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Requests for telework for medical reasons are rare, accounting 0.3% of employees. The main cause is musculoskeletal issues (30%), predominantly affecting women. Of these, 58% were denied, 33% were temporarily approved, and 8% were approved indefinitely. We believe that telework for office employees can reduce the incidence of sick leave. Objectives: The aim of the study is to describe the most common medical grounds for requesting or extending teleworking and to examine which requests are typically approved. This study also investigates whether there is a correlation with gender, age, or job location. Methods: A prevalence study of 33,190 Spanish employees found that, last year, 106 teleworking requests were addressed exclusively for medical reasons. Results: The most frequent cause was musculoskeletal issues (30%). Of all the requests, 58% were denied; 33% were temporarily approved, primarily for musculoskeletal reasons (P < 0.05); and 8% were indefinitely approved. Requests were predominantly made by women (P < 0.05). Indefinite approvals were more prevalent among male employees (P < 0.05). Conclusions: Musculoskeletal reasons were the primary cause for teleworking applications and for the temporary granting of teleworking. Teleworking appears to be associated with gender and job location. [ABSTRACT FROM AUTHOR]

This study presents the need for the development and testing of a Total Worker Health ® intervention within oncology settings. In focus groups with oncology care teams and occupational medicine physicians, major themes included the desire to better provide employment-related support during treatment, specifically work accommodations and guidance for oncology patients. Objectives: Few Total Worker Health ® studies and fewer interventions examine well-being in the work context of cancer survivorship. We investigated the possibility of occupation and oncology professionals working together to address employed survivors' work-associated needs. Methods: We employed a community-based participatory research approach to examine the educational, contextual, and workflow needs of oncology care team members to inform intervention design. Focus groups were conducted with oncology care team members and occupational medicine physicians. Key themes from each group were then examined. Results: Themes included oncology care team's role in helping patients navigate resources, providing psychosocial support, and educating patients. Major themes for ways to better provide employment-related support during treatment included referring patients to employment experts and providing education on employment support. Conclusions: Occupational health professionals in collaboration with oncology clinics could play an important role in assisting cancer survivors' ability to navigate employment challenges. [ABSTRACT FROM AUTHOR]

This study aimed to adapt and validate the Occupational Health Literacy Scale (OHLS) for the Italian workforce, assessing its psychometric properties and ensuring its relevance and applicability within this specific cultural setting. Validation process by observational and descriptive study. Initially, two members of the research team independently translated the original OHLS into Italian. Subsequent comparisons and syntheses of these translations produced a unified Italian document. To ensure translation accuracy, this document was then retranslated back into English. An expert committee with specialized knowledge in occupational safety and health evaluated the retranslations to finalize the Italian version. This version underwent a preliminary test using a pilot group, followed by anonymous administration to a sample of 398 workers. The adaptation of the OHLS into Italian demonstrated outstanding psychometric characteristics. The scale exhibited an excellent model fit and strong internal consistency. Furthermore, the factorial structures were congruent with theoretical expectations, underscoring the scale's robust construct validity. The Italian version of the OHLS has been validated as a reliable and effective instrument for quantifying occupational health literacy among Italian workers. This tool's demonstrated validity and reliability suggest its potential for broader application in promoting occupational health awareness and interventions within Italian-speaking populations. [ABSTRACT FROM AUTHOR]

A considerable literature places the emergence of occupational health discourses and institutions in the second half of the nineteenth century. This article uses the records of the Chatham Chest, a pension fund for maritime workers that existed from 1590 to 1803, as well as the records of the Sick and Hurt Boards and the Seamen's Registry for the Greenwich Hospital, to argue for the existence of an early modern system of occupational health. Over two centuries, these institutions collected contributions and paid out pensions and healthcare costs to and from tens of thousands of workers on hundreds of ships and in dozens of hospitals, prisons and shipyards. They used customary estimates of the costs of avoiding poverty to price the loss of body parts and other injuries, and created systems of inspection and registration that grew increasingly stringent through episodes of post-war austerity. Managing occupational injury and death focused on poverty alleviation and subsistence, through a discursive field based on concepts of custom, deservedness and service rather than prices, income replacement and risk factors. [ABSTRACT FROM AUTHOR]

Background: Occupational biomonitoring is essential for assessing health risks linked to workplace exposures. The use of 'omics' technologies, such as metabolomics and proteomics, has become crucial in detecting subtle biological alterations induced by occupational hazards, thereby opening novel avenues for biomarker discovery. Aims: This systematic review aims to evaluate the application of metabolomics and proteomics in occupational health. Methods: Following the PRISMA guidelines, we conducted a comprehensive search on PubMed, Scopus, and Web of Science for original human studies that use metabolomics or proteomics to assess occupational exposure biomarkers. The risk of bias was assessed by adapting the Cochrane Collaboration tool and the Newcastle-Ottawa Quality Assessment Scale. Results: Of 2311 initially identified articles, 85 met the eligibility criteria. These studies were mainly conducted in China, Europe, and the United States of America, covering a wide range of occupational exposures. The findings revealed that metabolomics and proteomics approaches effectively identified biomarkers related to chemical, physical, biomechanical, and psychosocial hazards. Analytical methods varied, with mass spectrometry-based techniques emerging as the most prevalent. The risk of bias was generally low to moderate, with specific concerns about exposure measurement and confounding factors. Conclusions: Integrating metabolomics and proteomics in occupational health biomonitoring significantly advances our understanding of exposure effects and facilitates the development of personalized preventive interventions. However, challenges remain regarding the complexity of data analysis, biomarker specificity, and the translation of findings into preventive measures. Future research should focus on longitudinal studies and biomarker validation across diverse populations to improve the reliability and applicability of occupational health interventions. [ABSTRACT FROM AUTHOR]

The article focuses on the ongoing shortage of trained occupational and environmental medicine (OEM) physicians, despite a high demand for the specialty. Topics include the funding challenges faced by OEM training programs, the limited visibility of the specialty among medical students and residents, and a historical perspective on the persistent issues affecting OEM residency education over the past decades.

