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Tropospheric ozone is an air pollutant that poses a public health problem in Europe. Climate change could increase the formation of ozone. Applying past and predicted annual total (all-cause) mortality data and modeled daily ozone concentrations, we performed a nationwide health impact assessment estimating annual ozone-related (attributable) deaths in Austria. Different approaches were compared. Estimates were based on maximal 1-h averages of ozone. Until the decade from 2045 till 2055, more people will die in Austria because of the demographic trends. Therefore, more deaths will also be attributable to ozone. Higher greenhouse gas emission scenarios (e.g. Representative Concentration Pathway RCP8.5 compared to RCP2.6) will lead to more ozone-related deaths, mostly due to the national emission of ozone precursors (a difference of 250-340 cases per year, depending on the model), but to a lesser extent because of global climate change. Increases in attributable deaths will be affected mostly by national, not global mitigation measures. National emission reduction will certainly have a strong and beneficial effect on local atmospheric chemistry, air quality, and public health., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Public Health Association.)

Epidemiological studies indicate that electromagnetic fields (EMF) are associated with cancer in humans. Exposure to mobile phone specific high frequency fields (HF-EMF) may lead to increased glioma risks, while low frequency radiation (LF-EMF) is associated with childhood leukemia. We studied the impact of HF-EMF (1950 MHz, UMTS signal) on DNA stability in an astrocytoma cell line (1321N1), and the effect of LF-EMF (50 Hz) in human derived lymphoma (Jurkat) cells. To find out if these fields affect chemically induced DNA damage, co-exposure experiments were performed. The cells were exposed to HF-EMF or LF-EMF and treated simultaneously and sequentially with mutagens. The compounds cause DNA damage via different molecular mechanisms, i.e. pyrimidine dimers which are characteristic for UV light (4-nitroquinoline 1-oxide, 4NQO), bulky base adducts (benzo[a]pyrene diolepoxide, BPDE), DNA-DNA and DNA-protein cross links and oxidative damage (NiCl 2 , CrO 3 ). DNA damage was measured in single cell gel electrophoresis (comet) assays. We found a moderate reduction of basal and 4NQO-induced DNA damage in the astrocytoma line, but no significant alterations of chemically induced DNA migration by the HF and LF fields under all other experimental series. The biological consequences of the moderate reduction remain unclear, but our findings indicate that acute mobile phone and power line specific EMF exposures do not enhance genotoxic effects caused by occupationally relevant chemical exposures., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Hans-Peter Hutter reports financial support was provided by Allgemeine Unfallversicherungsanstalt (AUVA). If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Several human studies indicate that mobile phone specific electromagnetic fields may cause cancer in humans but the underlying molecular mechanisms are currently not known. Studies concerning chromosomal damage (which is causally related to cancer induction) are controversial and those addressing this issue in mobile phone users are based on the use of questionnaires to assess the exposure. We realized the first human intervention trial in which chromosomal damage and acute toxic effects were studied under controlled conditions. The participants were exposed via headsets at one randomly assigned side of the head to low and high doses of a UMTS signal (n = 20, to 0.1 W/kg and n = 21 to 1.6 W/kg Specific Absorption Rate) for 2 h on 5 consecutive days. Before and three weeks after the exposure, buccal cells were collected from both cheeks and micronuclei (MN, which are formed as a consequence of structural and numerical chromosomal aberrations) and other nuclear anomalies reflecting mitotic disturbance and acute cytotoxic effects were scored. We found no evidence for induction of MN and of nuclear buds which are caused by gene amplifications, but a significant increase of binucleated cells which are formed as a consequence of disturbed cell divisions, and of karyolitic cells, which are indicative for cell death. No such effects were seen in cells from the less exposed side. Our findings indicate that mobile phone specific high frequency electromagnetic fields do not cause acute chromosomal damage in oral mucosa cells under the present experimental conditions. However, we found clear evidence for disturbance of the cell cycle and cytotoxicity. These effects may play a causal role in the induction of adverse long term health effects in humans., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: S. Knasmueller reports financial support was provided by Allgemeine Unfallversicherungsanstalt (AUVA) Austria. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Micro- and nanoplastics are omnipresent not only in the environment, but have also been detected in human body fluids and tissue. The subsequent commentary provides a perspective about potential risks for human health as well as resulting challenges for medical science., (© 2024. The Author(s).)

In this paper, we propose a novel deep neural model for Mathematical Expression Recognition (MER). The proposed model uses encoder-decoder transformer architecture that is supported by additional pre/post-processing modules, to recognize the image of mathematical formula and convert it to a well-formed language. A novel pre-processing module based on domain prior knowledge is proposed to generate random pads around the formula's image to create more efficient feature maps and keeps all the encoder neurons active during the training process. Also, a new post-processing module is developed which uses a sliding window to extract additional position-based information from the feature map, that is proved to be useful in the recognition process. The recurrent decoder module uses the combination of feature maps and the additional position-based information, which takes advantage of a soft attention mechanism, to extract the formula context into the LaTeX well-formed language. Finally, a novel Reinforcement Learning (RL) module processes the decoder output and tunes its results by sending proper feedbacks to the previous steps. The experimental results on im2latex-100k benchmark dataset indicate that each devised pre/post-processing as well as the RL refinement module has a positive effect on the performance of the proposed model. The results also demonstrate the higher accuracy of the proposed model compared to the state-of-the-art methods., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

The aim of this study was to investigate if age and body mass of humans have an impact on the DNA-damaging properties of high-frequency mobile phone-specific electromagnetic fields (HF-EMF, 1950 MHz, universal mobile telecommunications system, UMTS signal) and if this form of radiation has an impact on the genotoxic effects of occupationally relevant exposures. Pooled peripheral blood mononuclear cells (PBMC) from three groups [young normal weight, young obese (YO), and older age normal weight individuals] were exposed to different doses of HF-EMF (0.25, 0.5, and 1.0 W/kg specific absorption rate-SAR) and simultaneously or sequentially to different chemicals which cause DNA damage (CrO3, NiCl2, benzo[a]pyrene diol epoxide-BPDE, and 4-nitroquinoline 1-oxide-4NQO) via different molecular mechanisms. We found no difference in regard to the background values in the three groups but a significant increase of DNA damage (81% without and 36% with serum) in cells from old participants after radiation with 1.0 W/kg SAR 16 h. In combined treatment experiments we found no impact of the UMTS signal on chemically induced DNA damage in the different groups in general. However, a moderate decrease of DNA damage was seen in simultaneous treatment experiments with BPDE and 1.0 W/kg SAR in the YO group (decline 18%). Taken together our findings indicate that HF-EMF cause DNA damage in PBMC from older subjects (69.1 years). Furthermore, they show that the radiation does not increase induction of DNA damage by occupationally relevant chemicals., (© The Author(s) 2023. Published by Oxford University Press on behalf of the UK Environmental Mutagen Society.)

