Health Implications Research Articles

10.Q. Scientific session: Evolving landscape of scientific publishing practices: implications for public health

Abstract In the landscape of scientific publishing, questionable research practices pose significant threats to the integrity and reliability of health research. This is occurring alongside notable changes in both the quantity and quality of published work. This scientific session aims to dissect the implications of such changes and practices on public health, fostering a critical examination and encouraging proactive discourse among public health professionals, researchers, and policymakers. Meta-research can explore the nuances of publishing ethics and the idea behind this session is seeking to heighten awareness of these issues and initiate meaningful discussions among public health professionals on maintaining the integrity of scientific literature in the health domain. The session will delve into the complexities of contemporary publishing, including the proliferation of mega-journals, trends in retracted papers, journals delisted from scientific databases, and the disturbing trend of paper mills which produce fraudulent research papers. Each aspect will be scrutinized for its potential impact on the credibility of health research and the consequential risks to public health. Structured as an interactive panel discussion, the format of this session is designed to maximize engagement and foster an open exchange of ideas. Participants will be encouraged to contribute their experiences and perspectives after each of the three presentations, enriching the dialogue and enhancing collective understanding. The distinct topics presented will underscore the pervasive nature of publishing practices and malpractices across different aspects of health research, highlighting the interconnectedness of ethical challenges and their broader implications. This session will merge meta-research empirical evidence with practical repercussions, offering attendees a comprehensive perspective on how publishing ethics might be shaping public health outcomes. It aims to equip participants with the knowledge to identify dubious practices and advocate for higher standards in scientific publishing. Improving research integrity is a cornerstone for effective health policies and interventions. The subject matter is poised to stimulate debate, invite scrutiny, and inspire action. Through this discourse, the session will articulate key messages about the urgency of upholding ethical standards in publishing to safeguard health research, providing clear, actionable insights for attendees to implement in their respective fields Key messages • Unethical publishing practices endanger health research integrity and might have consequences for public health outcomes. • Acknowledging good publishing practices and combating malpractices will foster higher ethical standards in health research.

Vitamin D status and its determinants in pregnant women form the Faroe Islands

Abstract Background In regions like the Faroe Islands, where sunlight may be insufficient for vitamin D synthesis, alternative sources such as diet and supplements become crucial. This study focuses on assessing the vitamin D status of pregnant women in the Faroe Islands during the early second trimester, considering the potential implications for maternal and fetal health. Methods A nationwide cross-sectional study (June 2020-April 2022) with 652 women providing blood samples and a questionnaire on demographics, vitamin D intake, and diet. Binary logistic regression assessed predictors of low 25-hydroxyvitamin D (25OHD) levels (<50nmol/L). Plasma 25OHD concentrations were analysed at the local National Hospital using the Alinity i 25-OH Vitamin D assay, employing chemiluminescence microparticle immunoassay (CMIA) for quantitative determination. Results The mean age was 30.7 (SD, 4.9) years; 86% were locally born; 45% resided in the capital area; 49% were overweight (BMI ≥25.0), with a mean pre-pregnancy BMI of 26.0. Most participants (95%) reported vitamin D intake (median of 10µg/day) and consumed vitamin D-rich foods 5.3 times per week. Low 25OHD concentrations were observed in 26% of participants, associated with residency, vitamin D intake, dietary habits, overweight, and sampling time. Maternal age, education, BMI, smoking, and traditional food showed no significant associations. During winter, vitamin D intake correlated more strongly with plasma 25OHD levels (Spearman’s rho, winter: 0.4, p < 0.001; summer: 0.2, p = 0.002). Conclusions Our study’s findings are essential for the health of Faroese pregnant women. 74% of them had sufficient 25OHD levels, which is encouraging. However, low levels were associated with residence, diet, overweight, and winter. This underscores the need for public health efforts to focus on monitoring vitamin D status, promoting vitamin D-rich foods, especially in winter, and monitoring dietary intake to protect maternal and fetal health. Key messages • No previous data on vitamin D status in Faroese pregnant women. • Seasonal variation is observed.

