High-risk Occupational Groups Research Articles

Burden and factors associated with occupational tuberculosis infection among high-risk workers in Lahore District, Pakistan.

The main objective of the study was to estimate the burden of occupational tuberculosis infection in high-risk occupational workers and to identify risk factors associated with the prevalence of Mycobacterium tuberculosis complex (MTBC). An analytical cross-sectional study was conducted among high-risk occupational workers including veterinarians, abattoir workers, animal handlers, livestock farmers, and microbiology laboratory workers. Sputum samples were collected from 100 participants and polymerase chain reaction (PCR) tests were done to diagnose tuberculosis (TB) infection. Data on potential risk factors was collected in a pre-designed questionnaire. The MTBC prevalence ratio was estimated. Logistic regression analysis was conducted to identify risk factors and the crude odds ratio (OR) was calculated. Among the 100 enrolled high risk occupational workers, the prevalence of MTBC was 46% (95% CI: 35.98-56.25). Living in a joint family (OR 3.85, 95% CI: 1.58-9.37), and use of unpasteurized milk (OR 3.42, 95% CI: 1.4-8.39), were significantly associated with MTBC infection. Tuberculosis is a significant health burden in high-risk occupational groups, especially animal handlers and laboratory workers, in Lahore, Pakistan. The study also emphasized the need for formal work-related training, and enhanced zoonotic TB awareness among occupational workers.

Seroprevalence of human brucellosis in Turkey: A comprehensive meta-analysis.

Brucellosis remains a common zoonotic disease, in developing countries, as well as in Turkey where it is endemic, underdiagnosed, and underreported. The aim of this meta-analysis was to provide a comprehensive estimate of seroprevalence with a large sample size, covering all regions of Turkey, including both grey literature and published studies. A systematic search was performed in MEDLINE (via PubMed), TürkMedline (National Health Sciences-Periodicals Database), and YÖKSİS database (Higher Education Council Information System) until May 5th, 2023. The quality of the studies was evaluated independently using Joanna Briggs Institute (JBI) critical assessment tool for prevalence studies. A random-effects model (DerSimion and Laird) was utilized to estimate the overall pooled prevalence. A sensitivity analysis was performed, excluding studies with a high risk of bias. The subgroup analyses and meta-regression were conducted to explore sources of heterogeneity. Egger test and funnel plot were used to assess publication bias. The meta-analysis included 30 studies in total published between 1999 and 2021 with 51,560 individuals. In Turkey, the pooled seroprevalence of human brucellosis was estimated to be 4.5% (95% confidence interval [CI]: 3.8%-5.3%). According to the subgroup analysis, a higher seroprevalence was found in rural areas (8.0%, 95% CI: 5.4%-10.7%), high-risk occupational groups (9.9%, 95% CI: 5.3%-14.6%), and the Central East Anatolia Region (13%, 95% CI: 3.2%-22.8%). The meta-regression analysis identified living in rural areas and certain geographic regions as significant risk factors associated with higher seroprevalence. This meta-analysis revealed a significant burden of human brucellosis in Turkey. The findings highlight the need for public health measures and targeted interventions to reduce the burden of this zoonotic disease, especially in rural areas, high-risk occupational groups, and the East Anatolia Region.

Popular Musician Occupational Stress and Psychological Ill Health: An Exploratory Factor Analysis.