Climate change is a threat to health and social security of billions of people. Health and quality of life are increasingly affected in many ways due to the climate crisis. Rising global temperatures are resulting in increasingly frequent and severe extreme weather events, contributing to further increase in inequality, discrimination, and injustice overall and in health care specifically. Furthermore, climatic conditions are also becoming increasingly suitable for the transmission of infectious diseases and their spread into new regions. Socio-economically disadvantaged regions with weak health infrastructure (e.g. Global South) will be hardly able to cope without specific support. The overriding imperative is to achieve reductions in greenhouse gas emissions from transport, energy and food production at global, national and regional levels to mitigate negative health impacts. The 2015 Paris Agreement must also be seen as crucial health agreement. Our paper aims to highlight ethical aspects of climate change in the health sector., (© 2022. The Author(s).)

To better understand the influence of land use and meteorological parameters on air pollutants, we deployed passive air samplers in 15 regions with different land use in eastern Austria. The samplers consisted of polyurethane PUF and polyester PEF filter matrices, which were analyzed for 566 substances by gas-chromatography/mass-spectrometry. In a previous article, we highlighted a widespread contamination of ambient air with pesticides that depends on the surrounding land use and meteorological parameters. Here we report that, in addition to agricultural pesticides, eight other substances were frequently detected in ambient air: Nitrapyrin, a nitrification inhibitor used to increase nitrogen use efficiency of fertilizers and banned in Austria since 1993; biocides against insects (DEET and transfluthrin) used mainly outside agriculture; piperonyl butoxide (PBO), a synergist mixed into pesticide formulations; and four industrially used polychlorinated biphenyls (PCBs), long banned worldwide. Concentrations of the detected substances were positively related to air temperature, but only slightly related to agricultural land use in the sampler's vicinity. The city center showed the highest concentrations of biocides, PCBs and PBO, but also medium concentrations of nitrapyrin. Four sites had no air contamination with these substances; including two national parks dominated by grassland or forest, but also two sites with mixed land use. The potential human toxicity of the detected substances based on globally harmonized hazard classifications was high: seven substances had specific organ toxicity, six were cancerogenic, and two were acutely toxic; however, several substances had incomplete information of hazard profiles. Moreover, all substances were acutely and chronically toxic to aquatic life. We recommend that substances of different origins be included in the air pollution monitoring portfolio to comprehensively assess the potential hazards to humans and the environment., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Kruse, Schlechtriemen, Gruber reports financial support was provided by Verein zur Förderung einer enkeltauglichen Umwelt in Österreich., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)

Little is known about (i) how numbers and concentrations of airborne pesticide residues are influenced by land use, interactions with meteorological parameters, or by substance-specific chemo-physical properties, and (ii) what potential toxicological hazards this could pose to non-target organisms including humans. We installed passive air samplers (polyurethane PUF and polyester PEF filter matrices) in 15 regions with different land uses in eastern Austria for up to 8 months. Samples were analyzed for 566 substances by gas-chromatography/mass-spectrometry. We analyzed relationships between frequency and concentrations of pesticides, land use, meteorological parameters, substance properties, and season. We found totally 67 pesticide active ingredients (24 herbicides, 30 fungicides, 13 insecticides) with 10-53 pesticides per site. Herbicides metolachlor, pendimethalin, prosulfocarb, terbuthylazine, and the fungicide HCB were found in all PUF samplers, and glyphosate in all PEF samplers; chlorpyrifos-ethyl was the most abundant insecticide found in 93% of the samplers. Highest concentrations showed the herbicide prosulfocarb (725 ± 1218 ng sample -1 ), the fungicide folpet (412 ± 465 ng sample -1 ), and the insecticide chlorpyrifos-ethyl (110 ± 98 ng sample -1 ). Pesticide numbers and concentrations increased with increasing proportions of arable land in the surroundings. However, pesticides were also found in two National Parks (10 and 33 pesticides) or a city center (17 pesticides). Pesticide numbers and concentrations changed between seasons and correlated with land use, temperature, radiation, and wind, but were unaffected by substance volatility. Potential ecotoxicological exposure of mammals, birds, earthworms, fish, and honeybees increased with increasing pesticide numbers and concentrations. Human toxicity potential of detected pesticides was high, with averaged 54% being acutely toxic, 39% reproduction toxic, 24% cancerogenic, and 10% endocrine disrupting. This widespread pesticide air pollution indicates that current environmental risk assessments, field application techniques, protective measures, and regulations are inadequate to protect the environment and humans from potentially harmful exposure., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)

In recent decades, the possibility that use of mobile communicating devices, particularly wireless (mobile and cordless) phones, may increase brain tumour risk, has been a concern, particularly given the considerable increase in their use by young people. MOBI-Kids, a 14-country (Australia, Austria, Canada, France, Germany, Greece, India, Israel, Italy, Japan, Korea, the Netherlands, New Zealand, Spain) case-control study, was conducted to evaluate whether wireless phone use (and particularly resulting exposure to radiofrequency (RF) and extremely low frequency (ELF) electromagnetic fields (EMF)) increases risk of brain tumours in young people. Between 2010 and 2015, the study recruited 899 people with brain tumours aged 10 to 24 years old and 1,910 controls (operated for appendicitis) matched to the cases on date of diagnosis, study region and age. Participation rates were 72% for cases and 54% for controls. The mean ages of cases and controls were 16.5 and 16.6 years, respectively; 57% were males. The vast majority of study participants were wireless phones users, even in the youngest age group, and the study included substantial numbers of long-term (over 10 years) users: 22% overall, 51% in the 20-24-year-olds. Most tumours were of the neuroepithelial type (NBT; n = 671), mainly glioma. The odds ratios (OR) of NBT appeared to decrease with increasing time since start of use of wireless phones, cumulative number of calls and cumulative call time, particularly in the 15-19 years old age group. A decreasing trend in ORs was also observed with increasing estimated cumulative RF specific energy and ELF induced current density at the location of the tumour. Further analyses suggest that the large number of ORs below 1 in this study is unlikely to represent an unknown causal preventive effect of mobile phone exposure: they can be at least partially explained by differential recall by proxies and prodromal symptoms affecting phone use before diagnosis of the cases. We cannot rule out, however, residual confounding from sources we did not measure. Overall, our study provides no evidence of a causal association between wireless phone use and brain tumours in young people. However, the sources of bias summarised above prevent us from ruling out a small increased risk., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

