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The International Journal of Behavioral... Apr 2024Physical activity has benefits for the cardiovascular system, however, what levels and types of activity provide optimal cardiovascular health is unclear. We aimed to... (Meta-Analysis)
Meta-Analysis Review
Leisure-time and occupational physical activity and risk of cardiovascular disease incidence: a systematic-review and dose-response meta-analysis of prospective cohort studies.
BACKGROUND AND OBJECTIVE
Physical activity has benefits for the cardiovascular system, however, what levels and types of activity provide optimal cardiovascular health is unclear. We aimed to determine the level of physical activity that has the most benefits against cardiovascular diseases (CVD).
METHODS
PubMed, Scopus, and Web of Science were searched for prospective cohort studies on leisure-time (LTPA) or occupational physical activity (OPA) as the exposure and major types of CVD (total CVD, coronary heart disease [CHD], stroke, and atrial fibrillation [AF]) incidence as the outcome. Risk of bias of studies was evaluated using the ROBINS-I tool. Summary hazard ratios (HR) were calculated using random-effects pairwise model.
RESULTS
A total of 103 studies were included in the analysis. The highest versus the lowest LTPA was associated with a lower risk of overall CVD (HR = 0.81; 95% CI: 0.77-0.86), CHD (HR = 0.83; 0.79-0.88), and stroke (HR = 0.83; 0.79-0.88), but not AF (HR = 0.98; 0.92-1.05). Linear dose-response analyses showed a 10%, 12%, 9%, and 8% risk reduction in CVD, CHD, stroke, and AF incidence, respectively, for every 20 MET-hours/week increase in LTPA. In nonlinear dose-response analyses, there were inverse associations up to 20 MET-hours/week with 19% and 20% reduction in CVD and CHD risk, and up to 25 MET-hours/week with 22% reduction in stroke, with no further risk reduction at higher LTPA levels. For AF, there was a U-shaped nonlinear association with the maximum 8% risk reduction at 10 MET-hours/week of LTPA. Higher levels of OPA were not associated with risk of CVD, CHD, stroke, or AF.
CONCLUSIONS
Overall, results showed an inverse dose-response relationship between LTPA and risk of CVD, CHD, stroke, and AF. Running was the most beneficial LTPA but the risk was similar among various LTPA intensities. OPA showed no benefits in total or any type of CVD.
Topics: Humans; Leisure Activities; Cardiovascular Diseases; Exercise; Incidence; Prospective Studies; Risk Factors
PubMed: 38659024
DOI: 10.1186/s12966-024-01593-8 -
Environment International May 2024Potential effect of greenspace exposure on human microbiota have been explored by a number of observational and interventional studies, but the results remained mixed....
BACKGROUND
Potential effect of greenspace exposure on human microbiota have been explored by a number of observational and interventional studies, but the results remained mixed. We comprehensively synthesized these studies by performing a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
METHODS
Comprehensive literature searches in three international databases (PubMed, Embase, and Web of Science) and three Chinese databases (China National Knowledge Infrastructure, Wanfang, and China Biology Medicine disc) were conducted from inception to November 1, 2023. Observational and interventional studies that evaluated associations between greenspace exposure and human microbiota at different anatomical sites were included. Studies were assessed using the National Toxicology Program's office of Health Assessment and Translation risk of bias tool and certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation framework. Two authors independently performed study selection, data extraction, and risk of bias assessment, and evidence grading. Study results were synthesized descriptively.
RESULTS
Twenty studies, including 11 observational studies and 9 interventional studies, were finally included into the systematic review. The microbiota of the included studies was from gut (n = 13), skin (n = 10), oral cavity (n = 5), nasal cavity (n = 5) and eyes (n = 1). The majority of studies reported the associations of greenspace exposure with increased diversity (e.g., richness and Shannon index) and/or altered overall composition of human gut (n = 12) and skin microbiota (n = 8), with increases in the relative abundance of probiotics (e.g., Ruminococcaceae) and decreases in the relative abundance of pathogens (e.g., Streptococcus and Escherichia/Shigella). Due to limited number of studies, evidence concerning greenspace and oral, nasal, and ocular microbiota were still inconclusive.