Popular musicians are exposed to many occupational stressors, including unpredictable work schedules, touring and economic precarity, that have been associated in prior studies with psychological ill health. This study sought to identify occupational stressors most strongly associated with depression, anxiety, and alcohol misuse in popular musicians. An online survey was completed by 317 popular musicians that included the Musician Occupational Stress Scale (MOSS), a validated measure of occupational stress in popular musicians. An exploratory principle-factor analysis (EFA) investigated the dimensions of response pat¬terns in the items comprising the MOSS. Four factors were identified that predicted 50% of musician occupational stress: Work Insecurity Stress, Tour Stress, Performance Stress, and Professional Relationship Stress. In addition to financial distress, each factor was significantly associated with depression and anxiety and Tour Stress also was associated with alcohol misuse. After adjusting for all other factors and financial distress, only Work Insecurity Stress remained associated with depression (odds ratio [OR]= 5.42; 95% confidence interval [CI] = 3.23-9.09) and anxiety (OR=5.95; 95% CI = 3.51-10.11). Tour Stress became inversely associated with depression (OR= 0.59; 95% CI = 0.40-0.89) and anxiety (OR=0.60; 95% CI = 0.40-0.89). After adjustment, alcohol misuse was associated with Professional Relationship Stress (OR=1.66; 95% CI = 1.04-2.65) but inversely correlated with Performance Stress (OR=0.60; 95% CI = 0.40-0.91). The four-factor model was shown to reliably simplify driving associations of occupational stressors that negatively impact psychological functioning in popular musicians. Dissemination of these findings could have practical implications in developing effective outreach messaging to promote psychological resilience and guide psychotherapeutic intervention strategies for this high-risk occupational group.

Seroprevalence and Risk Factors Associated with Leptospirosis in High-Risk Occupational Groups in the State of Gujarat as Determined by IgM ELISA and MAT Test: A Cross-Sectional Study.

Leptospirosis is a reemerging zoonosis affecting humans and animals worldwide in tropical and subtropical countries. The study was conducted to estimate the seroprevalence of leptospirosis in high-risk occupational groups (cattle farm workers, poultry farm workers, and slaughterhouse workers) in the state of Gujarat and to determine related risk factors for leptospirosis. Using an interview-guided questionnaire, a cross-sectional study was conducted involving 123 people in high-risk occupational groups (namely, cattle farm workers, poultry farm workers, and slaughterhouse workers) from five districts of the state of Gujarat, India. The participants' serum samples were screened for antileptospiral antibodies by using Immunoglobulin G (IgG) and Immunoglobulin M (IgM) enzyme-linked immunosorbent assays (ELISAs) followed by a microscopic agglutination test (MAT). The Chi-square (χ2) test and odds ratio were calculated using IBM SPSS Statistics for Windows, version 22 (IBM Corp., Armonk, N.Y., USA) to ascertain the associated risk factors. Regarding demographic information, this study included 104 men and 19 women in high-risk occupational groups. The overall seroprevalence of antileptospiral antibodies in these high-risk workers was 46.3%. The seroprevalence was the highest among poultry farm workers (56.6%), followed by cattle farm workers (54.5%) and slaughterhouse workers (25.6%). The MAT in combination with IgM is adequate for the serological diagnosis of leptospirosis, but we have also employed IgG ELISA to understand the chronic infection in these high-risk occupational groups as exposure was both past and present. Tests were conducted for antibodies against various Leptospira serovars in the major serogroups; frequent serovars included Hurstbridge, Panama, Javanica, Tarassovi, Copenhageni, Pomona, and Weaveri, among others. The significant (P < 0.05) risk factors associated with leptospirosis in these high-risk occupations reported to be living in field areas, the presence of livestock in the neighborhood, working in slaughterhouses, drinking water from natural water resources, contact with animals such as dogs or livestock, and wounds during occupational practice. Considering the high seroprevalence of leptospirosis, high-risk occupational groups should be regularly screened for potential development of the fatal disease. Hurstbridge was found to be the most prevalent serovar in the studied population, followed by Panama, Javanica, and Tarassovi.

IJCM_168A: Cardiovascular disorder risk among the police personnel in Ernakulam District, Kerala, India