Background: Chronic obstructive pulmonary disease (COPD) is associated with subclinical atherosclerosis and endothelial dysfunction, which can be assessed non-invasively through flow-mediated dilation (FMD). In this study, we evaluated the potential impact of inhaled corticosteroid (ICS) therapy on FMD of COPD patients undergoing pulmonary rehabilitation (PR). Methods: Medical records of COPD patients undergoing FMD assessment upon admission to our Pulmonary Rehabilitation Unit were reviewed in this retrospective post hoc analysis. Results: A total of 46 patients with COPD (median age 71.5 years, 28.3% postmenopausal females) were included in the final analysis. Among these, 27 participants were currently receiving ICS therapy, while 19 were not. At baseline, the two groups showed no difference in the main clinical and functional variables. Similarly, no significant difference was observed in vascular reactivity parameters, with a median FMD of 3.12% (IQR: 2.23–4.45) in ICS users and 3.39% (IQR: 2.45–4.08) in ICS nonusers (p = 0.544). After PR, a significant improvement in the main rehabilitation and patient-reported outcomes was observed in all groups, with a significant improvement in FMD documented in both patients treated with steroids (from 3.12%; IQR: 2.23–4.45 to 4.77%; IQR: 3.25–5.63, p = 0.022) and in those who were not (from 3.39%; IQR: 2.45–4.08 to 5.04%; IQR: 3.98–6.06, p = 0.005). FMD changes were of comparable magnitude among groups. Conclusions: Our preliminary findings do not indicate a significant impact of medications containing ICS on the endothelial function of COPD patients, suggesting that the potential beneficial effect of PR on this surrogate marker of cardiovascular risk is independent of inhaled therapy. [ABSTRACT FROM AUTHOR]

Objectives: The underreporting of occupational diseases in many countries significantly hampers the development of intervention programs, posing a significant public health problem. Our study aimed to contribute to the occupational diseases surveillance by examining the data of hospitals authorized to issue reports throughout Turkey. Material and Methods: This cross‐sectional study was conducted using medical diagnoses of occupational diseases reported to the General Directorate of Public Health from 81 provinces in Turkey between 1 January 2018 and 31 December 2022. The study evaluated hospitals that made medical diagnoses of occupational diseases and compared age groups, genders, occupational disease diagnosis groups and provinces of work regarding legal and medical diagnoses. Results: The top three disease groups in terms of medical diagnosis are musculoskeletal disorders with 38.8%, respiratory diseases with 14.4% and hearing defects with 10.9%. Regarding legal diagnoses, respiratory system diseases ranked first with 26.4%, followed by musculoskeletal disorders with 8.2% and hearing defects with 5.5%. While the provinces where most cases of medical occupational diseases are diagnosed share similarities, the majority of affected individuals in Karabük and Batman have not received a legal recognition of the occupational disease. Two‐thirds of Turkey's medical occupational disease diagnoses were made in two hospitals. Conclusion: This study is reflecting national data in Turkey and is the country's first nationwide study. The number of occupational diseases in Turkey is lower than expected. It would be more accurate to express the data in a way that includes medical diagnoses instead of using the number of compensated files corresponding to legal diagnoses. [ABSTRACT FROM AUTHOR]

Background/aim: Physicians work under high levels of stress due to factors such as excessive workload, emotional factors, and economic variables. This leads to various health problems such as depression, burnout, fatigue, and hopelessness, resulting in decreased interest in a medical career and an increase in career choice regret. Materials and methods: The study included 300 volunteer resident physicians from Ankara University Medical Faculty Hospital. The data for the research were collected using a survey form prepared by reviewing the literature. The survey consisted of three parts, which questioned the physicians' sociodemographic characteristics and professional choices, including the Depression Anxiety Stress Scale-Short Form (DASS-21) items and the Decision Regret Scale. Results: Of the physicians, 216 (72.0%) chose the medical faculty due to personal preference. The percentage of those who were not regretful about their career choice was 14.3% (n = 43). Those not regretful about their career choice had fewer years in the profession than the others. According to the categorical assessment of the DASS-21, 73.7% (n = 221) of the physicians had depressive symptoms ranging from mild to severe, 78.7% (n = 236) had anxiety symptoms ranging from mild to severe, and 57.7% (n = 173) had stress symptoms ranging from mild to severe. Conclusion: Mental health problems such as depression, anxiety, and stress were common among the resident physicians independent of their sociodemographic characteristics, and this was also associated with the level of career regret. Improving working conditions and personal benefits, addressing economic and other issues for physicians, ensuring their well-being, preventing the development of mental health problems, and early screening and rehabilitation for those affected not only have personal benefits but also contribute positively to job satisfaction, strengthen the patient-physician relationship, and have a significant impact on healthcare services. [ABSTRACT FROM AUTHOR]

Cardiologists will commonly assess patients who hold an aviation medical certificate and require unique assessments and communications with national civil aviation authorities (in Australia, the Civil Aviation Safety Authority [CASA] and in New Zealand, the Civil Aviation Authority of New Zealand [CAA NZ]). Cardiac conditions are the most common reason for disqualification from holding an aviation licence, and coronary artery disease is considered a high-risk condition for pilot incapacitation. To provide a contemporary update on the aeromedical approach to the evaluation, detection, and management of coronary artery disease in an Australasian context. A narrative view of current and historical practice in the area of aeromedical evaluation of coronary disease was undertaken. This review highlights the aeromedical approach to risk stratification and specific challenges of the aviation environment for patients with coronary artery disease. Scenarios of coronary artery disease screening, common and rare acute coronary syndromes, and the assessment of established coronary artery disease are examined in detail. Suggestions to facilitate communications between specialists and CASA or CAA NZ to facilitate patient re-certification are also provided. Patients who are pilots have unique requirements in terms of their coronary assessment, management, and follow-up to maintain eligibility to fly. It is important for cardiologists to be aware of relevant occupational requirements to provide optimal care to their patients. [ABSTRACT FROM AUTHOR]

Purpose: Lower extremity chronic exertional compartment syndrome (LE-CECS) can limit rigorous physical activity, particularly in the US military, and fasciotomy is a potential treatment. Associations between LE-CECS, fasciotomy, and occupational outcomes appear understudied. We studied active-duty US service members to identify whether LE-CECS diagnoses and fasciotomy for LE-CECS predict military service separation. Methods: We conducted a retrospective cohort study of 1,103,417 individuals who entered service during 2011 to 2017. Distributions of separation statuses and independent variables were tabulated, and sex-specific multivariable regression models were computed for separation outcomes. Results: LECECS was associated with a 474% medical service separation risk in men (95% confidence interval (CI) for adjusted risk ratio: 5.21 to 6.33) and a 282% increase in women (CI: 2.99 to 4.88). Among 1947 patients with LE-CECS, men saw a 57% nonmedical separation risk increase (CI: 1.27 to 1.93) and women had a 119% increase (CI: 1.10 to 4.35) when anterior and/or lateral compartment procedures occurred. Men with LE-CECS and any posterior procedures saw a 47%nonmedical separation risk increase (CI: 1.17 to 1.86). Men with anterior and/or lateral procedures and any posterior procedures experienced 36% (CI: 1.09 to 1.71) and 78% (CI: 1.40 to 2.26) medical separation risk increases, respectively. No statistically significant risk increases for the outcomes were otherwise seen for women. Conclusions: LE-CECS was associated with increased military service discharge risks. Among the affected patients, positive effects on career longevity were not seen in association with fasciotomy. However, fasciotomy could simply serve as a marker of the most refractory cases that are least likely to continue service. More study is needed to clarify causal pathways and identify patients who may derive career benefits from surgical treatment. [ABSTRACT FROM AUTHOR]

