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Abstract Background Neurodevelopmental performance tasks are often separately analyzed, even when they tap into a similar construct. This may yield mixed findings for associations of an exposure-neurobehavioral outcome. We develop an item response theory (IRT) approach to integrate multiple task variables together to improve measurement precision of the underlying construct. We apply this approach to create an integrative measure of childhood inhibitory control, and study impacts of pre/post-natal lead exposure. Methods Using data from a prospective cohort based in Mexico (N = 533), we created an inhibitory control scale that integrates accuracy and reaction time information from four inhibitory control tasks (Go/NoGo Letter, Go/NoGo Neutral, Go/NoGo Happy, Delis-Kaplan Executive Function System (D-KEFS) Color-Word Interference Test, Condition 3). Using a generalized partial credit item response theory model, we estimated an inhibitory control index for each participant. We then assessed adjusted associations between umbilical cord blood and 4-year lead and childhood inhibitory control. We developed a resampling approach to incorporate error estimates from the inhibitory control variable to confirm the consistency of the lead-inhibitory control associations. We modeled time-varying associations of lead with each inhibitory control measure separately. Results Participants had a median age of 9 years; 51.4% were males. Umbilical cord blood [-0.06 (95% CI: -0.11, -0.01)] and 4-year lead [-0.07 (95% CI: -0.12, -0.02)] were associated with inhibitory control index at 8–10 years. A resampling approach confirmed that 4-year lead was consistently associated with childhood inhibitory control index. Umbilical cord blood and 4-year lead were each associated with 3 out of 8 measures in separate models. Conclusion This is the first application of IRT in environmental epidemiology to create a latent variable for inhibitory control that integrates accuracy and reaction time information from multiple, related tasks. This framework can be applied to other correlated neurobehavioral assessments or other phenotype data.

Abstract Background Epidemiological and toxicological studies indicate that increased exposure to air pollutants can lead to neurodegenerative diseases. To further confirm this relationship, we evaluated the association between exposure to ambient air pollutants and corneal nerve measures as a surrogate for neurodegeneration, using corneal confocal microscopy. Methods We used population-based observational cross-sectional data from The Maastricht Study including N = 3635 participants (mean age 59.3 years, 51.6% were women, and 19.9% had type 2 diabetes) living in the Maastricht area. Using the Geoscience and hEalth Cohort COnsortium (GECCO) data we linked the yearly average exposure levels of ambient air pollutants at home address-level [particulate matter with diameters of ≤ 2.5 µm (PM2.5), and ≤ 10.0 µm (PM10), nitrogen dioxide (NO2), and elemental carbon (EC)]. We used linear regression analysis to study the associations between Z-score for ambient air pollutants concentrations (PM2.5, PM10, NO2, and EC) and Z-score for individual corneal nerve measures (corneal nerve bifurcation density, corneal nerve density, corneal nerve length, and fractal dimension). Results After adjustment for potential confounders (age, sex, level of education, glucose metabolism status, corneal confocal microscopy lag time, inclusion year of participants, smoking status, and alcohol consumption), higher Z-scores for PM2.5 and PM10 were associated with lower Z-scores for corneal nerve bifurcation density, nerve density, nerve length, and nerve fractal dimension [stβ (95% CI): PM2.5 -0.10 (-0.14; -0.05), -0.04 (-0.09; 0.01), -0.11 (-0.16; -0.06), -0.20 (-0.24; -0.15); and PM10 -0.08 (-0.13; -0.03), -0.04 (-0.09; 0.01), -0.08 (-0.13; -0.04), -0.17 (-0.21; -0.12)], respectively. No associations were found between NO2 and EC and corneal nerve measures. Conclusions Our population-based study demonstrated that exposure to higher levels of PM2.5 and PM10 are associated with higher levels of corneal neurodegeneration, estimated from lower corneal nerve measures. Our results suggest that air pollution may be a determinant for neurodegeneration assessed in the cornea and may impact the ocular surface health as well.

Abstract Background While genetic, hormonal, and lifestyle factors partially elucidate the incidence of breast cancer, emerging research has underscored the potential contribution of air pollution. Polychlorinated biphenyls (PCBs) and benzo[a]pyrene (BaP) are of particular concern due to endocrine-disrupting properties and their carcinogenetic effect. Objective To identify distinct long term trajectories of exposure to PCB153 and BaP, and estimate their associations with breast cancer risk. Methods We used data from the XENAIR case–control study, nested within the ongoing prospective French E3N cohort which enrolled 98,995 women aged 40–65 years in 1990–1991. Cases were incident cases of primary invasive breast cancer diagnosed from cohort entry to 2011. Controls were randomly selected by incidence density sampling, and individually matched to cases on delay since cohort entry, and date, age, department of residence, and menopausal status at cohort entry. Annual mean outdoor PCB153 and BaP concentrations at residential addresses from 1990 to 2011 were estimated using the CHIMERE chemistry-transport model. Latent class mixed models were used to identify profiles of exposure trajectories from cohort entry to the index date, and conditional logistic regression to estimate their association with the odds of breast cancer. Results 5058 cases and 5059 controls contributed to the analysis. Five profiles of trajectories of PCB153 exposure were identified. The class with the highest PCB153 concentrations had a 69% increased odds of breast cancer compared to the class with the lowest concentrations (95% CI 1.08, 2.64), after adjustment for education and matching factors. The association between identified BaP trajectories and breast cancer was weaker and suffered from large CI. Conclusions Our results support an association between long term exposure to PCB153 and the risk of breast cancer, and encourage further studies to account for lifetime exposure to persistent organic pollutants.

Abstract Background Depression poses a significant challenge globally, including in safety-critical industries such as aviation. In Saudi Arabia, where the aviation sector is rapidly expanding, pilots encounter unique stressors inherent to their profession. However, research on pilot mental health, particularly within the Saudi context, remains limited despite its critical role in flight safety. Methods This cross-sectional survey was designed to estimate the self-reported prevalence of depression in a convenience sample of airline pilots in Saudi Arabia. Participants were recruited from various commercial airlines in Saudi Arabia. Recruitment efforts utilized targeted outreach on social media platforms, focusing on pilot forums and groups. The survey was administered online for accessibility and convenience. The structured questionnaire, developed through a literature review and expert consultation, comprises sections on demographic and professional characteristics, occupational information, health habits, and depression assessment via the Patient Health Questionnaire-9 (PHQ-9). Results This study enrolled 310 participants, with the largest cohort (34.8%, n = 108) falling within the 30–39 years age group, closely followed by individuals under 30 years (30.0%, n = 93). Males dominated the sex distribution (99.0%, n = 307). The mean PHQ-9 score was 8.2 ± 5.4. Notably, 40.6% (n = 126) of the participants had a score of 10 or higher, indicating the potential for moderate, moderate-severe, or severe depression. Multivariable binary logistic regression analysis revealed that pilots with 11–15 years of experience had greater odds of experiencing depression than did those with 0–10 years of experience did (odds ratio [OR]: 3.0, 95% confidence interval [CI]: [1.1–8.4], p = 0.04). Pilots with rest times exceeding 24 h had lower odds of depression than did those with rest times less than 1 h (OR: 0.3, 95% CI: [0.1–0.8], p = 0.02). Engaging in regular exercise was associated with reduced odds of depression (OR: 0.3, 95% CI: [0.2–0.5], p 8 h) (OR: 0.2, 95% CI: [0.1–1.0], p = 0.04). Conclusion Our study estimates the prevalence and severity of self-reported depressive symptoms among airline pilots in Saudi Arabia, surpassing global estimates. The identified factors, including lack of regular exercise, short sleep duration, and insufficient rest between flights, underscore the complex mental health challenges faced by pilots in this region. Addressing these issues is crucial not only for pilot well-being but also for flight safety.

Abstract Background The global market for lithium-ion batteries (LIBs) is growing exponentially, resulting in an increase in mining activities for the metals needed for manufacturing LIBs. Cobalt, lithium, manganese, and nickel are four of the metals most used in the construction of LIBs, and each has known toxicological risks associated with exposure. Mining for these metals poses potential human health risks via occupational and environmental exposures; however, there is a paucity of data surrounding the risks of increasing mining activity. The objective of this review was to characterize these risks. Methods We conducted a review of the literature via a systematic search of the PubMed database on the health effects of mining for cobalt, lithium, manganese, and nickel. We included articles that (1) reported original research, (2) reported outcomes directly related to human health, (3) assessed exposure to mining for cobalt, lithium, manganese, or nickel, and (4) had an available English translation. We excluded all other articles. Our search identified 183 relevant articles. Results Toxicological hazards were reported in 110 studies. Exposure to cobalt and nickel mining were most associated with respiratory toxicity, while exposure to manganese mining was most associated with neurologic toxicity. Notably, no articles were identified that assessed lithium toxicity associated with mining exposure. Traumatic hazards were reported in six studies. Three articles reported infectious disease hazards, while six studies reported effects on mental health. Several studies reported increased health risks in children compared to adults. Conclusions The results of this review suggest that occupational and environmental exposure to mining metals used in LIBs presents significant risks to human health that result in both acute and chronic toxicities. Further research is needed to better characterize these risks, particularly regarding lithium mining.

