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PubMed1996

Job strain among post office mailhandlers.

A sample of 4,018 U.S. Post Office mailhandlers nationwide completed a questionnaire assessing job demands, decision latitude, hazardous conditions, supervisory support, physical exertion, physical/psychological strain, sleeping problems, muscle strain, and job dissatisfaction. Scales were obtained from Karasek's Job Content Questionnaire. Comparative data were available from the U.S. Quality of Employment Surveys (for "mail carriers and handlers") and two samples of contemporary working populations. Hierarchical multiple regressions controlled for age, sex, education, length of postal service, Vietnam veteran status, and marital status. Mailhandlers reported significantly higher levels of negative job characteristics than both the national and contemporary samples, and their levels of job demands and decision latitude place them in the "high strain" quadrant of Karasek's model. Women not only reported higher strain, job dissatisfaction, and sleeping problems than men, but also higher levels of negative job characteristics. While other demographic variables, particularly Vietnam veteran status, were associated with stress-related outcomes, structural aspects of the work environment were more strongly associated with outcome. The authors conclude that postal mailhandlers face a highly stressful work environment.

Female↗
PubMed1990

Risk for occupational low-back injury after lumbar laminectomy for degenerative disc disease.

Thirty-two Postal Service applicants who had undergone laminectomies were classified as low risk for back injury after preplacement examinations and were subsequently hired for employment. Each was compared with six control subjects, who were matched by age, gender, date of hire, and job classification. The odds ratios for occupational back injury with 95% confidence intervals were 5.9 (1.9-18.8) overall and 9.1 (1.5-73.8) for letter carriers. Of subjects, 25% were injured, compared with 6% of controls. The median elapsed time between surgery and hire was 5.9 years for injured subjects and 6.8 years for uninjured subjects. A rank sum test comparing the elapsed times of the two groups was not significant (P = 0.30). Postal workers are at increased risk for back injury after laminectomy. The risk does not appear to decrease with increased time since surgery.

Adult↗
PubMed1995

Junk!

Each day, the US Postal Service delivers millions of pieces of unsolicited mail to our country's 500,000 physicians. This onslaught includes brochures for meetings in places both exotic and pedestrian, solicitations from financial institutions, newsletters, magazines, and elaborately packaged pharmaceutical promotions that may include such inducements as candy, flashlights, pens, and even golf tees! Our mailboxes groan under masses of unsolicited letters, periodicals, packets, brochures, booklets, and boxes.

Advertising↗
PubMed1997

A randomized trial of the impact of certified mail on response rate to a physician survey, and a cost-effectiveness analysis.

This study's goals were to (a) determine whether sending a survey by certified mail results in a higher response rate from physicians compared to sending by first-class mail and (b) evaluate the cost-effectiveness of this method. The study sample was 409 physicians who were nonrespondents to two previous mailings of a medical specialty society survey. Eligible physicians were designated at random to receive a final mailing either by U.S. Postal Service certified mail including a return-receipt postcard or by first-class mail. There was a higher response rate from the certified mail group compared with the first-class mail group (41.3% versus 24.8%; relative risk = 1.66, 95% Confidence interval 1.25, 2.21). A cost-effectiveness analysis showed that the cost per respondent was higher using certified mail versus first-class mail in the third mailing ($2.77 versus $2.34). Thus, use of certified mail is effective in increasing survey response but more costly.

Cost-Benefit Analysis↗
PubMed1978

Follow-up methods to trace women treated for pulmonary tuberculosis, 1930-1954.

A retrospective cohort study, designed to examine the relationship between multiple chest fluoroscopies and subsequent breast cancer risk, was conducted in which 93.6% of 1764 former sanatorium patients were successfully located. The methodology used to trace former female patients who were treated for pulmonary tuberculosis between 1930 and 1954 (20-45 years before the study began) is presented. Extensive use of city directories and telephone resulted in locating the majority of study subjects. Outpatient medical records and state vital statistics departments were also of value. Searching for death certificates of parents was helpful as the informant named on the certificate was often the woman being traced or her husband. The Postal Service was of limited use. No difference in the proportion of breast cancer cases was found between the more easily traced patients and the last 9.7% of patients who were difficult to locate. Fewer of the last patients located had died, however, than those located without intense effort. Patients lost to follow-up were younger at the time of sanatorium admission, had a higher proportion of Protestants and non-white women, had shorter lengths of hospitalization and had less severe tuberculosis requiring less aggressive treatment than patients located.