Background Smoking kills 8 million people a year worldwide. It is the most prevalent cause of death in France by cancer, cardiovascular, or respiratory diseases. Minimal advice consists in asking patients who smoke if they are interested in quitting. It is effective in reducing smoking. The French High Health Authority recommends its systematic use with patients, whatever their reason for seeking treatment. The beneficial effect of spirometry on smoking cessation is controversial. The objective of our study was to measure the consequences of spirometry associated with minimal advice, compared with only minimal advice in soldiers seen during a routine medical examination. Methods Our prospective, longitudinal, open, multicenter, controlled, randomized study was conducted among French military smokers presenting for an occupational medicine visit. Each participant received, depending on their group (intervention or control), either minimal advice associated with an evaluation of lung function by mini-spirometer, or only minimal advice. Follow-up visits were performed at 6 and 12 months. The primary objective was self-reported tobacco use cessation at 6 months. Results A total of 267 participants (126 in the intervention group and 141 for the control arm) were included in 10 centers between June 2019 and June 2020. The response rate was 75.6% at 6 months. The cessation rates were 17% and 18% in the intervention and control groups, respectively, with no significant difference between the two groups (P  = 0.9). The cessation rate in the general population was 13% at 6 months. Conclusions Spirometry does not seem to influence smoke cessation on a military population at 6 months. The overall cessation rate in our study was well in excess of the 3-6% expected from only providing minimal which is underused in general practice and should be encouraged. [ABSTRACT FROM AUTHOR]

Industrial wool textile production exposes workers mainly to the biomechanical loading of the shoulder joint. In this work context, which is characterized by poor machine ergonomics, exposure to biomechanical risk factors, and variable work organization, exoskeletons could facilitate work processes or could be a valuable means to protect workers from overuse injuries. Field evaluation is essential to verify the suitability of specific devices and their acceptance by users. As part of a pilot study, we examined the short-term subjective effects of a passive Arm-Support Exoskeleton (ASE) on workers performing repetitive overhead tasks. In a textile factory, eight workers participated in the study, answering questionnaires after carrying out a work session with (ASE) and without an exoskeleton (FREE). Participants had been using the Paexo exoskeleton for 4.2 ± 5.8 months (min 0–max 12). Subjective evaluations were collected regarding the workload (NASA-TLX) and relief (Borg's CR10 scale) obtained from the use of the exoskeleton, satisfaction (Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST)), usability (System Usability Scale (SUS)), and opinions on the ergonomics of the device (Ergonomics questionnaire). Workers reported a high workload (NASA 7.2 ± 1.0 ) and assessed a 46% reduction in effort on the CR10 in ASE conditions compared to FREE. They expressed high satisfaction with most characteristics of the ASE (100% satisfied with durability and effectiveness), high level of usability (62% of scores above 80, out of a maximum score of 100), and ergonomics of the device ( 88 ± 12 , out of a maximum score of 110). In addition to the objective effects (electromyography (EMG) reduction) already demonstrated in a previous publication, these qualitative results demonstrate a positive perception by textile workers regarding the effectiveness, usability, and suitability of the exoskeleton. The adoption of ASE in the textile industry appears beneficial in the short term, but the impact associated with individual variables and long-term effects remains to be explored. [ABSTRACT FROM AUTHOR]

Abstract Background Occupational biomonitoring is essential for assessing health risks linked to workplace exposures. The use of ‘omics’ technologies, such as metabolomics and proteomics, has become crucial in detecting subtle biological alterations induced by occupational hazards, thereby opening novel avenues for biomarker discovery. Aims This systematic review aims to evaluate the application of metabolomics and proteomics in occupational health. Methods Following the PRISMA guidelines, we conducted a comprehensive search on PubMed, Scopus, and Web of Science for original human studies that use metabolomics or proteomics to assess occupational exposure biomarkers. The risk of bias was assessed by adapting the Cochrane Collaboration tool and the Newcastle-Ottawa Quality Assessment Scale. Results Of 2311 initially identified articles, 85 met the eligibility criteria. These studies were mainly conducted in China, Europe, and the United States of America, covering a wide range of occupational exposures. The findings revealed that metabolomics and proteomics approaches effectively identified biomarkers related to chemical, physical, biomechanical, and psychosocial hazards. Analytical methods varied, with mass spectrometry-based techniques emerging as the most prevalent. The risk of bias was generally low to moderate, with specific concerns about exposure measurement and confounding factors. Conclusions Integrating metabolomics and proteomics in occupational health biomonitoring significantly advances our understanding of exposure effects and facilitates the development of personalized preventive interventions. However, challenges remain regarding the complexity of data analysis, biomarker specificity, and the translation of findings into preventive measures. Future research should focus on longitudinal studies and biomarker validation across diverse populations to improve the reliability and applicability of occupational health interventions.

OBJECTIVE: Occupational health has been influenced by societal and industrial changes. This study aimed to clarify topic trends in occupational health research in 1990–2022. METHODS: We conducted a text-mining-adjusted bibliometric study using research titles in occupational health. Data on research titles and the years of publication were collected from 26 peer-reviewed journals on PubMed. Using morphological and correspondence analyses in text mining, we structured research topics into multiple categories and visualized the relationship between all categories and publication years. Statistical analyses were conducted using the text mining software – KH Coder 3.0. RESULTS: We obtained 48 645 articles containing 714 890 words in their titles. The research topics were classified into 4 categories and 17 subcategories, of which those of occupations; countries; non-intervention; psychosocial factors; lifestyle factors; safety; symptoms; therapy and care; and productivity have recently shown an increasing trend. In contrast, the subcategories of risk, chemical factors, disease, and organ damage showed decreasing trends. Chemical factors, which were the main topics in the 1990s, included risk, organ damage, and disease. Productivity, the main topic in the 2020s, co-occurred with lifestyle factors, symptoms, and intervention. CONCLUSIONS: Focal areas in occupational-health research shift according to societal trends. Occupational-health research has primarily analyzed issues in developed countries with capitalist values and may not have sufficiently covered issues in developing countries. It is imperative for policymakers and public funding bodies to determine priorities for investigation in the field.

