Journal of Occupational Health

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.

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.

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: 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.

Background: Lumbar disc herniation, with or without concomitant disc degeneration, is a major cause of lumbar radiculopathy and low back pain, which also a key public musculoskeletal disorder without an exact pathophysiology. Studies have suggested that inflammatory cells and biochemical markers of inflammation also play an important role in lumbar radiculopathy in addition to nerve compression. The aim of the present study was to assess the association of selected circulatory inflammatory markers (CRP, hs-CRP and E-selectin) in patients with lumbar disc herniation without radiological degeneration (LDH) and lumbar disc herniation with radiological degeneration (LDHD). Materials & methods: This case-control study included 208 participants, comprising 104 patients with lumbar disc pathology and 104 controls. Patients were further stratified into LDH (n=67) and LDHD (n=37). Serum CRP, hs-CRP and E-selectin concentrations were measured. Results: Among the patients, 35.6 % presented with LDHD while 64.4 % had only LDH. Significantly increased median hs-CRP (p<0.001) and CRP (p<0.001) were observed in patients groups compared to controls, while CRP showing a consistent independent association across the combined disease (OR=1.68, 95% CI=1.33-2.14, p<0.001), LDHD (OR=1.62, 95% CI=1.16-2.20, p=0.005) and LDH (OR=1.69, 95% CI=1.30-2.20, p<0.001) multivariable models. No significant difference was observed in serum E-selectin between the study groups. Multivariable models incorporating inflammatory and clinical variables demonstrated substantially greater discriminatory performance than individual biomarkers alone. Conclusion: Elevated circulating CRP and hs-CRP concentrations were associated with lumbar disc pathology, with CRP showing a consistent independent association across the combined disease, LDH and LDHD multivariable models, whereas E-selectin showed no significant association. Multivariable models incorporating inflammatory and clinical variables demonstrated greater discriminatory performance than individual biomarkers. These findings support a potential systemic inflammatory component in lumbar disc pathology, although the cross-sectional nature of the measurements does not establish causality or a local inflammatory response within the disc.

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.

Background: Sacroiliac joint (SIJ) pain is a common musculoskeletal condition among postpartum women due to hormonal, biomechanical, and physiological changes during pregnancy and childbirth. Increased ligament laxity, altered posture, weight gain, and pelvic instability may contribute to sacroiliac joint dysfunction. This condition often leads to pelvic girdle pain, low back pain, and functional limitations that affect daily activities such as walking, sitting, standing, and childcare. Objective: To determine the prevalence of sacroiliac joint pain and assess the level of disability among postpartum females in Sialkot. Materials and Methods: A descriptive cross-sectional study was conducted among 300 postpartum women aged 20-40 years from public and private hospitals in Sialkot. Non-probability convenience sampling approach was employed. Sacroiliac joint pain was assessed using clinical provocation tests including FABER, compression, and distraction tests. Pain intensity was measured using the Numerical Pain Rating Scale (NPRS), and functional disability was evaluated using the Oswestry Disability Index (ODI). Data were analyzed using SPSS version 25. Results: Clinical provocation testing demonstrated positive SIJ pain provocation in 84.0% (n=252) of acute postpartum participants, with severe functional disability observed in 46.0% (n=138). Most women reported moderate pain (74.7%), while 20.7% experienced severe pain. According to the ODI, 46% of participants had severe disability, 37.7% moderate disability, 10.7% minimal disability, and 5.7% were classified as crippled. Conclusion: Sacroiliac joint pain is highly prevalent among postpartum females and is associated with considerable functional disability. Early screening and physiotherapy-based rehabilitation may help reduce pain and improve functional outcomes. Keywords: Sacroiliac joint pain, Postpartum women, Pelvic girdle pain, Functional disability, Oswestry Disability Index.

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.

Objectives This study aimed to assess sleep patterns and life satisfaction among employees of a private company in Dubai, United Arab Emirates, and to examine the relationships among sleep quality, life satisfaction, and selected demographic variables. A quantitative descriptive cross-sectional survey design was adopted. Methods A convenience sample of 110 male employees participated in the study. Data were collected using the Sleep Disorder Assessment Scale (16 items; Cronbachs = 0.89) and the Life Satisfaction Scale (5 items). Statistical analysis was performed using SPSS version 29, including descriptive statistics, chi-square tests, and Pearson correlation analysis. Results Most participants (66.4%) were aged 20-30 years, and 82.7% experienced moderate sleep-related problems. Mobile phone use before bedtime was common, with 60.9% reporting occasional use and 35.5% reporting regular use. Overall, 41.8% reported neutral life satisfaction, while 25.5% and 24.6% were slightly and extremely satisfied, respectively. A significant negative correlation was found between poor sleep patterns and life satisfaction (r = -0.389, p < 0.001). Mobile phone use before bedtime and shift work were significantly associated with sleep patterns (p = 0.048). Conclusion Poor sleep quality, particularly among shift workers and frequent bedtime mobile phone users, is associated with lower life satisfaction. Workplace interventions promoting sleep hygiene may enhance employee well-being.

