Occupational Risk Research Articles

ABSTRACT The effects of pesticide exposure on human health are a significant concern in the global agricultural sector. However, developed risk matrix of occupational exposure and pesticide screening have rarely been studied. This study aimed to investigate the sensitivity, specificity and accuracy of a developed occupational risk assessment matrix. Data were collected from both an interview questionnaire and serum cholinesterase testing by using cholinesterase reactive paper. The participants were 421 pesticide sprayers in northeastern Thailand. The risk matrix (4x4) was developed by multiplying the likelihood of pesticide exposure by the severity level of adverse symptoms. The risk score was classified into acceptable and unacceptable levels of risk. The sensitivity, specificity and accuracy of the risk matrix were assessed by using a standard 2 × 2table. Most of the sprayers were male (69%) and their ages ranged between 19 and 76 years old (mean = 53; SD = 10). Abnormal cholinesterase test results indicated an unsafe level of risk for 48% of sprayers (95% CI: 44% −53%). The risk matrix showed that the largest proportion of sprayers (42.52%, 95%CI: 38% −47%) were classified as moderate risk, followed by those at a low-to-very high risk (57%, 95% CI: 53% −62%). The risk matrix findings showed a sensitivity of 73.17% (95% CI: 69% −77%) and a specificity of 64% (95% CI: 59% −68%) for risk screening. The positive predictive value was 99% (95% CI: 98% −100%), the negative predictive value was 6% (95% CI: 4% −8%) and the accuracy was 73% (95% CI: 69% −77%). Conclusion: These pesticide sprayers represent a high-risk group, highlighting the need for effective guidance in conducting risk assessment programs for pesticide exposure. Therefore, this developed risk matrix is also valuable for health screening among pesticide applicators.

Communicators in public safety, such as 911 telecommunicators, emergency medical dispatchers, and police and fire dispatchers, frequently deal with distressing calls, traumatic narratives, and high-stakes decisions. Despite not being physically present at crisis scenes, these experts endure psychological stress on par with first responders. This scoping review examines the prevalence and determinants of depression and suicidal ideation among public safety communicators and their co-occurrence, summarizes the occupational and personal risk factors contributing to these outcomes, and evaluates proposed mitigation strategies. The research indicates that depression is reported at elevated rates in this workforce, ranging from 8.4% to 73%, depending on the population and the sensitivity of the instrument, based on 11 quantitative studies published between 1995 and 2025. Although less studied, suicidal ideation appears to be significantly higher in this group compared to the general population. Contributing factors include indirect trauma exposure, shift work, emotional suppression, organizational neglect, and a history of trauma. The frequent co-occurrence of depression and suicidal ideation supports the Interpersonal Theory of Suicide as a relevant explanatory framework. Despite accumulating evidence, research is methodologically limited due to cross-sectional designs, inconsistent screening tools, and sample homogeneity. Existing interventions, such as peer support, debriefing, and trauma-informed training, are inconsistently applied and under-evaluated. The findings highlight a pressingneed for longitudinal research, targeted interventions, and workplace reforms that take into account the unique psychological burdens associated with communicator roles. Addressing depression and suicide risk among these professionals is critical to ensuring both workforce well-being and the continued effectiveness of public safety systems.

ABSTRACT Given the comparatively high salaries of professional soccer players during their active athletic careers, investments in education during their career seem to be less prevalent than among other athletes. This exploratory study analyses to what extent professional soccer players participate in vocational training, and what factors influence their cost–benefit assessment of participating in such activities during their athletic career. We conducted semi-structured interviews with 25 German professional soccer players (9 still active, 16 retired). Of these, 18 had competed in the top two leagues, while 7 had played in the 3rd and 4th leagues. The data were interpreted using qualitative content analysis. The results reveal a range of investments by players in education during their careers: from pursuing high-quality education to not investing in further education at all; from low to high opportunity costs of vocational training; from high willingness to take risks to low willingness to take risks. Our findings shed light on the decisions not only specifically among professional soccer players when choosing an education path, but also more broadly among individuals that face high occupational career risks and earn high salaries, to develop approaches for sustainable education planning (e.g. career goal development or guidance on educational pathways).

