Environmental Medicine Research Articles

Incorporating Lifestyle Medicine into Occupational Medicine Practice - ACOEM Guidance Statement.

Lifestyle Medicine (LM) utilizes evidence-based therapeutic lifestyle changes to address lifestyle factors that impact health, performance, and injury risk and recovery. By integrating LM principles into clinical care, workplace policies, and programs, along with other evidence-based methods, occupational and environmental medicine clinicians and medical directors can enhance worker health and performance, manage chronic disease, and facilitate faster recovery from injury and illness. This guidance addresses approaches that can be used in the clinic and workplace to address tobacco, substance misuse, nutrition, physical activity, overweight/ obesity, sleep, mental well-being, and social connectedness.

Application of Polylactic Acid in Clinical Medicine

Polylactic acid (PLA), a bio-based and biodegradable material, shows significant potential in environmental protection and clinical medicine. Derived from renewable resources, PLA's biodegradability reduces long-term environmental pollution by allowing it to decompose rapidly under specific conditions. This review explores PLA's applications in clinical medicine, emphasizing its mechanical properties, biocompatibility, and controlled degradation rates. The study covers PLA's extensive use in drug delivery systems, absorbable sutures, and tissue engineering scaffolds, highlighting its compatibility with human tissues and low immunogenicity. Research methods and designs, including in vitro and in vivo experiments, are discussed to evaluate PLA's efficacy and safety. The challenges of high production costs and specific degradation conditions are also addressed. Future research directions include developing new catalysts to improve synthesis efficiency and exploring renewable raw materials to reduce costs and environmental impact. As global awareness of sustainable development grows, the demand for PLA and other degradable plastics is expected to increase, expanding their applications in various fields. In conclusion, PLA offers substantial advantages in reducing reliance on fossil fuels and mitigating environmental pollution, while providing innovative solutions in the medical field. Technological advancements and increased production are anticipated to lower costs, making PLA more economically competitive and accelerating its application in both environmental protection and clinical medicine.

Wilderness Medicine Curricula in US Multidisciplinary Training Courses.

Wilderness medicine (WM) is the study of medicine in austere environments. There are several US multidisciplinary courses that teach WM to people from varying medical backgrounds. However, WM topics are covered to different extents. This study's purpose was to compare WM components among US multidisciplinary training courses. The American College of Emergency Physicians WM fellowship curriculum's 19 components and the Fellowship of the Academy of Wilderness Medicine's 12 core and 16 elective competencies and their credits were used as two control lists. Curricula from 10 US multidisciplinary courses were analyzed for WM components. Using descriptive analysis, each course curriculum was compared with the controls. This study examines WM components in 10 courses. The greatest number of American College of Emergency Physicians WM fellowship topics (14 of 19) was covered by the Paramedic course and the fewest number (4 of 19) by the Tactical Combat Casualty Care-Combat Lifesaver course. The greatest number of Fellowship of the Academy of Wilderness Medicine core credits (56) was offered by the Paramedic course and the fewest number (24) by the Tactical Combat Casualty Care-Medical Personnel course. The greatest number of Fellowship of the Academy of Wilderness Medicine elective credits (83) was offered by the Paramedic course and the fewest number (25) by the Tactical Combat Casualty Care-Combat Lifesaver course. This research analyzed WM components in US multidisciplinary courses and demonstrated that each covers WM topics to varying extents. This shows an opportunity for these courses to expand their WM education within their scope. It also demonstrates competencies offered by different courses for interested trainees.

Addressing Environmental Health: Clinician Training and Practice of Environmental Medicine - ACOEM Guidance Statement.

Addressing Environmental Health: Clinician Training and Practice of Environmental Medicine - ACOEM Guidance Statement.

COVID-19 quer durch die Berufsgruppen – Infektions-, Krankenhausaufenthalts- und ICU-Muster in einem schwedischen Bezirk

COVID-19 Across Professions – Infection, Hospitalisation, and ICU Patterns in a Swedish County The study, which will be published in the Journal of Occupational and Environmental Medicine and which has already been pre-published online in May 2024, is one of the few research projects on the links between COVID-19 and occupational activity that analysed data from all three waves of the pandemic and was able to draw on a particularly large data set (data from 22,000 people). Based on this data, the study determined the number of all positive infection reports, hospitalisations and intensive care unit admissions as well as deaths caused by COVID-19 for relevant occupational groups. Healthcare workers and other professions with frequent/close human contact had a significantly higher number of confirmed COVID-19 infections and a higher risk of hospitalisation than other occupational groups, especially in the first wave of the pandemic, even if this trend gradually weakened with each subsequent wave of the pandemic. Based on this finding, the authors of the study conclude that effective preventive protective measures should be implemented immediately at the beginning of a future pandemic wave for the groups of people and professions particularly affected by frequent and close occupational contact with people. The study’s analysis of data from a longer period of time makes it possible to better recognise changes in infection patterns over time. Keywords: COVID-19 – occupational activity – infection reports – hospitalisations admissions – deaths

