Bus operators are exposed to many occupational hazards, ranging from workplace violence to air pollution to biohazards. Through a summer project, Occupational Health Internship Program students explored bus operators’ health and safety concerns at the Amalgamated Transit Union Local #265 in San Jose, CA. Pilot surveys and individual interviews were used to identify operators’ perspectives on split shifts. A majority of a small sample of 109 bus operators reported dissatisfaction with split shifts, experience with physical and mental fatigue, stress from working these shifts, and inability to focus on immediate tasks due to working split shifts. Some operators preferred split shifts for various reasons, including having time to perform errands, eat lunch, and rest. Operators’ suggestions to improve route scheduling include split shift observations by management, upward communication with senior management, and improvement of bus yard and relief point facilities where operators take their breaks between shifts.

Purpose: To compare retinal changes in young adults with previous SARS-CoV-2 infection with healthy young controls using optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). Methods: This prospective single-center study was conducted at the University Hospital of Zurich, Zurich, Switzerland. Participants were imaged from May to November 2021 using the SOLIX device (Visionix International SAS, Pont-de-l’Arche, France). We performed 12 mm × 12 mm, 6.4 mm × 6.4 mm, 6 mm × 6 mm and 3 mm × 3 mm OCT and OCTA scans, as well as fundus photography of each participant’s eyes. Results: In total, 466 participants were imaged. Of these, 233 were healthy controls with negative RT-PCR tests for SARS-CoV-2, 168 were young adults who had a SARS-CoV-2 infection at least 180 days previously, 19 were participants who had a SARS-CoV-2 infection < 180 days previously, and 46 were participants with asymptomatic SARS-CoV-2 infection (i.e., serologically positive but with no symptoms). Compared with healthy controls, statistically significant differences were found for OCTA recordings of the optic disc for the whole image (WI) and WI capillary vessel density, with both being higher in the SARS-CoV-2 group. Conclusion: Statistically significant results were only observed for selected variables, and in parts, only unilaterally, with relatively large p values (p = 0.02–0.03). Thus, we did not interpret these as clinically significant, leading to the conclusion that young and otherwise healthy individuals (mainly men) seem to recover from mild COVID-19 infections with no ophthalmological residues.

Vessel tortuosity (VT) is a parameter used to assess retinal involvement in patients affected by systemic diseases such as Fabry disease (FD). In this study, we assessed a retinal VT index (VTI) using optical coherence tomography angiography (OCTA) in a group of patients with FD (FD cohort) compared to a healthy control group (HC cohort). This is a single-center, retrospective study analysis of all consecutive patients with genetically tested and confirmed FD who underwent regular ophthalmological visits from December 2017 to January 2020 at the Department of Ophthalmology at the University Hospital of Zurich, Switzerland. VTI was calculated for each OCTA image and the results were compared between FD and HC cohort. A total of 56 participants, 32 (male:female ratio 12:20) in the FD cohort and 24 (male:female ratio 13:11) in the HC cohort. Classic onset was determined in 18 patients. Overall, mean VTI (±SD) was 0.21 (±0.07). Male patients with classic-onset FD had a significantly higher mean VTI (0.33, SD ± 0.35) compared to all other subgroups (p-value < 0.05). Further investigations of retinal VTI in patients with FD could be helpful to use OCTA as a noninvasive screening and follow-up modality to assess disease progression in affected patients.

Background: Few studies have assessed the impact of metformin use on glaucoma risk. The purpose of this study was to examine the association between metformin use and the incidence of primary open-angle glaucoma (POAG) in a diverse and large nationwide cohort. Methods: We included a retrospective cohort study of 18 440 participants in the National Institutes of Health All of Us Research Program aged 40 years or older, with a diagnosis of diabetes mellitus and without a diagnosis of POAG prior to diabetes diagnosis or metformin use. Bivariate logistic regression, multivariable logistic regression and survival analysis were used to analyse the association between ever use of metformin and incidence of POAG. Results: Within the cohort, 240 participants acquired a diagnosis of POAG during all available follow-up time, while 18 200 did not. In regression-based bivariate analysis, metformin use was significantly associated with a lower odds of developing POAG (OR 0.35, 95% CI 0.26 to 0.47, p<0.001). In multivariable regression analysis, metformin remained protective against POAG (OR 0.33, 95% CI 0.21 to 0.50, p<0.001), while the use of other diabetic medications was associated with an increased odds of developing POAG (OR 2.39, 95% CI 1.48 to 3.90, p<0.001). In survival analysis, the probability of developing POAG was significantly lower for the participants using metformin than for the participants not using metformin (log-rank p<0.001, Cox proportional HR 0.38, 95% CI 0.29 to 0.51). Conclusions: This study provides additional large-scale observational health data supporting the protective role of metformin in the development of POAG. However, limitations include the study’s observational design and lack of data on metformin dosage and duration, glaucoma severity and ocular exam findings. Despite these limitations, our findings contribute to the growing body of evidence suggesting a potential protective effect of metformin against POAG.

To examine the epidemiology and factors of cannabis use among open-angle glaucoma (OAG) patients. In this cross-sectional study, OAG participants in the All of Us database were included. Cannabis ever-users were defined based on record of cannabis use. Demographic and socioeconomic data were collected and compared between cannabis ever-users and never-users using Chi-Square tests and logistic regression. Odds ratios (OR) of potential factors associated with cannabis use were examined in univariable and multivariable models. Among 3723 OAG participants, 1436 (39%) were cannabis ever-users. The mean (SD) age of never-users and ever-users was 72.9 (10.4) and 69.2 (9.6) years, respectively (P < 0.001). Compared to never-users, Black (34%) and male (55%) participants were better represented in ever-users, while Hispanic or Latino participants (6%) were less represented (P < 0.001). Diversity was also observed in socioeconomic characteristics including marital status, housing security, and income/education levels. A higher percentage of ever-users had a degree ≥12 grades (91%), salaried employment (26%), housing insecurity (12%), and history of cigar smoking (48%), alcohol consumption (96%), and other substance use (47%) (P < 0.001). In the multivariable analysis, Black race (OR [95% CI] = 1.33 [1.06, 1.68]), higher education (OR = 1.19 [1.07, 1.32]), and history of nicotine product smoking (OR: 2.04–2.83), other substance use (OR = 8.14 [6.63, 10.04]), and alcohol consumption (OR = 6.80 [4.45, 10.79]) were significant factors associated with cannabis use. Increased age (OR = 0.96 [0.95, 0.97]), Asian race (OR = 0.18 [0.09, 0.33]), and Hispanic/Latino ethnicity (OR = 0.43 [0.27, 0.68]) were associated with decreased odds of use (P < 0.02). This study elucidated the previously uncharacterized epidemiology and factors associated with cannabis use among OAG patients, which may help to identify patients requiring additional outreach on unsupervised marijuana use.