Background: Appropriate assessment and management of cardiovascular risk is vital in reducing the occurrence of fatal and non fatal cardiovascular events like stroke or myocardial infarction in high risk occupational group such as Police personnel. Several studies have reported high prevalence of risk factors of cardiovascular diseases (CVD) such as hypertension, high blood lipids, physical inactivity, obesity, positive family history etc among police personnel Objective: To estimate the 10-year risk of cardiovascular events (fatal or non-fatal) among police personnel in Ernakulam City, Kerala, India Methodology: A cross sectional study was carried out among police personnel in various police stations of the district. All the police stations in the district were listed and selected randomly using the MS Excel random number generator. After getting prior permission from the concerned authorities in the Police department, Police personnel above the age of 40 years in Ernakulam city were screened for CVD risk using the WHO – non-laboratory-based CVD risk chart. Data was entered into Microsoft Office Excel and analysed using Jamovi version 2.3.28 Results: Out of 246 participants studied, the mean age was 48.4 + 3.97. Less than half of the participants (44.3%) were Civil Police Officers (CPO) or Senior Civil Police Officer (SCPO). About a third of the participants (32.1%) were having CVD risk in yellow category (5-&lt;10%), 3.3% in orange category (10-&lt;20%) and majority (64.6%) in green category (&lt;5%). On multivariate analysis, age&gt;50 years (OR – 3.36[1.73,6.5]) and duration of service&gt;20 years (OR – 4.9[2.35,10.23] were the independent determinants of higher CVD risk (yellow and orange category) Conclusion: About 35% of the participants belonged to higher risk category (yellow and orange) and duration of service&gt;20 years, age&gt;50 years were the independent determinants

Short-acting opioid prescriptions and Workers' Compensation using theNational Ambulatory Medical Care Survey.

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

Arthropod-Borne Viruses in Mauritania: A Literature Review.

During the past four decades, recurrent outbreaks of various arthropod-borne viruses have been reported in Mauritania. This review aims to consolidate the current knowledge on the epidemiology of the major arboviruses circulating in Mauritania. Online databases including PubMed and Web of Science were used to retrieve relevant published studies. The results showed that numerous arboviral outbreaks of variable magnitude occurred in almost all 13 regions of Mauritania, with Rift Valley fever (RVF), Crimean-Congo hemorrhagic fever (CCHF), and dengue (DEN) being the most common infections. Other arboviruses causing yellow fever (YF), chikungunya (CHIK), o'nyong-nyong (ONN), Semliki Forest (SF), West Nile fever (WNF), Bagaza (BAG), Wesselsbron (WSL), and Ngari (NRI) diseases have also been found circulating in humans and/or livestock in Mauritania. The average case fatality rates of CCHF and RVF were 28.7% and 21.1%, respectively. RVF outbreaks have often occurred after unusually heavy rainfalls, while CCHF epidemics have mostly been reported during the dry season. The central and southeastern regions of the country have carried the highest burden of RVF and CCHF. Sheep, cattle, and camels are the main animal reservoirs for the RVF and CCHF viruses. Culex antennatus and Cx. poicilipes mosquitoes and Hyalomma dromedarii, H. rufipes, and Rhipicephalus everesti ticks are the main vectors of these viruses. DEN outbreaks occurred mainly in the urban settings, including in Nouakchott, the capital city, and Aedes aegypti is likely the main mosquito vector. Therefore, there is a need to implement an integrated management strategy for the prevention and control of arboviral diseases based on sensitizing the high-risk occupational groups, such as slaughterhouse workers, shepherds, and butchers for zoonotic diseases, reinforcing vector surveillance and control, introducing rapid point-of-care diagnosis of arboviruses in high-risk areas, and improving the capacities to respond rapidly when the first signs of disease outbreak are identified.

Case-Control Study of Occupational Acute Myeloid Leukemia in the Republic of Korea

BackgroundWe conducted a case-control study to identify high-risk occupations and exposure to occupational hazards for acute myeloid leukemia (AML). MethodsWhen patients with AML admitted to the Department of Hematology in the study hospital for the first time are referred to the Department of Occupational and Environmental Medicine, data on occupation are collected by investigators to evaluate work-relatedness. Community-based controls were recruited through an online survey agency, and four controls per case were matched. Occupational information was estimated using structured questionnaires covering 27 specific occupations and 32 exposure agents. Conditional logistic regression analysis was performed by pairing cases and controls. ResultsIn the analysis of the risk of AML according to occupational classification, a significant association was found in paint manufacturing or painting work (OR = 2.22, 95% CI: 1.03–4.81) and aircrew (OR = 6.00, 95% CI: 1.00–35.91) in males, and in pesticide industry (OR = 6.89, 95% CI: 1.69–28.07) and cokes and steel industry (OR = 2.00, 95% CI: 1.18–22.06) in ≥60 years old. Moreover, the risk of AML increased significantly as the cumulative exposure to thinners increased. In the analyses stratified by sex and age, the association between pesticide exposure and AML was significant in males (OR = 3.28, 95% CI: 1.10–9.77) and in ≥60 years old (OR = 6.22, 95% CI: 1.48–26.08). ConclusionThis case-control study identified high-risk occupational groups in the Republic of Korea including paint manufacturers and painters, aircrew, and those who are occupationally exposed to pesticides or paint thinners.