In the context of facing the dual challenges of aging population and declining birth rates, the absolute number of working-age population in China is decreasing, while the proportion of middle-aged and elderly workers is significantly increasing. However, China possesses a vast labor force, and the advantages of talent dividend are gradually emerging, both of which can offset the negative impact of the shrinking demographic dividend on social productivity. Labor is the most active factor among various production factors and is an important component for developing new quality productive forces. With the development of new quality productive forces, occupational health and occupational medicine are presented with new development opportunities. In the process of aging of the labor force, occupational health and occupational medicine can investigate how to utilize next-generation information technology, artificial intelligence, biotechnology, and other growth engines to safeguard the occupational health of workers, extend their working lives, actively unleash their creativity and initiative, and compensate for the labor shortage caused by an aging population and the potential decrease in labor productivity. This transformation in occupational health and occupational medicine is not only crucial for the health and career development of workers in an aging society, but will also have a positive impact on the creation of an age-friendly society and the sustainable development of productivity.

It has been observed widely that, on average, Black individuals in the United States have lower FVC than White individuals, which is thought to reflect a combination of genetic, environmental, and socioeconomic factors that are difficult to disentangle. Debate therefore persists even after the American Thoracic Societys 2023 guidelines recommending race-neutral pulmonary function test (PFT) result interpretation strategies. Advocates of race-based PFT results interpretation argue that it allows for more precise measurement and will minimize disease misclassification. In contrast, recent studies have shown that low lung function in Black patients has clinical consequences. Furthermore, the use of race-based algorithms in medicine in general is increasingly being questioned for its risk of perpetuating structural health care disparities. Given these concerns, we believe it is time to adopt a race-neutral approach, but note that more research is urgently needed to understand how race-neutral approaches impact PFT results interpretation, clinical decision-making, and patient outcomes. In this brief case-based discussion, we offer a few examples of how a race-neutral PFT results interpretation strategy will impact individuals from racial and ethnic minority groups at different scenarios and stages of life.

A focus on sustainable employability has recently become more prevalent in research and practice. The working population ages, and employers' demand for work exceeds its supply, making the need for continued labour at later ages greater. Accordingly, the urgency of reducing sick leave is increasing. In this article the need for sustainable return-to-work trajectories is emphasised, as returning to work after sick leave can be challenging and often unsuccessful on the long term. I demonstrate the need for sustainable return-to-work trajectories by sketching the global issue of workplace absence and comparing how organisations in different countries respond to short-term and long-term sick leave. This comparison lays bare large gaps between theory and practice in recovery and return-to-work. Using insights from management science, industrial and organisational psychology, and occupational medicine, I reflect on ways to support a more sustainable (long-term) return-to-work, in which the emphasis is placed on sufficient time to recover and a contextualised, holistic approach to return-to-work. This approach is illustrated to be beneficial to both the employer and the employee. [ABSTRACT FROM AUTHOR]

Abstract Background Occupational medicine (OM) faces considerable challenges today, one of them related to the university training of future physicians considered suboptimal at a global level as it has been pointed out in many studies. The aim of this study is to update the state of OM medical education in European universities. Methods Between March and August 2022, an e-mail survey regarding OM training to undergraduate medical students was conducted among OM professors at European universities in 28 countries (n = 347). Results Of the 347 universities, 53 medical schools from 19 countries responded (response rate = 15.3%). In 89% of cases, OM was taught. The average number of hours per academic year was 24.3, with significant variation within the same country. Lectures were the most popular teaching technique (98%), with a considerable use of modern approaches such as problem-based learning (61%), and e-learning (57%). While occupational diseases and principles of prevention were covered, other subjects such as the environmental impact or collaboration with an OM physician were poorly represented in the educational program. Conclusion According to data, several European medical schools may provide insufficient OM education and training to their students. The education of undergraduate occupational medicine students in European medical schools should be designed to equip them with the knowledge and skills required to meet today’s challenges. It is critical that undergraduate OM education in European medical schools be enhanced, harmonized, and standardized.

Objectives. Carrying out SWOT analysis of undergraduate and postgraduate training programs to identify factors that may affect the quality, sustainability, and relevance of the program, with the aim of contributing to the training of occupational health and safety specialists. Material and methods. The SWOT analysis was carried out on four curricula, which were developed and applied in the period 2021–2023, within the Nicolae Testemitanu State University of Medicine and Pharmacy from the Republic of Moldova. Occupational health training programs are intended for students, residents, and physicians. Results. The SWOT analysis of the "Occupational Health" curriculum underscores its comprehensive approach to workplace health and the delivery of essential competencies. Strengths include clearly defined, relevant objectives, integration of related disciplines, and broad topic coverage. Nevertheless, challenges may arise from limited intersectoral collaboration and resource constraints. Opportunities lie in cross-disciplinary integration and industry partnerships, while threats stem from the rapidly evolving field and potential program stagnation. In the case of "Occupational Medicine and Occupational Diseases," it offers a practical approach but demands prerequisite knowledge and updates for sustained effectiveness. "Occupational Medicine" boasts diversity and accessibility but faces duration and funding challenges. "Workplace Health Promotion" addresses contemporary concerns but necessitates adequate funding and resources. Conclusions. Through a strategic approach and collaboration with stakeholders, the quality and relevance of the program can be ensured, contributing to the preparation of occupational health specialists for the current and future needs of the labor market.

Background: Severe eosinophilic asthma (SEA) is often linked to a dysregulation in the Interleukin-(IL)-5 axis. Mepolizumab, a humanized monoclonal antibody, reduces eosinophils by directly binging to IL-5, potentially restoring homeostatic eosinophil biology, with a significant impact on quality of life, acute exacerbations and oral corticosteroids (OCS) elimination in SEA patients. While its short-and middle-term effects are well described, no study has so far investigated its longlasting effects in SEA patients. The aim of our study was therefore to explore the effects of a long-term, six-year continuous treatment with mepolizumab on clinical control and clinical remission in a cohort of SEA patients. Methods: We conducted a retrospective review of clinical records of patients who were prescribed mepolizumab between June 2017 and April 2018. We collected demographical, functional, and clinical data from visits performed at baseline and then at the specified timepoints and checked if patients had reached clinical remission after 6 years. We assessed asthma control test (ACT), exacerbation rate, and OCS elimination dose at 6 years. Clinical Remission (CR) was defined on the basis of the elimination of OCS and the contemporary presence of all the following: 1) stable lung function; 2) no exacerbation in the previous 12 months; 3) acceptable symptom control (ACT ≥ 20). Results: Of 86 patients screened, 62 were included in the final analysis. Our study suggests that mepolizumab is effective and well tolerated after a six-year course of continuous treatment in patients with SEA. We reported a prevalence of 28 (46.8%) patients who reached complete CR at 72 months from the treatment start. 75% of patients eliminated the maintenance OCS already after 1 year of treatment; this proportion reached the 87% within the sixth year of treatment. Conclusion: Mepolizumab proved to be effective in real-life after 6 years of treatment, inducing a complete clinical remission in the 46.8% of patients, with sustained improvements in quality of life, exacerbation rate, OCS intake and lung function. [ABSTRACT FROM AUTHOR]

