International Journal of Environmental Research and Public Health

Wood is commonly used in the building sector, emitting volatile organic compounds (VOCs) contributing to indoor air quality. These VOC profiles can have a pleasant smell and positive effects e.g., induce relaxation. Contrarily, VOCs can have adverse health effects in higher concentrations. Therefore, some VOCs are regulated by guide values (GV). Potentially positive and negative effects of pinewood emissions, ranging from 0.2 mg/m3 (German GV I for bicyclic terpenes) to 2.0 mg/m3 (GV II) were investigated in an experimental 2 h exposure study using a within-subject design. Thirty-two healthy participants rated the perception, pleasantness, symptoms of irritation, and indicators of well-being. During a demanding working memory task (n-back) and a resting period, heart rate (HR) and HR variability (HRV) changes were measured. Before and after each session physiological markers of sensory irritation were assessed. Ratings indicated that the exposure to GV I and GV II were not perceived as more intense or pleasant. Mostly concentration-independent effects were revealed, indicating that inter-individual factors influenced the ratings rather than the VOCs. The pinewood odors during the n-back task did not cause distraction nor did it facilitate performance as previously suggested. HR/V changes indicated that pinewood odors during and after the n-back tasks did not induce relaxation. Only symptoms of nasal irritation showed some weak concentration-dependency, not supported by physiological markers or comparable ratings of sensory irritation. In conclusion, the fact that no distinct odor is detected suggests that interfering factors potentially prevent the regulation of odors at relevant indoor air concentrations.

This study investigates excess mortality in Germany in the years from 2020 to 2023 and its temporal alignment with reported COVID-19 deaths. The analysis uses annual and weekly all-cause mortality data and linear baseline trends derived from pre-pandemic years. Possible effects of demographic and population changes on baseline trends were also examined. Excess mortality was analysed over time and across age groups. Excess mortality was observed in all investigated years, rising from 2020 to its highest value in 2022. In absolute terms, the age group [≥]80 years accounted for the largest proportion of excess deaths throughout the study period. After 2021, elevated mortality relative to baseline was also observed in younger age groups down to 15 years of age, although absolute numbers remained substantially lower than in older groups. No evidence of excess mortality was observed for individuals younger than 15 years. Periods of excess mortality were temporally aligned with waves of reported COVID-19 deaths. In 2020, cumulative excess mortality after calendar week 11 closely matched reported COVID-19 deaths (43 876 vs. 41 835 deaths). Weekly excess mortality, reported COVID-19 deaths and wastewater viral load, when available showed strong temporal synchrony, although excess mortality increasingly exceeded reported COVID-19 deaths during later pandemic waves. Temporal patterns differed from the typical seasonal mortality peaks commonly associated with influenza epidemics during the early months of the year. In 2023, excess mortality declined substantially, possibly indicating a return to mortality levels before the emergence of SARS-CoV-2.

Introduction: Waste pickers face chemical exposures. We evaluated whether chemical exposure is associated with psychological distress and depression. Methods: A 2017 cross-sectional survey included 1,141 waste pickers working in the Estrutural open dump in Brasilia, Brazil. Participants self-reported occupational exposure to 11 chemical categories, 17 psychological distress symptoms, and depression diagnoses. Associations of chemical exposure with mean psychological distress scores and depression prevalence were assessed, adjusted for age, sex, marital status, and income. Results: Mean psychological distress score was higher among those exposed to any chemical (mean of 8.1 vs 6.1; adjusted mean difference [aMD]: 1.8 [0.9, 2.7]) and higher among those exposed to each of 11 chemical categories, for example, smoke (aMD: 1.2 [0.6, 1.7]), batteries (aMD: 1.5 [1.0, 1.9], and oils (aMD: 1.3 [0.9, 1.8]). Depression was more prevalent among those exposed to oils (16.6% vs 10.6%; adjusted prevalence difference [aPD]: 6.3% [95% CI: 2.3, 10.2]), cleaning products (aPD: 5.4% [1.2, 9.5]), medications (aPD: 4.7% [0.6, 8.8]), and aerosols (aPD: 5.3% [1.3, 9.3]) but, not smoke, batteries, greases, insecticides, solvents, paints, chemical containers, or any chemical. Conclusion: These associations highlight the need to consider policy level protections for waste pickers to reduce chemical exposure and guard against psychological distress. Further research is necessary to explore which specific chemicals, within broad chemical categories, are associated with psychological distress and depression.

