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Journal of Occupational Health

◐ Oxford University Press (OUP)

Preprints posted in the last 90 days, ranked by how well they match Journal of Occupational Health's content profile, based on 12 papers previously published here. The average preprint has a 0.00% match score for this journal, so anything above that is already an above-average fit.

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The Japanese version of the Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians (MPIIQM-J): Translation, cultural adaptation, and validation in Higher Music Education Institutions

AKAIKE, M.; TANAKA, T.; SUZUKAMO, Y.

2026-08-21 occupational and environmental health 10.64898/2026.08.18.26360635 medRxiv
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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.

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Work-related Musculoskeletal Pain Among Factory Workers in Kigali: Prevalence and Coping Strategies

Dusabeyezu, P.; Sagahutu, J. B.; Kemigisha, J.

2026-08-25 occupational and environmental health 10.64898/2026.08.22.26361118 medRxiv
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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.

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Professional Identity and Its Influencing Factors Among Nursing Interns: The Mediating Role of Career Adaptability Between Social Support and Professional Identity

Zhao, Y.; Liu, F.; Chen, L.; Li, X.; Wu, B.

2026-10-16 occupational and environmental health 10.64898/2026.10.14.26365571 medRxiv
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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.

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Assessing hospital workers' health: a tool for longitudinal health monitoring in a public tertiary hospital in Brazil's Unified Health System (SUS)

Amancio, R. T.; Cruz, L. N.; Dantas, R. d. S.; Gomes, M. P.; Silva, A. d. A. B. d.; Brasil, P. E.

2026-08-31 occupational and environmental health 10.64898/2026.08.27.26361318 medRxiv
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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.

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Occupational stressors, perceived injustice, and pathways to pain interference and insomnia among workers with headache or low back pain

Yamada, K.; Mibu, A.; Adachi, T.; Enomoto, K.; Nishigami, T.; Sullivan, M. J.

2026-09-21 pain medicine 10.64898/2026.09.18.26363293 medRxiv
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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.

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Occupational burnout in the UK film and television industry: A cross-sectional survey of mental health, job quality, perceived stigma, and sexual harassment

Caldwell, M. S.; Chamberlain, R.; Rippon, D.

2026-10-20 occupational and environmental health 10.64898/2026.10.15.26365611 medRxiv
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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.

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Protecting the protectors: Occupational burden and management of work-related musculoskeletal disorders among Cameroonian healthcare professionals and the Sustainable Development Goals

Kum, M. B.; Meh, B. K.; Buh, F. C.; Mandengue, S. H.; Bopda, O. S. M.

2026-08-02 occupational and environmental health 10.64898/2026.07.30.26359338 medRxiv
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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.

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Lived experiences and occupational pressures among Vietnamese nail salon workers in Maryland

Nguyen, K. K.; Agree, E. M.

2026-09-11 occupational and environmental health 10.64898/2026.09.10.26362742 medRxiv
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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.

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Multimorbidity and cardiometabolic clustering among university employees: findings from a comprehensive health assessment program in India

Jagtap, A. H.; Ingole Patil, A. S.; Kudale, A. M.

2026-10-20 occupational and environmental health 10.64898/2026.10.20.26365860 medRxiv
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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

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Effects of Virtual Co-working Environment Using a Work-Support Application on Subjective Workload, Mood, and Fatigue: A Randomized Crossover Trial

Momosaki, R.; Hasegawa, Y.; Ushida, K.; Shimizu, M.

2026-09-21 occupational and environmental health 10.64898/2026.09.19.26362890 medRxiv
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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.

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Sociodemographic and occupational factors associated with general sick leave among public school teachers in Bogota: A retrospective cohort study, 2010-2025

Bayona-Rodriguez, H.; Sanchez-Santiesteban, D.; Buitrago, G.

2026-08-10 occupational and environmental health 10.64898/2026.08.06.26359845 medRxiv
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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.

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Cardiovascular Risk Stratification Among University Employees in India: Comparison of WHO/ISH, ASCVD and Framingham Risk Models

Jagtap, A. H.; Ingole Patil, A. S.; Kudale, A. M.