AbstractThis article presents a case report of a three and half year-old boy with functional constipation and sensory hyperreactivity. The Integrated Sensory Toileting® approach was used to guide clinical reasoning and identify the sensory underlying factors that were impacting the child’s ability to acquire age-appropriate toileting habits and gastrointestinal health. The six months of treatment in occupational therapy and gastroenterology, as well as six months of follow-up are described. Improvements in sensory reactivity are documented using the Sensory Processing Measure-2 and the Toileting Habit Profile Questionnaire-Revised and corroborate with improvements in the child’s ability to participate in toileting routines and improved gastrointestinal health. [ABSTRACT FROM AUTHOR]

Background: Occupational medicine (OM) faces considerable challenges today, one of them related to the university training of future physicians considered suboptimal at a global level as it has been pointed out in many studies. The aim of this study is to update the state of OM medical education in European universities. Methods: Between March and August 2022, an e-mail survey regarding OM training to undergraduate medical students was conducted among OM professors at European universities in 28 countries (n = 347). Results: Of the 347 universities, 53 medical schools from 19 countries responded (response rate = 15.3%). In 89% of cases, OM was taught. The average number of hours per academic year was 24.3, with significant variation within the same country. Lectures were the most popular teaching technique (98%), with a considerable use of modern approaches such as problem-based learning (61%), and e-learning (57%). While occupational diseases and principles of prevention were covered, other subjects such as the environmental impact or collaboration with an OM physician were poorly represented in the educational program. Conclusion: According to data, several European medical schools may provide insufficient OM education and training to their students. The education of undergraduate occupational medicine students in European medical schools should be designed to equip them with the knowledge and skills required to meet today's challenges. It is critical that undergraduate OM education in European medical schools be enhanced, harmonized, and standardized. [ABSTRACT FROM AUTHOR]

The Green Transition aims to protect the health of our planet through changes at the economic, political, and social levels while also having a significant impact on the world of work through the creation of sustainable occupations, referred to as 'Green Jobs'. The aim of our research was to identify the new emerging occupational risks associated with Green Jobs and to propose a protocol to promote the adoption of more appropriate prevention and protection measures. Starting with a few keywords chosen by the authors, we conducted a narrative review of the scientific articles published in the literature. The results obtained show that the new occupational risks emerging in the activities involved in the green transition are mainly related to the introduction of new materials or new technologies and to modes of production processes. These risks may pose a danger to those exposed to them on a daily basis, causing damage to health. Our protocol proposal calls for a more careful and adequate risk assessment for Green Jobs, providing specific training on these issues for new professionals in the sector and introducing specific prevention and protection measures for the different occupational risks analysed in the workplace. By adopting these recommendations in the workplace and conducting in-depth research on these issues, it will be possible to contribute to the improvement of prevention and protection for these new emerging occupational risks, achieving a positive economic impact and better safety conditions for workers. [ABSTRACT FROM AUTHOR]

The article promotes the fifth European exam for the Specialty of Occupational Medicine, which will take place on October 21, 2024 in Brussels. The exam is aimed at final year residents or recent graduates in the specialty, and complies with European Training Requirements. The UEMS coordinates and accredits continuing medical education, and the certificate issued by the UEMS is recognized in all European countries, which can facilitate job opportunities abroad. [Extracted from the article]

The document presents information about the European exams of the Occupational Medicine Section of the UEMS. The fifth European exam for the Specialty in Occupational Medicine will take place on October 21, 2024 in Brussels. The exam is aimed at specialists in Occupational Medicine, especially residents in their final year or recent graduates. The importance of these exams for the training of specialists in Europe is highlighted. [Extracted from the article]

The article focuses on the first annual meeting of the Occupational Medicine Section of the European Union of Medical Specialists (UEMS-OM) in 2024, which took place in Slovenia. Representatives from 17 countries, as well as the European Association of Schools of Occupational Medicine (EASOM), ETUC, Business Europe, and EU-OSHA participated. Challenges and collaborations in the field of Occupational Health were discussed, with an emphasis on prevention and gender inclusion in the workplace. [Extracted from the article]

The document presents the first annual meeting of the Occupational Medicine Section of the European Union of Medical Specialists (UEMS-OM) in 2024, with the participation of representatives from various European countries, as well as organizations such as ETUC, Business Europe, and EU-OSHA. Current challenges in Occupational Health were discussed and greater collaboration among stakeholders was proposed. Additionally, the Examining Committee for the European specialty examination was partially renewed, which will take place in October 2024 in Brussels. [Extracted from the article]

The article focuses on the first annual meeting of the Occupational Medicine Section of the European Union of Medical Specialists (UEMS-OM) in 2024 in Portoroz, Slovenia. Representatives from 17 countries, including Spain, participated, and the European Association of Schools of Occupational Medicine (EASOM), ETUC, Business Europe, and EU-OSHA were present. Challenges in Occupational Health were discussed and proposals for collaboration between stakeholders were established. Additionally, the Examining Committee for the European specialty examination was partially renewed. [Extracted from the article]

Issue Addressed: Farmers experience skin cancer and die from melanoma at significantly higher rates than the general Australian population. This study examined Australian farmers' engagement with self‐skin examinations (SSE), participation in clinical skin examinations (CSE) by a health professional, and self‐reported barriers to engagement with these important skin cancer detection practices. Methods: A cross‐sectional, mixed‐methods design was used. Australian farmers were recruited through an industry‐based organisation representing livestock farmers. Farmers (N = 498; 22–89 years; 83.1% male) responded to a paper‐based survey that included closed‐ and open‐ended questions. Results: Farmers reported engagement with self‐conducted SSE and routine CSE that was comparable to findings in the general population, but 29.4% of farmers reported that they had not sought a CSE as soon as possible after noticing changes to their skin. Farmers reported a range of barriers to SSE, including physical difficulties examining their skin, difficulties identifying changes in their skin, forgetfulness, and lack of motivation. Barriers to CSE included accessibility, cost, difficulties finding the right doctor, and avoidance and complacency. Conclusions: There is a need to make clinical skin cancer detection more accessible to farmers, in addition to promoting self‐skin examination and help‐seeking behaviours within this at risk population. So What?: Novel approaches are needed to address systemic barriers faced by Australian farmers. These may include the use of teledermatology or artificial intelligence to assist with CSE. Remote training delivery methods may be also utilised to teach SSE skills to farmers who may be otherwise unable to access such opportunities. [ABSTRACT FROM AUTHOR]

Many physicians have not received formal training in occupational medicine, yet they are often asked to help their patients with work-related concerns. Four general questions are presented for physicians to consider when dealing with such issues: (1) Beyond duties to the patient as part of the doctor-patient relationship, what other professional obligations exist? (2) What should and shouldn't be communicated to employers and other third parties? (3) Are there clear clinical justifications for all recommendations and notes provided? (4) Outside of clinical management, where can patients be directed for more help? Advice is offered to better explain the roles and responsibilities physicians may have in these encounters. [ABSTRACT FROM AUTHOR]

