David A Lombardi | Harvard University (original) (raw)

Papers by David A Lombardi

Chronobiology International, 2016

Approximately 10% of the employed population in the United States works in multiple jobs. They ar... more Approximately 10% of the employed population in the United States works in multiple jobs. They are more likely to work long hours and in nonstandard work schedules, factors known to impact sleep duration and quality, and increase the risk of injury. In this study we used multivariate regression models to compare the duration of sleep in a 24-hour period between workers working in multiple jobs (MJHs) with single job holders (SJHs) controlling for other work schedule and demographic factors. We used data from the Bureau of Labor Statistics US American Time Use Survey (ATUS) pooled over a 9-year period (2003-2011). We found that MJHs had significantly reduced sleep duration compared with SJHs due to a number of independent factors, such as working longer hours and more often late at night. Male MJHs, working in their primary job or more than one job on the diary day, also had significantly shorter sleep durations (up to 40 minutes less on a weekend day) than male SJHs, even after controlling for all other factors. Therefore, duration of work hours, time of day working and duration of travel for work may not be the only factors to consider when understanding if male MJHs are able to fit in enough recuperative rest from their busy schedule. Work at night had the greatest impact on sleep duration for females, reducing sleep time by almost an hour compared with females who did not work at night. We also hypothesize that the high frequency or fragmentation of non-leisure activities (e.g. work and travel for work) throughout the day and between jobs may have an additional impact on the duration and quality of sleep for MJHs.

PLOS ONE, 2016

Falls are the leading cause of unintentional injuries in the U.S.; however, national estimates fo... more Falls are the leading cause of unintentional injuries in the U.S.; however, national estimates for all community-dwelling adults are lacking. This study estimated the national incidence of falls and fall-related injuries among community-dwelling U.S. adults by age and gender and the trends in fall-related injuries across the adult life span. Nationally representative data from the National Health Interview Survey (NHIS) 2008 Balance and Dizziness supplement was used to develop national estimates of falls, and pooled data from the NHIS was used to calculate estimates of fall-related injuries in the U.S. and related trends from 2004-2013. Costs of unintentional fall-related injuries were extracted from the CDC&amp;amp;amp;amp;amp;amp;amp;#39;s Web-based Injury Statistics Query and Reporting System. Twelve percent of community-dwelling U.S. adults reported falling in the previous year for a total estimate of 80 million falls at a rate of 37.2 falls per 100 person-years. On average, 9.9 million fall-related injuries occurred each year with a rate of 4.38 fall-related injuries per 100 person-years. In the previous three months, 2.0% of older adults (65+), 1.1% of middle-aged adults (45-64) and 0.7% of young adults (18-44) reported a fall-related injury. Of all fall-related injuries among community-dwelling adults, 32.3% occurred among older adults, 35.3% among middle-aged adults and 32.3% among younger adults. The age-adjusted rate of fall-related injuries increased 4% per year among older women (95% CI 1%-7%) from 2004 to 2013. Among U.S. adults, the total lifetime cost of annual unintentional fall-related injuries that resulted in a fatality, hospitalization or treatment in an emergency department was 111 billion U.S. dollars in 2010. Falls and fall-related injuries represent a significant health and safety problem for adults of all ages. The findings suggest that adult fall prevention efforts should consider the entire adult lifespan to ensure a greater public health benefit.

Professional safety

ABSTRACT

Introduction Slips and falls are the leading cause of injury among restaurant workers in the U.S.... more Introduction Slips and falls are the leading cause of injury among restaurant workers in the U.S. This study examined the association between floor surface characteristics, shoe type, floor cleaning and the risk of slipping in limited-service restaurant workers. Method 362 workers from 32 limited-service restaurants in five states were recruited to participate in a 12-week cohort study of workplace slipping. At baseline, demographic information and use of slip-resistant shoes for each worker was collected. Restaurant managers reported about the frequency of daily kitchen floor cleaning. Kitchen floor surface roughness and coefficient of friction (COF) were measured in nine floor areas and then averaged within each restaurant. In the following twelve weeks, participants reported their slip experience weekly. The associations between rate of slipping and risk factors were assessed using a negative binomial generalized estimating equation model. Results Mean age of participants was 31 ...