Food additive monosodium glutamate and risk of cardiovascular diseases - NutriNet-Santé cohort

Abstract Background One may add monosodium glutamate (MSG) to food for its flavour-enhancing properties. However, its implication in long-term cardiovascular health is uncertain due to a lack of precise epidemiological evidence. This study aimed to investigate the associations between food additive glutamate exposures and cardiovascular disease (CVD) risk, including cerebrovascular disease (CVA) and coronary heart disease (CHD) risks in a large prospective cohort of French adults. Methods Participants (n = 108,932, 79.3% women, mean age=42.4 years, SD = 14.5) were 15 years old and above from the French NutriNet-Santé prospective cohort (2009-2023). We assessed dietary intakes using repeated 24h-dietary records and exposure to food additive glutamate using food composition databases and laboratory assays. We characterised associations between cumulative time-dependent continuous exposures to total glutamate, natural glutamic acid, MSG and risk of CVD, CVA, and CHD using multivariable proportional hazards Cox models adjusted for known risk factors for standardised increments of glutamate intake. Results During follow-up (median 7.92 years), 2397, 1113, and 1284 participants were diagnosed with CVD, CVA, and CHD respectively. Higher intakes of naturally occurring glutamic acid (HR per 3000 mg/d increment=1.08, 95% CI [1.01-1.16], p-value=0.03), food additive MSG (HR per 200 mg/d increment=1.05, 95% CI [1.01-1.09], p-value=0.03), and total glutamate (HR per 3000 mg/d increment=1.09, 95% CI [1.01-1.17], p-value=0.02) were associated with higher risks of CHD (p-value for non-linearity>0.6). Conclusions This large prospective cohort study revealed positive associations between exposure to the widely used glutamate food additives, especially MSG (E621) and CVD, CVA, and CHD risks. Key messages • This large prospective cohort study revealed positive associations between exposure to the widely used glutamate food additives, especially MSG (E621) and CVD, CVA, and CHD risks. • If confirmed, our findings regarding MSG could lead to a re-evaluation of the safety of these food additives by European and international public health agencies to improve consumer protection.

The underestimated risk of prediabetes on cardiovascular outcomes in heart failure with reduced left ventricular function

Abstract Background The global prevalence of prediabetes and diabetes is increasing, highlighting an urgent public health challenge. While the cardiovascular (CV) risk of diabetes is well studied, profound data on the CV risk of prediabetes in patients with heart failure (HF) remain scarce in current literature. Therefore, we aimed to investigate the relationship of prediabetes and diabetes with common HF associated events such as all-cause, CV death and hospitalization for HF (HHF) in patients with HF with reduced ejection fraction (HFrEF). Methods Patients with HFrEF who were admitted to a tertiary academic center between 01/2005 and 07/2019 were included in the present analysis and then stratified according to their glycemic state. Prediabetes was defined as an HbA1c value between 5.7% and 6.4% and the absence of diabetes mellitus. The primary outcome was a composite of CV death and HHF. Secondary outcomes were the individual components of the primary outcome and all-cause death. We used cox regression models adjusted for age, sex, chronic kidney disease, body mass index, prior myocardial infarction, hypertension, CRP, and LDL-C. Results In total, 1,777 patients (median age 69 years, 24.3% female) were included in the present analysis and followed over a median of 4 years. Among them, 35.2% were diabetic, 18.7% prediabetic, and 46.1% showed non-impaired glucose metabolism. NT-proBNP levels were comparable between all glycemic groups. Both prediabetes and diabetes were found to significantly increase the risk of CV-death or HHF compared to those with normal glucose metabolism, with adjusted hazard ratios (HR) of 1.41 (95% Confidence Interval [CI]: 1.05-1.89) and 1.52 (95% CI: 1.17-1.97), respectively. This elevated risk applied to both components of the primary outcome, as illustrated in Figure 1. Notably, the increased risk of all-cause mortality was statistically significant only among diabetic patients (adj. HR 1.75; 95%CI: 1.30-2.36), with prediabetic patients showing a trend towards increased risk but not reaching statistical significance (adj. HR 1.40; 95%CI: 0.99-1.97). Conclusion The findings of this study underscores the independent associations between both prediabetes and diabetes with increased risks of cv-death and HHF in patients diagnosed with HFrEF. This emphasizes the critical role of glycemic status in the prognostication and management of HFrEF. The associations suggest that prediabetes is not merely a transient or benign state but has significant implications for cardiovascular health, particularly in the context of HF. In light of these findings, screening of prediabetes in patients with HFrEF might help to identify patients at risk who are susceptible for the development of HF related adverse events.Forest plot for all study endpointsKaplan-Meier curves for CV-death/HHF

Exposure to firearm injury and suicide in a rural Pennsylvania county: implications for mental and behavioral health.