We performed a time series analysis in Vienna, Austria, investigating the temporal association between daily air pollution (nitrogen dioxide, NO 2 and particulate matter smaller than 10 µm, PM10) concentration and risk of coronavirus disease 2019 (COVID-19) infection and death. Data covering about 2 months (March-April 2020) were retrieved from public databases. Infection risk was defined as the ratio between infected and infectious. In a separate sensitivity analysis different models were applied to estimate the number of infectious people per day. The impact of air pollution was assessed through a linear regression on the natural logarithm of infection risk. Risk of COVID-19 mortality was estimated by Poisson regression. Both pollutants were positively correlated with the risk of infection with the coefficient for NO 2 being 0.032 and for PM10 0.014. That association was significant for the irritant gas (p = 0.012) but not for particles (p = 0.22). Pollutants did not affect COVID-19-related mortality. The study findings might have wider implications on an interaction between air pollution and infectious agents., (© 2021. The Author(s).)

Nowadays "microplastics" (MPs) is an already well-known term and results of micro-sized particles found in consumer products or environments are regularly reported. However, studies of native MPs smaller than 1 μm, often referred to as nanoplastics (NPs), in analytically challenging environments are rare. In this study, a correlative approach between scanning electron microscopy and Raman microscopy is tested to meet the challenges of finding and identifying NPs in the 100 nm range in various environments, ranging from ideal (distilled water) to challenging (sea salt, human amniotic fluid). To test the viability of this approach in principle, standardized polystyrene beads (Ø 200 nm) are mixed into the various environments in different concentrations. Promising detection limits of 2 10 -3 μg/L (distilled water), 20 μg/L (sea salt) and 200 μg/L (human amniotic fluid) are found. To test the approach in practices both sea salt and amniotic fluid are analysed for native NPs as well. Interestingly a nylon-NP was found in the amniotic fluid, maybe originating from the sampling device. However, the practical test reveals limitations, especially with regard to the reliable identification of unknown NPs by Raman microscopy, due to strong background signals from the environments. We conclude from this in combination with the excellent performance in distilled water that a combination of this approach with an advanced sample preparation technique would yield a powerful tool for the analysis of NPs in various environments., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Conventional banana farming is pesticide-intensive and leads to high exposure of farmworkers. Ecuador is the world's biggest exporter of bananas. In this field study in 5 communities in Ecuador, we recorded potentially pesticide-associated subjective health symptoms in farmworkers and compared pesticide users to workers in organic farming. With one exception, symptom rates were always higher in the pesticide-exposed group. Significance was reached in 8 out of 19 investigated symptoms with the highest odds ratios (and smallest p -values) for local irritation like skin and eye irritation (OR = 3.58, CI 1.10-11.71, and 4.10, CI 1.37-12.31, respectively) as well as systemic symptoms like dizziness (OR = 4.80, CI 1.55-14.87) and fatigue (OR = 4.96, CI 1.65-14.88). Moreover, gastrointestinal symptoms were reported more frequently by pesticide users: nausea (OR = 7.5, CI 1.77-31.77) and diarrhea (OR = 6.43, CI 1.06-30.00). The majority of farmworkers were not adequately protected from pesticide exposure. For example, only 3 of 31 farmworkers that had used pesticides recently reported using gloves and only 6 reported using masks during active spraying. Improved safety measures and a reduction in pesticide use are necessary to protect the health of banana farmworkers.

We determined the impact of air pollution on COVID-19-related mortality and reported-case incidence, analyzing the correlation of infection case numbers and outcomes with previous-year air pollution data from the populations of 23 Viennese districts. Time at risk started in a district when the first COVID-19 case was diagnosed. High exposure levels were defined as living in a district with an average (year 2019) concentration of nitrogen dioxide (NO 2 ) and/or particulate matter (PM10) higher than the upper quartile (30 and 20 µg/m 3 , respectively) of all districts. The total population of the individual districts was followed until diagnosis of or death from COVID-19, or until 21 April 2020, whichever came first. Cox proportional hazard regression was performed after controlling for percentage of population aged 65 and more, percentage of foreigners and of persons with a university degree, unemployment rate, and population density. PM10 and NO 2 were significantly and positively associated with the risk of a COVID-19 diagnosis (hazard ratio (HR) = 1.44 and 1.16, respectively). NO 2 was also significantly associated with death from COVID-19 (HR = 1.72). Even within a single city, higher levels of air pollution are associated with an adverse impact on COVID-19 risk.

