-
Current Opinion in Infectious Diseases Aug 2024Timely postexposure prophylaxis is important after an occupational exposure. Here we review select organisms, exposure opportunities in the healthcare setting, and... (Review)
Review
PURPOSE OF REVIEW
Timely postexposure prophylaxis is important after an occupational exposure. Here we review select organisms, exposure opportunities in the healthcare setting, and postexposure prophylaxis regimens.
RECENT FINDINGS
Needlestick injuries pose a risk of exposure to bloodborne pathogens, such as HIV, Hepatitis B, and Hepatitis C. Risk mitigation strategies should be reexamined in light of newer vaccines and therapeutics. Increased vaccine hesitancy and vaccine denialisms may foster the re-emergence of some infections that have become extremely uncommon because of effective vaccines. With increasing occurrences of zoonotic infections and the ease of global spread as evidenced by COVID-19 and mpox, healthcare exposures must also consider risks related to emerging and re-emerging infectious diseases.
SUMMARY
Early recognition and reporting of occupational exposures to pathogens with available postexposure prophylaxis is key to mitigating the risk of transmission. Providers should be able to evaluate the exposure and associated risks to provide prompt and appropriate postexposure prophylaxis.
Topics: Humans; Post-Exposure Prophylaxis; Occupational Exposure; Health Personnel; Needlestick Injuries; Infectious Disease Transmission, Patient-to-Professional; COVID-19
PubMed: 38899948
DOI: 10.1097/QCO.0000000000001029 -
Kidney International Reports Jun 2024Men are vulnerable to ambient heat-related kidney disease burden; however, limited evidence exists on how vulnerable women are when exposed to high ambient heat. We...
INTRODUCTION
Men are vulnerable to ambient heat-related kidney disease burden; however, limited evidence exists on how vulnerable women are when exposed to high ambient heat. We evaluated the sex-specific association between ambient temperature and urine electrolytes, and 24-hour urine total protein, and volume.
METHODS
We pooled a longitudinal 5624 person-visits data of 1175 participants' concentration and 24-hour excretion of urine electrolytes and other biomarkers (24-hour urine total protein and volume) from southwest coastal Bangladesh (Khulna, Satkhira, and Mongla districts) during November 2016 to April 2017. We then spatiotemporally linked ambient temperature data from local weather stations to participants' health outcomes. For evaluating the relationships between average ambient temperature and urine electrolytes and other biomarkers, we plotted confounder-adjusted restricted cubic spline (RCS) plots using participant-level, household-level, and community-level random intercepts. We then used piece-wise linear mixed-effects models for different ambient temperature segments determined by inflection points in RCS plots and reported the maximum likelihood estimates and cluster robust standard errors. By applying interaction terms for sex and ambient temperature, we determined the overall significance using the Wald test. Bonferroni correction was used for multiple comparisons.
RESULTS
The RCS plots demonstrated nonlinear associations between ambient heat and urine biomarkers for males and females. Piecewise linear mixed-effects models suggested that sex did not modify the relationship of ambient temperature with any of the urine parameters after Bonferroni correction ( < 0.004).
CONCLUSION
Our findings suggest that women are as susceptible to the effects of high ambient temperature exposure as men.
PubMed: 38899224
DOI: 10.1016/j.ekir.2024.03.002 -
Journal of Global Health Jun 2024There is increasing evidence on the link between environmental factors and myopia in children and adolescents, yet with inconsistent conclusions. We investigated the...
BACKGROUND
There is increasing evidence on the link between environmental factors and myopia in children and adolescents, yet with inconsistent conclusions. We investigated the associations between socioeconomic inequalities and green space with myopia in school-aged students participating in the Tianjin Child and Adolescent Research of Eye (TCARE) study.