Parvovirus B19 (B19V) infection during pregnancy represents a significant clinical concern due to its potential impact on the fetus and pregnancy outcome. We analyzed temporal, spatial, and seasonal B19V seroepidemiology in childbearing-aged and pregnant women in Croatia over 10 years (2015–2024). A total of 976 women who underwent routine TORCH screening were included. The overall B19V IgG and IgM seroprevalence was 63.7 and 8.7%, respectively, with significant temporal differences (IgG 36.8–72.3%, IgM 1.3–18.4). Significant differences in the IgG seropositivity were observed among age groups, from 42.3% in the 16–20 group to 72.7% in the 36–40 group. Spatial analysis showed no significant differences in the IgG or IgM seroprevalence between regions (City of Zagreb/Northern Croatia, Pannonian and Adriatic Croatia) and settlements (urban, suburban/rural). Additionally, seropositivity did not differ significantly in relation to obstetric history. In a logistic regression model, age was a significant predictor for IgG seroprevalence, with each additional year of age associated with increased odds of IgG seropositivity. Year, region, and settlement type were not significant predictors, indicating no evidence of temporal trends, regional differences, or differences between urban and rural settings after adjusting for age. Year of sampling, age, and region were significant predictors for IgM positivity. Acute infections were most common from March to July (61.2%) and December (9.4%), with regional variations in seasonal prevalence patterns. Given that screening in pregnancy is not routinely recommended, the high susceptibility to B19V observed in Croatia supports targeted serologic testing in women with clinical symptoms, known exposure, or occupational risk.

Tuberculosis continues to represent a major occupational risk in healthcare environments, particularly for healthcare workers who have persistent contact with patients who may be infectious. Despite the high occupational burden of tuberculosis among healthcare workers, there remains a lack of focused reviews that comprehensively evaluate preventive interventions across all levels of prevention within healthcare settings. In this literature review, effective preventive interventions relevant to tuberculosis transmission have been examined. Primary preventive interventions seek to diminish exposure through protective interventions such as respirators, improvements in ventilation systems, and implementation of educational programs regarding infection control protocols. Secondary preventive interventions target early diagnosis and routine screening with efforts to detect cases and latent infections early, before they progress to active disease. Enhancements in diagnostic technology have improved both the accuracy and speed of detection, further aiding the efforts of controlling nosocomial transmission. Tertiary preventive interventions target enhancing compliance with treatment protocols, managing complications of active infection, and controlling resistant strains through individualized follow-up and interventions. Barriers like stigma and lack of resources, however, often impede such interventions’ effectiveness in many cases. This narrative literature review highlights the imperative for strengthened workplace policies, an expansion of educational programs, and continued research in new and emerging interventions like new vaccine and diagnostics technology development. All these factors aim to optimize intervention effectiveness for tuberculosis and protect the health and welfare of workers in the medical field.

This study investigates the occupational hazards and health risks associated with aquaculture in Rio Grande do Sul, Brazil. Data were collected utilizing a questionnaire distributed both in-person and online to registered participants. The study, conducted in 2023, involved 114 respondents who provided insights into work-related injuries and illnesses within the aquaculture industry. Findings indicate that most injuries occurred among male workers. A significant number of injuries were reported from small-scale farms, typically family-operated. The study identified various types of injuries, including falls, fish bites, cuts, and electric shocks. Additionally, participants reported infections, sun exposure-related conditions, and ergonomic issues. The study emphasizes the necessity for enhanced safety measures and improved health monitoring in the southern Brazilian aquaculture industry, aiming to enhance worker safety and reduce the incidence of work-related injuries and illnesses.

