Search Results (6,333)

Background: Work-related musculoskeletal disorders (WMSDs) have been reported to be very common among hospital workers and particularly nurses. They are assumed or found to be a result of physical workload or poor posture at work and only secondarily a consequence of (general) stress. Due to the increasing workload, more and more digestive endoscopy nurses have WMSDs, but there is still a lack of comprehensive research on the specific factors and patterns of WMSDs in China. Methods: A cross-sectional study was conducted among 400 digestive endoscopy nurses from 35 cities across 10 provinces in China. Data were collected using the Nordic Musculoskeletal Questionnaire (NMQ) and analyzed using multivariable logistic regression and latent class analysis (LCA) to identify associated factors and WMSD occurrence patterns. Results: The overall 12-month prevalence of WMSDs was high (82.5%), particularly in the neck, shoulder, and lower back. Frequent participation in complex endoscopic procedures (adjusted OR range 1.6–1.7) and 6–10 years of work experience (adjusted OR range 1.7–2.5)—rather than daily procedure volume alone—were independently associated with an increased likelihood of WMSDs (p < 0.05). BMI, analyzed using three categories (<24, 24–27.9, ≥28 kg/m²), was not significantly associated with WMSDs in any body region. The LCA revealed three distinct WMSD patterns characterized by multisite pain: a Full-body Pain group (19.0%), a Neck–Shoulder–Lower Back–Upper Back Pain group (42.25%), and a Mild Pain group (38.75%). Conclusions: This study found that digestive endoscopy nurses were at high risk for WMSDs, mainly due to repetitive physical strain and ergonomic challenges. As this was a cross-sectional study, the reported associations should not be interpreted as causal. Ergonomic training, improved workstation design, and workload optimization are important measures to ensure nurses’ health and improve the quality of care. Full article

This study explored the lived experiences of youth workers within formal education settings in South Africa. Utilising a qualitative approach, the study sampled 22 youth workers participating in presidential youth employment initiatives in partnership with the Department of Basic Education. The findings indicate that youth workers play a vital role in promoting social development among young people within formal education settings, a result that aligns with the empowerment theory guiding this research. Specifically, youth workers provide essential psychosocial and mental health support, contributing to holistic youth development. However, their effectiveness is frequently constrained by operational issues, including limited institutional recognition and ambiguous role definitions. Furthermore, a lack of sustainable funding and restricted time allocations for youth work activities remain significant challenges. The study recommends the formal institutionalisation of professional youth work within South African education policy, supported by clear operational frameworks, structured collaboration, and enhanced training to ensure sustainable learner support. Full article

Community pharmacies are increasingly providing health care services like tobacco treatment and disease-related management but need sustainable models for implementation. As several state Medicaid programs reimburse for community health worker (CHW) services, one promising model is to have pharmacy technicians engage with patients as designated CHWs. This qualitative study interviewed staff in seven California pharmacies about their experience with and perspectives on implementing community pharmacy technicians as CHWs. Guided by implementation science frameworks, data were hand-coded and analyzed iteratively using thematic analysis. Relative advantage and compatibility of CHWs was high across all pharmacies. Pharmacy culture aligned with CHW values, and CHW integration helped formalize the work that pharmacy staff were already doing. Challenges included the complexity of billing and obtaining payment for services provided. Despite these barriers, pharmacies successfully integrated and expanded their CHW services, ranging from social service connections to tobacco treatment or disease-related management education. Pharmacy peer networks, health plan champions and patient outcome improvements accelerated diffusion. Community pharmacies provide a trusted setting for delivering both CHW education and extending health care services, but broad implementation will need health plans to improve policy and procedure with guidance specifically for the pharmacy context that helps overcome administrative barriers. Full article

