeks 3 and 6., Conclusion: Use of CBTI Coach app demonstrated significant improvement in sleep quality in nurses with insomnia without coaching or healthcare provider visits.