Knee pain is common in the general population, increasingly so with age. It causes substantial disability which can lead to premature exit from the workforce. Current epidemiological data on knee pain prevalence in working-age populations are limited, particularly concerning the interplay of occupational, psychosocial, and cultural factors. To address this, in a large group of workers, we examined the prevalence of knee pain longitudinally, its relationship with pain at other sites and personal and occupational risk factors for pain at follow-up. Data came from the CUPID study, a cohort study including people aged 20-59years at work from 18 countries in broadly three types of occupations: office work, nurses and manual workers. Baseline data were collected on knee pain, pain at other anatomical sites, occupational characteristics and psychosocial aspects of work. Follow-up information about knee pain was obtained approximately a year later. Descriptive statistics were used to describe knee pain prevalence and characteristics as well as persistence. Poisson regression was used to explore baseline factors in relation to knee pain, and disabling knee pain, at follow-up. In total 9,161 workers provided baseline and follow-up data, amongst whom 28% reported knee pain in the past year and 21% knee pain in the past month at baseline. 79% of workers with knee pain reported disability. The prevalence increased with age and was higher among women. Only 8% of workers with knee pain had single-site pain. There was wide variation in the prevalence rates reported amongst workers even doing broadly similar work. Psychosocial and occupational work demands predicted knee pain at follow-up, as did poorer mental health and somatisation but the highest effect size was found amongst people reporting a high number of painful sites at baseline (PRR: 2.06,95%CI: 1.78-2.39). Knee pain is prevalent in the workforce, even at younger ages. It is commonly persistent and disabling. Given its link with work disability, the emphasis needs to be on prevention and both mechanical and psychosocial exposures at work are implicated. However, like low back pain, other factors appear to be important, particularly pain at other sites. Clinical trial number: not applicable.

Relevance. Nitrous oxide-oxygen sedation has been widely used in Russia since the early 2000s. It is widely regarded as an effective method for managing the behavior of uncooperative patients. However, despite generally positive assessments of its safety and efficacy, there remains a lack of research into the potential negative consequences and risks associated with its use, both for patients and healthcare personnel. Objective. To provide structured information that will help dentists working with nitrous oxide sedation minimize its potential toxicity for all personnel involved. Materials and methods. Publications from both international and Russian databases over the past 30 years were reviewed for key terms related to the effects of nitrous oxide on dental personnel. The initial selection process involved screening titles and abstracts, followed by a full-text review of the remaining articles. From the 145 sources identified, 33 of the most relevant studies were selected. Results. Nitrous oxide has been used in dentistry for over 150 years, but its significant toxicity raises concerns about its safety. The primary harmful mechanism is the irreversible oxidation of vitamin B 12 , which disrupts essential processes such as DNA synthesis, myelin formation, homocysteine metabolism, and folic acid metabolism. High-risk groups include dental personnel (due to chronic exposure), individuals with B 12 /folate deficiency, those with congenital MTHFR gene mutations, people with chronic diseases (such as autoimmune disorders and diabetes), pregnant women, and others. Acute effects for dental personnel include dizziness, nausea, and impaired cognitive and motor functions. Chronic effects can be neurological (paresthesia, ataxia, demyelination of peripheral nerves), hematological (anemia, leukopenia), cardiovascular (thromboembolism, hypertension), reproductive (reduced fertility, pregnancy complications), and immune-related. Despite control measures such as ventilation, nitrous oxide monitoring, and respirators, the risk remains due to system leaks and insufficient awareness. Regular check-ups for personnel, twice a year, are critical are critical, including tests for homocysteine and methylmalonic acid, complete blood count, and neurological evaluations when symptoms arise. Dentists must be informed about the occupational risks of nitrous oxide. Conclusion. Proper use of nitrous oxide sedation minimizes these risks. Dentists' proficiency in behavior management techniques, local anesthesia, and personal responsibility for following safety protocols are crucial for ensuring the safety of dental personnel.

Firefighters responding to wildland and wildland-urban interface (WUI) fires increasingly navigate a hazardous landscape of environmental pollutants and occupational risks that may influence their health risk perceptions, yet their firsthand experiences and work-related safety concerns are insufficiently understood. Between December 2024 and February 2025, we conducted seven focus groups and four key informant interviews with 51 Florida Forest Service personnel, whose service averaged 11.5 years. Qualitative analysis of interview data employed a coding reliability thematic approach informed by a postpositivist paradigm. Four primary themes emerged: (1) Safety risks associated with heavy equipment operations and inadequate immersive training; (2) environmental hazards from complex smoke mixtures, invasive species, anthropogenic contaminants, and expanding WUI conditions; (3) systemic deficiencies in personal protective equipment availability, decontamination infrastructure, and cultural norms that valorize soiled gear; and (4) acute and chronic health burdens, including respiratory irritation, cardiovascular strain, mental health stressors, and perceived elevated cancer risk. Preinterview survey data documented that 72.5% of respondents self-reported wearingno respiratory protection during fireground activities. Health conditions reported included hypertension (24.0%), arthritis (11.8%), and asthma (9.8%). Approximately 8.0% reported having depressive disorder, and 7.8% reported having kidney disease. Among all participants, 46.9% were obese. Findings highlight critical gaps in occupational health practices, resource allocation, and cultural attitudes within the wildland firefighting workforce. Integration of technical interventions, such as enhanced respiratory protection, realistic equipment training, and station-based laundering facilities with culturally informed strategies to shift perceptions of risk and of gear cleanliness should be validated in population-based studies.