Background: Children spend more than 90% of their time indoors, and early childhood education settings (ECEs) are an understudied, high-occupant-density indoor microenvironment where exposure to volatile organic compounds, particulate matter, and other toxicants has been documented. Limited knowledge exists on ECE-specific exposures affecting young children and how they compare to exposures in the home. Methods: This prospective, repeated-measures pilot study targeted enrollment of 44 preschool-aged children and 8 ECE staff across two geographically and sociodemographically distinct ECEs in metropolitan Atlanta, Georgia. Paired silicone wristbands, one home-designated and one ECE-designated, were exchanged between settings across three consecutive days and nights beginning at enrollment to characterize microenvironment-specific exposure. A single spot urine sample was also collected from each child. Continuous indoor air quality monitoring was conducted in two classrooms per site. Caregivers and ECE staff completed structured questionnaires assessing home and ECE environmental characteristics, child respiratory risk, and protocol feasibility and acceptability. Feasibility was evaluated using eight pre-specified indicators spanning recruitment and enrollment, wristband wear duration and loss by microenvironment, urine sample collection completeness, and survey completion by instrument and respondent group. Conclusion: This pilot will establish feasibility and acceptability parameters for a paired, multi-matrix silicone wristband protocol across home and ECE microenvironments. Findings will inform the design, sample size, and power calculations for a subsequent study testing indoor air interventions and pediatric respiratory outcomes in ECEs. Feasibility outcomes are reported in a companion manuscript.

Socioeconomic inequality in exposure to air pollution possess a significant public health challenge, yet little is known about how the disparities vary across the various economic status areas in Nairobi. Globally, studies have shown that exposure to air pollution is unequal across communities hence disparities in harm to human health. This study examined the association between socioeconomic characteristics and perceived air quality among residents of low- and high-socioeconomic status areas in Nairobi, Kenya. Two regions within Nairobi County were selected for this study: Mukuru kwa Njenga (representing the Low Socioeconomic Status) and Langata (representing the High Socioeconomic Status) with a sample size of 384 in HSES areas and 368 in LSES areas. A cross-sectional study was conducted among 752 respondents residing in selected LSES and HSES areas of Nairobi. Data was collected using a structured questionnaire assessing sociodemographic characteristics, income, education, employment, perceived air quality, and self-reported health outcomes associated with air pollution exposure. Descriptive statistics were used to summarize participant characteristics and perceived air quality. Chi-square tests were used to examine associations between residential area and categorical health outcomes, while ordinal logistic regression was used to assess the association between socioeconomic characteristics and perceived air-quality ratings. Perceived air quality differed significantly between residential socioeconomic groups. Respondents in LSES areas were more likely to rate air quality as poor or very poor, with 45.4% rating it as very poor, compared with only 1.6% of respondents in HSES areas. In contrast, 12.2% of HSES respondents rated air quality as good compared with 0.3% in LSES areas. The association between area of residence and perceived air-quality rating was statistically significant, {chi}2(3) = 282.672, p < 0.001. In the ordinal logistic regression model, HSES residence was associated with significantly lower odds of reporting poorer perceived air quality compared with LSES residence (OR = 0.135, 95% CI: 0.095-0.190, p < 0.001). Income was also significantly associated with perceived air quality, while respondents with no formal education had higher odds of reporting poorer perceived air quality compared with those with secondary education (OR = 3.254, 95% CI: 1.388-7.638, p = 0.007). Significant differences were also observed for several self-reported health outcomes. Respiratory problems were more prevalent among respondents in LSES areas than HSES areas (72.7% versus 50.4%; {chi}2(1) = 29.081, p < 0.001; Cramer's V = 0.224). However, allergies, eye irritation, and headaches were reported more frequently in HSES areas than in LSES areas, with significant associations observed for allergies ({chi}2(1) = 106.479, p < 0.001; Cramer's V = 0.429), eye irritation ({chi}2(1) = 136.577, p < 0.001; Cramer's V = 0.486), and headaches ({chi}2(1) = 149.180, p < 0.001; Cramer's V = 0.508). No statistically significant association was observed for cardiovascular problems, likely reflecting the very low number of reported cases. Substantial socioeconomic disparities in perceived air quality and self-reported respiratory health outcomes were observed. Residents of low-socioeconomic status areas consistently perceived poorer air quality and reported a higher burden of respiratory problems, highlighting the need for targeted interventions to reduce environmental health inequalities.