Air pollution is a threat to the general population, especially to pollen allergy sufferers in urban environments. Different air quality parameters have hitherto been examined which add to the burden of pollen allergy sufferers. Parameters such as NO 2 , SO 2 , PM 10 , PM 2.5 , and O 3 are supposed to have additional impact, not only on health in general (increase in asthma, allergy sensitization frequency), but also on pollen grains (increase of allergenicity). However, it remains unknown if those air quality parameters increase symptom severity during the pollen season. We selected the birch, grass, and ragweed pollen seasons as different time periods throughout the year and analyzed the relationship of symptom data to pollen, air quality, and meteorological data (temperature, relative humidity) for the metropolis of Vienna (Austria). A linear regression model was computed based on different symptom data, and both pollen and air quality data were tested simultaneously. Ozone was positively and significantly associated with symptom scores in all three seasons, whereas this was only rarely the case with other pollutants. Therefore, only ozone was selected for further analysis in a model including meteorological parameters. In this model, effect estimates of ozone were attenuated but remained significant for the grass pollen season. The lack of significance in the other seasons may be attributed to the less numerous symptom data entries and the shorter duration of the pollen seasons for birch and ragweed. All other air quality parameters usually showed lower concentrations during the pollen seasons and displayed little variation. This might explain the lack of a clear signal. Our results suggest that today's allergic population is already affected by air quality (rising O 3 levels). Air quality should be considered as well in pollen information and pollen allergy studies in general because of its increasing importance in the light of global warming., Competing Interests: Declaration of competing interest No conflicts of interest are reported., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Exposure to perfluoroalkyl substances (PFAS) was found to be associated with several pathological endpoints, including high cholesterol levels, specific defective functions of the immune system and reduced birth weight. While environmental PFAS have been recognized as threats for public health, surprisingly little is known about the underlying mechanisms of toxicity. We hypothesized that some of the observed vascular and developmental effects of environmental PFAS may share a common molecular pathway. At elevated levels of exposure to PFAS, a reduction in mean birth weight of newborns has been observed in combination with a high incidence rate of preeclampsia. As both, preeclampsia and reduced birth weight are consequences of an inadequate placental vascularization, we hypothesized that the adaptation of placental vasculature may get compromised by PFAS. We analyzed pseudo-vascular network formation and protein expression in the HTR8/SVneo cell line, an embryonic trophoblast cell type that is able to form vessel-like vascular networks in 3D-matrices, similar to endothelial cells. PFOA (perfluoroctanoic acid), but not PFOS (perfuoroctanesulfonic acid), induced morphological changes in the vascular 3D-network structure, without indications of compromised cellular viability. Incubation with PFOA reduced cellular sprouting and elongated isolated stalks in pseudo-vascular networks, while a γ-secretase inhibitor BMS-906024 induced directional opposite effects. We found a PFOA-induced increase in NOTCH intracellular domain (NICD) abundance in HTR8/SVneo, indicating that PFOA enhances NOTCH-signaling in this cell type. Enhancement of NOTCH-pathway by PFOA may be a key to understand the mode of action of PFAS, as this pathway is critically involved in many confirmed physiological/toxicological symptoms associated with PFAS exposure., (Copyright © 2020 The Authors. Published by Elsevier GmbH.. All rights reserved.)

In epidemiological studies, both spatial and temporal variations in nitrogen dioxide (NO 2 ) are a robust predictor of health risks. Compared to particulate matter, the experimental evidence for harmful effects at typical ambient concentrations is less extensive and not as clear for NO 2 . In the wake of the "Diesel emission scandal-Dieselgate", the scientific basis of current limit values for ambient NO 2 concentrations was attacked by industry lobbyists. It was argued that associations between NO 2 levels and medical endpoints were not causal, as NO 2 in older studies served as a proxy for aggressive particulate matter from incineration processes. With the introduction of particle filters in diesel cars, NO 2 would have lost its meaning as a health indicator. Austria has a high percentage of diesel-powered cars (56%). If, indeed, associations between NO 2 concentrations and health risks in previous studies were only due to older engines without a particle filter, we should expect a reduction in effect estimates over time as an increasing number of diesel cars on the roads were outfitted with particle filters. In previous time series studies from Vienna over shorter time intervals, we have demonstrated distributed lag effects over days up to two weeks and previous day effects of NO 2 on total mortality. In a simplified model, we now assess the effect estimates for moving 5-year periods from the beginning of NO 2 monitoring in Vienna (1987) until the year 2018 of same and previous day NO 2 on total daily mortality. Contrary to industry claims of a spurious, no longer valid indicator function of NO 2 , effect estimates remained fairly stable, indicating an increase in total mortality of previous day NO 2 by 0.52% (95% CI: 0.35-0.7%) per 10 µg/m 3 change in NO 2 concentration.

COVID-19 is an infectious disease caused by a novel coronavirus, which first appeared in China in late 2019, and reached pandemic distribution in early 2020. The first major outbreak in Europe occurred in Northern Italy where it spread to neighboring countries, notably to Austria, where skiing resorts served as a main transmission hub. Soon, the Austrian government introduced strict measures to curb the spread of the virus. Using publicly available data, we assessed the efficiency of the governmental measures. We assumed an average incubation period of one week and an average duration of infectivity of 10 days. One week after the introduction of strict measures, the increase in daily new cases was reversed, and the reproduction number dropped. The crude estimates tended to overestimate the reproduction rate in the early phase. Publicly available data provide a first estimate about the effectiveness of public health measures. However, more data are needed for an unbiased assessment., Competing Interests: The authors declare no conflict of interest.

A previously presented study investigated the impact of recent pesticide exposure on cytological signs of genotoxicity and on symptoms of intoxication in 71 male coffee workers in the Dominican Republic. An unexpected finding of this study was that conventional farming workers, among other symptoms, reported fewer children than controls working in organic farms without pesticide use. This study set out to investigate possible reasons for the latter difference. One statistical problem of this analysis is that the age of the workers is a strong predictor for the number of children and available data on the exposure determinants "duration of pesticide exposure" as well as "age at first pesticide exposure" are correlated with age. To correctly control statistics for these confounding parameters, different approaches to best control for age were explored. After careful elimination of the age-related confounding factors, a reduced number of children was still observed in exposed workers. The clearest effect is seen in those workers that reported first exposure before the age of 20 years. Socioeconomic factors could still confound that finding, but a direct effect of early life pesticide exposure is the most likely explanation of the observation.

