Reduction In Exposure Research Articles

Virtual reality simulations to alleviate fear and anxiety in children awaiting MRI: a small-scale randomized controlled trial.

Up to 75% of paediatric patients experience anxiety and distress before undergoing new medical procedures. Virtual reality is an interesting avenue for alleviating the stress and fear of paediatric patients due to its ability to completely immerse the child in the virtual world and thus expose them to the sights and sounds of an MRI before undergoing the exam. We aimed to explore the impact of virtual reality exposure on reducing fear and anxiety in paediatric patients scheduled to undergo an MRI. We hypothesised that patient who had undergone VR exposure before the MRI would experience lower levels of fear and anxiety and subsequently have a higher MRI success rate. We conducted a prospective randomized control trial in a tertiary paediatric hospital over three weeks. Inclusion criteria comprised children aged 4 to 14 undergoing MRI without medical contraindications for VR use. Thirty patients (16 in VR, 14 in control) were included in the study. The VR room, created in-house by a researcher, that the VR group experienced, simulated MRI room with typical sounds for up to 5min before their actual MRI. Fear and anxiety were measured using the FACES scale before and after MRI for the control group as well as after VR exposure for the VR group. The VR group exhibited a significant reduction in anxiety post-VR exposure regarding the upcoming MRI (p = 0.009). There was no significant difference with regards to fear and anxiety between the VR and control groups before or after the MRI exam. There was no significant difference between the MRI exam success rates. VR exposure effectively reduces pre-MRI anxiety in paediatric patients who are about to undergo the exam, this is important as it alleviates the psychological burden on the child. This research is in line with previous findings, showing the validity of VR as a method of reducing pre-procedural paediatric anxiety and suggesting that complex VR experiences may not be necessary to have a significant impact. There is, however, a need for further investigation in this field using larger and MRI-naïve groups of patients.

Implementing the eat, sleep, console method into a tertiary care delivery center

BackgroundInfants experiencing Neonatal Opioid Withdrawal Syndrome (NOWS) after birth has been a significant public health issue since the opioid crisis began in the U.S. Traditional assessment tools for symptom management have historically resulted in prolonged hospitalization and continued exposure to opioids after birth to treat them. PurposeEat, Sleep, Console (ESC) was implemented to replace a popular NOWS assessment tool in a neonatal intensive care unit at a large urban children's hospital's maternity center. The aim was to determine whether using ESC would decrease length of hospitalization, use of morphine for treatment, as well as increase the number of direct discharges from the postpartum unit. ResultsALOS decreased from 9.2 days to 6.2 days, a 33% reduction. Morphine treatment initiation decreased from 21.7% to 3.8%, an 82.4% reduction. Neither group included infants treated with a second line medication. Finally, the discharge rate improved by 47% directly from the postpartum unit. ConclusionsUsing ESC, all identified outcomes regarding management of infants with NOWS improved. Wide-scale use of ESC could have multiple benefits for this patient population including a reduction in healthcare costs and prolonged exposure to opioids after birth, as well as preservation of the mother-infant dyad in the immediate postpartum period. Further research is needed to study the long-term impact of the ESC method.

RAdiation Dose Attenuation using RADPAD in CATH lab for primary and secondary operators - RADAR-CATH STUDY.

Radiation injury is an important concern for interventional cardiologists and needs to be addressed. RADPAD is a radiation protection drape that has been shown to reduce the radiation exposure of the primary operator (PO). While Indian data on radiation exposure of the PO in the cath lab are scarce, the exposure of the secondary operator (SO) is even less well studied. The aim of this study was to evaluate the efficacy of RADPAD drapes in reducing radiation doses in the cath lab for the primary as well as the secondary operator. A total of 160 patients (40 patients each with single vessel disease [SVD], double vessel disease [DVD] and triple vessel disease [TVD] undergoing coronary angioplasty, and 40 patients undergoing balloon mitral valvuloplasty [BMV]) were randomised in a 1:1 pattern to undergo a procedure with or without the use of RADPAD. For patients with SVD, DVD and TVD undergoing percutaneous coronary intervention (PCI) and those undergoing BMV, the % reduction with the use of RADPAD reduced the PO's received dose (in mrem) by 65%, 54%, 28% and 67%, respectively, as compared to without RADPAD. The % reduction in relative operator exposure for the PO for the 4 groups was 55%, 34%, 18% and 75%, respectively, with the use of RADPAD. The corresponding % reduction for the SO's received dose (in mrem) was 80%, 63%, 33% and 69% and for relative operator exposure was 74%, 46%, 23% and 76% in the 4 groups, respectively. RADPAD significantly reduces the radiation exposure of the primary and secondary operator during prolonged complex PCI and BMV procedures.

