Journal of Occupational & Environmental Medicine

Background: Work-related musculoskeletal pain (MSP) is a prevalent concern among factory workers, impacting productivity, absenteeism, and overall quality of life. Factory workers, who perform repetitive tasks and engage in physically demanding work, are particularly susceptible to work-related MSP. Methods: This descriptive cross-sectional quantitative study included 148 factory workers (29 females and 119 males) from two factories in Kigali, surveyed between November 2023 and January 2024. Data were collected using a structured questionnaire that included demographic items, the Modified Nordic Musculoskeletal Questionnaire (M-NMQ) to assess work-related musculoskeletal pain (MSP) symptoms in nine body regions over the previous 12 months and seven days, and questions regarding interference of symptoms with normal work activities. The Coping Strategies Questionnaire (CSQ) was administered to identify coping practices among factory workers. Data analysis comprised descriptive statistics, including mean, frequency, Wilson 95% confidence intervals, and percentage values, calculated using SPSS version 25.0. Results: Participants were predominantly male (119/148, 80.4%), and 98/148 (66.2%) had worked at the factory for more than five years. Overall, 113/148 reported symptoms in at least one body region during the previous 12 months (76.4%, 95% CI 68.9-82.5). The lower back (90/148, 60.8%), shoulders (71/148, 48.0%), neck (61/148, 41.2%), and knees (58/148, 39.2%) were most frequently affected. Symptoms prevented normal work for 41/148 (27.7%, 95% CI 21.1-35.4), and 57/148 reported symptoms during the previous seven days (38.5%, 95% CI 31.1-46.5). Among 113 participants with 12-month symptoms, the most frequent Always responses were seeking medical help (78/113, 69.0%), rest and recovery (75/113, 66.4%), and medication use (59/113, 52.2%); ergonomic adjustment was least frequent (10/113, 8.8%). Conclusion: Self-reported work-related MSP symptoms were common, particularly in the lower back and shoulder, while ergonomic adjustments were uncommon. Frequent medication use highlights the need for comprehensive interventions combining ergonomic training, physiotherapy, and adequate recovery; however, these findings do not establish causation or intervention effectiveness.

Objective: Perceived injustice is a psychosocial risk factor associated with delayed recovery and poor occupational outcomes among workers with pain conditions. We examined a theory-informed pathway linking occupational stressors, perceived injustice, pain interference, depressive symptoms, and insomnia, while evaluating selected measurement properties of the Japanese Injustice Experience Questionnaire-Short Form (IEQ-SF-J). Methods: This cross-sectional online survey included 600 Japanese workers (300 with headache and 300 with low back pain). Structural validity of the IEQ-SF-J was evaluated using exploratory and confirmatory factor analyses (CFA) and item response theory. Construct validity was examined using Spearman correlations. Structural equation modelling (SEM) estimated indirect associations between job demands or low job control and pain interference, depressive symptoms, and insomnia, with perceived injustice specified as a latent intervening construct. Results: CFA supported a unidimensional structure (comparative fit index = 0.993; root mean square error of approximation = 0.080). Internal consistency was acceptable (Cronbach's ; = 0.82; McDonald's {omega}; = 0.90), and test-retest reliability was moderate (intraclass correlation coefficient = 0.60). IEQ-SF-J scores correlated significantly with pain interference, insomnia, and depressive symptoms. Job demands and low job control showed significant indirect associations with all three outcomes involving perceived injustice. Conclusions: The IEQ-SF-J showed supportive evidence for several measurement properties and occupied a theoretically coherent position in associations linking occupational stressors with pain interference, depressive symptoms, and insomnia among workers with headache or low back pain.

Recent industry surveys have reported widespread concern about mental health, working conditions, and harassment in the UK film and television industry, but no peer-reviewed empirical study has examined the determinants of occupational burnout in this workforce. The present study tested whether physical health, mental wellbeing, perceived public stigma, intrinsic job quality, and sexual harassment exposure predict burnout in industry professionals. A cross-sectional online survey was completed by 415 individuals across more than 100 job titles, with 286 also completing an optional harassment module. Mental wellbeing sat well below population norms, with 68% scoring in the range indicative of probable depressive symptoms and 82% in the high-exhaustion range on the Maslach Burnout Inventory General Survey. Mental wellbeing and intrinsic job quality were the strongest predictors of burnout (R2 = .56), with meaningfulness accounting for most of the job-quality effect. Working hours independently predicted emotional exhaustion. Harassment exposure was associated with burnout in women but not men, approximately 30% mediated by mental wellbeing; sexist behaviour directly predicted exhaustion in women. Workers with a disability reported higher stigma. Burnout was strongly associated with intent to leave, and the findings collectively indicate an industry-wide occupational health concern requiring structural rather than individual-level intervention.

