The mediation and interaction roles of hypertension on the pathway between occupational noise and cardiac arrhythmia: insights from a large cross-sectional occupational population of 229,686 workers.

Metal exposure in heart disease.

BackgroundAlzheimer's disease (AD) involves interactions among genetic, environmental, and lifestyle factors, yet the contribution of environmental exposures to cognitive decline and biomarker changes remains unclear. Detoxification genes such as EPHX1 may influence susceptibility to environmental neurotoxicants.ObjectiveTo evaluate associations between environmental risk, cognitive outcomes, and AD biomarkers, and to examine potential contributions of detoxification genes.MethodsWe analyzed 5101 participants from the Alzheimer's Disease Neuroimaging Initiative (ADNI) across four study phases. Environmental exposure was summarized using a composite Environmental Risk Score (ERS) derived from Rural-Urban Continuum Codes, Rural-Urban Commuting Area codes, Risk-Screening Environmental Indicators, and occupational exposure. Cognitive outcomes included Mini-Mental State Examination, Clinical Dementia Rating, Montreal Cognitive Assessment, Neuropsychological Test Battery, Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog), and Executive Dysfunction Cognitive Assessment. Biomarkers included PET amyloid/tau, MRI hippocampal volume, and cerebrospinal fluid amyloid-β, tau, and neurofilament light chain. Multivariable regression models adjusted for sociodemographic factors and APOE ε4 carrier status.ResultsERS was significantly associated with CDR (β = -1.13E-07; 95% CI -1.98E-07, -2.75E-08; p = 0.00956) but not with other cognitive measures. EPHX1 showed a significant main effect on ADAS-Cog (β = 0.479; 95% CI 0.0305, 0.927; p = 0.0356). ERS × gene interaction terms were not significant. ERS was not associated with amyloid PET SUVR.ConclusionsEnvironmental risk showed limited associations with AD-related outcomes, while EPHX1 demonstrated a significant main effect on cognitive performance. Longitudinal studies are needed to clarify mechanisms linking environmental exposure and AD.

Reliable assessment of disease state probabilities for an individual following a specific exposure event, such as an occupational exposure, is critical for managing isolation and quarantine and reducing onward transmission to susceptible individuals. Such assessments are particularly important for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), where infection, testing, and infectiousness vary substantially across individuals and time since exposure. We present a method, accompanying software programs, and a publicly available website for calculating the probability that an individual is in each disease state immediately following an exposure event that may or may not have resulted in transmission of SARS-CoV-2. The framework integrates timing of exposure, test type and timing, and symptom status to estimate probabilities of latent infection, infectiousness, recovery, or no infection. We illustrate the utility of this approach by calculating: (i) the time at which an exposed individual's risk of being infectious falls below an acceptable threshold; (ii) the benefit of a second test for asymptomatic individuals with an initial negative test; (iii) the value of polymerase chain reaction (PCR) and antigen testing for case counting; and (iv) the time at which the risk that an infected individual remains infectious becomes comparable to background population risk. The results demonstrate that test interpretation should not be done naively: a negative test may reflect absence of transmission, a false-negative result, rapid resolution of infection, or an unusually prolonged latent period, each with distinct implications for risk management. Accurate differentiation among possible disease states following exposure is essential for informed public health decision-making. Our software provides a rigorous, transparent means to assess and clearly communicate state probabilities, enabling more nuanced interpretation of test results and better-supported decisions regarding isolation, quarantine, and testing strategies.

Coal operations and cancer in the US: A systematic review.

An overview of mercury contamination: Environmental dynamics and mitigation strategies.

