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Commercial motor vehicle (CMV) drivers are one of the largest occupational populations in the U.S., with more than 3 million drivers. Relatively little is known about the health and risk factors of these drivers. Epidemiological evaluations of occupational factors associated with health outcomes, including musculoskeletal diseases, crashes, and chronic diseases, are severely lacking. My involvement in research in this area has meaningfully helped spotlight the large potential impact that well-designed and executed epidemiological studies can have for improving the health and safety of these workers, as well as provided guidance for identification of risk factors for common problems within the CMV industry. I have been both a principal investigator and co-investigator on large studies, responsible for study design, data collection and management, analyses, interpretation of results, and manuscript preparation.
Key Publications
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Quantification of exposures can be a meaningful limitation in occupational epidemiology studies. Prior studies have attempted to combine multiple individual measures into a single metric, such as the TLV for HAL, Strain Index, or Revised NIOSH lifting index. Assessment, validation, and refinement of these metrics in different populations has furthered the understanding of the relationships and interplay of common metrics like force, repetition, and posture. Such studies have advanced our understanding of these job physical exposures and how they influence the development of musculoskeletal disorders. In working with ergonomists to quantify these exposures and assess, validate, and refine them in relation to the health outcomes they are designed to predict, I have developed a strong understanding of the quantification and limitations of these exposures. The sample of articles below relates directly to carpal tunnel syndrome and related ergonomic issues.
Key Publications
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Distal Upper Extremity Musculoskeletal Disorders (DUE MSD) and Low Back Pain (LBP) are the most common occupational problems, with many competing etiological theories. These theories include both personal and occupational factors. Two different studies, the WISTAH prospective cohort study and the BACKWORKS study, are evaluating relationships between multiple potential risk factors and DUE MSDs. These prospective cohort studies are able to identify temporal relationships between both personal and occupational exposures and the outcomes of DUE MSDs and LBP. I, along with many co-authors, have conducted research that has quantified differences in case definitions of many DUE MSD and LBP case definitions and reported associations between personal and occupational factors using standardized case definitions in large prospective cohort studies. These studies have advanced the understanding of relationships between both personal and occupational risk factors and MSDs more than any others published in the past 15 years. My role as an epidemiologist on these studies included designing, collecting, managing, analyzing and interpreting data. Collectively, these studies have produced three dozen peer-reviewed articles, with many more still under review or being drafted.
Key Publications
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The global pandemic was one of the most impactful and disrupting events for all workers. I had the opportunity to serve as a NIOSH Independent Personal Agreement (IPA) collaborator as part of the COVID-19 response. I also served as a Co-PI on two large prospective studies evaluating vaccine effectiveness among first responders, frontline workers, and children. The first of these studies was the Research on the Epidemiology of COVID-19 in Essential Response Personnel (RECOVER) study. The goal was to assess vaccination efficacy with a community-based population using weekly swabs and electronic surveys. The team exceeded study enrollment targets and also has higher compliance rates with weekly nasal swabbing. The second study, Pediatric Research Observing Trends and Exposures in COVID-19 Timelines (PROTECT), was similarly designed but targeted pediatric populations. Publications highlighting the challenges and successes among both workers and employers during the pandemic, including vaccination effectiveness, perception of risk, and disease mitigation, have been some of the most widely cited and impactful publications regarding COVID-19 to date.
Key Publications
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Evidence-based practice guidelines are an increasingly important tool for clinicians when treating work-related diseases and injuries. The American College of Occupational and Environmental Medicine’s Occupational Medicine Practice Guidelines have meaningfully improved the health and wellness of workers across the U.S. They have been adopted in part or in whole by many states to improve workers compensation systems. I lead the research team in identifying, abstracting, and compiling the relevant randomized controlled trials, of which there are more than 10,000 to date. I also assist in scoring and drafting treatment recommendations prior to extensive peer review.
Key Publications
I have authored or co-authored more than 200 peer-reviewed publications. My primary areas of focus include transportation health and safety, occupational exposures, musculoskeletal disorders, COVID-19, and evidence-based occupational medicine practice guidelines.
See Google Scholar for a comprehensive list of my publications.