To evaluate the association between self-reported gun violence exposures and mental health and behavioral health indicators in a rural population. Using cross-sectional survey responses from 630 residents of a rural county in Pennsylvania, logistic regression models estimate the likelihood of residents indicating moderate or severe levels of health outcomes as a function of gun violence exposure. We control for a series of variables related to gun ownership, behavior, history with firearms and demographic characteristics. Personal firearm victimization was associated with self-reported depressive symptoms and interrupted sleep. Secondary exposure to firearm violence, particularly exposure to friends attempting or completing a suicide, was associated with higher odds of reporting severe levels (14days or more in the past month) of depressive symptoms, anxiety, and poor sleep. For firearm suicide involving a friend or family member, the odds of reporting severe levels of all three outcomes are 3 times greater (OR 2.984, 95% CI 1.457-6.108). For each additional firearm exposure, the odds of experiencing severe levels of mental health and sleep difficulties are 1.4 times greater (OR 1.384, 95% CI 1.115-1.720). Cumulative exposures also increase the odds of reporting binge drinking and drug use. Firearm violence exposure was associated with adverse health indicators in this rural population. Approaches to counter the effects of cumulative firearm exposure and firearm suicide exposure, including reinvigorating community spaces and strengthening social supports, may help to reduce mental health burden in rural communities.

Communication of EU agricultural antibiotic use policies to farmers & implications for public health

Abstract Background It is estimated that by 2050, ten million people will die each year from antimicrobial resistant infections. AMR is driven by the improper use of antimicrobials, particularly in agriculture. 73% of the antimicrobials sold globally are used in food-producing animals. Problem EU regulations 2019/6 and 2019/4 on veterinary medications and medicated feed require behavior change by farmers to reduce their antimicrobial use. While this is welcomed by public health professionals, the response of the farming community is more complicated, as these regulations exist within the complex context of the global food system and current political unrest between farmers and the EU. Given the influential role of agricultural media for farmers’ decision making, it is critical to understand how AMR and associated public health and EU policies are being communicated to farmers and how the views of specific stakeholders including farmer representative organizations, veterinary bodies and government regulators are being represented. To examine this problem, a case study content analysis of three major agricultural newspapers in Ireland is undertaken. Results Preliminary results suggest that AMR and AMU have been covered in the agricultural media with specific coverage on these EU policies. This includes negative coverage, with key terms such as “threatens”, “risk”, or “warns”, as well as potentially positive views (e.g. “hope”). Preliminary results also suggest that the agricultural media might be a useful source to identify the farming community’s concerns and reactions to EU policy, for example calls by farmer representative bodies for the national government to intervene. Lessons Public health professionals must recognize the important role of farmers in addressing AMR. Evaluating how EU policies on AMR are represented in the agricultural media can help to better understand how this public health issue and its solutions are being communicated to these important stakeholders. Key messages • Public health professionals must recognize the importance of animal health and the role of farmers in addressing the AMR problem. • It is critical to evaluate how EU policies on AMR and associated One Health issues are communicated to non-public health professionals.

Bridging the gap: mapping co-creation methods for public health impact and innovation

Abstract Background Co-creation offers a promising approach to public health innovation, particularly for tackling complex issues. However, the lack of a standardized methodology limits its reliability and reproducibility, especially across diverse contexts. This study explores co-creation methods used by researchers and practitioners, aiming to shed light on their implications for public health. Understanding this methodological landscape can enhance the effective implementation of co-creation processes to address complex challenges. Methods Utilizing the Systematic Methods Overview approach, we examined co-creation methods. Data were gathered from the Health CASCADE Co-Creation Database and grey literature using an artificial intelligence-assisted recursive search strategy and a two-step screening process. We conducted textual, comparative, and bibliometric analyses to evaluate methodological underpinnings and relationships between methods. Results Analysis of 2,627 academic articles and grey literature sources identified over 900 co-creation methods. While surveys, focus groups, and group discussions were prevalent, participatory methods were underutilized. Notably, 91.3% of methods co-occurred, with a predominant combination of qualitative approaches. Furthermore, a significant discrepancy between research and practice was evident, with only 10.2% convergence. Conclusions This study revealed a critical gap between co-creation in research and practice, emphasizing the need to bridge this methodological divide for advancing co-creation as a reliable approach in public health. The over-reliance on qualitative methods raises concerns about tokenistic engagement and undermines meaningful public participation in co-creation. Addressing this trend is vital to preserve the essence of true co-creation and maximize its potential for addressing complex public health challenges. Key messages • Mapping the diverse methods of co-creation in public health reveals both richness and disparities in approach, from surveys to participatory methods. • Addressing the discrepancy between co-creation in research and practice is vital for establishing a reliable and effective approach to tackling public health challenges.

