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Objective The objective of the study was to gain insight into the knowledge, behavior, attitudes and beliefs related to COVID-19 vaccines, and communication preferences of U.S. grocery store workers. Methods In-depth interviews were conducted from May 2021 through June 2022 with 75 grocery store workers across the United States (US) who identified themselves as Asian, Black, Hispanic, or White persons. Researchers used maximum variation sampling to recruit a diverse sample by race and ethnicity, age, sex, union status, and geographic location. Rapid Turn-Around (RTA) techniques were utilized to conduct qualitative data analysis. Results Of the 75 total participants, 39 were female and 36 were male. Participants identified as Asian ( n  = 16), Black or African American ( n  = 19), Hispanic or Latino ( n  = 16) and White ( n  = 22) persons and ranged in age: 18–34 years ( n  = 28), 35–49 years ( n  = 20) and ≥ 50 years ( n  = 27). Most (79%) participants reported that they were vaccinated against COVID-19 and considered various factors when deciding to get vaccinated such as protecting oneself and loved ones, vaccine safety and potential side effects, others’ experiences with vaccination, the vaccine development process, beliefs regarding their immune systems, vaccine effectiveness, and similarities between the COVID-19 and influenza vaccines. Most unvaccinated women expressed concerns about side effects, compared to about half of the unvaccinated men. Specifically, most unvaccinated female workers had concerns related to fertility issues. Participants’ attitudes regarding employer vaccine incentives and mandates and sources used to learn about the vaccine varied by vaccination status. Although participants’ employers had provided them information regarding the COVID-19 vaccine, these communications were not in participants’ preferred formats. Conclusion Unvaccinated participants’ attitudes and beliefs suggest there is a critical opportunity to address misinformation related to COVID-19 vaccines and potential side effects among grocery store workers. This study provides evidence of a gap for culturally and linguistically appropriate health communication efforts that are aligned with grocery workers’ health communication preferences.

Parkinson’s disease (PD) is a complex neurodegenerative disorder influenced by age, genetic predispositions, and environmental exposures, with a growing global incidence. This review aims to summarize findings from ATSDR Toxicological Profiles, EPA Risk Assessments, and other sources of peer-reviewed literature to examine the potential associations between PD and select metals, pesticides, and chlorinated organic compounds. Additionally, it explores using computational toxicology methods to elucidate the interactions between specific chemicals, associated genes, and their possible roles in PD. A total of 29 substances were identified to be neurotoxic with direct or probable association with PD. Risk of disease onset or symptom exacerbation of PD has been linked to exposures to neurodegenerative metals, pesticides, chlorinated organic compounds, and other environmental toxicants, alongside intrinsic factors such as genetic predisposition and aging. Supporting evidence from neurotoxicological studies directly or possibly associated with PD are summarized in referenced toxicological profiles and EPA risk assessments. Genotoxic endpoints evaluated in exposure-induced neurodegeneration including oxidative stress, DNA strand breaks, mitochondrial dysfunction, impaired DNA repair, and telomere alterations may play a critical role in linking environmental exposures to PD pathogenesis. Although these endpoints represent imperative data gaps between environmental and genetic risk factors for PD, isolating individual substances may not be necessary for prevention, as many co-occur at contaminated sites or within certain occupations. Further research is needed to clarify causal relationships between environmental exposure and genotoxic endpoints seen in neurodegenerative processes that can also be seen in PD for consideration in the development of preventive and therapeutic strategies.

Upon request from tribal nations, and as part of the Centers for Disease Control and Prevention’s (CDC’s) emergency response, CDC staff provided both remote and on-site assistance to tribes to plan, prepare, and respond to the COVID-19 pandemic. From April 2, 2020, through June 11, 2021, CDC deployed a total of 275 staff to assist 29 tribal nations. CDC staff typically collaborated in multiple work areas including epidemiology and surveillance (86%), contact tracing (76%), infection prevention control (72%), community mitigation (72%), health communication (66%), incident command structure (55%), emergency preparedness (38%), and worker safety (31%). We describe the activities of CDC staff in collaboration with 4 tribal nations, Northern Cheyenne, Hoopa Valley, Shoshone-Bannock, and Oglala Sioux Tribe, to combat COVID-19 and lessons learned from the engagement.

BackgroundSubjective cognitive decline (SCD) is one of the earliest noticeable symptom of dementia, including Alzheimer’s disease. Some studies have shown that half of older adults with subjective memory complaints go on to develop more severe cognitive decline within 7–18 years. The objective of this study was to examine the prevalence of SCD among US workers and to identify occupations with a high prevalence of SCD, even after adjustment for common risk factors.MethodsData from the 2015–2016 Behavioral Risk Factor Surveillance System were used to examine the prevalence of SCD among US workers aged ≥45 years who were currently employed or were employed at some point in the past 12 months. SCD is defined as frequent confusion or memory loss within the previous 12 months. Only states (n=28) that collected data on both industry/occupation and cognitive decline were included in this study.ResultsThe overall prevalence of SCD among US workers aged ≥45 years was 6.2%, and was higher for workers 65 years and older. The prevalence was significantly higher among Veterans (8.3%) compared to non-veterans (5.9%). 29.2% of those with SCD reported that they need assistance with day-to day activities and 35.1% had discussed confusion/memory loss with a healthcare professional. The prevalence of SCD was significantly lower among workers in management, business and financial operations, Healthcare practitioners and technical, and office and administrative support occupations. While workers in building and ground cleaning and maintenance, and personal care and service occupations had elevated prevalence of SCD.ConclusionCognitive decline is an important public health issue affecting older workers and their ability to work. SCD prevalence is much higher among occupations that are less mentally challenging which indicates that interventions to improve or maintain cognitive functioning may help older workers to remain productive and in the workforce.