Aims: The COVID-19 pandemic has significantly impacted global mental health. At the onset of the pandemic (2020), Belgians experienced increased anxiety, depression, and psychological distress compared to 2018 due to the outbreak and the associated public health measures. Understanding the drivers of this distress is crucial for mitigating mental health effects in future crises. This study examines determinants of psychological distress in Belgium during the March 2020 lockdown, using data from the Great Corona Study (GCS). Methods: Data were drawn from the second wave of the GCS, a citizen science initiative conducted in Belgium on March 24, 2020, with 332,169 respondents. Psychological distress was measured using the General Health Questionnaire-12 (GHQ-12), applying a 2/3 cutoff to classify distress levels. To identify predictor variables, a random forest algorithm and literature review reduced 207 initial variables to 16. A generalized linear model was then used to examine associations between predictors and psychological distress Results: Psychological distress was significantly associated with various demographic, social, occupational, and health-related factors. Younger individuals, women, and residents of Wallonia or Brussels exhibited higher odds of distress. Household composition, and the frequency of real-life social interactions significantly influenced distress levels. Occupational status played a key role, with part-time employees and working students exhibiting higher levels of distress. At the same time retired individuals with no current occupation showed lower odds. Perceived workplace safety and compliance with public health measures also significantly impacted distress levels. Lastly, individuals experiencing influenza-like or COVID-19 symptoms had substantially higher odds of psychological distress. Conclusions: Our findings highlight significant sociodemographic, occupational, and health-related predictors of psychological distress during the initial COVID-19 lockdown in Belgium. Young adults, women, individuals with limited in-person interactions, and those experiencing influenza-like illness or COVID-19 symptoms were particularly vulnerable. Additionally, perceptions of others' adherence to preventive measures played a crucial role in mental well-being. These results highlight the complex interplay between individual and environmental factors in shaping psychological distress, providing valuable insights for future public health policies and mental health interventions during crises.

Objectives The 2016 Draft National Institute for Occupational Safety and Health (NIOSH) universal protocol ''A Performance Test Protocol for Closed System Transfer Devices Used During Pharmacy Compounding and Administration of Hazardous Drugs.'' employing ATD GC MS with the 2016 Draft NIOSH proposed challenge agent 2 Phenoxyethanol (2 POE, 2.5% w/v in water) was used to assess the containment performance of two barrier and two air-cleaning CSTDs in a head-to-head test with replication (n=4) for both NIOSH tasks 1 (drug preparation) and 2 (drug administration). The study objective was to assess the containment performance of both physical barrier and air-cleaning CSTDs. Methods ChemoLock barrier (ICU Medical, USA), ChemoLock air-cleaning (ICU Medical, USA), PhaSeal barrier (Becton Dickinson, USA), and Tevadaptor air-cleaning (Simplivia, IL now marketed as Chemfort) CSTDs were evaluated using the 2016 Draft NIOSH universal test protocol for Task 1 (n=4) and Task2 (n=4). A 100 mL empty IV bag, accessed with a CH-10 ChemoClave bag spike was used with the IV administration set in Task 2 to avoid pressurisation of the occluded administration set during the simulated ''IV push''. Air samples were collected (GilAir pump) at 100mL/minute for 30 minutes on Tenax TA thermal desorption (TD) tubes (Markes, UK). 2 POE, a semi-volatile surrogate mimicking hazardous drugs was prepared at 2.5% w/v solution in MilliQ water. This was aliquoted (50mL) into drug vials and crimp sealed with a butyl rubber stopper (Adelphi, UK). 2 POE was analysed against a calibration curve (n=8) in the range 0.6ng to 200ng using analytical methods published previously. Chromeleon v7.3 CDS (Thermo Scientific, UK) was used for analysis based on detection of SIM ions (M/Z: 77, 94, 138). Blank TD tubes (n=85) were used to determine the experimental LOD and LLOQ. Negative control tests (employing MilliQ water as surrogate) were performed for each CSTD Task 1 (n=1) and Task 2 (n=1). An open ''needle and syringe'' positive control test was performed at 5 and 10 microlitre volumes in the NIOSH chamber to demonstrate system suitability. Results Chamber cleaning and analysis performed between tests, gave average blank values (n=85) of 0.05{+/-}0.01 ppbv (95% confidence interval). The experimental limit of detection (LOD) and quantification (LLOQ) for the tests was 0.16{+/-}0.01 ppbv and 0.41{+/-}0.01 ppbv respectively. The positive control tests produced signals of 3.13 ppbv (n=1) and 6.59 ppbv (n=1) for 5 microlitre and 10 microlitre releases of 2 POE respectively and demonstrated system suitability to quantify down to a 650 nanolitre liquid release volume. (1) ChemoLock barrier, (2) ChemoLock air-cleaning, (3) BD PhaSeal barrier and (4) Tevadaptor air-cleaning CSTDs all generated <LLOQ signals for both NIOSH tasks 1 and 2. No statistically significant difference was found between the containment performance of the two air-cleaning and the two physical barrier CSTDs evaluated in this study. Conclusions System suitability was demonstrated using deliberate releases of the 2 POE surrogate at 5 and 10 microlitre volumes producing 2-POE concentrations in the NIOSH chamber of 3.13 ppbv and 6.59 ppbv respectively. Evaluation of the containment performance gave <LLOQ (0.41{+/-}0.01ppbv) for all four of the CSTDs tested in the study: (1) ChemoLock barrier, (2) ChemoLock air-cleaning, (3) BD PhaSeal barrier and (4) Tevadaptor air-cleaning, based on testing of four replicates of each technology in both NIOSH Task 1 and NIOSH Task 2. There was no statistically significant difference in containment found between the two air-cleaning and the two barrier CSTDs evaluated in this study.