The adversity-activated development reflection tool (AART) has been used therapeutically to capture personal growth arising during adversity. Our mixed-methods study used this tool to assess adversity-activated growth in 854 mental and community healthcare workers during the COVID-19 pandemic. Participants used the tool to describe the positive and negative effects of the COVID-19 pandemic in different life domains (self, family, work, and community). Through an ideal-type analysis of 133 purposively subsampled AARTs, we derived three levels of adversity-activated development (AAD): none, minimal, and deep. Higher levels of AAD were associated with spending more time connecting with friends and family (OR = 1.83, 95% CI 1.23 to 2.75, p < 0.01) and skill development in mental health care (OR = 1.63, 95% CI 1.16 to 2.28, p < 0.01). Deep development was characterised by changes in life priorities, changes in coping, realising strengths and capabilities, and making stronger connections with others. The AART can usefully assess both positive and negative growth, enabling respondents to convey the complexities of their experiences in their own words, whilst allowing the levels of overall self-development to be distilled. Our findings reinforce the value of promoting social connectedness and skill development to facilitate employee growth during collective occupational stress. Full article

The global surge in industrial waste generation has raised substantial concerns regarding occupational exposure to per- and polyfluoroalkyl substances (PFASs) and the associated adverse health effects. However, critical knowledge gaps remain regarding the relationships among size-resolved airborne particulate matter (PM)-bound PFASs, internal exposure, and early-stage health damage. We conducted a panel study at a waste recycling plant in southern China, collecting 15 size-resolved PM samples and 280 repeated first morning void urine samples from 20 workers over 45 consecutive days. Relationship between size-resolved PM-bound PFASs, internal exposure, and oxidative stress biomarkers (OSBs:8-hydroxy-2′-deoxyguanosine (8-OHdG), malondialdehyde (MDA)) were analyzed using linear mixed-effects models. Our results indicate that short-chain PFASs predominated in both matrices. Intraclass correlation coefficients (ICCs) for urinary short-chain PFASs ranged from fair to excellent (ICC > 0.4). Notably, inhalation of PFASs in PM_2.1–10 correlate more strongly with internal exposure than those in PM_2.1. For the first time, we observed suggestive quantitative associations between OSBs and multiple short-chain PFASs in urine. More importantly, 8-OHdG levels were mainly correlated with PFASs in PM_4.7–5.8 and PM_9.0–10, with each unit increase in ln-transformed average daily intake (ADI) associated with a 10.2–12.6% increase in urinary 8-OHdG levels (p < 0.05). Similarly, MDA levels were primarily associated with PFASs bound to PM_5.8–9.0, with each unit increase in ln-transformed ADI corresponding to an 8.0–14.6% increase in MDA (p < 0.05). These findings are exploratory and warrant further confirmation in independent cohorts. Nevertheless, this study highlights the need for more exposure monitoring and health impact assessments regarding PM_2.1–10-bound short-chain PFASs among the occupational population. Full article

The simultaneous presence of multiple pesticide residues in the environment impairs honeybee health and survival. The toxicological interactions could result in additive, synergistic, or antagonistic effects as documented in previous studies. In most cases, the co-exposure produces an amplification of the singular toxicity, resulting in additive or synergistic effects. More rarely, the interaction of active principles leads to antagonistic effects. Previous studies demonstrated that deltamethrin (DMT, a type II pyrethroid) and flupyradifurone (FLU, a butenolide insecticide) produce antagonistic toxicity when co-administered orally to caged Apis mellifera workers, and that dietary supplementation with the bergamot polyphenolic fraction (BPF) independently protects against FLU- and DMT-induced intoxication. The present study investigates the three-way interaction of DMT, FLU, and BPF on honeybees. Survival rate, solution consumption, and abnormal behavior have been recorded over a 72-h exposure period in groups of twenty caged honeybees orally treated with DMT (21.6 mg/L), FLU (50 or 100 mg/L), their binary combinations, or their ternary combinations with BPF (1 mg/kg). Results demonstrate that BPF alone did not differ from control (p > 0.05) at any time point, confirming its safety. Binary combinations of DMT and FLU showed antagonistic survival profiles consistent with our previous report. The addition of BPF to both binary pesticide combinations significantly improved survival (p < 0.001), reduced abnormal behavioral frequencies (p < 0.05), and increased solution intake (p < 0.05) compared to the respective DMT + FLU groups. These results suggest that BPF exerts a protective effect that extends to complex multi-pesticide exposure scenarios. These effects may be associated with antioxidant and detoxification-related pathways, although further biochemical and molecular analyses are required to elucidate the underlying mechanisms. Full article

