eNews: January 2025

From the Director’s Desk

John Howard, M.D., Director, NIOSH

Neither Snow nor Rain nor Heat nor Gloom of Night... Protecting Workers From the Cold

As we enter January, outdoor work in extreme cold continues in parts of the United States. This presents unique challenges to worker safety and health. Advances in cold weather personal protective equipment and clothing have made working in harsh conditions more bearable. However, we must recognize the risks and inherent danger workers face during cold weather.

Reflecting on the jobs of the past when modern protections were unavailable offers insight into these extreme cold hazards. For example, back in the late 1800s and early 1900s, sled dogs were used for mail delivery in some of the coldest areas, such as the Alaska Territory and northern states like Maine.12

Famous sled dogs like Togo and Balto, along with their owners, are well-remembered for their infamous journey during the 1925 serum run to Nome during a diphtheria epidemic. In contrast, the mail carrier teams have largely been lost to popular history. These mail carriers and their sled dog teams braved some of the most extreme winter conditions, traveling during the day and night for long distances over frozen lakes, rivers, and dense forests during the gold rush era.13

Cold weather threats were a frequent danger, with low temperatures, snow, biting wind, and icy precipitation threatening the health and safety of both human mushers and their dog teams.3 Hypothermia and frostbite were ever-present risks, and preventive measures like layering warm clothing and outfitting dogs with leather booties were vital for survival.13

Today, cold stress remains a significant hazard for outdoor workers. Its effects can vary depending on location; near-freezing temperatures can cause serious health risks to those in areas unaccustomed to winter weather. Cold-related illnesses include hypothermia, frostbite, trench foot, and chilblains.

Employers should prepare their outdoor workers for winter hazards, including the following steps:

• Schedule cold jobs for warmer months or the warmer part of the day.
• Use relief workers or assign extra workers for longer jobs.
• Provide warm liquids to workers.
• Provide warmer areas for use during breaks.
• Limit the amount of time spent outside on extremely cold days.
• Monitor workers who are at risk of cold stress and initiate a buddy system.
• Provide cold stress training that includes information on worker risk, prevention strategies, symptoms, self-monitoring and monitoring of coworkers for symptoms, treatment options, and use of personal protective equipment.

Workers should avoid extremely cold temperatures when possible. If exposure is unavoidable, they can use the following strategies:

• Wear the right clothing.
• Wear several layers of loose clothing for better insulation.
• Avoid wearing clothing that may restrict movement, which could be dangerous.
• Make sure to protect the ears, face, hands, and feet.
• Boots should be waterproof and insulated.
• Wear a hat. Hats reduce body heat escaping from your head.
• Move into warmer locations during breaks.
• Carry extra socks, gloves, hat, jacket, clothes, and blankets.
• Include a thermometer and chemical hot packs in your first aid kit.
• Avoid touching cold metal surfaces with bare skin.
• Monitor your physical condition and that of your coworkers.

For more information on occupational cold stress, including symptoms and first aid for cold-related illnesses, visit NIOSH Working in the Cold. You can also follow us on Facebook, X (Twitter), Instagram, and LinkedIn using #WorkingInCold.

Research Rounds

Multiple Job Holding, Job Changes, and Associations With Gestational Diabetes and Pregnancy-related Hypertension in the National Birth Defects Prevention Study

Study authors: Amel Omari, Miriam R. Siegel, Carissa M. Rocheleau, Kaori Fujishiro, Kristen Van Buren, and Dallas Shi, NIOSH; A.J. Agopian, University of Texas School of Public Health; Suzanne M. Gilboa, CDC; and Paul A. Romitti, The University of Iowa

Why is this study important?

Where we live, work, learn, and age influences our health. Work arrangements have received less research attention as a non-medical factor influencing health. Among pregnant workers, the health effects of work remain unclear, in part because studies do not usually consider the combined effects of working multiple jobs. This study began to address this issue by comparing the health of people who worked a single job before and during pregnancy with the health of people working multiple jobs or changing jobs before and during pregnancy.

