Background: Injuries reported to workers’ compensation (WC) system are often used to estimate incidence of health outcomes and evaluate interventions in musculoskeletal epidemiology studies. However, WC claims represent a relatively small subset of all musculoskeletal disorders among employed individuals, and perhaps not a representative subset. This study determined the influence of workplace and individual factors on filing of workers’ compensation claims by nursing home employees with back pain. Methods: Surveys were conducted in 18 skilled nursing facilities in four U.S. states. Self-administered questionnaires obtained information on demographic characteristics, working environment, and health behaviors/status. Employees who reported low back pain at least once in four questionnaire surveys were included. WC claims from the same facilities were obtained from the employer’s workers compensation insurer and matched by employee name. The dichotomous dependent variable was filing of back-related worker’s compensation claim. Association with predictors of interest, including pain severity, physical job demand, job strain, social support, schedule control, and safety climate, was assessed using multivariate regression modeling. Individual characteristics were tested as potential confounders. Results: Pain severity level was significantly associated with filing low-back related claims (odds ratio (OR) = 1.49, 95% CI = 1.18 – 1.87). Higher physical demands at work (OR = 1.07, 95% CI = 1.01 – 1.14) also increased the likelihood of claim filing. Higher job strain (OR = 0.83, 95% CI = 0.73 – 0.94), social support at work (OR = 0.90, 95% CI = 0.82 – 0.99), and education (OR = 0.79, 95% CI = 0.71 – 0.89) decreased the likelihood of claim filing. Conclusions: The results suggest that the WC system captured the most severe occupational injuries. Workplace factors had additional influence on workers’ decision to file claims, after adjusting for low back pain severity. Education was correlated with worker’s socioeconomic status; its influence on claim filing is difficult to interpret because of the possible mixed effects of working conditions, self-efficacy, and content knowledge.

Depression is the second leading cause of disability worldwide. Health care workers report a higher prevalence of depressive symptoms than the general population. Emotional labor has contributed to poor health and work outcomes. However, the mechanism for the potential association between emotional labor and depressive symptoms has not been well studied. This study examines the relationship between emotional labor and depressive symptoms and whether sleep plays a role in explaining this relationship. In 2018, health care workers (n = 1,060) from five public sector facilities in the northeast United States participated in this cross-sectional survey. The survey included questions on participants’ surface-acting emotional labor (masking one’s feelings at work), depressive symptoms, sleep duration and disturbances, and socio-demographic characteristics. Multivariable linear and Poisson regression modeling were used to examine associations among variables. There was a significant association between emotional labor and depressive symptoms (β = 0.82, p < .001). Sleep disturbances, but not short sleep duration, partially mediated this association. Neither sleep variable moderated this association. Depressive symptoms were prevalent among health care workers and were associated with emotional masking. Sleep disturbances play an important intermediate role in translating emotional labor to depressive symptoms in these workers. Effective workplace programs are needed to reduce health care workers’ emotional labor to improve their mental health. Sleep promotion should also be emphasized to mitigate the negative effect of emotional labor and promote mental wellbeing.

Faced with the COVID-19 pandemic, the US system for developing and testing technologies was challenged in unparalleled ways. This article describes the multi-institutional, transdisciplinary team of the “RADx ^SM Tech Test Verification Core” and its role in expediting evaluations of COVID-19 testing devices. Expertise related to aspects of diagnostic testing was coordinated to evaluate testing devices with the goal of significantly expanding the ability to mass screen Americans to preserve lives and facilitate the safe return to work and school. Focal points included: laboratory and clinical device evaluation of the limit of viral detection, sensitivity, and specificity of devices in controlled and community settings; regulatory expertise to provide focused attention to barriers to device approval and distribution; usability testing from the perspective of patients and those using the tests to identify and overcome device limitations, and engineering assessment to evaluate robustness of design including human factors, manufacturability, and scalability.