Occupational health and safety (OHS) malpractices may increase the risk of occupational injuries and are a significant public health problem in the iron and steel industries, often leading to disability and death. Information on OHS practices related to occupational injuries in the iron and steel industries is limited in many countries. This study aimed to assess OHS practices in relation to occupational injuries among workers in the iron and steel industries in Tanzania. A cross-sectional study was conducted among 321 production line workers. Data were collected through interviews, using a structured OHS questionnaire and the modified International Labour Organization (ILO) injury assessment tool. A total of 209 workers had experienced an occupational injury in the past year. According to univariate regression analyses, the safety practice variables ‘safety inspections’ and ‘use of personal protective equipment’ were significantly associated with occupational injury. However, after adjusting for sociodemographic and organizational factors, including years of work experience, work section, daily working hours, and shift work, these associations were no longer statistically significant. Working in the rolling mill, having less than four years of work experience, working more than 10 h per day, and performing shift work were significant predictors of occupational injuries. These factors attenuated the associations between safety practices and occupational injuries. The severity of injuries was found to be related to the accessibility of PPE. The findings suggest that work experience and organizational characteristics play a critical role in shaping occupational injury risk, highlighting the need for multifaceted interventions that integrate effective safety practices, work experience and organizational measures to improve worker safety in Tanzania’s iron and steel industry. Full article

Climate change is increasing the frequency, intensity, and duration of heatwaves, making extreme heat a recurrent public health challenge with important nutritional implications. High ambient temperatures affect human health through thermoregulatory strain, sweating, dehydration, electrolyte imbalance, cardiovascular and renal stress, impaired cognitive and physical performance, and exacerbation of chronic diseases. Diet and hydration may therefore represent modifiable, although still underinvestigated, components of heat-health prevention. This narrative review synthesizes evidence on hydration, electrolyte balance, meal composition, dietary quality, vulnerable populations, Mediterranean dietary patterns, seasonality, environmental sustainability, and public health strategies for reducing heat-related health risks. Evidence from climate-health research, physiology, nutrition science, occupational and sports medicine, geriatrics, pediatrics, and public health guidance was integrated. Particular attention was given to distinguishing direct heat-health evidence from recommendations based on indirect evidence, physiological plausibility, or expert consensus. Regular water intake, water-rich foods, avoidance of alcohol, moderation of sugar-sweetened beverages, and individualized electrolyte replacement during prolonged or intense sweating are supported by physiological rationale and public health guidance, although direct heatwave-specific intervention studies remain limited. Dietary recommendations should prioritize smaller, digestible, nutrient-dense meals that preserve nutritional adequacy while reducing unnecessary digestive and metabolic burden. However, evidence on meal size, macronutrient composition, and heat-related outcomes remains largely indirect. Vulnerable groups, including older adults, children, pregnant women, individuals with chronic diseases, outdoor workers, athletes, and socioeconomically disadvantaged populations, require tailored strategies. The Mediterranean diet may provide a useful regional model because it emphasizes seasonal plant foods, fruits and vegetables with high water content, legumes, whole grains, olive oil, culinary simplicity, and environmental sustainability; however, its specific role in heat adaptation requires further study. Integrating nutrition and hydration into heat-health action plans may improve preparedness and support climate-resilient food systems. Future studies should evaluate hydration protocols, meal patterns, Mediterranean diet adherence, biomarkers of nutritional heat resilience, and nutrition-sensitive interventions in real-world heat exposure settings. Full article

