Self‐reported and objectively measured occupational exposures, health, and safety concerns among fishermen: A cross‐sectional Fishing Industry Safety and Health (FISH) pilot study

Background Fishing industry workers are exposed to hazardous working conditions, engage in strenuous labor, and work long hours in variable weather conditions. Despite these known employment challenges, little is known of their perceived occupational health and safety concerns. In this pilot study, we: (1) describe fishermen's perceptions on worker‐ and organizational‐level characteristics that impact occupational health and safety; and (2) estimate environmental exposure to polycyclic aromatic hydrocarbons (PAHs) encountered during fishing activities. Methods We collected both qualitative and quantitative data from Mississippi and Florida fishermen. Using an ethnographic approach, the study team conducted 1‐h key informant interviews, administered a one‐page demographic survey, and collected objective measurements to PAHs using silicone‐based passive sampling wristbands. Results Study participants (n = 17) had a mean age of 50.9 years (SD = 11.7), 88.2% were male, 94.1% white, 100.0% non‐Hispanic/Latino, and 52.9% were married. Approximately, 87.5% reported fishing as their primary job, with a mean of 26.4 years in the industry (SD = 15.3). Four broad themes describing the culture of the fishing industry, common workplace exposures that impact fishermen's safety and health, and facilitators and barriers to safety while working in the fishing industry were documented. Deckhands had the lowest mean exposure to PAHs (8.3 ppb), followed by crew members (11.0 ppb), captains (82.64 ppb), and net makers (208.1 ppb). Conclusions Gulf coast fishermen expressed specific occupational health and safety concerns and were exposed to carcinogenic PAHs during regular work. Opportunities exist and strategies are needed for health protection and health promotion interventions among Gulf fishermen

O-185 EFFECTS OF PER- AND POLYFLUOROALKYL SUBSTANCES (PFAS) ON THE METABOLOME OF U.S. AIRPORT AND STRUCTURAL FIREFIGHTERS: EVIDENCE FROM THE NATIONAL FIREFIGHTER CANCER INITIATIVE

Abstract Introduction Firefighters are occupationally exposed to per- and polyfluoroalkyl substances (PFAS) in Aqueous Film Forming Foam (AFFF), a fire suppressant and in the moisture barrier of their safety gear. Certain PFAS are increasingly linked to metabolic toxicity and carcinogenicity. We examine changes in metabolic pathways associated with exposure to serum PFAS in firefighters. Methods Firefighters from two U.S. fire departments consented to the study, completed a health survey and provided a blood sample. Seven distinct PFASs were quantified using a liquid chromatography-isotope dilution-tandem mass spectrometry approach. Global metabolomic profiles were determined across three experimental groups (i.e., male, female and airport firefighters). ANCOVA contrasts were used to identify biochemicals that differed significantly between groups. Results Among 50 firefighters, 30.0% were female, 66.0% White/non-Hispanic, and 53.1% overweight, with group average age, 41.8 years ±9.9 (standard deviation). Thirty percent worked as airport firefighters, while 70.0% as structural/career firefighters. Perfluorooctanesulfonate (PFOS) and perfluorohexanesulfonate (PFHxS) were higher in airport (ratio fold change [FC]:2.17 and 3.16;p≤0.05) and male firefighters (FC:2.22 and 2.81;p≤0.05) compared to females. Lactate levels were higher in airport firefighters (FC:1.44;p≤0.05) compared to male/female firefighters, while ceramides (FC:0.58 and 0.72;p≤0.05) and sphingomyelins (FC:0.76 and 0.78;p≤0.05) were lower in airport and male firefighters versus females. Eicosanoids (FC:2.37;p≤0.05), fibrinopeptide products FC:2.21;p≤0.05), glutathione related antioxidant metabolites (FC:2.66;p≤0.05) were higher in airport versus female/male firefighters. Discussion and conclusion Several observed differences were more robust in airport firefighters suggesting greater metabolic differences in these firefighters compared to non-airport firefighters

Abstract 25: Per- and polyfluoroalkyl substances and obesity in Florida firefighters