Regulatory mechanism of cysteine-dependent methionine biosynthesis in Bifidobacterium longum: insights into sulfur metabolism in gut microbiota

ABSTRACT Sulfur, a critical element for bacterial growth, is not directly utilized by bifidobacteria, rendering the sulfur-containing amino acid biosynthesis pathway, particularly for cysteine and methionine, poorly understood. This research identifies six genes involved in this pathway through re-annotation of the Bifidobacterium longum DJO10A genome. These genes play crucial roles in bioconversion processes essential for cysteine utilization, highlighting its significance in sulfur metabolism. Our study uncovers a novel regulatory mechanism of these pathways under varying cysteine concentrations. We demonstrate a dual-pathway mechanism for methionine biosynthesis: one directly utilizing cysteine (trans-sulfurylation pathway) and another utilizing H2S derived from cysteine degradation (direct sulfurylation pathway). This regulatory dual-pathway mechanism is contingent on environmental cysteine levels, with both pathways activated at low cysteine levels, while higher levels predominantly engage the H2S-utilizing pathway. This investigation not only advances our understanding of DJO10A’s metabolic capabilities but also underscores the bacterium’s adaptability through sophisticated regulatory mechanisms for sulfur-containing amino acid biosynthesis. The elucidation of these pathways provides valuable insights into the survival strategies of bifidobacteria in the gut environment, where sulfur sources can vary greatly. Through detailed genomic, transcriptional, and enzymatic analyses, this study significantly contributes to the field of microbiology, offering a foundation for future research on gut microbiota metabolic pathways and their implications for host health.

A canine onchocercosis report from the portuguese west region in 2024: implications for Public Health

Abstract Issue/problem Onchocerca lupi parasitosis, known as onchocercosis, affects dogs, sporadically cats and humans, posing a public health concern due to possible vectors in the environment. This neglected tropical disease(NTD), has no known human cases outside endemic areas. However, recent reports in non-endemic areas raise concerns about future implications. Climate change has increased the potential risk of disease vectors establishing themselves in previously unaffected areas. Description of the problem A case of canine onchocercosis in the West Region of Portugal, made the pet owner look for medical counselling. Primary health care providers contacted the Public Health Unit(PHU) for guidance and actions. There had been no previous reports in this region. In this case report, we explore the potential public health implications, through a one-health approach. Results History of the disease was collected, and travel history of the dog revealed that he had lived in the Algarve during 11 years with only a one-and-a-half-month travel to Italy in this period. Literature review revealed reports of previous cases of oncochercosis in the Iberian Peninsula. Collaboration between the PHU, research institutes, and veterinary authorities led to the assumption of probable transmission in the Algarve. Lessons Increased vector surveillance is needed, especially in areas associated with animal onchocercosis. Proactive measures reduce transmission risks, protecting both humans and animals. Tracking animal cases is vital for understanding regional environmental factors. PHU’s must conduct thorough risk evaluations and maintain assertive risk communication strategies to address public and pet owner concerns effectively. Adopting a One Health approach improves the understanding of the disease dynamics and enables targeted interventions. Key messages • NTD’s transmitted by vectors pose a potential future challenge. This report underscores the need for a One Health approach, with collaborative multidisciplinary efforts to address these challenges. • Furthermore, systematic interaction and reporting between human, animal, and environmental health authorities are crucial to ensure comprehensive surveillance and mitigation strategies.

Heterogeneity of postpartum bonding and maternity blues among mothers three days after delivery

Abstract Background Findings about risk factors for postpartum depression (PPD) are often inconsistent. The variability could be due to the heterogeneity of characteristics of mothers at risk for PPD in certain populations, which has important mental health implications. We examined the heterogeneity of sociodemographic, pregnancy and labor characteristics in postpartum women referred to follow-up care on the third day after delivery. Methods We performed a nested cross-sectional latent profile analysis (LPA) on a convenience sample of women in a tertiary community hospital in Split, Croatia in 2020. Participants completed the first subscales of Postpartum Bonding and Maternity Blues questionnaires, as well as five subscales of the Questionnaire of Family Functioning According to Parents and 12 sociodemographic, pregnancy and childbirth-related variables. LPA identified profiles of mother-infant bonding and postnatal blues, and multinomial regression analysis was used to determine the influence of different profiles. Results Of the 318 participants, the best-fitting model had three latent profiles. First (n = 76, 24% of participants) and second (n = 216, 68% of participants) latent profiles showed good postpartum bonding, while second profile showed higher primary blues. Third profile (n = 80, 25% of participants) was characterized by poorer postpartum bonding and elevated primary blues. Only good youth experiences of mothers with their parents (relative risk [RR] 0.26; 95% CI 0.12-0.57; p = 0.001) and good present-day relationships with partners (RR 0.26; 95% CI 0.13-0.52; p < 0.001), significantly decreased the risk for third latent profile classification. Conclusions Postpartum bonding and primary blues of women who gave birth three days prior were heterogeneous. This heterogeneity could result in the well-documented heterogeneity of postpartum depression in women, and therefore, be the focus of mental health interventions in similar settings. Key messages • We found heterogeneity of sociodemographic, pregnancy, and labor characteristics in postpartum women after delivery, highlighting the variability in risk factors for postpartum depression. • This heterogeneity could result in the well-documented heterogeneity of postpartum depression in women, and therefore, be the focus of mental health interventions in similar settings.