Objectives: To assess the influence health insurance on place of injury treatment and evaluate re... more Objectives: To assess the influence health insurance on place of injury treatment and evaluate representativeness of emergency department(ED) data for injuries. Methods: We analyzed 7,834 medically treated injuries from the 2000-2003 National Health Interview Survey (NHIS). Place of treatment was defined hierarchically as the highest level of ambulatory care provided. We used weighted multiple logistic regression to compare place of treatment for injury episodes covered by private, public and no health insurance. Results: We estimated 24.5 million injury episodes received medical treatment annually; 55% were treaded in EDs, 11% in clinics/outpatient departments, 28% in doctor's offices, and 3% sought only telephone advice. Privately insured patients used the ED for 50% of injury episodes compared to 64% among those publicly insured and 65% among persons uninsured. After controlling for age, race/ethnicity, geographic region, nature and cause of injury, there was no difference in...

BACKGROUND Our previous study showed that obese adults are at greater risk of work-related injury... more BACKGROUND Our previous study showed that obese adults are at greater risk of work-related injury. Several studies have attempted to address whether long sitting time at work contributes to obesity, yet the results remain inconclusive. To better evaluate sitting time’s potential contribution to obesity, we initiated a study that addressed temporality more appropriately and controlled for confounding more effectively using the National Longitudinal Survey of Youth 1979 (NLSY79) from 2002-2010. METHOD We used BMI as our outcome. The primary explanatory variable was “time spent on sitting”, extracted from O*NET (Occupational Information Network) and linked to the main NLSY79 data by occupation. Sitting time consists of five categories, ranging from never (1) to continuously or almost continuously (5). Workplace sitting time at six months prior to interview was used to predict the outcome in each wave. Age, education, weekly frequencies of leisure-time exercise were included as controls...

Injury Prevention, 2010

Objectives This study describes the type, location and severity of work-related acute traumatic h... more Objectives This study describes the type, location and severity of work-related acute traumatic hand injuries of 560 workers treated in 11 hospitals in three economically active cities in the People's Republic of China (PRC) over a 2-year period. Methods A structured questionnaire was used to collect participant's information. Log-linear and logistic models were constructed to identify factors associated with injury occurrence and severity, respectively. Results Participants (n¼560) had a mean age of 31.7 years (SD 10.5), 74.4% were men. 85.4% of participants were employed in manufacturing industries; 51.7% of 750 injuries were to the left hand. The index finger was injured most often and the most severe injury occurred to the right thumb. 68.3% of participants had only a single type of injury (29.7% crushes, 25.7% amputations and 18.5% fractures). Severe injuries occurred most often while working with food products (79.2% severe), furniture (72.2%), non-metallic mineral products (71.4%) and wood products (70.6%). Powered machines were involved in 59.5% of injuries. Injury frequency was associated with gender (male vs female, odds ratio (OR) 2.9, 95% CI 2.4 to 3.5) and company size (#100 vs >100 employees, OR 2.5, 95% CI 2.1 to 3.1). Injury severity was associated with gender (male vs female OR 0.6, 95% CI 0.4 to 0.9) and powered machine use (OR 2.2, 95% CI 1.3 to 3.7). Conclusions The present study suggests that working in manufacturing industries and working with powered machines are the primary sources of severe hand injuries in hospitalised workers in economically active areas of the PRC.

In most shiftworking situations safety is one of the primary concerns of both the employees and t... more In most shiftworking situations safety is one of the primary concerns of both the employees and their employers. The present chapter will review the available literature on shiftwork safety in which real measures of injuries and/or accidents can be related both to the time of day and/or to the point within the shift system that they occurred. Unfortunately, there are only a few studies that allow for an unbiased calculation of relative risk estimates of accidents and/or injuries associated with specific features of shift systems due to non-homogeneous a priori risk. These features include the type of shift, the length of the shift, and the number of successive shifts. Additionally, a recent study provides evidence of the influence of rest breaks on workplace safety. Since these trends can be expressed in terms of relative risk, it is possible to combine or pool their effect estimates in a simple manner to estimate the relative risk over any given span of shifts, and hence for an ent...

