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  1. Article ; Online: Extreme Heat and Occupational Health Risks.

    Gibb, Kathryn / Beckman, Stella / Vergara, Ximena P / Heinzerling, Amy / Harrison, Robert

    Annual review of public health

    2024  

    Abstract: Climate change poses a significant occupational health hazard. Rising temperatures and more frequent heat waves are expected to cause increasing heat-related morbidity and mortality for workers across the globe. Agricultural, construction, military, ... ...

    Abstract Climate change poses a significant occupational health hazard. Rising temperatures and more frequent heat waves are expected to cause increasing heat-related morbidity and mortality for workers across the globe. Agricultural, construction, military, firefighting, mining, and manufacturing workers are at particularly high risk for heat-related illness (HRI). Various factors, including ambient temperatures, personal protective equipment, work arrangements, physical exertion, and work with heavy equipment may put workers at higher risk for HRI. While extreme heat will impact workers across the world, workers in low- and middle-income countries will be disproportionately affected. Tracking occupational HRI will be critical to informing prevention and mitigation strategies. Renewed investment in these strategies, including workplace heat prevention programs and regulatory standards for indoor and outdoor workers, will be needed. Additional research is needed to evaluate the effectiveness of interventions in order to successfully reduce the risk of HRI in the workplace. Expected final online publication date for the
    Language English
    Publishing date 2024-01-02
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 760917-6
    ISSN 1545-2093 ; 0163-7525
    ISSN (online) 1545-2093
    ISSN 0163-7525
    DOI 10.1146/annurev-publhealth-060222-034715
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  2. Article ; Online: Occupational Contributions to Respiratory Health Disparities.

    Gandhi, Sheiphali A / Heinzerling, Amy / Flattery, Jennifer / Cummings, Kristin J

    Clinics in chest medicine

    2023  Volume 44, Issue 3, Page(s) 635–649

    Abstract: Occupation is an important contributor to disparities in respiratory disease, affecting financial status, health-care access, and exposure to hazardous substances. Although occupation and associated exposures are included in the socioecological models, ... ...

    Abstract Occupation is an important contributor to disparities in respiratory disease, affecting financial status, health-care access, and exposure to hazardous substances. Although occupation and associated exposures are included in the socioecological models, work exposures remain persistently absent from research on health inequities and their contribution to health. This article focuses on the occupational contribution to disparities in asthma, chronic obstructive pulmonary disease, silicosis, coronavirus disease 2019, and lung cancer. Because occupational exposures are largely preventable through proper workplace controls, the recognition of occupational causes of disease can provide an opportunity for interventions to bring about health equity.
    MeSH term(s) Humans ; Occupational Diseases/etiology ; Occupational Diseases/complications ; COVID-19/complications ; Pulmonary Disease, Chronic Obstructive/epidemiology ; Pulmonary Disease, Chronic Obstructive/etiology ; Asthma/epidemiology ; Asthma/etiology ; Respiration Disorders ; Occupational Exposure/adverse effects
    Language English
    Publishing date 2023-05-09
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 447455-7
    ISSN 1557-8216 ; 0272-5231
    ISSN (online) 1557-8216
    ISSN 0272-5231
    DOI 10.1016/j.ccm.2023.03.016
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    Se 805: Show issues Location:
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  3. Article ; Online: Risk factors for COVID-19 among Californians working outside the home, November 2020 - May 2021.

    Wong, Jessie / Cummings, Kristin J / Gibb, Kathryn / Rodriguez, Andrea / Heinzerling, Amy / Vergara, Ximena P

    American journal of industrial medicine

    2023  Volume 66, Issue 3, Page(s) 233–242

    Abstract: Background: Higher incidences of COVID-19 mortality and outbreaks have been found in certain industries and occupations. Workplace factors, including working in close proximity to others and contact with the public can facilitate SARS-CoV-2 transmission, ...