Abstract Background Polycyclic aromatic hydrocarbons (PAHs) have been linked to adverse birth outcomes that have been reported to be induced by oxidative stress, but few epidemiological studies to date have evaluated associations between urinary PAH metabolites and oxidative stress biomarkers in pregnancy and identified critical periods for these outcomes and PAH exposures in pregnancy. Methods A cohort of pregnant women was recruited early in pregnancy from antenatal clinics at the University of California Los Angeles during 2016–2019. We collected urine samples up to three times during pregnancy in a total of 159 women enrolled in the cohort. A total of 7 PAH metabolites and 2 oxidative stress biomarkers [malondialdehyde (MDA), 8-hydroxy-2’-deoxyguanosine (8-OHdG)] were measured in all available urine samples. Using multiple linear regression models, we estimated the percentage change (%) and 95% confidence interval (CI) in 8-OHdG and MDA measured at each sample collection time per doubling of PAH metabolite concentrations. Furthermore, we used linear mixed models with a random intercept for participant to estimate the associations between PAH metabolite and oxidative stress biomarker concentrations across multiple time points in pregnancy. Results Most PAH metabolites were positively associated with both urinary oxidative stress biomarkers, MDA and 8-OHdG, with stronger associations in early and late pregnancy. A doubling of each urinary PAH metabolite concentration increased MDA concentrations by 5.8-41.1% and 8-OHdG concentrations by 13.8-49.7%. Linear mixed model results were consistent with those from linear regression models for each gestational sampling period. Conclusion Urinary PAH metabolites are associated with increases in oxidative stress biomarkers during pregnancy, especially in early and late pregnancy.

Abstract Background EU workers exposed to hand-arm vibration should be offered health surveillance to detect early symptoms, and findings, of Hand-Arm Vibration Syndrome (HAVS). To execute the mandatory vocational rehabilitation, the employer needs to be aware of injuries found in the medical check-up. We aimed to analyse: 1) How physicians graded the neurosensory component of HAVS on the Stockholm Workshop Scale (SWS), compared to semi-objective findings. 2) What vocational rehabilitative decisions (VRD) were taken by physicians after examinations. 3) Whether the VRDs differed in relation to the SWS-grading. Methods Data came from 660 medical records - all examinations performed during twelve consecutive months in one large Swedish occupational healthcare company. 572 individuals had data on the SWS from the physician. For the qualitative analysis, we used the inductive-iterative immersion-crystallization method. Results 60% of the examined workers had symptoms and 32% had semi-objective findings consistent with HAVS. The physicians’ SWS gradings were underestimated in 59% of the cases with semi-objective findings. The VRDs were classified, relative to communication with the employer, as: “Adequate” (57%), when no injury was present, communication had already taken place, was planned, or was no longer needed in the absence of further exposure, “Semi-adequate” (18%), if no plan for communication was yet established or only communicated through a document with a shorter time until next check-up, and “Inadequate”(25%), when patients refused (20%), or physicians failed to communicate with the employer, despite findings (80%). Underestimated SWS-gradings of HAVS were significantly associated with more “Inadequate” VRDs in the group with semi-objective findings. Conclusions Occupational physicians underestimate the number of individuals with SWS 2–3 compared with semi-objective findings and regularly fail to communicate to the employer despite findings of HAVS. The underestimation of SWS-grading, followed by inadequate VRDs, excludes many workers from the employer’s mandatory protective measures which may lead to aggravation of an untreatable injury in the affected individual and development of HAVS in their similarly exposed colleagues.

Abstract Background This study aimed to explore the impact of occupational activities involving extensive finger movement on the muscular characteristics of the forearms. In particular, the flexor digitorum (FD) muscular thickness and strength asymmetry between right and left hand were compared between musicians and non-musicians. Methods Ultrasonography was employed to measure the thickness of the FD in each hand, while a validated custom-made device was used to assess the strength of the flexor and extensor digitorum (ED). Initially, muscle differences were estimated by computing the asymmetry index between dominant and non-dominant hands. To assess potential occupational disparities, comparisons of the asymmetry index were conducted between 25 right-handed instrumental musicians and 25 right-handed non-musicians. Results Musicians exhibited lower asymmetry between dominant and non-dominant hands in both FD thickness and ED strength when compared to non-musicians. This effect was particularly pronounced in musicians playing instruments that extensively use the left-hand fingers (e.g., violinists). Conclusions Occupational activities, such as playing a musical instrument, can alter forearm muscle mass and strength distribution between dominant and non-dominant hands. This underscores the importance of considering occupational parameters in clinical or experimental interventions and musculoskeletal assessments.

Abstract Background Despite accumulating evidence of an association between air pollution and renal disease, studies on the association between long-term exposure to air pollution and renal function are still contradictory. This study aimed to investigate this association in a large population with relatively low exposure and with improved estimation of renal function as well as renal injury biomarkers. Methods We performed a cross-sectional analysis in the middle-aged general population participating in the Swedish CardioPulmonary bioImaging Study (SCAPIS; n = 30 154). Individual 10-year exposure to total and locally emitted fine particulate matter (PM2.5), inhalable particulate matter (PM10), and nitrogen oxides (NOx) were modelled using high-resolution dispersion models. Linear regression models were used to estimate associations between exposures and estimated glomerular filtration rate (eGFR, combined creatinine and cystatin C) and serum levels of renal injury biomarkers (KIM-1, MCP-1, IL-6, IL-18, MMP-2, MMP-7, MMP-9, FGF-23, and uric acid), with consideration of potential confounders. Results Median long-term PM2.5 exposure was 6.2 µg/m3. Almost all participants had a normal renal function and median eGFR was 99.2 mL/min/1.73 m2. PM2.5 exposure was associated with 1.3% (95% CI 0.6, 2.0) higher eGFR per 2.03 µg/m3 (interquartile range, IQR). PM2.5 exposure was also associated with elevated serum matrix metalloproteinase 2 (MMP-2) concentration, with 7.2% (95% CI 1.9, 12.8) higher MMP-2 per 2.03 µg/m3. There was a tendency towards an association between PM10 and higher levels of uric acid, but no associations were found with the other biomarkers. Associations with other air pollutants were null or inconsistent. Conclusion In this large general population sample at low exposure levels, we found a surprising association between PM2.5 exposure and a higher renal filtration. It seems unlikely that particle function would improve renal function. However, increased filtration is an early sign of renal injury and may be related to the relatively healthy population at comparatively low exposure levels. Furthermore, PM2.5 exposure was associated with higher serum concentrations of MMP-2, an early indicator of renal and cardiovascular pathology.

Abstract Background The underlying mechanisms of post-COVID syndrome (PCS) are still not fully understood. While pre-existing conditions have been described as a risk factor for severe PCS in the general population, data specific to different occupational groups in this context is lacking. This study aimed to investigate the impact of pre-existing conditions on severe post-COVID syndrome among the occupational group of healthcare and social services employees. Methods Baseline data from a longitudinal, observational study were analysed. In February 2021, health workers who had a COVID-19 infection in 2020 were surveyed about sequelae of the infection. Factors influencing severe PCS with at least one persistent symptom categorised as severe were subjected to a multivariate logistic regression analysis. Results Of a total of 2,053 participants, 21.5% had severe PCS. Underlying respiratory (OR 1.94; CI 1.44–2.61), cardiovascular (OR 1.35; CI 1.04–1.77) and urogenital (OR 1.79; CI 1.10–2.91) disease were risk factors for severe PCS overall. Respiratory and mental illnesses had a statistically significant impact on persistent fatigue/exhaustion, concentration/memory difficulties and shortness of breath categorised as severe. Urogenital disease was associated with severe fatigue/exhaustion. Other significant risk factors for severe PCS were female sex, smoking, physical exercise and hospitalisation due to COVID-19 infection. Conclusion Workers in healthcare and social services with pre-existing conditions may face a higher risk of developing severe PCS. Additional analyses performed as part of the longitudinal study will show if and how this result changes over time.

Background Adolescents living in agricultural communities may be at risk for the adverse effects of pesticide exposure because they are involved in agriculture either as a career or to support their families. Objective The purpose of this study was to investigate the association of farm activities related to pesticide exposure on blood cholinesterase (ChE) levels among adolescents from farming families in the north of Thailand. Material and Methods This cross-sectional study included 336 adolescents aged 12-19 years from farming families in Chiang Dao District, Chiang Mai Province. Data on pesticide exposure was collected using a questionnaire, and blood ChE activity was assessed using a ChE reactive paper test kit via fingerstick blood sampling. Results Overall, 51.2% of participants had abnormal blood ChE levels. Univariable logistic regression analysis revealed that pesticide-related activities on farms associated with abnormal ChE levels were mixing/spraying (OR=10.54; 95%CI=4.63-23.99), assisting or working in areas with pesticide application (OR=5.54; 95%CI=3.45-8.89), and harvesting (OR=3.70; 95%CI=2.35-5.82). In a multivariable model (Nagelkerke R2=0.374), mixing/spraying (OR=4.90; 95%CI=2.03-11.83) and assisting or working in areas with pesticide application (OR=2.61; 95%CI=1.49-4.57) were significantly associated with abnormal ChE levels, but harvesting (OR=1.48; 95%CI=0.84-2.61) was not significant after adjusting for sex, age in years, and entering or walking through a farm. Conclusions The findings indicated that Thai adolescents living in farming families are at risk of pesticide exposure, particularly those involved in agricultural activities such as pesticide applicators. An intervention and measure to raise awareness and reduce the risk of pesticide exposure in adolescents is required.