How did you do the study?

We used the National Birth Defects Prevention Study to look at the relationship between work and gestational diabetes and pregnancy-related high blood pressure. Both conditions develop during pregnancy in people who did not have them before. They can cause serious complications if left untreated.

Study participants responded to a survey about their work from three months before they became pregnant until delivery. This study analyzed 11,488 U.S. parents who delivered a baby without birth defects from October 1, 1997, through December 31, 2011.

What did you find?

Compared to single-job holders, multiple-job holders had 50% higher odds of both gestational diabetes and pregnancy-related high blood pressure. In contrast, changing jobs was not linked to higher odds of either condition.

What are the next steps?

For future research on maternal health and work, it is important to consider all the jobs that people work. To further understand our findings, it could also be important to research what kinds of jobs pregnant workers tend to work at the same time compared to the kinds of jobs worked one at a time.

Working Hours, Shift, and Remote Work by Industry and Occupation in U.S. Full-time Workers

NIOSH study author: Guang X. Chen

Why is this study important?

Long work hours and inadequate sleep are known risk factors for many illnesses. These include heart disease, type 2 diabetes, infectious diseases, mental health conditions, and injuries.

In 2019, the NIOSH Working Hours, Sleep, and Fatigue Forum found that most studies in this area focused on a single occupation or industry. In this study, we compared working hours and sleep across occupations and industries to understand which work environments placed workers at risk for inadequate sleep.

How did you do the study?

For this study, we used results from 2011 to 2020 from the American Time Use Survey. The U.S. Bureau of Labor Statistics runs this household survey to understand how people 15 years and older spend their time in 24-hour periods.

What did you find?

Full-time workers in the United States spent slightly less time sleeping than working on workdays. On average, these workers spent 8.1 hours per day working and 7.8 hours sleeping. On non-workdays, sleep hours increased to 9.6.

By occupation, emergency medical technicians and paramedics worked the longest hours, with an average of more than 10 hours daily. Protective services workers, such as firefighters, police officers, and correctional officers, had the most shift, or non-daytime work with nearly 42% of workers engaged in shift work.

By industry, truck transportation workers averaged the longest hours with more than 9 hours daily. Food services and drinking places had the most shift workers with nearly 29% of workers engaged in shift work.

What are the next steps?

These findings can help inform interventions and programs designed to manage fatigue in workplaces where workers have long hours or shift work.

Highlights

Deadline Extended: Proposals for International Symposium to Advance Total Worker Health®

The deadline was extended to submit proposals for the 4th International Symposium to Advance Total Worker Health. You now have until January 24 at 11:59 p.m. (MST)/1:59 a.m. (EST) to submit proposals for in-person presentations on a variety of TWH-related topics. Review the guidelines to learn more and submit your proposal.

Nominations for the 2025 Prevention through Design Award

The Prevention through Design (PtD) award recognizes those who have eliminated or reduced hazards through design or added knowledge that enabled PtD solutions. Nominations are due March 3, and you can resubmit previous nominations. To learn how to nominate an individual, group, or business, visit the PtD Award webpage.

NIOSH Fire Fighter Fatality Investigation and Prevention Program Reports Have Moved

As part of the CDC/NIOSH web redesign, NIOSH Fire Fighter Fatality Investigation and Prevention Program (FFFIPP) reports are in a new location. Links to the previous site should automatically redirect, but if they do not, access the new site at Fire Fighter Fatality Investigation and Prevention Program Reports. Saved links will no longer work, so please update previous bookmarks with the new links. We will continue to add report organization and filters to the new page in the coming months.

NIOSH and Dr. Lorna Breen Heroes' Foundation Sign New Partnership Agreement

NIOSH and the Dr. Lorna Breen Heroes' Foundation will work together to look into the possibility of and to identify the best ways to develop a new healthcare quality measure. The measure will focus on reducing burnout and improving the well-being of healthcare workers. For more information on this project, please contact David Weissman.