Motivating parents to protect their children from wildfire smoke: the impact of air quality index infographics

Background. Wildfire smoke events are increasing in frequency and intensity due to climate change. Children are especially vulnerable to health effects even at moderate smoke levels. However, it is unclear how parents respond to Air Quality Indices (AQIs) frequently used by agencies to communicate air pollution health risks. Methods. In an experiment (3 × 2 × 2 factorial design), 2,100 parents were randomly assigned to view one of twelve adapted AQI infographics that varied by visual (table, line, gauge), index type (AQI [0-500], AQHI [1-11+]), and risk level (moderate, high). Participants were told to imagine encountering the infographic in a short-term exposure scenario. They reported worry about wildfire smoke, intentions to take risk-mitigating actions (e.g., air purifier use), and support for various exposure reduction policies. Subsequently, participants were told to imagine encountering the same infographic daily during a school week in a long-term exposure scenario and again reported worry, action intentions, and policy support. Results. Parents’ responses significantly differentiated between risk levels that both pose a threat to children’s health; worry and action intentions were much higher in the high-risk group than the moderate-risk group in both short-exposure (F = 748.68 p<.001; F = 411.59, p<.001) and long-exposure scenarios (F = 470.51, p<.001; F = 212.01, p<.001). However, in the short-exposure scenario, when shown the AQHI [1-11+] with either the line or gauge visuals, parents’ action intentions were more similar between moderate- and high-risk level groups (3-way interaction, F = 6.03, p = .002). Conclusions. These results suggest some index formats such as the AQHI—rather than the AQI—may better attune parents to moderate levels of wildfire smoke being dangerous to children’s health. Our research offers insights for agencies and officials seeking to improve current public education efforts during wildfire smoke events and speaks to the critical need to educate parents and help them act short-term and long-term to protect children’s health.

Ultrasound Assessment of Changes on the Lungs during Respiratory Distress Syndrome in Newborns with Low Body Weight

Introduction: Respiratory distress syndrome (RDS) is a common pathology of premature newborns and one of the most common causes of hospitalization in intensive care units, as well as mortality among them. Aims of Study: To study the possibilities of ultrasound imaging for respiratory distress syndrome of varying severity in premature newborns. Patients and Methods: Lung Ultrasound was performed in 72 premature infants in whom an X-ray diagnosis of RDS was established. Results: In accordance with the radiological data of RDS I degree diagnosed in 13 (18,1±4,5%) patients, RDS II degree – in 31 (43,0±5,8%), RDS III degree – in 19 (26,4±5,2%) and RDS IV degree – in 9 (12,5±3,9%) premature infants. The results of lung ultrasound and chest x-ray in the diagnosis of stage I and IV RDS coincided in all cases. Moreover, the correlation coefficient between them had a high degree (0.924 and 0.950, respectively). Ultrasound revealed stage II RDS in 21 out of 31 preterm infants diagnosed by radiography. By ultrasound of the lungs, stage III RDS was diagnosed in 4 more premature infants than by X-ray (23 and 19). Conclusions: 1. The integrated use of lung ultrasound and chest X-ray significantly improves the quality of diagnosis and monitoring of lung lesions in premature infants with RDS with a significant reduction in radiation exposure to the patient. 2. Ultrasound is particularly useful for monitoring established radiographic lung pathology (eg, RDS, pneumonia) to reduce radiation exposure.

