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Since COVID-19, mpox was the first emerging pathogen to have spread globally in 2022. Wastewater-based surveillance (WBS) has proven to be an efficient early warning system for detecting potential resurgences. This report aims to provide insight into the development and implementation of WBS of mpox in Slovenia and to incorporate the surveillance results into the development of public health interventions. WBS of mpox was conducted during the period from 1 June 2023 to 30 September 2023 at the wastewater treatment plant (WWTP) Ljubljana and WWTP Koper. The selected detection method of the monkeypox virus (MPXV) in the wastewater sample was based on PCR analysis. The implemented laboratory method showed that the sample preparation and concentration method enables a stable procedure for MPXV detection in wastewater samples. The laboratory analysis of wastewater samples from the selected WWTPs did not detect the MPXV during the monitoring period. In the event of MPXV detection in a wastewater sample, targeted public health interventions would be implemented, focusing on increasing awareness among the groups of men who have sex with other men and searching for positive mpox cases. We recommend that the developed system be retained in the case of an emergency epidemiological situation.

Poor indoor air quality (IAQ) in schools is associated with pupils’ health and their learning performance. This study aims to provide an overview of the outdoor factors that affect the IAQ in educational settings in order to develop public health measures. We conducted a systematic literature review to investigate the outdoor factors that affect IAQ in educational settings. The selection of articles included 17,082 search string hits from the ScienceDirect database published between 2010 and 2023, with 92 relevant studies selected based on the inclusion and exclusion criteria. Based on a systematic review of the literature, we identified the following outdoor factors: proximity to busy roads, commercial and industrial establishments, meteorological conditions, compounds from the natural environment, emissions from heating buildings, atmospheric reactions and secondary pollutants, unpaved school playgrounds, and smoking. This study provides key information on the mentioned outdoor factors and gives recommendations on measures to reduce classroom pollutant concentrations while highlighting educational settings that require special attention. Our study shows that classroom IAQ is affected by many outdoor pollutant sources, the prevalence of which depends on the educational setting’s micro location. Therefore, it is essential to develop an appropriate classroom ventilation strategy for each educational setting.

With the reclassification of COVID-19 as an endemic disease and the relaxation of measures, Slovenia needed a complementary system for monitoring SARS-CoV-2 infections. This article provides an overview of the epidemiological situation of SARS-CoV-2 in Slovenia using a wastewater surveillance system, demonstrating its usefulness as a complementary tool in epidemiological surveillance. This study found that estimated SARS-CoV-2 infections in Slovenia peaked in September 2022 and showed a declining trend with subsequent lower peaks in March–April and December 2023, mirroring the trends observed from clinical data. Based on both surveillance systems, the most prevalent variant in 2022 was BA.5. By 2023, BQ.1 and other Omicron variants increased in prevalence. By the end of 2023, XBB sublineages and the BA.2.86 variant had become predominant, demonstrating consistent dynamic shifts in variant distribution across both monitoring methods. This study found that wastewater surveillance at wastewater treatment plants in Slovenia effectively tracked SARS-CoV-2 infection trends, showing a moderate to strong correlation with clinical data and providing early indications of changes in infection trends and variant emergence. Despite limitations during periods of low virus concentration, the system proved significant in providing early warnings of infection trends and variant emergence, thus enhancing public health response capabilities.

From a public health perspective, it is necessary to improve indoor air quality (IAQ) in schools. This study aims to assess the state of perceived IAQ in Slovenian school classrooms and its association with the selected IAQ factors to improve the understanding of perceived IAQ for designing public health interventions aimed to improve IAQ in schools. A national cross-sectional study was performed in all 454 Slovenian primary schools in the school year 2019/2020. The questionnaires were filled out by the 3rd-grade teachers with the support of the caretakers. Teachers rated the IAQ in the classroom as the worst in winter. We found that the teachers’ perceived IAQ in the classroom is statistically significantly associated with the micro location of the school and some of the IAQ factors. Poor IAQ is associated with reduced manual airing of classrooms due to the thermal comfort of the occupants. Interventions should be aimed at improving occupants’ adaptive behaviors to increase the frequency of natural ventilation in classrooms.