Relationship between hypertension/blood pressure and hearing sensitivity among drivers: A correlation analysis

BACKGROUND: One of the most common chronic diseases is hypertension. The majority of research has linked hearing loss to hypertension. However, the relationship between hypertension and hearing is still unknown. The primary goal of the study is to investigate the effect of hypertension on hearing and to find out the association between blood pressure levels and auditory health in auto-rickshaw drivers. MATERIALS AND METHODS: The study utilized 121 healthy professional auto-drivers between the age range of 25 and 55 years. Pure-tone audiometry (PTA) and extended high-frequency audiometry (EHFA) were used to determine the participants' hearing thresholds from 0.25 to 16 kHz. The cochlear hair cell functioning was evaluated using distortion-product otoacoustic emission (DPOAE) testing. Blood pressure (mmHg) measurements were categorized under hypertension stage (normal (120; &lt;80); elevated (120–129; &lt;80); hypertension – stage 1 (130–139; 80–89); hypertension – stage 2 (≥140; ≥90)). RESULTS: The mean age of the study participants was 42.17 ± 9.03 years. The mean systolic and diastolic BP of all the study participants were 138.24 ± 19.73 (105–216) mmHg and 87.69 ± 12.14 (60–134) mmHg, respectively. BP levels were normal for 17.4% (N = 21) of the study participants, 21.5% (N = 26) had elevated blood pressure, 21.5% (N = 26) of the population falls under stage 1 hypertension, and 39.7% (N = 48) had stage 2 hypertension. Our study discovered a significant difference between main group effects and no significant difference between group interaction effects. Hearing thresholds were significantly higher in hypertensive participants compared to non-hypertensive participants. However, there was no statistically significant relationship between the two variables hypertension and hearing loss. CONCLUSION: Implementing health promotion initiatives and raising awareness about hearing health could improve the quality of life for a high-risk occupational group of drivers.

An Analysis of Psychiatric Morbidity and Its Related Factors in Ambulance Workers

Abstract Objectives: Ambulance workers belong to a high-risk occupational group, facing constant threats to their health and lives. Therefore, they are prone to mental health problems such as burnout, depression, and anxiety. A review of the literature has shown a scarcity of data concerning the magnitude and predictors of these psychiatric morbidities among Nigerian ambulance workers. In this study, we intended to determine the prevalence of burnout, the prevalence and predictors of depression and anxiety, as well as the relationship between burnout, depression, and anxiety among ambulance workers in Lagos, Nigeria. Methods: This was a cross-sectional study of 94 ambulance workers who were chosen using systematic random sampling. Copies of questionnaire used were the Maslach Burnout Inventory, the Hospital Anxiety and Depression Scale, as well as a sociodemographic questionnaire. Results: Mean scores ± standard deviation for burnout were emotional exhaustion (EE) 12 ± 9, depersonalization (DP) 7 ± 3, and personal achievement (PA) 36 ± 12. Furthermore, 12%, 34%, and 61% of the sample had high EE, high DP, and low PA, respectively. The prevalence of 34% and 52% was reported for depression and anxiety, respectively. Predisposing factors for depression were significantly to be female gender (p &lt; 0.05), being married (p = 0.01), junior cadre (p &lt; 0.05), and EE (p = 0.001). For anxiety, junior cadre (p &lt; 0.01), EE (p &lt; 0.01), and PA (p = 0.001) were predisposing factors. Conclusion: Ambulance workers suffer from diverse forms of psychiatric morbidities which have long-term effects on their mental health. There is a need for more support systems for ambulance workers to avert the occurrence of emotional problems in them.

