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IntroductionPer and polyfluoroalkyl substances (PFAS), including perfluorononanoic acid (PFNA) and perfluorooctanoic acid (PFOA), were detected in the community water supply of Paulsboro New Jersey in 2009.MethodsA cross-sectional study enrolled 192 claimants from a class-action lawsuit, not affiliated with this study, who had been awarded a blood test for 13 PFAS. Study participants provided their blood test results and completed a survey about demographics; 105 participants also completed a health survey. Geometric means, 25th, 50th, 75th, and 95th percentiles of exposure of PFNA blood serum concentrations were compared to that of the 2013–2014 NHANES, adjusted for reporting level. Associations between PFNA, PFOA, PFOS, and PFHxS and self-reported health outcomes were assessed using logistic regression.ResultsPFNA serum levels were 285% higher in Paulsboro compared with U.S. residents. PFNA serum levels were higher among older compared with younger, and male compared to female, Paulsboro residents. After adjustment for potential confounding, there was a significant association between increased serum PFNA levels and self-reported high cholesterol (OR: 1.15, 95% CI: 1.02, 1.29).Discussion/ConclusionFurther investigation into possible health effects of PFAS exposure in Paulsboro and other community settings is warranted. Since exposure has ceased, toxicokinetics of PFAS elimination should be explored.

INTRODUCTION:Psychosocial hazards in the workplace may adversely impact occupational and general health, including injury risk. METHODS:Among 16,417 adult workers in the 2010 National Health Interview Survey Occupational Health Supplement, weighted prevalence estimates were calculated for work-related injuries (WRI) and any injuries. The association between injury and psychosocial occupational hazards (job insecurity, work–family imbalance, hostile work environment) was assessed adjusting for sociodemographic and occupational factors. RESULTS:WRI prevalence was 0.65% (n = 99); any injury prevalence was 2.46% (n = 427). In multivariable models job insecurity, work–family imbalance, and hostile work environment were each positively associated with WRI prevalence (odds ratio [OR]1.60, 95% CI0.97–2.65; OR1.69, 95% CI 0.96–2.89; and 2.01, 95% CI 0.94–4.33, respectively). CONCLUSIONS:Stressful working conditions may contribute to injuries. There is need for ongoing surveillance of occupational psychosocial risk factors and further study of their relationship with injury.

Objectives: Extreme weather events require extensive tree removal and disposal, tasks associated with severe injury risks among workers and residents. To help understand the risks of such activities, we evaluated the impact of a large and destructive storm (Hurricane Sandy in 2012) on the incidence of tree-related injuries. Methods: We searched chief-complaint text fields for patients aged 18-65 from 2011-2014 emergency department visit records submitted by New Jersey hospitals through the state-based syndromic surveillance system. Tree-related keywords (eg, saw, branch, wood chip, woodchip, tree) identified possible injuries that we then reviewed to exclude unrelated cases and classify mechanisms of tree-related injury. We used Poisson regression analysis to evaluate changes in the rates of probable tree-related injuries, adjusting for total emergency department visits and seasonal variation. Results: We identified 698 probable tree-related injuries from 2011-2014 among patients aged 18-65, including 104 (14.9%) falls, 241 (34.5%) machine-related injuries, 311 (44.6%) struck-by injuries, and 42 (6.0%) other tree-related injuries. Tree-related injuries increased significantly in the quarter immediately after Hurricane Sandy (November 2012–January 2013) compared with the same quarter the year before (rate ratio [RR] = 1.67; 95% confidence interval [CI], 1.13-2.47) and the year after (RR = 2.47; 95% CI, 1.62-3.78) Hurricane Sandy, especially for struck-by injuries compared with the year before (RR = 2.74; 95% CI, 1.47-5.12) and the year after (RR = 4.17; 95% CI, 2.09-8.32) Hurricane Sandy. More than one-third of the injuries (33.4%) involved chainsaws. Conclusions: A major hurricane was associated with an increase in tree-related injuries in emergency departments, especially for mechanisms consistent with handling downed and damaged trees. Further research should confirm these findings and evaluate opportunities for preventing tree-related injuries.