Introduction There are many educational and health programs implemented on a smaller or larger scale in Poland. Many of them address the problem of overweight and obesity in different age groups. Each such activity is considered valuable and important, since the problem of excessive body fat is growing and, in addition, poses a health risk due to the development of other diseases, including diabetes and hypertension. The aim of the study was to test the effectiveness of nutrition education implemented over a 7-week period and to assess the nutritional status of 32 students aged 20-21 from Wroclaw. Material and Methods The study group of students participated in a Human Nutrition course that included 30 hours of lectures and 30 hours of exercises. In the study group, the level of knowledge was assessed twice (before and after education) using a questionnaire with 13 closed questions, and body composition analysis was performed twice (before and after education) using an InBody270 analyser. Results The study group showed a statistically significant increase in the number of correct answers on the nutrition knowledge questionnaire after the nutrition education (average 9.7 points vs. 11.4 points; p

Background The global prevalence of metabolic syndrome (MetS) increases susceptibility to non-communicable diseases such as obesity, type 2 diabetes, and cardiovascular disease, posing significant health risks. Effective prevention and management require objective tools. The hypertriglyceridemic waist (TG+WC+) phenotype is proposed as a less expensive approach to identify individuals with metabolic syndrome and other cardiovascular risk factors. Objective The current aim of this investigation is to study the epidemiological characteristics of the hypertriglyceridemic waist phenotype and their correlations with cardiovascular risk factors and MetS in the Moroccan Amazigh ethnic group from the Souss region of Morocco. Material and Methods A total of 827 Amazigh adults from the Sousse region of Morocco were divided into four distinct phenotype groups: TG-WC-, TG+WC-, TG-WC+, and TG+WC+ (normal TG- or high TG+ triglycerides/normal WC- or high WC+ waist circumference). The association of the different phenotypes with MetS and other cardiovascular risk factors was established by logistic regression analysis. Results The prevalence of the TG+WC+ phenotype was 27.7% and varied according to age group and sex. Among subjects with the TG+WC+ phenotype, most were 41-60 years old (53.3%) and in women (74.2%). Participants with the TG+WC+ phenotype had the highest prevalence of dyslipidemia (87.3%), hypoHDLaemia (69.9%), and general obesity (37.12%). The three phenotypes TG-WC-, TG+WC- and TG-WC+ were less associated with MetS and other cardiovascular risk factors. Moreover, people with the TG+WC+ phenotype had a very high odds ratio for MetS. Conclusion These findings suggest that the TG+WC+ phenotype exhibits a robust correlation with MetS and additional variables connected to cardiovascular risk. The TG+WC+ phenotype serves as a valuable clinical instrument for detecting individuals vulnerable to MetS and cardiovascular diseases.

Background Hepatitis B is a serious public health concern and health care professionals especially nurses are at higher risk of acquiring this infection. Basic knowledge, awareness and a positive attitude are required to prevent this disease. Objective The present pilot study was conducted to assess awareness and attitude regarding hepatitis B among staff nurses and nursing students of a teaching hospital in north India. Material and Methods A total of 205 subjects who gave consent to participate were included in this descriptive study. A self-structured pre-tested close ended questionnaire comprising of two parts was used to collect information from the study subjects. First part collected information on demographic details of the study subject and second part assessed subjects’ awareness and attitude on various aspects of hepatitis B infection including vaccination. Chi-square test and multiple linear regression analysis was used for statistical analysis. Results The mean age of the study subjects was 25.8±5.6 years. Awareness regarding HBV infection was present among 92.6% (190) of subjects. Long-term effects of hepatitis B were known to 58.4% (119) of subjects and 79.1% (162) of subjects reported taking universal precautions. Half of the subjects (105), were getting regularly tested for hepatitis B antigen.The odds of getting regularly tested for hepatitis B antigen were 3.26 times greater in female subjects and 3.45 times greater in subjects who were GNMs. Conclusion Low awareness levels were reported regarding some important aspects of hepatitis B among study subjects though more than 90% were aware of it. There is an urgent need for education and training programs for nurses designed to increase their knowledge about HBV infection.

Abstract Background Extending working lives due to labour market and pension regulations makes maintaining and promoting work ability necessary. The coronavirus pandemic has shown that employees in low-skilled jobs (no qualification required) contribute significantly to society and the economy. Research on these employees has been neglected in Germany for many decades despite demanding working conditions. Therefore, we investigate the relationship between low-skilled jobs and work ability. Moreover, we explore this relationship’s variation by psychosocial work demands and resources. Methods We use two waves of the German Study on Mental Health at Work (S-MGA). We calculate Ordinary-Least-Squares (OLS) regression models with pooled data (n = 6,050) to analyse the relationship between job requirement level and work ability. We also explore the contribution of job demands and resources on this relationship with interaction models. We use the Copenhagen Psychosocial Questionnaire (COPSOQ), to assess psychosocial work demands and resources. Results Employees performing low-skilled jobs report significantly less work ability than those in medium- or high-skilled jobs. Interaction models show significantly greater work ability for employees in medium- and high-skilled jobs with high influence on their work (amount or tasks). Unexpectedly, employees in low-skilled jobs have lower work ability with more influence on their work. Furthermore, high role clarity, describing responsibility, authority and work goals, is associated with lower levels of work ability among employees in low-skilled jobs. Conclusions The moderating effect of role clarity on the work ability of employees in low-skilled jobs can possibly be attributed to skills mismatch and limited responsibility, as well as a lack of self-perceived collective purpose of the job. The moderation of the influence on work dimension supports results of previous studies. Too much job autonomy can have negative effects under certain circumstances and is therefore perceived as a job demand in some studies. Consequently, mechanisms concerning psychosocial work demands and resources must be investigated in further studies with different theoretical approaches. The imbalance of job demands and resources shows that employers should invest in preserving the work ability to prevent early exit from the labour market in an aging society.

Abstract Objectives N95 or Type II filtering face pieces (FFP2) are often worn during work hours or on public transportation to prevent airborne infection. The aim of this randomized controlled crossover study is to assess the impact of FFP2 induced breathing resistance on pulmonary function, blood gas values and discomfort during walking and stair climbing. Methods N = 16 healthy adults (24.8 ± 2.2 years; 10 females, ) participated. Interventions included (1) six minutes of walking in a 16-meter-long hallway (612 m) and (2) eight minutes of stair climbing in a two-story staircase (420 stairs), both with and without a FFP2 (> 48 h wash-out). Spiroergometric data (Ventilation, breathing frequency, tidal volume, oxygen uptake and carbon dioxide exhalation (primary outcome), end tidal carbon dioxide- and oxygen pressure) and self-reported response (Perceived exertion, dyspnoea and pain) were assessed during activities. Blood gas analysis (capillary carbon dioxide- (pCO2) (primary outcome) and oxygen partial pressure (pO2), pH, lactate and base excess) was measured immediately after cessation of activities. Manipulation effects (FFP2 versus no mask) were tested using repeated measures analyses of variance. Results Analysis showed no effect of FFP2 on pCO2 or other blood-gas parameters but on carbon dioxide exhalation during walking: (mean 1067, SD 209 ml/min) (mean 1908, SD 426 ml/min) (F(15) = 19.5; p

Abstract Background Fluoride exposure during pregnancy has been associated with various effects on offspring, including changes in behavior and IQ. To provide clues to possible mechanisms by which fluoride may affect human fetal development, we completed proteomic analyses of cord blood serum collected from second-trimester pregnant women residing in northern California, USA. Objective To identify changes in cord blood proteins associated with maternal serum fluoride concentration in pregnant women. Methods The proteomes of 19 archived second-trimester cord blood samples from women living in northern California, USA, and having varied serum fluoride concentrations, were analyzed by quantitative mass spectrometry. The 327 proteins that were quantified were characterized by their abundance relative to maternal serum fluoride concentration, and subjected to pathway analyses using PANTHER and Ingenuity Pathway Analysis processes. Results Pathway analyses showed significant increases in process related to reactive oxygen species and cellular oxidant detoxification, associated with increasing maternal serum fluoride concentrations. Pathways showing significant decreases included complement cascade, suggesting alterations in alterations in process associated with inflammation. Conclusion Maternal fluoride exposure, as measured by serum fluoride concentrations in a small, but representative sample of women from northern California, USA, showed significant changes in the second trimester cord blood proteome relative to maternal serum fluoride concentration.