Abstract Background/Objective: Per- and polyfluoroalkyl substances (PFASs) are hazardous synthetic chemicals that have been linked to adverse human health effects such as cancer and endocrine disruption. Firefighters have been shown to be occupationally exposed to PFAS through aqueous film-forming foam (AFFF) used during difficult-to-suppress fires, and in the textile liners of their safety turnout gear. PFASs have both hydrophobic and hydrophilic chemical structures, giving them strong thermal stability and making them resistant to environmental and physiological degradation. Studies of human exposures to PFAS have observed associations between some PFAS and increased risk of obesity or elevated body mass index (BMI). Given the unique occupational exposures of firefighters to PFAS, we examine the association between obesity and PFAS in a sample of Florida firefighters. Methods: A cross-sectional study design was used to collect a health survey and a blood sample from a non-probabilistic sample of career Florida fighters between June and October 2021. The health surveys, administered on REDCap using tablet devices, assessed information on firefighter socio-demographic and work characteristics. We quantified 7 distinct PFASs using a solid-phase extraction-high-performance liquid chromatography-isotope dilution-tandem mass spectrometry approach; the limit of detection was between 0.5 and 0.05 ng/mL, depending on the analyte. All 7 PFASs, including Perfluorobutanesulfonic Acid (PFBS), Perfluoroheptanoic Acid (PFHpA), Perfluorohexanesulfonic Acid (PFHxS), Perfluorooctanoic Acid (PFNA), Perfluorononanoic Acid (PFNA), Perfluorooctanesulfonic Acid (PFOS), and Perfluoroctanesulfonamide (PFOSA), were detected in the blood samples; concentrations below the limit of detection were replaced by the limit of detection/√2.35. Results: Among the 208 firefighters who completed the survey and provided a blood sample, 92.8% were male, 16.2% Hispanic/Latinx, 81.7% White, 89.8% used AFFF at their fire department, with a group mean age 40.2±10.3 standard deviation. Approximately 15.8% of firefighters were of healthy weight, 51.5% overweight, and 32.7% obese. Firefighter body mass index was positively correlated with serum concentrations of PFHxS (rs=.17;p=.020) and PFBS (rs=.60;p=.26). Group geometric mean of each PFAS congener (in ng/mL): PFBS (0.09), PFHpA (0.08), PFHxS (2.17), PFOA (1.38), PFNA (0.42), PFOS (2.69), and PFOSA (0.10). Total serum PFAS concentrations was highest among obese firefighters (7.62 ng/mL) and lowest in healthy weight firefighters (6.55 ng/mL). Conclusions: Firefighters who were overweight and obese, based on body mass index, had higher total serum PFAS concentrations than those firefighters of healthy weight. Both long- and short-chain PFASs, PFHxS and PFBS respectively, were positively correlated with firefighter body mass index. Citation Format: Alberto J. Caban-Martinez, Paola Louzado Feliciano, Simi Oduwole, Natasha Schaefer Solle, Catalina Gonzalez-Umana, Thomas Stone, Erin N. Kobetz. Per- and polyfluoroalkyl substances and obesity in Florida firefighters [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 25.</jats:p

A Qualitative Assessment of Mothers' Experience With Pediatric Anemia Care in Arequipa, Peru

Background: Despite national efforts to control pediatric anemia in Peru, each year, 67.4% of all newborns are diagnosed with anemia during their first year of life. The literature on Peruvian mothers' understanding and beliefs of pediatric anemia is limited. In the present study, we aimed to understand mother's perspective of pediatric anemia and explore their perceptions on how to prevent and treat anemia in Peru. Methods: During May–June 2018, we administered a short demographic questionnaire and conducted language-sensitive interviews with mothers of children clinically diagnosed with anemia in three different governmental health centers in Arequipa, Peru. Interviews were audio-recorded and transcribed verbatim. We used the Framework Analysis approach to analyze qualitative data. Results: A total of 14 Peruvian mothers were interviewed. Across interviews, three main themes emerged: (I) Mothers' Understanding of Pediatric Anemia; (II) Attitudes about Provider Recommendations for Pediatric Anemia Control; and (III) Barriers to Effective Pediatric Anemia Control. Peruvian mothers expressed skepticism toward national pediatric anemia guidelines as they believe recommendations received at health clinics jeopardized their children's overall health. Participants identified several barriers to effective anemia control: limited and confusing health information received during pediatric healthcare appointments, lack of systematic protocols in health clinics, and inconsistent referral processes. Conclusion: We identified factors that limit the acceptance of current pediatric anemia control guidelines followed at governmental health centers in Arequipa, Peru. Understanding maternal beliefs concerning pediatric anemia can guide future anemia control guidelines at the primary care level for pediatric patients in Peru

