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During the COVID-19 pandemic, public health workers were at an increased risk for violence and harassment due to their public health work and experienced adverse mental health conditions. This article quantifies the prevalence of job-related threats, harassment, and discrimination against public health workers and measures the association of these incidents with mental health symptoms during the COVID-19 pandemic.A nonprobability convenience sample of state, local, and tribal public health workers completed a self-administered, online survey in April 2021. The survey link was emailed to members of national public health associations and included questions on workplace violence, demographics, workplace factors, and mental health symptoms. Mental health symptoms were measured using standardized, validated tools to assess depression, anxiety, post-traumatic stress disorder, and suicidal ideation. Multivariable Poisson models calculated adjusted prevalence ratios of mental health symptoms, with workplace violence as the primary risk factor. Analyses were conducted in 2021-2022.Experiencing any type or combination of workplace violence was significantly associated with an increased likelihood of reporting depression symptoms (prevalence ratio=1.21, 95% CI=1.15, 1.27), anxiety (prevalence ratio=1.21, 95% CI=1.15, 1.27), post-traumatic stress disorder (prevalence ratio=1.31, 95% CI=1.25, 1.37), and suicidal ideation (prevalence ratio=1.26, 95% CI=1.14, 1.38), after adjusting for confounders. A dose‒response relationship was found between the number of workplace violence events experienced by a public health worker and the likelihood of reporting mental health symptoms.Violence targeted at the public health workforce is detrimental to workers and their communities. Ongoing training, workplace support, and increased communication after a workplace violence incident may be helpful. Efforts to strengthen public health capacities and support the public health workforce are also needed.

Objectives Numerous states within the USA have legalized cannabis for medical or non-medical (adult/recreational) use. With the increased availability and use of cannabis, occupational and environmental exposures to secondhand cannabis smoke (SHCS) raise concerns over whether non-users may be at risk for a ‘contact high’, impaired neurocognitive function, harm from irritants and carcinogens in smoke, or potentially failing a cannabis screening test. The extent of health effects from potential occupational exposure to SHCS is unknown. This is a study of occupational exposures to SHCS among law enforcement officers (LEOs) providing security at outdoor concerts on a college campus in a state where adult use of cannabis is legal. Methods Investigators evaluated a convenience sample of LEOs’ potential exposure to SHCS and symptoms experienced while providing security during two open-air stadium rock-n-roll concerts on consecutive days in July 2018. During each event, full-shift area and LEO personal air samples were collected for Δ9-tetrahydrocannabinol (Δ9-THC), the psychoactive component of cannabis. Urine (pre- and postevent; n = 58) and blood (postevent; n = 29) were also collected and analyzed for Δ9-THC and two of its metabolites [11-nor-delta-9-tetrahydrocannabinol-9-carboxylic acid (THC-COOH) and 11-nor-hydroxy-delta-9-tetrahydrocannabinol (OH-THC)]. Urine samples were analyzed using ultrahigh performance liquid chromatography coupled with positive electrospray ionization tandem mass spectrometry and results were compared with the Department of Transportation guidelines for urine screening for cannabis. Blood (postevent) samples were also collected and the plasma fraction was tested for Δ9-THC, THC-COOH, and OH-THC using high-performance liquid chromatography coupled with mass spectrometry. LEOs also completed a medical questionnaire asking about symptoms experienced during the concerts. Results Twenty-nine LEOs participated in the evaluation. Measurable amounts of Δ9-THC were found in area (concentrations ranged from non-detectable to 330 ng m−3) and personal air samples (53–480 ng m−3). Small amounts ( Conclusions Identification of Δ9-THC in the breathing zone for some LEOs indicates the potential for airborne exposure to the psychoactive component of cannabis. However, the magnitude of these exposures was small compared with those that would result in a dose of Δ9-THC associated with psychotropic effects. Similarly, THC-COOH was found in the postevent urine of some LEOs at concentrations that were orders of magnitude below active use cut-points used during a cannabis screening test (50 ng ml−1). Exposure to SHCS was not high enough to detect concentrations of THC, THC-COOH, to OH-THC in the blood, which could be due to differences between the limits of detection for the tests employed. The ocular and respiratory symptoms reported by LEOs may be related to irritants in SHCS. However, the health effects of SHCS remain unclear, and further research concerning occupational and environmental exposures is warranted.