An Artificial Intelligence-Based Smartphone App for Assessing the Risk of Opioid Misuse in Working Populations Using Synthetic Data: Pilot Development Study.

Opioid use disorder (OUD) is an addiction crisis in the United States. As recent as 2019, more than 10 million people have misused or abused prescription opioids, making OUD one of the leading causes of accidental death in the United States. Workforces that are physically demanding and laborious in the transportation, construction and extraction, and health care industries are prime targets for OUD due to high-risk occupational activities. Because of this high prevalence of OUD among working populations in the United States, elevated workers' compensation and health insurance costs, absenteeism, and declined productivity in workplaces have been reported. With the emergence of new smartphone technologies, health interventions can be widely used outside clinical settings via mobile health tools. The major objective of our pilot study was to develop a smartphone app that can track work-related risk factors leading to OUD with a specific focus on high-risk occupational groups. We used synthetic data analyzed by applying a machine learning algorithm to accomplish our objective. To make the OUD assessment process more convenient and to motivate potential patients with OUD, we developed a smartphone-based app through a step-by-step process. First, an extensive literature survey was conducted to list a set of critical risk assessment questions that can capture high-risk behaviors leading to OUD. Next, a review panel short-listed 15 questions after careful evaluation with specific emphasis on physically demanding workforces-9 questions had two, 5 questions had five, and 1 question had three response options. Instead of human participant data, synthetic data were used as user responses. Finally, an artificial intelligence algorithm, naive Bayes, was used to predict the OUD risk, trained with the synthetic data collected. The smartphone app we have developed is functional as tested with synthetic data. Using the naive Bayes algorithm on collected synthetic data, we successfully predicted the risk of OUD. This would eventually create a platform to test the functionality of the app further using human participant data. The use of mobile health techniques, such as our mobile app, is highly promising in predicting and offering mitigation plans for disease detection and prevention. Using a naive Bayes algorithm model along with a representational state transfer (REST) application programming interface and cloud-based data encryption storage, respondents can guarantee their privacy and accuracy in estimating their risk. Our app offers a tailored mitigation strategy for specific workforces (eg, transportation and health care workers) that are most impacted by OUD. Despite the limitations of the study, we have developed a robust methodology and believe that our app has the potential to help reduce the opioid crisis.

Morally injurious events among aid workers: examining the indirect effect of negative cognitions and self-care in associations with mental health indicators.

Potentially morally injurious events (PMIE) are events that violate one's deeply held moral values or beliefs, and that have the potential to create significant inner conflict and psychological distress. PMIE have been recognized as an important psychological risk factor in many high-risk occupational groups. However, no study to date has investigated how PMIE relate to the mental health of aid workers. Furthermore, little is known about the mechanisms by which PMIE might be associated with mental health indicators. Participants were 243 aid workers (72% female; M age = 39.31) who had completed at least one aid assignment (M = 8.17). They completed an online questionnaire about their PMIE, trauma history, and mental health. A structural equation model was constructed to examine the roles of negative cognitions and subsequent self-care behaviors in the relationship between PMIE and PTSD symptoms, depression symptoms, and posttraumatic growth, above and beyond the contribution of potentially traumatic events. Within the model, the indirect effect through negative cognitions fully accounted for the associations between PMIE and symptoms of PTSD and depression. For the association between PMIE and posttraumatic growth, two indirect effects emerged: the first through negative cognitions and subsequent self-care and, the second, through self-care alone. This study highlighted PMIE as a novel psychological risk factor for aid workers and pointed to two possible mechanisms by which these events may lead to PTSD, depression, and posttraumatic growth. This study adds to the current understanding of how high-risk occupational groups adapt psychologically to PMIE.

Qualitative analysis to identify determinants of use among different occupational settings and channels of communication to address smokeless tobacco use in Sri Lanka.