Introduction: We used data from MOBI-Kids, a 14-country international collaborative case-control study of brain tumors (BTs), to study clinical characteristics of the tumors in older children (10 years or older), adolescents and young adults (up to the age of 24)., Methods: Information from clinical records was obtained for 899 BT cases, including signs and symptoms, symptom onset, diagnosis date, tumor type and location., Results: Overall, 64% of all tumors were low-grade, 76% were neuroepithelial tumors and 62% gliomas. There were more males than females among neuroepithelial and embryonal tumor cases, but more females with meningeal tumors. The most frequent locations were cerebellum (22%) and frontal (16%) lobe. The most frequent symptom was headaches (60%), overall, as well as for gliomas, embryonal and 'non-neuroepithelial' tumors; it was convulsions/seizures for neuroepithelial tumors other than glioma, and visual signs and symptoms for meningiomas. A cluster analysis showed that headaches and nausea/vomiting was the only combination of symptoms that exceeded a cutoff of 50%, with a joint occurrence of 67%. Overall, the median time from first symptom to diagnosis was 1.42 months (IQR 0.53-4.80); it exceeded 1 year in 12% of cases, though no particular symptom was associated with exceptionally long or short delays., Conclusions: This is the largest clinical epidemiology study of BT in young people conducted so far. Many signs and symptoms were identified, dominated by headaches and nausea/vomiting. Diagnosis was generally rapid but in 12% diagnostic delay exceeded 1 year with none of the symptoms been associated with a distinctly long time until diagnosis.

Banana farming represents an important segment of agricultural production in Ecuador. The health of farmworkers might be compromised by the extensive use of pesticides in plantations applied under poorly regulated conditions. Due to an increased awareness of pesticide-related problems for nature, as well as for worker and consumer health, ecological farming has been established in some plantations of Ecuador. We set out to investigate the occupational health of workers in both conventional and ecological farming. Nuclear anomalies in buccal epithelial cells were used as short-term indicators for genotoxicity and a potentially increased cancer risk in the two groups of farmworkers. By application of the Buccal Micronucleus Cytome Assay (BMCA), we found the frequency of micronuclei in conventional pesticide using farmworkers significantly increased by 2.6-fold, and other nuclear anomalies significantly increased by 24% to 80% (except pyknosis with a non-significant increase of 11%) compared to the farmworkers on ecological plantations. These results demonstrate that ecological farming may provide an alternative to extensive pesticide use with significantly reduced indicators of cancer risk. In conventional farming, improvements in education and instruction regarding the safe handling of pesticides and protective equipment, as well as regulatory measures, are urgently needed.

Aim: The aim of the survey was to obtain a rough estimate of the number and type of reported violations of children's rights in the health care system, as well as an expert evaluation of the problem by the responsible institutions., Methods: A written survey of all Austrian Ombudsman offices for Children and Youth (OCYs) and Patient Advocacy offices (PAs) asked for the number and type of potential violations of children's rights and their significance., Results: Both institutions are consulted very rarely regarding children's rights in health care. OCYs report a higher awareness about children's rights, even though health care issues are legally incorporated in the PA offices. PAs report incoming complaints regarding children's health care even less often. Cooperation between the 2 institutions is insufficient. Participation rights/consent issues and health care service deficiencies have been identified as the main children's rights problems., Conclusions: The low number of reported complaints as well the available literature indicates an insufficient awareness of supporting services and institutions for children's rights in health care in Austria. There is room for improvement in this area with more intensive cooperation between the responsible institutions, remediation of deficiencies in care, improved communication, and training and further education of personnel., Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht., (Eigentümer und Copyright ©Georg Thieme Verlag KG 2019.)

Associations between biodiversity, human health and well-being have never been discussed with reference to agriculturally managed, species-rich mountainous meadows. We evaluated these associations between extensively managed (one mowing a year, no fertilization) and abandoned (no mowing since more than 80 years, no fertilization) semi-dry meadows located in the Austrian and Swiss Alps. We quantified the richness and abundance of plants, grasshoppers, true bugs, bumblebees, syrphids and landscape characteristics in the surroundings of the meadows. Associations between these biodiversity attributes and short-term psychological and physiological human health effects were assessed with 22 participants (10 males, 12 females; mean age 27 years). Participants´ pulse rate, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were not affected during visits to managed or abandoned meadows. However, perceived health benefits (e.g., stress reduction, attention restoration) were higher during their stays in managed than in abandoned meadows. Also, the attractiveness of the surrounding landscape and the recreation suitability were rated higher when visiting managed meadows. Perceived naturalness was positively correlated with plant richness and flower cover. A positive correlation was found between SBP and forest cover, but SBP was negatively correlated with the open landscape. A negative association was found between grasshoppers and recreational and landscape perceptions. We suggest to discuss biodiversity attributes not only in connection with agricultural management but also with cultural ecosystem services and health benefits to raise more awareness for multifaceted interrelationships between ecosystems and humans.

A pumped storage power plant produces significant noise such that adjacent areas were deemed uninhabitable for the local population. In recent years, the population in the area has increased, and the noise levels are now causing significant distress to the local population. The company operating the power plant and a citizens' initiative have both commissioned noise measurements. The measurements showed that the continuous pump noise was audible over many kilometers. The A-weighted sound-pressure level of 50 dBA at the next residential area underestimates the perceived noise, given the clear tonal nature in the low frequency range. Interviews of the exposed population, together with detailed "annoyance diaries" by a sample of the residents, proved their high level of annoyance. Their reported observations on distress and sleep disturbances coincide with the time course of the pumping operation. The pumping noise leads to annoyance in a large area, and to considerable nuisance in a smaller one. For the most exposed homes, long-term exposure might be considered a health hazard due to stress and disturbances in sleep quality. Therefore, the operator committed to developing a technical noise control plan. This case shows that a scientific approach within a complex environmental noise problem can foster an agreement about noise protection measures. However, this can only be successful if all involved parties participate in the process. Pilot studies are underway to test the impact of damping material layers on the pipes, the housing of the pipes, and the kind of air vessel solutions between the pumps and the pipes. Int J Occup Med Environ Health. 2019;32(3):401-11., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

Higher rates of nuclear anomalies in buccal cells of coffee workers exposed to pesticides in comparison to their unexposed peers were detected in our field study. Here, we extend our findings by examining other exposure indicators in this sample. Occupational exposure of 38 exposed and 33 non-exposed farmworkers was assessed as exposure days in the last month (0-25 days) and as years of exposure (0-47 years). Genotoxic and cytotoxic markers in buccal cells were analysed following standard procedures for buccal micronucleus cytome assay. Both exposure markers were associated with a higher frequency of nuclear anomalies with odds ratios more than 1. After restricting the analysis to the exposed workers only, this association remained only with the marker of recent exposure. In a secondary analysis also environmental exposure defined as proximity of the home to the nearest sprayed field (distance <1000 m) was assessed. Proximity led to increased rates (with odds ratios more than 3) of genotoxic but not cytotoxic nuclear anomalies. Reported recent frequency and intensity of pesticide use and application are a valid exposure marker relevant for cytological pathologies in the buccal mucosa. The exposure metric for environmental exposure was rather crude and confounding by some unmeasured factor cannot be fully excluded. Nevertheless, simple exposure indicators that can even be obtained under rather difficult field conditions do provide health-relevant and valid information., (© The Author(s) 2018. Published by Oxford University Press on behalf of the UK Environmental Mutagen Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