BACKGROUND: Cannabis has been legalized in some form for much of the United States. The National Institute for Occupational Safety and Health (NIOSH) received a health hazard evaluation request from a Minnesota cannabis facility and their union to undertake a health hazard evaluation. METHODS: NIOSH representatives visited the facility in August 2016 and April 2017. Surface wipe samples were collected for the analysis of delta-9 tetrahydrocannabinol (Δ9-THC), delta-9 tetrahydrocannabinol (Δ9-THCA), cannabidiol, and cannabinol. Environmental air samples were collected for volatile organic compounds (VOCs), endotoxins (limulus amebocyte lysate assay), and fungal diversity (NIOSH two-stage BC251 bioaerosol sampler with Internal Transcribed Spacer region sequencing analysis). RESULTS: Diacetyl and 2,3-pentanedione were identified in both initial VOC screening and subsequent sampling at levels well below the NIOSH recommended exposure limits (RELs). Endotoxin concentrations were highest during processing activities, while Internal Transcribed Spacer region sequencing revealed that the Basidiomycota genus, Wallemia, had the highest relative abundance. CONCLUSIONS: Δ9-THC was identified throughout the facility. Although diacetyl and 2,3-pentanedione were identified, the exposures were below the NIOSH REL. Exposures to diacetyl and 2,3-pentanedione were highest in the decarboxylation oven where heat transference was greatest. Endotoxin levels were highest during grinding operations when aerosol generating activities occurred. The findings indicate that potential health hazards of significance are present during cannabis processing, and employers should be aware of potential exposures to VOCs, endotoxin, and fungi. Further research into the degree and intensity of respiratory and dermal hazards in this industry, as well as resulting health effects, is recommended.

Since 2004, the National Institute for Occupational Safety and Health (NIOSH) has received 10 cannabis-related health hazard evaluation (HHE) investigation requests from law enforcement agencies (n = 5), state-approved cannabis grow operations (n = 4), and a coroner’s office (n = 1). Earlier requests concerned potential illicit drug exposures (including cannabis) during law enforcement activities and criminal investigations. Most recently HHE requests have involved state-approved grow operations with potential occupational exposures during commercial cannabis production for medicinal and non-medical (recreational) use. As of 2019, the United States Drug Enforcement Administration has banned cannabis as a Schedule I substance on the federal level. However, cannabis legalization at the state level has become more common in the USA. In two completed cannabis grow operation HHE investigations (two investigations are still ongoing as of 2019), potential dermal exposures were evaluated using two distinct surface wipe sample analytical methods. The first analyzed for delta-9-tetrahydrocannabinol (Δ9-THC) using a liquid chromatography and tandem mass spectrometry (LC–MS–MS) method with a limit of detection (LOD) of 4 nanograms (ng) per sample. A second method utilized high performance liquid chromatography with diode-array detection to analyze for four phytocannabinoids (Δ9-THC, Δ9-THC acid, cannabidiol, and cannabinol) with a LOD (2000 ng per sample) which, when comparing Δ9-THC limits, was orders of magnitude higher than the LC–MS–MS method. Surface wipe sampling results for both methods illustrated widespread contamination of all phytocannabinoids throughout the tested occupational environments, highlighting the need to consider THC form (Δ9-THC or Δ9-THC acid) as well as other biologically active phytocannabinoids in exposure assessments. In addition to potential cannabis-related dermal exposures, ergonomic stressors, and psychosocial issues, the studies found employees in cultivation, harvesting, and processing facilities could potentially be exposed to allergens and respiratory hazards through inhalation of organic dusts (including fungus, bacteria, and endotoxin) and volatile organic compounds (VOCs) such as diacetyl and 2,3-pentanedione. These hazards were most evident during the decarboxylation and grinding of dried cannabis material, where elevated job-specific concentrations of VOCs and endotoxin were generated. Additionally, utilization of contemporary gene sequencing methods in NIOSH HHEs provided a more comprehensive characterization of microbial communities sourced during cannabis cultivation and processing. Internal Transcribed Spacer region sequencing revealed over 200 fungal operational taxonomic units and breathing zone air samples were predominantly composed of Botrytis cinerea, a cannabis plant pathogen. B. cinerea, commonly known as gray mold within the industry, has been previously associated with hypersensitivity pneumonitis. This work elucidates new occupational hazards related to cannabis production and the evolving occupational safety and health landscape of an emerging industry, provides a summary of cannabis-related HHEs, and discusses critical lessons learned from these previous HHEs.