Noise pollution in intensive care units (ICUs) is a pervasive occupational exposure that may affect nurses' well-being, patient safety and quality of care. To examine ICU nurses' perceptions and experiences of noise pollution and explore associations between perceived noise exposure, well-being, work performance and patient safety. A convergent mixed-methods design was used. Quantitative and qualitative data were collected using structured questionnaires and semi-structured interviews. Qualitative data were analysed using inductive thematic analysis in accordance with GRAMMS guidelines. A total of 60 nurses participated in the quantitative phase, and 13 nurses participated in the qualitative interviews. A substantial proportion of nurses reported that noise often or always increased stress (56.6%, n = 34), restlessness or discomfort (48.3%, n = 29), sleep disturbance (53.3%, n = 32), fatigue or frustration (45.0%, n = 27) and headaches (41.7%, n = 25); 33.3% (n = 20) reported frequent or constant effects on decision-making. Integrated analysis of quantitative and qualitative data identified three overarching themes: (1) the dual role of alarms in patient safety and workflow; (2) alarm burden as a systemic and technical challenge; and (3) strategies for managing alarm-related stress. ICU noise is functionally essential for monitoring and safety yet burdensome for nurses and patients. Individualising alarms for responding staff and using wrist-vibrating bands may reduce noise burden and improve staff well-being and perceived patient outcomes. ICU noise is a modifiable risk to provider health and clinical performance. Practice should move from unit-wide audible alerts to targeted, non-auditory systems (e.g., wrist-vibrating bands) to reduce cognitive load. Clinical leaders must implement 'quiet zones' for high-stakes tasks like medication titration and provide protected rest periods in low-decibel environments to mitigate documented nurse fatigue and sleep disturbance.

Seroepidemiology, clinical correlates, and GRA6-based genotyping of Toxoplasma gondii among immunocompromised patients in northeastern Iran.

Ethylene oxide (EtO) is a widely used industrial compound with known carcinogenic potential in humans. Due to its high reactivity and short biological half-life, occupational exposure assessments (> 1ppm) rely on the detection of stable biomarkers, such as N-(2-hydroxyethyl)-L-valine (HE-V), formed as hemoglobin adducts in blood. Existing analytical methods for HE-V detection often require large volumes of blood and purified hemoglobin due to limited sensitivity, restricting their application in characterizing the dose-response relationship between EtO exposure and HE-V accumulation-particularly at low environmental exposure levels relevant to assessing potential general population health risks. In this study, we aimed to characterize the molecular dosimetry of HE-V formation in B6C3F1 mice exposed by whole body inhalation to a broad range of concentrations of EtO: 0, 0.05, 0.1, 0.5, 1, 50, 100, and 200ppm, 7days/week for 4weeks. To achieve this, we developed a sensitive LC-MS-based workflow for HE-V quantification, incorporating hemoglobin purification, HE-V release plus enrichment, and targeted mass spectrometric detection from as little as 10μL of blood and 50μg of extracted hemoglobin. A clear, dose-dependent increase in HE-V levels was observed following EtO exposure, with statistically significant elevations detected even at 0.05ppm compared to endogenous background levels. At lower concentrations (0.5 to 1ppm), HE-V levels increased linearly with dose, while higher concentrations (50 to 200ppm) exhibited an upward-bending (increasing slope) dose response. No sex-specific differences were observed. Taken together, these findings indicate EtO exhibits linear systemic toxicokinetics at lower exposures that transition to nonlinear toxicokinetics in the range of higher exposures (likely due to saturation of glutathione-mediated detoxification), thus providing new quantitative insights to support improved risk assessments and toxicological evaluations of EtO exposure.

Nearly 40% of US farmers are over 65 years old. Some emerging evidence links agricultural occupational exposure to increased dementia risk. However, little is known about dementia and injury outcomes in agricultural settings. We employed data from the American College of Surgeons Trauma Quality Programs Participant Use File (ACS-TQP-PUF) (2017-2021), identifying individuals aged ≥ 60 with (1) agricultural injuries and dementia (Group 1; N = 318), (2) agricultural injuries without dementia (Group 2; N = 21,361), and (3) dementia without agricultural injuries (Group 3; N = 231,231). Injury mechanisms were compared across groups using chi-square tests. Injury severity was assessed via Injury Severity Score and the use of intensive care unit (ICU) or surgical care by hospitalized patients. Generalized ordered logit and logistic regression models estimated associations between group membership and injury severity, adjusting for demographics and comorbidities. Falls caused 94% of traumatic injuries in individuals with dementia alone but accounted for only 35% of injuries in those with both agricultural injuries and dementia. Group 1 and Group 2 experienced a broader range of injury mechanisms including motor vehicle traffic, transport, and environmental incidents. Compared to Group 3, Group 1 had higher probability of experiencing major injuries and receiving ICU/surgical care. Injury severity was largely similar between Groups 1 and 2. This cross-sectional study provides suggestive evidence that older adults with dementia and agricultural injuries experience more severe outcomes than those in nonagricultural settings. Future research should explore this group in greater depth as well as the implications for dementia caregivers in agricultural communities.

