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BACKGROUND: Physical fitness for health and professional performance play important roles in police workforce considering that policing is a dangerous job, associated with high physical demands. OBJECTIVES: (1) To evaluate the effects of a 6-month course of police academy training on health-related physical fitness (HRPF) of military police recruits. (2) To investigate whether recruits’ HRPF still met the academy entry standards after an unsupervised 7-month period prior to academy. METHODS: We conducted an observational and longitudinal study with 219 male police recruits (aged 25.5±3.6 years; BMI of 24.4±2.5 kg/m2). HRPF parameters included the Cooper 12-min running test for cardiorespiratory fitness (CRF), curl-ups, pull-ups and push-ups for muscle strength/endurance which were evaluated 3 times: 7 months prior to academy course and pre- and post-academy training period. RESULTS: Participants maintained optimal age-related HRPF during the unsupervised period prior to academy. After academy training upon graduation, all HRPF parameters further increased an average of 7.7 to 69.0% (p

Background Optic nerve sheath diameter (ONSD) ultrasound is a noninvasive and repeatable tool to dynamically evaluate intracranial pressure with high diagnostic accuracy; however, data in neonates are scarce. The aim of this study was to determine the reference value of ONSD and potential influencing factors in healthy term neonates. Methods We retrospectively reviewed 250 full-term neonates who underwent cranial ultrasound as part of selective newborn screening over a 2-year period. Neonates with any of the following conditions were excluded: using mechanical ventilation, sedatives and/or vasopressors, or signs of infection which needed cerebrospinal fluid analysis and/or intracranial pathologies. Data on sex, gestational age, birth body weight, birth body height, birth head circumference, Apgar score and types of delivery were collected. The neurodevelopmental outcomes were reviewed. Results A total of 234 neonates (123 girls and 111 boys) were included. The mean ONSD value was 3.30 ± 0.27 mm in the right eye and 3.30 ± 0.23 mm in the left eye, with no significant difference between both eyes (p = 0.797). Male neonates had a larger ONSD than female neonates (3.34 ± 0.22 mm versus 3.26 ± 0.20 mm, p = 0.007), and ONSD was correlated with birth weight in the males. Otherwise, there were no statistically significant associations between ONSD and other birth characteristics in both sexes. Most (63%) cases were followed for at least 12 months, and 98% had normal neurodevelopment. Conclusion The reference value reported in this study may be used to evaluate the ONSD in healthy term neonates. Sex differences should be considered in this age group.

BackgroundThe COVID-19 pandemic caused by the SARS-CoV-2 virus greatly affected healthcare workers and healthcare systems. It also challenged schools and universities worldwide negatively affecting in-person education. We conducted this study is to assess the evolution of SARs-CoV-2 virulence over the course of the pandemic.MethodsA combined cohort of affiliates from the University of Navarra, two hospitals in Spain, and one healthcare system in the Greater Boston area was followed prospectively from March 8th, 2020, to January 31st, 2022 for diagnosis with COVID-19 by PCR testing and related sequelae. Follow-up time was divided into four periods according to distinct waves of infection during the pandemic. Severity of COVID-19 was measured by case-hospitalization rate. Descriptive statistics and multivariable-adjusted statistics using the Poisson mixed-effects regression model were applied.ResultsFor the last two periods of the study (January 1stto December 15th, 2021 and December 16th, 2021 to January 31st, 2022) and relative to the first period (March 8thto May 31st, 2020), the incidence rate ratios (IRRs) of hospitalization were 0.08 (95% CI, 0.03-0.17) and 0.03 (95% CI, 0.01-0.15), respectively.InterpretationThe virulence of COVID-19 and immunity of our populations evolved over time, resulting in a decrease in case severity. We found the case-hospitalization rate decreased more than 90% in our cohort despite an increase in incidence.

