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ZusammenfassungDer Klimawandel ist eine Gefahr für Gesundheit und soziale Sicherheit von Milliarden von Menschen. Gesundheit und Lebensqualität werden unter dem Einfluss der Klimakrise zunehmend auf vielfältige Weise beeinträchtigt. Der Anstieg der globalen Temperaturen hat häufigere, stärkere Extremwetterereignisse zur Folge, die insgesamt und speziell in der Gesundheitsversorgung zur weiteren Aggravierung von Ungleichheit, Diskriminierung und Ungerechtigkeit beitragen. Zudem begünstigen die klimatischen Bedingungen die Übertragung zahlreicher Infektionskrankheiten und ihr Vordringen in neue Regionen. Sozio-ökonomisch benachteiligte Gebiete mit schwacher Gesundheitsinfrastruktur, etwa im globalen Süden, werden am wenigsten in der Lage sein, ohne gezielte Unterstützung die Folgen der Klimakrise zu bewältigen. Oberstes Gebot ist es, die Verringerung der Treibhausgasemissionen in den Bereichen Verkehr, Energie- und Nahrungsmittelproduktion zu erreichen – auf globaler, nationaler und regionaler Ebene, um negative Gesundheitsfolgen zu mildern. Das Pariser Übereinkommen (2015) ist daher auch als entscheidendes Gesundheitsabkommen zu begreifen. Der Fokus dieses Beitrages liegt auf ethischen Aspekten des Klimawandels im Gesundheitsbereich.

The Alpine region in Central Europe and its populations in principle face the same types of threats to their health due to climate change as those in other parts of the world. But special geographical and climatic aspects of that region warrant closer and special examination of the connections between health and climate change in the Alps. These include small-scale variation, in some instances steep mountain slopes, and, above all, a larger-than-average increase in near-surface temperatures. To that end, there are main pathways between climate change and health: “Direct effects” describe rather short-term health effects of extreme weather events. Such events have occurred in the past, and therefore ample epidemiological evidence is available for the assessment of their impact. With climate change, such extreme events are predicted to change in frequency and intensity. “Indirect effects” refer to a more complex pathway where long-term changes of various natural and anthropogenic systems in reaction or adaptation to climate change exert adverse or sometimes also beneficial impacts on health. Such systems include ecosystems in which, for example, the prevalence of disease vectors or the allergenicity of pollen will change. But agriculture and forestry or the built environment are also affected by climate change and in turn affect the health of people. “Distant effects” are also rather indirect in nature. But in this pathway, changes due to climate change in other parts of the world affect the health in the Alpine region. Increasing migration into the Alpine region and changing migration patterns are important examples of this pathway. In some instances, most importantly regarding mental health, there is still a need for more studies focusing on the Alpine environments. But apart from these especially understudied topics, as the climate crisis evolves, there is generally a need for continuous research on the health effects of climate change and the potential of health promotion to create co-benefits.

To reduce the high amount of Greenhouse Gas emissions, a more sustainable individual lifestyle is crucial. However, existing research regarding pro-environmental behaviors rarely focuses on a reduction in consumption. Hence, this study investigated different variables (e.g., habits, estimated efficacy of measures, estimated danger of climate change) that might enhance people’s willingness to cut back on several private consumptions for the sake of the environment. In a German-speaking online survey (n = 435), different areas of consumption were looked at separately in different regression models. Additionally, we investigated whether a randomized highlighting of climate change consequences could further increase willingness to implement private cut-backs, which could not be confirmed in subsequent variance analyses. Overall, some variables seem to be connected with a higher willingness to implement cut-backs in most consumption areas and on several levels (e.g., estimated efficacy); other predictors are only involved in specific cut-backs and specific levels (e.g., materialism). Furthermore, different variables seem to be of importance when it comes to already implemented consumption restrictions as opposed to willingness to implement further cut-backs. These results lead to the conclusion that, in order to maximize mitigation potential, it is important to tailor suggestions to the area of consumption. Additionally, for most areas, awareness of the mitigation efficacy of the respective behavior seems crucial.

Aims: Work breaks improve well-being, productivity, and health. The aim of this study was to investigate the individual determinants of rest-break behavior during work using the theory of planned behavior (TPB). Methods: The association between attitude, control, and subjective norm and rest-break intention (i.e., taking rest breaks regularly), and rest-break behavior (average number of rest breaks/workhour) was analyzed with stepwise linear regression in a cross-sectional design. The study participants included 109 clerical employees, and 215 nurses. Results: Attitude and control were positively associated with rest-break intention. Intention and control were positively associated with rest-break behavior. The effect of intention was moderated by occupation, with intention being more weakly associated with rest-break behavior in nurses who had less behavioral control. Conclusions: Job control is the major predictor of rest-break behavior, with attitudes playing a minor role, and social norm playing no role. To increase rest-break behavior, a greater extent of job control is necessary.