Abstract Introduction Occupation plays an important role in the spread of infectious diseases in humans. Toxoplasmosis and hydatidosis are world-wide diseases with different routes of transmission. This study aimed to investigate the prevalence of toxoplasmosis and hydatidosis and risk factors associated with these diseases among the butchers of Tabriz City, the northwest of Iran. Methods In this case-control study conducted in Tabriz city in 2023, 250 serum samples were collected from butchers (n = 125) and outpatients referred to Imam Reza Hospital (n = 125) and. The ELISA test was used to identify IgG and IgM antibodies against toxoplasmosis and IgG antibodies against hydatidosis. The results were analyzed by statistics tests using SPSS v. 16 software. Risk factors’ association was tested using Chi square or logistic regression analysis. Results The results indicated that 66/125 (52.8%) cases and 40/125 controls (32%) were positive for toxoplasmosis IgG antibody. Also, 5/125 (4%) and 1/125 (0.8%) were positive for toxoplasmosis IgM antibody in the case and control groups, respectively. In addition, 10/125 people (8%) were positive for anti-hydatidosis IgG antibody in the case group, while no positive cases were found in the control group. The main risk factors for toxoplasmosis were age (OR: 1.014), education level (OR: 0.638), and work experience(OR: 1.695), these factors for hydatidosis included age and education level (OR: 1.765 and 0.271) respectivily. Conclusions Our results suggest the high prevalence of toxoplasmosis and in butchers of Tabriz, which required special attention and basic measures. Moreover, the prevalence of hydatidosis IgG antibodies also requires more attention to be focused on breaking the transmission and reducing the infection.

Abstract Objective To investigate any connections between urinary organophosphorus pesticide (OPP) metabolites and adiposity measures. Methods In this study, data from the National Health and Nutrition Examination Survey (NHANES) projects from 2003 to 2008, 2011 to 2012, and 2015 to 2018 were analysed. Obesity was defined as a body mass index (BMI) of 30 kg/m² or higher. Abdominal obesity was defined as a waist circumference (WC) over 102 cm for men and 88 cm for women. Four urinary OPP metabolites (dimethyl phosphate [DMP], diethyl phosphate [DEP], dimethyl phosphorothioate [DMTP], and diethyl phosphorothioate [DETP]) and adiposity measures were examined using multiple linear regression and logistic regression analyses. The correlations between a variety of urinary OPP metabolites and the prevalence of obesity were investigated using weighted quantile sum regression and quantile g-computation regression. Results In this analysis, a total of 9,505 adults were taken into account. There were 49.81% of male participants, and the average age was 46.00 years old. The median BMI and WC of the subjects were 27.70 kg/m2 and 97.10 cm, respectively. Moreover, 35.60% of the participants were obese, and 54.42% had abdominal obesity. DMP, DMTP, and DETP were discovered to have a negative correlation with WC and BMI in the adjusted models. DMP (OR = 0.93 [95% CI: 0.89–0.98]), DEP (OR = 0.94 [95% CI: 0.90–0.99]), DMTP (OR = 0.91 [95% CI: 0.86–0.95]), and DETP (OR = 0.85 [95% CI: 0.80–0.90]) exhibited negative associations with obesity prevalence. Similar correlations between the prevalence of abdominal obesity and the urine OPP metabolites were discovered. Moreover, the mixture of urinary OPP metabolites showed negative associations with adiposity measures, with DMTP and DETP showing the most significant effects. Conclusion Together, higher levels of urinary OPP metabolites in the urine were linked to a decline in the prevalence of obesity.

Abstract Background Hybrid working arrangements that combine remote and office work are on the rise. Although hybrid work has been associated with mental health benefits in employees, challenges in the transformation to hybrid persist particularly in public administration organizations which have been connected to a pronounced culture of presence and inadequate technical infrastructure. Further evidence on the link between hybrid working conditions and employee health is needed. To support the establishment of healthy hybrid working conditions, this study aims to identify employees' job demands, resources and support needs in public administration. Methods Semi-structured interviews were conducted with N = 13 employees who work hybrid in public administration organizations in Northern Germany between February and May 2023. Interviewees were asked about their perceived job demands, resources, and support needs in hybrid work. The data was analyzed in a deductive-inductive approach of qualitative content analysis, primarily supported by the job demands-resources model as a theoretical framework. Results Several job demands, e.g., an increase in work and meetings, and resources such as personal freedom and responsibility, were identified in the context of hybrid work. A multitude of the reported job resources and demands relate to work organization and social relationships. The results disclose discrepancies between participants' experiences of job demands and resources, underlining the subjectivity of employees' perceptions of hybrid working conditions. Interviewees' support needs for hybrid work also varied, encompassing structural-level aspects such as increased acceptance and promotion of hybrid work in the organization as well as behavioral-level aspects, for instance, strategies and self-discipline for boundaries and structure. Conclusions This study provides a first comprehensive overview of the job demands, resources and support needs in hybrid work in public administration. This study builds an important basis for further research to understand the impact of hybrid working conditions on health-related employee outcomes. The identified support needs provide a valuable point of reference for health-promoting hybrid working conditions which public administration employers should begin establishing as early as possible in the ongoing transition to hybrid work.

Abstract Background The effects of air pollution on endothelial function remain unclear across populations. We aimed to use brachial artery flow-mediated dilatation (FMD) to identify demographic differences in the effects of air pollution exposure on endothelial dysfunction. Methods We measured FMD in 850 participants from October 2016 to January 2020. Location-specific concentrations of fine particulate matter

Abstract Background Brominated Flame Retardants (BFRs) have attracted widespread concern due to their environmental persistence and potential toxicity. This study aims to examine the association between BFRs exposure and hypertension. Methods We used data from the National Health and Nutrition Examination Survey (NHANES) spanning 2005 to 2016 for the cross-sectional analysis. To evaluate the individual and combined impacts of BFRs exposure on hypertension, we utilized multivariate models, including generalized additive models, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) models. Results 9882 individuals (48% male) aged ≥ 20 were included in the final analysis, of whom 4114 had hypertension. After controlling for potential covariates, higher serum concentrations of PBDE100 (OR: 1.26; 95% CI: 1.01, 1.57) and PBDE153 (OR: 1.50; 95% CI: 1.18, 1.88) were significantly associated with hypertension. A nonlinear relationship between PBDE28 and hypertension was observed (P = 0.03). Moreover, BFRs mixture were positively associated with the prevalence of hypertension in both the WQS (β:1.09; 95% CI: 1.02, 1.17; P = 0.02) and BKMR models. Conclusion Our study suggested that BFRs exposure is positively associated with hypertension in the general population. To confirm this association and elucidate the mechanisms, further research is required.

Abstract Background Gestational exposure to toxic environmental chemicals and maternal social hardships are individually associated with impaired fetal growth, but it is unclear whether the effects of environmental chemical exposure on infant birth weight are modified by maternal hardships. Methods We used data from the Maternal-Infant Research on Environmental Chemicals (MIREC) Study, a pan-Canadian cohort of 1982 pregnant females enrolled between 2008 and 2011. We quantified eleven environmental chemical concentrations from two chemical classes – six organochlorine compounds (OCs) and five metals – that were detected in ≥ 70% of blood samples collected during the first trimester. We examined fetal growth using birth weight adjusted for gestational age and assessed nine maternal hardships by questionnaire. Each maternal hardship variable was dichotomized to indicate whether the females experienced the hardship. In our analysis, we used elastic net to select the environmental chemicals, maternal hardships, and 2-way interactions between maternal hardships and environmental chemicals that were most predictive of birth weight. Next, we obtained effect estimates using multiple linear regression, and plotted the relationships by hardship status for visual interpretation. Results Elastic net selected trans-nonachlor, lead, low educational status, racially minoritized background, and low supplemental folic acid intake. All were inversely associated with birth weight. Elastic net also selected interaction terms. Among those with increasing environmental chemical exposures and reported hardships, we observed stronger negative associations and a few positive associations. For example, every two-fold increase in lead concentrations was more strongly associated with reduced infant birth weight among participants with low educational status (β = -100 g (g); 95% confidence interval (CI): -215, 16), than those with higher educational status (β = -34 g; 95% CI: -63, -3). In contrast, every two-fold increase in mercury concentrations was associated with slightly higher birth weight among participants with low educational status (β = 23 g; 95% CI: -25, 71) compared to those with higher educational status (β = -9 g; 95% CI: -24, 6). Conclusions Our findings suggest that maternal hardships can modify the associations of gestational exposure to some OCs and metals with infant birth weight.

