Background: Sickle cell disease is a major public health issue in the DRC while it is still poorly understood by health professionals. The objective of this study was to assess the knowledge and practices of Congolese physicians treating sickle cell disease (SCD) in order to identify areas for improvement in clinical care. Methods: This is a descriptive observational study conducted on Congolese physicians using a questionnaire. Participants were evaluated on a pre-established answer grid. Results: A total of 460 physicians participated, including 81 women (18%) with an average age of 35 years (range 25–60 years). Most physicians were general practitioners. Although self-assessment of their level of knowledge on SCD was estimated as average to good, less than half of the participants (n= 460; 46%) reported adequate management of vaso-occlusive crisis but only 1% of them had received specific training on SCD. Most physicians reported difficulties both in terms of diagnostic (65%) and management (79%) options of SCD patients. This study showed also that 85% of them did not have access to diagnostic tools for SCD. Conclusions: Insufficient knowledge on SCD, poor diagnostic and treatment options may contribute to morbidity and mortality of patients living in the DRC. Interventions aiming at improving physician’s knowledge, patient’s follow-up and treatment access are needed. Specific training alongside existing programs (HIV, malaria), early diagnosis of the disease, and creation of patients’ advocacy groups should improve SCD patient’s care.

Objectives: Social distancing measures are currently implemented to control COVID-19 pandemic in many countries, including Saudi Arabia. The aim of this study was therefore to evaluate the awareness and adherence of the Saudi population to these measures. Methods: A web-based questionnaire was designed with 16 questions (8 questions related to demographics, 3 in relation to awareness about social distancing and 5 related to overall practice of social distancing). Results: 5105 participants completed the survey [58.4% female, 66.3% young individuals (aged 18-37 years), 55.8% bachelor degree holders, and 51.0% from the western region]. The Saudi Ministry of Health (MOH) was the main source of information about COVID-19 for most participants (78.2%). High awareness (81.3%) regarding social distancing was observed, associated mainly with female participants, those from the middle region and those with high education and income. Overall implementation of social distancing was satisfactory (score 3.13/5), with 37.8% never leaving home during the home-stay period. Better adherence to social distancing was observed for female participants, higher degree holders and those aged over 38 years. Conclusions: Organised plans by the Saudi MOH have been effective in raising awareness and improving practice of social distancing among public. However, the observed lower practice of social distancing by individuals with lower education and income indicates the need for targeted interventions to achieve better outcome.

The physical environment plays an important role in the transmission of respiratory infections like Covid-19. To find relevant articles on environmental factors influencing respiratory infection outbreaks, we searched Pub med Central on the following topics: 1. Environmental pollution causing coronavirus fatality- 73 results, relevant 1 article, 2. Environmental factors affecting Covid-19, 149 results from which there were 6 relevant articles, 3. Impact of air pollution on Covid-19 fatality, 10 results, relevant 3 articles, 4. Environmental factors affecting respiratory viruses- 10646 results were obtained, 2 relevant articles. We searched Google scholar on environmental factors affecting Covid-19 transmission and found 7 relevant papers. We excluded the duplicates in each of the key words search. Date of search was on 20^th April 2020. All articles included in results were scrutinized and relevance of articles was based on their content that discussed meteorological and physical environment factors in the spread and severity of Covid-19. We have discussed factors like air pollution, smoking, air temperature, humidity and air velocity as contributing factors. If meteorological factors are conducive to spread in a particular area, we need protective measures way before a respiratory infection outbreak occurs. Covid-19 is a lesson learnt the hard way, and we must enable people to practice hygienic practices with limited resources but high level of protection that it provides. Air pollution control can prevent priming of respiratory system which shall further protect from pulmonary infections.