Background Global labor migration from LMIC to higher-income destinations has expanded rapidly, placing increasing pressure on destination-country health. Existing research on cross-border migrant workers has focused largely on occupational health, general healthcare utilization, and disease-specific risks, while there is considerably less evidence on their sexual and reproductive health. This study contributes to this understudied field by examining the policy and health-system factors that shape the sexual and reproductive health services for migrant workers in Taiwan. Methods A qualitative study was conducted in Taiwan between November 2025 and August 2026. 22 stakeholders were purposively recruited from academia, healthcare, nongovernmental organizations, government, labor brokerage, and employers. Data were collected through semi-structured interviews and small focus groups. Interviews were conducted in Mandarin Chinese, transcribed verbatim, and translated into English. Data were analyzed using framework analysis combining deductive coding based on the AAAQ framework with inductive coding of implementation and contextual themes. Results Gaps were identified across all four AAAQ dimensions. Participants described limited migrant-responsive SRH programming; physical, financial, administrative, social, and information barriers; shortcomings in linguistic and cultural responsiveness; and weaknesses in interpretation, coordination, and continuity of care, despite generally favorable views of Taiwan's clinical quality. Conclusions Our findings show that broad insurance coverage and strong clinical capacity do not by themselves ensure the realization of migrant workers' SRHR. In Taiwan, rights were mediated through labor brokerage, gendered live-in work arrangements, and fragmented governance across health, labor, immigration, and social-welfare systems. Improving migrant SRHR therefore requires stronger implementation of existing protections, reduced dependence on informal intermediaries, and more integrated institutional responsibility for cross-sector migrant health needs.

Introduction Smoking prevalence remains higher in rural than in urban populations in the United States. To examine recent trends, we assessed state-level differences in cigarette smoking between urban and rural areas from 2018 to 2024. Methods Using repeated cross-sectional data from the Behavioral Risk Factor Surveillance System, we estimated state-specific logistic regression models to examine the relationship between urban-rural county residence and cigarette smoking. Unadjusted models (model 1) included urban-rural county status and year. Subsequent models (model 2) added age, sex, and race/ethnicity. A final model (model 3) included education and an interaction term between urban-rural county status and year to examine whether gaps in urban-rural smoking changed over time. In states with significant interactions, simple effects tests compared trends for urban-rural groups separately. Results Compared to urban adults, rural adults had higher unadjusted odds of cigarette smoking (odds ratio [OR] range:1.07-1.88) in 88.4% (38/43) of states. Adjusting for demographic covariates (model 2) increased the proportion of states with significant marginal effects of rurality to 90.7% (ORs:1.09-1.87). A final model that also controlled for education (model 3) decreased the proportion of states with significant marginal effects of rurality to 60.5% (ORs:1.10-1.54). Among the 14 states with significant interaction terms, the odds of smoking declined faster among urban than rural residents. Conclusion Urban-rural differences in smoking persist across most states. No state showed a reduction in urban-rural disparities over time, and the urban-rural gap widened in 14 states. Demographic variation accounted for some, but not the majority, of observed urban-rural differences.

Objective: We examined whether perceived stress and sleep quality mediate the association between social support and later cognition among adults in the United States. Methods: We used longitudinal Midlife in the United States (MIDUS) data. Social support (1995-1996) was modeled as a latent construct indicated by family and friend support. Perceived stress and sleep quality were measured in the MIDUS 2 Biomarker Project (2004-2009), and cognition was assessed in MIDUS 2 and MIDUS 3. Structural equation models evaluated parallel indirect pathways, adjusting for MIDUS 2 cognition and covariates. Results: Higher social support was associated with lower perceived stress ({beta}=-0.32, 95% CI:-0.41, -0.23) and better sleep quality ({beta}=-0.25, 95% CI:-0.35, -0.15). Greater perceived stress was associated with lower cognition ({beta}=-0.06, 95% CI:-0.11, -0.01), whereas sleep quality was not associated with cognition. Direct and total social support-cognition associations were not statistically significant. A small positive indirect association through perceived stress was identified ({beta}=0.02, 95% CI:0.00, 0.04); no indirect association through sleep quality was identified. Conclusions: Findings are consistent with a possible psychosocial pathway through perceived stress, although the effect was modest and total and direct associations were not statistically significant. Sleep quality showed no statistically significant indirect association.