While exposure to volatile organic compounds such as ethylene dichloride and vinyl chloride monomer is a well-established cause of liver disease, particularly hepatic hemangiosarcoma, characterizing real-world exposure profiles in communities surrounding industrial centers remains challenging. Calvert City, Kentucky (population ~2,500), provides a unique setting characterized by both active industrial emissions and legacy sources of air toxics. To address these complexities, this method paper describes the framework for the Biomonitoring and Environmental Assessment for Community Outreach and Neighborhood Safety (BEACON) study. By utilizing a novel, multi-dimensional exposure assessment strategy, BEACON aims to characterize air toxic exposures and provide actionable data for community health and safety. For the BEACON study, we will leverage Kentucky Department of Air Quality measures of air toxics, analyze urine samples in a small cohort of community volunteers, analyze community urine via wastewater in an adjacent community, geocode citizen odor reporting, assess blood markers in wildlife, survey small and large animal veterinarians in the area for anomalies in morbidity and mortality, and work with the regional health system to enhance vigilance for health issues associated with toxicants present in the area. In addition, blood samples will be collected at three time points and biobanked for future analyses. Efforts will be made to link this study to additional large-scale long-term cohorts where possible. Throughout the project, community engagement will play a critical role by raising awareness, fostering collaboration, and ensuring that the voices of affected residents are heard.

Background: Obesity is a major global public health challenge, and teachers play a critical role in school-based health promotion. This study examined the perceived impact of a web-based educational program on metabolism and obesity delivered to Brazilian school teachers. Methods: This analytical cross-sectional study included 217 teachers who responded to the evaluation questionnaire after attending the course between 2017 and 2022. Statistical analyses included logistic regression and chi-square tests. Findings: Course completion rate was 81.98%, substantially exceeding the 5-15% typical of global MOOCs. However, ethnic disparities were observed: White respondents were 4.95 times more likely to complete the course than Black respondents (p=0.00097) and Brown respondents were 3.05 times more likely (p=0.0268) than Black respondents. Among non-completers, lack of time (64.7%) was the primary barrier. Participation was concentrated in Sao Paulo (77%), with no respondents from three northern states. Perceived difficulty showed a non-significant trend (p=0.0893) where by Black respondents had the lowest predicted difficulty; the most challenging course material was Scientific Content/Reading papers (50%). Completion was strongly associated with applying learned activities in teaching (p<2.2x10-16); 57.1% of completers implemented health-promoting activities, most commonly games, healthy eating, and combined diet-physical activity habits. Completers also reported significant improvements in lifestyle decisions (p=1.76x10-21) and healthy habits (p=9.35x10-77), including better diet and increased physical activity. Conclusion and interpretation: Course completion was associated with reported improvements in diet, physical activity, nutrition knowledge, and teaching practices among Brazilian teachers. However, marked ethnic and regional disparities were observed. White teachers were nearly five times more likely to complete the course than Black teachers. The absence of respondents from northern states reveals that scalability without equity widens existing gaps. Online access to free courses alone does not democratize education; mitigating ethnic and regional disparities must be a priority for digital health interventions.

