Work Hours and Cognitive Function: The Multi-Ethnic Study of Atherosclerosis

Charles, Luenda E.,Fekedulegn, Desta,Burchfiel, Cecil M.,Fujishiro, Kaori,Hazzouri, Adina Zeki Al,Fitzpatrick, Annette L.,Rapp, Stephen R. Occupational Safety and Health Research Institute 2020 Safety and health at work Vol.11 No.2

Background: Cognitive impairment is a public health burden. Our objective was to investigate associations between work hours and cognitive function. Methods: Multi-Ethnic Study of Atherosclerosis (MESA) participants (n = 2,497; 50.7% men; age range 44-84 years) reported hours per week worked in all jobs in Exams 1 (2000-2002), 2 (2002-2004), 3 (2004-2005), and 5 (2010-2011). Cognitive function was assessed (Exam 5) using the Cognitive Abilities Screening Instrument (version 2), a measure of global cognitive functioning; the Digit Symbol Coding, a measure of processing speed; and the Digit Span test, a measure of attention and working memory. We used a prospective approach and linear regression to assess associations for every 10 hours of work. Results: Among all participants, associations of hours worked with cognitive function of any type were not statistically significant. In occupation-stratified analyses (interaction p = 0.051), longer work hours were associated with poorer global cognitive function among Sales/Office and blue-collar workers, after adjustment for age, sex, physical activity, body mass index, race/ethnicity, educational level, annual income, history of heart attack, diabetes, apolipoprotein E-epsilon 4 allele (ApoE4) status, birth-place, number of years in the United States, language spoken at MESA Exam 1, and work hours at Exam 5 (β = -0.55, 95% CI = -0.99, -0.09) and (β = -0.80, -1.51, -0.09), respectively. In occupation-stratified analyses (interaction p = 0.040), we also observed an inverse association with processing speed among blue-collar workers (adjusted β = -0.80, -1.52, -0.07). Sex, race/ethnicity, and ApoE4 did not significantly modify associations between work hours and cognitive function. Conclusion: Weak inverse associations were observed between work hours and cognitive function among Sales/Office and blue-collar workers.

Vibration and Ergonomic Exposures Associated With Musculoskeletal Disorders of the Shoulder and Neck

Luenda E Charles,Claudia C. Ma,Cecil M. Burchfiel,Renguang G. Dong 한국산업안전보건공단 산업안전보건연구원 2018 Safety and health at work Vol.9 No.2

Background: According to the US Bureau of Labor Statistics, musculoskeletal disorders (MSDs) accounted for 32% of all nonfatal injury and illness cases in 2014 among full-time workers. Our objective was to review and summarize the evidence linking occupational exposures to vibration and awkward posture with MSDs of the shoulder and neck. Methods: A literature search was conducted using the terms musculoskeletal disorders, vibration, and awkward posture. All types of observational epidemiologic studies, with the exception of case reports, published during 1998e2015 were included. Databases searched were MEDLINE (Ovid), Embase (Ovid), Scopus, Ergonomic Abstracts, NIOSHTIC-2, and Health and Safety Science Abstracts. Results: Occupational exposures to whole-body or handearm vibration were significantly associated with or resulted in MSDs of the shoulder and neck. Awkward postures while working were also associated with MSDs in these locations. These findings were consistent across study designs, populations, and countries. Conclusion: Occupational exposure to vibration and awkward posture are associated with shoulder and neck MSDs. Longitudinal studies are required to elucidate the mechanisms responsible for these associations, and intervention studies are warranted

Vibration and Ergonomic Exposures Associated With Musculoskeletal Disorders of the Shoulder and Neck

Charles, Luenda E.,Ma, Claudia C.,Burchfiel, Cecil M.,Dong, Renguang G. Occupational Safety and Health Research Institute 2018 Safety and health at work Vol.9 No.2

Background: According to the US Bureau of Labor Statistics, musculoskeletal disorders (MSDs) accounted for 32% of all nonfatal injury and illness cases in 2014 among full-time workers. Our objective was to review and summarize the evidence linking occupational exposures to vibration and awkward posture with MSDs of the shoulder and neck. Methods: A literature search was conducted using the terms musculoskeletal disorders, vibration, and awkward posture. All types of observational epidemiologic studies, with the exception of case reports, published during 1998-2015 were included. Databases searched were MEDLINE (Ovid), Embase (Ovid), Scopus, Ergonomic Abstracts, NIOSHTIC-2, and Health and Safety Science Abstracts. Results: Occupational exposures to whole-body or hand-arm vibration were significantly associated with or resulted in MSDs of the shoulder and neck. Awkward postures while working were also associated with MSDs in these locations. These findings were consistent across study designs, populations, and countries. Conclusion: Occupational exposure to vibration and awkward posture are associated with shoulder and neck MSDs. Longitudinal studies are required to elucidate the mechanisms responsible for these associations, and intervention studies are warranted.