CONCLUSION
The current evidence suggests that greenspace exposure may diversify gut and skin microbiota and alter their composition to healthier profiles. These findings would be helpful in uncovering the potential mechanisms underlying greenspace and human health and in promoting a healthier profile of human microbiota.
Topics: Humans; Microbiota; Environmental Exposure
PubMed: 38653130
DOI: 10.1016/j.envint.2024.108662 -
Applied Ergonomics Jul 2024This review is an update of a previous systematic review and assesses the evidence for the association of work-related physical and psychosocial risk factors and...
This review is an update of a previous systematic review and assesses the evidence for the association of work-related physical and psychosocial risk factors and specific disorders of the shoulders. Medline, Embase, Web of Science Core Collection, Cochrane Central and PsycINFO were searched and study eligibility and risk of bias assessment was performed by two independent reviewers. A total of 14 new articles were added with the majority focusing on rotator cuff syndrome (RCS) with seven studies. Nine articles reported psychosocial exposures in addition to physical exposures. The strongest evidence was found for the association between elevation, repetition, force and vibration and the occurrence of SIS and tendinosis/tendonitis. Evidence also suggests that psychosocial exposures are associated with the occurrence of RCS and tendinosis/tendonitis. Other findings were inconsistent which prevents drawing strong conclusions.
Topics: Humans; Occupational Diseases; Occupational Exposure; Risk Factors; Rotator Cuff Injuries; Vibration; Tendinopathy; Shoulder Pain
PubMed: 38579494
DOI: 10.1016/j.apergo.2024.104277 -
Applied Ergonomics Jul 2024Whole-body vibration (WBV) is prevalent in labour-related activities and can have adverse effects on the health and performance of the individuals exposed. However,...
Whole-body vibration (WBV) is prevalent in labour-related activities and can have adverse effects on the health and performance of the individuals exposed. However, evidence regarding the extent to which human functionality is affected following occupational WBV exposure has not been collated. The current systematic review sought to synthesize existing literature and assess the strength and direction of evidence regarding the acute after-effects of occupational WBV exposure on cognition, visual function, postural stability, and motor control. We conducted a comprehensive search of AMED, CINAHL, MEDLINE, PubMED, Psychology and Behavioural Sciences Collection, SPORTDiscus, APA PsychInfo, Cochrane Library, EMBASE, HMIC, Global Health, ProQuest Central, Scopus, Web of Science, and the US National Technical Information Service on April 26, 2023. Studies that quantified vibration exposure and measured acute changes in cognition, visual function, postural stability, and motor control from baseline to post-vibration were considered without date restriction. Out of the 2663 studies identified, 32 were eligible for inclusion. Based on the Risk of Bias in Non-Randomized Studies of Exposure (ROBINS-E) tool, the studies demonstrated low (66%), moderate (25%) and high risk of bias (9%). The findings indicate that after exposure to WBV, postural stability either deteriorates or remains unchanged. Inconsistent effects of WBV on cognition were reported, while visual function and motor control showed no pronounced changes following WBV. This might be attributed to assessment limitations such as learning effects in neuropsychological and motor tasks, and non-functional measures of vision employed. There was a lack of consistency in the characterization of vibration exposure and the assessment of associated effects on functional performance. Current evidence is therefore insufficient to provide definitive guidance for updating occupational health and safety regulations regarding WBV. However, this review highlights the potential for WBV to jeopardize post-exposure human performance and, consequently, safety. The completion of the review was supported by a UKRI EPSRC training grant. The review has been registered on PROSPERO (ref CRD42023391075).