Handgrip strength (HGS) is a practical measure of muscular strength, but the factors associated with relative HGS among young adults remain insufficiently understood. This exploratory cross-sectional study examined demographic and anthropometric characteristics, total physical activity (PA), and depressive symptoms in relation to relative HGS among medical students in Serbia. A total of 424 students from the Faculty of Medicine, University of Belgrade, completed HGS testing and study questionnaires. HGS was measured using a VALD DynaMo Lite dynamometer and expressed relative to body weight (N/kg). Participants were categorized according to sample-specific relative HGS percentiles: <25th, 25th to 75th, and >75th percentile. PA was assessed using the IPAQ-SF and depressive symptoms using the PHQ-9. Three pairwise multivariable logistic regression models were used to examine factors associated with relative HGS categories. Sex and BMI were the most consistent correlates of relative HGS. Female students had lower odds of belonging to higher relative HGS categories, while higher BMI was consistently associated with lower odds of belonging to higher categories. Age was associated only with the 25th to 75th percentile group compared with the <25th percentile group. Total PA volume and PHQ-9 score were not independently associated with relative HGS categories. These findings suggest that relative HGS in this population was more strongly associated with demographic and anthropometric characteristics than with total self-reported PA or depressive symptom severity. Keywords: handgrip strength; relative handgrip strength; muscular strength; medical students; physical activity; depressive symptoms; body mass index

Work-related musculoskeletal disorders (WRMSDs) constitute the primary occupational health burden among healthcare professionals (HCPs) globally and directly threaten health workforce sustainability, a critical concern for Sustainable Development Goal 3 (Good Health and Well-being) and SDG 8 (Decent Work and Economic Growth). Despite high prevalence in Cameroon, downstream occupational effects and management strategies across hospital levels remain undocumented. A hospital-based, analytical cross-sectional study was conducted across five referral hospitals in Douala, Cameroon (2019-2022). A total of 561 HCPs were enrolled by stratified random sampling. The Modified Nordic Musculoskeletal Questionnaire and structured interviews assessed WRMSD occupational effects and management strategies. Data were analysed using IBM SPSS v26; chi-square tests and logistic regression assessed associations (p < 0.05). The 12-month WRMSD prevalence was 83.4% (468/561). WRMSDs caused absenteeism in 83.4% of affected HCPs ({chi}2 = 14.414; p < 0.001), reduced daily activity capacity in 55.6%, and job dissatisfaction in 60.4%; 38.9% were considering a career change. Management was predominantly reactive: fitness training (76.3%), rest (41.4%), and non-steroidal anti-inflammatory drugs (NSAIDs; 37.3%). Only 15.0% received physiotherapy referral, and no hospital had a formal WRMSD protocol. WRMSDs impose a substantial and measurable occupational burden on HCPs in Douala. Current management is reactive, non-standardised, and under-integrated with physiotherapy. Evidence-based, multicomponent prevention programmes, physiotherapy integration, and a national occupational health policy are urgently required to protect the healthcare workforce and advance SDG 3 and SDG 8 targets in Cameroon.

Indiana still faces significant health challenges, ranking among the least healthy U.S. states due to high obesity rates, mental health issues, and other chronic conditions. These disparities are closely linked to inequities in healthcare access, which are largely shaped by social determinants of health. Using data from the Social Vulnerability Index and County Health Rankings and Roadmaps, this study analyzes trends in obesity, mental health, and premature death across Indiana counties before, during, and after the COVID-19 pandemic. Descriptive statistics, correlation analyses, and Negative Binomial regression models were used to evaluate county-level disparities. In 2018, higher rates of uninsured, obese, and physically inactive populations were associated with increased premature death. In 2020, diabetes, smoking, and alcohol consumption were significant factors. By 2022, unemployment, education, obesity, insurance, exercise access, and mental health provider availability were associated with premature death. Findings indicate that socially vulnerable counties experienced amplified health impacts, with obesity rising most sharply where exercise infrastructure was limited and poor mental health days increasing across all counties. These results highlight persistent service gaps and the critical need for targeted investments in recreational infrastructure and mental healthcare. Future research should examine policy influences and causal relationships to inform equity-focused interventions.