After one of Austria's largest environmental scandals in 2014, which involved the release of hexachlorobenzene (HCB) in the Carinthian valley Görtschitztal, concerns about increased cancer rates have arísen in the affected local population. A descriptive study was conducted to examine the cancer incidence rates between 1983 and 2012. Data from the affected area (Görtschitztal, district St. Veit) were compared to data from the neighboring area within the same district and Carinthia excluding St. Veit, considering incidence rates of liver, lung, kidney, thyroid cancer and mesothelioma. Prostate cancer and carcinoma in situ were both included and excluded from overall cancer incidents in order to prevent potential bias due to screening programs. Considering the observed variability at an overall level, no conspicuous differences in cancer incidences could be found (Carinthia: 495, St. Veit West: 408, St. Veit East: 572 cases per 100,000 person-years in 2012). For some cancer types, e. g. liver, thyroid cancer and mesothelioma, the affected region showed a higher increase in rates than the neighboring area or Carinthia overall; however, these increased rates date back to a time prior to the HCB exposure, suggesting other carcinogenic influences, such as asbestos exposure from antecedent years.

In a cross-sectional study on 433 schoolchildren (aged 6⁻9 years) from 9 schools in Austria, we observed associations between housing factors like passive smoking and lung function as well as improved lung function in children who had been breast-fed. The latter findings urged the question of whether the protective effects of breast-feeding act on environmental stressors or if they act independently. Therefore, the effect of passive smoking on lung function was stratified by breast-feeding. The detrimental effects of passive smoking were significant but restricted to the group of 53 children without breast-feeding. Breast-feeding counteracts the effect of environmental stressors on the growing respiratory organs., Competing Interests: The authors declare no conflict of interest.

The study compared psychological and physiological health effects of short-term stays at managed and abandoned meadows, a mountain river, and an urban site of a dependent sample of 22 adult participants (mean age 27) during an 11-day field trip. The study found that pulse rates decreased during the stays at all the meadows and the urban site while no decrease was observed at the river. Blood pressure increased at all sites during the stay, with no study-site differences for systolic, but for diastolic, blood pressure. Participants reported more positive psychological health effects as a result of their stays at the most remote meadow and the river on attention restoration, stress reduction and wellbeing compared to the urban site, while no differences in health perceptions were observed between managed and unmanaged meadows. This study suggests that perceived and measured health benefits were independent of the degree of naturalness of meadows. While differences measured on the physiological level between urban built and natural sites were marginal, psychological measures showed higher health benefits of the natural environments compared to the built one.

No saturation in the introduction, acceleration of spread and the increasing impacts of alien species are a characteristic feature of the Anthropocene. Concomitantly, alien species affecting human health are supposed to increase, mainly due to increasing global trade and climate change. In this study, we assess challenges and solutions posed by such species to the public health sector in Austria over the next few decades. We did so using an online questionnaire circulated to 131 experts and stakeholders working on human health and biological invasions, supplemented by in-depth interviews with eleven selected experts. Results from the online survey and in-depth interviews largely support and complement each other. Experts and stakeholders suggest that (i) the allergenic Ambrosia artemisiifolia (common ragweed), the photodermatoxic Heracleum mantegazzianum (giant hogweed), and vectors of diseases such as Aedes albopictus (Asian tiger mosquito) are considered the alien species posing the most severe challenges; (ii) challenges are expected to increase in the next few decades and awareness in the public health sector is not sufficient; (iii) effective and efficient solutions are mainly related to prevention. Specific solutions include pathway management of introduction and spread by monitoring and controlling established populations of ragweed, hogweed and mosquitos.

Background: Heatwaves form a serious public health threat, especially for vulnerable groups. Interventions such as active outreach programs, exposure reduction measures and monitoring and mapping of at-risk groups are increasingly implemented across the world but little is known about their effect., Objectives: To assess how vulnerable groups are identified and reached in heat health interventions, to understand the effectiveness and efficiency of those interventions, and to identify research gaps in existing literature., Methods: We performed a literature search in relevant scientific literature databases and searched with a four element search model for articles published from 1995 onward. We extracted data on intervention measures, target group and evaluation of effectiveness and efficiency., Results: We identified 23 eligible studies. Patterns exist in type of interventions 1) to detect and 2) to influence extrinsic and intrinsic risk and protective factors. Results showed several intervention barriers related to the variety and intersection of these factors, as well as the self-perception of vulnerable groups, and misconceptions and unfavorable attitudes towards intervention benefits. While modest indications for the evidence on the effectiveness of interventions were found, efficiency remains unclear., Discussion: Interventions entailed logical combinations of measures, subsumed as packages. Evidence for effective and efficient intervention is limited by the difficulty to determine effects and because single measures are mutually dependent. Interventions prioritized promoting behavioral change and were based on behavioral assumptions that remain untested and mechanisms not worked out explicitly., Conclusions: Multifaceted efforts are needed to tailor interventions, compiled in heat health warning systems and action plans for exposure reduction and protection of vulnerable populations, to fit the social, economic and geographical context. Besides adequately addressing relevant risk and protective factors, the challenge is to integrate perspectives of vulnerable groups. Future research should focus on intervention barriers and improving the methods of effectiveness and efficiency evaluation., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Acute and sub-acute effects of pesticide use in coffee farmers have rarely been investigated. In the present field study, self-reported health symptoms from 38 male pesticide users were compared to those of 33 organic farmers. Results of cytological findings have been reported in an accompanying paper in this issue. The present second part of the study comprises a questionnaire based survey for various, potentially pesticide related symptoms among the coffee farmers. Symptom rates were generally higher in exposed workers, reaching significance in nine out of 19 assessed symptoms. Significantly increased symptom frequencies were related to neurotoxicity, parasympathic effects and acetylcholine esterase inhibition, with the highest differences found for excessive salivation, dizziness and stomach ache. We revealed a lack of precautionary measures in the majority of farmers. Better education, regulations, and safety equipment are urgently needed.