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.

Background: Digitalization and remote work have increased interest in work environments that reduce workload, negative mood, and fatigue. Low-interaction co-presence in virtual spaces may offer a new digital work environment, but its effects on subjective workload remain unclear. Objective: To examine the effects of the 3D-avatar work-support application gogh on subjective workload, mood, and fatigue. Methods: We conducted an open-label randomized two-period crossover trial in 40 gogh desktop users performing desk- or computer-based tasks. Participants completed 30-min task periods with and without gogh, separated by a 30-min break, in randomized order. The NASA Task Load Index (NASA-TLX) was the primary outcome, with the mood and fatigue domains of the Inventory Scale for Mood and Sense of Fatigue as secondary outcomes. Linear mixed-effects models used condition and period as fixed effects and participant as a random intercept. Results: All 40 participants completed both conditions. NASA-TLX scores were 42.3 +/- 12.9 with gogh and 51.7 +/- 15.1 without gogh; the adjusted mean difference was -9.5 (95% confidence interval (CI) -13.4 to -5.5). Adjusted mean differences were -11.4 for mood (95% CI -16.6 to -6.2) and -15.0 for fatigue (95% CI -20.3 to -9.7). Exploratory analyses showed lower Frustration, Effort, and Physical Demand with gogh. Conclusions: The gogh condition was associated with a decrease in post-task perceived workload, negative mood, and fatigue. This combined virtual co-working environment may reduce task-related psychological burden, although objective performance, productivity, and long-term occupational health effects require further study.

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.

Individuals of Vietnamese descent comprise a majority of the United States nail salon workforce. Whereas prior research has centered on chemical exposures, thematic analysis of interviews with Vietnamese nail salon workers around Baltimore, Maryland examined the lived experiences of nail salon workers. Six themes were identified: (1) nail work as a familial livelihood and a sacrifice-oriented pathway towards intergenerational mobility; (2) perceived flexibility within the workplace with low control; (3) professional pride grounded in artistry, detail, and customer care; (4) cumulative occupational risks; (5) emotional labor as an expected and core component of nail salon work; and (6) limited perceived capacity to change working conditions. These findings suggest that the occupational pressures in nail salon work cannot be solely framed as a lack of worker knowledge or motivation towards adopting safer practices. Intervention success depends on a holistic view of workers' lives, whose choices are shaped by family obligations, customer demands, and conditions largely outside their control. Therefore, efforts to improve nail salon health may benefit from shifting the burden of risk management away from individual workers and engaging the wider community.

Background: Health and administrative professionals in tertiary hospitals face high levels of occupational stress, mental illness, and multimorbidity. The integrated measurement of these multidimensional health aspects is essential for informing effective workplace health promotion strategies. Objective: To describe the general health status of federal public hospital staff and correlate the measured health dimensions to inform institutional health promotion initiatives. Methods: A cross-sectional, online survey study was conducted at Hospital Universitario dos Servidores do Estado (HUSE) between November and December 2025. Data collection was performed via online REDCap questionnaires covering sociodemographic profiles and validated instruments (SRQ-20, MIDAS, AUDIT, WHOQOL-BREF, PHI, WHOQOL-SRPB BREF, CBI, GPAQ, and EPSO). Descriptive statistics, comparisons across employment ties (permanent vs. contracted staff), and Spearman correlation matrices were calculated. Results: Among 197 accesses, 117 completed the informed consent, and 86 finished all questionnaires. Participants were predominantly female, aged 40 to 60 years, and Christian. Screening positivity was 25% for common mental disorders, 21% for headache-related disability, and 10% for harmful drinking. Burnout scores clustered in the second quartile, while quality of life, happiness, and spirituality scores were in the upper third. Median physical activity was 670 min/week. Mental symptoms (SRQ-20), headache (MIDAS), and burnout (CBI) correlated positively with each other and negatively with quality of life, happiness, spirituality, and institutional support (EPSO). Conclusion: The set of instruments proved feasible for situational health diagnosis among hospital staff. Although the sample size was limited in this baseline wave, the initiative fostered workplace health awareness, driving concrete initiatives, including an on-site functional gym and workplace vaccination campaigns.