METHODS
We obtained data from a population-based dynamic cohort study conducted in Tianjin, China, in 2021 and followed up in 2022. We included 1 245 271 participants from 16 districts with an average age of 11.6 years (standard deviation = 3.3) in our analysis. We synthesized their area-level SES through a prediction model that combined economic, educational, and health care variables and assessed the greenness levels surrounding the school using the Normalized Difference Vegetation Index (NDVI) based on data obtained through satellite remote sensing. We performed generalised linear mixed effects analyses for each myopia outcome separately, with adjustments for students' sex, years of education completed, and the school's geographical location.
RESULTS
We observed that students living in low SES areas had the highest prevalence of myopia (60.7%) in the last screening in 2022, as well as a higher incidence of one-year myopia (26.4%) compared to those residing in middle SES areas (22.7%). With a 0.1 increase in the 250, 500, and 1000 m buffer NDVI, the prevalence of myopia dropped by 6.3% (odds ratio (OR) = 0.937; 95% confidence interval (CI) = 0.915, 0.960), 7.7% (OR = 0.923; 95% CI = 0.900, 0.946), and 8.7% (OR = 0.913; 95% CI = 0.889, 0.937), respectively. The interaction analysis showed that low SES and low greenness exacerbate the prevalence of myopia. Findings from longitudinal analyses consistently demonstrated a correlation between higher values of NDVI and a slower progression of myopia. These findings remained robust across sensitivity analyses, including for variables on parental myopia and students' behaviors.
CONCLUSIONS
Exposure to green spaces could play a crucial role in slowing the progression of myopia among school-aged students. Myopia control policies should prioritise young populations residing in low SES areas with limited access to green spaces, as they face the highest potential risks.
Topics: Humans; Myopia; Female; Male; China; Child; Adolescent; Cohort Studies; Students; Socioeconomic Factors; Prevalence; Parks, Recreational; Socioeconomic Disparities in Health; East Asian People
PubMed: 38898796
DOI: 10.7189/jogh.14.04140 -
BMC Public Health Jun 2024The world health organization's global health observatory defines maternal mortality as annual number of female deaths, regardless of the period or location of the...
BACKGROUND
The world health organization's global health observatory defines maternal mortality as annual number of female deaths, regardless of the period or location of the pregnancy, from any cause related to or caused by pregnancy or its management (aside from accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy and an estimated 287 000 women worldwide passed away from maternal causes between 2016 and 2020, that works out to be about 800 deaths per day or about one every two minutes.
METHOD
The most recent 2018-2023 DHS data set of 14 SSA countries was used a total of 89,489 weighted mothers who gave at list one live birth 3 years preceding the survey were included, a multilevel analysis was conducted. In the bi-variable analysis variables with p-value ≤ 0.20 were included in the multivariable analysis, and in the multivariable analysis, variables with p-value less than ≤ 0.05 were considered to be significant factors associated with having eight and more ANC visits.
RESULT
The magnitude of having eight and more ANC visits in 14 sub-Saharan African countries was 8.9% (95% CI: 8.76-9.13) ranging from 3.66% (95% CI: 3.54-3.79) in Gabon to 18.92% (95% CI: 18.67-19.17) in Nigeria. The multilevel analysis shows that maternal age (40-44, AOR;2.09, 95%CI: 1.75-2.53), maternal occupational status (AOR;1.14, 95%CI; 1.07-1.22), maternal educational level (secondary and above, AOR;1.26, 95%CI; 1.16-1.38), wealth status(AOR;1.65, 95%CI; 1.50-1.82), media exposure (AOR;1.20, 95%CI; 1.11-1.31), pregnancy intention (AOR;1.12, 95%CI; 1.05-1.20), ever had terminated pregnancy (AOR;1.16 95%CI; 1.07-1.25), timely initiation of first ANC visit (AOR;4.79, 95%CI; 4.49-5.10), empowerment on respondents health care (AOR;1.43, 95%CI; 1.30-1.56), urban place of residence (AOR;1.33, 95%CI; 1.22-1.44) were factors highly influencing the utilization of AN. On the other hand higher birth order (AOR;0.54, 95%CI; 0.53-0.66), not using contraceptive (AOR;0.80, 95%CI; 0.75-0.86) and survey year (AOR;0.47, 95%CI; 0.34-0.65) were factors negatively associated with having eight and more ANC visits.