Obstructive sleep apnea (OSA) is a common cause of hypertension. Previous studies have demonstrated beneficial short-term effects of continuous positive airway pressure (CPAP) therapy on blood pressure. However, long-term antihypertensive effects of CPAP have not been properly verified. This study examined the longitudinal effect of CPAP therapy adherence on blood pressure among OSA patients. All patients diagnosed with OSA and undergoing subsequent CPAP therapy at a Kanagawa-area sleep clinic were clinically followed for 24 months to examine CPAP adherence, as well as longitudinal changes in blood pressure and body weight because it may become a confound factor for changes in blood pressure. The hours of CPAP usage were collected over the course of 30 nights prior to each follow-up visit (1st, 3rd, 6th, 12th, and 24th month). The relationship between CPAP adherence and blood pressure was analyzed using mixed-effect logistic regression models. A total of 918 OSA patients were enrolled in the study. We found a significant reduction in diastolic blood pressure among patients with good CPAP adherence during the 24-month follow-up period (β = − 0.13, p = 0.03), when compared to the group with poor CPAP adherence. No significant association was found between CPAP adherence and weight loss (β = − 0.02, p = 0.59). Long-term, good CPAP therapy adherence was associated with lower diastolic blood pressure without significant weight loss.

Background: Epidemiological studies have yielded conflicting results regarding climate and incident SARS-CoV-2 infection, and seasonality of infection rates is debated. Moreover, few studies have focused on COVD-19 deaths. We studied the association of average ambient temperature with subsequent COVID-19 mortality in the OECD countries and the individual United States (US), while accounting for other important meteorological and non-meteorological co-variates. Methods: Information on average temperature and other weather conditions for 25 days prior and 25 days after the first reported COVID-19 death was collected in the OECD countries and US states. Cumulative COVID-19 mortality was assessed for each region at 25, 30, 35, and 40 days after the first reported death. Analyses were performed with negative binomial regression and adjusted for other weather conditions, particulate matter, soc iodemographic factors, smoking, obesity, ICU beds, and social distancing. Findings: A 1oC increase in ambient temperature was associated with 6% lower COVID-19 mortality at 30 days following the first reported death (multivariate-adjusted mortality rate ratio: 0.94, 95% CI: 0.90, 0.99, p=0.016). The results were robust for COVID-19 mortality at 25, 35 and 40 days after the first death, as well as other sensitivity analyses. Interpretation: The results provide consistent evidence across various models of an inverse association between higher average temperatures and subsequent COVID-19 mortality rates after accounting for other meteorological variables and predictors of SARS-CoV-2 infection or death. This suggests potentially decreased viral transmission in warmer regions and during the summer season. Funding Statement: None declared. Declaration of Interests: The authors declare no competing interests.

Career firefighters are at considerable risk for chronic diseases, including an increased risk of various cancers, compared to the general population. Over the last two decades, several systematic reviews and large cohort studies have demonstrated that firefighters have statistically significant increases in overall and site-specific cancer incidence and site-specific cancer mortality compared to the general population. Exposure assessment and other studies have documented exposures to a variety of carcinogens in fire smoke and within the fire station. Other occupational factors such as shift work, sedentary behavior, and the fire service food culture may also contribute to this working population’s increased cancer risk. Furthermore, obesity and other lifestyle behaviors such as tobacco use, excessive alcohol consumption, poor diet, inadequate physical activity, and short sleep duration have also been associated with an increased risk of certain firefighting-associated cancers. Putative prevention strategies are proposed based on suspected occupational and lifestyle risk factors.