Background Playing-related musculoskeletal disorders are highly prevalent among musicians, yet no validated The aim of this study was to translate and culturally adapt the MPIIQM into Japanese and to examine its psychometric properties in students of higher music education institutions (HMEIs). Methods Forward-backward translation followed ISPOR guidelines, with linguistic validation through pilot testing. Psychometric evaluation was conducted in instrumental music majors enrolled at nine HMEIs in Japan, combining in-person and online surveys. Exploratory factor analysis, Cronbach's , and Pearson correlations with the Brief Pain Inventory (BPI), QuickDASH, and QuickDASH Performing Arts Module (PAM) were computed in symptomatic respondents (n = 48). Symptom prevalence in the full HMEIs sample (n = 226) was compared with national data (Ministry of Health, Labour and Welfare in Japan, 2022) using binomial tests with Holm correction. Results Exploratory factor analysis yielded a two-factor structure (pain intensity; pain interference) explaining 76.8% of the variance. Cronbach's was .864 (pain intensity), .890 (pain interference), and .903 (total). The pain intensity subscale correlated strongly with BPI pain severity (r = .71), and the pain interference subscale correlated with the QuickDASH PAM (r = .62). Test-retest reliability could not be computed because only 9 of 30 retest respondents met inclusion criteria. HMEIs students reported significantly higher prevalence than national peers in 25 of 41 symptoms, most markedly stiff shoulders and low back pain. Conclusions The MPIIQM-J demonstrated adequate structural validity, internal consistency, and convergent validity, and is expected to be useful in educational and clinical settings.

The prevalence of shift work-centric industries and the rise of flexible working render it crucial to investigate the health risks posed by unnatural patterns of work and sleep. Shift working in healthcare has been linked to emotional dysregulation, reduced alertness, and cognitive impacts, with Shift Work Disorder (SWD) classified as a circadian rhythm sleep-wake disorder in the DSM-5. These impacts have historically been attributed to schedule-related sleep disturbances; however certain individuals appear more acutely affected. One measure of individual inflexibility to altered routines is chronotype distinctness, an amplitude dimension of the Caen Chronotype Questionnaire (CCQ). Here, we use Structural Equation Modelling (SEM) to unravel the mechanisms by which sleep and chronotype distinctness govern the neuropsychiatric symptom profiles of a cohort of National Health Service (NHS) shift workers (n=102). We constructed a measurement model, extracting latent constructs from questionnaires for sleep disturbances (PSQI), chronotype distinctness (CCQ), mood disorder (MDQ), depression (PHQ8) and emotional reactivity (ERS), and cognitive assessments. Correlations were identified between constructs, then translated into two SEMs - day and rotating shifts respectively - with sleep and distinctness as predictors of detrimental effects. Models were tested for direct effects, significant paths, and overall model fit. We found that, whilst sleep governed fatigue-based symptoms in day-shift workers, chronotype distinctness determined the severity of adverse effects in rotating-shift workers, including mood disorders and cognitive impairments. We surmise that high chronotype distinctness should be considered a risk factor for adverse effects surrounding night and rotating-shift work, and that interventions should incorporate chronotype-specific remediation.