Topics: Humans; Cognition; Occupational Exposure; Postural Balance; Vibration; Vision, Ocular
PubMed: 38565009
DOI: 10.1016/j.apergo.2024.104264 -
Ecotoxicology and Environmental Safety Apr 2024Although the association between changes in human telomere length (TL) and ambient fine particulate matter (PM) has been documented, there remains disagreement among the... (Meta-Analysis)
Meta-Analysis Review
Although the association between changes in human telomere length (TL) and ambient fine particulate matter (PM) has been documented, there remains disagreement among the related literature. Our study conducted a systematic review and meta-analysis of epidemiological studies to investigate the health effects of outdoor PM exposure on human TL after a thorough database search. To quantify the overall effect estimates of TL changes associated with every 10 μg/m increase in PM exposure, we focused on two main topics, which were outdoor long-term exposure and prenatal exposure of PM. Additionally, we included a summary of short-term PM exposure and its impact on TL due to limited data availability. Our qualitative analysis included 20 studies with 483,600 participants. The meta-analysis showed a statistically significant association between outdoor PM exposure and shorter human TL, with pooled impact estimates (β) of -0.12 (95% CI: -0.20, -0.03, I= 95.4%) for general long-term exposure and -0.07 (95% CI: -0.15, 0.00, I= 74.3%) for prenatal exposure. In conclusion, our findings suggest that outdoor PM exposure may contribute to TL shortening, and noteworthy associations were observed in specific subgroups, suggesting the impact of various research variables. Larger, high-quality studies using standardized methodologies are necessary to strengthen these conclusions further.
Topics: Female; Pregnancy; Humans; Particulate Matter; Air Pollution; Prenatal Exposure Delayed Effects; Telomere Shortening; Telomere; Air Pollutants; Environmental Exposure
PubMed: 38518608
DOI: 10.1016/j.ecoenv.2024.116206 -
Environment International Mar 2024The World Health Organization is coordinating an international project aimed at systematically reviewing the evidence regarding the association between radiofrequency... (Meta-Analysis)
Meta-Analysis
Effects of radiofrequency electromagnetic field (RF-EMF) exposure on male fertility: A systematic review of experimental studies on non-human mammals and human sperm in vitro.
BACKGROUND
The World Health Organization is coordinating an international project aimed at systematically reviewing the evidence regarding the association between radiofrequency electromagnetic field (RF-EMF) exposure and adverse health effects. Reproductive health outcomes have been identified among the priority topics to be addressed.
OBJECTIVES
To evaluate the effect of RF-EMF exposure on male fertility of experimental mammals and on human sperm exposed in vitro.
METHODS
Three electronic databases (PubMed, Scopus and EMF Portal) were last searched on September 17, 2022. Two independent reviewers screened the studies, which were considered eligible if met the following criteria: 1) Peer-reviewed publications of sham controlled experimental studies, 2) Non-human male mammals exposed at any stage of development or human sperm exposed in vitro, 3) RF-EMF exposure within the frequency range of 100 kHz-300 GHz, including electromagnetic pulses (EMP), 4) one of the following indicators of reproductive system impairment:Two reviewers extracted study characteristics and outcome data. We assessed risk of bias (RoB) using the Office of Health Assessment and Translation (OHAT) guidelines. We categorized studies into 3 levels of overall RoB: low, some or high concern. We pooled study results in a random effects meta-analysis comparing average exposure to no-exposure and in a dose-response meta-analysis using all exposure doses. For experimental animal studies, we conducted subgroup analyses for species, Specific Absorption Rate (SAR) and temperature increase. We grouped studies on human sperm exposed in vitro by the fertility status of sample donors and SAR. We assessed the certainty of the evidence using the GRADE approach after excluding studies that were rated as "high concern" for RoB.
RESULTS
One-hundred and seventeen papers on animal studies and 10 papers on human sperm exposed in vitro were included in this review. Only few studies were rated as "low concern" because most studies were at RoB for exposure and/or outcome assessment. Subgrouping the experimental animal studies by species, SAR, and temperature increase partly accounted for the heterogeneity of individual studies in about one third of the meta-analyses. In no case was it possible to conduct a subgroup analysis of the few human sperm in vitro studies because there were always 1 or more groups including less than 3 studies. Among all the considered endpoints, the meta-analyses of animal studies provided evidence of adverse effects of RF-EMF exposure in all cases but the rate of infertile males and the size of the sired litters. The assessment of certainty according to the GRADE methodology assigned a moderate certainty to the reduction of pregnancy rate and to the evidence of no-effect on litter size, a low certainty to the reduction of sperm count, and a very low certainty to all the other meta-analysis results. Studies on human sperm exposed in vitro indicated a small detrimental effect of RF-EMF exposure on vitality and no-effect on DNA/chromatin alterations. According to GRADE, a very low certainty was attributed to these results. The few studies that used EMP exposure did not show effects on the outcomes. A low to very low certainty was attributed to these results.