Recent increases in the rate of drug overdose-related deaths, the emergence of potent opioids such as carfentanil, and media reports of incidents have raised concerns about the potential for work-related exposure to a variety of illicit drugs among law enforcement officers (LEOs), other emergency responders, and other workers in the United States. To characterize the risk associated with unintentional occupational exposure to drugs, we retrospectively investigated two incidents that occurred in 2017 and 2018 where LEOs were exposed to opioid and stimulant drugs and experienced health effects. We interviewed five affected LEOs and others. We reviewed records, including emergency department documentation, incident reports, forensic laboratory results, and when available, body camera footage. Multiple drug types, including opioids and nonopioids, were present at each incident. Potential routes of exposure varied among LEOs and were difficult to characterize with certainty. Health effects were not consistent with severe, life-threatening opioid toxicity, but temporarily precluded affected LEOs from performing their essential job duties. While health risks from occupational exposure to drugs during law enforcement activities cannot currently be fully characterized with certainty, steps to prevent such exposures should be implemented now. The creation and implementation of appropriate controls plus education and training are both important to protecting first responders from these hazardous agents. To more fully characterize potential exposures, timely prospective toxicological evaluation of affected responders is recommended.

As of May 2, 2017, the U.S. Virgin Islands (USVI), comprising St. Thomas, St. John, and St. Croix, had reported 1,021 probable or confirmed cases* of Zika virus disease in its population of approximately 100,000 (1); 222 symptomatic and asymptomatic pregnant women in the USVI had tested positive for Zika virus. In January 2016, USVI Department of Health (USVI DOH) initiated Zika response measures, including surveillance, vector control, and a communications program. Interventions included education and outreach, distribution of Zika prevention kits† to pregnant women in the USVI, and provision of free Zika virus laboratory testing and vector control services. In November 2016, USVI DOH staff members conducted interviews with convenience samples of community members and pregnant women to gather feedback about current and proposed interventions (2). Pregnant women reported taking a median of two actions to protect themselves from Zika, with repellent use being the most commonly reported action. Community members reported taking a median of one action and were supportive of several proposed vector control approaches. Whereas multiple pregnant women and community members reported hearing messages about the cause and consequences of Zika virus infections, few recalled messages about specific actions they could take to protect themselves. Integrating evaluation into response measures permits ongoing assessment of intervention effectiveness and supports improvement to serve the population's needs.

Each year in the United States, more than 200,000 people are hospitalized for influenza-related illnesses.1 The Centers for Disease Control and Prevention (CDC) estimates that from 1976 to 2007, influenza-associated deaths ranged from a low of about 3000 to a high of about 49,000 people per year in the United States.2 Influenza has been estimated to cause more than 70 million lost working days and $6.2 billion in lost productivity in the United States every year.3,4 Vaccination is the most effective method to prevent influenza and to prevent serious illness and death from influenza infection.5,6 Since 2010, the Advisory Committee on Immunization Practices (ACIP) has recommended annual influenza vaccination for all persons aged ≥6 months in the United States.7,8 Over 7.3 million people in the United States are employed in and over 62 million students are enrolled in approximately 130,000 public and private schools.9 Schools have the potential to become centers of influenza outbreaks because of their large population, high levels of close social contact, and interaction with the community.10 School settings place teachers, administrators, other school employees, and students at risk for influenza infection and subsequent transmission to others outside the school environment. Vaccinating these groups could help protect one fifth of the country’s population from influenza.11 In January 2013, the National Institute for Occupational Safety and Health (NIOSH) at the CDC received a health hazard evaluation request from a suburban school district in Ohio. The district requested assistance in determining 2012–2013 influenza vaccination coverage among employees in the school district, assessing employees’ knowledge and attitudes toward vaccination, and determining factors associated with acceptance and refusal of the vaccine.