The agricultural sector remains one of the most hazardous working environments, with viticulture posing particularly high risks due to repetitive manual tasks, pesticide exposure, and machinery operation. This study explores the potential of vision-based Artificial Intelligence (AI) systems to enhance occupational health and safety by evaluating their coherence with human expert assessments. A dataset of 203 annotated images, collected from 50 vineyards in Northern Italy, was analyzed across three domains: manual work activities, workplace environments, and agricultural machinery. Each image was independently assessed by safety professionals and an AI pipeline integrating convolutional neural networks, regulatory contextualization, and risk matrix evaluation. Agreement between AI and experts was quantified using weighted Cohen’s Kappa, achieving values of 0.94–0.96, with overall classification error rates below 14%. Errors were primarily false negatives in machinery images, reflecting visual complexity and operational variability. Statistical analyses, including McNemar and Wilcoxon signed-rank tests, revealed no significant differences between AI and expert classifications. These findings suggest that AI can provide reliable, standardized risk detection while highlighting limitations such as reduced sensitivity in complex scenarios and the need for explainable models. Overall, integrating AI with complementary sensors and regulatory frameworks offers a credible path toward proactive, transparent, and preventive safety management in viticulture and potentially other high-risk agricultural sectors. Furthermore, vision-based AI systems inherently act as optical sensors capable of capturing and interpreting occupational risk conditions. Their integration with complementary sensor technologies—such as inertial, environmental, and proximity sensors—can enhance the precision and contextual awareness of automated safety assessments in viticulture.

PurposeGiven the paucity of data regarding workplace risk of COVID-19, particularly from countries with limited lockdowns, we aimed to quantify the occupational risks of COVID-19-related hospital admission among workers in Sweden.MethodsWe identified 607,179 employed individuals, 20−69 years of age, in Skåne, Sweden. From December 31st, 2019—December 31st 2021, 2,633 incident COVID-19-related admissions were identified. Using a job exposure matrix for risk of becoming infected with the SARS-CoV-2 virus in an occupational setting we delineated occupations with low work-related risk. Based on these reference occupations, incidence rate ratios (IRR) and 95% confidence intervals (CI) were computed by Poisson regression for four-digit occupations defined by the International Standard Classification of Occupations job codes (ISCO-08).ResultsAfter adjusting for various sociodemographic characteristics, risk compared to reference occupations was elevated among healthcare occupations as a group (IRR 1.31; 95% CI: 1.13–1.51), with nurses, healthcare assistants, and nursing aids having the highest IRRs (ranging from 1.28–1.54). In the educational sector, no apparent elevated overall risk was observed (IRR 1.03; 95% CI: 0.86–1.23). For the transportation sector, an overall excess risk was observed (IRR 1.34; 95% CI: 1.10–1.65), with bus and tram drivers having the highest risks. IRRs < 1 were observed among electricians, some builders, and software developers.ConclusionExcess risk of COVID-19-related hospital admission was observed in many patient-facing occupations across the healthcare sector and in multiple occupations within the transportation sector. However, despite limited lockdowns and legislation, no apparent increased risks were observed in the educational or retail sales sectors.