Background: Australia received its first case of coronavirus on 25 January 2020. Since then the demands of COVID-19 has presented unparalleled levels of strain on the public healthcare systems in the country. In this time of crisis, pharmacists and community pharmacy staff have modified work strategies according to the rapidly changing environment. With a delayed dissemination of resources and guidelines, pharmacist and pharmacies are practicing innovative infection control methods across Australia to protect their staff, patients and the community. This article seeks to explore the current activities undertaken by pharmacists in various community pharmacy settings across Australia in relation to the safety of the workplace environments for staff and patients. Information collected can help inform future decisions in pandemic preparation for pharmacies in response to similar health crisis now and in the future. Methods: An online cross-sectional survey study was conducted in Australia during the COVID-19 outbreak from 1^st to 30^th April 2020. The questionnaire addressed community pharmacist’s awareness and response to infection and sanitation control. Results: A total of 137 pharmacists took part in the survey, with almost half (45.26%) belonging to the age group of 25 to 34 years. Community pharmacy formed the bulk (89.05%) of the respondent’s primary place of practice. There was a good uptake of safety measures by pharmacists and their pharmacies to protect staff and patients. However the task of reassigning high health risk staff was not heavily practiced (34.31%). Regular cleaning took place in the pharmacy, but the use of gloves while cleaning was not practiced in 48.18% of respondents. In addition, only 46.72% of respondents reported observing script baskets being cleaned and disinfected. About one-third (37.96%) of pharmacists were aware of the two-step cleaning and disinfecting process, but only 18.98% of pharmacists reported observing or performing this sanitation procedure. More than half of surveyed pharmacists reported having difficulty keeping up with infection control changes and pharmacy practice guidelines during the pandemic. Conclusion: This study demonstrates that the majority of pharmacists are not fully aware of the infection control measures needed in a community pharmacy setting. The influx of coronavirus updates has made it difficult for pharmacists to implement accurate procedures on some aspects of workplace hygiene, which may have led to some gaps in infection control measures. Pharmacists must aim to uphold their public health ambassador role and aim to keep up-to-date with professional guidance to provide the necessary infection control measures to ensure staff, patient and public health safety.

Economic burden due to premature mortality has a negative impact not only in health system even though in the society. The aim of this study was to estimate the potential years of work tenure lost (PYWL) due to Chagas disease in Colombia from 2010-2017. National data on mortality by sex and ages between 15 and 62 dues to Chagas from 2010 to 2017. The PYWL methodology was applied to assess the impact of Chagas disease in workers who suffer from them. In total, 1,261 deaths were analyzed in the study, of which 60% corresponded to males. The loss of labor productivity caused by Chagas disease was estimated at $29 million. Overall, 48,621 PYWL were lost, and there was an average of 21 years for all subjects with Chagas. Throughout the analyzed period, PYWL increased substantially, and it is necessary to continue with early detection programs to avoid premature death in working age population.

Smoking during pregnancy remains one of the most significant risk factors for poor birth outcomes. The Loma Linda University Health Comprehensive Tobacco Treatment Program (CTTP) is the largest maternal tobacco cessation program in San Bernardino County – the largest county in the contiguous US. CTTP is an eight week, incentivized, behavioral intervention for tobacco cessation for pregnant smokers. As part of program evaluation, we used a retrospective cohort design to assess smoking abstinence and to identify predictors of relapse/smoking after enrollment. Among CTTP cohort enrollees (n=233) from 2012-2013 we found: 1) a 28.4% 8 week point prevalence abstinence (PPA), and at a median of 9 months of follow-up after the PPA, 81.6% continued to indicate tobacco cessation, and 2) a high rate of relapse or loss to follow-up (56%). Our modeling of relapse/smoking after enrollment indicated that this was higher in young mothers, non-Hispanic mothers (White, Black), first/third trimester mothers, and rural mothers. The evaluation identified efficacy of the behavioral model at 8 weeks, but that relapse/smoking was occurring in disparity populations. Formative research is needed to expand the programmatic outreach and enrollment of mothers wanting to quit smoking.

There are numerous hazards found on the farms. Most of them are ignored, which might cause the farmer to pay later in terms of his ill health, potential injuries or death. The current article discusses some of the common issues such as dust and air quality concerns; environmental (weather) stressors and psychological stressors; noise and hearing protection; and tractor safety and seatbelt use. And finally, the recommendations to overcome the hazards are discussed.

Purpose: The study is aimed to quantify the effects of social noise (personal music players (PMP), high-intensity noise exposure events) and road traffic noise exposures in the sample of Slovak university students living and studying in Bratislava. Methods: There were 1,003 university students (306 males and 697 females, average age 23.13±2) enrolled in the study; 347 lived in the student housing facility exposed to road traffic noise (LAeq =67.6 dB) and 656 in the control one (LAeq =53.4 dB). Respondents completed a validated ICBEN 5-grade scale “Noise annoyance questionnaire”. The exposure to PMP was objectified by the conversion of the subjective evaluation of the volume setting and duration. With the cooperation of the ENT specialist, we arranged audiometric examinations on the pilot sample of 41 volunteers. Results: From the total sample of 1,003 students, 794 (79.16 %) of them reported the use of PMP in the course of the last week; average time of 285 minutes. There was a significant difference in PMP use between the exposed (85.59 %) and the control group (75.76 %) (p=0.01). Among PMP users 30.7 % exceeded the LAV (lower action value for industry LAeq,8h = 80 dB). On a pilot sample of volunteers (n=41) audiometry testing was performed indicating a hearing threshold shift at higher frequencies in 22% of subjects. Conclusions: The results of the study on a sample of young healthy individuals showed the importance of exposure to environmental noise from different sources (transportation, neighborhood, construction, entertainment facilities, etc.) as well as social noise and the need for prevention and intervention.