Objective:To better understand coronavirus disease 2019 (COVID-19) transmission among healthcare workers (HCWs), we investigated occupational and nonoccupational risk factors associated with cumulative COVID-19 incidence among a Massachusetts HCW cohort.Design, setting, and participants:The retrospective cohort study included adult HCWs in a single healthcare system from March 9 to June 3, 2020.Methods:The SARS-CoV-2 nasopharyngeal RT-PCR results and demographics of the study participants were deidentified and extracted from an established occupational health, COVID-19 database at the healthcare system. HCWs from each particular job grouping had been categorized into frontline or nonfrontline workers. Incidence rate ratios (IRRs) and odds ratios (ORs) were used to compare subgroups after excluding HCWs involved in early infection clusters before universal masking began. A sensitivity analysis was performed comparing jobs with the greatest potential occupational risks with others.Results:Of 5,177 HCWs, 152 (2.94%) were diagnosed with COVID-19. Affected HCWs resided in areas with higher community attack rates (median, 1,755.2 vs 1,412.4 cases per 100,000; P < .001; multivariate-adjusted IRR, 1.89; 95% CI, 1.03–3.44 comparing fifth to first quintile of community rates). After multivariate adjustment, African-American and Hispanic HCWs had higher incidence of COVID-19 than non-Hispanic white HCWs (IRR, 2.78; 95% CI, 1.78–4.33; and IRR, 2.41, 95% CI, 1.42–4.07, respectively). After adjusting for race and residential rates, frontline HCWs had a higher IRR (1.73, 95% CI, 1.16–2.54) than nonfrontline HCWs overall, but not within specific job categories nor when comparing the highest risk jobs to others.Conclusions:After universal masking was instituted, the strongest risk factors associated with HCW COVID-19 infection were residential community infection rate and race.

ObjectivesTo investigate SARS-CoV-2 (the virus causing COVID-19) infection and exposure risks among grocery retail workers, and to investigate their mental health state during the pandemic.MethodsThis cross-sectional study was conducted in May 2020 in a single grocery retail store in Massachusetts, USA. We assessed workers’ personal/occupational history and perception of COVID-19 by questionnaire. The health outcomes were measured by nasopharyngeal SARS-CoV-2 reverse transcriptase PCR (RT-PCR) results, General Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9).ResultsAmong 104 workers tested, 21 (20%) had positive viral assays. Seventy-six per cent positive cases were asymptomatic. Employees with direct customer exposure had an odds of 5.1 (95% CI 1.1 to 24.8) being tested positive for SARS-CoV-2 after adjustments. As to mental health, the prevalence of anxiety and depression (ie, GAD-7 score >4 or PHQ-9 score >4) was 24% and 8%, respectively. After adjusting for potential confounders, those able to practice social distancing consistently at work had odds of 0.3 (95% CI 0.1 to 0.9) and 0.2 (95% CI 0.03 to 0.99) screening positive for anxiety and depression, respectively. Workers commuting by foot, bike or private cars were less likely to screen positive for depression (OR 0.1, 95% CI 0.02 to 0.7).ConclusionsIn this single store sample, we found a considerable asymptomatic SARS-CoV-2 infection rate among grocery workers. Employees with direct customer exposure were five times more likely to test positive for SARS-CoV-2. Those able to practice social distancing consistently at work had significantly lower risk of anxiety or depression.

ObjectiveTo investigate COVID-19 vaccine efficacy (VE) among healthcare workers (HCWs) in an ethnically diverse community healthcare system, during its initial immunization campaign. MethodsHCWs of the system were retrospectively included from the beginning of a COVID-19 vaccination program (December 16, 2020) until March 31, 2021. Those with a prior COVID-19 infection before December 15 were excluded. The Occupational Health department of the system ran a COVID-19 screening and testing referral program for workers, consistently throughout the study period. A master database had been established and updated comprising of the demographics, COVID-19 PCR assays, and vaccinations of each HCW. Andersen-Gill extension of the Cox models were built to estimate the VE of fully/partially vaccinated person-days at risk. ResultsAmong the 4317 eligible HCWs, 3249 (75%) received any vaccination during the study period. Vaccinated HCWs were older, less likely to be Black/African American, Hispanic/Latino or identify as two or more races, and more likely to be medical providers. After adjusting for age, sex, race, and the statewide background incidence at the time of vaccination, we observed a VE of 80.2% (95% CI: 57.5-90.8%) for [greater double equals]14 days after the first dose of Pfizer/Moderna, and 95.5% (95% CI: 88.2-98.3%) among those fully vaccinated (i.e. [greater double equals]14 days after the second dose of Pfizer/Moderna or the single dose of J&J/Janssen). ConclusionCOVID-19 vaccine effectiveness in the real world is promising, and these data in concert with culturally appropriate may decrease vaccine hesitancy.