Introduction: Parents and club staff are primarily responsible for recognising and managing concussion in junior community Australian Football (ARF), yet no recent research has examined their knowledge or practices. This study assessed concussion knowledge, attitudes, and confidence among parents and staff in junior (under-16 years) community ARF, and identified management practices and perceived barriers. Methods: An online survey assessing concussion knowledge and attitudes (RoCKAS-ST), confidence, and AFL-specific guideline knowledge was distributed nationally to parents and staff of junior community ARF players. A subsample whose child had a concussion in the previous 12 months completed additional questions on management practices. Closed-ended responses were analysed descriptively and using Pearsons correlation. Open-ended responses underwent qualitative content analysis. Results: Responses (n=223) reflected high general concussion knowledge (76.6% of maximum) and positive attitudes toward safe concussion management (86.8% of maximum), but AFL-specific guideline knowledge was limited (49.8%). Self-reported confidence was not associated with knowledge (r = -0.04) or attitudes (r = .09). Among 58 respondents whose child recently sustained a concussion, medical evaluation (74.1%) and clearance prior to return (60.3%) were common, but graded return-to-play protocol use (50.0%) and club support during recovery (43.1%) were inconsistent. Knowledge gaps (70.4%), cultural attitudes favouring playing through symptoms (29.6%), and inadequate volunteer capacity (29.6%) were most common barriers. Conclusions: Parents and staff in junior community ARF hold safe attitudes toward concussion but lack the sport-specific knowledge, structural support, and resources to translate these attitudes into practice. Targeted, mandated education, and improved support are needed to close this gap.

Background: Sweeping sliders with large horizontal break are hypothesized to be associated with arm injury, and prior work suggests a link between slider usage, arm angle, and injury. Purpose: To evaluate whether arm angle and slider horizontal movement are associated with elbow or forearm injury risk in MLB pitchers. Study Design: Retrospective cohort study; Level of evidence, 3 Methods: Statcast data from 2020-2025 and injury data were used to study the relationship between sliders and arm injuries. Pitchers with at least 30 innings pitched (IP) were evaluated for same- and next-season injury incidence to the Elbow, Forearm, or Elbow/Forearm. A generalized additive model (GAM) related pitch-level variables to injury incidence, and average marginal effect (AME) odds ratios are reported for main effects. Results: All fits were significant at p<.01. Fits for same-season (N=1,957, p=.00008, R2=.066) and next-season (N=2,511, p=.00005, R2=.053) Elbow/Forearm injury were significant at p<.001. Same-season (R2=.061) and next-season (R2=.055) Forearm injury fits had p=.001. Main effects for slider glove-side movement and fastball usage, their interactions with arm angle, and arm angle main effects were the most predictive features. Across the three fits where the slider glove-side movement main effect was significant, odds ratios ranged from 1.03 to 1.07, meaning that each additional inch of slider glove-side movement was associated with a 3% to 7% increase in the observed injury incidence. Furthermore, this effect was magnified at high arm angle and muted at low arm angle. Conclusion: We observed that slider horizontal movement, arm angle, and their interaction were significantly associated with incidence of Forearm and combined Elbow/Forearm injury. This effect was weak or non-existent at low arm angles and strong at high arm angles, suggesting that arm angle moderates the risk of slider horizontal movement, and providing evidence that sliders with large horizontal break (e.g. sweepers) may pose an injury risk. Keywords: baseball; sweeper; slider; arm angle; horizontal movement; elbow injury; forearm injury

This study aimed to clarify aerosol exposure risks throughout the workflow of a Biosafety Level 2 (BSL-2) polymerase chain reaction (PCR) laboratory, validate the suitability of the {Phi}X174 bacteriophage as an indicator virus, and provide evidence for biosafety control measures. The {Phi}X174 bacteriophage was used to simulate viral samples, and a concentration-bacteriophage plaque standard curve was constructed (R2=0.998). Five operational steps in a simulated PCR laboratory were quantitatively monitored for aerosol concentration using double-layer agar plates, with blank controls used to eliminate interference. Statistical analysis was employed to identify risk differences. Sample homogenization ((5.67 {+/-} 1.23) x 104 plaque-forming units (PFU)/m3) and nucleic acid extraction ((3.45 {+/-} 0.89) x 104 PFU/m3) were identified as high-/very high-risk steps. The viral load in the samples was strongly positively correlated with the aerosol concentration (r = 0.926, P <0.001), with aerosol levels linearly decreasing with increasing distance in high-risk steps. The {Phi}X174 bacteriophage demonstrated high detection sensitivity (101 PFU/ml) and demonstrated safety compatibility with BSL-2 laboratories. Aerosol risks in PCR laboratories exhibit step-specific differentiation, and {Phi}X174 serves as an ideal indicator virus. Proposed strategies such as equipment upgrades and personal protective equipment (PPE) grading can reduce exposure risks.