Objective Results are presented for a registry-based study of hepatobiliary cancer (liver and biliary tract) nested in a cohort of workers from three automobile manufacturing plants with potential exposure to metalworking fluids. Methods Altogether 63 cases of hepatobiliary cancer were identified from the cohort by the Michigan cancer registries. Each case was matched to 10 controls. Odds ratios (OR) were estimated in conditional logistic regression models for lifetime exposure to straight, soluble, and synthetic metalworking fluid and fluid components. Results Overall, hepatobiliary cancer was not associated with exposure to metalworking fluids. However, when the cases were stratified into liver cancer (N=39) and biliary tract cancer (N=24) the risk was nonhomogeneous across the two categories. While liver cancer was not associated with exposure to metalworking fluids, the results suggested a possible excess risk of biliary tract cancer with more than 1.0 mg/m 3 -years of exposure to straight metalworking fluids [OR 2.7, 95% confidence interval (95% CI) 0.9–7.6], as well as any exposure to chlorinated paraffins (OR 3.9, 95% CI 0.9–17). When exposures to straight metalworking fluids were separated into 10-year exposure periods, the odds ratio increased to 6.24 (95% CI 1.62–24.16) for exposures occurring >20 years prior to the risk date. Conclusions There is limited evidence that exposure to straight metalworking fluids is associated with biliary tract cancer. The small numbers of cases of these rare cancers were reflected in the wide confidence intervals, and these findings need to be examined further in other exposed populations.

Background: Process evaluation measures the context in which an outcome was or was not achieved through the ongoing monitoring of operations. Mobile apps are a potentially less burdensome tool for collecting these metrics in real time from participants. Research-driven apps are not always developed while paying attention to their usability for target users. Usability testing uncovers gaps in researchers’, developers’, and users’ mental models of what an efficient, effective, and satisfying product looks like and facilitates design improvement. Models may vary by user demographics. Objective: This study describes the development of a mobile app for collecting process evaluation metrics in an intervention study with health care workers that uses feedback at multiple stages to refine the app design, quantify usage based on workers' overall adoption of the app and the app's specific function, and compare the demographic and job characteristics of end users. Methods: An app was developed to evaluate the Center for Promotion of Health in the New England Workplace Healthy Workplace Participatory Program, which trains teams to develop solutions for workforce health obstacles. Labor-management health and safety committee members, program champions, and managers were invited to use the app. An accompanying website was available for team facilitators. The app’s 4 functions were meeting creation, postmeeting surveys, project time logs, and chat messages. Google Analytics recorded screen time. Two stages of pilot tests assessed functionality and usability across different device software, hardware, and platforms. In stage 1, student testers assessed the first functional prototype by performing task scenarios expected from end users. Feedback was used to fix issues and inform further development. In stage 2, the app was offered to all study participants; volunteers completed task scenarios and provided feedback at deployment. End user data for 18 months after deployment were summarized and compared by user characteristics. Results: In stage 1, functionality problems were documented and fixed. The System Usability Scale scores from 7 student testers corresponded to good usability (mobile app=72.9; website=72.5), whereas 15 end users rated usability as ok (mobile app=64.7; website=62.5). Predominant usability themes from student testers were flexibility and efficiency and visibility of system status; end users prioritized flexibility andefficiency and recognition rather than recall. Both student testers and end users suggested useful features that would have resulted in the large-scale restructuring of the back end; these were considered for their benefits versus cost. In stage 2, the median total use time over 18 months was 10.9 minutes (IQR 23.8) and 14.5 visits (IQR 12.5). There were no observable patterns in use by demographic characteristics. Conclusions: Occupational health researchers developing a mobile app should budget for early and iterative testing to find and fix problems or usability issues, which can increase eventual product use and prevent potential gaps in data.

Nitrogen dioxide (NO₂) and particulate matter of 2.5 microns (PM_2.5) are air pollutants that impact health, especially among vulnerable populations with respiratory disease. This study identifies factors influencing indoor NO₂ and PM_2.5 in low-income households of older adults with asthma who use gas stoves in Lowell, Massachusetts. Environmental sampling was conducted in 73 homes, measuring NO₂, PM_2.5, fractional stove-use, temperature, and humidity for 5–7 days. Participants were recruited between December 2020 and July 2022. Questionnaires were used to collect data on factors influencing indoor NO₂ and PM_2.5 concentrations. Daily outdoor NO₂ and PM_2.5 concentrations were obtained from a United States Environmental Protection Agency (EPA) monitoring station. Paired t-tests were conducted between indoor and outdoor NO₂ and PM_2.5 concentrations, and linear regression was used to evaluate factors influencing indoor NO₂ and PM_2.5 concentrations. The average indoor concentration for NO₂ and PM_2.5 were 21.8 (GSD = 2.1) ppb and 16.2 (GSD = 2.7) µg/m³, respectively. Indoor NO₂ and PM_2.5 concentrations exceeded outdoor concentrations significantly. In multiple regression models, season and pilot light stove use significantly predicted indoor NO₂. Season and air freshener use for 6–7 days/week significantly predicted indoor PM_2.5. Season-influenced higher indoor concentrations are likely due to reduced ventilation in colder months in the Northeast U.S.