Adolescent↗
PubMed2005

Lytle S. Adams, DDS (1883-1970): Nonstop Airmail Pick-up inventor.

Between 1923 and 1940, a restless, optimistic, self-styled, inventor, Lytle S. Adams, DDS (1883-1970) was tirelessly working to develop a nonstop, airmail delivery and pick-up system. He believed that his invention would enable air postal services to serve those smaller, more isolated communities that would otherwise be bypassed due to economic and operational reasons. For 17 years, Adams vigorously promoted his pick-up system in both public and private arenas, and he even obtained congressional support for his ideas. However, he was unable to arrange for long-term, hardheaded financial and engineering support. Consequently, the once promising Adams Nonstop Airmail Pick-up System had only temporary and limited success. His endeavor, like others which came before and after, initially appeared to be a sound idea in search of inspired realization.

Aviation↗
PubMed2002

Symptoms associated with anthrax exposure: suspected "aborted" anthrax.

Anthrax is a naturally occurring organism with a low incidence of infection. There are no known cases of human-to-human transmission. Bioterrorism-related anthrax in the United States has been seen in three high-risk groups: (1) postal workers, (2) politicians and their staffs, and (3) the press. It appears as though the bioterrorism-related anthrax cases of fall 2001 have been transmitted through the US Postal Service. The authors present a case in which a person at high risk for anthrax exposure was inadequately treated and had symptoms that do not fall into any specific category of disease. It emphasizes the need for someone who has been started on prophylaxis for anthrax to complete a full 60-day course of treatment. It also shows the effectiveness of antibiotic therapy, even in those with high exposure to weaponized anthrax. Further, we would like to suggest that there may exist a new clinical entity of "aborted anthrax infection."

Adult↗
PubMed2003

Geocoding addresses from a large population-based study: lessons learned.

BACKGROUND: Geographic information systems (GIS) and spatial statistics are useful for exploring the relation between geographic location and health. The ultimate usefulness of GIS depends on both completeness and accuracy of geocoding (the process of assigning study participants' residences latitude/longitude coordinates that closely approximate their true locations, also known as address matching). The goal of this project was to develop an iterative geocoding process that would achieve a high match rate in a large population-based health study. METHODS: Data were from a study conducted in Wisconsin using mailing addresses of participants who were interviewed by telephone from 1988 to 1995. We standardized the addresses according to US Postal Service guidelines, used desktop GIS geocoding software and two versions of the Topologically Integrated Geographic Encoding and Referencing street maps, accessed Internet mapping engines for problematic addresses, and recontacted a small number of study participants' households. We also tabulated the project's cost, time commitment, software requirements, and brief notes for each step and their alternatives. RESULTS: Of the 14,804 participants, 97% were ultimately assigned latitude/longitude coordinates corresponding to their respective residences. The remaining 3% were geocoded to their zip code centroid. CONCLUSION: The multiple methods described in this work provide practical information for investigators who are considering the use of GIS in their population health research.

Data Collection↗
PubMed2006

Address-based versus random-digit-dial surveys: comparison of key health and risk indicators.

Use of random-digit dialing (RDD) for conducting health surveys is increasingly problematic because of declining participation rates and eroding frame coverage. Alternative survey modes and sampling frames may improve response rates and increase the validity of survey estimates. In a 2005 pilot study conducted in six states as part of the Behavioral Risk Factor Surveillance System, the authors administered a mail survey to selected household members sampled from addresses in a US Postal Service database. The authors compared estimates based on data from the completed mail surveys (n = 3,010) with those from the Behavioral Risk Factor Surveillance System telephone surveys (n = 18,780). The mail survey data appeared reasonably complete, and estimates based on data from the two survey modes were largely equivalent. Differences found, such as differences in the estimated prevalences of binge drinking (mail = 20.3%, telephone = 13.1%) or behaviors linked to human immunodeficiency virus transmission (mail = 7.1%, telephone = 4.2%), were consistent with previous research showing that, for questions about sensitive behaviors, self-administered surveys generally produce higher estimates than interviewer-administered surveys. The mail survey also provided access to cell-phone-only households and households without telephones, which cannot be reached by means of standard RDD surveys.