Zusammenfassung Der Klimawandel stellt eine der größten Herausforderungen unserer Zeit dar. Er hat massive Auswirkungen auf die menschliche Gesundheit. Daher ist das Gesundheitswesen gefordert a) aktiv einen Beitrag zum Klimaschutz zu leisten und b) sich verstärkt auf die Auswirkungen des Klimawandels vorzubereiten. In Österreich wurde die Thematik im Rahmen einer „Klimamahnwoche“ aufgegriffen und es wurden Schritte gesetzt, um auf Ebene des Gesundheitswesens das Bewusstsein zu schärfen.

Zusammenfassung Ziel dieser Umfrage war es, eine grobe Einschätzung von Zahl und Art von gemeldeten Verletzungen von Kinderrechten innerhalb der Gesundheitsversorgung sowie eine Einschätzung der Problematik durch die zuständigen Einrichtungen zu erhalten. Methodik Schriftliche Umfrage bei den Kinder- und Jugendanwaltschaften (KIJAs) und Patientenanwaltschaften (PAs) aller 9 Bundesländer Österreichs mit der Fragestellung nach Zahl und Art von möglichen Kinderrechtsverletzungen und ihrer Bedeutung. Ergebnisse Beide Anwaltschaften werden nur selten mit den erfragten Belangen konfrontiert. KIJAs haben ein deutlich höheres Problembewusstsein in Bezug auf Kinderrechte, obgleich Gesundheitsagenden gesetzlich bei der PA verankert sind. Diese berichten jedoch seltener von einlangenden Beschwerden in Hinblick auf mögliche Kinderrechtsverletzungen. Eine systematische Zusammenarbeit dieser beiden Einrichtungen scheint nicht vorzuliegen. Kinderrechtlich problematische Bereiche werden insbesondere bezüglich Teilhaberechten und medizinischen Versorgungsdefiziten berichtet. Schlussfolgerung Ausgehend von den geringen Beschwerdezahlen und der vorliegenden Literatur scheint es ein unzureichendes Bewusstsein über bestehende Unterstützungs- und Beschwerdeangebote bei Kinderrechtsverletzungen in der Bevölkerung zu geben. Verbesserungspotenzial gibt es in der intensiveren Zusammenarbeit der zuständigen Einrichtungen, der Behebung von Versorgungsmängeln, in der Verbesserung der Kommunikation sowie in Bezug auf Aus- und Fortbildung von Gesundheits-Personal.

Summary 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.

Conventional banana farming is pesticide-intensive and leads to high exposure of farmworkers. Ecuador is the world&rsquo, 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&ndash, 11.71, and 4.10, CI 1.37&ndash, 12.31, respectively) as well as systemic symptoms like dizziness (OR = 4.80, CI 1.55&ndash, 14.87) and fatigue (OR = 4.96, CI 1.65&ndash, 14.88). Moreover, gastrointestinal symptoms were reported more frequently by pesticide users: nausea (OR = 7.5, CI 1.77&ndash, 31.77) and diarrhea (OR = 6.43, CI 1.06&ndash, 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 (NO2) and/or particulate matter (PM10) higher than the upper quartile (30 and 20 &micro, g/m3, respectively) of all districts. The total population of the individual districts was followed until diagnosis of or death from COVID-19, or until April 21, 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 NO2 were significantly and positively associated with the risk of a COVID-19 diagnosis (hazard ratio (HR) = 1.44 and 1.16, respectively). NO2 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.

In epidemiological studies, both spatial and temporal variations in nitrogen dioxide (NO2) 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 NO2. In the wake of the &ldquo, Diesel emission scandal&mdash, Dieselgate&rdquo, the scientific basis of current limit values for ambient NO2 concentrations was attacked by industry lobbyists. It was argued that associations between NO2 levels and medical endpoints were not causal, as NO2 in older studies served as a proxy for aggressive particulate matter from incineration processes. With the introduction of particle filters in diesel cars, NO2 would have lost its meaning as a health indicator. Austria has a high percentage of diesel-powered cars (56%). If, indeed, associations between NO2 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 NO2 on total mortality. In a simplified model, we now assess the effect estimates for moving 5-year periods from the beginning of NO2 monitoring in Vienna (1987) until the year 2018 of same and previous day NO2 on total daily mortality. Contrary to industry claims of a spurious, no longer valid indicator function of NO2, effect estimates remained fairly stable, indicating an increase in total mortality of previous day NO2 by 0.52% (95% CI: 0.35&ndash, 0.7%) per 10 &micro, g/m3 change in NO2 concentration.

In times of rising temperatures, the question arises on how the human body adapts. When assumed that changing climate leads to adaptation, time series analysis should reveal a shift in optimal temperatures. The city of Vienna is especially affected by climate change due to its location in the Alpine Range in Middle Europe. Based on mortality data, we calculated shifts in optimal temperature for a time period of 49 years in Vienna with Poisson regression models. Results show a shift in optimal temperature, with optimal temperature increasing more than average temperature. Hence, results clearly show an adaptation process, with more adaptation to warmer than colder temperatures. Nevertheless, some age groups remain more vulnerable than others and less able to adapt. Further research focusing on vulnerable groups should be encouraged.