The hypothesis of attenuating SARS-CoV-2 virulence has been raised. We examined the temporal distribution of COVID-19 complications (ER visits, hospitalization, intubation/code, and/or death) among healthcare workers in one system that applied uniform screening criteria throughout the research period, and found the complication rate significantly decreased after April 15, 2020.

Purpose To investigate changes in firefighter recruits' select health and fitness measurements, from academy training through the early probationary firefighter period. Methods Firefighter recruits from two New England fire academies were followed prospectively from enrollment at the academy, to graduation after 15-16 week training programs, and then for an average of eight months as probationary firefighters. The participants' demographic, lifestyle, and mental health information were collected using a questionnaire. Body mass index (BMI), percent body fat, blood pressure, and push-ups were also measured at each time point. Furthermore, the academies tested the recruits on selected fitness measures (push-ups, pull-ups, and 1.5-mile running time) at academy entry, mid-training, and at graduation. Results Ninety-two recruits consented and were included in the analyses. The recruits' percent body fat significantly decreased (median: 21.0% to 18.2%) from baseline to graduation and push-up capacity significantly improved (median: 34 to 53/minute) in the same period, along with pull-ups and 1.5-mile running time. However, the recruits' blood pressure, both systolic and diastolic, increased significantly by an average of 3 mmHg during the training. Those completing probationary follow-up (45 out of 92 recruits) showed that most health/fitness improvements declined after graduation. From academy graduation through probationary follow-up, recruits' physical activity decreased and TV screen time increased significantly, leading to a lower healthy lifestyle score (median: 4 to 3). After multivariate adjustments, the recruits' diastolic blood pressure increased by 2 mmHg per measuring time throughout the study period. Conclusion Fire academy training improved recruits' select health and fitness measurements, but the benefits dissipated as probationary firefighters, and blood pressures increased throughout the study period. Further interventions are warranted regarding blood pressure and to maintain training benefits after joining fire departments.

SARS-CoV-2 antibody seroprevalence among health-care workers (HCW) can assess past exposure and possible immunity, which varies across different regions, populations and times. We investigated the seroprevalence among HCW in Massachusetts (a region suffering high COVID-19 mortality) at the end of first wave of the SARS-CoV-2 pandemic. All HCW at Cambridge Health Alliance were invited to participate in this cross-sectional survey in June 2020. Those who volunteered, consented and provided a blood sample were included. Dried blood specimens from finger-prick sampling collected either at home by each HCW or onsite by the study team were analyzed for anti-SARS-CoV-2 IgM and IgG to the virus’ receptor binding domain, using an enzyme-linked immunosorbent assay. IgM and IgG antibody abundance were categorized based on the number of standard deviations above the cross-reacting levels found in existing, pre-pandemic blood samples previously obtained by the Ragon Institute and analyzed by the Broad Institute (Cambridge, MA). Seroprevalence estimates were made based on ‘positive’ IgM or IgG using ‘low’ (>6 SD), ‘medium’ (>4.5 SD), and ‘high’ prevalence cutoffs (>3 SD). A total of 433 out of 5,204 eligible HCWs consented and provided samples. Participating HCWs had a lower cumulative incidence (from the start of the pandemic up to the bloodspot collections) of SARS-CoV-2 RT-PCR positivity (1.85%) compared to non-participants (3.29%). The low, medium, and high seroprevalence estimates were 8.1%, 11.3%, and 14.5%, respectively. The weighted estimates based on past PCR positivity were 13.9%, 19.4%, and 24.9%, respectively, for the entire healthcare system population after accounting for participation bias.

