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Background: Green jobs are a rapidly emerging category of very heterogeneous occupations that typically involve engagement with new technologies and changing job demands predisposing them to physical stressors that may contribute to the development of joint pain., Methods: We estimated and compared the prevalence of self-reported acute (past 30 days) joint pain between green and non-green collar workers using pooled 2004-2012 National Health Interview Survey (NHIS) data linked to the Occupational Information Network Database (O*NET)., Results: Green collar workers have a higher prevalence of acute joint pain as compared to non-green collar workers. Green collar workers with pain in the upper extremity joints were significantly greater than in the non-green collar workforce, for example, right shoulder [23.2% vs 21.1%], right elbow [13.7% vs 12.0%], left shoulder [20.1% vs 18.2%], and left elbow [12.0% vs 10.7%]., Conclusions: Acute joint pain reported by the emerging green collar workforce can assist in identifying at risk worker subgroups for musculoskeletal pain interventions., (© 2017 Wiley Periodicals, Inc.)

Objective: We describe the socio-demographic, occupational, and health characteristics of "green collar" workers, a vital and emerging workforce in energy-efficiency and sustainability., Methods: We linked data from the 2004 to 2012 National Health Interview Surveys (NHIS) and US Occupational Information Network (O*NET). Descriptive and logistic regression analyses were conducted using green collar worker status as the outcome (n = 143,346)., Results: Green collar workers are more likely than non-green workers to be men, age 25 to 64 years, obese, and with less than or equal to high school (HS) education. They are less likely to be racial/ethnic minorities and employed in small companies or government jobs., Conclusions: Green collar workers have a distinct socio-demographic and occupational profile, and this workforce deserves active surveillance to protect its workers' safety. The NHIS-O*NET linkage represents a valuable resource to further identify the unique exposures and characteristics of this occupational sector.

Introduction: Young adult workers (18-24 years) in the United States have been identified as a high-risk group for smoking. This study compares changes in smoking behavior by occupational class among this group between 2005 and 2010., Methods: Data were pooled from the Tobacco Supplement in the 2005 and 2010 National Health Interview Survey. All respondents 18-24 years who reported that they were employed during the two surveys were selected (n = 1880 in 2005; and n = 1531 in 2010). Weighted percentages and 95% confidence interval were reported. Logistic regression analyses were performed to compare smoking behavior between occupational groups (white-collar, blue-collar, and service) and between years (2005-2010), and to examine correlates of smoking, successful quit attempt, and heavy smoking., Results: Smoking prevalence and daily smoking declined in 2010 in white-collar. Smoking prevalence and intensity decreased while age of smoking initiation increased in blue-collar workers. Young workers were more likely to smoke in 2005 than 2010. Service and blue-collar workers were more likely to smoke than white-collar workers. Older young adults, whites, individuals with a high school/or less education, those without health insurance were more likely to smoke. White workers and individuals with a high school/or less education were more likely to be heavy smokers., Conclusions: White-collar workers have benefited the most from tobacco control efforts. Although improvements were seen in smoking behavior among blue-collar workers, smoking prevalence remained the highest in this group. Smoking behavior among service workers did not change. Young service workers and blue-collar are priority populations for workplace tobacco control efforts., Implications: The current study examines changes in smoking behavior among young adult workers (18-24 years) by occupational class (white-collar, blue-collar, and service workers) between 2005 and 2010. Data were pooled from the Tobacco Supplement in the 2005 and 2010 National Health Interview Survey. Smoking prevalence and daily smoking declined significantly in white-collar workers. No change in smoking behavior was observed among service workers. Positive changes in smoking behavior were observed among blue-collar workers, but smoking prevalence remained the highest in this group. Blue-collar and service workers are priority groups for future workplace tobacco control efforts., (© The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: Violence toward children (childhood victimization) is a major public health problem, with long-term consequences on economic well-being. The purpose of this study was to determine whether childhood victimization affects occupational prestige and income in young adulthood. We hypothesized that young adults who experienced more childhood victimizations would have less prestigious jobs and lower incomes relative to those with no victimization history. We also explored the pathways in which childhood victimization mediates the relationships between background variables, such as parent's educational impact on the socioeconomic transition into adulthood., Methods: A nationally representative sample of 8,901 young adults aged 18-28 surveyed between 1999-2009 from the National Longitudinal Survey of Youth 1997 (NLSY) were analyzed. Covariate-adjusted multivariate linear regression and path models were used to estimate the effects of victimization and covariates on income and prestige levels and on income and prestige trajectories. After each participant turned 18, their annual 2002 Census job code was assigned a yearly prestige score based on the 1989 General Social Survey, and their annual income was calculated via self-reports. Occupational prestige and annual income are time-varying variables measured from 1999-2009. Victimization effects were tested for moderation by sex, race, and ethnicity in the multivariate models., Results: Approximately half of our sample reported at least one instance of childhood victimization before the age of 18. Major findings include 1) childhood victimization resulted in slower income and prestige growth over time, and 2) mediation analyses suggested that this slower prestige and earnings arose because victims did not get the same amount of education as non-victims., Conclusions: Results indicated that the consequences of victimization negatively affected economic success throughout young adulthood, primarily by slowing the growth in prosperity due to lower education levels.