The National Institute for Occupational Safety and Health (NIOSH) received a health hazard evaluation (HHE) request from employees and union representatives at a steel mill. They were concerned with skin and upper respiratory irritation, and safety and hygiene issues regarding the required use of cut-resistant protective sleeves. The manufacturer of the cut-resistant sleeves reported that the sleeves were made of a blended weave of para-aramid (Kevlar), cellulose, and E-glass fibers. New sleeves were shown to emit very few fibers into the air under controlled use conditions.(1) However, employees were concerned that the sleeves could shed respirable fiberglass fibers, that this shedding could increase after repeated launderings, and that this exposure could cause skin irritation, respiratory irritation, or chronic respiratory disease. During our evaluation, we met with union representatives and company health and safety managers, toured the facility, and confidentially interviewed employees. We collected surface samples using either Stick-to-it lift tape (SKC Inc., Eighty Four, Pa.) or vacuuming with a polycarbonate filter from work surfaces, workers’ skin, and workers’ clothing, including the surface of new and laundered protective sleeves. We also collected bulk samples of new and laundered protective sleeves and other potential sources of fibers at the steel mill (i.e., insulation materials). These samples were analyzed by stereomicroscope and polarized light microscopy for identification of fiberglass, Kevlar, and cellulose fibers, as well as for fiber morphology and size. This case study focuses on the industrial hygiene sampling component of our evaluation. Information regarding the medical interviews, and safety and hygiene issues related to the use of the sleeves can be found in the NIOSH HHE report. (2)

We determined the prevalence of influenza-like illness (ILI) among employees of a suburban Ohio school district. In a survey of 412 of 841 employees (49%), 120 (29%) reported ILI symptoms during the school year, and 92 (77%) reported working while ill. Age ≥50 years and asthma were significantly associated with reporting of ILI symptoms. Encouraging school employees to receive the seasonal influenza vaccine and to stay home when ill should be part of a comprehensive influenza prevention strategy.

Two field studies measured college students' actual intoxication levels using handheld breathalyzers on Halloween and St. Patrick's Day and compared these celebration days to typical nights surrounding these events. In addition, across all nights of Study 2, participants were asked if they were celebrating any occasion or event that night, and those reporting a celebration motive were compared to those with no such motive. The combined sample was 70% men ( n = 498), and 89.9% ( n = 639) were students at the local university. Across both years of the study, those reporting a celebration motive reached significantly higher levels of intoxication (mean blood alcohol concentration = .096, n = 413) than those not celebrating (mean blood alcohol concentration = .074, n = 298, p < .05). These results support the hypothesis that those consuming alcohol with a specific reason to celebrate reach higher levels of intoxication.

This rejoinder discusses some common points raised in the commentaries of this special issue of JOBM, including (1) different definitions of positive and negative, (2) use of the terms reinforcement and establishing operation, and (3) concerns over the abandonment of behavior analysis for mentalistic research. In addition, a people-based approach to psychology is introduced and advocated as a leading-edge approach to understanding and improving organizational behavior.

Attributions are examined within the context of media representations of an antigay hate crime. It was predicted that media sources from different political/ideological viewpoints would differ in their attributions regarding Matthew Shepard's murder, and these differences in attributions would be associated with overall attitudes toward homosexuality and hate crimes in general. Consistent with the authors' predictions, conservative media representations were less likely to attribute the incident itself to the political climate, thereby downplaying the role of situational factors. At the same time, the same conservative representations presented homosexuality as a controllable condition, thereby emphasizing situational attributions. In addition, a regression analysis suggests that attributions mediate the relationship between political viewpoint and (a) attitudes toward stricter hate crime legislation and (b) sympathy toward the gay community.