Attitudes, fears and experiences of medical scientists towards using AI tools in their work routine

Abstract Background Artificial intelligence (AI) has experienced an explosive growth in the healthcare sector and the scientific field. Large Language Models (LLMs) are investigated as potential tool to be used in medical treatment, by e.g. producing doctor’s reports, supporting personalized medicine or educating patients. However, limitations are broadly discussed addressing patient safety and ethical concerns due to false and misleading content. Therefore, LLMs face criticism among users not only towards their integration in the patient-provider-interaction, but also in its use in medical research and health care education. In the ongoing EXPOLS (Exploring the Potential of LLMs in Statistical Consulting) study, we address the question ‘What are the attitudes, fears and experiences regarding the integration of AI tools in the clinical/scientific work routine?’ Methods We implemented an online survey that will be accessible in 07/2024. All employees at the University and Medical Center Freiburg will be asked to participate in the survey via online media. We expect a sample size of n = 600-1,200. The survey combines published measurements (e.g. TRI 2.0, result expectation measure), as well as a self-designed instrument with 15 items aiming to measure fears and attitudes towards AI. Latter was developed within a multidisciplinary team making use of ChatGPT as item generator. We will investigate its psychometric properties using exploratory factor analysis and describe distribution characteristics. Results At the time of the conference, the project will be completed and both psychometric insights and content-related results will be reported. The results could have important public health implications, since attitudes towards AI will steer its integration in the medical and clinical routine. Conclusions The EXPOLS study makes a current inventory among medical scientists in Freiburg following a modern approach in instrument development by including ChatGPT as collegial advisor. Key messages • This study explores attitudes, fears and experiences towards the integration of AI tools in the work routine from medical and scientific staff at the University of Freiburg. • The findings might be crucial in determining the integration of AI based tools in the medical and clinical work routine.

Long-term changes in frailty and incident atrial fibrillation: multicenter prospective cohort study

Abstract Background Atrial fibrillation is the most common sustained cardiac arrhythmia and is prevalent among the elderly. Previous findings indicated a higher prevalence of AF in frail adults and frailty prevalent in AF patients. However, the association between dynamic changes of frailty and risk of new-onset AF is unclear. Purpose We aimed to investigate the associations of long-term changes in frailty with incident AF. Its associations with heart failure (HF), coronary heart disease (CHD), and stroke were also evaluated as a secondary aim. Methods Over 50,000 participants from UK Biobank cohort were included, with available frailty index (FI) data and free of AF, HF, CHD or stroke in both baseline and final follow-up assessments. Participants were categorized into nonfrailty, prefrailty and frailty based on their FI scores. Changes of frailty status from baseline to final follow-up assessment included alleviation, maintenance, and aggravation. Thus, transitions of frailty status included 7 categories: nonfrailty maintenance, nonfrailty aggravation (nonfrailty to prefrailty or frailty), prefrailty alleviation (prefrailty to nonfrailty), prefrailty maintenance, prefrailty aggravation (prefrailty to frailty), frailty alleviation (frailty to prefrailty or nonfrailty), and frailty maintenance. FI in baseline and follow-ups are used to calculate the trajectories of frailty (ΔFI). Cox proportional hazard models were used. Results Compared with nonfrailty at baseline, the HRs (95% CI) of AF for prefrailty and frailty were 1.32 (1.29, 1.36) and 1.89 (1.83, 1.96) in the multivariable-adjusted model. During a median of 5.1 years of follow-up from the final assessment, 1729 cases of AF were recorded. Frailty trajectory analysis showed that even a 0.01 point/year increase in ΔFI was associated with 14% (95% CI 1.08-1.20) higher risk of AF, independent of baseline FI and the risk rose to 1.89 (1.45, 2.46) with per 0.05 point/year increase in ΔFI. This association was strengthened in low genetic risk of AF, but sex, age, smoking status, alcohol intake, obesity, hypertension, diabetes and cancer did not materially modify the associations. Moreover, compared with nonfrailty maintenance, sustained frailty had the highest risk of AF (HR 1.95, 1.61-2.36). Alleviation from frailty reduced the risk of AF by 30% (95%CI 0.53-0.94), compared to sustained frailty. These associations were similar in HF and CHD, however, not significant in stroke. Conclusions Middle aged and elderly people, including those with diabetes, obesity and hypertension, may gain substantial benefits in risk of AF, HF and CHD by becoming less frail or maintaining nonfrailty, irrespective of past frailty status and established risk factors, delivering public health implications for the necessity of early identification and timely interventions of frailty in heart health management.