Objective: To explore the association between cardiovascular fitness and metabolic syndrome across occupational groups using a nationally representative sample of the US population., Methods: Respondents aged 18 to 49 years from the 1999 to 2004 National Health and Nutrition Examination Survey were evaluated for cardiovascular fitness and classified with regard to metabolic syndrome. Comparisons were made across 40 occupational categories., Results: For all occupations with and without metabolic syndrome, the estimated maximal oxygen consumption (VO2max) was 38.8 mL/kg/min (standard error = 0.5) and 41.1 mL/kg/min (standard error = 0.2), respectively. The estimated VO2max was higher for those without metabolic syndrome for most occupational groups, particularly for sales supervisors and proprietors, sales representatives, finance, business, and commodities, and freight, stock, and material movers., Conclusions: Low estimated VO2max among workers with metabolic syndrome can be addressed, in part, by workplace interventions designed to increase fitness. This study identifies priority occupational groups for these interventions.

Objectives: To provide an overview of the health status of young US workers across four domains: functional health, physical and psychological health, health behavior, and health care utilization., Methods: Pooled data from the 2004 to 2010 National Health Interview Survey were analyzed for 11,279 US workers aged 18 to 24 years, representing an estimated 16.9 million workers annually. Thirty-nine health indicators were examined and compared across nine occupational groups., Results: Compared with other occupational groups, craft workers and laborers and helpers had the highest prevalence of risky health behaviors, including current smoking and risky drinking, as well as fewer reported visits to a primary care physician in the past year., Conclusions: Young workers engage in risky health behaviors, and may benefit from targeted workplace interventions to mitigate the potentially negative long-term effects on health and well-being.

The association between education or income and mortality has been explored in great detail. These measures capture both the effects of material disadvantage on health and the psychosocial impacts of a low socioeconomic position on health. When explored independently of educational attainment and income, occupational prestige - a purely perceptual measure - serves as a measure of the impact of a psychosocial phenomenon on health. For instance, a fire-fighter, academician or schoolteacher may carry the social benefits of a higher social status without actually having the income (in all cases) or the educational credentials (in the case of the fire-fighter) to match. We explored the independent influence of occupational prestige on mortality. We applied Cox proportional hazards models to a nationally representative sample of over 380,000 US workers who had worked at any time between 1986 and 1994 with mortality follow up through 2002. We found that occupational prestige is associated with a decrease in the risk of all-cause, cancer, cardiovascular and respiratory-related mortality after controlling for household income and educational attainment. We further investigated the question of whether the effects of prestige are moderated by sex and broader occupational groupings. Prestige effects operate in white-collar occupations for men only and within service occupations for all workers., (© 2012 The Authors. Sociology of Health & Illness © 2012 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.)

Background: Workplace injuries can have a substantial economic impact. Rates of workplace injuries differ across age groups, yet occupations/industry sectors at highest risk within age groups have not been identified. We examined workplace injury risk across industry sectors for three age groups using nationally representative U.S. data., Methods: Data from 1997 to 2009 National Health Interview Survey (NHIS) were pooled for employed adults by age groups: (1) 18-25 (n = 22,261); (2) 26-54 (n = 121,559); and (3) 55+ (n = 24,851). Workplace injury risk comparisons were made using logistic regression, with the Services sector as the referent and adjustment for sample design, gender, education, race/ethnicity, age, and income-to-poverty ratio., Results: Overall 3-month injury prevalence was 0.88%. Highest risk sectors for workers aged 18-25 included: Agriculture/forestry/fisheries (odds ratio = 4.80; 95% confidence interval 2.23-10.32), Healthcare/social assistance (2.71; 1.50-4.91), Construction (2.66; 1.56-4.53), Manufacturing (2.66; 1.54-4.61); for workers 26-54: Construction (2.30; 1.76-3.0), Agriculture/forestry/fisheries (1.91; 1.16-3.15), and Manufacturing (1.58; 1.28-1.96); for workers 55+: Agriculture/forestry/fisheries (3.01; 1.16-7.81), Transportation/communication/other public utilities (2.55; 1.44-4.49), and Construction (2.25; 1.09-4.67)., Conclusions: Agriculture/forestry/fisheries and Construction were among the sectors with highest workplace injury risk for workers across all age groups. Differences in highest risk industries were identified between the youngest and oldest industry groups. Our results indicate a need for age-specific interventions in some industries, and a need for more comprehensive measures in others., (Copyright © 2011 Wiley Periodicals, Inc.)