Intensive agrochemical use in coffee production in the Global South has been documented. The aim of this study was to investigate cytotoxic and genotoxic effects of pesticide exposure in male farmworkers in the Dominican Republic comparing conventional farming using pesticides to organic farming. Furthermore, feasibility of the buccal micronucleus cytome assay (BMCA) for field studies under difficult local conditions was tested. In a cross-sectional field study, pesticide exposed (sprayers) and non-exposed male workers on coffee plantations were interviewed about exposure history, and pesticide application practices. Buccal cells were sampled, and BMCA was applied to assess potential effects on cell integrity. In total, 38 pesticide-exposed and 33 non-exposed workers participated. Eighty-four and 87%, respectively, of the pesticide-exposed respondents did not use masks or gloves at all. All biomarkers from the BMCA were significantly more frequent among exposed workers-odds ratio for micronucleated cells: 3.1 (95% confidence interval: 1.3⁻7.4) or karyolysis: 1.3 (1.1⁻1.5). Buccal cells as sensitive markers of toxic oral or respiratory exposures proved feasible for challenging field studies. Our findings indicate that the impact of pesticide use is not restricted to acute effects on health and wellbeing, but also points to long-term health risks. Therefore, occupational safety measures including training and protective clothing are needed, as well as encouragement towards minimal application of pesticides and more widespread use of organic farming.

Cognitive functioning and academic performance of pupils depend on regular breaks from classroom work. However, it is unclear which settings during such breaks provide the best environment to restore cognitive performance and promote wellbeing of adolescent pupils. Therefore, we investigated the effects of staying in different urban green spaces during breaks. Sixty-four pupils (16⁻18 years old) participated in a cross-over experiment. They were placed into one of three settings (small park, larger park, forest) for one hour during a lunch break. Wellbeing was assessed four times (Nitsch scale), and a cognitive test (d2-R Test of Attention) was applied in the classrooms before and after the break. Wellbeing was almost always highest after the stay in the green spaces. However, a sustained effect was only found for the forest. Concentration performance values of the d2-R test were significantly higher after the pupils&rsquo; stay in green spaces for all sites. The highest increase of performance was found for the larger park type. In conclusion, this pilot study showed that study breaks in green spaces improved wellbeing and cognitive performance of adolescents. It also found that larger green spaces, either parks or forests, have stronger positive impacts on wellbeing and cognitive performance than small parks.

There is growing recognition that implementation of low-carbon policies in urban passenger transport has near-term health co-benefits through increased physical activity and improved air quality. Nevertheless, co-benefits and related cost reductions are often not taken into account in decision processes, likely because they are not easy to capture. In an interdisciplinary multi-model approach we address this gap, investigating the co-benefits resulting from increased physical activity and improved air quality due to climate mitigation policies for three urban areas. Additionally we take a (macro-)economic perspective, since that is the ultimate interest of policy-makers. Methodologically, we link a transport modelling tool, a transport emission model, an emission dispersion model, a health model and a macroeconomic Computable General Equilibrium (CGE) model to analyze three climate change mitigation scenarios. We show that higher levels of physical exercise and reduced exposure to pollutants due to mitigation measures substantially decrease morbidity and mortality. Expenditures are mainly born by the public sector but are mostly offset by the emerging co-benefits. Our macroeconomic results indicate a strong positive welfare effect, yet with slightly negative GDP and employment effects. We conclude that considering economic co-benefits of climate change mitigation policies in urban mobility can be put forward as a forceful argument for policy makers to take action.

Meat is an important food for human nutrition, by especially providing high-quality protein and also some essential micronutrients, in front iron, zinc, and vitamin B 12 . However, a high intake of red and processed meat is associated with an increased risk for diseases, especially type 2 diabetes and colorectal cancer, as several epidemiological studies and meta-analyses have shown. This review summarizes meta-analyses of publications studying the association between red and processed meat intake and type 2 diabetes, cardiovascular diseases, colorectal and other cancers, and all-cause mortality. Various potential mechanisms involved in the increased disease risk are discussed. Furthermore, the beneficial effects of healthy alternatives for meat, like fish, nuts, vegetables and fruits, pulses and legumes, whole grains, and dairy products are reviewed by including selected papers and recent meta-analyses.

Involvement of sport utility vehicles (SUV) in accidents especially with children is of increasing importance. Studies have indicated a more risky behavior in SUV drivers. We conducted an observational study focusing on traffic violations, car type, and the gender of the driver in Vienna. The study was conducted on five weekdays at the beginning of school term. Three busy intersections were selected.Drivers of 43,168 normal cars and 5653 SUVs were counted at the intersections during the observation period. In total 13.8% drivers were unbelted, 3.1% were using a handheld mobile phone, and 2.5% violated traffic lights. These frequencies were significantly higher in SUV drivers than in normal passenger car drivers. This "SUV effect" also occurred in women for all violations, although male drivers violated traffic laws more often than female drivers. However, for driving unbelted the difference between males and females was smaller in SUV drivers.

Passive houses and other highly energy-efficient buildings need mechanical ventilation. However, ventilation systems in such houses are regarded with a certain degree of skepticism by parts of the public due to alleged negative health effects. Within a quasi-experimental field study, we investigated if occupants of two types of buildings (mechanical vs. natural ventilation) experience different health, wellbeing and housing satisfaction outcomes and if associations with indoor air quality exist. We investigated 123 modern homes (test group: with mechanical ventilation; control group: naturally ventilated) built in the years 2010 to 2012 in the same geographic area and price range. Interviews of occupants based on standardized questionnaires and measurements of indoor air quality parameters were conducted twice (three months after moving in and one year later). In total, 575 interviews were performed (respondents' mean age 37.9 ± 9 years in the test group, 37.7 ± 9 years in the control group). Occupants of the test group rated their overall health status and that of their children not significantly higher than occupants of the control group at both time points. Adult occupants of the test group reported dry eyes statistically significantly more frequently compared to the control group (19.4% vs. 12.5%). Inhabitants of energy-efficient, mechanically ventilated homes rated the quality of indoor air and climate significantly higher. Self-reported health improved more frequently in the mechanically ventilated new homes ( p = 0.005). Almost no other significant differences between housing types and measuring time points were observed concerning health and wellbeing or housing satisfaction. Associations between vegetative symptoms (dizziness, nausea, headaches) and formaldehyde concentrations as well as between CO₂ levels and perceived stale air were observed. However, both associations were independent of the type of ventilation. In summary, occupants of the mechanically ventilated homes rated their health status slightly higher and their health improved significantly more frequently than in occupants of the control group. As humidity in homes with mechanical ventilation was lower, it seems plausible that the inhabitants reported dry eyes more frequently.