Background: Asbestos causes cancer and non‐cancerous lung and pleural diseases and can also have a negative psychological impact but little is known about its effect on health‐related quality of life. Objectives: The aim of this study is to describe the health‐related quality of life (HRQoL) of retired men with a history of occupational exposure to asbestos and examine factors linked with low HRQoL. Methods: Retired male workers of the French Asbestos‐Related Disease Cohort (ARDCO) completed self‐questionnaires that included SF‐36v2 and HAD scales, questions about their perception of asbestos (perceived dangers and level of exposure, expectations to fall ill, or knowing someone who is) and their respiratory symptoms. Asbestos exposure was assessed by industrial hygienists. A perceived risk score was created using factorial analysis. Multivariable regressions were performed for all SF‐36 subscales. Results: A total of 1266 of 2075 questionnaires (61%) were returned complete and included in analysis. After adjustment for potential confounders, an increase in perceived risk score resulted in a decrease in physical component summary score (PCS), up to 10.7 points (p = 0.048) and in mental component summary score (MCS) (p = 0.044). Presence of respiratory symptoms was also associated with significantly decreased PCS and MCS (p < 0.001). Poor HRQoL was linked to higher perceived risk score with p ≤ 0.01 for all SF‐36 dimensions. Asbestos exposure assessed by an expert was not associated with any outcome. Conclusions: All dimensions of HRQoL appear to be affected by the perceived risk of incurring asbestos‐related disease and respiratory symptoms. [ABSTRACT FROM AUTHOR]

Background: Occupational physicians (OPs) can lead to substantial economic costs due to work-related injuries and diseases, including early retirement, skill loss, and increased medical and insurance expenses. These have led the American College of Occupational and Environmental Medicine (ACOEM) established competencies for OPs. Objective: To investigate the occupational medicine practices among physicians in Thailand according to residency training in preventive medicine, or occupational medicine, course in various settings including medical residency training institute, tertiary hospital, and company or factory. Materials and Methods: The present study was a qualitative design research by structural in-depth interviews. The study sample consisted of 15 OPs, selected through criterion sampling. The research tools included a structured interview form with two parts, 1) personal information, 2) competency of OPs in practice according to the World Federation of Medical Education (WFME) Standard. Results: Twelve out of 15 OPs (80%) participated in the present study. The findings revealed that the predominant workplace was in tertiary hospitals at 58.33%. These physicians mainly conducted fitness for work and return to work assessments for 75%, which requires compliance with legal mandates. Medical emergencies in workplaces were less often addressed, with 66.67% of physicians reporting infrequent handling. They attributed this to the limited regulations. Notably, adherence to the Occupational Safety and Health Administration (OSHA) medical surveillance standards was low, showing a preference for the Thai over global regulations. Fit for work assessments were common, averaging 48 cases per month, while disease investigation was minimal, at less than one case per month. Confidence levels mode was five points across most of the competencies, with lower confidence in conducting occupational disease investigations due to low volume of cases. Conclusion: Fitness for work assessment was the most proficient and frequently used practice among Thai OPs. The practice of OPs should adhere to the clear laws and guidelines to ensure the expertise of OPs in performing their duty effectively. [ABSTRACT FROM AUTHOR]

BACKGROUND: During the COVID-19 pandemic, digital working methods were increasingly implemented within the setting of German public administrations. Beyond the ostensible risk of infection, a high psychological burden arose for the employees. OBJECTIVE: A subsequent progression of mental strain is to be estimated as a residual effect (approximated by controlling other influencing factors) due to the impossibility of a counterfactual control group. METHODS: An online survey was conducted in 2020 and repeated in 2021 among a cohort of n = 706 employees of 38 departments of three public administrations in North Rhine-Westphalia, Germany. Mental strain was assessed by the Wuppertal Screening Instrument. Its temporal variation was operationalized as the intercept of a first-difference multiple regression model. Unit of analysis was the department level. RESULTS: The prevalence of suboptimal and dysfunctional strain increased from 71% to 73%. The multiple regression model showed a significant increase whilst controlling the influence of socio-demographic changes on the department level. Children, age and educational level were significant predictors. R2 indicated that about 40% of the variance in the temporal variation of mental strain could be explained. CONCLUSION: The observed factors explained a significant proportion of the increase in mental strain in German public administrations. Still, far more than half of the increase stemmed from external influences which were largely determined by pandemic conditions and latency effects remain still to be seen. [ABSTRACT FROM AUTHOR]

Data on post‐coronavirus disease (COVID) in healthcare workers (HCWs) are scarce. We aimed to assess prevalence, determinants, and consequences of post‐COVID in HCWs. In fall 2022, we performed a cross‐sectional survey in a tertiary care hospital with a web‐based questionnaire sent to HCWs. Post‐COVID was defined as persistent/new symptoms 3 months after acute COVID. Propensity score weighting was performed to assess the impact of post‐COVID on return‐to‐work. 1062 HCWs completed the questionnaire, 713 (68%) reported at least one COVID, and 109 (10%) met the definition for post‐COVID, with workplace contamination reported in 51 (47%). On multivariable analysis, risk factors for post‐COVID were female gender (p = 0.047), ≥50 years (p = 0.007), immunosuppression (p = 0.004), ≥2 COVID episodes (p = 0.003), and ≥5 symptoms during acute COVID (p = 0.005). Initial sick leave was prescribed for 94 HCWs (86% post‐COVID), for a median duration of 7 [7–9] days, and extended for 23. On return‐to‐work, 91 (84%) had residual symptoms, primarily asthenia/fatigue (72%) and cognitive impairment (25%). Cognitive impairment at return‐to‐work was associated with post‐COVID. Ten HCWs (9%) received a medical diagnosis of post‐COVID, 8 consulted the occupational physician, and four required work adaptation. Post‐COVID affected 10% of HCWs. Long‐term consequences included repeated sick leaves and residual symptoms on return‐to‐work. [ABSTRACT FROM AUTHOR]

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ObjectiveOccupational health (OH) documentation has traditionally been separate from health system electronic health records (EHRs), but this can create patient safety and care continuity challenges. Herein, we describe outcomes and challenges of such integration including how one health system managed compliance with laws, regulations, and ethical principles concerning digital privacy.MethodsOccupational health integration with the enterprise EHR at the University of California San Diego Health was started in June 2021 and completed in December 2021.ResultsIntegrating with the enterprise EHR allowed for a secure telehealth system, faster visit times, digitization of questionnaires medical clearance forms, and improved reporting capabilities.ConclusionsIntegration and interoperability are fundamental building blocks to any OH EHR solution and will allow for evaluation of worker population trends, and targeted interventions to improve worker health status.