Abstract Background Drinking water at U.S. Marine Corps Base (MCB) Camp Lejeune, North Carolina was contaminated with trichloroethylene and other industrial solvents from 1953 to 1985. Methods A cohort mortality study was conducted of Marines/Navy personnel who, between 1975 and 1985, began service and were stationed at Camp Lejeune (N = 159,128) or MCB Camp Pendleton, California (N = 168,406), and civilian workers employed at Camp Lejeune (N = 7,332) or Camp Pendleton (N = 6,677) between October 1972 and December 1985. Camp Pendleton’s drinking water was not contaminated with industrial solvents. Mortality follow-up was between 1979 and 2018. Proportional hazards regression was used to calculate adjusted hazard ratios (aHRs) comparing mortality rates between Camp Lejeune and Camp Pendleton cohorts. The ratio of upper and lower 95% confidence interval (CI) limits, or CIR, was used to evaluate the precision of aHRs. The study focused on underlying causes of death with aHRs ≥ 1.20 and CIRs ≤ 3. Results Deaths among Camp Lejeune and Camp Pendleton Marines/Navy personnel totaled 19,250 and 21,134, respectively. Deaths among Camp Lejeune and Camp Pendleton civilian workers totaled 3,055 and 3,280, respectively. Compared to Camp Pendleton Marines/Navy personnel, Camp Lejeune had aHRs ≥ 1.20 with CIRs ≤ 3 for cancers of the kidney (aHR = 1.21, 95% CI: 0.95, 1.54), esophagus (aHR = 1.24, 95% CI: 1.00, 1.54) and female breast (aHR = 1.20, 95% CI: 0.73, 1.98). Causes of death with aHRs ≥ 1.20 and CIR > 3, included Parkinson disease, myelodysplastic syndrome and cancers of the testes, cervix and ovary. Compared to Camp Pendleton civilian workers, Camp Lejeune had aHRs ≥ 1.20 with CIRs ≤ 3 for chronic kidney disease (aHR = 1.88, 95% CI: 1.13, 3.11) and Parkinson disease (aHR = 1.21, 95% CI: 0.72, 2.04). Female breast cancer had an aHR of 1.19 (95% CI: 0.76, 1.88), and aHRs ≥ 1.20 with CIRs > 3 were observed for kidney and pharyngeal cancers, melanoma, Hodgkin lymphoma, and chronic myeloid leukemia. Quantitative bias analyses indicated that confounding due to smoking and alcohol consumption would not appreciably impact the findings. Conclusion Marines/Navy personnel and civilian workers likely exposed to contaminated drinking water at Camp Lejeune had increased hazard ratios for several causes of death compared to Camp Pendleton.

Abstract Background Autism spectrum disorder (ASD) is a prevalent and heterogeneous neurodevelopmental disorder. Risk is attributed to genetic and prenatal environmental factors, though the environmental agents are incompletely characterized. Methods In Early Autism Risk Longitudinal Investigation (EARLI) and Markers of Autism Risk in Babies Learning Early Signs (MARBLES), two pregnancy cohorts of siblings of children with ASD, urinary metals concentrations during two pregnancy time periods (

Background Aronia melanocarpa is nowadays valued for its high content of biologically active substances, the main group of which are polyphenols, which include anthocyanins, flavonols, flavanols, proanthocyanidins and phenolic acids. From the available sources, we can conclude that extracts and juices from black chokeberry have a great potential in human nutrition and influence on their health. Objective The research was to evaluate the effect of regular consumption of 100% organic chokeberry juice on selected anthropometric and lipid parameters of overweight or obese women. Material and Methods A clinical study consisted of 19 women with overweight and obesity, age from 44 to 63. The probands consumed 50 ml of chokeberry juice daily for 8 weeks as part of their regular diet. Body composition and biochemical indicators were monitored before consumption, after 4 and 8 weeks of nutritional intervention. Body composition was determined using multifrequency bioelectrical impedance analysis (MFBIA) – InBody 720. Biochemical analyzes of blood serum were performed using standard methods in an accredited laboratory using automatic biochemical analyzer a BioMajesty JCA-BM6010/C. Results The monitored group of probands is characterized by menopausale and postmenopausale women, overweight or obese women with hypercholesterolemia without pharmacological treatment. Statistically significant differences (p

Abstract An under-recognised aspect of the current humanitarian catastrophe in Gaza is the impact of the war on the environment and the associated risks for human health. This commentary contextualises these impacts against the background of human suffering produced by the overwhelming violence associated with the use of military force against the general population of Gaza. In calling for an immediate cessation to the violence, the authors draw attention to the urgent need to rebuild the health care system and restore the physical and human infrastructure that makes a liveable environment possible and promotes human health and well-being, especially for the most vulnerable in the population. Environmental remediation should therefore form one of the most important parts of international efforts to assist reconstruction, through which we hope Palestinians and Israelis will achieve lasting peace, health, and sustainable development, all as part of accepted international human rights obligations.

Abstract Background The prevalence of metabolic syndrome (MetS) in American adults increased from 37.6% in the 2011–12 period to 41.8% in 2017–2018. Environmental exposure, particularly to common compounds such as glyphosate, has drawn increasing attention as a potential risk factor. Methods We employed three cycles of data (2013–2018) from the National Health and Nutrition Examination Survey (NHANES) in a cross-sectional study to examine potential associations between urine glyphosate measurements and MetS incidence. We first created a MetS score using exploratory factor analysis (EFA) of the International Diabetes Federation (IDF) criteria for MetS, with data drawn from the 2013–2018 NHANES cycles, and validated this score independently on an additional associated metric, the albumin-to-creatinine (ACR) ratio. The score was validated via a machine learning approach in predicting the ACR score via binary classification and then used in multivariable regression to test the association between quartile-categorized glyphosate exposure and the MetS score. Results In adjusted multivariable regressions, regressions between quartile-categorized glyphosate exposure and MetS score showed a significant inverted U-shaped or saturating dose‒response profile, often with the largest effect for exposures in quartile 3. Exploration of potential effect modification by sex, race, and age category revealed significant differences by race and age, with older people (aged > 65 years) and non-Hispanic African American participants showing larger effect sizes for all exposure quartiles. Conclusions We found that urinary glyphosate concentration is significantly associated with a statistical score designed to predict MetS status and that dose–response coefficient is nonlinear, with advanced age and non-Hispanic African American, Mexican American and other Hispanic participants exhibiting greater effect sizes.

Objectives: In the protocol for cleaning and sterilizing dental handpieces (DHs), water retention within the instrument poses a challenge and may compromise the sterilization process. This study aimed to assess the reliability and reproducibility of the sterilization protocol regarding the dryness of DHs. It evaluated the presence of residual water in these instruments after various conditions of treatment through multiple dryness tests. Methods: This comparative study examined the dryness of seven different DHs following five washing–disinfection and/or sterilization protocols. Dabbing tests, shaking by hand, or compressed air tests through DHs and over absorbent paper were employed to ascertain the thorough dryness of DHs after treatment. As soon as the first sign of water appeared on the absorbent paper, the DH was deemed to be not dry. Results: Upon completion of the washing–disinfection protocol without sterilization, five out of seven DHs were deemed dry using the dabbing test, yet none were fully dry when subjected to shaking or compressed air. However, in the four protocols incorporating final sterilization, all DHs were dry according to the three drying tests. Conclusion: This study underscores the essential role of the sterilization step in eliminating residual water from DHs, thereby ensuring optimal conditions for effective sterilization in terms of dryness. Furthermore, the study recommends against relying solely on the dabbing drying test, emphasizing the importance of shaking or using compressed air to confirm instrument dryness.

Orthodontic therapy is associated with a more significant accumulation of dentobacterial plaque and impaired oral hygiene, which increase the risk of developing dental caries and periodontal disease. Therefore, it is crucial to educate orthodontic patients about proper oral hygiene maintenance and oral health before and during treatment. The aim of this pilot study was to implement evidence-based best practices related to oral hygiene in adult orthodontic patients and improve compliance. In addition to evaluating oral hygiene practices, another goal of the project was to assess the knowledge of orthodontic patients regarding oral health. Questionnaires with seven pre- (before) and post-test criteria (90 day after implementation) were developed based on the best evidence available. This project was conducted in a private dental clinic in Split, Croatia, and included 45 patients. The baseline audit showed a gap between clinical practice and the best evidence. Three criteria achieved a high compliance baseline, while after implementation, there were substantial improvements in compliance for all. The everyday use of mouthwash improved from 17.8% at baseline to 66.7% at follow-up, as did the use of interdental aids, which increased from 55.6% to 91.1%. Statistically significant differences were found in the total score for oral health knowledge between the baseline (6.67 ± 1.74) and the follow-up audit (7.78 ± 0.56, p ≤ 0.001). The strategies developed in this project were effective in providing essential information to adult orthodontic patients and improving compliance with evidence. Guidelines on this topic should be designed to assist orthodontists and patients in maintaining oral health and oral hygiene.