Introduction: Approximately 40% of Americans annually diagnosed with cancer are working-age adults. Using a nationally representative database, we characterized differences in health status and occupation of working cancer survivors and persons without cancer., Methods: Cross-sectional data pooled from the 1997-2009 US National Health Interview Survey for adults with self-reported physician-diagnosed cancer (n=22,952) and those without (n=358,495), were analyzed. Multivariable logistic regression was used to compare the health and disability status of employed cancer survivors across occupational sectors relative to workers without a cancer history and unemployed cancer survivors., Results: Relative to workers with no cancer history, cancer survivors were more likely (OR; 95%CI) to be white-collar workers and less likely to be service workers. Working cancer survivors were significantly less likely than unemployed survivors, but more likely than workers with no cancer history, to report poor-fair health (0.25; 0.24-0.26) and (2.06; 1.96-2.17) respectively, and ≥ 2 functional limitations (0.37; 0.35-0.38) and (1.72; 1.64-1.80) respectively. Among employed cancer survivors, blue-collar workers reported worse health outcomes, yet they reported fewer workdays missed than white-collar workers., Conclusion: Blue-collar cancer survivors are working with high levels of poor health and disability. These findings support the need for workplace accommodations for cancer survivors in all occupational sectors, especially blue-collar workers., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Objective: To explore cardiovascular fitness in 40 occupations using a nationally representative sample of the US population., Methods: Respondents aged 18 to 49 years (N = 3354) from the 1999 to 2004 National Health and Nutrition Examination Survey were evaluated for cardiovascular fitness and classified into low, moderate, and high levels. Comparisons were made among occupations., Results: Of all the US workers, 16% had low, 36% moderate, and 48% high cardiovascular fitness. Administrators, health occupations, wait staff, personal services, and agricultural occupations had a lesser percentage of workers with low cardiovascular fitness compared with all others. Sales workers, administrative support, and food preparers had a higher percentage of workers with low cardiovascular fitness compared with all others., Conclusions: Cardiovascular fitness varies significantly across occupations, and those with limited physical activity have higher percentages of low cardiovascular fitness. Workplace strategies are needed to promote cardiovascular fitness among high-risk occupations.

Objectives: Through use of a nationally representative database, we examined the variability in both self-rated health and overall mortality risk within occupations across the National Occupational Research Agenda (NORA) Industry Sectors, as well as between the occupations within the NORA Industry sectors., Methods: Using multiple waves of the National Health Interview Survey (NHIS) representing an estimated 119,343,749 US workers per year from 1986 to 2004, age-adjusted self-rated health and overall mortality rates were examined by occupation and by NORA Industry Sector., Results: There was considerable variability in the prevalence rate of age-adjusted self-rated poor/fair health and overall mortality rates for all US workers. The variability was greatest when examining these data by the Industry Sectors. In addition, we identified an overall pattern of increased poor/fair self-reported health and increased mortality rates concentrated among particular occupations and particular Industry Sectors., Conclusions: This study suggests that using occupational categories within and across Industry Sectors would improve the characterization of the health status and health disparities of many subpopulations of workers within these Industry Sectors., (Copyright © 2011 Wiley-Liss, Inc.)

Objectives: The working poor sometimes delay retirement to survive. However, their higher risk of disease and disability threatens both their financial survival and their ability to work through the retirement years. We used the burden of disease attributable to arthritis by occupational class to illustrate the challenges faced by the older poor., Methods: We merged data from the National Health Interview Survey, Medical Expenditure Panel Survey, and the National Death Index into a single database. We then calculated and compared age- and occupational class-specific quality-adjusted life years (QALYs) between workers with and without arthritis by using unabridged life tables., Results: White-collar workers have a higher overall health-related quality of life than do other workers, and suffer fewer QALYs lost to arthritis at all ages. For instance, whereas 65-year-old white-collar workers without arthritis look forward to 17 QALYs of future life, blue-collar workers with arthritis experience only 11, and are much less likely to remain in the workforce than are those in service, farming, or white-collar jobs., Conclusions: To meet the needs of the aging workforce, more extensive health and disability insurance will be needed.