Reduction of radiation exposure during coronary interventions using coronary roadmap imaging software

BackgroundCoronary Roadmap (CR), a modern imaging software, provides real-time information for decision-making during coronary interventions. However, whether CR also reduces the required volume of contrast medium and radiation dose remains uncertain. In this study, the volume of contrast medium and radiation exposure for both patients and operators in the CR-guided interventions were compared with those in the conventional group. MethodsIn this single center and case control study, 124 patients receiving percutaneous coronary interventions were retrospectively studied and divided into the conventional and CR-guided coronary intervention group. The contrast medium volume used, Dose-Area Product (DAP), and corresponding skin doses of the patients as well as the radiation exposures of the operators were recorded and compared. SPSS. ResultsDespite no significant differences between age and underlying comorbidities, there were significantly lower DAP and skin doses in patients receiving CR-guided interventions compared with those receiving conventional ones. Moreover, the volume of contrast medium was significantly reduced in the CR group. Regarding the radiation exposure for the operators, there was a significantly lower exposure in the CR-guided group than in the conventional group. ConclusionThe CR-guided interventions may significantly reduce the required volume of contrast medium and radiation exposure compared with conventional interventions. More comprehensive applications of the CR-guided intervention is suggested for clinical use.

Farmworker-Relevant Heat Exposure in Different Crop and Shade Conditions

ABSTRACT Objectives Agricultural workers are at risk of heat-related illness, which is preventable. Few field studies have compared farmworker-relevant heat exposure in different conditions. We examined heat exposure over time in different potential shade and work locations to inform future occupational heat prevention approaches. Methods We assessed heat exposure in Eastern Washington State (WA) cherry and grape fields in August 2022. QUESTemp° monitors recorded Wet Bulb Globe Temperature (WBGT) and Black Globe Temperature (BGT) every 10 min from approximately 07:00–14:00 for three days in the center of crop rows (mid-row), under portable shade structures (shade), and in open field (open) locations. Linear mixed effects regression (LMER) models compared WBGT and BGT among field locations. Hourly time-weighted average WBGT and comparisons with occupational exposure limits (OELs) were computed for different hypothetical work-rest cycles during the hottest sampling hours, assuming different worker effort levels, rest locations (mid-row versus shade), and acclimatization statuses. Results Across all crops and locations during the study period, the mean/SD air temperature was 31°C (88°F)/3.9°C (6.9°F), with a maximum temperature of 39°C (102°F) and a mean/SD relative humidity of 30%/9.6%. LMER models suggested no significant difference in mid-row versus open WBGT but significantly lower WBGT in shade versus open locations for both cherries (main effect −5.14: 95% confidence interval [CI] −6.97,−3.32) and grapes (−6.20: 95%CI −7.73,−4.67), though this difference diminished over the course of the day. BGT was significantly higher in the mid-row than the shade (cherries main effect 14.33: 95%CI 9.52,19.13 and grapes 17.10: 95%CI 13.44,20.75). During the hottest sampling hour, the exceedances of OELs were reduced with assumptions of increased shaded break lengths, reduced effort level, and acclimatization. Conclusions Shade canopies, but not the crops studied, provided significant reductions in heat exposure. We observed increased protection from heat assuming longer shaded breaks and reduced effort levels. Results highlight the need for additional field research on the effectiveness, feasibility, and acceptability of different shade types and work-rest cycles to guide employer optimization of best practices for worker protections, including acclimatization before high heat, sufficient shaded rest time, reduced effort levels as the day warms, and avoiding work in peak heat.

Ideal Model of Policy Providing Remissions to Corruption Prisoners in Indonesia: Comparative Study between Indonesia and the Netherlands

The main objective of this research is to examine the ideal model of remission policy for corruption convicts in correctional institutions in terms of fulfilling the rights of inmates, in order to analyze the policy revision arrangements for reducing the sentences of corruption convicts in the statutory regulations and look for an ideal model that can be applied to optimize the implementation of granting remissions to prisoners involved in corruption cases in correctional institutions. This thesis research uses a juridical-normative method. The data collection process was carried out using observation techniques, in-depth interviews and documentation studies. In analyzing the data, researchers used qualitative analysis techniques with steps for data exposure and data reduction. This research's conclusions were drawn using varied extrapolation based on the reliability of the research findings. Meanwhile, data validity guarantee techniques are carried out using credibility, transferability and confirmability. The results of this research illustrate that the birth of Law Number 22 of 2022 concerning Corrections is a series of criminal law enforcement units, therefore its implementation cannot be separated from the development of general conceptions regarding punishment. Prisoners are not only objects, but also legal subjects who are no different from other humans, who at any time can make mistakes or mistakes that can be punished. Punishment is an effort to make prisoners aware of regretting their actions, and returning them to be good citizens, obeying the law, upholding moral, social and religious values, so as to achieve a safe, orderly and peaceful society.