Abstract Background Lead is one of the most nonessential toxic heavy metal agents found in automotive garages. The occupational exposure of garage workers to lead commonly poses acute and chronic health risks that can be prevented. In Ethiopia, there have been limited studies on lead exposure among garage workers, who overemphasize exposure to lead. This study aimed to assess occupational blood lead levels and associated factors in garage workers using a cross-sectional comparative design. Methods A comparative cross-sectional study design was used to compare the occupational blood lead levels of 36 randomly selected garage workers and 34 office workers who were matched by age and sex. Blood specimens were collected by trained medical laboratory experts. The collected blood samples were tested in a certified laboratory using a microwave plasma atomic emission spectrometry (MP-AES) device at a wavelength of 405.78 nm. Excel and SPSS Version 26 were used for data management and analysis, respectively. Results The mean (SD) age of the exposed group was 39.0 (7.5) years, whereas the mean age of the unexposed group was 38.0 (6.1) years. The occupational mean (SD) blood-lead-level in the exposed groups was 29.7 (12.2) µg/dl, compared to 14.8 (9.9) µg/dl among the unexposed groups. The mean blood-lead level among the exposed workers was significantly different from that among the unexposed workers (P 0.05). Conclusions The BLL of the Garage workers was significantly greater than that of the Non-Garage workers. Hence, it is advised that garage management should encourage workers to use exposure prevention methods, such as washing their hands before eating and taking showers after the completion of work, by providing regular occupational safety training.

Abstract Background In a previous study from 2018, 38 wheel loader assembly workers were examined, showing high exposures to transient and high-frequency vibrations. After the investigation, preventive measures were immediately implemented to reduce the vibration exposure. In 2022, a follow-up study was carried out to examine the effect of these measures. Methods The follow-up study included 35 (27 men and 8 women) of the original 38 workers. They were divided into two groups, 24 workers with ongoing vibration exposure and 11 workers, not vibration exposed since 2018. All participants completed a questionnaire and underwent a thorough examination, including several neurophysiological tests and a comprehensive assessment of musculoskeletal symptoms. The questionnaire responses and on-site vibration level measurements formed the basis for the individual vibration exposure assessment. Results In 2018, clear differences were noted between the two groups regarding vibration perception thresholds (VPT), needle test, 2-PD (2-point discrimination), and monofilament test with deviating results in the unexposed group. The difference between the two groups was significantly smaller at the follow-up examination in 2022, where differences remained for VPT and monofilament tests, with deviating test results in the unexposed group. When comparing variable values between 2018 and 2022 within the exposed and unexposed groups, respectively, the unexposed group showed mostly unchanged values, while a deterioration was observed for VPT, needle test and temperature sensitivity test among the exposed workers during follow-up. The prevalence of VWF (Vibration white fingers) was around 30–40% and neuropathy around 75% among exposed workers during follow-up compared to about 60% and 85% respectively, in the unexposed group. Conclusion The overall categorization of white fingers and neuropathy, according to the Stockholm Workshop Scale, remained largely unchanged in both study groups from 2018 to 2022. The introduction of cost-effective and relatively simple preventive measures may have contributed to this result. Throughout the follow-up period, the number of exposed workers who developed musculoskeletal disorders and newly reported cases of vibration injuries at the factory decreased. Without this preventive program, increased vascular and nerve symptoms would most likely have occurred during follow-up due to continued vibration exposure.

Abstract Background Very recently, it has been reported that exposure to different mixtures of organochlorine pesticides (OCP) is associated with the development of diabetes mellitus (DM). In Mexico, DM is a public health problem that might be related to the historical intense use of OCP. We aimed to evaluate, the association between DM and serum concentrations of OCP mixtures, and identify the main contributors within them. Methods We conducted a secondary cross-sectional analysis on the control group from a breast cancer population-based case-control study conducted from 2007 to 2011 in Northern Mexico. We identified 214 self-reported diabetic women and 694 non-diabetics. We obtained direct information about sociodemographic, lifestyle and reproductive characteristics. We determined 24 OCP and metabolites in serum by gas chromatography using an electron capture micro detector. We used Weighted Quantile Sum regression to assess the association of DM and exposure to multiple OCP, and the contribution of each compound within the mixture. Results We found a positive adjusted association between DM and an OCP mixture (OR: 2.63, 95%CI: 1.85, 3.74), whose primary contribution arose from p, p’-DDE (mean weight 23.3%), HCB (mean weight 17.3%), trans nonachlor (mean weight 15.4%), o, p’-DDE (mean weight 7.3%), heptachlor epoxide (mean weight 5.9%), oxychlordane (mean weight 4.7%), and heptachlor (mean weight 4.5%). In addition, these OCP along with p, p’-DDT and cis chlordane, were of concern and remained associated when excluding hypertensive women from the analysis (OR 2.55; 95% CI 1.56, 4.18). Conclusions Our results indicate, for the first time in a Latin-American population, that the concomitant exposure to multiple OCP is associated with DM. Further research is needed since the composition of OCP mixtures may vary according to regional pesticides use patterns.

Abstract Background Several legacy and emerging per- and polyfluoroalkyl substances (PFAS) have been regulated around the world. There is growing concern over the proliferation of alternative PFAS, as well as PFAS precursors. Biomonitoring data for PFAS are critical for assessing exposure and human health risk. Methods We collected serum samples from 289 adult female participants in a 2018–2021 follow-up study of the Maternal-Infant Research on Environmental Chemicals (MIREC) Canadian pregnancy cohort. Samples were analyzed for 40 PFAS using ultra-performance liquid chromatography–tandem mass spectrometry. For those compounds with > 50% detection, as well as the sum of these compounds, we describe serum concentrations and patterns of exposure according to sociodemographic and obstetrical history characteristics. Results 17 out of 40 PFAS were detected in > 50% of samples with 7 of these detected in > 97% of samples. Median [95th percentile] concentrations (µg/L) were highest for PFOS (1.62 [4.56]), PFOA (0.69 [1.52]), PFNA (0.38 [0.81]), and PFHxS (0.33 [0.92]). Geometric mean concentrations of PFOA and PFHxS were approximately 2-fold lower among those with more children (≥ 3 vs. 1), greater number of children breastfed (≥ 3 vs. ≤ 1), longer lifetime duration of breastfeeding (> 4 years vs. ≤ 9 months), and shorter time since last pregnancy (≤ 4 years vs. > 8 years). We observed similar patterns for PFOS, PFHpS, and the sum of 17 PFAS, though the differences between groups were smaller. Concentrations of PFOA were higher among “White” participants, while concentrations of N-MeFOSE, N-EtFOSE, 7:3 FTCA, and 4:2 FTS were slightly higher among participants reporting a race or ethnicity other than “White”. Concentrations of legacy, alternative, and precursor PFAS were generally similar across levels of age, education, household income, body mass index, and menopausal status. Conclusions We report the first Canadian biomonitoring data for several alternative and precursor PFAS. Our findings suggest that exposure to PFAS, including several emerging alternatives, may be widespread. Our results are consistent with previous studies showing that pregnancy and breastfeeding are excretion pathways for PFAS.

Abstract Background Mental illness is the leading cause of years lived with disability, and the global disease burden of mental ill-health has increased substantially in the last number of decades. There is now increasing evidence that environmental conditions, and in particular poor air quality, may be associated with mental health and wellbeing. Methods This cross-sectional analysis uses data on mental health and wellbeing from The Irish Longitudinal Study on Ageing (TILDA), a nationally representative survey of the population aged 50+ in Ireland. Annual average PM2.5 concentrations at respondents’ residential addresses over the period 1998–2014 are used to measure long-term exposure to ambient PM2.5. Results We find evidence of associations between long-term exposure to ambient PM2.5 and depression and anxiety. The measured associations are strong, and are comparable with effect sizes for variables such as sex. Effects are also evident at relatively low concentrations by international standards. However, we find no evidence of associations between long-term ambient particulate pollution and other indicators of mental health and well-being such as stress, worry and quality of life. Conclusions The measured associations are strong, particularly considering the relatively low PM2.5 concentrations prevailing in Ireland compared to many other countries. While it is estimated that over 90 per cent of the world’s population lives in areas with annual mean PM2.5 concentrations greater than 10 μg/m3, these results contribute to the increasing evidence that suggests that harmful effects can be detected at even low levels of air pollution.

Abstract Background Despite significant advancements in treatments such as surgery, radiotherapy, and chemotherapy, the survival rate for patients with asbestos-related cancers remains low. Numerous studies have provided evidence suggesting that air pollution induces oxidative stress and inflammation, affecting acute respiratory diseases, lung cancer, and overall mortality. However, because of the high case fatality rate, there is limited knowledge regarding the effects of air pollution exposures on survival following a diagnosis of asbestos-related cancers. This study aimed to determine the effect of air pollution on the survival of patients with malignant mesothelioma and asbestos-related lung cancer. Methods We followed up with 593 patients with malignant mesothelioma and 998 patients with lung cancer identified as asbestos victims between 2009 and 2022. Data on five air pollutants—sulfur dioxide, carbon monoxide, nitrogen dioxide, fine particulate matter with a diameter

Abstract Background Research on cannabis use motives has focused on youth. Little is known about motives among working adults, including how work may play a role. This study aimed to describe cannabis use motives and their connection to work, and identify the personal and work correlates of work-related motives among a sample of workers. Methods A national, cross-sectional sample of Canadian workers were queried about their cannabis use. Workers reporting past-year cannabis use (n = 589) were asked their motives for using cannabis and whether each motive was related to work or helped them manage at work (i.e., work-related). Multinomial logistic regression analyses were conducted to estimate the associations of personal and work characteristics with work-related cannabis use motives (no work-related motives,

Abstract Background This study aimed to examine time trends in physical working conditions across and within occupational groups in Germany between 2006 and 2018. Methods Logistic regression analyses were conducted using data from the BIBB/BAuA Employment Surveys in 2006, 2012, and 2018, with a total sample size of 59,006 participants. The study investigated changes in various self-reported occupational exposure measures over time, along with demographic shifts in the workforce. Results The results showed overall improvements in most occupational exposure measures during the study period, alongside an aging and upskilling workforce. However, exposure to awkward postures, microorganisms, and, to a lesser extent, noise increased. Substantial variation was observed between occupational groups, with more favourable trends among white-collar high-skilled and blue-collar low-skilled workers, and less favourable trends among white-collar low-skilled and blue-collar high-skilled workers. Conclusions While trends in physical working conditions in Germany are partly promising, some exposures are worsening, and substantial inequalities between occupations persist. As occupational exposures remain common, there is still a need for targeted interventions to improve working conditions, particularly in higher-risk occupations.