Adolescent↗
PubMed2006

Postal workers' occupational and leisure-time sun safety behaviors (United States).

OBJECTIVES: United States Postal Service letter carriers are exposed to long bouts of UVR and thus are vulnerable to skin cancer. While previous studies have shown that occupational sun protection is often deficient, few studies have examined outdoor workers' behavior during leisure time. METHODS: Subjects (n = 2,660) self-reported widebrim hat and sunscreen use over the past five workdays and past two non-working days using Likert-type scales. Generalized linear mixed models and generalized estimating equations were used to compare hat and sunscreen rates and predictors during occupational and leisure time. RESULTS: On average, carriers spent 3.9 h outside during workdays and 3.3 h during non-working days. Sunscreen and widebrim hat use during the workday is low and rates of use are significantly lower during non-working days. CONCLUSIONS: Sun safety interventions for carriers should encourage sun protection at all times when outdoors.

Adult↗
PubMed2002

Adherence to antimicrobial inhalational anthrax prophylaxis among postal workers, Washington, D.C., 2001.

In October 2001, two envelopes containing Bacillus anthracis spores were processed at the Washington, D.C., Processing and Distribution Center of the U.S. Postal Service; inhalational anthrax developed in four workers at this facility. More than 2,000 workers were advised to complete 60 days of postexposure prophylaxis to prevent inhalational anthrax. Interventions to promote adherence were carried out to support workers, and qualitative information was collected to evaluate our interventions. A quantitative survey was administered to a convenience sample of workers to assess factors influencing adherence. No anthrax infections developed in any workers involved in the interventions or interviews. Of 245 workers, 98 (40%) reported full adherence to prophylaxis, and 45 (18%) had completely discontinued it. Anxiety and experiencing adverse effects to prophylaxis, as well as being <45 years old were risk factors for discontinuing prophylaxis. Interventions, especially frequent visits by public health staff, proved effective in supporting adherence.

Adolescent↗
PubMed2002

Environmental sampling for spores of Bacillus anthracis.

On November 11, 2001, following the bioterrorism-related anthrax attacks, the U.S. Postal Service collected samples at the Southern Connecticut Processing and Distribution Center; all samples were negative for Bacillus anthracis. After a patient in Connecticut died from inhalational anthrax on November 19, the center was sampled again on November 21 and 25 by using dry and wet swabs. All samples were again negative for B. anthracis. On November 28, guided by information from epidemiologic investigation, we sampled the site extensively with wet wipes and surface vacuum sock samples (using HEPA vacuum). Of 212 samples, 6 (3%) were positive, including one from a highly contaminated sorter. Subsequently B. anthracis was also detected in mail-sorting bins used for the patient's carrier route. These results suggest cross-contaminated mail as a possible source of anthrax for the inhalational anthrax patient in Connecticut. In future such investigations, extensive sampling guided by epidemiologic data is imperative.

Anthrax↗
PubMed2005

Inactivation of Bacillus endospores in envelopes by electron beam irradiation.