Hurricane Sandy made landfall in New Jersey on October 29, 2012, resulting in widespread power outages and gasoline shortages. These events led to potentially toxic exposures and the need for information related to poisons/toxins in the environment. This report characterizes the New Jersey Poison Information and Education System (NJPIES) call patterns in the days immediately preceding, during, and after Hurricane Sandy to identify areas in need of public health education and prevention. We examined NJPIES case data from October through December 2012. Most Sandy-related calls had been coded as such by NJPIES staff. Additional Sandy-related cases were identified by performing a case narrative review. Descriptive analyses were performed for timing, case frequencies, exposure substances, gender, caller site, type of information requests, and other data. The most frequent Sandy-related exposures were gasoline and carbon monoxide (CO). Gasoline exposure cases were predominantly males and CO exposure cases, females (P < 0.0001). Other leading reasons for Sandy-related calls were poison information, food poisoning/spoilage information, and water contamination. This analysis identified the need for enhanced public health education and intervention to improve the handling of gasoline and encourage the proper use of gasoline-powered generators and cleaning and cooking equipment, thus reducing toxic exposures.

We aimed to evaluate the occurrence of work-related injuries after Hurricane Sandy potentially related to response and recovery. Emergency and hospital discharges (patients aged 18-65 years) with a diagnosis of unintentional injury were obtained from the New Jersey Department of Health. Work-related injuries were identified as those with a workers' compensation payer or other work-related codes. Counties were categorized as high-, medium-, or low-impact areas. Poisson regression analysis was used to compare the rate of work-related injury the year following Sandy landfall with the 3 previous years. Total work-related injuries declined the week immediately after Sandy (rate ratio [RR]: 0.85; 95% confidence interval [CI]: 0.69-1.05) and no overall increase was found in the year after Hurricane Sandy. However, high-impact counties showed an elevated risk of work-related injuries in the first and third quarters after Hurricane Sandy among men, especially for blacks and Hispanics. The greatest excesses occurred in the third quarter after the storm, May to July, for falls (RR: 1.30; 95% CI: 1.08-1.57), cut/pierce injuries (RR: 1.24; 95% CI: 1.09-1.40), struck-by injuries (RR: 1.17; 95% CI: 1.02-1.34), and overexertion (RR: 1.26; 95% CI: 1.10-1.44). Hospital data suggested an increase in injuries associated with rebuilding and recovery rather than with initial response. Future efforts aimed at prevention should evaluate the mechanisms and circumstances of injury in more detail. (Disaster Med Public Health Preparedness. 2016;10:394-404).

Objectives This study evaluated multiple blood lead measures collected over time and assessed differences arising from exposure and testing variability. Methods Blood lead data was used to compare individuals from manufacturing and construction occupational cohorts. Trends of blood lead levels (BLLs) over time were analysed using mixed model analysis. Random selection of BLL values was used to determine the improvement in the precision of mean BLL estimates as the number of tests increased. Results From 2003–2007, there were 619 manufacturing and 657 construction workers with more than one blood lead test reported. Construction workers had much more variability in their blood lead trends. They also tended to have less frequent follow-up blood tests compared with manufacturing workers. Both occupational cohorts had persistent BLLs that resulted in many workers with chronically high blood lead values (>25 µg/dL). Approximately 11.2% of construction workers and 34.8% of manufacturing workers with an initial blood lead test above 25 µg/dL remained above this blood level through the study period. The precision in the mean BLL estimates increased more substantially for construction workers when compared with manufacturing workers as the number of blood lead tests per worker increased. Conclusions This study confirmed differences in the pattern of blood lead tests and the resulting trends for manufacturing compared with construction workers. It also suggested that the number of blood lead tests performed on a worker is an important consideration in the assessment of a worker's mean blood lead estimate, and this is particularly true for workers with highly variable exposures.