CONCLUSION
In the 14 SSA included in this study, there is low adherence to WHO guidelines of eight and more ANC visits. Being educated, having jobs, getting access to media being from rural residence and rich wealth group contribute to having eight and more ANC visits, so we highly recommend policy implementers to advocate this practices.
Topics: Humans; Female; Adult; Africa South of the Sahara; Multilevel Analysis; Young Adult; Pregnancy; Prenatal Care; Adolescent; Middle Aged; Mothers
PubMed: 38898450
DOI: 10.1186/s12889-024-19145-x -
BioRxiv : the Preprint Server For... Jun 2024Evidence from in vitro studies and observational human disease data suggest the complement system plays a significant role in SARS-CoV-2 pathogenesis, although how...
Evidence from in vitro studies and observational human disease data suggest the complement system plays a significant role in SARS-CoV-2 pathogenesis, although how complement dysregulation develops in patients with severe COVID-19 is unknown. Here, using a mouse-adapted SARS-CoV-2 virus (SARS2-N501Y) and a mouse model of severe COVID-19, we identify significant serologic and pulmonary complement activation following infection. We observed C3 activation in airway and alveolar epithelia, and in pulmonary vascular endothelia. Our evidence suggests that while the alternative pathway is the primary route of complement activation, components of both the alternative and classical pathways are produced locally by respiratory epithelial cells following infection, and increased in primary cultures of human airway epithelia in response to cytokine exposure. This locally generated complement response appears to precede and subsequently drive lung injury and inflammation. Results from this mouse model recapitulate findings in humans, which suggest sex-specific variance in complement activation, with predilection for increased C3 activity in males, a finding that may correlate with more severe disease. Our findings indicate that complement activation is a defining feature of severe COVID-19 in mice and lay the foundation for further investigation into the role of complement in COVID-19.
PubMed: 38895461
DOI: 10.1101/2024.05.31.596892 -
Cancers May 2024Although rare, sinonasal cancers (SNCs) have a high occupational attributable fraction.
BACKGROUND
Although rare, sinonasal cancers (SNCs) have a high occupational attributable fraction.
METHODS
We applied gender-based approaches to descriptive analyses, incidence, and patterns of exposures using the Italian National Sinonasal Cancer Registry (ReNaTuNS: Registro Nazionale Tumori Naso-Sinusali).
RESULTS
The study included 2851 SNC patients. SNC was diagnosed more often in men (73%) than in women (27%). The most frequent morphology in men was intestinal-type adenocarcinoma (33%), whereas in women, it was squamous cell carcinoma (49%). Nasal cavities were predominant in both genders (50%), ethmoidal sinus in men (24%), and maxillary in women (24%). Incidence rates were 0.76 (per 100,000 person-years) in men and 0.24 in women and increased by age, more evidently in men, peaking over 75 years in both. Occupational exposures to wood and leather dusts were the most frequent (41% for men, 33% for women). Few exposures were extra-occupational or domestic. Unlikely exposure was relevant in women (57%).
CONCLUSIONS
The surveillance of SNC cases through a registry that allows for the identification of and compensation for this occupational disease is important in Italy, where numerous workers are exposed to carcinogens for SNC, without even being aware. Considering the rarity of the disease, particularly among women, the ReNaTuNS can provide a method to analyze gender differences.
PubMed: 38893172
DOI: 10.3390/cancers16112053 -
International Journal of Molecular... May 2024E-cigarette users predominantly also continue to smoke cigarettes. These Dual Users either consume e-cigarettes in locations where smoking is not allowed, but vaping is,...
