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Article ; Online: Integrating the Lifestyle Medicine Residency Curriculum into an Occupational Medicine Training Program.

Lutchman, Kevan / Wan, Melissa / Lan, Fan-Yun / Kales, Stefanos N / Frates, Elizabeth Pegg

Journal of occupational and environmental medicine

2024 Volume 66, Issue 4, Page(s) e143–e144

MeSH term(s)	Humans ; Occupational Medicine/education ; Internship and Residency ; Curriculum ; Life Style
Language	English
Publishing date	2024-01-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	1223932-x
ISSN	1536-5948 ; 1076-2752
ISSN (online)	1536-5948
ISSN	1076-2752
DOI	10.1097/JOM.0000000000003056
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Article: Cancer and Potential Prevention with Lifestyle among Career Firefighters: A Narrative Review.

Sidossis, Amalia / Lan, Fan-Yun / Hershey, Maria S / Hadkhale, Kishor / Kales, Stefanos N

Cancers

2023 Volume 15, Issue 9

Abstract: 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 ... ...

Abstract	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.
Language	English
Publishing date	2023-04-24
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers15092442
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Article ; Online: Association between SARS-CoV-2 infection, exposure risk and mental health among a cohort of essential retail workers in the USA.

Lan, Fan-Yun / Suharlim, Christian / Kales, Stefanos N / Yang, Justin

Occupational and environmental medicine

2020 Volume 78, Issue 4, Page(s) 237–243

Abstract: Objectives: To 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.: Methods: This cross-sectional study was conducted in May ... ...

Abstract	Objectives: To 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. Methods: This 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). Results: Among 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). Conclusions: In 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.
MeSH term(s)	Adult ; Anxiety/epidemiology ; Anxiety/psychology ; COVID-19/diagnosis ; COVID-19/epidemiology ; COVID-19/prevention & control ; COVID-19/transmission ; Cross-Sectional Studies ; Depression/epidemiology ; Depression/psychology ; Female ; Humans ; Male ; Mental Health/statistics & numerical data ; Middle Aged ; Occupational Exposure/statistics & numerical data ; Occupational Health ; Prevalence ; Risk ; SARS-CoV-2/isolation & purification ; Supermarkets ; Surveys and Questionnaires ; United States/epidemiology ; Workplace/statistics & numerical data
Keywords	covid19
Language	English
Publishing date	2020-10-30
Publishing country	England
Document type	Journal Article
ZDB-ID	1180733-7
ISSN	1470-7926 ; 1351-0711
ISSN (online)	1470-7926
ISSN	1351-0711
DOI	10.1136/oemed-2020-106774
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Article: COVID-19 and healthcare workers: emerging patterns in Pamplona, Asia and Boston

Lan, Fan-Yun / Fernandez-Montero, Alejandro / Kales, Stefanos N.

Occupational Medicine

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #457328
Database	COVID19

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Article ; Online: Risk of SARS-CoV-2 Infection Among Essential Workers in a Community-Based Cohort in the United States

Chih-Fu Wei / Fan-Yun Lan / Yu-Tien Hsu / Nina Lowery / Lauren Dibona / Ream Akkeh / Stefanos N. Kales / Justin Yang

Frontiers in Public Health, Vol

2022 Volume 10

Abstract: ObjectivesThe objective of this paper is to identify the risk factors for SARS-CoV-2 infection that are related to occupation type as well as workplace conditions. Identifying such risk factors could have noteworthy implications in workplace safety ... ...

Abstract	ObjectivesThe objective of this paper is to identify the risk factors for SARS-CoV-2 infection that are related to occupation type as well as workplace conditions. Identifying such risk factors could have noteworthy implications in workplace safety enhancement and emergency preparedness planning for essential workers.MethodsWe conducted a retrospective analysis of visits at a community-based SARS-CoV-2 testing site in the greater Boston area between March 18th and June 19th, 2020, for individuals between 14 and 65 years of age. Nasopharyngeal swab specimen, medical review, and self-administered questionnaire were obtained, and SARS-CoV-2 infection was determined with real-time, reverse transcriptase-polymerase chain reaction (RT-PCR). Medical record-verified job classification, customer-facing, and work patterns were extracted from each individual's response through chart review and validated by licensed clinicians. The occupational patterns were coded by occupational medicine physicians with pre-specified criteria and were analyzed with logistic regression and inverse probability weighting.ResultsAmong the 780 individuals included in the final analysis, working in healthcare-related jobs was associated with a four-fold increase in risk of SARS-CoV-2 infection (Adjusted OR: 4.00, 95% CI: 1.45–11.02). Individuals with customer-facing jobs had a two times risk increase (Adjusted OR: 1.97, 95% CI: 1.12–3.45) in having a positive SARS-CoV-2 RT-PCR assay result compared to participants with non-customer facing positions.ConclusionsIn this U.S. community-based population during the initial wave of the pandemic, a significant increase in risk of SARS-CoV-2 infection was observed in those employed in the healthcare sector or with customer-facing positions. Further research is warranted to determine if these correlations continued with the buildup of population immunity together with the attenuation of SARS-CoV-2 virulence.
Keywords	COVID-19 ; communicable diseases ; occupational health ; healthcare workers ; Public Health Surveillance ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2022-05-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: COVID-19 and healthcare workers