Poor indoor air quality (IAQ) in schools is associated with pupils' health and their learning performance. This study aims to provide an overview of the outdoor factors that affect the IAQ in educational settings in order to develop public health measures. We conducted a systematic literature review to investigate the outdoor factors that affect IAQ in educational settings. The selection of articles included 17,082 search string hits from the ScienceDirect database published between 2010 and 2023, with 92 relevant studies selected based on the inclusion and exclusion criteria. Based on a systematic review of the literature, we identified the following outdoor factors: proximity to busy roads, commercial and industrial establishments, meteorological conditions, compounds from the natural environment, emissions from heating buildings, atmospheric reactions and secondary pollutants, unpaved school playgrounds, and smoking. This study provides key information on the mentioned outdoor factors and gives recommendations on measures to reduce classroom pollutant concentrations while highlighting educational settings that require special attention. Our study shows that classroom IAQ is affected by many outdoor pollutant sources, the prevalence of which depends on the educational setting's micro location. Therefore, it is essential to develop an appropriate classroom ventilation strategy for each educational setting. [ABSTRACT FROM AUTHOR]

With the reclassification of COVID-19 as an endemic disease and the relaxation of measures, Slovenia needed a complementary system for monitoring SARS-CoV-2 infections. This article provides an overview of the epidemiological situation of SARS-CoV-2 in Slovenia using a wastewater surveillance system, demonstrating its usefulness as a complementary tool in epidemiological surveillance. This study found that estimated SARS-CoV-2 infections in Slovenia peaked in September 2022 and showed a declining trend with subsequent lower peaks in March–April and December 2023, mirroring the trends observed from clinical data. Based on both surveillance systems, the most prevalent variant in 2022 was BA.5. By 2023, BQ.1 and other Omicron variants increased in prevalence. By the end of 2023, XBB sublineages and the BA.2.86 variant had become predominant, demonstrating consistent dynamic shifts in variant distribution across both monitoring methods. This study found that wastewater surveillance at wastewater treatment plants in Slovenia effectively tracked SARS-CoV-2 infection trends, showing a moderate to strong correlation with clinical data and providing early indications of changes in infection trends and variant emergence. Despite limitations during periods of low virus concentration, the system proved significant in providing early warnings of infection trends and variant emergence, thus enhancing public health response capabilities. [ABSTRACT FROM AUTHOR]

Since COVID-19, mpox was the first emerging pathogen to have spread globally in 2022. Wastewater-based surveillance (WBS) has proven to be an efficient early warning system for detecting potential resurgences. This report aims to provide insight into the development and implementation of WBS of mpox in Slovenia and to incorporate the surveillance results into the development of public health interventions. WBS of mpox was conducted during the period from 1 June 2023 to 30 September 2023 at the wastewater treatment plant (WWTP) Ljubljana and WWTP Koper. The selected detection method of the monkeypox virus (MPXV) in the wastewater sample was based on PCR analysis. The implemented laboratory method showed that the sample preparation and concentration method enables a stable procedure for MPXV detection in wastewater samples. The laboratory analysis of wastewater samples from the selected WWTPs did not detect the MPXV during the monitoring period. In the event of MPXV detection in a wastewater sample, targeted public health interventions would be implemented, focusing on increasing awareness among the groups of men who have sex with other men and searching for positive mpox cases. We recommend that the developed system be retained in the case of an emergency epidemiological situation. [ABSTRACT FROM AUTHOR]

From a public health perspective, it is necessary to improve indoor air quality (IAQ) in schools. This study aims to assess the state of perceived IAQ in Slovenian school classrooms and its association with the selected IAQ factors to improve the understanding of perceived IAQ for designing public health interventions aimed to improve IAQ in schools. A national cross-sectional study was performed in all 454 Slovenian primary schools in the school year 2019/2020. The questionnaires were filled out by the 3rd-grade teachers with the support of the caretakers. Teachers rated the IAQ in the classroom as the worst in winter. We found that the teachers' perceived IAQ in the classroom is statistically significantly associated with the micro location of the school and some of the IAQ factors. Poor IAQ is associated with reduced manual airing of classrooms due to the thermal comfort of the occupants. Interventions should be aimed at improving occupants' adaptive behaviors to increase the frequency of natural ventilation in classrooms. [ABSTRACT FROM AUTHOR]

Poor indoor air quality (IAQ) in schools is associated with impacts on pupils' health and learning performance. We aimed to identify the factors that affect IAQ in primary schools. The following objectives were set: (a) to develop a questionnaire to assess the prevalence of factors in primary schools, (b) to conduct content validity of the questionnaire, and (c) to assess the prevalence of factors that affect the IAQ in Slovenian primary schools. Based on the systematic literature review, we developed a new questionnaire to identify factors that affect the IAQ in primary schools and conducted its validation. The questionnaires were sent to all 454 Slovenian primary schools; the response rate was 78.19%. The results show that the most important outdoor factors were the school's micro location and the distance from potential sources of pollution, particularly traffic. Among the indoor factors, we did not detect a pronounced dominating factor. Our study shows that the spatial location of schools is key to addressing the problem of IAQ in schools. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has negatively affected educational settings (ES) in Slovenia. To effectively limit the emergence and spread of SARS-CoV-2 infections in ES, it is important to identify the pathways of introduction and transmission of infection. This study aims to analyse the spread of infections in ES according to the level of education, taking into account the predominant variant of the virus in Slovenia in order to advise on public health action. We calculated the incidence rate of infection by age group, according to the level of the ES. Additionally, we analysed data on the reported outbreak criteria in ES. In Slovenia, SARS-CoV-2 infections in children and adolescents (1–18 years) accounted for 16.8% of all confirmed infections. The incidence and leading outbreak criteria differed according to the level of the ES and predominant SARS-CoV-2 variant. The occurrence of cases in ≥3 different "bubbles" was the most common outbreak criteria (59%). A high number of employee-imported outbreaks was observed in pre-school settings (44%). As countries move away from widespread nonpharmaceutical interventions, the focus should be on vaccination promotion among teaching staff in pre-school settings and systemic solutions, such as self-testing and ventilation, to enable safe educational environments. [ABSTRACT FROM AUTHOR]