Purpose: Physical behaviors, including physical activity, sedentary time, and sleep, are associated with health and together comprise the 24-hour day. Among working-aged adults, the composition of these 24-hour physical behaviors may vary across occupations, but the extent of these differences remains unknown. This population-based study examined how the composition of 24-hour physical behaviors differs in working-aged adults across occupational groups during work and leisure time. Methods: The study population consisted of 2,809 adults from the Northern Finland Birth Cohort 1966 46-year follow-up study, who wore a hip-worn accelerometer for 14 days. The accelerometry data was combined with self-reported diaries to determine time in bed and work hours. Four occupational groups were aggregated based on occupation type and occupational skill level: high-skill white-collar, low-skill white-collar, high-skill blue-collar and low-skill blue-collar. Time spent on physical behaviors during workdays (including working hours and leisure time separately) and non-workdays were calculated. Differences in physical behavior compositions were assessed using a compositional data analysis approach based on log-ratios of geometric means, with the low-skill blue-collar group as the reference group. Results: Significant differences in 24-hour physical behaviors across occupational groups were mainly observed during workdays. During workday working hours, all other occupational groups had less physical activity (both moderate-to-vigorous and light-intensity physical activity) compared to the reference group. During workday leisure time, significant differences were observed in all physical behaviors, except for sedentary time. On non-working days, the high-skill white collar group had higher moderate-to-vigorous physical activity compared to the reference group. Conclusions: The composition of domain-specific 24-hour physical behaviors differs across occupational groups, particularly during workdays.

Introduction: Rotating night shift work is associated with chronic circadian disruption and may contribute to higher cardiovascular disease (CVD) risk and mortality. The impact of rotating night shift work may vary by chronotype, particularly when an individual's circadian preference is misaligned with work schedules. Methods: In 2009, 69,458 women (mean age 54.4 years) free of CVD in the Nurses' Health Study II reported chronotype. Duration of rotating night shift work has been assessed biennially since 1989. Participants were followed from 2009 through June 2021 for incident CVD (myocardial infarction or stroke) and all-cause mortality. We used time-varying Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for outcomes in relation to rotating night shift work and chronotype and to evaluate whether the associations differed by chronotype. Primary models adjusted for key demographics, CVD risk factors, and workplace factors. Results: We documented 1,005 incident CVD events over 800,630 person-years and 1,777 deaths over 806,043 person-years. Each 5-year increase in rotating night shift work was associated with a modestly higher risk of incident CVD (HR 1.07; 95% CI 1.01, 1.14) and a 13% higher risk of all-cause mortality (HR 1.13; 95% CI 1.08, 1.17). Greater eveningness was associated with higher incident CVD risk (HR 1.17; 95% CI 1.06, 1.28) and all-cause mortality (HR 1.18; 95% CI 1.10, 1.26). For incident CVD, the increased risk per 5-year increment in rotating night shift work was observed only among definite morning types (HR 1.11; 95% CI 0.99, 1.23), but not among definite evening types (HR 0.99; 95% CI 0.86, 1.15; p-interaction=0.1732). For all-cause mortality, the increased risk associated with shorter-term rotating night shift work (<5 years) was more evident among definite morning types (HR 1.39; 95% CI 1.12, 1.73) than definite evening types (HR 1.37; 95% CI 0.98, 1.91). However, this difference was not observed for longer duration of shift work ([&ge;]5 years), and the overall interaction was not statistically significant (p-interaction=0.57). Similar patterns were observed when shift work duration was modeled continuously using restricted cubic spline analyses. Conclusion: Rotating night shift work was associated with a modest increase in CVD and all-cause mortality risk. The overall pattern of associations across chronotypes suggested that nurses with a morning chronotype may be more susceptible to the adverse effects of rotating night shift work.

Occupational injuries remain a cause of preventable morbidity and death, but evidence from emergency departments in Nigeria is limited. This retrospective study described occupational injuries treated at two hydropower plant hospitals between May 2020 and December 2022. Records of 120 patients were reviewed using a standardized abstraction form. Data were summarized using frequencies and percentages, and associations were assessed using chi-square tests. Vehicular crashes were the leading cause of injury (50.0%), lacerations were the most frequent injury type (39.2%), and the head/face was the most commonly affected single site (30.0%). Most patients were discharged (85.0%); 12.5% were transferred and 3.3% died. Serious injuries accounted for 40.8% of cases. Injury type was associated with discharge and injury severity, while injury site was associated with discharge and transfer. These findings support stronger workplace prevention, timely emergency assessment, and clearer referral pathways for injured workers.