Unmanned vehicles in health monitoring and medicine delivery with swarm algorithm innovations

The article delves into modern approaches and innovative technologies designed to monitor the health of military personnel using unmanned vehicles, while also assessing their potential for delivering medicines in combat environments. It thoroughly examines the wide range of sensors and technologies that enable remote measurement of vital signs, including but not limited to thermal imaging cameras, photoplethysmography sensors, and radio frequency sensors, highlighting their effectiveness in various operational contexts. The article also reviews numerous real-world applications of drones in both medical and humanitarian projects, showcasing the transformative impact these technologies can have in providing timely healthcare and support in areas where traditional medical infrastructure may be lacking. In addition to discussing the practical benefits of using unmanned vehicles for healthcare delivery, the article also addresses the challenges posed by their integration into military operations, such as logistical, technical, and regulatory hurdles. Furthermore, it presents a detailed example of how these innovative systems can be effectively combined to enhance the medical care provided to military personnel, especially during combat, where traditional access to medical services is often limited or compromised. The article proposes several key areas for future research and development, emphasizing the importance of continued technological advancements to fully harness the potential of unmanned vehicles for medical applications in the military sector. These areas include improving sensor accuracy, developing better communication systems, and creating more autonomous and efficient delivery mechanisms. Here are examples that prove, the article suggests that unmanned vehicles could play a critical role in revolutionizing both battlefield medicine and military logistics, offering new solutions for healthcare delivery in challenging environments.

Occupational Electronic Health Records: Recommendations for the Design and Implementation of Information Systems in Occupational and Environmental Medicine Practice-ACOEM Guidance Statement.

Occupational and environmental medicine (OEM) clinicians require specialized electronic health records (EHRs) to address the privacy, data governance, interoperability, and medical surveillance concerns that are specific to occupational health. The American College of Occupational and Environmental Medicine (ACOEM) Section of Health Informatics evaluated clinical workflow concerns, assessed health information requirements, and developed informatics recommendations through iterative consultation with ACOEM members. The ACOEM presents 10 recommendations that specialized occupational EHR systems (OEHRs) should meet to serve the information needs and practice requirements of OEM clinicians. Common challenges in OEM practice and potential informatics solutions are used to illustrate each recommendation. The recommendations serve as a framework for occupational health clinicians to consider in their adoption of OEHRs and provide software engineers a set of requirements to facilitate the development and improvement of OEHRs.

Seventy-five years of impactful environmental and occupational health research at the Nelson Institute of Environmental Medicine at New York University.

Founded in 1947 as the Institute of Industrial Medicine, the Nelson Institute and Department of Environmental Medicine at New York University (NYU) Grossman School of Medicine (NYUGSOM) was supported by a National Institute of Environmental Health Science (NIEHS) Center Grant for over 56 years. Nelson Institute researchers generated 75 years of impactful research in environmental and occupational health, radiation effects, toxicology, and cancer. Environmental health research is continuing at NYUGSOM in its departments of medicine and population health. The objective of this historical commentary is to highlight the major achievements of the Nelson Institute and the department in the context of its history at facilities in Sterling Forest, Tuxedo, NY and Manhattan, NY. Aspects of our discussion include leadership, physical facilities, and research in many areas, including air pollution, health effects of environmental radiation exposures, inhalation toxicology methodology, carcinogenesis by chemicals, metals, and hormones, cancer chemoprevention, human microbiome, ecotoxicology, epidemiology, biostatistics, and community health concerns. The research of the institute and department benefited from unique facilities, strong leadership focused on team-based science, and outstanding investigators, students, and staff. A major lasting contribution has been the training of hundreds of graduate students and postdoctoral fellows, many of whom have been and are training the next generation of environmental and occupational health researchers at various institutions.

