Health support workers, registered nurses at high risk for suicide

Health care workers in three common professions are at significantly higher risk of dying by suicide than the general U.S. workforce, new research shows.

Published Sept. 26 in the Journal of the American Medical Association, the research found that U.S. registered nurses, health technicians and health care support workers are at increased risk of suicide.

In the overall U.S. workforce, suicide rates averaged about 12.6 per 100,000 people from 2008-2019. But for health care support workers, who include home health aides, dental assistants and medical assistants, the rate was 16 per 100,000. For registered nurses, it was 15.6, and for health technicians — who include emergency medical technicians, dental hygienists and laboratory technicians — it was 13.1.

Trailing behind those professions were health care workers who diagnose or treat patients, social and behavioral health workers, and physicians. Physicians died by suicide at a rate of 10.1 per 100,000 people; in general, they tend to live healthier, longer lives than the larger workforce, the researchers noted. 

Health care work was more strongly associated with suicide risk among female than male workers.

While the exact reasons for the elevated suicide rates are not known, past research has linked them with burnout, work and home stress, the study said.

The researchers — who were with Columbia University, the U.S. Census Bureau and the National Institute of Drug Abuse — called for new programs to protect the mental health of health workers at high risk for suicide.

OIG: EPA lagging at addressing emissions from ports

The U.S. Environmental Protection Agency needs to do more to monitor and address increasing air pollution at U.S. seaports and its impact on neighboring communities, a new federal report says.

While traffic at U.S. ports has increased significantly since 2020, air quality monitoring is nonexistent at most of them, putting human health at risk, according to the Sept. 21 report from the EPA’s Office of Inspector General.

In 2021, the ports of Los Angeles and Long Beach, which handle 40% of the nation’s containerized imports, broke records for the number of shipments they handled. While the shipments delivered much-needed goods during shortages caused by the COVID-19 pandemic, they also led to significant increases in atmospheric air pollution, according to the National Aeronautics and Space Administration. 

Emissions from anchored ships at the Port of Los Angeles rose from about 450 tons in 2020 to more than 2,870 tons in 2021 — a 633% increase. Maritime traffic congestion near the Southern California coast in October 2021 led to an increase in nitrogen oxide pollution equal to emissions from about 5.8 million passenger cars, the report said. Ocean-going vessels, cargo-handling equipment, trucks and other equipment contribute to air pollution at ports.

Other busy U.S. seaports include those in Seattle, Houston, Savannah, New York-New Jersey, and Norfolk, Virginia.

While the EPA has a Ports Initiative that encourages ports to decrease emissions, the program is voluntary and lacks clearly defined performance measures, the IG report said. The EPA should track air emissions in neighborhoods that are near ports and develop guidance for air monitoring by community groups, the office recommended.

Black patients restrained more often at EDs

Black patients are considerably more likely to be restrained when visiting a hospital emergency department for care, a new study shows. 

Researchers examined 24,000 instances, primarily at EDs in urban areas, where physical restraint was used with the intention of keeping people safe from an agitated patient. When compared with white patients, Black patients were much more likely to be physically restrained, according to the JAMA Internal Medicine study. Asian and Hispanic patients had lower levels of restraint use.

While acknowledging that using physical restraints may be appropriate in some circumstances, researchers noted that the procedure can lead to aspiration, choking and other forms of physical harm. Previous research has shown that some people who are restrained at EDs have lower trust in the health care system.

The researchers said that systemic racism may account for the disparities in restraint use. 

High heat bad for health of pregnant women

Exposure to extreme heat can raise the risk of death for pregnant women, a new study finds.

Published in JAMA Network Open, the study looked at more than a decade of data on maternal deaths and temperatures in Southern California. Researchers found that unusually high temperatures were associated with severe and unexpected deaths from conditions such as heart failure, anesthesia complications, sepsis and kidney failure. 

Late-pregnancy exposure raised risks, with extreme heat in the third trimester associated with a 28% increase in risk of severe and unexpected deaths among pregnant women. Women younger than 25 and older than 35 may be more susceptible to heat-related risks during pregnancy, the researchers said.

Extreme heat has become more frequent in the U.S. in recent decades. The National Oceanic and Atmospheric Administration confirmed this month that the world experienced its warmest August ever recorded this summer.

Women who begin their pregnancies in cooler months of the year, such as from November through April, may be in higher danger from the effects of  heat, as the later months of their pregnancy would occur in the hottest part of the year, the researchers warned.

Gender bias raises cancer risks for women

Gender inequalities make it harder for women around the world to prevent and receive care for cancer, a new report concludes.

The lives of about 1.5 million women could be saved annually by eliminating their exposures to known cancer risks and by increasing early detection and diagnosis among the population, the Sept. 26 report from a Lancet commission said. 

An additional 800,000 yearly deaths could be prevented if all women could access high-quality cancer care. About 2.3 million women die prematurely from cancer annually around the world.

Discrimination against women can make it harder for them to avoid cancer risks and receive quality care, the report said. Lower levels of education for women can make it harder for them to be aware of risk factors. And as women tend to earn less than men, they are less able to handle cancer-related expenses. A 2021 study of U.S. women diagnosed with breast cancer found that 21% experienced financial hardship and about 13% borrowed money or took on debt to pay for their care.

Globally, 3 million adults under age 50 were diagnosed with cancer in 2020, with about 65% of cases among women. Factors that influence cancer in women are less understood than those for men, said commission researchers, who called for more studies on occupational and environmental factors that raise cancer risks for women.

Disparities also occur within the global cancer workforce, the report said. Women tend to be underrepresented as leaders and report frequent bullying and sexual harassment. They are also much more likely to serve as unpaid caregivers for people with cancer.

The Watch is written by Michele Late, who has more than two decades of experience as a public-health journalist.