E-cigarette users predominantly also continue to smoke cigarettes. These Dual Users either consume e-cigarettes in locations where smoking is not allowed, but vaping is, or to reduce their consumption of cigarettes, believing it will lead to harm reduction. Whilst it is known that e-cigarette vapour is chemically less complex than cigarette smoke, it has a distinct chemical profile, and very little is known about the health impacts of exposure to both chemical profiles vs. either alone. We simultaneously exposed cells in vitro to non-toxic levels of e-cigarette vapour extract (EVE) and cigarette smoke extract (CSE) to determine their effects on 16HBE14o- airway epithelial cell metabolism and inflammatory response, as well as immune cell (THP-1 cells and monocyte-derived macrophages (MDM) from healthy volunteers) migration, phagocytosis, and inflammatory response. We observed increased toxicity, reduced metabolism (a marker of proliferation) in airway epithelial cells, and reduced monocyte migration, macrophage phagocytosis, and altered chemokine production after exposure to either CSE or EVE. These cellular responses were greater after dual exposure to CSE and EVE. The airway epithelial cells from smokers showed reduced metabolism after EVE (the Switcher model) and dual CSE and EVE exposure. When EVE and CSE were allowed to interact, the chemicals were found to be altered, and new chemicals were also found compared to the CSE and EVE profiles. Dual exposure to e-cigarette vapour and cigarette smoke led to worse functional outcomes in cells compared to either single exposure alone, adding to limited data that dual use may be more dangerous than smoking only.
Topics: Humans; Macrophages; Monocytes; Electronic Nicotine Delivery Systems; Smoke; Epithelial Cells; E-Cigarette Vapor; Vaping; Phagocytosis; THP-1 Cells; Cell Movement; Smoking; Tobacco Products
PubMed: 38892256
DOI: 10.3390/ijms25116071 -
Healthcare (Basel, Switzerland) May 2024The incidence and mortality of pleural mesothelioma (PM) reflect the production and consumption of asbestos over time. However, despite the current global concern, these...
BACKGROUND
The incidence and mortality of pleural mesothelioma (PM) reflect the production and consumption of asbestos over time. However, despite the current global concern, these data remain to be known.
OBJECTIVE
Our aim was to carry out a descriptive analysis of PM cases and mortality from some Portuguese databases between 2014 and 2020.
METHODS
A retrospective observational study was carried out between 2014 and 2020. Data on the number of PM cases were provided by the Portuguese Cancer Registry, and data on mortality were from the Portuguese Death Certificate Information System.
RESULTS
Between 2014 and 2020, 315 cases of PM were reported, with 222 (70.5%) men. The average age of patients was 72.1, with the highest number of cases in patients aged >70 years (n = 198; 62.9%). The highest number of cases was reported in 2018 (n = 62; 19.7%). Regarding mortality, 169 deaths were reported, with 126 (74.6%) men and mostly in individuals aged >70 years (n = 109; 64.5%). It is estimated that around 520 years of potential life were lost. The highest number of deaths occurred in 2015 (n = 33; 19.5%).
CONCLUSION
It is mandatory to reinforce the need for surveillance programs that allow us to gather real and reliable data and eliminate asbestos-related diseases.
PubMed: 38891178
DOI: 10.3390/healthcare12111103 -
Archives of Public Health = Archives... Jun 2024Tuberculosis (TB) treatment is more challenging for patients with silicosis, as it complicates the diagnosis of both diseases and increases mortality risk. Silicosis, an...