Abstract The Arabian Peninsula is experiencing increasing extreme heat, driven by rising global temperatures, with profound implications for outdoor labor productivity. This study investigates the spatiotemporal evolution of Wet Bulb Globe Temperature (WBGT) calculated from the ERA5 data at a 0.25° × 0.25° resolution from 1974 to 2023. The outdoor labor productivity under light, moderate, and heavy workloads is assessed following ISO/DIS 7243 guidelines, while population exposure is evaluated using LandScan data. Results show a pronounced increase in WBGT over the past five decades, with annual levels rising by up to 1.5 °C and summer levels by 1.0 to 1.5 °C. Coastal areas experience the highest WBGTs, surpassing 28 °C in the summer. In terms of productivity, Heavy workloads exhibit the most severe productivity losses, declining from 94% in 1974 to under 88% in 2023, with an annual decrease of 0.136%. Moderate and light workloads show smaller declines of 0.085% and 0.041%, respectively. Coastal and urban locales emerge as hotspots, where midday productivity losses can reach 30% for heavy work. Bivariate analyses indicate an inverse relationship between productivity and temperature/humidity. On the other hand, higher wind speeds mitigate some heat stress effects. These findings underscore the need for urgent policy action, including the implementation of adaptive work-rest schedules, investment in cooling infrastructure, and the development of protective technologies to safeguard labor productivity in warm climates. Graphical Abstract This graphical abstract provides a visually compelling summary of research investigating the intensification of heat stress and its implications for labor productivity across the Arabian Peninsula. It encapsulates the core methodology and findings of the study, enabling readers to quickly grasp the significance of the work without needing to delve into the full manuscript. Central to the visual is the spatiotemporal analysis of Wet Bulb Globe Temperature (WBGT) derived from ERA5 reanalysis data at a 0.25° × 0.25° resolution spanning 1973–2023. A series of maps illustrate the annual and summer WBGT trends, with coastal zones consistently exceeding 28 °C during summer months. The integration of LandScan population data allows for the identification of high-exposure regions. Productivity loss across different light, moderate, and heavy workload intensities is assessed using ISO/DIS 7243 guidelines. Temporal trends reveal a marked decline in productivity for heavy workloads, dropping from 94% in 1974 to below 88% by 2023, with smaller declines for lighter tasks. Additional charts show the diurnal variation in productivity and highlight midday periods as critical stress windows. A bivariate map visualizes the combined effect of temperature and humidity on productivity, indicating wind speed as a mitigating factor. This visual narrative highlights the increasing occupational heat risk, particularly in urban and coastal areas. It underscores the necessity for adaptive measures such as rest-work cycles and climate-resilient infrastructure.

ABSTRACT Nursery operators are potentially exposed to environmental contaminants, particularly toxic trace elements from prolonged agrochemical use. This study evaluated and compared trace element concentrations in hair and nail samples of nursery operators from conventional and organic nurseries in Peninsular Malaysia. A comparative cross-sectional study was conducted with 48 participants (20 from conventional and 28 from organic nurseries). Hair and nail samples were analyzed using Inductively Coupled Plasma Mass Spectrometry (ICP-MS) to quantify 14 trace elements. Results showed that conventional nursery operators had significantly higher concentrations of toxic elements, including arsenic (As), cadmium (Cd), lead (Pb), and ammonia (NH₃), than their organic counterparts (p < 0.05). Correlation analysis between hair and nail matrices showed strong associations for magnesium, chromium, cobalt, and zinc, suggesting shared sources and possible co-exposure. Notably, synergistic accumulation patterns were observed among lead, arsenic, manganese, and mercury, while antagonistic interactions were evident between cadmium and essential elements such as zinc and chromium. These findings underscore heightened occupational health risks in conventional nursery environments due to cumulative trace element exposure, highlight the utility of hair and nail biomarkers for long-term exposure monitoring, and advocate for stricter agrochemical regulations and enhanced occupational safety practices.