Collective intergenerational trauma is a complex phenomenon affecting descendants and families exposed to the enduring effects of collective traumatic events, such as forced displacement, genocide and war. This systematic review aimed to explore the mechanisms through which collective trauma is transmitted across generations, examine its consequences for children and families, and critically analyse interventions employed by health professionals and social workers. A systematic review was conducted using ScienceDirect, Wiley Online Library and PubMed. Studies published between 2016 and 2026 were screened for eligibility, resulting in the inclusion of 22 studies. The indexing terms “collective intergenerational trauma”, “collective transgenerational trauma”, “trauma transmission”, “transmission mechanisms”, “consequences”, “intergenerational trauma interventions”, “Social Care”, and “Health Professionals”, were used, along with the Boolean operators AND and OR. The included studies were synthesised using thematic analysis. The findings indicate that collective intergenerational trauma is transmitted through interacting family, communicative, sociocultural and biological mechanisms. Its consequences include psychological and psychosocial difficulties among descendants, disruptions in family relationships and adverse effects on family functioning. Existing interventions primarily focus on individual trauma, with limited attention to its collective and intergenerational dimensions. The findings highlight the need for culturally responsive, trauma-informed and family-centred interventions addressing collective intergenerational trauma within a systemic framework. Health professionals and social workers can play an important role in promoting mental health, strengthening resilience, mitigating the long-term effects of trauma and supporting affected children, families and communities. Full article

Healthcare systems face increasing pressure from demographic, technological, and organizational changes that intensify psychosocial risks and threaten both healthcare workers’ well-being and patient safety. This study investigates whether burnout mediates the relationship between psychosocial risk factors and patient safety culture in healthcare settings. A cross-sectional study was conducted with 220 Portuguese healthcare workers using three validated instruments: the Psychosocial Risks Scale (INSAT_ERPS), the Burnout Assessment Tool (BAT-23), and the Hospital Survey on Patient Safety Culture (HSOPSC). Descriptive statistics, Pearson correlations, and mediation analyses were performed using SPSS (version 31.0) and the PROCESS (version 5) macro. Results showed a moderately strong positive association between psychosocial risks and burnout, and a significant negative association between burnout and patient safety culture. Psychosocial risks were not directly associated with patient safety culture. However, burnout indirectly mediated this relationship, indicating that adverse working conditions impair safety perceptions through their impact on psychological strain. These findings highlight burnout as a significant key mediator linking unsustainable working conditions to unsafe care, showing the relevance of the psychosocial environment. Targeted interventions to reduce psychosocial risks are thus fundamental to improving patient safety culture and promoting the sustainable functioning of healthcare systems. Full article

Indoor-air research has largely examined infection, microbial ecology, immune effects and antimicrobial resistance separately, leaving the pathway from indoor biological sources to chronic respiratory outcomes insufficiently integrated. This narrative review synthesises evidence on indoor airborne pathogens and non-viable microbial components as health-relevant biological exposures beyond acute infection. Literature published between 2000 and February 2026 was reviewed from PubMed, Scopus and Web of Science, supplemented by guidance from WHO, ECDC, US EPA and ASHRAE. Viable microorganisms and non-viable components, including endotoxin, β-(1→3)-glucans, microbial DNA and extracellular vesicles, engage epithelial pattern-recognition pathways and promote inflammatory signalling. Findings included 6.5% higher TNF-α and 5% higher IL-8 per log-unit increase in fungal-spore exposure among sawmill workers; uncontrolled asthma in 45% of moisture- or mould-exposed versus 33% of non-exposed children; airborne resistance-gene and mobile-element loads of 0.55–479.44 copies/m³ in hospital departments; and a 32.8% reduction in viral diversity, but no significant reduction in high viral exposure, following classroom HEPA filtration. These findings support biological plausibility but reveal a fragmented evidence base dominated by observational studies, heterogeneous sampling and limited longitudinal exposure–response data. Indoor bioaerosols should be considered continuous exposures within the exposome, requiring research and regulation across microbiology, environmental engineering, medicine and public health. Full article