Optimum ultrasonication duration for effective antimicrobial activity of Ti3C2-MXene

The characteristics of two-dimensional (2D) nanomaterials have attracted remarkable attention, particularly in the fields of environmental engineering, sciences and medicine. This study was focused on Ti3C2Tx-MXene, a novel 2D nanomaterial known for its antibacterial efficacy against both Gram-negative and Gram-positive bacteria. Our investigation has represented the initial exploration of the primary antifungal capabilities of Ti3C2Tx-MXene nanosheets, with variations in lateral size induced by ultrasonication time. The Ti3C2-MXene, characterized by negative surface potential, was tested against Staphylococcus aureus, Escherichia coli, Klebsiella pneumonia, Enterobacter cloacae and fungal strains of Candida albicans. Ultrasonication was employed without the use of any chemical intercalant for delamination, separation, and exfoliation. The optimal ultrasonication duration was determined, revealing the minimum inhibitory concentrations of 8 μl/mL and 4 μl/mL against E. coli and S. aureus, respectively, as observed through the broth dilution test. The antifungal activity against Candida albicans has been assessed using the well diffusion method, revealing a substantial zone of inhibition measuring 14 mm. The demonstrated antimicrobial efficacy of ultrasonicated MXene sheets has shown a huge potential for serving as an effective anti-biofouling material.

ECHO OEM virtual community of learning for primary care.

Health issues caused and/or exacerbated by work are common in patients seeking primary health care. Yet, primary care providers generally receive little or no training in the assessment and management of occupational injuries and illnesses. To conduct a pilot project to develop, implement and evaluate a programme to teach occupational and environmental medicine to primary healthcare providers. We followed the Extensions for Community Healthcare Outcomes (ECHO) model to connect primary healthcare providers with experts in Occupational and Environmental Medicine (OEM). We employed an observational pre-post study design to assess changes in self-efficacy, knowledge, attitudes and beliefs towards OEM. From September 2021 to June 2022, we offered two cycles of 12 sessions each. Participants came from medicine, nursing, psychology, occupational and physical therapy, chiropractic, kinesiology, social work, and pharmacy. Sixty-seven participants completed both pre- and post-ECHO questionnaires. Self-efficacy and knowledge ratings significantly increased after attendance at ECHO compared to the pre-ECHO responses. Attitudes and beliefs were unchanged in most of the items assessed. Participants rated their satisfaction with ECHO between 59% and 97%. Our pilot study demonstrated the challenges in implementing the first ECHO OEM in Canada. Findings show acceptability and satisfaction, improved self-efficacy, and small increases in knowledge, but not overall attitudes and beliefs. There is a need to understand barriers to participation and to target participants with less knowledge and experience in occupational and environmental medicine.

Sources of moral distress among obstetrician-gynecologists after Dobbs: A qualitative, multi-state study

Since the US Supreme Court's 2022 decision in Dobbs v Jackson Women's Health Organization, 18 states have enacted functional bans on abortion, yet little is known about how these laws contribute to workplace stress and its sequelae among clinicians. The purpose of this study was to characterize sources of moral distress—which occurs when a clinician knows the right course of clinical action but is barred from taking that action by external constraints—among obstetrician-gynecologists (OB-GYNs) in states with abortion bans. We conducted qualitative, semi-structured interviews with 54 OB-GYNs practicing in 13 of 14 states where abortion was illegal as of March 2023. Using a qualitative descriptive coding approach, we identified four types of clinical situations leading to moral distress: delaying treatment for patients with obstetric complications, conflict with other clinicians, denying care they would have provided locally prior to Dobbs, and restrictions on clinical counseling. These situations provoked feelings of anger, frustration, helplessness, and emotional exhaustion. Participants attributed moral distress to the cumulative toll of routinely being unable to provide evidence-based healthcare, in addition to the acute burden of managing obstetric emergencies in legal gray areas, which was relatively rarer. The findings demonstrate a previously unreported source of moral distress: the everyday chipping away of professional integrity that occurs when OB-GYNs cannot care for patients in the way that patients need. Next steps include developing institutional-level policies and programs to support clinicians and enable them to practice ethical medicine in abortion-restrictive policy environments.

Multifunctional microwave absorption materials: construction strategies and functional applications.

The widespread adoption of wireless communication technology, especially with the introduction of artificial intelligence and the Internet of Things, has greatly improved our quality of life. However, this progress has led to increased electromagnetic (EM) interference and pollution issues. The development of advanced microwave absorbing materials (MAMs) is one of the most feasible solutions to solve these problems, and has therefore received widespread attention. However, MAMs still face many limitations in practical applications and are not yet widely used. This paper presents a comprehensive review of the current status and future prospects of MAMs, and identifies the various challenges from practical application scenarios. Furthermore, strategies and principles for the construction of multifunctional MAMs are discussed in order to address the possible problems that are faced. This article also presents the potential applications of MAMs in other fields including environmental science, energy conversion, and medicine. Finally, an analysis of the potential outcomes and future challenges of multifunctional MAMs are presented.