Associations between Psychological Distress and Body Mass Index among Law Enforcement Officers: The National Health Interview Survey 2004-2010

Gu, Ja K.,Charles, Luenda E.,Burchfiel, Cecil M.,Andrew, Michael E.,Ma, Claudia,Bang, Ki Moon,Violanti, John M. Occupational Safety and Health Research Institute 2013 Safety and health at work Vol.4 No.1

Objectives: To investigate the association between psychological distress and obesity among law enforcement officers (LEOs) in the United States. Methods: Self-reported data on psychological distress based on six key questions were obtained from LEOs who participated in the National Health Interview Survey (2004-2010). We used Prochaska's cut-point of a Kessler 6 score ${\geq}5$ for moderate/high mental distress in our analysis. Mean levels of body mass index (BMI) were compared across three levels of psychological distress. Results: The average age of LEOs (n = 929) was 39.3 years; 25% were female. Overall, 8.1% of LEOs had moderate or high psychological distress; 37.5% were obese (BMI ${\geq}30$). Mean BMI increased with increasing psychological distress (no distress, BMI = $27.2kg/m^2$; mild distress, $27.6kg/m^2$; and moderate/high distress, $33.1kg/m^2$; p = 0.016) after adjustment for age, race, income, and education level among female officers only. Physical activity modified the association between psychological distress and BMI but only among male LEOs (interaction p = 0.002). Among male LEOs reporting low physical activity, psychological distress was positively associated with BMI ($30.3kg/m^2$ for no distress, 30.7 for mild distress, 31.8 for moderate/high distress; p = 0.179) after adjustment, but not significantly. This association was not significant among males reporting high physical activity. Conclusion: Mean BMI significantly increased as psychological distress increased among female LEOs. A longitudinal study design may reveal the directionality of this association as well as the potential role that physical activity might play in this association.

Associations between Psychological Distress and Body Mass Index among Law Enforcement Officers: The National Health Interview Survey 2004-2010

Ja K Gu,Luenda E Charles,Cecil M Burchfiel,Michael E Andrew,Claudia Ma,Ki Moon Bang,John M Violanti 한국산업안전보건공단 산업안전보건연구원 2013 Safety and health at work Vol.4 No.1

Objectives: To investigate the association between psychological distress and obesity among law enforcement officers (LEOs) in the United States. Methods: Self-reported data on psychological distress based on six key questions were obtained from LEOs who participated in the National Health Interview Survey (2004-2010). We used Prochaska's cut-point of a Kessler 6 score ≥ 5 for moderate/high mental distress in our analysis. Mean levels of body mass index (BMI) were compared across three levels of psychological distress. Results: The average age of LEOs (n = 929) was 39.3 years; 25% were female. Overall, 8.1% of LEOs had moderate or high psychological distress; 37.5% were obese (BMI ≥ 30). Mean BMI increased with increasing psychological distress (no distress, BMI = 27.2 kg/m2; mild distress, 27.6 kg/m2; and moderate/high distress, 33.1 kg/m2; p = 0.016) after adjustment for age, race, income, and education level among female officers only. Physical activity modified the association between psychological distress and BMI but only among male LEOs (interaction p = 0.002). Among male LEOs reporting low physical activity, psychological distress was positively associated with BMI (30.3 kg/m2 for no distress, 30.7 for mild distress, 31.8 for moderate/high distress; p = 0.179) after adjustment, but not significantly. This association was not significant among males reporting high physical activity. Conclusion: Mean BMI significantly increased as psychological distress increased among female LEOs. A longitudinal study design may reveal the directionality of this association as well as the potential role that physical activity might play in this association.