2026-10-14 occupational and environmental health 10.64898/2026.10.12.26365229 medRxiv
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Background Cardiovascular disease (CVD) risk prediction is an important component of primary prevention, particularly in populations with increasing cardiometabolic risk. Several risk prediction models are available, but their estimates may differ because of differences in derivation populations, predictors, calibration, and cardiovascular outcomes. Evidence comparing these models within Indian occupational populations remains limited. This study compared 10-year CVD risk estimates generated by the World Health Organization/International Society of Hypertension (WHO/ISH) cardiovascular risk charts, the American College of Cardiology/American Heart Association (ACC/AHA) Pooled Cohort Equation (ASCVD-PCE), and the Framingham general cardiovascular disease risk equation among university employees in India. Methods A comparative observational study was conducted using standardized health assessment data from 266 university employees. Participants aged 40-74 years were selected to provide a common analytical age range across the three risk prediction approaches. Of 127 employees within this age range, three with documented previous ischemic heart disease were excluded because the analysis focused on primary prevention. The final analytical cohort comprised 124 participants. Blood pressure was assessed using a standardized protocol involving three readings at five-minute intervals, with repeat assessments during three subsequent weekly visits for employees with elevated initial readings. Ten-year cardiovascular risk was estimated using the 2019 WHO/ISH laboratory-based risk charts for the South Asian region, the ASCVD-PCE, and the 2008 Framingham general CVD equation. Agreement between risk categories was assessed using Cohen's kappa and linear weighted kappa. Agreement was also examined at [&ge;]10% and [&ge;]20% thresholds. Results The mean age of the 124 participants was 47.63 {+/-} 6.45 years, and 86.3% were male. Diabetes was present in 25.8%, smoking/tobacco use in 19.4%, and 29.0% were receiving antihypertensive treatment. Mean estimated risk was 5.94% for WHO/ISH, 5.95% for ASCVD-PCE, and 12.86% for Framingham. High risk ([&ge;]20%) was identified in 2.4%, 4.8%, and 20.2% of participants by WHO/ISH, ASCVD-PCE, and Framingham, respectively. Exact four-category agreement was 70.2% between WHO/ISH and ASCVD-PCE, compared with 31.5% between WHO/ISH and Framingham and 26.6% between ASCVD-PCE and Framingham. Cohen's kappa was 0.502 for WHO/ISH versus ASCVD-PCE, 0.079 for WHO/ISH versus Framingham, and 0.047 for ASCVD-PCE versus Framingham. Weighted kappa values were 0.639, 0.323, and 0.342, respectively. Conclusion WHO/ISH and ASCVD-PCE produced closely similar mean risk estimates and substantially greater categorical agreement than either model showed with the Framingham equation. Framingham generated considerably higher 10-year CVD risk estimates and classified a larger proportion of participants into higher-risk categories. These findings highlight the importance of model selection when cardiovascular risk assessment is undertaken in Indian occupational populations and support cautious interpretation of risk estimates derived from models developed in different populations and for different cardiovascular endpoints. Keywords: cardiovascular disease; risk prediction; WHO/ISH; ASCVD; Pooled Cohort Equation; Framingham; India; occupational health; university employees; risk classification

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Inflammation Beyond the Disc: Circulating Inflammatory Biomarkers in Lumbar Disc Herniation and Degeneration--A Case-Control Study

Withanage, N. D.; Perera, S.; Athiththan, L.

2026-08-31 orthopedics 10.64898/2026.08.28.26361607 medRxiv
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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.

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Mortality among Brazilian male police officers and firefighters over three decades

Teixeira, E. M.; Damacena, F. C.; de Souza, F. B.; Jarske, R. D.; Grossi-Porto, L. G.; Zandonade, E.; Sampaio, K. N.

2026-10-11 epidemiology 10.64898/2026.10.08.26365007 medRxiv
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Background: Long-term mortality data among Brazilian police officers and firefighters are scarce. This study investigated the leading causes of death in Brazilian male military police officers and firefighters over three decades, comparing their mortality and mean age at death with those of the male population. Methods: We retrospectively analyzed death records of male military police officers and firefighters from Espirito Santo (ES), Brazil, from 1988 to 2019. Mortality was analyzed across three decades and the standardized mortality ratios (SMRs) for the three leading causes were calculated using the male populations of ES and Brazil as references. Results: Overall, 2,198 deaths were identified, with a mean age at death of 59 {+/-} 18.5 years, compared with 60.5 {+/-} 23.9 years among men in ES and 63.4 {+/-} 23.7 years among Brazilian men. Mean age at death was 36 {+/-} 9 years among active-duty and 68 {+/-} 13 years among inactive personnel. Across the study population, the leading causes of death were circulatory system diseases (32%), external causes (26%) and neoplasms (15%). Circulatory disease mortality was higher in the second and third decades compared with both reference populations, whereas external-cause mortality shifted from higher, in the first two decades, to lower than expected in the last decade. Neoplasm mortality was higher relative to Brazil only in the last decade. Conclusion: Mortality patterns differed by cause and over time. The younger mean age at death among active-duty personnel, together with cause-specific excess mortality, highlights the importance of long-term occupational health surveillance and preventive strategies.

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Knowledge, attitudes, and practices related to ocular safety among maintenance workers in a Ghanaian university: A cross-sectional study

Kwarteng, C.; Brew, F. M.; Owusu, E.