Unit-level organizational resources and occupational exposure to bloodborne pathogens: A multi-hospital study.

Effectiveness of stepwise hepatitis B revaccination according to vaccination history in healthcare students: a retrospective observational study.

Modelling health risks of urine-derived fertiliser application in urban green areas using quantitative microbial risk assessment.

Despite significant resources invested in malaria control interventions for several years, the disease remains a persistent health challenge impacting millions of people especially children and pregnant women in the lower income regions of the world. Progress towards eliminating malaria has stagnated, in part due to the limited consideration of the social determinants of the disease such as poverty. We conducted a qualitative study exploring stakeholder perspectives on social determinants of malaria including lived experiences with the disease in Wakiso, one of the districts with high malaria cases in Uganda. This was a cross-sectional study using fourteen key informant interviews at community, health facility, district and national levels, 10 focus group discussions among community members and community health workers, and 11 in-depth interviews with household heads. Data collection was conducted in English and Luganda (local language), transcribed, coded using Atlas.ti. (version 6) and Nvivo (version 14) and analysed using a thematic approach. This paper focuses on the perspectives on poverty as a social determinant of malaria. The participants linked poverty to malaria through five themes: poor housing conditions; limited access to malaria control services; limited water and sanitation-related exposures; occupational and psychological exposures; and heavy economic burden (consequences) of malaria. The themes are presented under various sub-themes which separately highlight in detail the different pathways of the malaria-poverty relationship. These include: substandard housing structures enabling mosquito exposure; building close to mosquito breeding grounds; homelessness and street life; inadequate malaria prevention and treatment services; limited access to water supply; poor sanitation and waste management practices; occupational exposures; social and psychological constraints; high treatment costs; undernutrition causing low immunity; and loss of income. These perspectives emphasize a cyclic poverty-malaria relationship through the high treatment costs and loss of income due to illness or livelihood disruption. Malaria is rooted in economic inequalities suggesting that improvement in malaria control interventions through policies and frameworks that address poverty as a consequence, and driver of the disease should be prioritised. The study underscores the need for integrated malaria control strategies that address vulnerabilities related to poverty in all its dimensions-economic, environmental and psychosocial.

We aimed to examine which workers are more likely to work outdoors, and therefore at risk of occupational exposure to climate-related health hazards. We developed a matrix that assigns outdoor/indoor exposure levels to occupations. We used 2018-2022 American Community Survey data to estimate the number and percentage of Massachusetts workers who worked outdoors by select characteristics. An estimated 17.5% of workers (nearly 641,000) worked outdoors. The percentage was highest in the Construction industry (80.2%), higher among males than females (28.1% vs. 6.4%) and varied by race/ethnicity, with the highest percentage among American Indian/Alaska Native, non-Hispanic/non-Latino workers (29.2%). This matrix could be used for climate-related health research and practice. Understanding the numbers and characteristics of workers more likely to work outdoors can inform planning and equitable implementation of prevention efforts.