Objectives: Healthcare data can reveal actionable opportunities to prevent asthma hospitalizations. Limited national-level data exist regarding social determinants of health (SDOH) and asthma hospitalizations. We examined SDOH-related International Classification of Diseases, Tenth Revision (ICD-10) Z-codes in national administrative data on asthma hospitalizations and described patient- and hospital-level characteristics associated with documented SDOH Z-codes. Methods: Pooled cross-sectional analysis of 2016-2022 Nationwide Inpatient Sample for 200,452 U.S. hospitalizations (all ages) with a primary diagnosis of asthma. Presence of SDOH Z-codes (codes Z55-Z65) assessed by descriptive statistics and multivariable logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (95% CIs) for associations between SDOH Z-codes and patient- and hospital-level characteristics. Results: In unweighted analyses, 3,149 asthma hospitalizations had SDOH Z-codes (1.57%). The most common SDOH Z-codes were homelessness (Z59.0; n=942) and unemployment (Z56.0; n=349). Weighted chi-square analyses found all selected variables were associated with asthma hospitalization SDOH Z-code documentation. Logistic regression results varied; adjusted odds for SDOH Z-code documentation were higher for asthma hospitalizations involving male patients (aOR=1.51; 95% CI, 1.39-1.63; P < .001) compared to female patients. Asthma hospitalizations involving rural hospitals had lower odds of SDOH Z-codes documentation (aOR=0.57; 95% CI, 0.47-0.70; P < .001) compared to urban teaching hospitals. Conclusions: National 2016-2022 data indicate housing- and employment-related Z-codes were the most commonly documented SDOH within asthma hospitalizations. Future analyses could consider establishing causality and exploring how relationships between these SDOH may be used by public health practitioners and others to improve program interventions.

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.

Objectives: To estimate the prevalence of Post-Exertional Malaise (PEM) among adults with prior COVID-19 and associated mental health and disability outcomes. Methods: We conducted a cross-sectional analysis of data from a survey of 9,620 adults with prior COVID-19 in New York City, collected May - June 2024. PEM was measured with the DePaul Symptom Questionnaire - Post Exertional Malaise, categorized by symptom duration (< 14 vs. [&ge;]14 hours). Weighted prevalence estimates were stratified by socio-demographic and clinical characteristics. Modified Poisson regression was used to assess the association of PEM with depression, anxiety, and disability. Results: The prevalence of PEM symptoms was 20.9% overall and 4.0% with symptom duration [&ge;]14 hours, representing over 800,000 New Yorkers affected and over 150,000 who meet a diagnostic criterion for ME/CFS. PEM prevalence was higher among women, transgender and non-binary adults, people of color, and lower educational attainment, chronic comorbidities, or disabilities. PEM was associated with 3 - 4 times higher prevalence of mental health outcomes and 4 - 5 times higher disability scores. Conclusions: PEM symptoms were common and strongly associated with disability and adverse mental health. Screening, pathways to care, and supportive policies are needed to mitigate long-term consequences, particularly among marginalized populations.

Introduction: Nicotine Pouches are increasingly used as a smokeless alternative to cigarettes and other nicotine products, yet their acute cardiovascular effects remain poorly documented. While nicotine's impact on heart rate and electrocardiogram (ECG) parameters is well-documented in smoking, no trials have evaluated these effects specifically for nicotine pouches. Methods: This study is a single-center, double-blind, placebo-controlled, crossover trial which will include 20 healthy adult nicotine users. Participants will undergo three sessions, receiving either a placebo, 6 mg, or 14 mg nicotine pouch in random order. Heart rate obtained by an ECG and various other ECG parameters, vital signs, and subjective symptoms will be measured at baseline, and multiple time points over 30 minutes. Conclusions: This study aims to determine whether nicotine pouches cause acute changes in heart rate, ECG parameters, vital signs, and self-reported symptoms. We hypothesize that higher nicotine pouch does will lead to measurable increases in heart rate and other autonomic effects compared to placebo.