Influenza can spread quickly among children and caregivers in child day care settings. Vaccination is the most effective method to prevent influenza. We determined 2009 pandemic influenza A (H1N1) (pH1N1) and seasonal influenza vaccination rates during the 2009–2010 influenza season among child care center employees, assessed knowledge and attitudes regarding the vaccines, and determined factors associated with vaccine receipt. Using a cross-sectional study design, from January 30–March 1, 2010, we surveyed 384 (95%) of 403 employees at 32 licensed child centers in the United States about personal and work characteristics, vaccine receipt, and knowledge and attitudes regarding each vaccine. Forty-five (11%) and eighty five (22%) respondents reported receiving the pH1N1 and seasonal influenza vaccines, respectively. The most common reasons cited for not getting either vaccine were “I don’t think I need the vaccine,” “I don’t think the vaccine will keep me from getting the flu,” and “the vaccine is not safe.” Factors independently associated with receipt of either vaccine included belief in its efficacy, having positive attitudes towards it, and feeling external pressure to get it. Child care center employees had low rates of pH1N1 and seasonal influenza vaccination largely due to misconceptions about the need for and efficacy of the vaccine. Public health messages should address misconceptions about vaccines, and employers should consider methods to maximize influenza vaccination of employees as part of a comprehensive influenza prevention program.

Every weekday during the school year, school transportation systems in the United States operate approximately 440,000 yellow school buses to provide safe and reliable transportation for more than 24 million school-aged children. This sizeable transportation system is considered the largest mass transit program in the nation, with more than 55 million student trips per day, which equates to approximately 10,000,000,000 student trips per year. The objective of this synthesis is to document current information on the various safety issues faced by school bus operators, including how the issues are currently addressed, barriers to improvements, and making improvements in the future. This synthesis includes a literature review and a peer-reviewed survey on school bus safety issues that was disseminated to a variety of professionals associated with school bus operations. The literature review involved investigating resources dating back 34 years. School bus safety issues identified in the literature review are presented in terms of each aspect of school bus operations, including the driver, environment, equipment/technology, and organizational design. The survey was distributed widely across the nation using e-mail, telephone, flyer, print, and electronic advertisements. A total of 198 individuals responded to the survey. Although there are a variety of safety issues in pupil transportation, those regarded as the most critical by survey respondents included illegal passing of buses by other motorists, the behavior of passengers both on the bus and while loading and unloading, and driver skill level. In addition, there appears to be growing concern regarding security and violence issues on the school bus and at bus stops. These results, including a description of barriers to safety and potential solutions, are discussed in this report. (51 pages)

To explore the relation of commercial truck drivers' body mass indexex (BMI) to fatigued driving episodes and involvement in safety-critical events.One hundred and three professional truck drivers participated in a long-term naturalistic (on-road) driving study whereby vehicle motion data as well as video of the driver and driving environment were gathered continuously. This data set was analyzed to identify safety-critical events as well as fatigued driving episodes using two independent measures of fatigue. Odds ratio analyses were then performed to explore the relative risk of driving while fatigued and involvement in safety-critical events based on driver's BMI classification (obese versus non-obese).Results indicated that of the 103 participating truck drivers, 53.4 percent were obese based on BMI. Odds ratio calculations revealed that obese individuals were between 1.22 (CI = 1.03-1.45) and 1.69 times (CI = 1.32-2.18) more likely than non-obese individuals to be rated as fatigued based on the two measures of fatigue. Other analyses showed that obese individuals were at 1.37 times (CI = 1.19-1.59) greater risk for involvement in a safety-critical event than non-obese individuals. Finally, one of the fatigue measures showed that obese individuals were 1.99 times (CI = 1.02-3.88) more likely than non-obese individuals to be fatigued while involved in an at-fault safety-critical incident.The results of this study support other research in the field of health and well-being that indicate a link between obesity and fatigue, which is a major safety issue surrounding commercial motor vehicle operations given the long hours these drivers spend on the road.

Introduction Safety coaching is an applied behavior analysis technique that involves interpersonal interaction to understand and manipulate environmental conditions that are directing (i.e., antecedent to) and motivating (i.e., consequences of) safety-related behavior. A safety coach must be skilled in interacting with others so as to understand their perspectives, communicate a point clearly, and be persuasive with behavior-based feedback. Method This article discusses the evidence-based “ability model” of emotional intelligence and its relevance to the interpersonal aspect of the safety coaching process. Results Emotional intelligence has potential for improving safety-related efforts and other aspects of individuals' work and personal lives. Safety researchers and practitioners are therefore encouraged to gain an understanding of emotional intelligence and conduct and support research applying this construct toward injury prevention.