Nanoenergetics are defined as a class of nanomaterials that possess the ability to release energy in certain situations. These properties have been studied and deepened in recent years, so much so that nanoenergetics have been introduced into the use of the weapons industry, among others. It is therefore an emerging reality that deserves attention with regard to potential harmful effects on human and environmental health. it has been suggested that nanoenergetics may have genotoxic and immunotoxic effects, among others. Problems related to exposure to nanonenergetics can therefore potentially affect both exposed workers (both in the production and use phase) and the civilian population, if used in war scenarios, for example,. Starting from these assumptions, the INNOTOX research project aims to contribute to the in-depth study of the toxicity of nanonenergetics, through an integrated approach involving experts in occupational and forensic medicine, nanotoxicology and bioengineering.

Exposure of an individual to occupational and environmental risk factors for a certain disease affects them and their family. Children are highly vulnerable in this setting because they are family-dependent. This review discusses diseases that occur in children according to the occupational and behavioral characteristics of their parents. Toxic agents in the home environment can affect children’s health. Maternal exposure to substances during pregnancy may directly affect fetal outcomes. The Industrial Accident Compensation Insurance Act in Korea was amended in 2023 to compensate for children’s adverse health effects due to their parents’ occupational risks. The long working hours and smoking behaviors of parents and toxic materials in the home environment are highlighted. To control for the diverse factors affecting children’s health in medical research, this review introduces directed acyclic graphs. Pediatric, occupational, and environmental medicine must collaborate to prevent childhood diseases related to environmental factors.

Abstract Background The objective was to investigate self-reported hand eczema, and skin complaints at other skin locations among workers exposed to particulate matter, especially ultrafine particles. Method We conducted a cross-sectional study on workers from one ferro-silicon smelter plant, eight chimney sweeper stations and one firefighter station across Norway. Participants answered an extended version of the Nordic Occupational Skin Questionnaire (NOSQ-2022), with additional questions about whole-body skin complaints and visible dust deposition. Results are presented as descriptive data using firefighters as reference group. Odds ratio (OR) was calculated using logistic regression on lifetime prevalence of hand eczema adjusted for potential confounders and mediators. P-values were calculated using likelihood ratio test against the crude OR. Results A total of 186 participants answered the questionnaire: 74 chimney sweepers, 52 firefighters and 60 smelter workers. Participation rate was 95.0, 94.5 and 63.6%, respectively. Lifetime prevalence of hand eczema was 9.5, 9.6, and 28.3%, respectively. The point prevalence of hand eczema was 1.4, 1.9 and 10.0%, respectively. We estimated OR for lifetime hand eczema in smelter workers to 4.36 [95% CI: 1.31–14.43, p = 0.016] and for lifetime skin complaints in other locations to 2.25 [95% CI: 0.98–5.18, p = 0.058]. The lifetime prevalence of skin complaints at other locations was 18.9, 23.1 and 40.0%, respectively. The point prevalence was 14.9, 9.6 and 16.7%, respectively. These estimates were not statistically significant but indicates that smelter workers have more skin complaints also at other locations. Conclusion This study reports a more than four-fold increased risk of hand eczema in smelter workers, and possibly a higher risk of skin complaints in other body locations, compared to the other occupations. Longitudinal studies with larger population are needed to verify the marked increased risk of eczema among smelters and establish causation.

Abstract Background Well-being is an important issue in workplace. One of these assessment tools of well-being, Workplace PERMA Profiler, is based on Seligman’s five dimensions well-being. Prolonged fatigue may last for a long time, leading a great impact on both employees and enterprises. However, rare studies about the association between well-being and fatigue had been investigated. Our aim is to establish the Chinese version Profiler, and to discovery the association between workplace well-being and fatigue. Methods The Chinese version was established according to International Society of Pharmacoeconomics and Outcomes Research (ISPOR) task force guidelines. In the study, researchers employed simple random sampling by approaching individuals undergoing health checkups or receiving workplace health services, inviting them to participate in a questionnaire-based interview. Prolonged Fatigue was evaluated by Checklist Individual Strength (CIS). The reliability was evaluated by Cronbach’s alphas, Intra-class Correlation Coefficients (ICCs), and measurement errors. Moreover, confirmatory factor analysis and correlational analyses were assessed for the validity. Results The analyses included 312 Chinese workers. Cronbach’s alphas of the Chinese version ranged from 0.69 to 0.93, while the ICC ranged from 0.70 to 0.92. The 5-factor model of confirmatory factor analysis revealed a nearly appropriate fit (χ2 (82) = 346.560, Comparative Fit Index [CFI] = 0.887, Tucker-Lewis Index [TLI] = 0.855, Root Mean Square Error of Approximation [RMSEA] = 0.114, Standardized Root Mean Square Residual [SRMR] = 0.060). Moreover, the CIS and its four dimensions were significantly and negatively associated with the Positive Emotion, while they are positively associated with Engagement dimension except CIS-Motivation dimension. Conclusion The Chinese version Workplace PERMA-Profiler indicate nice reliability and validity. Furthermore, all CIS dimensions were negatively influenced by Positive Emotion, while commonly positively associated with Engagement.

OBJECTIVE: The study aimed to identify the effects of ground reaction forces (GRF) recorded during landing in typical elements of three dance styles, including classical, modern, and folk dance, on injuries` topography. METHODS: The research involved a survey and measurements of GRF generated during landing after the jump. The survey involved a group of 90 professional dancers. In the questionnaire, the dancers marked areas of the human body that were affected at least once by injuries. Biomechanical tests of the GRF recording were conducted on a group of 15 professional dancers. The analysis focused on the following parameters: a maximum value of the vertical variable of the GRF relative to body weight (maxGRF_z), the time between the moment from first foot contact with the ground to the moment of reaching the maxGRF_z (_tmaxGRFz), and the loading rate of the GRF relative to body weight (LR_GRFz). RESULTS: Regardless of dance style and sex, the lower spine, knee joints, ankle joints and feet were the areas most affected by injuries among professional dancers. The level of maxGRF_z, t_maxGRFz and LR_GRFz during typical jumps in classical, modern, and folk dance was statistically significantly different (P

This updated guideline replaces the "Guideline for the application of heart rate and heart rate variability in occupational medicine and occupational health science" first published in 2014. Based on the older version of the guideline, the authors have reviewed and evaluated the findings on the use of heart rate (HR) and heart rate variability (HRV) that have been published in the meantime and incorporated them into a new version of this guideline. This guideline was developed for application in clinical practice and research purposes in the fields of occupational medicine and occupational science to complement evaluation procedures with respect to exposure and risk assessment at the workplace by the use of objective physiological workload indicators. In addition, HRV is also suitable for assessing the state of health and for monitoring the progress of illnesses and preventive medical measures. It gives an overview of factors influencing the regulation of the HR and HRV at rest and during work. It further illustrates methods for measuring and analyzing these parameters under standardized laboratory and real workload conditions, areas of application as well as the quality control procedures to be followed during the recording and evaluation of HR and HRV. [ABSTRACT FROM AUTHOR]