Research into professionalization in health and safety has recently gained in interest. Graduate training is one of the factors that determines or conditions the role of the safety professional, thus intervene in the professionalization process. This article is the result of a workshop and the discussions of nine academic directors of safety education programs about quality evaluation. This article introduces the issue with a historic overview of safety education, presents a synthesis of nine selected education programs, discusses quality evaluation of health and safety education programs, propose a quality evaluation frame and finally, proposes a process for designing a quality safety education program with an associated model of the learning objectives. The outcomes are interesting for everyone who is interested in health and safety education and quality evaluation and will give insights into how safety professionals are educated.

The Brazilian economy, the rural in particular, was until the end of the 19th century based on slave labour. In this research, it was intended to obtain, through a review of historical descriptive studies, a detailed picture of the occupational hygiene conditions related to the slaves’ work and their interactions with climatic and environmental conditions. The search was done in the following databases: Science Direct, Scopus, Web of Science, Criminal Justice, Ebsco, Business Source Supplement, as well as original historical documents. Descriptive studies, without the restriction of language, were selected that involved the rural work of slaves in colonial and imperial Brazil. Working environmental conditions have been evaluated: environmental and occupational hygiene conditions to which the captive workers were exposed, as well as their accommodation and clothing. The analysed studies registered the existence of accommodation and similar dresses all over Brazil, regardless of the region's climate. In addition to these accommodation conditions, slaves were still exposed in a similar way to physical, chemical and biological agents throughout the country. Finally, it was also possible to identify a clear similarity with the occupational exposure conditions of the modern slaves in the 21^st century.

Abstract: Background: Exposure to ETS (Environmental Tobacco Smoke) is one of the most toxic environmental exposures. Objective: To investigate the impact of ETS on physiological, biochemical, psychological indicators, on the urine antioxidant capacity (AC) and oxidative damage to lipids in a pilot sample of healthy pregnant women. Methods: The exposure to ETS was investigated by a validated questionnaire, urine cotinine and the marker of oxidative damage to lipids - 8-isoprostane concentrations using an ELISA kit. Urine AC was determined by the spectrophotometric TEAC method. From the sample of pregnant women (n=319, average age 30.84 ± 5.09 years) in 80 the levels of cotinine and oxidative stress markers were analyzed. Results: From our sample, 5 % individuals (7.4 % objectified by cotinine) were current smokers and 25 % reported passive smoking in the household (18.8 % objectified by cotinine). The Kappa was 0.78 for smokers and 0.22 for ETS exposed non-smokers. Smokers as well as non-smokers had significantly higher (p<0.05) urine AC than ETS exposed non-smokers. Non-smokers had significantly lower levels of 8-isoprostane than smokers (p<0.01) and ETS-exposed non-smokers (p<0.05). Correlations between urine levels of cotinine and AC were positive in ETS exposed non-smokers. Conclusion: The harmful effect of active and passive smoking on oxidative stress parameters has been indicated.

The aim of this study was to explore perspectives of occupation health personnels (OHPs) regarding education and training of mineworkers on occupational noise induced hearing loss (ONIHL) and its impact on mineworkers’ hearing. Qualitative, in-depth telephonic and face-to-face interviews were conducted with 16 OHPs comprising representatives from the state, employer and labour as well as audiologists and occupational health hygienists. Purposive and snowball sampling were utilized to recruit participants. Data were analysed using inductive thematic analysis. Findings revealed that mineworkers have a superficial awareness and knowledge of the impact of noise on their hearing and health. Moreover, OHPs are not knowledgeable on how mineworkers are educated on ONIHL and its latent consequences. Furthermore, language, low levels of education and literacy as well as the financial constraints were factors that had a negative impact on raising awareness and training mineworkers. There is a need to prioritize health literacy among mineworkers. Additionally, audiologists need to play an active role in educating mineworkers about the effects of excessive exposure to noise. There is a need to take into account literacy levels and language barriers in planning training material for mineworkers.