This paper presents recommendations for avoiding or eliminating unnecessary barriers to mobile application usage by older generations. It sets out ten areas of age-appropriate application design. The aim of this paper is to help ensure that the design of mobile applications, including assistive applications, is accessible for elderly persons.

Exposure to bisphenol-A (BPA) and phthalates has been associated with negative health outcomes in animal and human studies, and human bio-monitoring studies demonstrate widespread exposure in the US and Europe. Out of concern for the environment and health, individuals may attempt to modify their environment, diet, and consumer choices to avoid such exposures, but these natural experiments are rarely if ever quantitatively evaluated. The aim of the study was to evaluate the difference in urinary concentrations of BPA and phthalate metabolites following an exposure reduction intervention among an Austrian family of five. Urine samples were taken shortly after the family had removed all plastic kitchenware, toys, and bathroom products, and started a concerted effort to eat less food packaged in plastic. Two-months later, urine samples were collected at a follow-up visit, and concentrations of BPA and phthalate metabolites were compared. Shortly after removal of plastic urinary concentrations of BPA were below limit of quantification in all samples. Phthalate concentrations were low, however, 10 of 14 investigated metabolites could be found above limit of quantification. After the two-month intervention, phthalate urinary concentrations had declined in some but not all family members. In the mother most phthalate metabolites increased. The low levels might be partly due to the environmentally conscious lifestyle of the family and partly due to the fact that body levels had dropped already because of the delay of four days between finishing removal and first measurement. Further two months avoidance of dietary exposure and exposure to environmental plastics reduced urinary concentrations for all but one metabolite in the oldest son only, but decreased somewhat in all family members except the mother., (Copyright © 2016 Elsevier Inc. All rights reserved.)

In general, routine industrial hygiene (IH) data are collected not to serve for scientific research but to check for compliance with occupational limit values. In the preparation of an occupational retrospective cohort study it is vital to test the validity of the exposure assessment based on incomplete (temporal coverage, departments) IH data. Existing IH data from a large hard metal plant was collected. Individual workers' exposure per year and department was estimated based on linear regression of log-transformed exposure data for dust, tungsten, and cobalt. Estimated data were back-transformed, and for cobalt the validity of the estimates was confirmed by comparison with individual cobalt concentrations in urine. Air monitoring data were available from 1985 to 2012 and urine tests from the years 2008 to 2014. A declining trend and significant differences among departments was evident for all three air pollutants. The estimated time trend fitted the time trend in urine values well. At 1 mg/m³, cobalt in the air leads to an excretion of approximately 200 µg/L cobalt in urine. Cobalt levels in urine were significantly higher in smokers with an interaction effect between smoking and air concentrations. Exposure estimates of individual workers are generally feasible in the examined plant, although some departments are not documented sufficiently enough. Additional information (expert knowledge) is needed to fill these gaps., Competing Interests: All authors declare that there are no competing interests.

Phthalates are multifunctional chemicals used in a wide variety of consumer products. The aim of this study was to investigate whether levels of urinary phthalate metabolites in urine samples of Austrian mothers and their children were associated with consumer habits and health indicators. Within an Austrian biomonitoring survey, urine samples from 50 mother-child pairs of five communities (two-stage random stratified sampling) were analysed. The concentrations of 14 phthalate metabolites were determined, and a questionnaire was administered. Monoethyl phthalate (MEP), mono-n-butyl phthalate (MnBP), mono-isobutyl phthalate (MiBP), monobenzyl phthalate (MBzP), mono-(2-ethylhexyl) phthalate (MEHP), mono-(2-ethyl-5-hydroxyhexyl) phthalate (5OH-MEHP), mono-(2-ethyl-5-oxohexyl) phthalate (5oxo-MEHP), mono-(5-carboxy-2-ethylpentyl) phthalate (5cx-MEPP), and 3-carboxy-mono-propyl phthalate (3cx-MPP) could be quantified in the majority of samples. Significant correlations were found between the use of hair mousse, hair dye, makeup, chewing gum, polyethylene terephthalate (PET) bottles and the diethyl phthalate (DEP) metabolite MEP. With regard to health effects, significant associations of MEP in urine with headache, repeated coughing, diarrhoea, and hormonal problems were observed. MBzP was associated with repeated coughing and MEHP was associated with itching.

Since the beginning of the 20th century there has been a scientific debate about the potential effects of air ions on biological tissues, wellbeing and health. Effects on the cardiovascular and respiratory system as well as on mental health have been described. In recent years, there has been a renewed interest in this topic. In an experimental indoor setting we conducted a double-blind cross-over trial to determine if higher levels of air ions, generated by a special wall paint, affect cognitive performance, wellbeing, lung function, and cardiovascular function. Twenty healthy non-smoking volunteers (10 female, 10 male) participated in the study. Levels of air ions, volatile organic compounds and indoor climate factors were determined by standardized measurement procedures. Air ions affected the autonomous nervous system (in terms of an increase of sympathetic activity accompanied by a small decrease of vagal efferent activity): In the test room with higher levels of air ions (2194/cm³ vs. 1038/cm³) a significantly higher low to high frequency ratio of the electrocardiography (ECG) beat-to-beat interval spectrogram was found. Furthermore, six of nine subtests of a cognitive performance test were solved better, three of them statistically significant (verbal factor, reasoning, and perceptual speed), in the room with higher ion concentration. There was no influence of air ions on lung function and on wellbeing. Our results indicate slightly activating and cognitive performance enhancing effects of a short-term exposure to higher indoor air ion concentrations.