Investigations of young workers, including limited surveys in supervised school settings, suggested their elevated injury risk. This study identified factors contributing to cuts-lacerations among adolescents in New Jersey secondary school career, technical, and vocational education programs. Of 1,772 injuries reported between December 1, 1998, and September 1, 2010, 777 (44%) were cuts-lacerations; analyses focused on 224 reports (n = 182 post-exclusions) submitted after fall 2005 in three career groups-Food, Hospitality & Tourism (FH&T) (n = 71), Manufacturing & Construction (M&C) (n = 84), and Automotive & Transportation (A&T) (n = 27). Most students were \"struck by\" tools or hard surfaces (n = 93, 51%); 63 cuts were from knives in FH&T. In M&C, most cuts-lacerations were caused by hand-held tools (n = 18) and being \"struck against/by\" or \"caught between hard surfaces\" (n = 19). Males reported more cuts-lacerations (n = 145), most commonly among 11th graders (n = 54) and ages 16 to 17 years (n = 79). Fingers (n = 117) were most often injured, usually by cutting tools (n = 83). Training, supervision, and appropriate equipment, and further assessments of \"struck by\" and \"pinch point\" hazards, are needed.

Investigations of young workers, including limited surveys in supervised school settings, suggested their elevated injury risk. This study identified factors contributing to cuts-lacerations among adolescents in New Jersey secondary school career, technical, and vocational education programs. Of 1,772 injuries reported between December 1, 1998, and September 1, 2010, 777 (44%) were cuts-lacerations; analyses focused on 224 reports (n = 182 post-exclusions) submitted after fall 2005 in three career groups—Food, Hospitality & Tourism (FH&T) (n = 71), Manufacturing & Construction (M&C) (n = 84), and Automotive & Transportation (A&T) (n = 27). Most students were “struck by” tools or hard surfaces (n = 93, 51%); 63 cuts were from knives in FH&T. In M&C, most cuts-lacerations were caused by hand-held tools (n = 18) and being “struck against/by” or “caught between hard surfaces” (n = 19). Males reported more cuts-lacerations (n = 145), most commonly among 11th graders (n = 54) and ages 16 to 17 years (n = 79). Fingers (n = 117) were most often injured, usually by cutting tools (n = 83). Training, supervision, and appropriate equipment, and further assessments of “struck by” and “pinch point” hazards, are needed.

Objectives— The goal of the study was to examine the effects of the potential pesticide exposure of parents on the risk of limb reduction defects in their offspring. Methods — A case-referent study was conducted utilizing New York State Congenital Malformation Register data. Persons with limb reduction defects and referents were compared in terms of parental occupations and residence counties. Parental occupations and industries reported on birth certificates were qualitatively rated by industrial hygienists to estimate potential pesticide (list four groups) exposures. Residential exposures were estimated from agricultural census data according to county of residence. Results — Neither parental exposure to pesticides [odds ratio (OR) 0.9, 95% confidence interval (95% Cl) 0.6—1.4] nor farming occupation (OR 1.1, 95% Cl 0.5—2.7) had an effect on the risk of total limb reduction defects. Those persons with limb reduction defects who had additional defects showed weak but consistent elevated risks in relation to parental occupational pesticide exposure. However, isolated cases of limb reduction defects were negatively related to these exposures. Residence in a farming or high pesticide use county was not associated with any type of limb reduction defect. Conclusions—Cases of limb reduction defect with additional malformations appear to be associated with parental occupational pesticide exposure. Improving exposure classifications and subdividing the limb reduction defects by types in the analyses are suggested for future research.

This article examines the association between two birth defects, neural tube defects, and oral cleft defects, and maternal physical work demands during the periconceptional period. A case-control study was conducted by comparing exposure characteristics of mothers of malformed infants, as ascertained from the New York State Congenital Malformations Registry (n = 520), with mothers of non-malformed infants (n = 1154). Case groups were further subdivided on whether infants had additional defects. Occupational exposure information was collected from a self-administered questionnaire, and demographic variables from vital records. The results showed no general differences between cases and controls in most variables. However, those infants with cleft defects plus additional defects tended to have a marginally increased risk (odds ratio = 1.76; 95% confidence interval, 1.02-3.21) in relation to maternal jobs requiring standing (≥ 75% of time). We suggest that exposure assessment be improved and defects subdivided for future studies.