The anthrax incidents in the United States in the fall of 2001 led to the use of electron beam (EB) processing to sanitize the mail for the U.S. Postal Service. This method of sanitization has prompted the need to further investigate the effect of EB irradiation on the destruction of Bacillus endospores. In this study, endospores of an anthrax surrogate, B. atrophaeus, were destroyed to demonstrate the efficacy of EB treatment of such biohazard spores. EB exposures were performed to determine (i) the inactivation of varying B. atrophaeus spore concentrations, (ii) a D10 value (dose required to reduce a population by 1 log10) for the B. atrophaeus spores, (iii) the effects of spore survival at the bottom of a standardized paper envelope stack, and (iv) the maximum temperature received by spores. A maximum temperature of 49.2 degrees C was reached at a lethal dose of approximately 40 kGy, which is a significantly lower temperature than that needed to kill spores by thermal effects alone. A D10 value of 1.53 kGy was determined for the species. A surface EB dose between 25 and 32 kGy produced the appropriate killing dose of EB between 11 and 16 kGy required to inactivate 8 log10 spores, when spore samples were placed at the bottom of a 5.5-cm stack of envelopes.

Anthrax↗
PubMed2003

Extraction and analysis of human nuclear and mitochondrial DNA from electron beam irradiated envelopes.

The United States Postal Service is considering methods such as electron beam irradiation to neutralize biological agents sent through the mail. While this is proven to reduce/eliminate pathogenic organisms, it may also degrade human genomic DNA and therefore hinder the ability to garner forensically informative genetic profiles. To determine the effects of electron beam irradiation on DNA typing, 16 white, standard letter-sized envelopes were licked. Half of the envelopes served as nonirradiated controls while the other half underwent irradiation at dosages sufficient to kill anthrax spores (29.3 and 51.6 kGy). Total cellular DNA was extracted from all envelopes; nuclear short tandem repeat loci, as well as the hypervariable region I from mitochondrial DNA, were amplified by means of the polymerase chain reaction. Short tandem repeat profiles and mitochondrial DNA sequence haplotypes were acquired on an ABI Prism 310 Genetic Analyzer platform. Analysis of data from irradiated samples revealed evidence of DNA degradation; however, the ability to construct full genetic profiles from both nuclear and mitochondrial DNA remained largely unaffected. The use of the polymerase chain reaction, coupled with florescent fragment analysis and mitochondrial DNA sequencing, should be considered to profile biological material from evidence enduring irradiation to inactivate infectious agents.

Complementarity Determining Regions↗
PubMed2003

Effects of electron-beam irradiation on buccal-cell DNA.

Buccal cells were collected from 29 participants, by use of mouthwash rinses, and were split into equal aliquots, with one aliquot irradiated by electron-beam (E-beam) irradiation equivalent to the sterilizing dosage used by the U.S. Postal Service and the other left untreated. Aliquots were extracted and tested for DNA yields (e.g., TaqMan assay for quantifying human genomic DNA), genomic integrity, and amplification-based analysis of genetic variants (e.g., single-nucleotide polymorphisms [SNPs] and single tandem repeats [STRs]). Irradiated aliquots had lower median DNA yields (3.7 microg/aliquot) than untreated aliquots (7.6 microg/aliquot) (P<.0005) and were more likely to have smaller maximum DNA fragment size, on the basis of genomic integrity gels, than untreated aliquots (P<.0005). Irradiated aliquots showed poorer PCR amplification of a 989-bp beta-globin target (97% for weak amplification and 3% for no amplification) than untreated aliquots (7% for weak amplification and 0% for no amplification) (P<.0005), but 536-bp and 268-bp beta-globin targets were amplified from all aliquots. There was no detectable irradiation effect on SNP assays, but there was a significant trend for decreased detection of longer STRs (P=.01) in irradiated versus untreated aliquots. We conclude that E-beam irradiation reduced the yield and quality of buccal-cell specimens, and, although irradiated buccal-cell specimens may retain sufficient DNA integrity for some amplified analyses of many common genomic targets, assays that target longer DNA fragments (>989 bp) or require whole-genome amplification may be compromised.

Bioterrorism↗
PubMed2005

Stability of salivary concentrations of the newer antiepileptic drugs in the postal system.