Background/Objectives: Empowerment strategies promoting healthy behaviors are important for preventing chronic diseases and cancer, while individual health responsibility (IHR) plays a significant role. Although widely discussed in the literature, the concept of IHR does not have clearly defined domains or a validated instrument for assessment. Its overlap with locus of control theory, self-motivation, and personality type creates further difficulties. Meanwhile, perception of one’s own responsibility for health is an intuitive, simple item to answer, reflecting a person’s belief related to this topic. Moreover, for ethical reasons, this concept cannot be separated from personal beliefs and should not be adjusted according to strict scales and externally imposed definitions. Therefore, this study aimed to: (1) explore whether there is an association between self-perception of IHR and preventive/risk-taking behaviors; and (2) examine socio-demographic factors associated with the IHR score and three self-perceived characteristics, namely self-perceived locus of control, health literacy, and health status. Methods: A cross-sectional study with 968 healthcare workers was conducted in a large, multidisciplinary hospital covering several behaviors (smoking, alcohol consumption, diet, and participation in a screening program for hepatitis C). IHR was evaluated on a scale from 1 to 10, where 1 meant “to very little extent” and 10 meant “to a great extent”. Results: The average IHR score was 8.80 (SD = 1.88). In the univariate analysis, the IHR score was significantly related to gender, age, education, marital status, and all three personal characteristics. In the multivariate analysis, the socio-demographic associations lost statistical significance. IHR maintained its association with the healthy diet score in the multivariable model (B = 0.113, p = 0.036). In the unadjusted analyses, the distribution of IHR differed between participants who declared alcohol consumption and those who declared abstinence (χ² = 17.157, p = 0.002). However, this association was not retained in the multivariable model. Self-perceived internal locus of control was negatively associated with screening acceptance, but not with IHR. The OR of 0.927 refers to a one-point increase on the 1–10 scale. Across the full observed scale range, this corresponds to an OR of 0.51 (95% CI: 0.29–0.89), indicating lower odds of screening acceptance among participants with higher perceived internal control. Because this estimate assumes linearity across the entire scale, it should be interpreted cautiously. Conclusions: The gap between perceived responsibility and actual behavior suggests that IHR messaging alone is unlikely to be sufficient. Future research should consider social desirability and external locus of control when analyzing IHR and health behaviors. Full article

Non-communicable diseases (NCDs) represent a growing challenge for developing countries, as they are among the leading causes of morbidity and mortality within the working-age population. Beyond their effects on health outcomes, NCDs are associated with reductions in labor productivity, which may influence long-term development dynamics through human capital. This study estimates the conditional labor productivity penalty associated with Non-Communicable Diseases (NCDs) among employed workers in Mexico using an observational high-dimensional framework. By addressing high-dimensional confounding under the Conditional Independence Assumption (CIA), the analysis isolates the relationship between NCD status and hourly labor earnings. Using microdata from the Mexican National Survey of Household Income and Expenditure, labor productivity is defined as the ratio of labor income to hours worked. To obtain robust causal estimates, a Double Machine Learning (DML) framework is implemented, integrating regularized regression and machine learning algorithms to control for high-dimensional confounding factors. These covariates include socioeconomic, demographic, and health-related variables, allowing for flexible adjustment of observable heterogeneity across individuals. The empirical findings demonstrate a statistically significant conditional negative penalty of −11.44% (p = 1.03 × 10⁻¹¹, 95% CI: [−14.59, −8.40]) on hourly labor earnings under the cross-fitted DML specification using XGBoost and Random Forest. To resolve an observational measurement artifact where chronic individuals report artificially inflated hourly wages due to severe hours contraction, a presenteeism adjustment factor ($\theta *=0.8125$) was calibrated. Incorporating this presenteeism correction, the aggregate national economic burden among the employed population is estimated at approximately 496.82 billion pesos annually. The findings suggest that NCDs constitute a relevant constraint on labor productivity at the microeconomic level. The study highlights the importance of prevention-oriented health strategies, workplace health promotion, and early disease management. From a methodological perspective, the results illustrate the usefulness of Double Machine Learning for purging high-dimensional confounding in cross-sectional survey data, providing robust conditional empirical benchmarks for public health policy. Full article