Malaysia became the centre of international attention when it democratically removed a semi-authoritarian government of 62 years during its 14th general election this year. This electoral success has provided geriatric medicine in Malaysia with the unexpected ageing icon in the oldest prime minister in the world. Political change has led to a wave of optimism for the expansion of geriatric services in Malaysia, which has met with numerous challenges in the last two decades. The number of geriatrics specialists and services had already begun expanding under the previous government. However, existing geriatricians will need to reassess the landscape of delivery and access of care in our rapidly growing ageing population and develop new strategies to truly expand their services. In addition to unrelenting efforts in the recruitment and training of future geriatricians, the steady expansion of the geriatric workforce should take into account the inclusion of geriatric medicine in the undergraduate training curricula of all healthcare professionals. Expansion of geriatric services will also be a cost-effective strategy to reduce the growing national healthcare budget incurred by the growing needs of an ageing population.

Hospitalized patients frequently have disordered and poor-quality sleep due to a variety of both intrinsic and extrinsic factors. These include frequent nighttime intrusions, insomnia related to pain and unfamiliar environments, dark conditions during the day with loss of natural light, and disruption of natural sleep cycle due to illness. Sleep wake disturbances can result in deleterious consequence on physical, emotional and cognitive status, which may impact patient satisfaction, clinical recovery, and hospital length of stay. Despite this, clinicians frequently fail to document sleep disturbances and are generally unaware of best practices to improve sleep quality in the hospital. The purpose of this review is to discuss sleep disturbances in hospitalized patients with a focus on causes of sleep disturbance, effect of poor quality sleep, high risk populations, considerations for surveillance and prevention, as well as pharmacologic and non-pharmacologic options for treatment.

Abstract Introduction: Visual perceptual skills are essential for independent participation in self-care tasks, educational, work and leisure time activities. The effect of HIV on the visual perceptual skills is not well understood among children in low resource settings like Zimbabwe. Methods: A cross sectional comparative study was done with 30 children living with HIV and 30 children living without HIV residing in Harare urban area. The TVPS-3 was used to assess their visual perceptual skills. SPSS version 22, STATISTICA 13 and Microsoft 2016 were used for data analysis. Results: Both groups of children had mean percentile ranks below 50 on their TVPS-3 scores. Children without HIV generally performed better than those with HIV but the difference was not statistically significant in most cases. Through univariate analysis, only performance on Spatial Relations significantly differed between the two groups. Both groups had lowest scores in Basic visual perceptual skills. Age and school grade were the independent predictors of the children’s performances in the study. Conclusion: There is need for Occupational therapy services in public primary schools and in the pediatric Opportunistic Infections clinics in hospitals to be part of the health team which caters for children with visual perceptual challenges.

Using the culture-work-health model, this study investigates the factors influencing the quality of life of maritime workers. This study conducted a survey of 320 maritime workers who have experience living and working on a ship for more than six months. This self-administered questionnaire included questions on organizational culture and support, self-efficacy, perceived fatigue, as well as the quality of work life. Organizational culture and self-efficacy were identified as factors affecting the quality of work life, while organizational support was found to have an indirect effect after passing through self-efficacy and perceived fatigue. The final model accounts for 63.1% of the variance in maritime workers’ quality of life. As such, this study shows that self-efficacy is important for the quality of life of maritime workers, having both direct and indirect effects. Moreover, organizational support may prove the primary intervention point for relieving perceived fatigue and enhancing self-efficacy, thus improving the quality of work life.

Resilience embodies the personal qualities that enable one to thrive in the face of adversity. A previous Italian study showed that injured workers had a lower level of resilience than non-injured workers. The aim of this paper is to examine the relationship between occupational injuries and psychological resilience. The subjects were 197 drivers from two Finnish waste transport companies. As a part of larger questionnaire, they fulfilled the Connor-Davidson Resilience Scale, which consisted of 25 items. Drivers reported their occupational injuries during the last three years. The drivers involved in occupational injuries had higher score (average 69.3) on Connor-Davidson Resilience Scale than drivers avoided injuries (67.7). According to Student’s t-test the difference between groups was highly significant (t = 40.44, df = 196, p<0.001). The result of this study was contradictory to earlier Italian study. One explanation may be that the Italian study was done with traumatic context with seriously injured patients. Waste transport drivers were rather young and fit males, who had suffered only minor injuries.