Objectives The association between occupational physical activity (OPA) and cardiovascular disease (CVD) may depend on how OPA is classified. This study examined the association between OPA and incident CVD using individual level and occupational group level classifications, and assessed whether factors contributing to attenuation differed. Methods A total of 137,592 employed UK Biobank participants aged 40 to 69 years who were free of CVD at baseline were included. OPA was classified using (i) individual level self reported physical activity at work and (ii) occupational group level two digit Standard Occupational Classification. Associations with incident CVD were examined using Cox proportional hazards models. Attenuation of associations by sociodemographic, lifestyle, health, occupational and psychosocial factors was assessed using univariate adjustments and Heller's coefficient. Results During 1,656,378 person-years of follow up (median 12.6 years), 10,465 incident CVD events occurred. The association between OPA and CVD differed markedly according to exposure classification. High individual level self reported OPA was associated with increased CVD incidence after full adjustment [hazard ratio (HR) 1.19, 95% confidence interval (CI) 1.10 to 1.27]. In contrast, no association was observed when OPA was classified at the occupational-group level using Standard Occupational Classification groupings (HR 1.00, 95% CI 0.94 to 1.06). Sociodemographic and health factors accounted for the greatest attenuation across both classifications, whereas psychosocial factors contributed primarily to associations based on individual-level self-reported OPA. Conclusions The association between occupational physical activity and incident cardiovascular disease differed substantially according to how OPA was classified. These findings highlight exposure classification as a critical consideration when interpreting evidence on the physical activity paradox.

The sonography profession faces a persistent occupational health crisis, with nearly 90% of practitioners reporting work-related musculoskeletal disorders (WRMSDs) despite two decades of ergonomic education. This study performs a definitive bibliometric analysis to map the evolution of ergonomic technology and interventions for WRMSDs from 2000 to 2025. Addressing this unabated prevalence of injury is paramount to ensuring the long-term sustainability and resilience of the imaging workforce amid rising clinical demands. Adhering to PRISMA guidelines, the methodology utilized the Scopus database to extract a curated dataset of 93 peer-reviewed publications. Quantitative and network analyses were performed using VOSviewer and the Bibliometrix R-package to evaluate publication growth, leading contributors, and thematic clusters. The findings reveal a conceptual shift from foundational hazard identification toward high-order technological solutions, such as workstation automation and specialised transducer handles. Notably, the results indicate that traditional education-only models have reached a maximum threshold, as environmental constraints and high patient volumes frequently override individual behavioural changes. By providing the first integrated evaluation of the transition from awareness to technology-driven intervention, this study fills a critical gap in the literature regarding the structural role of technology as a prevention support tool. In practice, these findings provide a roadmap for hospital administrators and manufacturers to prioritise proactive environmental transformation over individual posture correction to safeguard practitioners' health. Keywords: Sonographer Ergonomics; musculoskeletal disorders (WRMSDs); Bibliometric Mapping; Technological Intervention; Workforce Sustainability.

Occupational ocular injuries are a preventable yet neglected public health problem, particularly in low- and middle-income countries. Maintenance workers are exposed to diverse ocular hazards daily, yet compliance with protective measures is consistently poor. A descriptive cross-sectional study was conducted among 85 maintenance workers at the Maintenance and Essential Services Organization (MESO) of Kwame Nkrumah University of Science and Technology (KNUST), Ghana, recruited through stratified convenience sampling across seven occupational sections. A structured questionnaire assessed knowledge of ocular hazards and protective equipment, attitudes toward ocular safety, and safety practices. Data were analyzed using IBM SPSS version 26 (IBM Corp., Armonk, NY, USA); chi-square and Fishers exact tests assessed associations (p < 0.05). Participants were predominantly male (84/85, 98.8%), with a mean age of 44.5 {+/-} 10.4 years. Overall knowledge was good (mean 9.40 {+/-} 1.59 out of 11), but attitude and practice scores were average (2.78 {+/-} 0.92 and 3.27 {+/-} 0.93, respectively). Most workers correctly identified goggles and face shields as protective, but only about half recognized that ordinary sunglasses and spectacles offer inadequate protection. Although 97.6% (83/85) recognized the need for ocular protection, only 7.1% (6/85) reported consistent protective eyewear use, and fewer than half (45.9%, 39/85) had received formal ocular safety training. Routine general protective equipment use was significantly associated with ocular protection use (Fishers exact test, p = 0.011). Sand and dust particles were the leading causes of injury and only 25% (5/20) of injured workers sought formal care. Workers demonstrated good knowledge but poor attitudes and practices toward ocular safety, suggesting that knowledge alone does not translate into protective behaviour even within a relatively well-resourced institutional setting. Findings suggest that limited access to task-appropriate protective eyewear may represent an important institutional barrier. Institutional PPE supply and section-specific safety training are essential to bridge this knowledge-practice gap.