Introduction A high burden of tuberculosis (TB) complicated by occupational risk factors implies a need for the workplace to develop strategies to reduce workplace incidence of TB. Methods We conducted a cross-sectional study to establish the knowledge, attitudes, and practices (KAP) related to TB among senior management officials of manufacturing and construction companies associated with exposure to silica dust. The study was conducted in Lusaka and Southern provinces of Zambia between February and October 2022 using a 28-question multiple-choice self-administered electronic questionnaire. Descriptive statistics were used to determine KAP levels. The total score in KAP was calculated based on correct responses out of a maximum of 17, 7, and 14 points, respectively and categorized into “poor” or “good” using the mean/median. Logistic regression was done to explore the association between characteristics and KAP. Results Of 118 participants, 48.3% were aged between 31–40 years, 86.4% were male), and 63.6% represented construction companies. The median/mean KAP scores were 8(IQR 6–10), 3.3 (SD 1.66) and 6.00 (IQR 4–8) respectively. Of the participants, only 47.5% (56/118) had good knowledge, 49.2% (58/118) had good attitudes, and 47.5% (56/118) had good practice scores. Individuals aged over 50 years old, female, and officials from construction companies had higher odds of good knowledge (aOR = 7.8, p = 0.027; aOR = 4.70, p = 0.016 and aOR = 3.45, p = 0.008 respectively) and good attitude (aOR = 14.64, p = 0.021; aOR = 6.51, p = 0.006 and aOR = 3.90, p = 0.006 respectively) Participants working in construction companies had higher odds of good practice (aOR = 2.26, p = 0.048). Discussion Senior management officials had gaps in knowledge despite having favorable attitudes and practices. Companies must be educated on TB alongside efforts to improve attitudes and practices towards TB in the workplace.

Construction sites present intrinsically hazardous conditions characterized by dynamic and complex operational environments which persistently contribute to elevated rates of occupational injuries. While conventional safety management emphasizes controls during the execution phase, addressing safety considerations during the earliest phases of a project is more effective. In this work, a Nonlinear Multifactor Safety Index (NMF-SI) is developed to quantify activity-level occupational risk for use in project planning. The index synthesizes multiple risk factors, including accident probability, task severity, exposure duration, workforce size, and contextual variables, such as weekday effects, and site conditions, like waste accumulation. Additionally, it incorporates a structured questionnaire to capture the implementation of safety measures on site. Its nonlinear formulation reflects interactions among factors, penalizes temporal clustering of high-risk tasks, and prioritizes temporal distribution and proactive planning. To produce risk-aware schedules, a hybrid optimization framework that couples a tree-based constructive heuristic with the marine predators algorithm is introduced, maximizing NMF-SI subject to project-duration, precedence, and resource constraints. In simulation, the optimized schedules achieve higher NMF-SI values and a smoother risk profile over time than baseline plans. These results translate into a quantitative, data-driven contribution to safety by design, offering a practical decision-support tool for intelligent, risk-aware construction scheduling.

Healthcare workers face significant occupational risks, with high prevalence rates of workplace accidents reported globally. These accidents compromise worker well-being and patient care quality. Emergency and intensive care technicians are particularly vulnerable due to the nature of their work; necessitating targeted safety training to mitigate risks. This study aims to evaluate the efficacy of an educational intervention to increase knowledge and attitudes toward workplace accidents in a hospital setting among emergency care and resuscitation trainees immediately following the intervention and assesses the retention of these skills 1 month after the training. A pre-experimental study was conducted among second- and third-year emergency care and resuscitation trainees at the School of Health Sciences and Techniques of Sousse during the 2024 to 2025 academic year. The intervention included an educational session and interactive workshops on managing work-related accidents in the hospital setting. Knowledge and attitudes were assessed through pre-, post-, and 1-month retention tests using a pretested questionnaire. Statistical analysis was performed using SPSS, with significance set at p &lt; .05. Among the 67 participants, only 49.3% had received prior training on workplace accidents, and knowledge of risks and preventive measures was generally inadequate at baseline. Post-intervention scores for knowledge and attitudes showed significant improvement. The mean total score in the Retention test at 1 month was higher than pre-training scores but a slight decline from the post-test score. The study reveals gaps in trainees’ knowledge and attitudes on workplace accident prevention among trainees. The intervention effectively improved knowledge and attitudes immediately after training and 1 month later, demonstrating the value of structured educational programs in enhancing trainee competence in hospital safety practices.

Percutaneous absorption of climbazole: In vitro data from human skin.

Next generation risk assessment and new approach methodologies for safe and sustainable by design chemicals and materials: Perspectives and challenges for occupational health.

Occupational Exposure Risk and Safety of Novel Intraperitoneal Oxaliplatin Delivery via Heated CO2 and Dual-Flow Nozzle System

Evaluating the concordance, prevalence, and risk factors of latent tuberculosis infection among healthcare workers in Makkah: A comparative analysis of TST and IGRA.