Background: Racial segregation provides a potential mechanism to link occupations with adverse health outcomes., Methods: An African-American segregation index (I(AA)) was calculated for US worker groups from the nationally representative pooled 1986-1994 National Health Interview Survey (n = 451,897). Ranking and logistic regression analyses were utilized to document associations between I(AA) and poor worker health., Results: There were consistent positive associations between employment in segregated occupations and poor worker health, regardless of covariate adjustment or stratification (e.g., age, gender, income, education, or geographic region). This association between segregation and poor health was stronger for White as compared to African-American workers., Conclusions: Occupational segregation negatively affects all workers. Potential mechanisms need to be identified through which occupational segregation may adversely impact worker health.

Background: Early detection of skin cancer by skin examination may reduce its associated morbidity and mortality, in particular for workers routinely exposed to sun., Objectives: We sought to describe the proportion of US workers reporting skin cancer screening examination in a representative sample of the US worker population in the National Health Interview Survey., Methods: Report of skin cancer examination in the 2000 and 2005 National Health Interview Survey cancer control supplements were examined by a range of variables., Results: Lifetime and 12-month reported clinical skin examination prevalence was 15% and 8%, respectively. Workers with elevated occupational exposure to ultraviolet light were less likely to have ever received a skin examination than the average US worker. Logistic regression analysis identified occupational category and age, sex, race, education level, health insurance, and sun-protective behavior as significant independent correlates of skin cancer examination., Limitations: A limitation is potential healthy worker effect and underestimation of skin cancer screening with self-reported data., Conclusions: Routine examination by primary care physicians frequently does not include a thorough skin examination. Physicians should be even more vigilant with patients at increased risk of excessive occupational sun exposure, as early detection of skin cancer by periodic skin examination decreases morbidity and can improve survival.

Objective: To explore trends in cotinine levels in US worker groups., Methods: Using NHANES III data, serum cotinine levels of US workers not smokers nor exposed to secondhand smoke (SHS) at home were evaluated for trends by occupational/industrial and race/ethnicity-gender sub-groups., Results: Decreases from 1988 to 2002 ranged from 0.08 to 0.30 ng/mL (67% to 85% relative decrease), with largest absolute reductions in: blue-collar and service occupations; construction/manufacturing industrial sectors; non-Hispanic Black male workers., Conclusions: All worker groups had declining serum cotinine levels. Most dramatic reductions occurred in sub-groups with the highest before cotinine levels, thus disparities in SHS workforce exposure are diminishing with increased adoption of clean indoor laws. However, Black male workers, construction/manufacturing sector workers, and blue-collar and service workers have the highest cotinine levels. Further reductions in SHS exposure will require widespread adoption of workplace clean air laws without exemptions.

Background: Healthy People 2010 oral health objectives call for an increase in the proportion of adults who use the oral health care system annually. To assess progress toward this goal, the authors evaluated dental care utilization and the extent of unmet dental care needs of U.S. workers and their families., Methods: The authors conducted sex-specific analyses by occupation of 135,004 U.S. worker participants in the nationally representative National Health Interview Surveys (NHIS) conducted from 1997 to 2003., Results: The reported lack of oral health care within the preceding year ranged from 18.9 to 57.8 percent among male workers and from 17.6 to 50.0 percent among female workers. Sex-specific occupational groups with the highest rates of reported unmet dental care needs included male health service occupations (17.1 percent) and female construction and extractive trade workers (26.8 percent)., Conclusion: There are significant oral health care underutilization and high rates of unmet dental care needs among many U.S. worker groups. Strategies to increase regular dental visits for U.S. worker groups reporting low dental care access and high dental need are paramount., Clinical Implications: Targeting strategic dental care access programs to identified U.S. worker groups reporting dental care access deficits can improve oral health.

Objective: The objective of this study was to assess the risk of lung cancer mortality in a nationally representative sample of U.S. workers by occupation., Methods: National Death Index linkage identified 1812 lung cancer deaths among 143,863 workers who participated in the 1987, 1988, and 1990-1994 National Health Interview Surveys., Results: Current and former smoking status was predictive of lung cancer mortality (hazard ratio [HR] = 15.1 and 3.8, respectively). Occupations with significantly higher risk for age- and smoking-adjusted lung cancer mortality included heating/air/refrigeration mechanics (HR = 3.0); not specified mechanics and repairers (HR = 2.8); financial records processing occupations (HR = 1.8); freight, stock, and materials handlers (HR = 1.5); and precision production occupations (HR = 1.4)., Conclusion: Although tobacco use continues to be the single most important risk factor for lung cancer mortality, occupational exposure to lung carcinogens should be targeted as well to further reduce the burden of lung cancer.