Dissolution Mechanisms and Surface Charge of Clay Mineral Nanoparticles: Insights from Kinetic Monte Carlo Simulations

The widespread use of clay minerals and clays in environmental engineering, industry, medicine, and cosmetics largely stems from their adsorption properties and surface charge, as well as their ability to react with water. The dissolution and growth of minerals as a function of pH are closely related to acid–base reactions at their surface sites and their surface charge. The vivid tapestry of different types of surface sites across different types of clay minerals generates difficulties in experimental studies of structure–property relationships. The aim of this paper is to demonstrate how a mesoscale stochastic kinetic Monte Carlo (kMC) approach altogether with atomistic acid-base models and empirical data can be used for understanding the mechanisms of dissolution and surface charge behavior of clay minerals. The surface charge is modeled based on equilibrium equations for de/protonated site populations, which are defined by the pH and site-specific acidity constants (pKas). Lowered activation energy barriers for these sites in de/protonated states introduce pH-dependent effects into the dissolution kinetics. The V-shaped curve observed in laboratory experiments is reproduced with the new kMC model. A generic rate law for clay mineral dissolution as a function of pH is derived from this study. Thus, the kMC approach can be used as a hypothesis-testing tool for the verification of acid–base models for clay and other minerals and their influence on the kinetics of mineral dissolution and growth.

Seminar: Functional Exposomics and Mechanisms of Toxicity-Insights from Model Systems and NAMs.

Significant progress has been made over the past decade in measuring the chemical components of the exposome, providing transformative population-scale frameworks in probing the etiologic link between environmental factors and disease phenotypes. While the analytical technologies continue to evolve with reams of data being generated, there is an opportunity to complement exposome-wide association studies (ExWAS) with functional analyses to advance etiologic search at organismal, cellular, and molecular levels. Exposomics is a transdisciplinary field aimed at enabling discovery-based analysis of the nongenetic factors that contribute to disease, including numerous environmental chemical stressors. While advances in exposure assessment are enhancing population-based discovery of exposome-wide effects and chemical exposure agents, functional screening and elucidation of biological effects of exposures represent the next logical step toward precision environmental health and medicine. In this work, we focus on the use, strategies, and prospects of alternative approaches and model systems to enhance the current human exposomics framework in biomarker search and causal understanding, spanning from bench-based nonmammalian organisms and cell culture to computational new approach methods (NAMs). We visit the definition of the functional exposome and exposomics and discuss a need to leverage alternative models as opposed to mammalian animals for delineating exposome-wide health effects. Under the "three Rs" principle of reduction, replacement, and refinement, model systems such as roundworms, fruit flies, zebrafish, and induced pluripotent stem cells (iPSCs) are advantageous over mammals (e.g., rodents or higher vertebrates). These models are cost-effective, and cell-specific genetic manipulations in these models are easier and faster, compared to mammalian models. Meanwhile, in silico NAMs enhance hazard identification and risk assessment in humans by bridging the translational gaps between toxicology data and etiologic inference, as represented by in vitro to in vivo extrapolation (IVIVE) and integrated approaches to testing and assessment (IATA) under the adverse outcome pathway (AOP) framework. Together, these alternatives offer a strong toolbox to support functional exposomics to study toxicity and causal mediators underpinning exposure-disease links. https://doi.org/10.1289/EHP13120.

Neue Empfehlungen zur Lungenfunktionsprüfung

New recommendations for pulmonary function testing – practical relevance for occupational medicine The latest German recommendations on pulmonary function diagnostics date back to 2015, when the guideline on spirometry was published. In 2022, an official document was published by the European Respiratory Society (ERS) in collaboration with the American Thoracic Society (ATS), in which new interpretations of routine lung function tests were presented. This affects spirometry, body plethysmography, diffusion capacity, the bronchodilation test and the reference values. The previous German recommendations for pulmonary function were therefore revised and published in March 2024. The German Respiratory Society (DGP), the German Lung Foundation, the German Respiratory League and the German Society for Occupational and Environmental Medicine (DGAUM) were involved in the revision of the recommendations under the leadership of Prof. Criée.

A dearth of disability-related competencies in Accreditation Council for Graduate Medical Education's Milestones 2.0.