Associations of Depressive Symptoms and Brachial Artery Reactivity among Police Officers

Violanti, John M.,Charles, Luenda E.,Gu, Ja K.,Burchfiel, Cecil M.,Andrew, Michael E.,Joseph, Parveen N.,Dorn, Joan M. Occupational Safety and Health Research Institute 2013 Safety and health at work Vol.4 No.1

Objectives: Mental health has been shown to be linked with certain underlying physiological mechanisms. The objective of this cross sectional study was to investigate the relationship between depressive symptoms and brachial artery reactivity (BAR) in an understudied population: police officers. Methods: Participants were 351 police officers who were clinically examined in the Buffalo Cardio-Metabolic Police Stress (BCOPS) study. BAR was performed using standard B-Mode ultrasound procedures. Depressive symptoms were measured using the Center for Epidemiological Studies Depression (CES-D) scale. Mean values of the difference between the baseline and maximum diameters of the brachial artery were determined across three categories of CES-D score using the analysis of variance and the analysis of covariance. p-values for linear trends were obtained from linear regression models. Results: The mean age (${\pm}$ standard deviation) of all officers was $40.9{\pm}7.2$ years. Women had a slightly higher mean CES-D score than men ($8.9{\pm}8.9$ vs. $7.4{\pm}6.4$) and a slightly higher percentage increase of BAR than men (6.90 vs. 5.26%). Smoking status significantly modified the associations between depressive symptoms and BAR. Among current smokers, mean absolute values of BAR significantly decreased as depressive symptoms increased after adjustment for age, gender, race/ethnicity, hypertension, and diabetes; the multivariate-adjusted p-values were 0.033 (absolute) and 0.040 (%). Associations between depressive symptoms and BAR were not statistically significant among former smokers or never smokers. Conclusion: Depressive symptoms were inversely associated with BAR among police officers who were current smokers and together may be considered a risk factor for cardiovascular disease among police officers. Further prospective research is warranted.

Associations of Depressive Symptoms and Brachial Artery Reactivity among Police Officers

John M Violanti,Luenda E Charles,Ja K Gu,Cecil M Burchfiel,Michael E Andrew,Parveen N Joseph,Joan M Dorn 한국산업안전보건공단 산업안전보건연구원 2013 Safety and health at work Vol.4 No.1

Objectives: Mental health has been shown to be linked with certain underlying physiological mechanisms. The objective of this cross sectional study was to investigate the relationship between depressive symptoms and brachial artery reactivity (BAR) in an understudied population: police officers. Methods: Participants were 351 police officers who were clinically examined in the Buffalo Cardio-Metabolic Police Stress (BCOPS) study. BAR was performed using standard B-Mode ultrasound procedures. Depressive symptoms were measured using the Center for Epidemiological Studies Depression (CES-D) scale. Mean values of the difference between the baseline and maximum diameters of the brachial artery were determined across three categories of CES-D score using the analysis of variance and the analysis of covariance. p-values for linear trends were obtained from linear regression models. Results: The mean age (± standard deviation) of all officers was 40.9 ± 7.2 years. Women had a slightly higher mean CES-D score than men (8.9 ± 8.9 vs. 7.4 ± 6.4) and a slightly higher percentage increase of BAR than men (6.90 vs. 5.26%). Smoking status significantly modified the associations between depressive symptoms and BAR. Among current smokers, mean absolute values of BAR significantly decreased as depressive symptoms increased after adjustment for age, gender, race/ethnicity, hypertension, and diabetes; the multivariate-adjusted p-values were 0.033 (absolute) and 0.040 (%). Associations between depressive symptoms and BAR were not statistically significant among former smokers or never smokers. Conclusion: Depressive symptoms were inversely associated with BAR among police officers who were current smokers and together may be considered a risk factor for cardiovascular disease among police officers. Further prospective research is warranted.

Shift Work and Occupational Stress in Police Officers

Claudia C. Ma,Michael E Andrew,Desta Fekedulegn,Ja K Gu,Tara A. Hartley,Luenda E Charles,John M. Violanti,Cecil M Burchfiel 한국산업안전보건공단 산업안전보건연구원 2015 Safety and health at work Vol.6 No.1