Abstract Background Time-varying exposures like pet ownership pose challenges for identifying critical windows due to multicollinearity when modeled simultaneously. The Distributed Lag Model (DLM) estimates critical windows for time-varying exposures, which are mainly continuous variables. However, applying complex functions such as high-order splines and nonlinear functions within DLMs may not be suitable for situations with limited time points or binary exposure, such as in questionnaire surveys. Objectives (1) We examined the estimation performance of a simple DLM with fractional polynomial function for time-varying binary exposures through simulation experiments. (2) We evaluated the impact of pet ownership on childhood wheezing onset and estimate critical windows. Methods (1) We compared logistic regression including time-varying exposure in separate models, in one model simultaneously, and using DLM. For evaluation, we employed bias, empirical standard error (EmpSE), and mean squared error (MSE). (2) The Japan Environment and Children's Study (JECS) is a prospective birth cohort study of approximately 100,000 parent-child pairs, registered across Japan from 2011 to 2014. We applied DLM to the JECS data up to age 3. The estimated odds ratios (OR) were considered to be within critical windows when they were significant at the 5% level. Results (1) DLM and the separate model exhibited lower bias compared to the simultaneously model. Additionally, both DLM and the simultaneously model demonstrated lower EmpSEs than the separate model. In all scenarios, DLM had lower MSEs than the other methods. Specifically, where critical windows is clearly present and exposure correlation is high, DLM showed MSEs about 1/2 to 1/200 of those of other models. (2) Application of DLM to the JECS data showed that, unlike other models, a significant exposure effect was observed only between the ages of 0 and 6 months. During that periods, the highest ORs were 1.07 (95% confidence interval, 1.01 to 1.14) , observed between the ages of 2 and 5 months. Conclusions (1) A simple DLM improves the accuracy of exposure effect and critical windows estimation. (2) 0–6 months may be the critical windows for the effect of pet ownership on the wheezing onset at 3 years.

Abstract Background Spina bifida, a developmental malformation of the spinal cord, is associated with high rates of mortality and disability. Although folic acid-based preventive strategies have been successful in reducing rates of spina bifida, some areas continue to be at higher risk because of chemical exposures. Bangladesh has high arsenic exposures through contaminated drinking water and high rates of spina bifida. This study examines the relationships between mother’s arsenic exposure, folic acid, and spina bifida risk in Bangladesh. Methods We conducted a hospital-based case-control study at the National Institute of Neurosciences & Hospital (NINS&H) in Dhaka, Bangladesh, between December 2016 and December 2022. Cases were infants under age one year with spina bifida and further classified by a neurosurgeon and imaging. Controls were drawn from children seen at NINS&H and nearby Dhaka Shishu Hospital. Mothers reported folic acid use during pregnancy, and we assessed folate status with serum assays. Arsenic exposure was estimated in drinking water using graphite furnace atomic absorption spectrophotometry (GF-AAS) and in toenails using inductively coupled plasma mass spectrometry (ICP-MS). We used logistic regression to examine the associations between arsenic and spina bifida. We used stratified models to examine the associations between folic acid and spina bifida at different levels of arsenic exposure. Results We evaluated data from 294 cases of spina bifida and 163 controls. We did not find a main effect of mother’s arsenic exposure on spina bifida risk. However, in stratified analyses, folic acid use was associated with lower odds of spina bifida (adjusted odds ratio [OR]: 0.50, 95% confidence interval [CI]: 0.25-1.00, p = 0.05) among women with toenail arsenic concentrations below the median value of 0.46 µg/g, and no association was seen among mothers with toenail arsenic concentrations higher than 0.46 µg/g (adjusted OR: 1.09, 95% CI: 0.52–2.29, p = 0.82). Conclusions Mother’s arsenic exposure modified the protective association of folic acid with spina bifida. Increased surveillance and additional preventive strategies, such as folic acid fortification and reduction of arsenic, are needed in areas of high arsenic exposure.

Abstract Risk assessment (RA) of microbial secondary metabolites (SM) is part of the EU approval process for microbial active substances (AS) used in plant protection products (PPP). As the number of potentially produced microbial SM may be high for a certain microbial strain and existing information on the metabolites often are low, data gaps are frequently identified during the RA. Often, RA cannot conclusively clarify the toxicological relevance of the individual substances. This work presents data and RA conclusions on four metabolites, Beauvericin, 2,3-deepoxy-2,3-didehydro-rhizoxin (DDR), Leucinostatin A and Swainsonin in detail as examples for the challenging process of RA. To overcome the problem of incomplete assessment reports, RA of microbial AS for PPP is in need of new approaches. In view of the Next Generation Risk Assessment (NGRA), the combination of literature data, omic-methods, in vitro and in silico methods combined in adverse outcome pathways (AOPs) can be used for an efficient and targeted identification and assessment of metabolites of concern (MoC).

Abstract Background In previous studies a moderator effect of management position could be found between Person-environment fit of masculinity, and burnout. Present study goals are to analyze previous fundings of the importance of the individual gender-role in relation to the work environment in more detail. Methods In this cross sectional explanative study, an online survey took place using Gender Role Orientation Scale (GTS +) by Altstötter-Gleich and DearEmployee-Survey by Wiedemann et al. The sample consists of 891 participants–516 female (58%), 373 male (42%), among those 277 executives (32%) and 594 participants without managerial responsibility (68%), age 17–70 years (M = 29.86; S = 7.67). Four groups were divided according to P-E fit in femininity and P-E fit in masculinity, this enabled a more precise distinction between the participants. The proportions of executives were determined, and compared in each group by a $${\chi }^{2}$$ χ 2 -Test Hierarchical linear regression models predicting burnout and proving moderator effects of managerial position were calculated for each group. Results The proportions of executives were the highest in the two groups with participants, who had a higher individual masculinity compared to their work environment. A moderator effect of managerial position between P-E fit in masculinity and burnout was found in group “Indifferent” (participants with lower feminity and masculinity compared with work environment). With a worse P-E fit in masculinity burnout values rise for individuals with no managerial position. On the other hand, among leaders burnout values decrease a worse P-E fit in masculinity. Conclusions People with a high individual masculinity compared to work environment tend more to be selected as managers, regardless of the individual characteristics of femininity, which may generally lead to a highly masculine and less feminine leadership and corporate culture. This culture could increase burnout risk for people with low individual masculinity and high feminity scores compared to work environment as well as for persons with low individual masculinity and feminity compared to work environment, especially if they are not in a managerial position.

Abstract Background Latex gloves are essential for protecting healthcare workers from biological hazards but pose a risk of latex allergy, particularly due to powdered, protein, and allergen content. Recent advancements in latex glove manufacturing have led to reduced levels of extractable proteins, a known factor triggering allergenic reaction. This study aimed to compare latex sensitization between nursing staff using low-protein and high-protein latex gloves at a tertiary university hospital in Thailand. Methods A cross-sectional analytical study categorized participants into two groups based on glove exposure: the low extractable protein group (only exposed to non-powdered latex gloves with extractable protein levels below 50 µg/g) and the high extractable protein group (exposed to powdered latex gloves with levels above 50 µg/g). The sample size comprised 163 individuals in the low protein group and 318 in the high protein group (1:2). Latex allergy symptoms and sensitization were assessed using a self-administered questionnaire and latex-specific IgE measurement (ImmunoCAP), respectively. Data analysis involved descriptive and inferential statistics, including odds ratios and 95%CI. Results Demographic data was mostly similar in both exposure groups except for age. No significant differences in latex sensitization between the low and high protein groups were found via latex-specific IgE measurement (crude OR 1.90, 95%CI: 0.5, 7.18), potentially attributed to lower extractable protein levels in powdered latex gloves compared to previous studies. In contrast, the low protein group exhibited significantly fewer current latex allergy symptoms in both bivariate (crude OR 0.24, 95%CI: 0.06, 0.74) and multiple variable analysis (adjusted OR 0.18, 95%CI: 0.04, 0.86). Moreover, there was a significant reduction in latex allergy symptoms among the low protein group, decreasing from 9.8% who reported experiencing symptoms (when powdered latex gloves were used) to 1.2% who still reported current symptoms (OR 0.11, 95%CI: 0.02, 0.44). Conclusions This study underscores the importance of using non-powdered and low-protein latex gloves to reduce latex allergy symptoms while emphasizing the need for further investigation into the relationship between extractable protein levels in addition to the attempt of the major allergen removal and latex sensitization amid evolving glove manufacturing practices.