The purpose of this study was to report data analysis results from the International Health Regulations (2005) Ship Sanitation Certificates (SSC), recorded in the European Information System (EIS). International sea trade and population movements by ships can contribute to the global spread of diseases. SSC are issued to ensure the implementation of control measures if public health risk exists on board. EIS designed according to the World Health Organization (WHO) “Handbook for Inspection of Ships and Issuance of SSC”. Inspection data were recorded and SSC issued by inspectors working at European ports were analysed. From July 2011-February 2017, 107 inspectors working at 54 ports in 11 countries inspected 5579 ships. Of these, there were 29 types under 85 flags (including 19 EU flags). As per IHR (2005) 10,281 Ship Sanitation Control Exception Certificates (SSCEC) and 296 Ship Sanitation Control Certificates (SSCC) were issued, 74 extensions to existing SSC were given, 7565 inspection findings were recorded, and 47 inspections were recorded without issuing an SSC. The most frequent inspection findings were the lack of potable water quality monitoring reports (23%). Ships aged ≥12 years (Odds Ratio, OR = 1.77, 95%Confidence Intervals, CI = 1.37–2.29) with an absence of cargo at time of inspection (OR = 3.36, 95%CI = 2.51–4.50) had a higher probability of receiving an SSCC, while ships under the EU flag had a lower probability of having inspection findings (OR = 0.72, 95%CI = 0.66–0.79). Risk factors to prioritise the inspections according to IHR were identified by using the EIS. A global information system, or connection of national or regional information systems and data exchange, could help to better implement SSC using common standards and procedures.

Gonorrhea is a major global public health problem with emergence of multiple drug-resistant strains with no effective vaccine. This retrospective cohort study aimed to estimate the effectiveness of the New Zealand meningococcal B vaccine against gonorrhea associated hospitalization. The cohort consisted of individuals born 1984-1999 residing in New Zealand, therefore eligible for meningococcal B vaccination during 2004-2008. Administrative datasets of demographics, customs, hospitalization, education, income tax and immunization, were linked using the national Integrated Data Infrastructure. The primary outcome was hospitalization with a primary diagnosis of gonorrhea. Cox’s proportional hazards models were applied with a Firth correction for rare outcomes to generate estimates of hazard ratios. Vaccine effectiveness estimates were calculated as 1-Hazard Ratio expressed as percent. There were 1,143,897 eligible cohort members, with 135 missing information on gender, 16,245 missing ethnicity and/or 197,502 missing deprivation hence 935,496 were included in the analysis. After adjustment for gender, ethnicity and deprivation, vaccine effectiveness (MeNZB™) against hospitalization caused by gonorrhea was estimated to be 24% (95% CI 1-42%). In conclusion, vaccination with MeNZB™ significantly reduced the rate of hospitalization from gonorrhea. This supports prior research indicating possible cross protection of this vaccine against gonorrhea acquisition and disease in the outpatient setting.

If environmental exposures are shown to cause an adverse health outcome, reducing exposure should reduce the disease risk. Links between exposures and outcomes are typically based on ‘associations’ derived from observational studies, and causality may not be clear. Randomised controlled trials to ‘prove’ causality are often not feasible or ethical. Here the history of evidence that tobacco smoking causes lung cancer – in observational studies – is compared to that of low sun exposure and/or low vitamin D status as causal risk factors for the autoimmune disease, multiple sclerosis. Evidence derives from in vitro and animal studies, as well as ecological, case-control and cohort studies, in order of increasing strength. For smoking and lung cancer, the associations are strong, consistent, and biologically plausible – the evidence is coherent or ‘in harmony’. For low sun exposure/vitamin D as risk factors for MS, the evidence is weaker, with smaller effect sizes, but coherent across a range of sources of evidence, and biologically plausible. The association is less direct – smoking is directly toxic and carcinogenic to the lung, but sun exposure/vitamin D modulate the immune system, which in turn may reduce the risk of immune attack on self-proteins in the central nervous system. Opinion about whether there is sufficient evidence to conclude that low sun exposure/vitamin D increase the risk of multiple sclerosis, is divided. General public health advice to receive sufficient sun exposure to avoid vitamin D deficiency (<50nmol/L) should also ensure any benefits for multiple sclerosis.

Disadvantaged circumstances in youth tend to translate into poor health development. Yet, the fact that this is not always the case has been seen as indicative of differential resilience. The current study highlights factors outside the context of the family with the potential to counteract the long-term negative influences of social and material adversity in adolescence on general health status. This study was based on two waves of questionnaire data from the Northern Swedish Cohort. From the wave in 1981 (age 16), indicators of social and material conditions as well as factors related to school, peers, and spare time, were derived. From the wave in 2008 (age 43), information about self-rated health was used. Ordinal logistic regression models (n=908) showed that adversity in youth was associated with poorer self-rated health in midlife among men and women alike, net of health status at baseline. However, having an advantaged situation with regard to school, peers, or spare time appeared to protect against the detrimental influences of disadvantaged circumstances in the family context on subsequent health. This suggests that health-promoting interventions may benefit from focusing on contexts outside the family in their effort to strengthen processes of resilience among disadvantaged youths.