Saliva antiepileptic drug (AED) concentrations strongly correlate with serum concentrations. Saliva collection is painless and noninvasive, and untrained personnel can easily be taught the collection process. Remote patients could mail saliva samples to a laboratory for monitoring, and samples could be obtained in the immediate postictal state to provide a "real-time" concentration. The objectives of this study were to assess the stability of saliva lamotrigine (LMT), levetiracetam (LEV), oxcarbazepine (OXC), topiramate (TPM), and zonsiamide (ZNS) concentrations sent through the United States Postal Service (USPS) and to quantify the amount of time needed for patients and the USPS to return samples to clinic. Saliva samples were obtained from patients currently taking 1 of the targeted AEDs. Samples were split into 2 storage vials. One sample was sealed in an addressed envelope, which the patient mailed from home, whereas the other sample was frozen immediately. Postmark date and day returned were collected for mailed samples. Saliva concentrations were determined using HPLC. Wilcoxon rank sum tests were used to compare the immediately-frozen and mailed sample means. Correlations were determined by the Spearman test. Thirty-seven patients were enrolled in the study. The median time between collection and postmark was 1 day (range 0-6 days); and between collection and receipt was 4 days (range 1-160 days). The mean concentrations for mailed and immediately frozen samples were similar for each AED (P > 0.15). Spearman rank order correlations between mailed and immediately frozen aliquots were strong (LMT rs = 1, LEV rs = 1, OXC rs = 0.964, TPM rs = 0.90, and ZNS rs = 1). Saliva samples mailed by patients maintain stability and can be returned in a reasonable length of time. Further studies are needed to assess patient/caretaker capability of obtaining an adequate sample.

Adolescent↗
PubMed2005

In their own words: lessons learned from those exposed to anthrax.

OBJECTIVES: We evaluated perceptions of workers at the US Postal Service Brentwood Processing and Distribution Center and US Senate employees regarding public health responses to the anthrax mailings of October 2001. We generated recommendations for improving responses to bioterrorism on the basis of the perceptions we recorded. METHODS: Transcripts from focus groups conducted with Brentwood and US Senate employees were examined, and qualitative analysis identified common domains. RESULTS: Brentwood focus groups consisted of 36 participants (97% African American and 19% hearing impaired). US Senate focus groups consisted of 7 participants (71% White and 0% hearing impaired). The focus groups revealed that participants' trust in public health agencies had eroded and that this erosion could threaten the effectiveness of communication during future public health emergencies. Among Brentwood participants, lack of trust involved the perception that unfair treatment on the basis of race/ethnicity and socioeconomic status had occurred; among US Senate participants, it derived from perceptions of inconsistent and disorganized messages. CONCLUSIONS: Effective communication during a public health emergency depends on the provision of clear messages and close involvement of the affected community. Diverse populations may require individualized approaches to ensure that messages are delivered appropriately. Special attention should be given to those who face barriers to traditional modes of communication.

Black or African American↗
PubMed2005

Back where we belong.

If you were the CEO of Pitney Bowes, the postage meter maker, how would you envision the future of the business? The company has an undeniable core competence in the solutions it provides to high-volume postal service users. But with snail mail on the decline, some would say that core has about as much future as the buggy whip. In this article, Pitney Bowes chairman and CEO Michael Critelli gives us a glimpse of how he leads his company's strategy development--and how that development has supported a counterintuitive return to the company's core after decades of diversification. He and others in the company begin the process by tapping into deeply knowledgeable people and organizations to understand key trends in the business and the rate at which change is occurring. Then, it's a question of the firm reshaping the environment in which it does business, whether through R&D investments or work with regulators and policy makers who influence market forces; this is especially important in emerging markets. Focusing on a core business area enables a company to find adjacent high-margin opportunities and to offer comprehensive solutions to customers. What stands out most sharply in this account, however, is the importance of having a strategist's mind-set. Whether Critelli is reading the day's news, visiting a key account, or spending an hour with his own people working in the context of a customer mail room, he is constantly extrapolating possible long-term competitive implications from the immediate facts. Often inspired by strategic thinkers, Critelli believes that the greatest thing he can do for his organization is to shift the terms of the debate. "Rarely am I credited with sterling words or bold, symbolic actions", he writes. "Instead, I help people to see the business we are in differently and to reach a shared vision as to where we want to end up. And, little by little, things move in the right direction".

Administrative Personnel↗