Glucocorticoid Minimization in Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis: An International Survey of Clinicians

Rationale & ObjectiveResearch in anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV) has focused on reducing treatment toxicities, notably through reduction of exposure to glucocorticoids. Glucocorticoid-sparing therapies such as avacopan are not widely available in many countries and patients are exposed to high glucocorticoid doses. There is little data concerning what clinicians would accept as the lowest glucocorticoid dosing that could be used in induction therapy for AAV. Study DesignInternational, online survey Setting & ParticipantsClinicians in various countries, with experience in managing vasculitis. Exposure and OutcomesSurvey questions to gauge interest and preferences in studying an induction of remission regimen for severe AAV using only 2 or 4 weeks of glucocorticoids, without avacopan. Data collected included general opinions about standard of care for induction agents, glucocorticoids and avacopan. Respondents were presented with three candidate trial designs, two of which proposed a combination of cyclophosphamide and rituximab induction. Analytical ApproachUsing a 10-point Likert scale, respondents ranked each candidate trial on its usefulness in demonstrating whether a minimal glucocorticoid regimen will be safe and effective, and their willingness to randomize into the trial. ResultsThere were 210 respondents to the survey. The candidate trials were rated moderate-to-high for usefulness to demonstrate safety and efficacy (scores 6-7/10), and moderate (scores 5-6/10) for willingness to randomize. Four weeks glucocorticoid duration was preferred to 2 weeks, and combination cyclophosphamide-rituximab with 4 weeks glucocorticoids was the most preferred design. 42% of respondents felt avacopan had to be incorporated into a minimal GC trial design to want to recruit patients. LimitationsRepresentativeness of survey sample and generalisability of findings. ConclusionsCombination cyclophosphamide-rituximab may be the ideal way of studying minimal glucocorticoid use in severe AAV. Given its increasing uptake, incorporating avacopan into a potential trial design would be important.

Investigation of metal concentration distribution and corresponding health exposure assessment of fabricated metal product manufacturers

The fabricated metal product industries were identified as producers of variable and heterogeneous pollution. Workers in these manufacturing facilities are exposed to multiple pollutants present at variable concentrations. Specific known adverse health effects include bladder cancer associated with metalworking fluid exposure and lung cancer associated with electroplating processes. To reduce the incidence of these adverse effects, the main challenge is to identify the most hazardous pollutants within this complex exposure environment and evaluate the corresponding health potentials. In this study, exposure indices were formulated to assess multiple metal exposures with the ultimate goal of providing relevant information for exposure reduction and control measures. Fifteen plants, including metal mold manufacturing, metal casting, and surface treatment plants, were investigated in terms of total concentration, summation of corresponding ratio to threshold limit value (STLVr), hazard index (HI), and incremental cancer risk. The results revealed that emissions of aluminum, iron, and manganese were primarily found in the metal mold manufacturing/casting plants, while emissions of chromium, nickel, and zinc were found in surface treatment plants. STLVr and HI were more useful than the total concentration for identifying hazardous metals, which were chromium and nickel, and could specify the facilities that were in need of control measures. As for cancer risk, the metal mold manufacturing/casting plants had lower risk than the surface treatment plants, and the contributing metals for these two plant types were cobalt and chromium, respectively. This study established a useful procedure to evaluate health hazards and cancer risk. The resulting information is useful for prioritizing mitigation control of multiple metal exposures.

Validation of a sampling method and liquid chromatography mass spectrometry analysis method for measurement of fentanyl and five other illicit drugs.

With the increased provision of services by health authorities and community organizations allowing supervised inhalation of illicit substances comes concerns about the potential for secondhand exposure to the substances being used, whether in the adjacent community or to workers at the sites. In order to address community concerns surrounding secondhand illicit substance exposure and better protect harm reduction workers, a validated sampling and LC-MS/MS analysis method was developed for 6 illicit drugs: fentanyl, heroin, methamphetamine, cocaine, etizolam, and bromazolam. It was found that the filter used needed to be silanized to be made more inert and avoid loss of analyte due to degradation. Using the silanized filters, recoveries were good (>90%) and the collected samples were found to be stable at room temperature for 2 wk. The sampling volume validated was up to 960 L. The sensitivity and range of the method make it appropriate for short-term (15 min), full shift (8 h), or environmental sampling.