DISCUSSION
Many of the studies examined suffered of severe limitations that led to the attribution of uncertainty to the results of the meta-analyses and did not allow to draw firm conclusions on most of the endpoints. Nevertheless, the associations between RF-EMF exposure and decrease of pregnancy rate and sperm count, to which moderate and low certainty were attributed, are not negligible, also in view of the indications that in Western countries human male fertility potential seems to be progressively declining. It was beyond the scope of our systematic review to determine the shape of the dose-response relationship or to identify a minimum effective exposure level. The subgroup and the dose-response fitting analyses did not show a consistent relationship between the exposure levels and the observed effects. Notably, most studies evaluated RF-EMF exposure levels that were higher than the levels to which human populations are typically exposed, and the limits set in international guidelines. For these reasons we cannot provide suggestions to confirm or reconsider current human exposure limits. Considering the outcomes of this systematic review and taking into account the limitations found in several of the studies, we suggest that further investigations with better characterization of exposure and dosimetry including several exposure levels and blinded outcome assessment were conducted.
PROTOCOL REGISTRATION
Protocols for the systematic reviews of animal studies and of human sperm in vitro studies were published in Pacchierotti et al., 2021. The former was also registered in PROSPERO (CRD42021227729 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID = 227729) and the latter in Open Science Framework (OSF Registration DOI https://doi.org/10.17605/OSF.IO/7MUS3).
Topics: Animals; Humans; Male; Electromagnetic Fields; Mammals; Radio Waves; Reproduction; Semen; Infertility, Male
PubMed: 38492496
DOI: 10.1016/j.envint.2024.108509 -
Radiation Protection Dosimetry Apr 2024This study reviews recent research on Radiofrequency Electromagnetic Field (RF-EMF) exposure in confined environments, focusing on methodologies and parameters. Studies... (Review)
Review
This study reviews recent research on Radiofrequency Electromagnetic Field (RF-EMF) exposure in confined environments, focusing on methodologies and parameters. Studies typically evaluate RF-EMF exposure using an electric field and specific absorption rate but fail to consider temperature rise in the tissues in confined environments. The study highlights the investigation of RF-EMF exposure in subterranean environments such as subways, tunnels and mines. Future research should evaluate the exposure of communication devices in such environments, considering the surrounding environment. Such studies will aid in understanding the risks and developing effective mitigation strategies to protect workers and the general public.
Topics: Electromagnetic Fields; Humans; Radio Waves; Environmental Exposure; Radiation Monitoring; Occupational Exposure
PubMed: 38491820
DOI: 10.1093/rpd/ncae045 -
Scandinavian Journal of Work,... May 2024The aim was to conduct a systematic review and meta-analysis investigating the association between occupational mechanical exposures and hip osteoarthritis. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
The aim was to conduct a systematic review and meta-analysis investigating the association between occupational mechanical exposures and hip osteoarthritis.
METHODS
The study was registered in PROSPERO. A systematic literature search was conducted in six databases to identify relevant articles. Two authors independently excluded articles, extracted data, assessed the risk of bias of each included article, and graded the level of evidence. We conducted a meta-analysis using random-effects model and performed a sensitivity analysis stratifying articles based on the risk of bias assessment, study design, and the outcome measurement.
RESULTS
Twenty-four articles were eligible for inclusion. The highest pooled odds ratio (OR) was found for combined mechanical exposures [OR 1.7, 95% confidence interval (CI) 1.4-2.0], non-neutral postures (OR 1.7, 95% CI 1.4-2.1), lifting/carrying loads (OR 1.6, 95% CI 1.3-1.9), and climbing stairs (OR 1.6, 95% CI 1.1-2.2). The range of pooled OR for the remaining mechanical exposures (eg, standing, walking, kneeling, squatting, and sitting) was 0.6-1.6. Grading the quality of evidence, a moderate level of evidence was found for the combined mechanical exposures and for lifting/carrying loads. The remaining exposure categories were graded as having either low or very low levels of evidence.