Mercury speciation in environmental samples associated with artisanal small-scale gold mines using a novel solid-phase extraction approach to sample collection and preservation

In artisanal small-scale gold mines (ASGM), mercury (Hg) is known to pollute nearby river waters and sediments where it can be methylated to the highly bioavailable methylmercury (MeHg). The assessment of Hg speciation in water samples has been challenging for many years, with recommended procedures often not adequately allowing for analysis of samples in a suitable timeframe. Using a novel solid-phase extraction (SPE) method for sampling and preservation of Hg species, representative speciation data can be safely and easily collected and retained for up to 4-weeks (MeHg = 115 ± 8% refrigerated and 109 ± 13% unrefrigerated storage; Hg2+ = 100 ± 14% refrigerated and 94 ± 12% unrefrigerated storage). Concentrations of MeHg in environmental water samples and drinking water were below detection limit across two ASGM sites in western Kenya and concentrations of Hg2+ were below drinking water guidelines; however, drinking water sources contribute 20–30% of the tolerable weekly intake of Hg, indicating a need to minimise exposure of Hg from dietary sources to prevent Hg poisoning. Sediments from receiving rivers at ASGM sites showed total Hg concentrations above guideline limits (0.08–1.84 mg kg−1 total Hg) along the length of the river; however, MeHg concentrations fluctuated dependent on the stagnation of the river due to damns and ponds (5.9 ± 14.3 µg kg−1 MeHg). The findings show that SPE can be used as a robust sample collection and preservation approach for Hg speciation, which can better inform mitigation measures, understand ecological and human health implications, and improve environmental monitoring.

Hydroxyl radical oxidation of chemical contaminants on indoor surfaces and dust

Humans are widely exposed to semivolatile organic contaminants in indoor environments. Many contaminants have long lifetimes following partitioning to the large surface reservoirs present indoors, which leads to long exposure times to gas-phase oxidants and multiphase chemistry. Studies have shown selective multiphase oxidation of organics on indoor surfaces, but the presence of hydroxyl radicals with nonselective reactivity and evidence of multiphase OH radical reactivity toward common indoor contaminants indicates that there may be additional unknown transformation chemistry indoors. We screened genuine indoor samples for 60 OH radical oxidation products of the common plasticizer and endocrine-disrupting contaminant bis(2-ethylhexyl) phthalate (DEHP) identified in laboratory experiments using nontargeted high-resolution mass spectrometry. At least 30 and 10 of these products are observed in indoor dust and DEHP films exposed to ambient indoor conditions, respectively, indicating that multiphase OH reactions occur indoors. Using the PROTEX model and a multimedia indoor chemical fate model, we demonstrate that these products have long indoor lifetimes and cause a higher potential for human exposure than DEHP. Some of these products are more active endocrine disruptors than DEHP itself, but most have unknown toxicities. Coexposure to all oxidation products will likely have an additive effect, leading to higher human health risks from indoor organic contaminants than previously thought. Due to the nonselective reactivity of OH radicals, it is likely that most indoor contaminants follow similar chemistry, and further study is needed to understand the prevalence and human health implications of such multiphase chemistry.

Public perceptions of the health impacts of climate change: a survey study in Greece

Abstract Background Climate change is the biggest global health threat of the 21st century. Despite the tremendous challenges, many people remain unaware of the human health implications of climate change. People perceptions about the health harms of climate change can increase public support for the action needed to reduce climate change. The aim of this study was to examine the public perception of climate change as a human health issue in Greece. Methods A population survey study was conducted from October to December 2023 in the municipalities of Messini and Alexandroupoli, Greece, following proportional quota sampling. A questionnaire was developed and included measures about the socio-demographic background of participants, their understanding of key facts about climate change and their views about climate change thread to human health. Results 406 individuals with a mean age 37.7 (sd = 14.8) participated in the study. Participants understood that climate change is happening (93.6%) and 54% of them think climate change is mostly or entirely caused by human activities, whereas 38% think it is caused equally by human activities and natural causes, and about 8% think climate change is mostly or entirely caused by natural causes. A majority of participants reported that climate change has adversely affected the health of people in various way, either a moderate amount or a great deal, including physical or mental harm from forest fires (90%), physical or mental harm from storms and floods (87%), heat-related illnesses (82%), illness due to reduced outdoor air quality (70%) and loss of housing for residents displaced by extreme weather events (70%). Conclusions Participants viewed climate change as an important cause of health harm, however they partially understood that climate change is caused by humans. Public health authorities should educate the public and policymakers about the climate change and advocate for policies to address the human health challenges of climate change. Key messages • Public health authorities should educate the public and policymakers about the climate change problem and its impact to human health. • Providing people with information about the health harms of climate change can increase public support for the actions needed to reduce emissions.