Abstract Objective To estimate the burden and patterns of multimorbidity and cardiometabolic multimorbidity among university employees undergoing a comprehensive health assessment programme, and to examine demographic and behavioural factors associated with multimorbidity. Design Cross-sectional study. Setting A public university in Maharashtra, India. Participants A total of 266 university employees who underwent a comprehensive health assessment were included. Main outcome measures Multimorbidity was defined as the presence of two or more of nine chronic conditions: hypertension, diabetes mellitus, dyslipidaemia, ischaemic heart disease, chronic kidney disease, thyroid disease, stroke, chronic obstructive pulmonary disease and cancer. Cardiometabolic multimorbidity was defined as the presence of two or more of hypertension, diabetes mellitus, dyslipidaemia, ischaemic heart disease and chronic kidney disease. Results Hypertension was identified in 119 participants (44.7%), comprising 50 participants with pre-existing hypertension and 69 newly identified during the assessment. Dyslipidaemia was present in 189 (71.1%) and diabetes mellitus in 45 (16.9%). Overall, 108 participants (40.6%) had multimorbidity and 103 (38.7%) had cardiometabolic multimorbidity. The prevalence of multimorbidity increased progressively with age, from 17.5% among participants aged <30 years to 83.3% among those aged [&ge;]60 years. The predominant exact multimorbidity patterns were hypertension with dyslipidaemia alone (49 participants) and hypertension, diabetes mellitus and dyslipidaemia (27 participants). Overall, 173 participants (65.0%) had at least one newly identified hypertension, diabetes mellitus or dyslipidaemia diagnosis. In multivariable logistic regression, age (adjusted OR [aOR] 1.058 per year, 95% CI 1.027 to 1.091), BMI (aOR 1.163 per kg/m2, 95% CI 1.076 to 1.257) and tobacco use (aOR 3.296, 95% CI 1.377 to 7.888) were independently associated with multimorbidity. The model had an area under the receiver operating characteristic curve of 0.731. Conclusion Multimorbidity affected approximately two in five university employees, with cardiometabolic conditions accounting for most of the observed disease clustering. Comprehensive health assessment identified a substantial burden of previously unrecognised chronic disease. Integrating institutional or occupational health assessment with longitudinal primary care follow-up may provide an opportunity for earlier detection, risk-factor modification and coordinated management of multimorbidity. Keywords: Multimorbidity; cardiovascular diseases; hypertension; diabetes mellitus; dyslipidaemia; occupational health; university employees; India

Background: Workplace discrimination and violence against health workers including sexual harassment is a societal problem worldwide. We aimed to assess the frequency, predictive factors, and effects of sexual harassment using a nationwide survey of physicians working in Switzerland. Materials and Methods: We conducted a self-administered questionnaire survey of physicians working in Swiss healthcare institutions. The questionnaire assessed experiences of sexual harassment at work, including frequency, types, and sources of harassment. It also asked about the impact of sexual harassment, whether incidents were reported, and what actions were taken following a report. Results: Among the 1837 physicians that participated in the survey, 575 (31.3%) had experienced sexual harassment at least once during their career. Among those reporting sexual harassment, 39.1% of women and 13.2% of men had experienced harassment at least once in their job. Women reported more verbal harassment, while men reported more physical harassment. Women were also more likely to face both forms combined. The main sources of harassment were colleagues of the same profession (46.7%), patients (42.3%), and superiors (41.0%). The most frequently reported impacts included stress (60.1%), emotional exhaustion (34.7%), reduced motivation at work (30%), and considering leaving the job (7.5%). Gender-men was associated with a lower likelihood of experiencing harassment 0.24 (0.18 to 0.31), whereas working in the German-speaking region was associated with a slightly higher likelihood of having experienced sexual harassment at least once (OR 1.35, 95% CI:1.02-1.81). Conclusions: Sexual harassment is common among physicians in Swiss healthcare institutions. It adversely affects the mental health and career trajectories of both men and women yet remains widely underreported due to fears of reprisals and inaction. Institutions should effectively intervene to ensure that reported incidents result in appropriate actions, and that those who report them receive adequate protection from reprisals.