Background: Shift work has been associated with occupational stress in health providers and in those working in some industrial companies. The association is not well established in the law enforcement workforce. Our objective was to examine the association between shift work and police work-related stress. Methods: The number of stressful events that occurred in the previous month and year was obtained using the Spielberger Police Stress Survey among 365 police officers aged 27e66 years. Work hours were derived from daily payroll records. A dominant shift (day, afternoon, or night) was defined for each participant as the shift with the largest percentage of total time a participant worked (starting time from 4:00 AM to 11:59 AM, from 12 PM to 7:59 PM, and from 8:00 PM to 3:59 AM for day, afternoon, and night shift, respectively) in the previous month or year. Analysis of variance and covariance were used to examine the number of total and subscale (administrative/professional pressure, physical/psychological danger, or organizational support) stressful events across the shift. Results: During the previous month and year, officers working the afternoon and night shifts reported more stressful events than day shift officers for total stress, administrative/professional pressure, and physical/psychological danger (p < 0.05). These differences were independent of age, sex, race/ethnicity, and police rank. The frequency of these stressful events did not differ significantly between officers working the afternoon and night shifts. Conclusion: Noneday shift workers may be exposed to more stressful events in this cohort. Interventions to reduce or manage police stress that are tailored by shift may be considered.

Separate and Joint Associations of Shift Work and Sleep Quality with Lipids

Luenda E Charles,Ja K. Gu,Cathy A. Tinney-Zara,Desta Fekedulegn,Claudia C. Ma,Penelope Baughman,Tara A. Hartley,Michael E. Andrew,John M. Violanti,Cecil M. Burchfiel 한국산업안전보건공단 산업안전보건연구원 2016 Safety and health at work Vol.7 No.2

Background: Shift work and/or sleep quality may affect health. We investigated whether shift work and sleep quality, separately and jointly, were associated with abnormal levels of triglycerides, total cholesterol (TC), and low-and high-density lipoprotein cholesterol in 360 police officers (27.5% women). Methods: Triglycerides, TC, and high-density lipoprotein were analyzed on the Abbott Architect; lowdensity lipoprotein was calculated. Shift work was assessed using City of Buffalo payroll work history records. Sleep quality (good, < 5; intermediate, 6e8; poor, > 9) was assessed using the Pittsburgh Sleep Quality Index questionnaire. A shift work þ sleep quality variable was created: day plus good sleep; day plus poor sleep; afternoon/night plus good; and poor sleep quality. Mean values of lipid biomarkers were compared across categories of the exposures using analysis of variance/analysis of covariance. Results: Shift work was not significantly associated with lipids. However, as sleep quality worsened, mean levels of triglycerides and TC gradually increased but only among female officers (age- and raceadjusted p = 0.013 and 0.030, respectively). Age significantly modified the association between sleep quality and TC. Among officers > 40 years old, those reporting poor sleep quality had a significantly higher mean level of TC (202.9 ± 3.7 mg/dL) compared with those reporting good sleep quality (190.6 ± 4.0 mg/dL) (gender- and race-adjusted p = 0.010). Female officers who worked the day shift and also reported good sleep quality had the lowest mean level of TC compared with women in the other three categories (p = 0.014). Conclusion: Sleep quality and its combined influence with shift work may play a role in the alteration of some lipid measures.

Shift Work and Occupational Stress in Police Officers

Ma, Claudia C.,Andrew, Michael E.,Fekedulegn, Desta,Gu, Ja K.,Hartley, Tara A.,Charles, Luenda E.,Violanti, John M.,Burchfiel, Cecil M. Occupational Safety and Health Research Institute 2015 Safety and health at work Vol.6 No.1

Background: Shift work has been associated with occupational stress in health providers and in those working in some industrial companies. The association is not well established in the law enforcement workforce. Our objective was to examine the association between shift work and police work-related stress. Methods: The number of stressful events that occurred in the previous month and year was obtained using the Spielberger Police Stress Survey among 365 police officers aged 27-66 years. Work hours were derived from daily payroll records. A dominant shift (day, afternoon, or night) was defined for each participant as the shift with the largest percentage of total time a participant worked (starting time from 4:00 AM to 11:59 AM, from 12 PM to 7:59 PM, and from 8:00 PM to 3:59 AM for day, afternoon, and night shift, respectively) in the previous month or year. Analysis of variance and covariance were used to examine the number of total and subscale (administrative/professional pressure, physical/psychological danger, or organizational support) stressful events across the shift. Results: During the previous month and year, officers working the afternoon and night shifts reported more stressful events than day shift officers for total stress, administrative/professional pressure, and physical/psychological danger (p < 0.05). These differences were independent of age, sex, race/ethnicity, and police rank. The frequency of these stressful events did not differ significantly between officers working the afternoon and night shifts. Conclusion: Non-day shift workers may be exposed to more stressful events in this cohort. Interventions to reduce or manage police stress that are tailored by shift may be considered.