Wildfire smoke has increasingly affected air quality across North America, raising concerns about the health effects of fine particulate matter (PM2.5) exposure, including potential impacts on brain health. However, relatively few studies have characterized personal PM2.5 exposure during these events using wearable monitoring. We examined daily personal PM2.5 concentrations during wildfire smoke episodes in southeast Michigan alongside neighborhood outdoor PM2.5 estimates. Four participants (one adolescent and three adults) wore AirBeam3 personal monitors during ongoing studies. Neighborhood outdoor PM2.5 was estimated using the average of three nearest PurpleAir outdoor air quality sensors, and wildfire smoke days were identified using state air quality advisories. Group-level descriptive statistics summarized personal and neighborhood outdoor PM2.5 and self-reported time spent outdoors. Exploratory within-participant analyses quantified associations between neighborhood outdoor and personal PM2.5 concentrations on smoke and non-smoke days. Neighborhood outdoor daily PM2.5 concentrations were higher during wildfire smoke days than non-smoke days (87.6 + 80.2 vs. 12.3 + 7.0 {micro}g/m3). Personal PM2.5 concentrations were more than five times higher during wildfire smoke days (28.2 + 20.0 vs. 5.1 + 4.7 {micro}g/m3) than non-smoke days. Within participants, every 10 {micro}g/m3 increase in neighborhood PM2.5 was associated with 2.3 {micro}g/m3 increase in personal PM2.5 concentrations. Wearable PM2.5 monitoring captured elevated personal exposures while providing individual-level exposure information beyond neighborhood outdoor air quality estimates. These findings demonstrate that wearable monitoring complements neighborhood air quality measurements by capturing individual-level exposure, providing a more comprehensive assessment of real-world wildfire smoke exposure for future studies examining the effects on brain health.

Objectives: Collaboration among health care professionals and the services they provide can be strengthen by interprofessional education (IPE). IPE can be implemented at the undergraduate level. Accordingly, the objective of the present study was to evaluate senior students' understanding of the terms interdisciplinarity and multidisciplinarity within the context of IPE. Methods: A retrospective cross-sectional study design was used. Students understanding of interdisciplinarity and multidisciplinarity was assessed through an assessment question completed by three consecutive cohorts of senior undergraduate dental students at the UBC Faculty of Dentistry between 2021/22 and 2023/24 (N = 177). Responses had a maximum of 100 words and were categorized into one of four predetermined themes: concordant knowledge (when both definitions were correct), discordant rhetoric (when both definitions were incorrect), switched ideas (when the definitions were reversed), and altered discourse (when the concepts of discipline and specialty were conflated). Descriptive and inferential statistical analyses were performed using SPSS Version 31. Results: Of the 177 students enrolled, 164 provided responses to the question on multidisciplinarity and interdisciplinarity: 60 students in 2021/22, 51 students in 2022/23, and 53 students in 2023/24; the mean age was 25 years and 88 were female. Of the four predetermined themes, 45.7% of responses reflected concordant knowledge, 15.9% discordant rhetoric, 18.3% switched ideas, and 20.1% altered discourse. The logistic regression analysis showed age associated with a higher probability of providing the correct definitions (adjusted OR = 1.39; 95% CI: 1.06 - 1.83; p = 0.017). Conclusions: Knowledge of interdisciplinary and multidisciplinary appeared to be retained by the majority of students. However, dental education programs, alongside other health professional training programs, should continue to incorporate interprofessional education through both didactic and experiential learning opportunities to equip students with the skills necessary to provide collaborative care in future practice.