Lan, Fan-Yun / Fernandez-Montero, Alejandro / Kales, Stefanos N

Occupational Medicine

emerging patterns in Pamplona, Asia and Boston

2020 Volume 70, Issue 5, Page(s) 340–341

Keywords	Public Health, Environmental and Occupational Health ; covid19
Language	English
Publisher	Oxford University Press (OUP)
Publishing country	uk
Document type	Article ; Online
ZDB-ID	1103950-4
ISSN	1471-8405 ; 0962-7480
ISSN (online)	1471-8405
ISSN	0962-7480
DOI	10.1093/occmed/kqaa089
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Article ; Online: Risk of SARS-CoV-2 Infection Among Essential Workers in a Community-Based Cohort in the United States.

Wei, Chih-Fu / Lan, Fan-Yun / Hsu, Yu-Tien / Lowery, Nina / Dibona, Lauren / Akkeh, Ream / Kales, Stefanos N / Yang, Justin

Frontiers in public health

2022 Volume 10, Page(s) 878208

Abstract: Objectives: The objective of this paper is to identify the risk factors for SARS-CoV-2 infection that are related to occupation type as well as workplace conditions. Identifying such risk factors could have noteworthy implications in workplace safety ... ...

Abstract	Objectives: The objective of this paper is to identify the risk factors for SARS-CoV-2 infection that are related to occupation type as well as workplace conditions. Identifying such risk factors could have noteworthy implications in workplace safety enhancement and emergency preparedness planning for essential workers. Methods: We conducted a retrospective analysis of visits at a community-based SARS-CoV-2 testing site in the greater Boston area between March 18 Results: Among the 780 individuals included in the final analysis, working in healthcare-related jobs was associated with a four-fold increase in risk of SARS-CoV-2 infection (Adjusted OR: 4.00, 95% CI: 1.45-11.02). Individuals with customer-facing jobs had a two times risk increase (Adjusted OR: 1.97, 95% CI: 1.12-3.45) in having a positive SARS-CoV-2 RT-PCR assay result compared to participants with non-customer facing positions. Conclusions: In this U.S. community-based population during the initial wave of the pandemic, a significant increase in risk of SARS-CoV-2 infection was observed in those employed in the healthcare sector or with customer-facing positions. Further research is warranted to determine if these correlations continued with the buildup of population immunity together with the attenuation of SARS-CoV-2 virulence.
MeSH term(s)	COVID-19/epidemiology ; COVID-19 Testing ; Humans ; Pandemics ; Retrospective Studies ; SARS-CoV-2 ; United States/epidemiology
Language	English
Publishing date	2022-05-17
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2711781-9
ISSN	2296-2565 ; 2296-2565
ISSN (online)	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2022.878208
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Article ; Online: Continued effectiveness of COVID-19 vaccination among urban healthcare workers during delta variant predominance.

Lan, Fan-Yun / Sidossis, Amalia / Iliaki, Eirini / Buley, Jane / Nathan, Neetha / Bruno-Murtha, Lou Ann / Kales, Stefanos N

BMC infectious diseases

2022 Volume 22, Issue 1, Page(s) 457

Abstract: Background: Data on COVID-19 vaccine effectiveness (VE) among healthcare workers (HCWs) during periods of delta variant predominance are limited.: Methods: We followed a population of urban Massachusetts HCWs (45% non-White) subject to epidemiologic ... ...