The Hopi Tribe is a sovereign nation home to ~7500 Hopi persons living primarily in 12 remote villages. The Hopi Tribe, like many other American Indian nations, has been disproportionately affected by COVID-19. On 18 May 2020, a team from the US Centers for Disease Control and Prevention (CDC) was deployed on the request of the tribe in response to increases in COVID-19 cases. Collaborating with Hopi Health Care Center (the reservation’s federally run Indian Health Service health facility) and CDC, the Hopi strengthened public health systems and response capacity from May to August including: (1) implementing routine COVID-19 surveillance reporting; (2) establishing the Hopi Incident Management Authority for rapid coordination and implementation of response activities across partners; (3) implementing a community surveillance programme to facilitate early case detection and educate communities on COVID-19 prevention; and (4) applying innovative communication strategies to encourage mask wearing, hand hygiene and physical distancing. These efforts, as well as community adherence to mitigation measures, helped to drive down cases in August. As cases increased in September–November, the improved capacity gained during the first wave of the pandemic enabled the Hopi leadership to have real-time awareness of the changing epidemiological landscape. This prompted rapid response coordination, swift scale up of health communications and redeployment of the community surveillance programme. The Hopi experience in strengthening their public health systems to better confront COVID-19 may be informative to other indigenous peoples as they also respond to COVID-19 within the context of disproportionate burden.

BackgroundAs the proportion of older workers in the U.S. increases, understanding the health and safety needs of an aging workforce is critical, especially in the hazardous and physically demanding construction industry. According to the Bureau of Labor Statistics (BLS), in 2016 the rate of work-related musculoskeletal disorders (WMSDs) in construction was 32.7 per 10 000 full-time equivalent workers, which was 11% higher than the rate for all industries combined. The objective of this study was to examine the rate and cost of WMSDs due to overexertion, the leading cause of WMSDs, among construction workers by age group in Ohio using workers’ compensation claims.MethodsOverexertion related WMSDs allowed claims, submitted to Ohio Bureau of Worker’s Compensation (OBWC) by workers in the construction industry for injuries occurring from 2007–2013 were analyzed to compute rates of allowed claims and claim costs by age group. The American Community Survey of the U.S. Census Bureau was used to determine the proportion of construction workers in each age group in Ohio. For this study, age was categorized as 14–24, 25–34, 35–44, 45–54 and ≥55 years old.ResultsThere were 7434 overexertion related WMSD claims accepted by OBWC for construction workers who were injured due to overexertion in 2007–2013. Workers 35–44 years old experienced the highest claim rate of 7.28 per 1000 for WMSDs due to overexertion. However, the highest mean medical compensation cost for WMSD claims due to overexertion was for construction workers 55 years and older.ConclusionOverexertion-related WMSD claims appear to rise and then fall with age (≥55). There is a need to understand how aging interacts with WMSDs risk factors. Age-specific interventions to reduce WMSDs may help to retain older and skilled workers whose knowledge and experience might otherwise be lost when workers need to leave work because of debilitating WMSDs.

Overexertion is a leading cause of work-related musculoskeletal disorders (WMSDs) among construction workers. Nearly 90% of construction jobs require manual handling of materials for approximately one half of the worker's time (1). In 2015, overexertion from lifting and lowering materials caused 30% of WMSDs among construction workers; overexertion involving pushing, pulling, holding, carrying, and catching materials caused an additional 37% of WMSDs (1). This study examined the rate and cost of WMSD claims from overexertion among Ohio construction workers during 2007-2017. Workers' compensation claims related to overexertion that were submitted to the Ohio Bureau of Worker's Compensation (OHBWC) by workers in the construction industry for injuries and illnesses occurring during 2007-2017 were analyzed. Rates and costs of allowed claims were measured by age group. Workers aged 35-44 years experienced the highest claim rate: 63 per 10,000 full-time employees (FTEs) for WMSDs from overexertion. However, claims by workers aged 45-54 years and 55-64 years were more costly on average and resulted in more days away from work. Ergonomic design improvements and interventions are needed to ensure that the majority of construction workers can safely perform jobs throughout their careers. Age-specific WMSD prevention and risk communication efforts also might be helpful.

On June 3, 2020, a woman aged 73 years (patient A) with symptoms consistent with coronavirus disease 2019 (COVID-19) (1) was evaluated at the emergency department of the Hopi Health Care Center (HHCC, an Indian Health Services facility) and received a positive test result for SARS-CoV-2, the virus that causes COVID-19. The patient's symptoms commenced on May 27, and a sibling (patient B) of the patient experienced symptom onset the following day. On May 23, both patients had driven together and spent time in a retail store in Flagstaff, Arizona. Because of their similar exposures, symptom onset dates, and overlapping close contacts, these patients are referred to as co-index patients. The co-index patients had a total of 58 primary (i.e., direct) and secondary contacts (i.e., contacts of a primary contact); among these, 27 (47%) received positive SARS-CoV-2 test results. Four (15%) of the 27 contacts who became ill were household members of co-index patient B, 14 (52%) had attended family gatherings, one was a child who might have transmitted SARS-CoV-2 to six contacts, and eight (30%) were community members. Findings from the outbreak investigation prompted the HHCC and Hopi Tribe leadership to strengthen community education through community health representatives, public health nurses, and radio campaigns. In communities with similar extended family interaction, emphasizing safe ways to stay in touch, along with wearing a mask, frequent hand washing, and physical distancing might help limit the spread of disease.