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There is a lack of feeding-assessments tools for neurological patients in Slovenia. The purpose of the study was to explore the use of the McGill Ingestive Skills Assessment (MISA) in occupational therapy of patients with neurological impairments. Eighty-one adult patients were included in the study: 27 rehabilitation inpatients and 54 from a residential program for the elderly. Patients with dementia scored the lowest on average (56 % of the maximum possible score). Positioning received the lowest average score among feeding categories (48 %). The difference in the average score between the two patient groups was statistically significant, whereby rehabilitation inpatients scored higher on average by 15 %. Positioning was statistically significantly positively associated with other areas of feeding (ability to self-feed, ingestion of liquid and solid foods, texture management of liquid and solid foods). The patients' ability to eat independently therefore seems to be affected by their diagnosis as well as the type of health-care setting. Positioning appears to play a crucial role in achieving independence with feeding. The MISA is a promising assessment tool for neurological patients in Slovenia. [ABSTRACT FROM AUTHOR]

Ultrafine particles are outdoor air pollutants, the exposure to which is associated with morbidity and mortality for respiratory and cardiovascular diseases. The purpose of this study is to assess the temporal variability of ultrafine particle number concentrations in outdoor air and daily counts of deaths from respiratory diseases. Epidemiological ecological temporal variability study lasted 731 days. The observed population included residents of the Municipality of Ljubljana, who died of respiratory diseases in the observed period. Descriptive statistics was implemented. The highest daily counts of deaths from respiratory diseases in 2012 were in the periods February-April, May-June, and October. The next periods with the highest daily counts of deaths from respiratory diseases repeated again in the periods December 2012-April 2013, May-July 2013, and October 2013. These periods coincide with the periods of increased levels of ultrafine particle number concentrations. We concluded that there was a temporal variability association between the periods with higher daily counts of deaths from respiratory diseases and heightened levels, of ultrafine particle number concentrations. Research of the ultrafine particles' effect in outdoor air on public health is a new scientific field in public health, which because of its complexity needs an interdisciplinary approach. [ABSTRACT FROM AUTHOR]

Outdoor air pollution is an important determinant of health. Children are one of the most sensitive population groups due to their yet underdeveloped respiratory system. Methodology for linkage environmental and health data at population level had been initiated by the World Health Organization about twenty years ago. The aim of our study is an overview of methods with which the effects of outdoor air pollution on children's health have been investigated at the population level. Literature overview was made systematically. Health effects of outdoor air pollution at the population level were firstly investigated after 1990. Simultaneously with the most common outdoor air pollutants (NO2, SO2, O3, PM10 and CO) monitoring of health effects was measured. Poisson regression analysis was the most frequently used method of ecological timeseries studies and spatial studies. Exposure misclassification was in this research field the most common limitation of ecological studies. This study supports the need of future research on outdoor air pollution's effects on the at population level from an engineering and public health view. [ABSTRACT FROM AUTHOR]

Most children in early childhood spend approximately one third of the day in kindergartens. Therefore, it is essential that their stay in an educational institution is comfortable and without adverse health effects. Statistical data over the last decade show that the amount of enrolled children in kindergartens has increased. The problem of overcrowded kindergartens is usually solved by changing the existing norms for class sizes, or with alternative spaces that do not serve the original purpose. According to EU Directives, kindergartens are among building facilities that have to be renovated. The purpose of the paper was to analyse sanitary-technical and hygienic conditions of the selected playrooms of kindergartens and to define measures. Real-state conditions were evaluated in 35 playrooms of 16 kindergartens in the Central Slovenian region. The main emphasis was on the used materials, their cleaning capability, room acoustics, natural daylight, safety and comfort issues, as well on their possible adverse health effects. The combination of observation, measurements and calculations of reverberation time, and comparison with regulation demands was carried out. In many playrooms sanitary-technical and hygienic conditions did not fulfil regulation demands. Irregularities are mainly related to improper installation of final coverings, to low parapet heights and total opening area of windows, poor hygienic conditions, and selection of materials that may present health risks. Calculated and measured reverberation times deviated from optimal values. [ABSTRACT FROM AUTHOR]