Journal of Exposure Science and Environmental Epidemiology, 2015

Job exposure matrices (JEMs) are tools used to classify exposures for job titles based on general... more Job exposure matrices (JEMs) are tools used to classify exposures for job titles based on general job tasks in the absence of individual level data. However, exposure uncertainty due to variations in worker practices, job conditions, and the quality of data has never been quantified systematically in a JEM. We describe a methodology for creating a JEM which defines occupational exposures on a continuous scale and utilizes elicitation methods to quantify exposure uncertainty by assigning exposures probability distributions with parameters determined through expert involvement. Experts use their knowledge to develop mathematical models using related exposure surrogate data in the absence of available occupational level data and to adjust model output against other similar occupations. Formal expert elicitation methods provided a consistent, efficient process to incorporate expert judgment into a large, consensus-based JEM. A population-based electric shock JEM was created using these methods, allowing for transparent estimates of exposure.

International Journal of Environmental Research and Public Health, 2015

We present an update to an electric shock job exposure matrix (JEM) that assigned ordinal electri... more We present an update to an electric shock job exposure matrix (JEM) that assigned ordinal electric shocks exposure for 501 occupational titles based on electric shocks and electrocutions from two available data sources and expert judgment. Using formal expert elicitation and starting with data on electric injury, we arrive at a consensus-based JEM. In our new JEM, we quantify exposures by adding three new dimensions: (1) the elicited median proportion; (2) the elicited 25th percentile; and (3) and the elicited 75th percentile of those experiencing occupational electric shocks in a working lifetime. We construct the relative interquartile range (rIQR) based on uncertainty interval and the median. Finally, we describe overall results, highlight examples demonstrating the impact of cut point selection OPEN ACCESS Int. J. Environ. Res. Public Health 2015, 12 3890

Sleep, 2010

Commentary-Lombardi

The Journal of Pediatrics, 1991

To determine the relationship between activity levels of parents and those of their young childre... more To determine the relationship between activity levels of parents and those of their young children, we monitored physical activity with a mechanical device, the Caltrac accelerometer, in one hundred 4-to 7-year-old children and in 99 of their mothers and 92 of their fathers. During 1 year in the Framingham Children's Study, data were obtained for an average of more than 10 hours per day for 8.6 _+ t.8 days for the children, for 8.3 _ 2.1 days for their mothers, and for 7.7 _+ 2.3 days for their fathers. Children of active mothers (average Caltrac accelerometer counts per hour greater than the median) were 2.0 times as likely to be active as children of inactive mothers (95% confidence interval = 0.9, 4.5); the relative odds ratio of being active for the children of active fathers was 3.5 (95% confidence interval = 1.5, 8.3). When both parents were active, the children were 5.8 times as likely to be active (95% confidence interval = t.9, 17.4) as children of two inactive parents. Possible mechanisms for the relationship between parents' and child's activity levels include the parents' serving as role models, sharing of activities by family members, enhancement and support by active parents of their child's participation in physical activity, and genetically transmitted factors that predispose the child to increased levels of physical activity. (J PEDIATR 1991;118:215"9)

Safety Science, Aug 1, 2001

The purpose of this review was to summarize the literature on occupational, acute, traumatic hand... more The purpose of this review was to summarize the literature on occupational, acute, traumatic hand injury and suggest directions for future research. In 1996, the leading occupational injury treated in United States' hospital emergency departments was an acute hand injury (e.g. laceration, crush or fracture). These injuries aected 30% of an estimated 3.3 million injured workers (990,000). Cuts and lacerations of the ®ngers ranked third after back and leg strains in the number of lost workday cases in the USA in 1994. The incidence rate of hand injuries studied in seven manufacturing environments around the world ranged from 4 to 11 per 100 workers per year. Workers aged 24 years or less had the highest risk of hand injury. Men had higher rates of severe hand injury than women.