Evaluating a Modified Use of the Kaiser Permanente Early-onset Sepsis Risk Calculator to Reduce Antibiotic Exposure: a Retrospective Study

BackgroundEarly-onset neonatal sepsis (EONS) remains an important disease entity due to very serious adverse outcomes if left untreated. Lack of diagnostic tools in identifying healthy from diseased neonates, and clinicians’...

Phase I study of the pharmacokinetics and safety of rezafungin in subjects with moderate/severe hepatic impairment and matched control subjects.

Rezafungin is a second-generation, once-weekly echinocandin antifungal approved for the treatment of invasive candidiasis, including candidemia. In phase II/III studies of rezafungin versus caspofungin, patients with severe hepatic impairment were excluded due to lack of caspofungin data in this population. This open-label, single-dose, phase I study evaluated the pharmacokinetics (primary objective) and safety of rezafungin in subjects with moderate or severe hepatic impairment versus matched, healthy subjects with normal hepatic function. Eight subjects each with moderate (Child-Pugh B) or severe (Child-Pugh C) hepatic impairment were matched 1:1 with healthy subjects for age, sex, and body mass index. Each subject received a single 400-mg, intravenous, 1-h infusion of rezafungin. Plasma pharmacokinetic sampling was performed at various time points through 336 h postdose. Pharmacokinetic parameters were derived by non-compartmental analysis. Safety was assessed throughout. All 32 subjects received study treatment and were included in all analyses. Despite overlapping distributions of total plasma concentrations, based on geometric least-squares (LS) mean ratios, the area under the plasma concentration-time curve from time zero (prior to the start of infusion) to infinity (AUC0-∞) was 32% lower in subjects with moderate (LS mean ratio, 67.55; 90% confidence interval [CI]: 53.91, 84.65) and severe (LS mean ratio, 67.84; 90% CI: 57.49, 80.05) hepatic impairment versus matched healthy subjects. The maximum plasma concentration (Cmax) was 12% lower in moderate hepatic impairment and 28% lower in severe hepatic impairment groups. Linear regression showed no significant trend in the degree of hepatic impairment (based on Child-Pugh score) on AUC0-∞ or Cmax (p > 0.05). Treatment-emergent adverse events were reported in seven subjects (21.9%; three subjects in each of the hepatic impairment groups, and one healthy subject), none of which were severe, serious, or resulted in withdrawal. Rezafungin is well tolerated and can be administered to patients with moderate or severe hepatic impairment without the need for dose adjustment. The modest reduction in exposures in subjects with hepatic impairment is not clinically meaningful and is unlikely to impact efficacy.

Accelerated aging among survivors of childhood leukemia and lymphoma: Estimates of early onset and excess morbidity from the COMPASS model.

10028 Background: Cohort studies have detected an increased risk of accelerated aging among survivors of childhood cancer but the timing and magnitude are not known. Methods: To predict the clinical course of diseases of aging— cancer and cardiovascular disease — among survivors of childhood leukemia and lymphoma compared to the general population, we developed the Cancer Outcomes Microsimulation: Pediatric and Adolescent SurvivorShip (COMPASS) model. The model simulates 8 severe, disabling or life-threatening chronic health conditions (CHCs), including 4 subsequent cancers (breast, colorectal, glial tumors, sarcomas) and 4 cardiovascular diseases (heart failure, myocardial infarction/coronary artery disease, valvular disease, stroke), and excess mortality risks among survivors diagnosed between 1970 and 1999 over the course of their lifetimes. Treatment-related risks varied by patient characteristics (sex, age at diagnosis, diagnosis) and treatment exposures (chemotherapy, radiation dose) and were based on data from the Childhood Cancer Survivor Study (CCSS). Age-related risks and competing mortality were based on national databases (SEER, NHLBI, CDC Wonder). We used model calibration to identify parameter sets that generated outcomes consistent with observed data. Model outcomes included cumulative CHC risk. For comparisons to the general population, age-, sex, and diagnosis year-matched individuals who faced only age-related risks were simulated. Results: Among survivors representative of CCSS participants, the model estimated that 45% of leukemia and 65% of lymphoma survivors will develop at least 1 of the 8 CHCs by age 65. Compared to the estimated 20% cumulative risk for the general population, this represented a two- to three-fold excess morbidity risk among survivors. The age at which 20% of survivors developed at least 1 CHC was 51 years for leukemia and 42 years for lymphoma, suggesting an early onset of 14 and 21 years compared to the general population. Outcomes varied by diagnosis and treatment era due to competing risk changes. Among leukemia survivors diagnosed in the 1990s vs. 1970s, cumulative late recurrence mortality by age 40 (11% to 1%) declined. This combined with a reduction in radiation exposure (79% to 24%) resulted in a greater proportion living into adulthood and developing CHCs by age 65 (38% to 48%). In contrast, among lymphoma survivors, the proportion projected to develop a CHC by age 65 remained stable during the same period (62% to 65%) as late recurrence mortality risk declined (8% to 1%), but almost half still received radiation (90% to 49%). Conclusions: Despite improvements in therapy, leukemia and lymphoma survivors are projected to experience CHC early onset and excess morbidity, underscoring the importance of prevention-focused survivorship care and continued efforts to develop more targeted therapies.