    Abstract Background: Higher incidences of COVID-19 mortality and outbreaks have been found in certain industries and occupations. Workplace factors, including working in close proximity to others and contact with the public can facilitate SARS-CoV-2 transmission, especially without appropriate protective measures. Limited information is available about workers at highest risk for SARS-CoV-2 infection.
    Methods: A phone-based, nonprobability study was conducted between November 2020 and May 2021 among California workers who were tested for SARS-CoV-2. Participants were asked about demographics and workplace factors, including industry, occupation, and implementation of COVID-19 mitigation measures. Using the SARS-CoV-2 occupational exposure matrix, three exposure metrics and a combination index were used to categorize occupations. We assessed the association between workplace risks and SARS-CoV-2 test positivity using adjusted logistic regression.
    Results: We enrolled 451 (13%) of 3475 potentially eligible workers in the study: 212 with positive and 239 with negative SARS-CoV-2 test results. Those working very close to others and with the highest combined exposure index had a positive association with SARS-CoV-2 positivity. Primarily indoor workers had a lower odds of test positivity compared to those with any outdoor work. There was no association between public-facing occupations and test positivity. Participants with employers who implemented mitigation measures in all three control categories-engineering, administrative, and personal protective equipment-had lower odds of test positivity than those with fewer mitigation measures.
    Conclusions: Worker groups with higher risk factors should be prioritized for outreach. Assessment of occupational risk factors collectively can provide insight to inform preventative actions for workers, employers, and public health entities.
    MeSH term(s) Humans ; COVID-19/epidemiology ; Occupations ; Risk Factors ; SARS-CoV-2 ; Workplace ; California/epidemiology ; Occupational Health
    Language English
    Publishing date 2023-01-24
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 604538-8
    ISSN 1097-0274 ; 0271-3586
    ISSN (online) 1097-0274
    ISSN 0271-3586
    DOI 10.1002/ajim.23459
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1605: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  4. Article ; Online: Notes from the Field: E-cigarette, or Vaping, Product Use-Associated Lung Injury Cases During the COVID-19 Response - California, 2020.

    Armatas, Christina / Heinzerling, Amy / Wilken, Jason A

    MMWR. Morbidity and mortality weekly report

    2020  Volume 69, Issue 25, Page(s) 801–802

    MeSH term(s) Adolescent ; Adult ; COVID-19 ; COVID-19 Testing ; California/epidemiology ; Clinical Laboratory Techniques/statistics & numerical data ; Coronavirus Infections/diagnosis ; Coronavirus Infections/epidemiology ; Coronavirus Infections/prevention & control ; Electronic Nicotine Delivery Systems ; Humans ; Lung Injury/epidemiology ; Lung Injury/therapy ; Middle Aged ; Pandemics/prevention & control ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/prevention & control ; Vaping/adverse effects ; Young Adult
    Keywords covid19
    Language English
    Publishing date 2020-06-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 412775-4
    ISSN 1545-861X ; 0149-2195
    ISSN (online) 1545-861X
    ISSN 0149-2195
    DOI 10.15585/mmwr.mm6925a5
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  5. Article ; Online: Self-reported silica exposures and workplace protections among engineered stone fabrication workers in California.

    Spiegel, Ariana / Cummings, Kristin J / Flattery, Jennifer / Harrison, Robert / Heinzerling, Amy

    American journal of industrial medicine

    2022  Volume 65, Issue 12, Page(s) 1022–1024

    MeSH term(s) Humans ; Workplace ; Self Report ; Air Pollutants, Occupational/analysis ; California ; Silicon Dioxide/analysis ; Occupational Exposure/adverse effects ; Occupational Exposure/prevention & control ; Occupational Exposure/analysis
    Chemical Substances Air Pollutants, Occupational ; Silicon Dioxide (7631-86-9)
    Language English
    Publishing date 2022-10-10
    Publishing country United States
    Document type Letter ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 604538-8
    ISSN 1097-0274 ; 0271-3586
    ISSN (online) 1097-0274
    ISSN 0271-3586
    DOI 10.1002/ajim.23432
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    Zs.A 1605: Show issues Location:
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  6. Article ; Online: Silicosis Among Immigrant Engineered Stone (Quartz) Countertop Fabrication Workers in California.

    Fazio, Jane C / Gandhi, Sheiphali A / Flattery, Jennifer / Heinzerling, Amy / Kamangar, Nader / Afif, Nawal / Cummings, Kristin J / Harrison, Robert J

    JAMA internal medicine

    2023  Volume 183, Issue 9, Page(s) 991–998

    Abstract: Importance: Silicosis associated with inhalation of respirable crystalline silica among engineered stone countertop fabrication workers is an emerging health concern.: Objective: To describe clinical, socioeconomic, and occupational characteristics ... ...