Pediatric Allergy Management at ULSNE: Insights into Public Health Implications

Abstract Introduction Pediatric allergies present a complex challenge to public health systems, affecting both policy-making and clinical management. This study explores the management trends and challenges of pediatric allergies at the Unidade Local de Saúde do Nordeste (ULSNE) in Portugal, emphasizing its implications for refining healthcare practices over a seven-year period. Methods A retrospective review of medical records was performed, from children aged 0 to 18 who presented with allergic reactions at ULSNE’s emergency services between 2017 and 2023. The analysis concentrated on demographics, allergen types, reaction severity, and the management strategies deployed. Results The analysis revealed a wide range of allergens, from food to insect stings, with medication being the most prevalent triggers. Significant findings include observing severe allergic reactions across all age groups, highlighting the need for acute emergency interventions. The data underscores a critical demand for early diagnosis and tailored-made management plans to efficiently handle the diverse severity of allergic reactions observed. Conclusions This study demonstrates the complexity of managing pediatric allergies within ULSNE’s public health framework. Standardized, evidence-based management methods should be adopted to strengthen emergency response capabilities, as shown by the frequency of severe responses and the prevalence of various allergens. As an outcome, our results support a comprehensive, interdisciplinary strategy that includes medical personnel, educational institutions, and family involvement to create a supportive community that is supportive of both immediate care and long-term preventive measures. Subsequent efforts should give precedence to educational programs designed to increase consciousness and encourage preventive measures in community environments. Key messages • A rapid response is essential for healthcare systems to have fast, effective strategies ready for children’s severe allergic reactions. • Emphasizes a collective approach involving healthcare workers, schools, and families to prevent and manage children’s allergies, enhancing safety and awareness.

Real-time exposure to negative news media and suicidal ideation intensity among LGBTQ young adults in a high-stigma US state

Abstract Background With a recent surge in anti-LGBTQ policies and associated news/media coverage worldwide, there is a crucial need to study the role of LGBTQ negative news/media on proximal risk for suicide among LGBTQ youth, especially in high-stigma contexts. Methods Using a smartphone-based protocol, participants responded to brief self-report surveys 3x per day for 28 consecutive days. LGBTQ young adults (ages 18-24 years old) residing in Tennessee with recent suicidal ideation were recruited. At each assessment, participants reported real-time exposure to negative news/media, whether the news/media was related to LGBTQ topics, expectations of anti-LGBTQ rejection, and current intensity of passive suicidal ideation, active suicidal ideation, and self-harm ideation. Statistical analyses employed multilevel path analyses with restricted maximum likelihood estimation. Results 31 participants completed 2189 assessments (90.5% median compliance). Within-person effects showed that real-time exposure to LGBTQ - but not general - negative news/media was positively associated with suicidal ideation intensity. Significant indirect effects were present from exposure to LGBTQ negative news/media to higher suicidal ideation intensity through expectations of rejection. Mediation through expectations of rejection accounted for 25% and 39% of the total effect for active and passive suicidal ideation, respectively. Conclusions Findings have important public health implications related to media reporting, policy, and clinical intervention. Interventions targeting media organizations should promote responsible reporting practices and increase awareness of the potential suicidogenic impact of negative LGBTQ news coverage. This study joins numerous others in documenting the potential mental health harms of policies that restrict LGBTQ visibility and rights. Mental health professionals play a vital role in promoting coping in the face of exposure to LGBTQ negative news/media content.

3.O. Scientific session: Migrant labour exploitation and health: How can research foster protection of migrant workers?