Radon exposure in Colombian never smoker patients with non-small cell lung cancer: A pilot study.

e22521 Background: Lung cancer (LC) is the leading cause of cancer-related death globally, with 1.8 million deaths estimated in 2022. In Colombia, up to 74% of patients with LC are diagnosed with stage IV which negatively impacts survival, with 6,000 estimated deaths in 2022. The most critical strategy for reducing LC is the reduction of tobacco exposure; however, up to 38% of LC cases are not related to tobacco. Among other risk factors different from tobacco smoke; indoor radon, a radioactive gas found naturally in closed spaces, stands out and could be the most important one. In Latin America, information on the influence of radon on the incidence of LC is scarce. This study aims to establish the prevalence of Radon exposure in Colombian never-smoker LC patients. Methods: This is a Pilot study. Adult patients with de novo NSCLC diagnosis ( &lt; 6 mo) were included. Past smokers (≥100 cigarettes in life or ≥1 cigarette daily for 6 mo) or patients with a change in place of living in the last 10 years were excluded. Sociodemographics, clinical, and molecular information were obtained and included in an eCRF using REDCap®, Radon measurement was done using a DTPA-type detector (Alfa-track). The detector was located in the patient's home, (60-140 cm from the floor at the point of least ventilation of the space to be measured), for 90 days, Subsequently an automated count quantification was carried out using the Radosys® system at a certified lab (Universidad Santiago de Compostella Radon Lab). The Radon levels were reported in Bq/m3, using the average value observed during the measurement period (The threshold was 20 Bq/m3). Results: Between February 2022 to May 2023, 30 patients were included in the study, 86.7% were women, 73% had stage IV disease at inclusion, 53% had a driver mutation, with EGFR being the most frequent (62,5%) followed by ALK (31.3%). The mean Radon levels were 25.6 Bq/m3 (5 – 48). No patient had Radon levels ≥100 Bq/m3. Conclusions: In this pilot study, we didn´t find high radon exposure among never-smoker NSCLC patients. 2 other studies on indoor Radon concentrations have been done in Colombia, with only one demonstrating high radon levels (≥100 Bq/m3) in Bogotá. These differences could be explained by the type of house, rainfall adjustment, or underlying rock composition in our study. It´s important to increase the sample size for a definitive conclusion and to explore other risk factors in non-smoker patients as the quality of air or occupation, among others. [Table: see text]

Impact of improved air quality on lung function and blood pressure of middle-aged and older population in China

Long-term exposure to fine particulate matters (PM2.5) has been associated with respiratory and cardiovascular diseases and the burden are potentially higher in China experiencing heavy air pollution. In this study, we established the exposure-response association between long-term exposures to PM2.5 and lung function and blood pressure in Chinese middle-aged and older adults using linear mixed-effects and generalized additive mixed models based on 3 waves longitudinal health outcomes data by enrolling 19,988 participants from 121 cities across the mainland of China. We also assessed the effect of Clean Air Policy (CAP) based on a quasi-experimental difference-in-differences (DID) design. A 10 µg/m3 increase in PM2.5 concentration was associated with a 7.18 (95 % confidence interval [CI]: -8.35, -6.02) L/min decrease in PEF (peak expiratory flow) and a 0.72 (95 % [CI]: 0.53, 0.90) and a 0.30 (95 % [CI]: 0.18, 0.42) mmHg increase in systolic and diastolic blood pressure, respectively. The associations were more pronounced in males and rural areas for PEF, but similar across subgroups for blood pressure. DID results suggested that the effect of CAP on health outcomes were sensitive to magnitudes of reduction in PM2.5. A 5 µg/m3 reduction in PM2.5 or more generally led to 18.70 (95 % [CI]:0.79, 36.61) higher PEF and -2.05 (95 % [CI]: -3.87, -0.23) lower diastolic blood pressure, respectively, compared to no reduction or increase in exposure. However, the effects were significant only in rural areas. Our analysis support CAP aiming to benefit public health and provides insights to inform future control policy for efficiently decreasing air pollution exposure burden.