    Abstract Importance: Silicosis associated with inhalation of respirable crystalline silica among engineered stone countertop fabrication workers is an emerging health concern.
    Objective: To describe clinical, socioeconomic, and occupational characteristics of patients diagnosed with silicosis associated with engineered stone in California.
    Design, setting, and participants: This case series included reported cases of silicosis associated with fabrication of engineered stone countertops, as identified by statewide surveillance by the California Department of Public Health (2019-2022). Data analysis was performed from October 2022 to March 2023.
    Exposures: Patient interviews and medical record abstractions were used to assess occupational exposure to respirable crystalline silica, including duration of work tenure and preventive measures undertaken.
    Main outcomes and measures: Demographics, clinical characteristics, health care utilization, and clinical outcomes were obtained, including vital status, hypoxia, and lung transplant.
    Results: This case series identified 52 male patients meeting inclusion criteria; median (IQR) age was 45 (40-49) years, and 51 were Latino immigrants. Ten (19%) were uninsured, and 20 (39%) had restricted-scope Medi-Cal; 25 (48%) presented initially to an emergency department. A delay in diagnosis occurred in 30 (58%) patients, most commonly due to alternative initial diagnoses of bacterial pneumonia (9 [30%]) or tuberculosis (8 [27%]). At diagnosis, 20 (38%) patients had advanced disease (progressive massive fibrosis) with severely or very severely reduced forced expiratory volume in 1 second in 8 (18%) and 5 (11%), respectively. Of the cases, 10 (19%) were fatal; median (IQR) age at death was 46 (38-51) years, and 6 patients (12%) were alive with chronic resting hypoxia. Eleven were referred for lung transplant: 3 underwent transplant with 1 fatality; 7 were declined transplant, with 6 fatalities; and 1 died prior to listing. Median (IQR) work tenure was 15 (10-20) years; 23 (45%) reported use of water suppression for dust mitigation, and 25 (48%) continued to fabricate stone after being diagnosed with silicosis.
    Conclusions and relevance: In this case series performed in California, silicosis associated with occupational exposure to dust from engineered stone primarily occurred among young Latino immigrant men. Many patients presented with severe disease, and some cases were fatal.
    MeSH term(s) Humans ; Male ; Middle Aged ; Quartz/analysis ; Silicosis/diagnosis ; Silicosis/epidemiology ; Silicon Dioxide ; Dust ; Occupational Exposure
    Chemical Substances Quartz (14808-60-7) ; Silicon Dioxide (7631-86-9) ; Dust
    Language English
    Publishing date 2023-07-24
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, P.H.S. ; Research Support, N.I.H., Extramural
    ZDB-ID 2699338-7
    ISSN 2168-6114 ; 2168-6106
    ISSN (online) 2168-6114
    ISSN 2168-6106
    DOI 10.1001/jamainternmed.2023.3295
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  7. Article ; Online: Active Surveillance of Engineered Stone Workers Facilitates Early Identification of Silicosis: A Discussion of Surveillance of Occupational Lung Diseases.

    Gandhi, Sheiphali A / Heinzerling, Amy / Flattery, Jennifer / Fazio, Jane C / Alam, Asim / Cummings, Kristin J / Harrison, Robert J

    New solutions : a journal of environmental and occupational health policy : NS

    2023  Volume 33, Issue 2-3, Page(s) 119–129

    Abstract: Silicosis in workers exposed to respirable crystalline silica while fabricating engineered stone products is an emerging respiratory health issue. We describe silicosis in engineered stone workers in California and examine clinical features by the source ...

    Abstract Silicosis in workers exposed to respirable crystalline silica while fabricating engineered stone products is an emerging respiratory health issue. We describe silicosis in engineered stone workers in California and examine clinical features by the source of identification. Cases were identified passively using hospital-based patient discharge data or actively through outreach and medical testing following enforcement investigation. Outcomes were examined based on the source of case identification. We identified 18 cases diagnosed between 2006 and 2020. Cases identified passively compared to other identification methods were associated with lower percent predicted forced vital capacity (FVC) (
    MeSH term(s) Humans ; Watchful Waiting ; Occupational Exposure/adverse effects ; Occupational Exposure/analysis ; Silicosis/epidemiology ; Silicosis/diagnosis ; Silicon Dioxide/analysis ; Occupational Diseases
    Chemical Substances Silicon Dioxide (7631-86-9)
    Language English
    Publishing date 2023-08-30
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, P.H.S. ; Research Support, N.I.H., Extramural
    ZDB-ID 1236515-4
    ISSN 1541-3772 ; 1048-2911
    ISSN (online) 1541-3772
    ISSN 1048-2911
    DOI 10.1177/10482911231189503
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    Zs.A 4297: Show issues Location:
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  8. Article: Notes from the Field: E-cigarette, or Vaping, Product Use-Associated Lung Injury Cases During the COVID-19 Response - California, 2020

    Armatas, Christina / Heinzerling, Amy / Wilken, Jason A

    MMWR Morb Mortal Wkly Rep

    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #616581
    Database COVID19

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  9. Article ; Online: Elevated exposures to respirable crystalline silica among engineered stone fabrication workers in California, January 2019-February 2020.

    Surasi, Krishna / Ballen, Brittany / Weinberg, Justine L / Materna, Barbara L / Harrison, Robert / Cummings, Kristin J / Heinzerling, Amy

    American journal of industrial medicine

    2022  Volume 65, Issue 9, Page(s) 701–707

    Abstract: Background: Workers fabricating engineered stone face high risk for exposure to respirable crystalline silica (RCS) and subsequent development of silicosis. In response, the California Division of Occupational Safety and Health (Cal/OSHA) performed ... ...