Burnout and psychological distress among healthcare workers (HCWs) have become a major workforce challenge, raising an important question: should responsibility for worker wellbeing rest primarily with individuals or with the organization of work itself? This systematic review evaluated workplace mental health programs for HCWs, comparing individual-level psychological interventions with organizational-level approaches. Following PRISMA 2020 guidelines, 54 studies (2016–2026) from more than 18 countries were identified from approximately 7144 records through a PubMed/MEDLINE search. The included studies comprised 29 individually randomized controlled trials (RCTs), 11 cluster-randomized or stepped-wedge trials, and 14 additional non-randomized or contextual studies. ROBINS-I was applied only to the five eligible non-randomized intervention studies—the remaining non-randomized studies contributed contextual evidence and were not included in the ROBINS-I assessment. Here, 41 studies contributed effectiveness evidence, of which 34 (83%) reported a statistically significant improvement in at least 1 primary or key outcome, while 13 studies provided contextual, feasibility, or implementation evidence. Individual-level interventions dominated the evidence base (39/54; 72%). In contrast, organizational interventions were less frequently evaluated, rarely randomized, and showed mixed findings. Observational studies consistently identified workload, organizational trust, and other structural stressors as factors associated with burnout, although causal inferences remain limited. Risk of bias was substantial, with only 7 of 40 randomized trials (17.5%) rated as low risk. All five non-randomized intervention studies assessed using ROBINS-I were judged to have serious risk of bias. Overall, individual-level interventions were evaluated more frequently than organizational interventions and generally reported improvements in mental health outcomes. However, the evidence base was limited by the single-database search, variability in study quality, and methodological limitations. Further well-designed and adequately powered studies, particularly of organizational interventions, are needed to strengthen the evidence base. Full article

The present study evaluated the association between morning serum cortisol levels and burnout syndrome among healthcare workers in the department of Boyacá, Colombia. An observational, analytical, cross-sectional, and quantitative study was conducted on 69 employees. Total serum cortisol was measured via chemiluminescence in fasting morning samples (reference: 110–692 nmol/L). Burnout was assessed using the Maslach Burnout Inventory–General Survey (MBI-GS). A total of 96.6% of participants fell within the normal range for serum cortisol. MBI-GS dimensions reported mean scores of: exhaustion 1.54 ± 1.17, cynicism 0.93 ± 0.89, and professional efficacy 5.60 ± 0.60. High exhaustion prevalence was 16.9%, high cynicism 6.8%, and low efficacy 3.4%. Profile classification showed 67.8% “engaged,” 13.6% “overextended/worn-out,” and 5.1% with “burnout.” No significant association was found between cortisol and burnout dimensions: exhaustion (r = 0.069, p = 0.605), cynicism (r = −0.135, p = 0.309), and professional efficacy (r = 0.044, p = 0.742). Mean cortisol comparisons between high and low dimension groups showed no statistically significant differences (p > 0.05). The study documented a low prevalence of established burnout and an absence of significant association between morning serum cortisol and MBI-GS dimensions, suggesting a relatively healthy work environment; however, the prevalence of high emotional exhaustion warrants preventive interventions. Multilevel organizational strategies like workload management, job stability, role clarity, and psychosocial support are recommended for worker mental health protection. Full article