CONCLUSIONS
Considerable heterogeneity was observed across the included studies, and high-quality literature using objective exposure measurements is warranted. Despite various limitations affecting the comparability, occupational mechanical exposures seem to influence the likelihood of developing hip osteoarthritis.
Topics: Humans; Osteoarthritis, Hip; Occupational Exposure; Posture; Occupational Diseases; Lifting
PubMed: 38483209
DOI: 10.5271/sjweh.4152 -
Journal of Thermal Biology Feb 2024Cross-adaptation (CA) refers to the successful induction of physiological adaptation under one environmental stressor (e.g., heat), to enable subsequent benefit in... (Meta-Analysis)
Meta-Analysis
Cross-adaptation (CA) refers to the successful induction of physiological adaptation under one environmental stressor (e.g., heat), to enable subsequent benefit in another (e.g., hypoxia). This systematic review and exploratory meta-analysis investigated the effect of heat acclimation (HA) on physiological, perceptual and physical performance outcome measures during rest, and submaximal and maximal intensity exercise in hypoxia. Database searches in Scopus and MEDLINE were performed. Studies were included when they met the Population, Intervention, Comparison, and Outcome criteria, were of English-language, peer-reviewed, full-text original articles, using human participants. Risk of bias and study quality were assessed using the COnsensus based Standards for the selection of health status Measurement INstruments checklist. Nine studies were included, totalling 79 participants (100 % recreationally trained males). The most common method of HA included fixed-intensity exercise comprising 9 ± 3 sessions, 89 ± 24-min in duration and occurred within 39 ± 2 °C and 32 ± 13 % relative humidity. CA induced a moderate, beneficial effect on physiological measures at rest (oxygen saturation: g = 0.60) and during submaximal exercise (heart rate: g = -0.65, core temperature: g = -0.68 and skin temperature: g = -0.72). A small effect was found for ventilation (g = 0.24) and performance measures (peak power: g = 0.32 and time trial time: g = -0.43) during maximal intensity exercise. No effect was observed for perceptual outcome measures. CA may be appropriate for individuals, such as occupational or military workers, whose access to altitude exposure prior to undertaking submaximal activity in hypoxic conditions is restricted. Methodological variances exist within the current literature, and females and well-trained individuals have yet to be investigated. Future research should focus on these cohorts and explore the mechanistic underpinnings of CA.
Topics: Male; Humans; Acclimatization; Adaptation, Physiological; Heat-Shock Response; Exercise; Hypoxia; Heat Stress Disorders
PubMed: 38471285
DOI: 10.1016/j.jtherbio.2024.103793 -
Iranian Journal of Public Health Dec 2023Working in hot environments can cause diseases and reduce performance by upsetting the balance of physiological parameters of workers' bodies. Bakers are among the... (Review)
Review
BACKGROUND
Working in hot environments can cause diseases and reduce performance by upsetting the balance of physiological parameters of workers' bodies. Bakers are among the people exposed to heat stress continuously and daily. This review study aimed to investigate the effect of heat stress on bakers.
METHODS
In this review study, the related articles based on keywords were reviewed using "IranMedex", "Science Direct", "PubMed", "Scopus", "Web of Science", "SID", "Google Scholar", and "Magiran" databases from the years 2000 to 2021. The used search terms were "Heat stress", "Heat strain", "Heat exposure", "Heat waves", "Workplace", "Baker", and "health effects". In order to extract the required data, all parts of the articles have been reviewed.
RESULTS
Out of the 16 studies reviewed in this study, 43.75% were cross-sectional, 25% were descriptive cross-sectional, and 31.25% were performed according to other study designs. In all of the studies, the WBGT index was used to assess ambient heat stress. In most studies, the mean exposure temperature was higher than the WBGT-ACGIH limit, especially among traditional bakery workers. The findings showed that exposure to thermal stress significantly affects some hematological parameters of blood, oxidative stress, heart rate, and body temperature.
CONCLUSION
The situation of heat stress in the bakery environment is worrying in terms of health and reduced productivity of employees. Therefore, it is essential to take the necessary preventive and control measures to reduce heat stress and the resulting strain.
PubMed: 38435770
DOI: 10.18502/ijph.v52i12.14314