Abstract Migrant workers sustain essential industries such as the food supply chain, construction, and domestic and care work. They tend to perform onerous and risk-laden tasks at low pay without employment or health protections, and often under exploitative terms (e.g., debt bonding, piecework). Current evidence on associations between migration, employment terms and conditions, and health indicates profound inequities in work-related health outcomes for migrant workers. Although the COVID-19 pandemic highlighted these disparities and their potential social and public health implications, migrant workers continue to be overlooked by public health scholars and policymakers. Supranational regulations (such as EU directives) and national policies rarely consider migrants in their role as workers, and little research is dedicated to questions at the intersection of migration, employment, and health. The invisibility of migrant workers is also a matter of disciplinary and sectoral silos, with different aspects of migrant labour regulated separately by Ministries of Immigration, Labour, Agriculture, Health, and others. These silos create incompatible, context-contingent definitions, terminologies, and administrative categorizations, leading to inconsistent data collection and data gaps which, in turn, translate into policy blind spots. Data that are comparable across contexts and that refer to migration, employment/work and health are generally scarce. For some sectors and contexts, virtually no data exist; e.g., for migrant workers in agriculture, construction, and domestic work, and for migrant workers in low- and middle-income countries. There is barely any evidence about interventions to improve the structures that dictate migrant workers’ employment conditions or obligations of employers. Given the limited participatory research with migrant workers, we have a very poor understanding of their views and viable intervention options, and migrant workers’ voices thus also remain absent from policymaking. This workshop aims to contribute to greater visibility of - and ultimately action on - migrant labour exploitation in research and policy. To this end, it will map current challenges and shortcomings in generating evidence on the links between migration, work/employment, and health; and it will suggest ways to improve research and interventions to address migrant workers’ health, based on the speakers’ experience in developing intervention-focused evidence in different contexts. The workshop will conclude with an open discussion to identify further relevant questions and elaborate steps towards better research and greater protections for mobile worker populations. Key messages • Harm from exploitative working conditions among migrant workers is substantial, yet data collection methods and intervention designs are limited. • For public health research to effectively help protect the health and rights of migrant workers, it is essential to share methods and insights across disciplines to drive research for action.

Exploring the use of meal delivery services in Belgium

Abstract Background Ready-to-eat meal delivery services have become commonplace in recent years and their growth accelerated during the COVID-19 pandemic. However, the potential ramifications on dietary habits and subsequent health outcomes remain largely unexplored. Given the well-established links between unhealthy dietary patterns and chronic diseases such as obesity, type II diabetes, and cardiovascular diseases, understanding the determinants and public health implications of ready-to-eat meal delivery services use is imperative. This study aims to investigate the determinants associated with the use of ready-to-eat meal delivery services and their implications for health behaviours and outcomes. Methods This cross-sectional study is conducted amongst adults residing in Flanders or Brussels, Belgium. A quantitative online survey commenced in April 2024 and is scheduled to conclude by June 2024. Structural equation models will be used to assess determinants and implications of ready-to-eat meal delivery services use. Latent class analysis will be used to identify user profiles and subsequent structural equation modelling will assess determinants of these profiles and their associated health (behaviour) outcomes. Results Preliminary results suggest meal delivery usage was higher in younger and middle-income users. Main reasons of use amongst users (n = 139) were more time for leisure activities (66%) and supermarket avoidance (64%). Main reasons for non-use amongst non-users (n = 69) were not wanting to spend money with meal delivery services (70%) and preference to cook own meals (81%). Data collection is currently ongoing. Further analysis is planned, and full results will be available by November 2024. Conclusions This study will provide a better understanding of drivers of meal delivery services use in Belgium and their potential impact on public health. It will also help inform public health strategies targeted at improving dietary habits. Key messages • Recognising that meal delivery services will become ever present in the future, insights into why people order meals for delivery and the potential health implications of such services are essential. • The use of advanced statistical techniques highlights the potential of the study to offer novel insights into determinants and ramifications of meal delivery services usage.

Epigenetic modulation of vascular calcification: Looking for comprehending the role of sirt1 and histone acetylation in VSMC phenotypic transition

In light of the complex origins of ectopic vascular calcification and its significant health implications, this study offers a comprehensive exploration of the molecular dynamics governing vascular smooth muscle cells (VSMCs). Focusing on epigenetic modulation, we investigate the transition from a contractile to a calcifying phenotype in VSMCs, with an emphasis on understanding the role of SIRT1. For this purpose, a single batch of human aortic SMCs, used at a specified passage number to maintain consistency, was subjected to calcium and phosphate overload for up to 72 h. Our findings, validated through RT q-PCR, Western blot, immunofluorescence, and DNA methylation analyses, reveal a complex interplay between acetyltransferases and deacetylases during this phenotypic transition. We highlight HAT1A's critical role in histone acetylation regulation and the involvement of HDACs, as evidenced by subcellular localization studies. Moreover, we demonstrate the modulation of SIRT1 expression, a class III deacetylase, during VSMC calcification, underscoring the influence of DNA methylation in this process. Importantly, the study addresses previously unexplored aspects of the dynamic protein expression patterns observed, providing insight into the counterintuitive expressions of key proteins such as Runx2 and osterix. This research underscores the significant impact of epigenetic mechanisms, particularly the modulation of SIRT1, in the transition from a contractile to a calcifying phenotype in VSMCs, offering potential avenues for further exploration in the context of vascular calcification.