Purpose To compare the effectiveness of COVID-19 mitigation strategies in two homeless shelters in Massachusetts during the pandemic. Methods We conducted a prospective cohort study that followed guests in two Massachusetts homeless shelters between March 30 and May 13, 2020, which adopted different depopulation strategies. One set up temporary tents in its parking lot, while the other decompressed its guests to a gym and a hotel. The outcome was assessed by comparing the odds ratios of positive SARS-CoV-2 RT-PCR assays. Results Guests residing at the shelter that used temporary tents had 6.21 times (95% CI = 1.86, 20.77) higher odds of testing positive for SARS-CoV-2 at follow-up after adjusting for loss to follow up, age, gender, and race. The daily COVID-19 symptoms checklist performed poorly in detecting positive infection. Conclusions The study highlights the importance of depopulating shelter guests with stable and adequate indoor space to prevent SARS-CoV-2 transmission. Daily temperature and symptom checks should be combined with routine testing. With the rising homelessness due to mass unemployment and eviction crisis, our study supports further governmental assistance in decompressing homeless shelters during this pandemic.

Background Healthcare workers (HCWs) and other essential workers are at risk of occupational infection during the COVID-19 pandemic. Several infection control strategies have been implemented. Evidence shows that universal masking can mitigate COVID-19 infection, though existing research is limited by secular trend bias. Aims To investigate the effect of hospital universal masking on COVID-19 incidence among HCWs compared to the general population. Methods We compared the 7-day average incidence rates between a Massachusetts (USA) healthcare system and Massachusetts residents statewide. The study period was from 17 March (the date of first incident case in the healthcare system) to 6 May (the date Massachusetts implemented public masking). The healthcare system implemented universal masking on 26 March, we allotted a 5-day lag for effect onset and peak COVID-19 incidence in Massachusetts was 20 April. Thus, we categorized 17–31 March as the pre-intervention phase, 1–20 April the intervention phase and 21 April to 6 May the epidemic decline phase. Temporal incidence trends (i.e. 7-day average slopes) were compared using standardized coefficients from linear regression models. Results The standardized coefficients were similar between the healthcare system and the state in both the pre-intervention and epidemic decline phases. During the intervention phase, the healthcare system’s epidemic slope became negative (standardized β: −0.68, 95% CI: −1.06 to −0.31), while Massachusetts’ slope remained positive (standardized β: 0.99, 95% CI: 0.94 to 1.05). Conclusions Universal masking was associated with a decreasing COVID-19 incidence trend among HCWs, while the infection rate continued to rise in the surrounding community.

ObjectivesTo investigate SARS-CoV-2 (the virus causing COVID-19) infection and exposure risks among grocery retail workers, and to investigate their mental health state during the pandemic.MethodsThis cross-sectional study was conducted in May 2020 in a single grocery retail store in Massachusetts, USA. We assessed workers’ personal/occupational history and perception of COVID-19 by questionnaire. The health outcomes were measured by nasopharyngeal SARS-CoV-2 reverse transcriptase polymerase chain reaction (RT-PCR) results, GAD-7 (General Anxiety Disorder-7) and PHQ-9 (Patient Health Questionnaire-9).ResultsAmong 104 workers tested, twenty-one (20%) had positive viral assays. Seventy-six percent positive cases were asymptomatic. After multi-variate adjustments, employees with direct customer exposure had an odds of 4.7 (95% CI 1.2 to 32.0) being tested positive for SARS-CoV-2, while smokers had an odds of 0.1 (95% CI 0.01 to 0.8) having positive assay. As to mental health, the prevalence of anxiety and depression (i.e. GAD-7 score > 4 or PHQ-9 score >4) was 24% and 8%, respectively. After adjusting for potential confounders, those able to practice social distancing consistently at work had odds of 0.2 (95% CI 0.1 to 0.7) and 0.1 (95% CI 0.01 to 0.6) screening positive for anxiety and depression, respectively.ConclusionsWe found a considerable asymptomatic SARS-CoV-2 infection rate among grocery workers. Employees with direct costumer exposure were 5 times more likely to test positive for SARS-CoV-2, while cigarette smokers were 90% less likely to have positive assays. Those able to practice social distancing consistently at work had significantly lower risk of anxiety or depression.