The human casualties from simulated nuclear detonation scenarios in New Delhi, India are analyzed, with a focus on the distribution of casualties in urban environments and the theoretical application of a nuclear-specific triage system. Model estimates of nuclear war casualties employed ESRI's ArcGIS 9.3, blast and prompt radiation were calculated using the Defense Nuclear Agency's WE program, and fallout radiation was calculated using the Defense Threat Reduction Agency's (DTRA's) Hazard Prediction and Assessment Capability (HPAC) V404SP4, as well as custom GIS and database software applications. ESRI ArcGISTM programs were used to calculate affected populations from the Oak Ridge National Laboratory's LandScanTM 2007 Global Population Dataset for areas affected by thermal, blast and radiation data. Trauma, thermal burn, and radiation casualties were thus estimated on a geographic basis for New Delhi, India for single and multiple (six) 25 kiloton (kt) detonations and a single 1 megaton (1000kt) detonation. Major issues related to the emergency management of a nuclear incident are discussed with specific recommendations for improvement. The consequences for health management of thermal burn and radiation patients is the worst, as burn patients require enormous resources to treat, and there will be little to no familiarity with the treatment of radiation victims.

ETS exposure has been shown as an important environmental risk factor in vulnerable population groups. The aim of the project is to analyze the relationships among the ETS and behavior and health in 6−15-year-old children in Slovakia. The status of physical and mental health of children in relation to exposure to tobacco smoke was examined in the representative group of 1478 school children. The methods used, included anonymous questionnaires filled in by parents, Columbia Impairment Scale (CIS), Behavior Problem Index (BPI) and anthropometry. The prevalence of passive smoking is the highest in the capital (27%) and southern cities. Significant relationships have been confirmed between ETS and the age, socio-economic status, the incompleteness of the family, the level of mother's education and the significantly higher prevalence of respiratory diseases (26.7%).The relationships of ETS with emotional (CIS scores ≥16) and behavioral functions (BPI score ≥14) were significant in children exposed to mother‘s and father‘s smoking at home. In the multivariate analysis this association was not significant; the factors such as income and completeness of the family were dominant. The results confirmed the impact of ETS and social factors on health state and health behavior and could be the argumentation for legislative changes.

Pesticide exposure is a growing concern for public health. Although Brazil is the world's largest consumer of pesticides, few studies addressed the health effects among farmers. This study aimed to evaluate whether pesticide exposure is associated with respiratory outcomes among rural workers and relatives in Brazil during the crop and off-seasons. 82 family farmers were interviewed about occupational history and respiratory symptoms, and cholinesterase tests were conducted in the crop-season. Spirometry was performed during the crop and off-season. Respiratory outcomes were compared between seasons and multiple regressions were conducted to search for associations with exposure indicators. Participants were occupationally and environmentally exposed to multiple pesticides from an early age. During the crop and off-season, respectively, they presented a prevalence of 40% and 30.7% for cough, 30.7% and 24% for nasal allergies, and 24% and 17.3% for chest tightness. Significant relations between spirometry impairments and exposure indicators were found both during the crop and off-season. These findings provide complementary evidence about the association of pesticide exposure with adverse respiratory effects among family farmers in Brazil. This situation requires special attention as it may increase the risk of pulmonary dysfunctions, and the morbidity and mortality burden associated with these diseases.

The difference of smoker’s topography has been found to be a function of sex, personality, nicotine yield, cigarette type (i.e., flavored versus non-flavored) ethnicity and etc. We evaluated the puffing behaviors of Korean smokers and its association with smoking-related biomarker levels. A sample of 300 participants was randomly recruited from metropolitan areas, South Korea. Topography measures during a 24-hour period were obtained using a CReSS pocket device. Korean male smokers smoked two puffs less per cigarette, compared to female smokers [15.0 (13.0–19.0) vs. 17.5 (15.0–21.0) as median (Interquartile range)], but had a significantly larger puff volume [62.7 (52.7–75.5) mL vs. 53.5 (42.0–64.2) mL); p = 0.012]. The interpuff interval was similar between men and women [8.9 (6.5–11.2) s vs. 8.3 (6.2–11.0) s; p = 0.122] but much shorter than other study results. A dose-response association (p = 0.0011) was observed between daily total puff volumes and urinary cotinine concentrations, after controlling for sex, age, household income level, nicotine addiction level. Understanding of the difference of topography measures, especially, larger puff volume and shorter interpuff interval of Korean smokers may help to overcome potential underestimation of internal dose of hazardous substitutes of smoking or corresponding its health effect.