(1) Background: When it comes to estimating the annoyance potency of odors, European countries relate to different guidelines. In a previous study we compared complaint rates for different agricultural odors, but due to different guidelines, the results we obtained are hard to generalize. (2) Methods: We compare our findings on complaint rates to Dutch and German findings on annoyance rates, using diverse regression models. We also discuss whether the use of the polarity profile for hedonic odor quality could improve annoyance potency assessment. This is demonstrated by comparing the graphical profiles of two different odor types (swine and cattle). (3) Results: Official complaint rates are comparable to a percentage of annoyed residents. Confounder variables such as personal variables do not greatly contribute to annoyance. However, individual emission sites also showed an important influence on complaints and hence on annoyance. Considering the hedonic quality of odors via the polarity profile method for improving an annoyance potency assessment cannot be recommended when using the given state of the method. This is particularly true when it comes to the rating of specific odors, as the method then seems to lack reliability. (4) Conclusions: Where data on annoyance rates are lacking, complaint data could be used instead.

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.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.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.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.ZIEL: dieser Umfrage war es, eine grobe Einschätzung von Zahl und Art von gemeldeten Verletzungen von Kinderrechten innerhalb der Gesundheitsversorgung sowie eine Einschätzung der Problematik durch die zuständigen Einrichtungen zu erhalten.Schriftliche Umfrage bei den Kinder- und Jugendanwaltschaften (KIJAs) und Patientenanwaltschaften (PAs) aller 9 Bundesländer Österreichs mit der Fragestellung nach Zahl und Art von möglichen Kinderrechtsverletzungen und ihrer Bedeutung.Beide Anwaltschaften werden nur selten mit den erfragten Belangen konfrontiert. KIJAs haben ein deutlich höheres Problembewusstsein in Bezug auf Kinderrechte, obgleich Gesundheitsagenden gesetzlich bei der PA verankert sind. Diese berichten jedoch seltener von einlangenden Beschwerden in Hinblick auf mögliche Kinderrechtsverletzungen. Eine systematische Zusammenarbeit dieser beiden Einrichtungen scheint nicht vorzuliegen. Kinderrechtlich problematische Bereiche werden insbesondere bezüglich Teilhaberechten und medizinischen Versorgungsdefiziten berichtet.Ausgehend von den geringen Beschwerdezahlen und der vorliegenden Literatur scheint es ein unzureichendes Bewusstsein über bestehende Unterstützungs- und Beschwerdeangebote bei Kinderrechtsverletzungen in der Bevölkerung zu geben. Verbesserungspotenzial gibt es in der intensiveren Zusammenarbeit der zuständigen Einrichtungen, der Behebung von Versorgungsmängeln, in der Verbesserung der Kommunikation sowie in Bezug auf Aus- und Fortbildung von Gesundheits-Personal.

Birth related complications and comorbidities are highly associated with a poor nutritional status of pregnant women, whereas iron and iodine are among especially important trace elements for healthy maternal and fetal outcomes. The study compares the status of iron, iodine, and related functional parameters in pregnant and non-pregnant women from a developing country and associates the data with pregnancy complications. The concentrations of ferritin, hemoglobin (Hb), total triiodothyronine (TT3), total thyroxine (TT4), and thyroid-stimulating hormone (TSH) were determined in the blood serum of 80 pregnant women at the time of delivery and compared with 40 non-pregnant healthy controls. Spot urine samples were taken to evaluate the urinary iodine concentration (UIC). In pregnant women, ferritin, Hb concentrations, and UIC were significantly lower, and TT4 values were significantly higher compared to controls. Higher Hb levels were tendentially associated with a reduced risk for pregnancy complications (OR = 0.747, CI (95%) 0.556&ndash, 1.004, p = 0.053). Regarding covariates, only previous miscarriages were marginally associated with pregnancy complications. High consumption of dairy products was associated with lower Hb and ferritin values. Our results suggest that pregnant women from a developing country have lower iron status with Hb levels being possibly associated with pregnancy complications.

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.

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.

In the planning and authorization process of industrial plants or agricultural buildings, it needs to be ensured that odor emissions do not annoy nearby residents in an unacceptable way. Previous studies have shown that odor-hour frequency is an important predictor for odor annoyance. However, odor-hour frequencies can be assessed for day and night separately. The present study relates complaint rates with different odor types and different metrics of frequency calculated via a dispersion model. Binary logistic regression analyses show that odor type and frequency of odor-hours are important predictors for complaints, while type of residential area does not increase the predictive value of the model. The combination of calculated frequency of day time odor-hours and type of odor explains complaint rates best. It is recommended to keep odor emissions as low as possible, especially for highly annoying odor types.

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.

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&ndash, 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.