Abstract	Background: Data on COVID-19 vaccine effectiveness (VE) among healthcare workers (HCWs) during periods of delta variant predominance are limited. Methods: We followed a population of urban Massachusetts HCWs (45% non-White) subject to epidemiologic surveillance. We accounted for covariates such as demographics and community background infection incidence, as well as information bias regarding COVID-19 diagnosis and vaccination status. Results: During the study period (December 16, 2020 to September 30, 2021), 4615 HCWs contributed to a total of 1,152,486 person-days at risk (excluding 309 HCWs with prior infection) and had a COVID-19 incidence rate of 5.2/10,000 (114 infections out of 219,842 person-days) for unvaccinated person-days and 0.6/10,000 (49 infections out of 830,084 person-days) for fully vaccinated person-days, resulting in an adjusted VE of 82.3% (95% CI 75.1-87.4%). For the secondary analysis limited to the period of delta variant predominance in Massachusetts (i.e., July 1 to September 30, 2021), we observed an adjusted VE of 76.5% (95% CI 40.9-90.6%). Independently, we found no re-infection among those with prior COVID-19, contributing to 74,557 re-infection-free person-days, adding to the evidence base for the robustness of naturally acquired immunity. Conclusions: We found a VE of 76.5% against the delta variant. Our work also provides further evidence of naturally acquired immunity.
MeSH term(s)	COVID-19/epidemiology ; COVID-19/prevention & control ; COVID-19 Testing ; COVID-19 Vaccines ; Health Personnel ; Humans ; SARS-CoV-2/genetics ; Vaccination
Chemical Substances	COVID-19 Vaccines
Language	English
Publishing date	2022-05-12
Publishing country	England
Document type	Journal Article
ZDB-ID	2041550-3
ISSN	1471-2334 ; 1471-2334
ISSN (online)	1471-2334
ISSN	1471-2334
DOI	10.1186/s12879-022-07434-y
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Article ; Online: Measurement of optic nerve sheath diameter by ultrasound in healthy term neonates.

Lan, Shih-Yun / Tai, Hung-Lin / Lin, Jainn-Jim / Lan, Fan-Yun / Tsai, Hsin-Yu / Lin, Kuang-Lin

Pediatrics and neonatology

2021 Volume 62, Issue 6, Page(s) 591–597

Abstract: 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 ... ...

Abstract	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.
MeSH term(s)	Female ; Humans ; Infant, Newborn ; Intracranial Hypertension ; Male ; Optic Nerve/diagnostic imaging ; Prospective Studies ; Retrospective Studies ; Ultrasonography
Language	English
Publishing date	2021-06-19
Publishing country	Singapore
Document type	Journal Article
ZDB-ID	2441816-X
ISSN	2212-1692 ; 1875-9572
ISSN (online)	2212-1692
ISSN	1875-9572
DOI	10.1016/j.pedneo.2021.05.021
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Article: Surviving & Thriving

Hershey, Maria Soledad / Bouziani, Eleni / Chen, Xin Yu Maggie / Lidoriki, Irene / Hadkhale, Kishor / Huang, Ya-Chin / Filippou, Theodoros / López-Gil, José Francisco / Gribble, Anne Katherine / Lan, Fan-Yun / Sotos-Prieto, Mercedes / Kales, Stefanos N

Frontiers in endocrinology

2023 Volume 14, Page(s) 1250041

Abstract: In the United States (US), new firefighters' fitness and health behaviors deteriorate rapidly after fire academy graduation. Over the long-term, this increases their risks for chronic diseases. This study protocol describes the proposed usability testing ...

Abstract	In the United States (US), new firefighters' fitness and health behaviors deteriorate rapidly after fire academy graduation. Over the long-term, this increases their risks for chronic diseases. This study protocol describes the proposed usability testing and pilot study of a newly designed and developed healthy lifestyle smartphone app, "Surviving & Thriving", tailored towards young US firefighters. "Surviving & Thriving" will provide interactive educational content on four lifestyle factors; nutrition, sleep, physical activity, and resilience, and include a personalized journey, habit tracker, and elements of gamification to promote engagement and long-term healthy behavior change. The first phase of the app development entails alpha testing by the research team and pre-beta testing by a fire service expert panel which will help refine the app into a pre-consumer version. Upon completion of the full app prototype, beta 'usability' testing will be conducted among new fire academy graduates from two New England fire academies to collect qualitative and quantitative feedback via focus groups and satisfaction surveys, respectively. A last phase of piloting the app will evaluate the app's efficacy at maintaining/improving healthy lifestyle behaviors, mental health metrics, and physical fitness metrics. We will also evaluate whether firefighters' perceived "health cultures" scores (ratings of each fire station's/fire department's environments as to encouraging/discouraging healthy behaviors) modify the changes in health metrics after utilizing the app for three to six months. This novel user-friendly app seeks to help new firefighters maintain/improve their health and fitness more effectively, reducing their risk of lifestyle-related chronic disease. Firefighters who can establish healthy habits early in their careers are more likely to sustain them throughout their lives.
MeSH term(s)	Humans ; United States ; Mobile Applications ; Pilot Projects ; Firefighters/psychology ; Health Behavior ; Healthy Lifestyle
Language	English
Publishing date	2023-10-05
Publishing country	Switzerland
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S. ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	2592084-4
ISSN	1664-2392
ISSN	1664-2392
DOI	10.3389/fendo.2023.1250041
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