    Abstract Background: Workers fabricating engineered stone face high risk for exposure to respirable crystalline silica (RCS) and subsequent development of silicosis. In response, the California Division of Occupational Safety and Health (Cal/OSHA) performed targeted enforcement inspections at engineered stone fabrication worksites. We investigated RCS exposures and employer adherence to Cal/OSHA's RCS and respiratory protection standards from these inspections to assess ongoing risk to stone fabrication workers.
    Methods: We extracted employee personal air sampling results from Cal/OSHA inspection files and calculated RCS exposures. Standards require that employers continue monitoring employee RCS exposures and perform medical surveillance when exposures are at or above the action level (AL; 25 μg/m
    Results: We analyzed RCS exposures for 152 employees at 47 workplaces. Thirty-eight (25%) employees had exposures above the PEL (median = 89.7 μg/m
    Conclusions: Our investigation demonstrates widespread RCS overexposure among workers and numerous employer Cal/OSHA standard violation citations. More enforcement and educational efforts could improve employer compliance with Cal/OSHA standards and inform employers and employees of the risks for RCS exposure and strategies for reducing exposure.
    MeSH term(s) California/epidemiology ; Dust/analysis ; Humans ; Inhalation Exposure/adverse effects ; Inhalation Exposure/analysis ; Inhalation Exposure/prevention & control ; Occupational Exposure/adverse effects ; Occupational Exposure/analysis ; Occupational Exposure/prevention & control ; Silicon Dioxide/analysis ; Silicosis/epidemiology ; Silicosis/prevention & control ; Workplace
    Chemical Substances Dust ; Silicon Dioxide (7631-86-9)
    Language English
    Publishing date 2022-07-28
    Publishing country United States
    Document type Journal Article
    ZDB-ID 604538-8
    ISSN 1097-0274 ; 0271-3586
    ISSN (online) 1097-0274
    ISSN 0271-3586
    DOI 10.1002/ajim.23416
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    Zs.A 1605: Show issues Location:
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  10. Article ; Online: Chemical Composition of Electronic Vaping Products from School Grounds in California.

    Wang, Ping / Williams, Rebecca J / Chen, Wenhao / Wang, Flavia / Shamout, Mays / Tanz, Lauren J / Herzig, Carolyn T A / Oakley, Lisa P / Peak, Corey M / Heinzerling, Amy / Al-Shawaf, Maeh / Melstrom, Paul / Marynak, Kristy / Tynan, Michael A / Agaku, Israel T / Kumagai, Kazukiyo

    Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco

    2024  

    Abstract: Introduction: The use of electronic vaping products (EVPs) containing nicotine, marijuana, and/or other substances remains prominent among youth; with EVPs containing nicotine being the most commonly used tobacco product among youth since 2014. However, ...

    Abstract Introduction: The use of electronic vaping products (EVPs) containing nicotine, marijuana, and/or other substances remains prominent among youth; with EVPs containing nicotine being the most commonly used tobacco product among youth since 2014. However, a detailed understanding of the chemical composition of these products is limited.
    Methods: During February 25th-March 15th, 2019, a total of 576 EVPs, including 233 e-cigarette devices (with 43 disposable vape pens) and 343 e-liquid cartridges/pods/bottled e-liquids, were found or confiscated from a convenience sample of 16 public high schools in California. Liquids inside 251 vape pens and cartridges/pods/bottled e-liquids were analyzed using a gas chromatography/mass spectrometry (GC/MS). For comparison, new JUUL pods, the most commonly used e-cigarette among youth during 2018-2019, with different flavorings and nicotine content were purchased and analyzed.
    Results: For e-cigarette cartridges/pods/bottled e-liquids, nicotine was detected in 204 of 208 (98.1%) samples. Propylene glycol (PG) and vegetable glycerin (VG) were dominant solvents in nicotine-containing EVPs. Among 43 disposable vape pen devices, cannabinoids such as tetrahydrocannabinol (THC) or cannabidiol (CBD) were identified in 39 of 43 (90.1%) samples, of which 3 contained both nicotine and THC. Differences in chemical compositions were observed between confiscated or collected JUULs and purchased JUULs. Measured nicotine was inconsistent with labels on some confiscated or collected bottled e-liquids.
    Conclusions: EVPs from 16 participating schools were found to widely contain substances with known adverse health effects among youth, including nicotine and cannabinoids. There was inconsistency between labeled and measured nicotine on the products from schools.
    Implications: This study measured the main chemical compositions of EVPs found at 16 California public high schools. Continued efforts are warranted, including at the school-level, to educate, prevent and reduce youth use of EVPs.
    Language English
    Publishing date 2024-02-26
    Publishing country England
    Document type Journal Article
    ZDB-ID 1452315-2
    ISSN 1469-994X ; 1462-2203
    ISSN (online) 1469-994X
    ISSN 1462-2203
    DOI 10.1093/ntr/ntae042
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