Laurel Kincl

Fatalities continue to plague the US commercial fishing industry and have broad impacts on coastal communities and families. The success of the Lifejackets for Lobstermen program in the US Northeast led to the development of a Pacific Northwest regional Fishermen Led Injury Prevention Program (FLIPP) for Lifejackets. To be effective in a different region with distinct fisheries, adaptations must be based on regional community input. The goal of this research was to collect and apply the perspectives of commercial fishermen and community partners to improve vessel safety and in particular, lifejacket use, to guide the development of the FLIPP for Lifejackets program. Four approaches were used in Washington and Oregon: (1) structured interviews with commercial fishing community partners, (2) surveys with fishermen, (3) lifejacket ranking by fishermen, and (4) brief surveys of regional fish observers. Commercial fishing community partners (n = 54) confirmed that: a variety of brands/designs with good potential for commercial fishermen exist; there is interest in education around advances in materials and design; and the style depends on fishery, fishermen, and season. There is not a perfect model for all commercial fishing situations. From 98 fishermen interviewed, 15% always reported wearing a lifejacket on deck, 16% most, 40% some, and 25% none of the time. Most fishermen agreed it was important to wear a lifejacket/personal flotation device (PFD) (75%) and indicated interest in learning about new types of lifejackets (71%). Fishermen completed a ranking (n = 56), which showed the Mustang Inflatable Work Vest and Kent Rogue Work Vest stood out as the most preferred lifejackets. The majority of regional fish observers (n = 22) shared the frequency of vessels with at least one crew wearing a lifejacket was below 50%. Most reported fishermen's use of lifejackets was situational and agreed that attitudes regarding lifejacket use among fishermen had become more positive since they began observing. Conversations and connections established through our efforts created collaborative opportunities and directly informed the design of the FLIPP for Lifejackets Program. These approaches can be used in other regions to establish commercial fishing as a safer industry.

Interest in improving roadside services for long-haul truckers’ health, safety, and well-being has led to an effort to describe the services offered at truck stop/rest areas. This study aimed to describe services offered in truck stop and rest areas and to determine, based on what was available, their implications for the health of long-haul truck drivers. A systematic and structured direct observation of thirteen truck stop and rest areas was undertaken within one state in the US on a major north–south interstate highway from October 2023 to June 2024. The categories of services observed included food, physical activity, rest, personal hygiene and health, and safety. A descriptive analysis of the data was performed. Seventeen visits were carried out in 13 truck stop and rest areas. All sites offered paved parking areas, with lighting and signage; 92% offered internet access; more than 85% offered food, safety, and personal hygiene services; 69% offered laundry services; 54% had a convenience store and hotel nearby; and 15% had green/natural areas with benches. The services offered at the truck stop and rest areas in this study meet the basic needs of food, personal hygiene, and safety of truckers and can serve as lessons for other states and countries to consider.

Commercial fishing is a dangerous occupation where injuries, stress, and traumatic events are common. This study determined probable Post-Traumatic Stress Disorder (PTSD) rates in a cohort of 142 commercial fishermen in the United States and assessed factors that influence PTSD outcomes and severity. Fishermen representing four fisheries were sampled: salmon gillnetters (Alaska), Dungeness crab (Oregon), scallopers and lobstermen (Massachusetts). Participants self-reported information on health, sleep, activity, and substance use through surveys, and responded to a brief PTSD screener (PC-PTSD-5) that assesses probable PTSD under the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Positive PTSD screening rates in male fishermen were 12% (as compared to 10% for female fishermen), roughly three times the national average for US men (4%). Fishermen with self-reported depression, financial struggles, inability to control important things in their lives, difficulty going to (p = .0278) or staying (p = .038) asleep were significantly more likely to screen positive for PTSD. Factors influencing the severity of PTSD symptoms in those that have experienced a traumatic event included: financial insecurity, interpersonal concerns (family, crew), stress, and concern for safety on the vessel. Interestingly, sleep variables did not impact the severity of PTSD symptoms, only the outcome of probable PTSD. These results suggest the need to better understand the nature of traumatic events in fishing communities and to validate existing PTSD screening tools with fishermen to determine their accuracy in diagnosing PTSD in this population. Additionally, tailored behavioral health care for fishermen is essential to effective treatment and recovery from trauma.