Background Licensed registered nurses (RNs) who are not employed in nursing are often counted as reserve capacity. A license, however, does not indicate readiness to enter the workforce. We examined whether this population contains distinct workforce activation states and how reported reasons for not working in nursing correspond to those states. Methods We analyzed the 2022 National Sample Survey of Registered Nurses, a nationally representative cross-sectional survey of licensed US nurses. The study population comprised RNs and RN advanced practice registered nurses who were actively licensed but not working for pay in nursing on 31 December 2021. The outcome distinguished five states reported at survey response: no future intention, actively looking, plans future entry or return, undecided, and already entered or returned. Ten prespecified reasons with adequate cell sizes were examined in separate survey-weighted multinomial models. Variance estimation used the main survey weight and 80 successive difference replicate weights. Models adjusted for age, sex, race and ethnicity, nursing education and license type; the family caregiving model also adjusted for marital status and dependents. Results The model-eligible sample included 7,744 respondents, representing 869,236 licensed RNs. An estimated 44.4% had no future intention to work in nursing, 25.6% were undecided, 14.6% had entered or returned, 10.7% planned future entry or return, and 4.7% were actively looking. Retirement was associated with a 27.0 percentage point higher adjusted probability of no future intention (95% CI 21.1 to 32.9). Family caregiving was associated with a 14.6 point higher probability of planned entry or return (95% CI 10.9 to 18.3) and a 13.3-point lower probability of no future intention (95% CI -18.0 to -8.5). Burnout, stressful work, inadequate staffing, scheduling problems and poor management were each concentrated in the undecided state, with adjusted probability differences from 6.1 to 14.6 points. These patterns remained in analyses restricted by retirement, prior nursing work, license type and official imputation status. Conclusions The licensed nonworking RN population is a stratified labor reserve. Family caregiving identifies a planned reserve, workplace barriers identify a conditional reserve, and retirement identifies a largely nonmobilizable group. Workforce planning should measure activation state before treating licensed capacity as available supply.

Purpose: The internship period is a critical stage for nursing students to develop professional values. This study aimed to investigate the current status of professional identity among nursing interns, analyze the effects of social support, perceived stress, psychological resilience, and career adaptability on professional identity, and explore the mediating role of career adaptability between social support and professional identity, so as to provide empirical evidence for enhancing professional identity and optimizing nursing talent training systems. Methods: Using convenience sampling, 407 nursing interns from a tertiary hospital in Quanzhou were selected as participants from May to July 2025. Data were collected using a general information questionnaire, the Social Support Scale, the Perceived Stress Scale, the Psychological Resilience Scale, the Professional Identity Questionnaire for Nursing Students, the Career Adaptability Scale, and the Questionnaire for Nurse Intention to Retention Employed. SPSS 26.0 was used for reliability analysis, descriptive analysis, independent samples t-test, one-way ANOVA, Pearson correlation analysis, and multiple linear regression analysis. The PROCESS macro was employed to test the mediating effect. Results: The total score of professional identity among nursing interns was (61.74{+/-}11.08), with 73.5% showing moderate professional identity. Parents' attitude toward nursing, reasons for choosing the profession, personal attitude toward the major, and employment intention showed statistically significant differences in professional identity scores (p<0.05). Pearson correlation analysis revealed that professional identity was significantly positively correlated with social support (r=0.474), psychological resilience (r=0.389), and career adaptability (r=0.609) (p<0.01), and significantly negatively correlated with perceived stress (r=-0.378) (p<0.01). Multiple linear regression analysis indicated that career adaptability ({beta}=0.309, p<0.001) and social support ({beta}=0.383, p<0.001) were significant positive predictors of professional identity, whereas reasons for choosing the profession ({beta}=-3.603, p=0.001) and employment intention ({beta}=-7.116, p<0.001) were significant negative predictors. The model explained 49.2% of the variance in professional identity. Mediation effect analysis showed that career adaptability played a partial mediating role between social support and professional identity, with a mediation effect value of 0.288 (95% CI: 0.221-0.363), accounting for 40.2% of the total effect. Conclusions: Nursing interns' professional identity is at a moderately high level. Social support and career adaptability are positive influencing factors. Career adaptability plays a partial mediating role between social support and professional identity; social support indirectly enhances professional identity by strengthening career adaptability.