Find more on our website

• Current Job Opportunities
• Newsroom

Federal Register Notices

Proposed Data Collection Submitted for Public Comment and Recommendations: EEOICPA Dose Reconstruction Interviews and Forms

The notice was posted on November 8, 2024. Comments must be received by January 7.

Safety and Occupational Health Study Section; Notice of Solicitation of Nominations for Appointment; Correction

The notice was posted on December 2, 2024. Nominations must be received by January 31.

Expansion of NIOSH B Reader Certification Eligibility; Request for Information

The notice was posted on December 17, 2024. Comments must be received by March 17.

New Communication Products

Fact Sheet

• Officers: Stay Safe From Needlesticks!

Fire Fighter Fatality Investigation and Prevention Program Report

• Volunteer Firefighter Killed After Becoming Trapped at an Assisted Living Facility Fire and Two Firefighters Injured—New York (Report Slides)

Health Hazard Evaluation Report

• Evaluation of Ergonomic Risks, Musculoskeletal Disorders, and Peracetic Acid Exposure Among Employees at a Pork Processing Plant in Michigan

Technical Report

• NIOSH List of Hazardous Drugs in Healthcare Settings

Workplace Solutions

• Reducing Hearing Loss in Recycling Workers

News From Our Partners

Annotated Sample Template of a Respiratory Protection Program

The Massachusetts Department of Public Health's Occupational Health Surveillance Program has released an Annotated Sample Template of a Respiratory Protection Program. The editable template, based on the Hospital Respiratory Protection Program Toolkit developed by NIOSH and OSHA, can be easily adapted for users' needs. Although it is tailored for medical facilities, the template is a valuable resource for anyone developing a respiratory protection program.

Workplace Impacts and Occupational Risks of the COVID-19 Pandemic

The New Hampshire Occupational Health Surveillance Program published two reports describing workplace impacts and occupational risks of the COVID-19 pandemic. The reports showed the risk of contracting COVID-19 was highest among protective service, healthcare, and food service industry workers. These workplace assessments revealed inequities across industries and identified successful approaches to workplace infectious disease prevention in non-healthcare settings.

• COVID Risk Experienced by NH Workers—2021
• Pandemic Impacts on the Workplace: Voices From NH Small Businesses

Work-related Injuries Among Massachusetts Teens and Employer Resource Guide

The Massachusetts Department of Public Health's Occupational Health Surveillance Program released a new data brief. It highlights work-related injuries among Massachusetts teens, with a focus on teens in food service. The brief includes a summary of key resources for employers of teen workers to help prevent work-related injuries.

Updates From State Fatality Assessment and Control Evaluation (FACE) Programs:

• Fatality Narrative: Driver Dragged and Pinned by Rollaway Dump Truck—This Fatality Narrative (as a slideshow) from Washington State involves a driver who was dragged and pinned by a rollaway dump truck. To help prevent similar occurrences, the narrative provides prevention recommendations and requirements.
• Safety Alert: Working in Roadways Exposes Workers to Hazards of Moving Vehicles and Equipment—The Safety Alert from Massachusetts involves working on roadways that exposes workers to moving vehicles and equipment. Three incidents led to the deaths of four workers in Massachusetts. To help prevent similar occurrences, the Alert provides prevention recommendations and requirements.

NORA

Upcoming Sector Council Meetings:

Hearing Loss Prevention Council Meeting

Join the NORA Hearing Loss Prevention council January 23 at 1 p.m. (EST) for their next meeting. Please contact Elizabeth Masterson for the meeting invite.

Healthy Work Design and Well-being Council Meeting

Join the NORA Healthy Work Design and Well-being council January 23 at 3 p.m. (EST) for their next meeting. Please contact Naomi Swanson for the meeting invite.

Editorial & Production Team

Director

John Howard, M.D

Editor in Chief

Christina Spring

Managing Editor

Tanya Headley

Section Editor

Anne Blank, Research Rounds

Kiana Harper, Highlights & Monthly Features

Contributing Editor

Anne Blank

Copy Editor

Cheryl Hamilton

Technical Support

Steve Leonard, Adobe Technical Lead