Occupational nerve injuries span a broad array of pathologies and contribute toward functional limitation, disability, and economic impact. Early and accurate recognition, treatment, and management of workplace factors rely on a thorough understanding of the anatomic and biomechanical factors that drive nerve injury. This review explores the interplay between anatomy, biomechanics, and nerve pathology common to occupational nerve injury and provides the treating physician with a rational, evidence‐based approach to diagnosis and to occupational aspects of management. Assessment of potential occupational nerve injury begins with a detailed understanding of the employee's work duties through a biomechanical lens. One must consider likelihood of occupational causation while accounting for predisposing conditions or preexisting symptoms. Beyond overt crush injury or laceration, potential mechanisms of nerve injury, with effects compounded over time, include compression, stretch, vibration, and repetitive or high‐force movements of regional muscles and joints. Injury often occurs at nerve locations that experience higher pressures, changes in pressure over time, or abrupt changes in trajectory, often near a tethered point. This understanding, coupled with condition‐specific knowledge presented in this review, equips managing physicians to diagnose occupational nerve injury and enhance treatment recommendations with rational activity modifications or equipment that can protect the nerve or decrease likelihood of continued injury. Long‐term management often involves follow‐up to assess effectiveness of interventions in the setting of the work environment, with gradual progression of the worker toward return to unrestricted duty or to a point of maximal medical improvement. [ABSTRACT FROM AUTHOR]

Occupational diseases are characterized by diseases produced or unleashed by the professional exercise peculiar to a given activity. Even though they are present in work environments, these workers cannot always identify the risk factors or even the diseases to which they are exposed. In this sense, this paper aims to report the experience of a group of researchers during the execution of extension activities through worker health education actions to prevent occupational diseases. To this end, an Instagram account was created, where informative posts and news on topics related to Occupational Medicine were periodically shared. In addition, through the Family Health Strategy (FHS) Units, didactic and interactive lectures were offered to the working population, and distribution folders addressing the central occupational diseases. At the end of the project, the Instagram profile reached 717 followers. Thirty-three publications were made, which were reposted in stories and reached a total of 7544 views. In addition, lectures were given in the waiting room of 24 FHS, reaching 210 people. With this, it was possible to consider that the execution of the extension project was successful because it contributed to the dissemination and expansion of workers' knowledge about occupational diseases resulting from work. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study is to understand the needs and interests of occupational medicine physicians (OMPs) as they transition to retirement. Methods: An electronic survey was distributed through member organizations in the United States (ACOEM), United Kingdom (SOM/FOM), India (IAOH), South Africa (SASOM), and Medichem. Results: Four hundred ninety-seven OMPs at various career stages responded, including 282 from the United States, 97 from the United Kingdom, 36 from India, 30 from South Africa, and 52 from other countries. Two hundred seventy-eight work full-time, 160 part-time, and 58 are not doing paid work. Approximately 60% serve as volunteers. Sixty percent have a written financial plan. Thirty-five percent are very comfortable with their retirement plans. After leaving full-time work, 85% plan to work part-time. There is a high level of interest in learning about opportunities for part-time work and volunteering. Conclusions: Occupational medicine physicians are very interested in learning more about compensated and uncompensated work in retirement. [ABSTRACT FROM AUTHOR]

Objectives Assess the impact of environmental heat and a rest-shade-hydration (RSH) intervention against heat stress on productivity of piece-paid Mesoamerican sugarcane cutters. These workers are at a high risk of chronic kidney disease of non-traditional origin (CKDnt), from the severe heat stress they experience due to heavy work under hot conditions. RSH interventions in these populations improve kidney health outcomes, but their impact on productivity has yet to be examined. Methods We accessed routine productivity data from seed (SC, N = 749) and burned (BCC, N = 535) sugarcane cutters observed over five harvest seasons with increasing RSH intervention at a large Nicaraguan sugarcane mill. Hourly field-site wet-bulb globe temperature (WBGT) was recorded by mill staff and summarized as a daily mean. Mixed linear regression was used to model daily productivity, adjusting for age (18–29, 30–44, and >45 years), sex, WBGT (<28, 28–29, 29–30, 30–31, and >31 °C) on the same and preceding day, harvest season (2017–18 to 2021–22), month, and acclimatization status (<1, 1–2, and >2 weeks). Results There was an inverse dose–response relationship between SC productivity and WBGT on the same and preceding days, decreasing by approximately 3%/°C WBGT. Productivity increased during the study period, i.e. coinciding with RSH scale-up, by approximately 19% in SC and 9% in BCC. Conclusion Agricultural worker productivity was expected lower on hotter days, strengthening the interest in all stakeholders to mitigate increasing global temperatures and their impact. Despite decreasing the total time allocated for work each day, an RSH intervention appears to result in increased productivity and no apparent loss in productivity. [ABSTRACT FROM AUTHOR]

Background: Short‐acting opioids have been utilized for pain management with little known about their use in patients on Workers' Compensation (WC) insurance. Our goal was to investigate this association in the ambulatory care setting. Methods: Using the National Ambulatory Medical Care Survey, visits from patients aged 18–64 during the years 2010 until 2018 were evaluated (excluding 2017 due to data availability). Demographic and co‐morbidity data from each visit was obtained along with the visit year. The first short‐acting opioid medication prescribed in the database was considered. Survey‐weighted frequencies were evaluated. Logistic regression estimated the crude and adjusted odds ratios (OR) with 95% confidence intervals for the use of short‐acting opioid prescription. Results: There were 155,947 included visits with 62.5% for female patients. Most patients were White with 11.7% identifying as Black, and 6% identifying as another race. Over 13% of the sample was of Hispanic descent. WC was the identified insurance type in 1.6% of the sample population. Of these patients, 25.6% were prescribed a short‐acting opioid, compared with 10.1% of those with another identified insurance. On multivariable regression, Black patients had increased odds of being prescribed a short‐acting opioid compared to white patients (OR: 1.22, 95% CI: 1.11–1.34). Those on WC had 1.7‐fold higher odds of being prescribed short‐acting opioids (95% CI: 1.46–2.06). Conclusion: Certain patient characteristics, including having WC insurance, increased the odds of a short‐acting opioid prescription. Further work is needed to identify prescribing patterns in specific high‐risk occupational groups, as well as to elicit potential associated health outcomes. [ABSTRACT FROM AUTHOR]