Abstract Background Migraine is common and can be highly disabling. Adequate migraine self-management (SM) can mitigate the potentially adverse health effects of migraine. However, adequate SM can be challenging to implement in everyday life, for instance, at the workplace. We aimed to explore how migraine SM is carried out at work and which occupational factors may determine effective implementation according to employees with migraine. We also explored the potential impact of the COVID-19 pandemic and the associated re-arrangement of working conditions on migraine SM at work. Methods We conducted semi-structured qualitative interviews (08/2020–01/2021). Participants were eligible if they have worked for at least six months with a minimum of twenty hours per week and with a migraine diagnosis. The interviews were transcribed and content-analyzed using MAXQDA. Results Migraine SM was perceived to be influenced by social interactions at work (e.g., in terms of understanding vs. stigmatization), the level of job decision latitude (JDL, i.e., the extent to which one is able to influence work processes, e.g., when working from home), and workplace design (e.g., in terms of opportunities to withdraw from work). During the COVID-19 pandemic, especially increased JDL appeared to favorably influence migraine SM. Conclusions Migraine SM at work is fostered or complicated by various psychosocial working conditions. By considering these facilitators and barriers, more migraine-friendly workplaces can be created.

Background Red fruits are characterised by a particularly high content of bioactive compounds, e.g. anthocyanins, tannins, pectins, vitamins and minerals. Dietary supply of proper amounts of antioxidants is essential to reduce oxidative stress, and thus is an important element in the prevention of lifestyle diseases. Objective The aim of the study was to evaluate and compare the content of polyphenols in selected red fruit juices (chokeberry, elderberry, pomegranate, cranberry), as well as to assess the impact of storage time on the content of these compounds in the analysed samples. Material and Methods The research material consisted of 17 juices (100%): 3 chokeberry juices, 4 elderberry juices, 5 pomegranate juices and 5 cranberry juices, which differed in terms of the manufacturer, type, price range, country of origin and production method. The total polyphenol content was measured by spectrophotometry using the Folin�Ciocalteu reagent. The procedure was based on a modified method described by Waterhouse. Active acidity (pH) was measured with the potentiometric method using a pH-meter and the sucrose content was measured using a refractometer. Results The highest mean content of polyphenolic compounds was found in chokeberry and elderberry juices. Juice storage time did not reduce the mean content of polyphenolic compounds. The highest sucrose content was found in chokeberry juices and the lowest in cranberry juice. Conclusions Chokeberry and elderberry juices had the highest content of polyphenols among the tested products. Juices stored after opening in accordance with the manufacturer’s instructions (at 4°C) do not lose their nutritional properties.

Background After suffering from COVID-19, a large number of patients need respiratory rehabilitation. One of the methods of rehabilitation is inhalation with salt aerosols. Objective Our work aimed to study the effectiveness of inhalations of a dry aerosol of salt precipitated from the mineral water of the “Teplitsa multidisciplinary sanatorium”, Transcarpathian region of Ukraine. Material and Methods 30 male patients were examined after suffering from COVID-19. We formed two groups of patients, control and main, 15 people each. Patients in the control group received inhalation with a dry aerosol of table salt of the “Aero-M-sol”. In contrast, patients in the main group received a course of inhalations with a dry aerosol of salt precipitated from the mineral water. Results and discussion Under the influence of the rehabilitation complex in both groups, there is a performance improvement but significant changes are observed only in patients of the main group. The indicator Forced Vital Сapacity1 increased to the greatest extent, which after rehabilitation is significantly higher than in the control group (p

Background Acne is an inflammatory disease affecting adolescents during puberty, but also adults. Determinants of acne may include genetic predisposition as well as diet. The Western diet is rich in processed products with low nutrient density, resulting in a lack of supply of many essential minerals that are needed for the body to function properly. Objective The aim of this study was to assess the dietary behaviour of people with acne vulgaris and respondents’ selfassessment of the severity of acne lesions after consumption of selected products. Material and Methods The study was carried out by means of an online, self-administered questionnaire, a link to which was inserted in group of people struggling with acne on a social network. Results More than half of the respondents said that acne was present in their parents. Almost 91% of the women surveyed said that acne lesions were exacerbated before menstruation. Respondents were most often treated by a dermatologist. The most common foods consumed by the respondents were milk and milk products and wheat bread. The least frequently consumed products were: sultanas, cornflakes, alcohol and fizzy drinks. Statistical analysis showed a strong strength of association between consumption of white rice, fast food, omega-6-rich oils on the severity of acne lesions, while sultana consumption was very strong correlated. In addition, the study showed an almost certain correlation regarding the consumption of white flour pasta on acne lesions. Conclusions Statistical analysis showed a relationship between the consumption of white rice, white flour pasta, fast food products, sultanas, oils rich in omega-6 fats and the exacerbation of acne lesions.

Background Obesity, especially abdominal obesity, is strongly correlated with metabolic and other health risks. Diagnosis and assessment of obesity is important in clinical and routine preventive practice. From the point of view of risk, it is necessary to distinguish not only the area of fat tissue accumulation, but also its type. Objective The aim of the study was to use a new portable abdominal bioimpedance analyzer, which is intended for the area of abdominal adipose tissue, as part of the evaluation of the body structure of a selected group of volunteers with a focus on the differentiation of subcutaneous and visceral adipose tissue and to assess its usefulness in practice. Material and Methods Body composition was analyzed using a portable abdominal bioimpedance analyzer Yscope (PA-BIA) in combination with a bioimpedance device InBody 970 (high-frequency bioelectrical impedance/HF-BIA). Eighty-three volunteers at the age of 24.92±7.24 years with representation of both sexes participated in the study. Results Abdominal fat did not differ significantly between the sexes, women reached an average value of 2.01±1.14 kg, men 2.22±1.60 kg (p>0.05). Gender differentiation was manifested in the case of visceral fat (p

Background Essential oils have important antibacterial activities and can successfully replace antibiotics, which show their inefficiency, especially against fungi and multi-resistant bacteria. Objective The main purpose of our research was to investigate the antibacterial and antifungal activity of essential oils from fifteen plants harvested in the Taroudant region. Material and Methods In this work, the essential oils were extracted by hydrodistillation using a Clevenger-type apparatus. The method of disc diffusion in agar medium (aromatogram) is the one used to evaluate the activity of these essential oils against four pathogenic bacteria (Staphylococcus aureus, Escherichia coli, Bacillus sp., and Enterococcus cloacae) and two yeasts (Candida albicans and Cryptococcus neoformans). Results Our findings, show that all of the plants’ leaves yielded extremely aromatic essential oils that differed in look and color. Furthermore, the 93.33% of the fifteen essential oils that were evaluated proved to be effective against at least one kind of bacteria or fungus. This suggests that the proportion of essential oils with no antibacterial action was rather low, at around 7%. Our data also showed that the freshness or dryness of the plant at the time of harvest could affect the extraction rate of essential oils. This screening showed us that these essential oils present inhibitory activities towards the studied Gram+ bacteria, as well as a resistance against Gram-, in particular Enterococcus cloacae. Conclusion These essential oils can therefore be used in the prevention and treatment of certain infectious diseases and to fight against bacteria that are multi-resistant to the usual antibiotics.

Healthcare-associated infections (HAIs) are considered to be one of the biggest health problems as they continue to be an important cause of morbidity and mortality worldwide. They cannot be completely prevented, but their incidence can be significantly limited. Preventive action is the most important measure in this case. Due to the frequent interaction between healthcare professionals and patients, the crucial importance of hand hygiene is therefore emphasised. Adherence to good disinfection and hand washing practices remains around 40%, which can be improved by using a variety of nudge tools to promote desired hygienic behaviour. We conducted an open observation of employees and visitors with participation. The aim of this study was to determine the actual status of hand disinfection in a selected healthcare facility amongst doctors, registered nurses, medical technicians, cleaners, and visitors or parents of children; then, we selected and introduced three nudge tools of desired hygiene behaviour and analysed their effectiveness; finally, we provided suggestions for the use of nudge tools of desired hygiene behaviour with the aim of influencing doctors, registered nurses, medical technicians, cleaners, and visitors or parents of children so that they disinfect their hands properly. The actual state of hand disinfection was determined on the basis of observation without introducing any changes; then, we separately introduced three nudge tools, posters with an inscription and picture, the scent of citrus, and flashing lights. The obtained results were analysed with the help of the SpeedyAudit Lite application, and the effectiveness of each nudge tool and the adequacy of hand disinfection by categories of people were compared. In general, posters with a picture and an inscription contributed the most to more consistent disinfection of employees’ hands, while the scent of citrus and flashing lights contributed slightly less.