Tuberculosis (TB) treatment is more challenging for patients with silicosis, as it complicates the diagnosis of both diseases and increases mortality risk. Silicosis, an incurable occupational disease, confounds the diagnosis of TB and vice versa, making it more difficult to accurately identify and treat either condition. Moreover, TB appears to accelerate the progression of silicosis. Exposure to silica dust, a common cause of silicosis, can also trigger latent TB to become active TB. This correspondence outlines a proposed framework for implementing collaborative TB-silicosis activities in India, aimed at improving early diagnosis and management for both diseases. An expert panel of medical professionals developed this framework through online consultations in October and November 2022. The panel's goal was to establish a consensus on integrating TB-silicosis activities, with a focus on early detection and proper management. The framework suggests testing all patients with silicosis for active TB and screening workers exposed to silica dust for latent TB infection. It also recommends that patients with TB who have a history of occupational exposure to silica dust should be tested for silicosis. Reliable diagnostic tools, such as chest X-rays, are emphasized, providing guidance on their use for both diseases. The proposed collaborative TB-silicosis framework offers a structured approach to identifying and managing these two diseases, contributing to the global goal of eliminating silicosis by 2030 and aligning with the World Health Organization's targets for reducing TB incidence and mortality. It recommends specific strategies for implementation, including testing, referral systems, and workplace-based interventions. The framework also underscores the need for coordinated efforts among stakeholders, including the ministries of health, labor, industry, and environment. This correspondence provides valuable insights into how India can successfully implement collaborative TB-silicosis activities, serving as a model for other regions with similar challenges.
PubMed: 38890764
DOI: 10.1186/s13690-024-01325-1 -
BMJ Open Jun 2024The occurrence of hand and forearm disorders related to vibration exposure, adjusted for relevant background factors, is scarcely reported. We analysed the prevalence of...
OBJECTIVES
The occurrence of hand and forearm disorders related to vibration exposure, adjusted for relevant background factors, is scarcely reported. We analysed the prevalence of such conditions in a large population cohort, stratified by sex, and associations with exposure to vibrating hand-held tools.
DESIGN
This is a retrospective cohort study.
SETTING
Individuals in the Malmö Diet and Cancer Study cohort (MDCS; inclusion 1991-1996; followed until 2018) were asked, 'does your work involve working with vibrating hand-held tools?' (response: 'not at all', 'some' and 'much'). Data were cross-linked with national registers to identify treatment for carpal tunnel syndrome (CTS), ulnar nerve entrapment (UNE), Dupuytren's disease, trigger finger or first carpometacarpal joint (CMC-1) osteoarthritis (OA). Cox regression models, unadjusted and adjusted (age, sex, prevalent diabetes, smoking, hypertension and alcohol consumption), were performed to analyse the effects of reported vibration exposure.
PARTICIPANTS
Individuals in the MDCS who had answered the questionnaire on vibration exposure (14 342 out of the originally 30 446 individuals in MDCS) were included in the study.
RESULTS
In total, 12 220/14 342 individuals (76%) reported 'no' exposure, 1392/14 342 (9%) 'some' and 730/14 342 (5%) 'much' exposure to vibrating hand-held tools. In men, 'much' exposure was independently associated with CTS (HR 1.71 (95% CI 1.11 to 2.62)) and UNE (HR 2.42 (95% CI 1.15 to 5.07)). 'Some' exposure was independently associated with UNE in men (HR 2.10 (95% CI 1.12 to 3.95)). 'Much' exposure was independently associated with trigger finger in women (HR 2.73 (95% CI 1.49 to 4.99)). We found no effect of vibration exposure on Dupuytren's disease or CMC-1 OA. 'Much' vibration exposure predicted any hand and forearm diagnosis in men (HR 1.44 (95% CI 1.08 to 1.80)), but not in women.
CONCLUSIONS
Vibration exposure by hand-held tools increases the risk of developing CTS and UNE and any common hand and forearm conditions in men, whereas women only risk trigger finger and CMC-1 OA. Adjustment for relevant confounders in vibration exposure is crucial.
Topics: Humans; Male; Female; Retrospective Studies; Sweden; Middle Aged; Vibration; Carpal Tunnel Syndrome; Aged; Occupational Exposure; Occupational Diseases; Trigger Finger Disorder; Dupuytren Contracture; Hand; Prevalence; Risk Factors; Ulnar Nerve Compression Syndromes; Adult; Proportional Hazards Models
PubMed: 38890140
DOI: 10.1136/bmjopen-2023-080777