Measuring health literacy is important in addressing health inequity. However, current measures are developed from the individualistic perspective that values personal autonomy and choice. Applying such measures to people from a communal culture that values collective actions may lead to biased responses. To address this gap, a health literacy measure drawing on the communal perspective was developed in Thailand. With the aim to also develop an equitable measure, a grounded approach including strategies to include people with special needs such as people with chronic illness or physical disabilities, blind people and deaf people, was used. Concept mapping workshops were conducted, involving 254 participants including general community members, people with special needs, health professionals and policymakers. The result was a draft questionnaire of 17 hypothesized scales. Psychometric testing involving a survey of 2,228 participants resulted in a 14-scale questionnaire, the Information and Support for Health Actions Questionnaire (ISHAQ). This paper reports on the psychometric testing of the 14-scale ISHAQ and its supplementary scales for people with special needs. Item difficulty, scale reliability, one-factor confirmatory factor analysis using robust maximum likelihood estimator, and measurement invariance across groups with special needs using the alignment method with Bayesian estimation, were evaluated. A total of 2,262 respondents participated in the survey. Six scales achieved excellent model fit while one with reasonable fit and seven scales achieved reasonable to excellent fit following modifications. Supplementary scales also achieved reasonable to excellent model fit. Reliability for all scales were acceptable to good. Measurement invariance was confirmed for eight scales. With strong validity evidence, the ISHAQ is translated into English and ready for implementation. With the potential to be applied in different settings given cultures exist in a continuum, the ISHAQ can be used for health literacy needs assessment to support intervention development to improve health outcomes and equity.

Ambient particulate matter (PM) is a well-established environmental risk factor for non-communicable diseases, yet its influence on mitochondrial function remains poorly defined. Mitochondrial DNA copy number (mtDNA-CN) serves as a biomarker of mitochondrial biogenesis, making it a candidate exposure biomarker. We conducted the study per PRISMA guidelines (PROSPERO-CRD420261320957) and examined the association between ambient PM exposure and mtDNA-CN. Risk of bias was assessed using Joanna Briggs Institute tools, and relative and absolute changes in mtDNA-CN were pooled using random-effects models, with subgroup analyses by pollutant type and descriptive synthesis of mechanistic evidence. Of 1,224 records identified, 24 studies met inclusion criteria for quantitative analysis, with 12 reporting percentage change and 12 reporting absolute values, covering 13,092 participants. PM exposure was significantly associated with decreased percentage mtDNA-CN (ES: -4.90; 95% CI: -7.97 to -1.82; p = 0.002), while absolute mtDNA-CN levels increased significantly (ES = 0.55; 95% CI: 0.05 to 1.04; p = 0.030). Mechanistic pathways contributing included mtDNA hypermethylation, impaired mitochondrial biogenesis and dynamics. Our findings show ambient PM exposure alters mtDNA-CN, though directionality differs by metric, pointing to the need for larger prospective studies to validate mtDNA-CN as a reliable biomarker of airborne PM and nanoparticulate exposure.

Background: Environmental noise and air pollution are both shaped by road traffic and the built environment, and exposure assessment increasingly folds them into composite indices or proxies both by traffic exposure. Whether the two share a social distribution has rarely been tested against direct measurement of several exposures in the same communities, and community noise is almost always characterized by A-weighted levels alone, which discount low-frequency energy. Methods: At 176 sites across Rhode Island, spanning the contiguous urban area of Providence, Central Falls, and Pawtucket together with four rural municipalities, we measured the acoustic environment under A- and C-weighting (LAeq, LCeq), fine particulate matter (PM2.5), night-time illuminance, and relative humidity across four session types over roughly one year (704 site-sessions). Exposures were linked to census-tract composition (American Community Survey), and mixed-effects models were fitted for each of eight area-level markers of disadvantage, adjusting for campaign and session. Relative humidity was carried through the identical model as a negative control. Results: A-weighted noise was consistently higher in more disadvantaged tracts, rising with non-White, poverty, renter, and no-vehicle shares and falling with income and older-resident share (six of eight markers significant; 1.3 to 1.8 dBA per standard deviation; 6.6 dBA between the least and most racially diverse neighborhoods). C-weighted levels followed the same gradient on every marker and exceeded their A-weighted counterparts at block-group scale for renter occupancy and vehicle absence. Night-time illuminance was also socially patterned, whereas short-term PM2.5 was roughly an order of magnitude weaker and relative humidity showed no gradient. The acoustic gradient persisted within the urban core alone. Conclusions: Measured burden was carried by the acoustic environment, including its low-frequency component, and by night-time light, not by short-term particulates. The exposure metric and the averaging time determine which disparities are visible at all.