Transgender youth experience elevated levels of victimization and may therefore report greater drug use than their cisgender peers, yet little is known about protective factors like school belonging that may mediate this relationship. Further, scant research has explored the experiences of youth at the intersection of transgender identity and youth of color status or low socioeconomic status, especially with respect to these multiple minority statuses’ associations with peer victimization, drug use, and school belonging. Using data from the California Healthy Kids Survey, the current study employs structural equation modeling to explore the relationships among school belonging, peer victimization, and drug use for transgender youth. Findings indicate that school belonging does mediate the pathway between peer victimization and drug use for transgender youth and that although youth of color experience greater victimization, they do not engage in greater drug use than their white transgender peers. Based on these results, those concerned with the healthy futures of transgender youth should advocate for more open and affirming school climates that engender a sense of belonging and treat transgender youth with dignity and fairness.

Policing duties may inherently be dangerous due to stab, blunt trauma and ballistic threats. The addition of individual light armour vests (ILAVs) has been suggested as a means to protect officers. However, the addition of the extra load of the ILAV may affect officer ability to conduct occupational tasks. The purpose of this study was to determine if wearing any of 3 different ILAVs (ILAV A, ILAV B, & ILAV C) affected occupational task performance when compared to that in normal station wear. A prospective, within-subjects repeated measures design was employed, using a counterbalanced randomization in which each ILAV was worn for an entire day while officers completed a variety of occupationally relevant tasks. These tasks included a victim drag, car exit and 5 meter sprint, step down and marksmanship task. Results showed that performance in each task did not vary between any of the ILAV or normal station wear conditions. There was less variability in the marksmanship task with ILAV B, however. The results suggest that none of the ILAVs used in this study were heavy enough to significantly affect task performance in the assessed tasks when compared to wearing normal station wear.

Objectives: 1) To describe the cardiovascular health of the construction workers in Hong Kong, 2) to examine the demographic differences in cardiovascular health, and 3) to examine the association between modifiable lifestyle behaviors and cardiovascular conditions. Methods: 626 registered construction workers were included in the analysis. Blood chemistry, blood pressure, weight and height were measured. Face-to-face questionnaire interview was conducted. T-tests and One-way ANOVAs were used to compare the cardiovascular health score, cardiovascular outcomes, and lifestyle behaviors by demographic characteristics. Logistic regressions were performed to assess the cardiovascular outcomes by lifestyle behaviors. Results: Two-thirds of the construction workers failed to achieve three out of the seven “ideal” cardiovascular health indicators. The younger, more educated, and female subjects had better cardiovascular health scores than their counterparts. The ideal fish and seafood consumption was associated with 1) ideal weight status and 2) ideal cholesterol level, whereas less soft drink consumption was associated with ideal cholesterol level. Conclusions: The findings highlighted the importance of promoting cardiovascular health in the construction industry. This study provided insights for future interventions, which should include increasing fish and seafood intake, decreasing soft drink consumption, and enhancing the health literacy amongst older, less educated, and male construction workers.

Background. Asbestos has been used for thousands of years but in a large industrial scale for about 100–150 years. The first identified disease was asbestosis, a type of incurable pneumoconiosis caused by asbestos dust and fibres. The latest estimate of global number of asbestosis deaths from the Global Burden of Disease estimate 2016 is 3495. Asbestos caused cancer was identified in the late 1930’s but despite of today’s overwhelming evidence of the strong carcinogenicity of all asbestos types including chrysotile it is still widely used globally. Various estimates have been made over time including those of WHO and ILO 107,000–112,000 deaths. Present estimates are radically higher. This special edition of the Journal summarizes key aspects of the past and present of the asbestos problem globally. Methods. Documentation on milestones of asbestos related diseases, ARDs, their recognition, reporting, compensation and prevention efforts were examined, in particular from the regulatory and prevention point of view. Estimated global numbers of incidence and mortality of ARDs were looked at. Results. Asbestos causes an estimated 257,000 deaths (243,223–270,635) annually according to latest knowledge. Work-related exposures are responsible for 235,000 deaths (222,322–247,363) of those. In the European Union, USA and in other High income economies (WHO regional classification) the direct costs for sickness, early retirement and death, including production losses, have been estimated to be very high, in the Western European countries and EU equivalent of 0.70% of the GDP or 114.9*109 USD. Intangible costs could be much higher. When applying the Value of Statistical Life (VSL) of 4 million EUR per cancer death used by the European Commission we arrived 5at 410*109 USD while the human suffering and loss of life is impossible to quantify. The numbers and costs are increasing practically in every country and region in the world. Asbestos has been banned in 55 countries but used widely today, some 2,030,000 tons consumed annually according to latest available consumption data. Every 20 tons of asbestos produced and consumed kills a person somewhere in the world. Buying 1 kg asbestos powder format e.g. in Asia costs some 0.38 USD and 20 tons would cost in such retail market 7600 USD. Conclusions. Present efforts to eliminate this man-made problem, in fact an epidemiological disaster, and preventing exposures leading to it are insufficient in most countries in the world. Applying programmes and policies, such as those on the elimination of all kind of asbestos use—that is banning of new asbestos use and tight control and management of existing structures containing asbestos—need revision and resources. The ILO/WHO Joint Programme for the Elimination of Asbestos-related Diseases need to be revitalized. Exposure limits do not protect properly against cancer but for asbestos removal and equivalent exposure elimination work we propose a limit value of 1000 fibres/m³.