Smokeless tobacco (SLT) use is a leading cause for oral and pharyngeal cancers in the Southeast Asian region which leads to considerable morbidity and mortality. This study aims to Identify the determinants of use and channels of communication to address smokeless tobacco use among specific user groups in Sri Lanka. The study uses a qualitative approach with purposive, snowballing sampling among groups. Specific high-risk demographic and occupational groups that are known to have high prevalence of SLT use were identified in five of the 25 administrative districts of Sri Lanka, were approached. Sixty-two in-depth interviews and 10 focus group discussions were carried out among different occupational groups in five districts. Thematic analysis coding each reported determinants and communication methods was carried out. Users of SLT of different groups revealed different determinants of use. Some of the determinants were common to several groups. When investigated the preferred methods to address SLT, it is found that the media use was also different among these groups. All preferred group level awareness programmes to individual level awareness programmes. Most groups watch specific television channels at specific times of the day. Most groups stated that they accepted the messages of religious leaders and cancer victim groups. Radio and newspapers were used rarely by these groups that were studied. Smart phones were used only by urban youth and others used basic mobile phones only for calling. Different risk groups were identified allowing preparation of an overall communication approach to address use of SLT. The findings here Identify determinants of use and the communication approaches that can be used to prepare an effective communication strategy to address SLT use among different and sometimes hidden groups in resource poor settings in low a middle-income country.

Spatiotemporal Assessment of PM2.5 Exposure of a High-risk Occupational Group in a Southeast Asian Megacity

Drivers of open-air public utility jeepneys (PUJs) in the Philippines are regularly exposed to severe levels of fine particulate pollution (PM2.5), making them the appropriate sub-population for investigating the health impacts of PM2.5 on populations chronically exposed to these kinds of unique sources. Real-time PM2.5 exposures of PUJ drivers for a high-traffic route in Metro Manila, Philippines were assessed using Academia Sinica-LUNG (AS_LUNG) portable sensing devices. From all 15-second measurements obtained, the mean concentration of PM2.5 is 36.4 µg m–3, seven times greater than the mean annual guideline value (5.0 µg m–3) set by the World Health Organization (WHO). Elevated levels of PM2.5 were observed at key transportation microenvironments (TMEs) such as a transport terminal and near a shopping mall. The occurrence of hotspots along the route is mainly attributed to traffic-promoting factors like stoplights and traffic rush hours. Multiple linear regression (MLR) analysis revealed that the area by the shopping mall had the highest contribution (β = 52 µg m–3) to PUJ driver exposure. To the best of our knowledge, this study is the first in the country to perform a detailed characterization of the exposure of a high-risk occupational group to PM2.5. These results reveal information that is normally undetected by fixed site monitoring (FSM), underscoring the importance of mobile measurements as a complement to FSM in assessing the exposure of urban populations to air pollution more extensively. Furthermore, this study demonstrates the heavy influence of traffic-promoting factors on air pollution, and the feasibility of high-resolution mobile sensing for quantifying pollution characteristics in rapidly developing nations with unique air pollution sources. Gaps in our knowledge of their health impacts may be closed through quantifying exposure using reliable sensing devices and methods presented in this work.

Risk factors for the development of femoroacetabular impingement in physically demanding occupations: a systematic review

Background: Femoroacetabular impingement (FAI) syndrome, or hip impingement, is a musculoskeletal condition affecting the hip joint. It involves motion- or position-related pain originating from an abnormal, premature contact between the femoral head-neck junction (femur) and the acetabular rim (rim around the hip socket). Cumulative and repetitive mechanical overloads at the hip joint appear to contribute to the development of FAI. However, occupational exposures to such loads in potential high-risk occupational groups (e.g., military personnel and athletes) and the relationships between these exposures and the development of FAI remain unclear.

Epidemiological Characteristics of Human Anthrax - China, 2018-2021.