Technologies and the elderly

Abstract Technological development and the increase in the elderly population are undoubtedly the two phenomena that have most characterized the last forty years. Although the elderly are credited with a certain resistance towards new things, in the last 20 years there has been a growing interest in the use of technological tools such as smartphones, PCs and tablets by the elderly population. This phenomenon has undergone a strong acceleration starting from the COVID-19 pandemic which has made technological tools indispensable in order to maintain virtual social and family relationships as it was not possible to meet people directly. Technologies promise undoubted advantages, especially for elderly people who are more easily subject to fatigue and walking problems and are more in need of constant monitoring of their health, but, at the same time, it exposes everyone, especially those over sixty-five, to collateral damage, such as reduction of in-person relationships and exposure to online scams. In this article we will try to identify the pros and cons of the diffusion of modern technological tools among the elderly.

Significant Reduction of Potential Exposure to Extreme Marine Heatwaves by Achieving Carbon Neutrality

AbstractMarine heatwave (MHW), a prolonged period of anomalously warm seawater, has a catastrophic repercussion on marine ecosystems. With global warming, MHWs have become increasingly frequent, intense, and prolonged. To avoid irreversible damages from such extreme events, net‐zero carbon emissions by the 2050s, called carbon neutrality, were proposed. Here, we evaluate the impact of carbon neutrality on MHWs in the late 21st century using multi‐model projections from the Coupled Model Intercomparison Project Phase 6 (CMIP6) Shared Socioeconomic Pathway (SSP) 1–1.9 and SSP3‐7.0 scenarios. It is found that if the current regional rivalry over carbon emissions continues (i.e., SSP3‐7.0), the MHWs in the late 21st century will become stronger and longer than historical ones, especially in the western boundary current and equatorial current regions. Approximately 68% of the global ocean will be exposed to permanent MHWs, regionally 93% in the Indian Ocean, 76% in the Pacific Ocean, 68% in the Atlantic Ocean, 65% in the Coastal Ocean, and 48% in the Southern Ocean. Such MHWs can be significantly reduced by achieving carbon neutrality (i.e., SSP1‐1.9). In particular, the spatial proportion of the ocean exposed to permanent MHWs can be reduced to as low as 0.02%–0.07%, depending on the regions. This result underscores the critical importance of ongoing efforts to achieve net‐zero carbon emissions to reduce the potential ecological risks induced by extreme MHWs.

228a - How can biomonitoring support occupational hygiene in a further reduction of exposure to hexavalent chromium? – Results from the HBM4EU chromate study

228a - How can biomonitoring support occupational hygiene in a further reduction of exposure to hexavalent chromium? – Results from the HBM4EU chromate study

Resilience and Sustainability Through Green Infrastructure

This research explores the pivotal role of green infrastructure in fostering urban resilience and sustainability based on a critical analysis of study findings from best practices. The literature review integrates ecological, social, and economic aspects to clarify its importance. Defined as a network of natural and artificial components, Green infrastructure is subject to several interpretations, as this study explores. Green infrastructures are becoming more critical in developing smart cities in our modern era. Through psychological relaxation and stress relief, social cohesion, physical activity support, and a reduction in exposure to air pollution, noise, and extreme heat, urban green space such as parks, playgrounds, and residential greenery can improve mental and physical health and lower morbidity and mortality rates among urban residents. The conceptual framework's development plans focus on community involvement and smooth integration with current urban structures. The conclusion emphasizes how green infrastructure may change cities for the better. It provides a road map for overcoming challenges and embracing a future in which urbanization and nature coexist to create resilient and sustainable urban cities.