Background: Coronavirus 2019 disease (COVID-19) is caused by the virus SARS-CoV-2, transmissible both person-to-person and from contaminated surfaces. Early COVID-19 detection among healthcare workers (HCWs) is crucial for protecting patients and the healthcare workforce. Because of limited testing capacity, symptom-based screening may prioritize testing and increase diagnostic accuracy. Methods: We performed a retrospective study of HCWs undergoing both COVID-19 telephonic symptom screening and nasopharyngeal SARS-CoV-2 assays during the period, March 9 – April 15, 2020. HCWs with negative assays but progressive symptoms were re-tested for SARS-CoV-2. Findings: Among 592 HCWs tested, 83 (14%) had an initial positive SARS-CoV-2 assay. Fifty-nine of 61 HCWs (97%) who were asymptomatic or reported only sore throat/nasal congestion had negative SARS-CoV-2 assays (P=0·006). HCWs reporting three or more symptoms had an increased multivariate-adjusted odds of having positive assays, 1·95 (95% CI: 1·10–3·64), which increased to 2·61 (95% CI: 1·50–4·45) for six or more symptoms. The multivariate-adjusted odds of a positive assay were also increased for HCWs reporting fever and a measured temperature ≥ 37·5°C (3·49 (95% CI: 1·95–6·21)), and those with myalgias (1·83 (95% CI: 1·04–3·23)). Anosmia/ageusia was reported less frequently (16%) than other symptoms by HCWs with positive assays, but associated with more than a seven-fold multivariate-adjusted odds of a positive test: OR=7·21 (95% CI: 2·95–17·67). Of 509 HCWs with initial negative SARS-CoV-2 assays, nine had symptom progression and positive re-tests, yielding an estimated negative predictive value of 98·2% (95% CI: 96·8–99·0%) for the exclusion of clinically relevant COVID-19. Interpretation: Symptom and temperature reports are useful screening tools for predicting SARS-CoV-2 assay results in HCWs. Anosmia/ageusia and fever were the two strongest independent predictors of positive assays. The absence of symptoms or symptoms limited to nasal congestion/sore throat were associated with negative assays. Funding Statement: None. Declaration of Interests: None Ethics Approval Statement: The Institutional Review Board of the healthcare system reviewed the study protocol, determined it to be exempt and waived informed consent based on the use of existing, HIPAA-deidentified data.

ImportanceOur study helps fill the knowledge gap related to work-related transmission in the emerging coronaviral pandemic.ObjectiveTo demonstrate high-risk occupations for early coronavirus disease 2019 (Covid-19) local transmission.MethodsIn this observational study, we extracted confirmed Covid-19 cases from governmental investigation reports in Hong Kong, Japan, Singapore, Taiwan, Thailand, and Vietnam. We followed each country/area for 40 days after its first locally transmitted case, and excluded all imported cases. We defined a possible work-related case as a worker with evidence of close contact with another confirmed case due to work, or an unknown contact history but likely to be infected in the working environment (e.g. an airport taxi driver). We calculated the case number for each occupation, and illustrated the temporal distribution of all possible work-related cases and healthcare worker (HCW) cases. The temporal distribution was further defined as early outbreak (the earliest 10 days of the following period) and late outbreak (11th to 40th days of the following period).ResultsWe identified 103 possible work-related cases (14.9%) among a total of 690 local transmissions. The five occupation groups with the most cases were healthcare workers (HCWs) (22%), drivers and transport workers (18%), services and sales workers (18%), cleaning and domestic workers (9%) and public safety workers (7%). Possible work-related transmission played a substantial role in early outbreak (47.7% of early cases).Occupations at risk varied from early outbreak (predominantly services and sales workers, drivers, construction laborers, and religious professionals) to late outbreak (predominantly HCWs, drivers, cleaning and domestic workers, police officers, and religious professionals).ConclusionsWork-related transmission is considerable in early Covid-19 outbreaks, and the elevated risk of infection was not limited to HCW. Implementing preventive/surveillance strategies for high-risk working populations is warranted.