Objective: The objective of this study was to rank U.S. occupations by worker morbidity., Methods: From 1986 through 1994, morbidity information was collected on over 410,000 U.S. workers who participated in the National Health Interview Survey, an annual household survey representative of the U.S. civilian noninstitutionalized population. A multivariate adjusted logistic regression morbidity summary score was created for each worker group based on seven indicators: days of restricted activity, bedrest, and missed work in the previous 2 weeks; doctor visits and hospitalizations in the previous 12 months; reported health conditions; and health status., Results: Worker groups reporting the greatest morbidity included social workers, inspectors, postal clerks, psychologists, and grinding machine operators; worker groups reporting the least morbidity included dentists, pilots, physicians, pharmacists, and dietitians., Conclusions: These findings aid in the identification of worker groups that require increased attention for morbidity research and prevention.

Objective: We sought to assess the validity of using current or most recent occupation as surrogate for longest-held job (and its exposures)., Methods: The National Health Interview Survey (NHIS) is an annual, probability, cross-sectional U.S. population survey. The 1986 and 1988 NHIS occupational supplements provided information for more than 49,000 workers. Using Cohen's Kappa, concordance was assessed by occupational group and several subgroups., Results: Statistically significant results were observed for all occupational groups. More than 70% of 13 broad occupations had a Kappa of 50.0 or greater, with variable concordance by subpopulation. Among 206 occupational groups, there was more variability: Kappa ranged from 92.7 (dentists) to 9.2 (farm managers)., Conclusions: Moderate-to-high levels of agreement was observed in this large, representative sample of US workers. Therefore, current occupation can be used as a surrogate for longest-held job for many occupational subgroups.

It is unknown if reductions in U.S. adult smoking rates are uniform across occupational groups. The National Health Interview Survey (NHIS) is a multistage area probability cross-sectional survey of the U.S. civilian population. Data on occupational and smoking status were collected on 141122 adult participants from the 1987, 1988, and 1990 -1994 NHIS annual surveys. Overall smoking rates ranged from 58% in roofers to 4% in physicians, with higher rates found among blue collar professions. There were reductions in smoking from 1987-1994 within 72% of occupational groups; 19 of these downward trends were significant and occurred exclusively within white collar professions. Blue collar workers continue to smoke in large numbers, whereas white collar workers report lower rates along with corresponding significant downward trends in rates among selected occupational groups. The development of effective smoking prevention strategies targeting blue collar groups is needed.

The article discusses a study which was aimed to describe the health status and risk indicator trends in a representative sample of U.S. health care workers aged 45 years and older. The study performed logistic regression analyses using pooled data from the 1997-2009 National Health Interview Survey. The study concluded that healthier workplaces and targeted interventions are needed to optimize the ability to meet health care demands of this aging workforce.

Objectives. This article examines the effects of work status, occupational sector, and occupation type on depressive symptoms in older Americans. We partially controlled for the healthy worker selection effect by including disability as a predictor of both work status and depressive symptoms. Methods. We analyzed a nationally representative sample of 23,247 respondents aged 65 to 88 from the National Health Interview Survey pooled over 1997 to 2000. We used structural equation models with latent variables to assess relationships between work/occupation and depressive symptoms. Results. Older Americans who work had lower levels of depressive symptoms as compared to older nonworkers. Membership in several worker groups, generally higher status occupations, protected against depressive symptoms. After controlling for disability, the difference in level of depressive symptoms for workers versus nonworkers did not persist. However, workers in specific occupational sectors and types reported different levels of depressive symptoms even when we controlled for disability. Discussion. The mental health benefit of working, among persons aged 65 and older, may be due to the healthy worker effect. However, the particular job sector in which older workers are employed matters. Socioeconomic status and financial versus personal motivations for working are potentially important explanations for differences. [ABSTRACT FROM AUTHOR]

This study assessed the risk of hospitalization among firefighters. Data were derived from a nationally representative sample of 235897 employed men from the National Health Interview Survey. Firefighters aged 30 to 39 years were at significantly increased risk for hospitalization relative to other employed men in the same age group (odds ratio=1.93; 95% confidence interval=1.21, 3.09). Findings from this study and others support the call for longitudinal studies to monitor the health of this high-risk occupational group. (Am J Public Health. 2004;94:1938-1939). [ABSTRACT FROM AUTHOR]