Despite the high prevalence of disability and the frequency with which people with disabilities encounter the health care system, physicians report inadequate knowledge regarding caring for their patients with disabilities. To determine the number and type of disability-related competencies in the Accreditation Council for Graduate Medical Education's Milestones 2.0. Cross-sectional analysis of publicly available data to identify, via key word search, the presence of disability-related competencies using disability-related terms derived from the World Health Organization's International Classification of Functioning Disability and Health. Accreditation Council for Graduate Medical Education's Milestones 2.0. N/A INTERVENTIONS: N/A MAIN OUTCOME MEASURE: Presence of disability-related competencies. Over one-third (37.5%) of specialties had zero disability-related competencies. Nineteen (59.4%) included an Interpersonal and Communication Skills Milestonethat mentions disability as a potential barrier to communication. No specialties had Systems-Based Practice or Practice-Based Learning and Improvement disability-related competencies. Physical medicine and rehabilitation (PM&R) had six disability-related competencies, preventive medicine occupational and environmental medicine had three, and otolaryngology and transition year each had two. A minority of medical and surgical specialties had disability-related competencies outside of the Interpersonal and Communication domain. With the rising prevalence of disability and the lack of physicians with expertise in the care of people with disability, the time is now to integrate disability competencies into residencies, especially for the primary care specialties.

Simulation of Hospital Waste Supply Chain in the Context of Industry 4.0—A Systematic Literature Review

Supply chain management is a crucial task for all companies, as it is essential to respond to increased demand and competitiveness. An exponential increase in hospital waste can cause very significant risks to both humans and the environment if it is not treated adequately. In this way, the efficient management of this waste can bring benefits and prevent an increase in the likelihood of disease occurring. With the growth of technology, there are various tools available to improve decision-making in the supply chain. Simulation, one of the pillars of Industry 4.0, is one of the tools being used. With the complexity of systems increasing, hybrid simulation provides more precise solutions to problems. The aim of this article is therefore to systematically research and analyze the literature on the use of simulation/hybrid simulation in supply chains in the health sector. In this way, 20 articles that approach simulation as a decision support tool in hospital waste supply chains were analyzed in the context of Industry 4.0. The results indicate that the years 2020 and 2023 had the highest number of publications (with five each) and that countries such as China and Indonesia had the highest number of documents on this topic (with five each). The topics in this research area with more related documents were environmental sciences, computer sciences and medicine. This research highlights the fundamental role of simulation approaches in improving the performance of supply chains in the healthcare sector, promoting resilience and improving healthcare outcomes for patients.

The Slow-Moving Crisis of Training in Occupational and Environmental Medicine.

The Slow-Moving Crisis of Training in Occupational and Environmental Medicine.

Mapping global research on space tourism (1993–2022): a three-decade bibliometric assessment using R and VOSviewer

Purpose Space tourism is currently experiencing significant attention because of its rapid and burgeoning development in the present era. This surge has resulted in an unprecedented growth in publications dedicated to unravelling the intricacies of space tourism. However, there is a conspicuous absence of a large-scale bibliometric analysis focusing on space tourism research from 1993 to 2022. Therefore, the aim of this study is to fill this research gap by examining and mapping the scholarly output published across the world in the spectrum of space tourism over the past 30 years (1993–2022). Design/methodology/approach A corpus of 7,438 publications pertaining to space tourism published from 1993 to 2022 was gathered from the Web of Science Core Collection. Accordingly, bibliometrix package in R and VOSviewer software were used to conduct a comprehensive bibliometric analysis. Findings The current study highlights a significant surge in publications related to space tourism, indicating a heightened scholarly interest and a significant paradigm shift in its exploration. Scott M. Smith, affiliated with National Aeronautics Space Administration Johnson Space Center, emerges as the most prolific author. Leading journals in disseminating space tourism research are Acta Astronautica and Aviation Space and Environmental Medicine. Keyword analysis revealed hotspots such as “space flight”, “simulated microgravity”, “weightlessness” and “stress”, while research gaps include “skylab”, “shuttle”, “cartilage”, “herpes virus” and “herniation”, offering potential avenues for exploration. Research limitations/implications This study’s implications empower stakeholders with actionable insights and deepen the understanding of the evolving landscape of space tourism research, fostering an environment conducive to continuous exploration and innovation in this burgeoning field. Originality/value This study enriches the understanding of global space tourism research and offers valuable insights applicable to a diverse audience, including researchers, policymakers and industry stakeholders. The broad applicability of the study’s findings underscores its significance, serving as a guide for strategic decision-making and shaping research agendas in the dynamic realm of space tourism.

How do different navigation systems affect emergency response time? A prospective simulation study

ObjectiveThere has not been a theoretical test run in Germany that compares different navigation systems with an industry solution (MapTrip112). The aim of this study was to compare navigation systems...