ObjectiveThere is limited evidence of work-related transmission in the emerging coronaviral pandemic. We aimed to identify high-risk occupations for early coronavirus disease 2019 (COVID-19) local transmission.MethodsIn this observational study, we extracted confirmed COVID-19 cases from governmental investigation reports in Hong Kong, Japan, Singapore, Taiwan, Thailand, and Vietnam. We followed each country/area for 40 days after its first locally transmitted case, and excluded all imported cases. We defined a possible work-related case as a worker with evidence of close contact with another confirmed case due to work, or an unknown contact history but likely to be infected in the working environment (e.g. an airport taxi driver). We calculated the case number for each occupation, and illustrated the temporal distribution of all possible work-related cases and healthcare worker (HCW) cases. The temporal distribution was further defined as early outbreak (the earliest 10 days of the following period) and late outbreak (11th to 40th days of the following period).ResultsWe identified 103 possible work-related cases (14.9%) among a total of 690 local transmissions. The five occupation groups with the most cases were healthcare workers (HCWs) (22%), drivers and transport workers (18%), services and sales workers (18%), cleaning and domestic workers (9%) and public safety workers (7%). Possible work-related transmission played a substantial role in early outbreak (47.7% of early cases). Occupations at risk varied from early outbreak (predominantly services and sales workers, drivers, construction laborers, and religious professionals) to late outbreak (predominantly HCWs, drivers, cleaning and domestic workers, police officers, and religious professionals).ConclusionsWork-related transmission is considerable in early COVID-19 outbreaks, and the elevated risk of infection was not limited to HCW. Implementing preventive/surveillance strategies for high-risk working populations is warranted.

OBJECTIVE This study aimed to determine if occupational exposure to whole-body vibration is associated with cervical intervertebral disc herniation among container truck drivers. METHODS We conducted a walk-through survey among container truck drivers and unexposed workers. We also measured the vibration hazard of the container truck over the driver's back and seat when the driver was loading a container and driving the loaded truck. RESULTS AND DISCUSSION Among the 38 workers interviewed, 32 were container truck drivers. Four of them reported cervical herniated discs, and all of these individuals were container truck drivers with a job tenure of greater than 10 years. Self-reported cervical herniated disc, nuchal pain, nocturia, arm/forearm weakness, arm/forearm numbness, and finger numbness were significantly more prevalent as the driver's duration of exposure increased (all p values of test for trend

ObjectivesHigh respiratory hazards among search and rescue workers (SRWs) emerged after the World Trade Center attacks on 11 September 2001. There have been limited studies on respiratory symptoms among earthquake SRWs. We investigated the respiratory symptoms and the use of respiratory protective equipment among the SRWs who responded to the 2016 Taiwan earthquake.MethodsOn 6 February 2016, a 6.4-magnitude earthquake struck southern Taiwan and caused 513 injuries and 117 deaths. During the 9-day field operation, 519 firefighters affiliated with the Tainan City Government Fire Bureau participated in the search and rescue response. A standardised, self-completed questionnaire was used to collect data on demographics, dust exposures, personal protective measures and health outcomes 3 weeks after the earthquake. Descriptive and multivariate analyses adjusting for demographics and exposure variables were performed for new or worsened outcomes.ResultsOf the 519 SRWs, 414 (80%) responded to the questionnaire. Of these SRWs, 153 (37%) reported new or worsened respiratory symptoms, with cough (23%) as the leading symptom, followed by rhinorrhoea or nasal congestion (22%) and chest tightness (6%). More than 90% of the symptoms persisted to the third week after the earthquake. The prevalence of new or worsened respiratory symptoms was significantly higher among SRWs with a higher level of exposure to dust. Prior training in response to respiratory pollutants was only 5%.ConclusionsThere were significant respiratory hazards among earthquake SRWs. The persistent symptoms and low coverage of training warrant further regular examination and occupational health programmes.