Describe health outcomes among workers affected by the Tijuana River Valley (TRV) sewage crisis. In October-November 2024, a cross-sectional online survey was administered to individuals who worked in areas affected by the TRV sewage crisis as part of an Assessment of Chemical Exposures. Among 443 workers, 110 (25%) reported direct contact with contaminated Tijuana River or beach water. 55% of workers reported exposure to severe odor. Nearly two-thirds experienced physical symptoms attributed to the crisis, and one-third missed work due to symptoms. Direct water contact was linked to higher prevalence of physical and mental health symptoms and absenteeism. Those reporting work-related direct water contact were largely outdoor workers. TRV workers have experienced health impacts due to the ongoing sewage crisis. Findings may help inform public health response and resource needs.

Occupational exposure to PAHs, PCBs, and VOCs representatives in port-industrial settings: A dual-track approach using silicone wristbands and diffusive passive samplers.

Crystalline silica particles exposure modulated miRNA expression profiles in human macrophage-like THP-1 cells.

Methotrexate is a cornerstone disease-modifying antirheumatic drug for rheumatoid arthritis (RA), effectively controlling disease activity and reducing cardiovascular mortality. Despite its efficacy, parenteral methotrexate, which offers higher bioavailability, faster response, and fewer gastrointestinal side effects compared to oral administration, remains underutilized in clinical practice. Understanding the factors influencing its utilization is critical to improving RA management. To explore the barriers and enablers towards using parenteral methotrexate in rheumatoid arthritis patients from the perspective of Australian healthcare professionals (HCPs). A qualitative study was conducted using semi-structured interviews between May and August 2022. Participants were recruited via advertising and snowballing. The Theoretical Domains Framework was used to guide the development of the interview guide and data analysis (directed content analysis), supplemented by conventional content analysis (inductive content analysis) to identify emergent themes. Nineteen HCPs (57.9% male, 42.1% female, 63.2% with more than 10years of experience) were interviewed, including 14 rheumatologists, 3 pharmacists and 2 nurses. Findings related to domains "environmental context and resources", "social influences" and "skills" were frequently identified, whereas the domains "intention", "reinforcement" and "emotion" were least reported. The most prominent enablers related to HCPs' knowledge and skills. Necessary skills were grouped into communication, logistical planning, and patient selection. Other enablers included the accessibility of injection support services, availability of prefilled syringes and online resources for patients ("environmental context and resources") and social influences. The most common identified barriers related to the logistics of implementing parenteral methotrexate. Other barriers included issues with the Occupational Health and Safety guidelines, time constraints ("environmental context and resources"), concerns about patients withdrawing methotrexate from the vial ("emotion") and patients' low acceptability or affordability of the injectable medication ("social influences"). Our findings suggest that training and guidance on selecting appropriate patients, utilization of systems to support education of patients and to minimize occupational exposure, and availability of patient-friendly devices would support greater implementation of parenteral methotrexate in practice.

Studies have shown that industrial hygiene exposure assessments are subject to inaccurate judgment, may not be different from random chance, and may be biased low, resulting in underestimation of exposures. However, these limitations can be mitigated by the use of modeling and statistical tools. This study shows that before sample collection or when few samples have been taken, modeling tools such as the Structured Deterministic Model (SDM) 2.0 and Expostats can augment a practitioner's risk communication to an employer. SDM and Expostats were used to analyze compliance datasets as follows: (1) comparing the performance of the SDM tool to predict airborne lead and silica overexposures as confirmed by sample data; (2) comparing statistical outputs for similar exposure groups (SEGs) between initial samples that did not contain overexposures and respective follow-up samples that did contain overexposures for airborne lead and iron oxide, and noise; and (3) statistical analysis of airborne lead and silica, and noise datasets that did not contain overexposures to determine the prevalence of unacceptable overexposure risk. In evaluation one, SDM correctly predicted overexposures in all SEGs where samples were above the exposure limit. Evaluation two results showed that inferential statistics from the initial results indicated an unacceptable risk of overexposure, and this was confirmed by follow-up samples that contained overexposures. In evaluation three, results suggested an unacceptable risk of overexposure in half of the datasets analyzed. The results of this study demonstrate that compliance-focused practitioners could also voluntarily leverage modeling and statistical outputs to communicate overexposure risk and encourage controls to reduce the risk of future occupational illnesses and compliance activity.