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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]

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.

CONTEXT: Latex allergy and sensitization have been an important problem facing health care workers. Providing a latex-safe environment is the intervention of choice. CASE PRESENTATION: A 46-year-old surgical pathologist presented with increasing shortness of breath for the previous 4 years. Twenty years before presentation, he noted a pruritic, erythematous rash on his hands, associated with latex glove use. Fourteen years before presentation, during pathology residency, he developed a nonproductive cough, wheezing, and an urticarial rash, temporally associated with use of powdered latex gloves. These symptoms improved while away from work. At presentation, he had one-flight dyspnea. His skin prick test was positive for latex, and pulmonary function testing showed mild obstruction, which was reversible with bronchodilator use. Because the patient was at risk for worsening pulmonary function and possible anaphylaxis with continued exposure, he was removed from the workplace because no reasonable accommodation was made for him at that time. DISCUSSION: The patient's presentation is consistent with latex-induced occupational asthma. Initially noting dermal manifestations, consistent with an allergic contact dermatitis secondary to accelerators present in latex gloves, he later developed urticaria, flushing, and respiratory symptoms, consistent with a type I hypersensitivity reaction to latex. He also has reversible airways disease, with significant improvement of peak expiratory flow rate and symptoms when away from work. RELEVANCE TO CLINICAL OR PROFESSIONAL PRACTICE: The ideal treatment for latex sensitization is removal from and avoidance of exposure. Clinicians should consider occupational asthma when patients present with new-onset asthma or asthmatic symptoms that worsen at work. [ABSTRACT FROM AUTHOR]

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.

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 offers information on the importance of incorporating occupational health data into electronic health records (EHRs) for all clinicians caring for workers. The topics covered include the support of the American College of Occupational and Environmental Medicine (ACOEM) for collecting and sharing occupational health information in EHRs, the criteria for EHR systems to effectively share this information, and the recommendations for recording and using occupational information in EHRs.

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. [ABSTRACT FROM AUTHOR]