IntroductionThe epidemic of human anthrax is at a low level in China in recent years, but the reported incidence increased in 2021. In order to understand the current landscape of research and knowledge about anthrax in China, the epidemiological characteristics of anthrax in humans from 2018 to 2021 were analyzed and the prevention and control suggestions were proposed.MethodsSurveillance data of anthrax in humans and livestock, together with human outbreaks data during 2018–2021, were collected and analyzed by descriptive statistics methods. The number and proportion of outbreaks, cases and deaths by provincial-level administrative divisions (PLADs), clinical types, and contributing factors were calculated.ResultsA total of 1,244 cases of human anthrax and 53 outbreaks were reported from 2018 to 2021 in China. While the incidence of anthrax declined from 2018 to 2020, it increased in 2021. The regions of anthrax were mainly located in the west and the northeast PLADs of China, though cases were reported in some central and eastern PLADs in 2021. Young and middle-aged men involved in animal husbandry were found to be at a higher risk of anthrax. All the reported outbreaks were associated with the exposure of infected livestock. A total of 296 livestock anthrax cases were reported.ConclusionsThe increased incidence and wider geographical distribution of human anthrax in 2021 were found to be the result of inadequate supervision of diseased animals as well as updated diagnostic criteria. As such, the monitoring of risk factors and emergency preparation procedures should be strengthened at the national level. In addition, it is also critical to strengthen health education for high-risk occupational groups and strengthen professional training for local clinicians. Finally, more measures should be carried out to strengthen anthrax surveillance in livestock husbandry.

Seroprevalence of Anti-SARS-CoV-2 Antibodies in High-Risk Occupational and Low-Risk Groups in Southwestern Iran

Background: Monitoring the spread of SARS-CoV-2 has been considered by the World Health Organization (WHO). We examined the prevalence of anti-SARS-CoV-2 immunoglobulin antibodies in southwestern Iran in spring 2020. The circulation of SARS-CoV-2 is high in the general population, especially among health care workers (HCWs) who are in close contact with patients. Objectives: The aim of this study was to determine the prevalence of anti-SARS-CoV-2 antigen in high-risk occupational and low-risk groups to investigate risk factors for serum positivity in Shiraz, southwestern Iran. Methods: A cross-sectional survey was performed on 366 participants (204 from high-risk and 162 from low-risk subjects). IgG and IgM antibodies were detected using Pishtaz Teb COVID-19 ELISA Kits to evaluate SARS-CoV-2-antigen in serum samples. After enzyme-linked immunosorbent assay (ELISA), serum prevalence, as well as IgG/IgM positive factors, was determined using logistic regression. Results: From July to September 2020 (a few months after reporting the first case of COVID-19 cases in Iran), out of 366 survived people, 72 (40.9%) were IgG positive, and 50 (27.5%) were IgM positive. The frequency of positive serology for IgG and IgM antibodies in individuals aged &lt; 30 years was higher in the low-risk group than in the high-risk group. Multivariate logistic regression showed that headache (OR 0.312 [95% CI: 0.136 - 0.717]) and cough (OR 0.427 [95% CI: 0.182 - 1.004]) factors were associated with IgG or IgM positive serology. Conclusions: Between July and September 2020, the prevalence of anti-SARS-CoV-2 antigen was high in Shiraz. The prevalence of SARS-CoV-2 IgG/IgM antibodies in the high-risk group and their family as low risk was shown to increase viral infection due to close contact with COVID 19 patients than in the general population. Several factors were found to be related to the prevalence of anti-SARS-CoV-2 antigen that needs to be considered by policymakers to determine what to do about the SARS-CoV-2 pandemic.

Organizational strategies to address posttraumatic stress injuries among Canadian paramedics.

Paramedics are a high-risk occupational group for posttraumatic stress injuries (PTSI), and increasingly, evidence suggests that organizational factors play a significant role. While several resources for paramedic services to address PTSI exist, there is limited knowledge as to which PTSI-related programs and practices are implemented and how they are perceived in the workplace. This research aimed to explore key informants' perspectives on existing and desired organizational-wide initiatives for, as well as the challenges and potential solutions to, the primary prevention, early detection and intervention, and disability management of PTSI in Canadian paramedic services. Semi-structured interviews were conducted with 12 key informants from jurisdictions across Canada who have over five years of work experience in prehospital care. Interviews were audio-recorded, transcribed, and analyzed using thematic analysis. Eight recurrent organizational elements (themes) for addressing PTSI emerged: psychologically safe and healthy work culture; consistent supervisor support, mental health training and awareness, opportunities for recovery and maintaining resiliency, recognition of PTSI and its diverse risk factors, access to a variety of support initiatives for PTSI, communication during medical leave, and meaningful work accommodations. While organizational-wide initiatives were in place for the primary prevention, early detection and intervention, and disability management of PTSI, systemic challenges with coordination, resource allocation, and worker engagement were also identified. These challenges prevented paramedic services from optimally addressing PTSI in their workplace. Integrating considerations from the eight organizational elements to address PTSI into broader existing management systems may have merit in overcoming the systemic challenges.