Perceptions of Occupational Cancer Risk and Prevention among Dominican Republic Firefighters

Characterize occupational cancer risk perceptions and attitudes toward cancer prevention practices among firefighters in the Dominican Republic.Focus group discussions and key informant interviews were conducted in June 2019 among firefighters from three fire departments. Themes were inductively created using a qualitative descriptive approach.Thirty-seven firefighters were interviewed with a group mean age of 36.2 ± 10.3 years, of which 97.3% were male, and 37.1% worked at least 10 years. Six themes emerged: 1) availability of personal protective equipment (PPE); 2) toxic exposure during fire suppression; 3) work-related stress; 4) lack of workplace health promotion activities; 5) Dominican culture impacts medical checkups; and 6) expensive medical copays limits healthcare access.Dominican firefighters are willing to adopt cancer prevention practices, however organizational barriers (ie, PPE availability, cultural barriers, and health promotion practices) limit engagement

Weight Status and Binge Drinking among Male and Female Florida Firefighters

OBJECTIVEExamine the association between weight status and binge drinking among Florida firefighters. METHODSHealth survey data collected between 2015 and 2019 among Florida firefighters participating in the Annual Cancer Survey were analyzed for weight class (healthy, overweight, obese) and binge-drinking behaviors. Binary logistic regression models were fit and stratified by sex while controlling for socio-demographic and health characteristics. RESULTSAmong 4,002 firefighter participants, 45.1% binge drink, 50.9% are overweight, and 31.3% are obese. Among male firefighters, being overweight (adjusted odds ratio = 1.34; 95%CI [1.10-1.64]) or obese (1.29; [1.04-1.61]) was significantly associated with binge drinking compared to healthy weight counterparts. In female firefighters, being obese (2.25; [1.21-4.22]) was significantly associated with binge drinking but being overweight was not. CONCLUSIONSBeing overweight or obese is selectively associated with binge drinking among male and female firefighters

Characterizing the Health and Safety Concerns of US Rideshare Drivers: A Qualitative Pilot Study

Background: Despite the growth and popularity of gig work, limited information exists about the occupational health and safety concerns faced by individuals who are employed through ridesharing online applications. In this qualitative study, we characterized the perceived health and safety concerns of drivers employed by rideshare companies. Methods: During September-October 2019, we requested car rides, using digital rideshare platforms. During the ride, drivers responded verbally to a brief closed-end sociodemographic and work characteristics survey. A semi-structured interview script was used to collect rideshare driver perceptions on health and safety risks. Findings: A total of 35 rideshare drivers of group mean age of 43.1 +/- 11.2 years were interviewed, of whom 77.1% were male and 82.9% identified as Latino. Sixty percent of participants reported rideshare as their primary job, working an average of 47.9 +/- 19.6 hours weekly (minimum = 6 hours, maximum = 84 hours). Drivers enjoyed job autonomy yet faced stressors such as passenger risky behavior, car accidents, and lack of policies that protect the driver. Rideshare drivers also raised concerns about their current health status, economic pressures, and worker safety. Conclusion/Application to Practice: Drivers are forced to extend work hours to support themselves financially, exacerbating their current health concerns and safety risks as it means more time spent working in their sedentary job, compromising their mental and physical health as well as their safety. Occupational health and safety programs geared toward workers in the gig economy are needed

Perceptions of Occupational Cancer Risk and Prevention Among Dominican Republic Firefighters: A Qualitative Study

Characterize occupational cancer risk perceptions and attitudes toward cancer prevention practices among firefighters in the Dominican Republic. Focus group discussions and key informant interviews were conducted in June 2019 among firefighters from three fire departments. Themes were inductively created using a qualitative descriptive approach. Thirty-seven firefighters were interviewed with a group mean age of 36.2 ± 10.3 years, of which 97.3% were male, and 37.1% worked at least 10 years. Six themes emerged: 1) availability of personal protective equipment (PPE); 2) toxic exposure during fire suppression; 3) work-related stress; 4) lack of workplace health promotion activities; 5) Dominican culture impacts medical checkups; and 6) expensive medical copays limits healthcare access. Dominican firefighters are willing to adopt cancer prevention practices, however organizational barriers (ie, PPE availability, cultural barriers, and health promotion practices) limit engagement