ADVANCEMENT OF THE SCIENCE
indicated they were not sure about their willingness to go to work, and 8.9% of par- ticipants reported that they were not willing to work (Rafi et al., 2021). Similarly, the ability and willingness to work during the pandemic were found to be an issue among public-facing hotel employ- ees (Stergiou & Farmaki, 2021). Risk per- ceptions of COVID-19 were relatively high in the general population, and it has been suggested that individuals overestimated the risk of contracting the disease or dying from it (Attema et al., 2021). In the UK, a study showed that the population’s health- protective behavior and risk perception of the pandemic increased over time and was influenced by psychosocial determinants such as worldviews, trust in government and medical science, and prosocial tenden- cies (Schneider et al., 2021). Finally, it is fair to say that, as with pre- vious novel biological threats to the human population such as severe acute respiratory syndrome (SARS; Wenzel & Edmond, 2003) and Zika virus (Piltch-Loeb et al., 2017), COVID-19 has created international anxiety among the general population, including health experts, because of its novelty, infec- tiousness, and morbidity and fatality rates. EHPs, as essential public health workers, have not been spared this anxiety. Workplace Violence Data from our study suggest that workplace violence experienced by EHPs is less of an intraorganizational issue but rather comes from the very people EHPs are trying to help, namely the customers or owners of services and activities regulated by EHPs. The work that EHPs do requires a high frequency of interpersonal contact with customers (e.g., business owners, developers, builders, prop- erty owners), which is a type of work char- acteristic that has been associated with pub-
lic-initiated violence (LeBlanc & Kelloway, 2002). For example, it has been reported that health inspectors from the Philadelphia Department of Health were threatened with violence when they attempted to inspect food establishments for COVID-19 compliance protocols (D’Onofrio, 2021). Altercations with the regulated community are a usual and customary risk associated with the licensing and permitting enterprise. For- tunately, these unsavory exchanges are rela- tively infrequent, yet they represent a predict- able element of the scope of work of EHPs, so much so that NEHA hosted a national training course in October 2022 on inspector conflict de-escalation. The training program attracted more than 300 EHPs to register, which is a re- flection of the interest in the subject. Real and threatened physical conflict di- rected at the public health community, partic- ularly local health ocials, has been reported since pandemic-era precautions materialized in March 2020. Disinformation and misinfor- mation related to social distancing, business and school closures, masking, vaccination, and other preventive measures exacerbated existing political tensions centered on the role of government in the U.S. While intermittent political and infec- tious disease disruptions are a dimension of contemporary practice that can be planned for, elements of field-based employment ex- pose inspectors to random risks. In January 2021, an EHP was stabbed to death during the workday in a parking lot in Sacramento, California (Miller, 2021). On another in- stance, an EHP was mauled to death by dogs in Franklin County, Alabama, in April 2022 while they were responding to a nuisance dog complaint (Sharp, 2022). Recommendation National professional organizations, such as NEHA, should consider developing a com-
prehensive OHS guideline for EH profession- als that can be adopted or customized at the local level. The guideline should be devel- oped in consultation with EHPs and reviewed over time to ensure that it reflects EHP func- tions and emerging risks. Limitations Our study was conducted during the peak of the pandemic. Thus, some of the work- place risk exposures, risk perceptions, and OHS concerns expressed by EHPs might be directly or indirectly linked to circumstances brought about by the pandemic. Our study relied on self-reported exposure to hazards and symptoms of musculoskeletal discom- fort, fatigue, and stress due to work. Our study did not address the causes of OHS haz- ards among EHPs. Conclusion Our study indicates that there are significant workplace hazards associated with the EH workforce in the U.S. Some of the OHS con- cerns that emerged from our study are simi- lar to concerns observed in Australia. Bio- logical and chemical exposures appear to be important hazards, but an in-depth study is required to determine the nature and mecha- nism of these hazards within the EH work- force. Furthermore, our study suggests that the unprecedented COVID-19 pandemic had a significant impact on the health and safety of EHPs in terms of increased work demand, stress of potentially contracting the virus, and unforeseen hostility from some groups in the community. Corresponding Author: Garry Dine, School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, Perth, Western Australia, 6027, Australia. Email: y.dine@ecu.edu.au.
References
The American Institute of Stress. (2019, September 25). 42 worrying workplace stress statistics . https://www.stress.org/42-worrying- workplace-stress-statistics Andel, S.A., Tedone, A.M., Shen, W., & Arvan, M.L. (2021). Safety implications of diªerent forms of understang among nurses
during the COVID-19 pandemic. Journal of Advanced Nursing , 78 (1), 121–130. https://doi.org/10.1111/jan.14952 Attema, A.E., L’Haridon, O., Raude, J., Seror, V., & the COCONEL Group. (2021). Beliefs and risk perceptions about COVID-19: Evi- dence from two successive French representative surveys during
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Volume 86 • Number 6
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