Commercial fishing is one of the most dangerous industries in the United States, and although injuries have been a prominent focus for research, some health and safety risk factors such as sleep are understudied. In this paper, data from a multi-modal research study of sleep patterns, lifestyle factors, occupational exposures, medical histories, and health assessments in four U.S. fisheries are used to explore the connections between pain and sleep. A mixture of randomized cluster sampling, study promotions, and dockside recruitment was utilized to gather a sufficient number of fishermen in the Alaska Salmon, Oregon Dungeness Crab, Massachusetts Scallop, and Massachusetts Lobster fisheries for the study. Fishermen were surveyed about sleep patterns, occupational exposures, and lifestyle factors. Surveyed fishermen were provided with free comprehensive health assessments by occupational health nurses and physicians or Advanced Practice Providers. Data were collected in REDCap and downloaded into SAS for analysis using a variety of analytic methods. A total of 262 surveys and 162 physical examinations were completed with captains and crew members in the four fisheries targeted for study. The average self-reported consecutive hours of sleep for fisheries workers that spend several days at sea (i.e. Crab, Scallop, and Salmon fisheries) were roughly 3.5 to 4.0 h in a 24-h period. Of particular note, the majority of fishermen, regardless of fishery, suffered from back pain, and roughly 40% of fishermen noted pain and discomfort significantly impede their ability to sleep. This study underscores the connections between musculoskeletal pain and sleep, providing yet further impetus for preventing musculoskeletal injuries among fishermen. Given the ties between existing sleep debt in the industry and the health and safety risks posed by repeated exposure to insufficient sleep, this study highlights the need for the prevention of these injuries and potentially better treatment options for fishermen who suffer from musculoskeletal disorders.

Long-haul truck drivers are responsible for transporting goods valued at millions of dollars of the world economy, and may have their health affected by living and working conditions. This study analyzed and synthesized scientific findings about risk factors for the development of chronic non-communicable diseases in long-haul truck drivers. An integrative literature review was conducted. We identified 23 studies that met the inclusion criteria and evaluated the health of 7363 drivers. The biological risk factors identified were age, gender, race/ethnicity, genetics, and comorbidities, and were considered to be non-modifiable for chronic diseases. The behavioral risks considered to be modifiable were sedentary lifestyle, smoking, alcohol consumption, overweight, diet, stress, anxiety, and unfavorable socioeconomic conditions. Environmental risks involved working conditions such as the following: number of working hours per day, week, and month; time away from home; risk of musculoskeletal injury; and opportunities for rest, hours of sleep, and access to health services. The results were presented in two categories: (1) biological, behavioral, and environmental risks, and (2) general recommendations to promote physical, cognitive, and emotional health. Macro-structural changes are needed to reorganize work and rest, improve access to health services to control modifiable risk factors, and to support behavioral and environmental changes to reduce chronic non-communicable diseases and deaths.

Long-haul truck drivers are responsible for transporting goods valued at millions of dollars of the world economy and may have their health affected by living and working conditions. This study analyzed and synthesized the scientific findings about risk factors for the development of chronic non-communicable diseases in long-haul truck drivers. An integrative literature review was conducted. We identified 23 studies that met the inclusion criteria and evaluated the health of 7,363 drivers. The biological risks identified were age, gender, race/ethnicity, genetics, comorbidities, and were considered non-modifiable for chronic diseases. The behavioral risks, considered modifiable, were sedentary lifestyle, smoking, alcohol consumption, overweight, diet, stress, anxiety, unfavorable socioeconomic conditions. Environmental risks involved working conditions such as the number of working hours per day, week and month; time away from home, risk of musculoskeletal injury, and opportunities for rest, hours of sleep and access to health services. The results were presented in two categories: 1) biological, behavioral and environmental risks, and 2) general recommendations to promote physical, cognitive and emotional health. Macro-structural changes are needed to reorganize work and rest, improve access to health services to control risk factors, and to support behavioral and environmental changes to reduce chronic non-communicable diseases and deaths.

To understand how chemical exposure can impact health, researchers need tools that capture the complexities of personal chemical exposure. In practice, fine particulate matter (PM_2.5) air quality index (AQI) data from outdoor stationary monitors and Hazard Mapping System (HMS) smoke density data from satellites are often used as proxies for personal chemical exposure, but do not capture total chemical exposure. Silicone wristbands can quantify more individualized exposure data than stationary air monitors or smoke satellites. However, it is not understood how these proxy measurements compare to chemical data measured from wristbands. In this study, participants wore daily wristbands, carried a phone that recorded locations, and answered daily questionnaires for a 7‐day period in multiple seasons. We gathered publicly available daily PM_2.5 AQI data and HMS data. We analyzed wristbands for 94 organic chemicals, including 53 polycyclic aromatic hydrocarbons. Wristband chemical detections and concentrations, behavioral variables (e.g., time spent indoors), and environmental conditions (e.g., PM_2.5 AQI) significantly differed between seasons. Machine learning models were fit to predict personal chemical exposure using PM_2.5 AQI only, HMS only, and a multivariate feature set including PM_2.5 AQI, HMS, and other environmental and behavioral information. On average, the multivariate models increased predictive accuracy by approximately 70% compared to either the AQI model or the HMS model for all chemicals modeled. This study provides evidence that PM_2.5 AQI data alone or HMS data alone is insufficient to explain personal chemical exposures. Our results identify additional key predictors of personal chemical exposure.