Environmental lead exposure is a population health concern in many low- and middle-income countries. Lead is found throughout Myanmar and prior to the 1940s, the country was the largest producer of lead worldwide. The aim of this study was to examine any potential association between lead mining and adult literacy rates at the level of the 330 townships in Myanmar. Townships were identified as lead or non-lead mining areas and 2015 census data were examined with association being identified using descriptive, analytical and spatial statistical methods. Overall, there does appear to be a significant relationship between lead mining activity and adult literacy levels (P<0.05) among townships with both low access [OR= 2.701 (1.136-6.421)] as well as townships with high access to safe sanitation [OR=18.40 (1.794-188.745)]. LISA cluster maps confirm these findings. This exploratory analysis is a first step in the examination of potential environmental lead exposure and its implications in Myanmar.

The workplace is an ideal setting for health promotion. The regular medical examination of workers enables us to screen for numerous diseases, spread good practices and correct lifestyles, and obtain a favourable risk/benefit ratio. The continuous monitoring of the level of workers' wellbeing using a holistic approach that goes beyond the simple prevention of occupational risks enables us to promptly identify problems in work organization and the company climate. Problems of this kind can be adequately managed by using a participatory approach. In this study participatory ergonomics groups were used to improve occupational life in a small company. After intervention we observed a reduction in levels of perceived occupational stress measured with the effort / reward imbalance model, and an improvement in psychological wellbeing assessed by means of the Goldberg anxiety / depression scale. Although the limited size of the sample calls for a cautious evaluation of this study, the GEP© strategy proved to be a useful tool due to its cost-effectiveness.

Garment sector has crucial working field in Turkey.It has also very high risky occupational health conditions and safety.The objective of this study is to define level of job level, work-related stress’ symptoms, social support and coping mechanisms of garment workers and to determine any related factors.This study is descriptive and cross-sectional. The study population comprised garment workers in the 16-65 age range. The data was collected by Assessment Form, The Brief Stress Coping Profile and Brief Job Stress Questionnaire. The level of work-related stress was statistically higher among the workers who had chronic disease, low economic, education status and poor quality of sleep. Psychological and physical physiological reactions to stress were found higher among women workers and those with chronic disease.It also was seen that job stress scores had a meaningful relationship with “emotional expression involving others” (r =.20) and “Avoidance and suppression” coping profile (r =.16; p <.01).Psychological symptom scores were found to have a low level of meaningful relationship with “Seeking help for solution” (r =-.08), “changing point of view” (r=.13) and “emotional expression involving others” coping profiles (r=.21). Work-related stress causes many health and behavioral problems. Work related reasons and coping profiles have powerful effects on stress.

The ageing of workers is one of the most important issues for occupational health and safety in Europe. A number of intervention studies on health promotion for older workers were conducted in European workplaces between 2000 and 2015. This review gives an overview of these studies and considers perspectives for workplace health promotion.

Surgical smoke is produced by energy-based surgical instruments. The airborne volatile organic compounds (VOCs) from surgical smoke may have potential health risk. This study aimed to evaluate the evidence for the harmful effects on the operating theater staff. An internationally recognized evaluation model of health risk assessment (HRA) was adapted to preliminarily assess the health risks caused by VOCs in surgical smoke. Results of HRA indicated that non-carcinogenic risk indexes of VOCs did not exceed one, indicating that these pollutants didn't cause significant non-carcinogenic harm to the health of the operating theater staff. But the cancer risk indexes exposed to formaldehyde and benzene all exceed 10-5, which was higher than the suggested value of USEPA (10-6) and might cause potential harm to the health of the operating theater staff. Long-term exposure of such surgical smoke will be harmful to the health of the operating theater staff and have a great risk of cancer.