Designing Adjuvant Formulations to Promote Immunogenicity and Protective Efficacy of Leptospira Immunoglobulin-Like Protein A Subunit Vaccine.

The leptospirosis burden on humans, especially in high-risk occupational groups and livestock, leads to public health and economic problems. Leptospirosis subunit vaccines have been under development and require further improvement to provide complete protection. Adjuvants can be used to enhance the amplitude, quality, and durability of immune responses. Previously, we demonstrated that LMQ adjuvant (neutral liposomes containing monophosphoryl lipid A (MPL) and Quillaja saponaria derived QS21 saponin) promoted protective efficacy of LigAc vaccine against Leptospira challenge. To promote immunogenicity and protective efficacy of the subunit vaccines, three alternative adjuvants based on neutral liposomes or squalene-in-water emulsion were evaluated in this study. LQ and LQuil adjuvants combined the neutral liposomes with the QS21 saponin or Quillaja saponaria derived QuilA® saponin, respectively. SQuil adjuvant combined a squalene-in-water emulsion with the QuilA® saponin. The immunogenicity and protective efficacy of LigAc (20 µg) formulated with the candidate adjuvants were conducted in golden Syrian hamsters. Hamsters were vaccinated three times at a 2-week interval, followed by a homologous challenge of L. interrogans serovar Pomona. The results showed that LigAc combined with LQ, LQuil, or SQuil adjuvants conferred substantial antibody responses and protective efficacy (survival rate, pathological change, and Leptospira renal colonization) comparable to LMQ adjuvant. The LigAc+LQ formulation conferred 62.5% survival but was not significantly different from LigAc+LMQ, LigAc+LQuil, and LigAc+SQuil formulations (50% survival). This study highlights the potential of saponin-containing adjuvants LMQ, LQ, LQuil, and SQuil for both human and animal leptospirosis vaccines.

Epidemiological and numerical simulation of rabies spreading from canines to various human populations in mainland China.

BackgroundThe mortality of humans due to rabies in China has been declining in recent years, but it is still a significant public health problem. According to the global framework, China strives to achieve the goal of eliminating human rabies before 2030.MethodsWe reviewed the epidemiology of human deaths from rabies in mainland China from 2004 to 2018. We identified high risk regions, age and occupational groups, and used a continuous deterministic susceptibility-exposure-infection-recovery (SEIR) model with periodic transmission rate to explore seasonal rabies prevalence in different human populations. The SEIR model was used to simulate the data of human deaths from rabies reported by the Chinese Center for Disease Control and Prevention (China CDC). We calculated the relative transmission intensity of rabies from canines to different human groups, and they provided a reliable epidemiological basis for further control and prevention of human rabies.ResultsResults showed that human deaths from rabies exhibited regional differences and seasonal characteristics in mainland China. The annual human death from rabies in different regions, age groups and occupational groups decreased steadily across time. Nevertheless, the decreasing rates and the calculated R0s of canines of various human groups were different. The transmission intensity of rabies from canines to human populations was the highest in the central regions of China, in people over 45 years old, and in farmers.ConclusionsAlthough the annual cases of human deaths from rabies have decreased steadily since 2007, the proportion of human deaths from rabies varies with region, age, gender, and occupation. Further enhancement of public awareness and immunization status in high-risk population groups and blocking the transmission routes of rabies from canines to humans are necessary. The concept of One Health should be abided and human, animal, and environmental health should be considered simultaneously to achieve the goal of eradicating human rabies before 2030.