American journal of preventive medicine, Jan 23, 2015

Technological advancements have made life and work more sedentary, and long hours of sitting are ... more Technological advancements have made life and work more sedentary, and long hours of sitting are known to be associated with many health concerns. Several studies have reported an association between prolonged sitting time at work and weight gain, but the results are inconsistent. This study examined the relationship between sitting time at work and BMI using data from a large prospective cohort of U.S. men and women from 2002 to 2010. Initial analyses were performed in 2013, with additional analyses in 2014 and 2015. The sample size at the base year (2002) was 5,285 and the age range 38-45 years. The outcome, BMI, was based on self-reported measures of height and weight. Estimates of workplace sitting time were linked from an external database (Occupational Information Network), and the occupation-wide rating for sitting time was linked to survey participants by occupation. Fixed-effects models controlling for time-invariant effects of all time-invariant characteristics were employ...

American Journal of Preventive Medicine, 2015

Although exercise and strength training have been shown to be protective against falls in older a... more Although exercise and strength training have been shown to be protective against falls in older adults (aged 65 years and older), evidence for the role of leisure-time physical activity (LTPA) in the prevention of falls and resulting injuries in middle-aged adults (aged 45-64 years) is lacking. In the present study, we investigate the association between self-reported engagement in LTPA and the frequency of falls and fall-related injuries among middle-aged and older adults, while controlling for key sociodemographic and health characteristics. Nationally representative data from the 2010 U.S. Behavioral Risk Factor Surveillance Survey were analyzed in April 2014 to examine the number of adults aged ≥45 years who self-reported their fall experience in the previous 3 months and any injuries that resulted from those falls. We then evaluated the association between LTPA and self-reported falls and injuries across three age strata (45-54, 55-64, and ≥65 years). The two main self-reported outcome measures were (1) frequency of falls in the 3 months prior to the survey interview date and (2) the number of injuries resulting from these falls. Prevalence ratios (PRs) and 95% CIs were calculated using Poisson regression models with robust SEs. Of 340,680 survey participants aged ≥45 years, 70.7% reported engaging in LTPA, and 17% reported one or more falls. Among those reporting a fall within 3 months, 25.6% experienced one injurious fall (fall resulting in an injury) and 8.4% reported two or more injurious falls. Controlling for sociodemographic and health characteristics, among adults aged 45-54 years, those who engaged in LTPA were significantly less likely to report one fall (PR=0.90, 95% CI=0.81, 0.99); two or more falls (PR=0.84, 95% CI=0.77, 0.93); one injurious fall (PR=0.88, 95% CI=0.78, 0.99); and two or more injurious falls (PR=0.69, 95% CI=0.58, 0.83) than those who did not exercise. A similar protective effect of LTPA on reporting falls and injuries was noted for adults aged 55-64 and ≥65 years. Similar to older adults, middle-aged adults who engage in LTPA report fewer falls and fall-related injuries. Upon further confirmation of the relationship between LTPA and falls among middle-aged adults, fall prevention interventions could be developed for this population.

Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 2000

... Gary S. Sorock ab,c, David A. Lombardi b,c, Russ B. Hauser b, Ellen A. Eisen b,c, Robert F. H... more ... Gary S. Sorock ab,c, David A. Lombardi b,c, Russ B. Hauser b, Ellen A. Eisen b,c, Robert F. Herrick", Murray A. Mittleman" ... lost work time, there is only one published case-control study of acute traumatic injury to the hand in the work envirorunent, [Hertz and Emmet 1986] leaving ...

Proceedings of the International Conference on Contemporary Ergonomics (CE2008), 1-3 April 2008, Nottingham, UK, 2008

Occupational and environmental medicine, Jan 20, 2015

Safety climate has previously been associated with increasing safe workplace behaviours and decre... more Safety climate has previously been associated with increasing safe workplace behaviours and decreasing occupational injuries. This study seeks to understand the structural relationship between employees' perceptions of safety climate, performing a safety behaviour (ie, wearing slip-resistant shoes) and risk of slipping in the setting of limited-service restaurants. At baseline, we surveyed 349 employees at 30 restaurants for their perceptions of their safety training and management commitment to safety as well as demographic data. Safety performance was identified as wearing slip-resistant shoes, as measured by direct observation by the study team. We then prospectively collected participants' hours worked and number of slips weekly for the next 12 weeks. Using a confirmatory factor analysis, we modelled safety climate as a higher order factor composed of previously identified training and management commitment factors. The 349 study participants experienced 1075 slips durin...