Perioperative safety checklists standardize critical actions, but reliable completion depends on the surrounding work system and team behavior. We conducted a prospective observational analytic study from April to May 2026 in the central surgical unit of a high-volume public teaching referral hospital in Indonesia to examine whether patient safety culture and teamwork were associated with directly observed perioperative safety compliance and whether teamwork mediated the culture-compliance relationship. Patient safety culture was measured with the Hospital Survey on Patient Safety Culture 2.0, teamwork with a 35-item TeamSTEPPS Teamwork Perceptions Questionnaire research adaptation, and compliance by direct role-based observation using a 45-item checklist derived from the AORN Comprehensive Surgical Checklist. Eighty of 92 recruited professionals contributed 240 person-operation observations across 50 operations. Overall compliance was 74.75%, with sign-out lowest at 70.68%. Patient safety culture was associated with teamwork ({beta} = 0.590; 95% CI 0.510-0.770) and directly with compliance ({beta} = 0.407; 95% CI 0.187-0.712). The teamwork-compliance coefficient was positive ({beta} = 0.285; p = 0.046), but the prespecified percentile 95% CI included zero (-0.045 to 0.517). The indirect effect through teamwork was not supported ({beta} = 0.168; p = 0.079). These findings support a system-level interpretation of perioperative safety and identify learning-oriented responses to error, situation monitoring, and sign-out fidelity as measurable targets for future improvement efforts.

Background: General illness-related sick leave among teachers represents a relevant public health and workforce management issue. However, long-term population-based evidence describing its distribution and associated factors in Latin American urban educational systems remains limited. This study aimed to characterize the occurrence, distribution, duration, and sociodemographic, occupational, temporal, and territorial factors associated with general illness-related sick leave among public school teachers in Bogota between 2010 and 2025. Methods: A retrospective cohort study was conducted using integrated administrative databases from the Bogota District Department of Education. The primary outcome was the occurrence of at least one general illness-related sick leave episode in a teacher-month observation. Descriptive analyses were performed to characterize sociodemographic and occupational patterns. A multivariable logistic regression model was used to estimate associations. Month and year were included as temporal fixed effects to account for seasonal patterns, academic-calendar effects, pandemic-related disruption, and secular changes. Results: The cohort included 59,697 unique teachers, contributing 537,025 teacher-year observations from teachers with an active employment record between January 1, 2010, and July 31, 2025. Overall, 41.59% of teacher-year observations included at least one general illness-related sick leave episode, and 83.26% of teachers had at least one episode at any time during follow-up. Respiratory diseases accounted for the largest share of episodes, followed by musculoskeletal and infectious diseases. Mean duration varied substantially by diagnostic category, ranging from short respiratory and infectious episodes to longer absences related to neoplasms, circulatory diseases, injuries, and mental health conditions. In the multivariable teacher-month model, sick leave occurrence was associated with age, sex, occupational role, teaching area, contract type, locality, calendar month, and calendar year. Lower odds were observed among male teachers, principals, and teachers with provisional contracts, while temporal and territorial variation was observed across months, years, and localities. Conclusions: General illness-related sick leave among public school teachers in Bogota showed consistent sociodemographic, occupational, temporal, and territorial patterns. Respiratory and musculoskeletal conditions accounted for the largest share of episodes, while chronic, neoplastic, injury-related, circulatory, and mental health conditions were associated with longer durations. These findings provide population-level evidence to inform occupational health surveillance, seasonal preparedness, and workforce planning strategies within urban educational systems.

Objective: The Brief-cope questionnaire explore coping behavior. However, the underlying factor structure remains a subject of ongoing debate. Exploratory factor analyses (EFA) conducted across different populations have identified factor solutions ranging from two to fourteen factors. As of yet, the underlying factor structure of the Brief-cope has not been investigated in patients with seropositive rheumatoid arthritis (RA). Therefore, the aim of this study was to explore the underlying factor structure of the Brief-cope in a German population of seropositive RA. Methods: 216 outpatients with seropositive RA completed the Brief-cope. An EFA with principal axis factoring and Promax rotation was conducted. Results: EFA indicated a five-factor solution. The five-factor solution explained 51.95% of variance. The identified factors were: (1) problem-focused coping (Cronbach's = .851), (2) emotion-focused coping ( = .754), (3) maladaptive coping ( = .747), (4) religious coping ( = .851), and (5) substance-use coping ( = .869). Conclusion: A five-factor solution provided the most appropriate representation of the underlying factor structure of the Brief-cope in patients with seropositive RA. This factor structure may serve as a suitable basis for future analyses of Brief-cope data in comparable RA populations.