2026-09-03 occupational and environmental health 10.64898/2026.09.01.26361906 medRxiv
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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.

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Patterns and Outcomes of Occupational Injuries in Emergency Departments at Nigerian Hydropower Plant Hospitals: A Retrospective Study

Ojo, J. O.

2026-09-04 emergency medicine 10.64898/2026.08.31.26361543 medRxiv
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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.

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Ergonomic Interventions and Technology in Preventing Musculoskeletal Disorders Among Sonographers (2000-2025): A Systematic Mapping Review

Akomah, A. B.; Piersson, A. D.; Tizumah, M. W.

2026-09-16 radiology and imaging 10.64898/2026.09.15.26363110 medRxiv
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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.

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MAPEVAScR: a four-phase framework integrating transparent rule based text mining, evidence gap mapping and a mandatory human validation gate for scoping reviews framework development and empirical validation in occupational health.

ERAS LEVANO, C. J.

2026-09-10 occupational and environmental health 10.64898/2026.09.08.26362521 medRxiv
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Background. Automation is increasingly used to reduce the screening workload of evidence syntheses, but its error is real, variable and rarely reported. The 2025 joint position statement of Cochrane, Campbell, JBI and the Collaboration for Environmental Evidence mandates human oversight of artificial intelligence in evidence synthesis, yet, as of today, no international guideline requires quantitative measurement and reporting of automated-screening error against a human gold standard. Methods. We developed MAPEVAScR (MAPeo de EVidencia con VAlidacion humana), a four phase framework for scoping reviews: (A) datalake construction with deterministic, traceable deduplication; (B) transparent, record level auditable rule based text mining with confidence tiers; (C) evidence gap mapping that feeds back human screening prioritisation; and (D) a mandatory human validation gate verifying 100% of the candidate corpus and issuing a quantitative screening error report (per tier precision, confusion matrix, falsepositive families, documented changes to conclusions). The framework was empirically validated on a scoping review of epilepsy and occupational fitness (2015 to 2025; PubMed, Scopus, Web of Science): a funnel of 2,008 [-&gt;] 1,435 [-&gt;] 1,114 [-&gt;] 230 records was reduced to 127 human confirmed inclusions (present study). Results. The rule based filter achieved a global precision of 55.2% (Tier A 75.5%, Tier B 37.5%, Tier C 45.8%); human validation identified 103 false positives classifiable into seven reproducible error families, and 107 of 127 included records required human correction of automated thematic labels. Without the gate, the review's central thematic conclusion would have been published reversed: automated labelling ranked Aptitude/employability third (12.6% of records), whereas after validation it ranked first (73.2%) (present study). Conclusions. A mandatory human validation gate with quantitative error metrics closes a reporting gap that current guidelines leave open: in the present study it prevented publication of an inverted synthesis. We propose the screening error report as a minimum reporting standard for any evidence synthesis using automated screening. Keywords: scoping review; text mining; human validation; automation bias; evidence gap map; occupational health; epilepsy; PRISMAScR

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Differences in domain-specific composition of 24-hour physical behaviors across occupational groups

Hirvonen, N.-P.; Niemela, M.; Leinonen, A.-M.; Farrahi, V.

2026-07-27 epidemiology 10.64898/2026.07.23.26358754 medRxiv
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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.

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Prevalence and Patterns of Lumbar Spine Modic Changes Among Adult Patients with a History of Low Back Pain in the Northern Zone, Tanzania.

Lutatina, J.; Temu, R.; Magembe, P. M.; Mandari, F. N.; Majuka, L.; Mtui, D.; Mollel, J.; Olottu, F.; Uisso, F.; Kawiche, G.; Ncheye, M. S.; Massawe, H. H.

2026-09-29 orthopedics 10.64898/2026.09.24.26363960 medRxiv
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Introduction Low back pain (LBP) is a common leading cause of functional disability in adults worldwide, presenting with Modic changes that are visible within the endplates of the vertebral body under magnetic resonance imaging (MRI). Modic changes (MC) are not just a coincidental imaging finding; they reflect underlying pathology that needs treatment focus. This study aimed to ascertain the prevalence and patterns of Modic changes in the lumbar spine among adult patients with a history of low back pain attending the Kilimanjaro Christian Medical Centre (KCMC) Orthopedic clinic. Methods A descriptive cross-sectional study was conducted at the KCMC orthopedic clinic from 2nd October 2024 to 30th May 2025. Data from adult patients with a history of low back pain who had undergone lumbar spine MRI were collected, cleaned, and analyzed in SPSS (version 25). Categorical variables were summarized by frequency and proportion, while continuous variables were summarized using the mean and standard deviation. Frequency tables, histograms, and pie charts were used for results presentation. Results Of the 283 patients enrolled in the study, the mean age was (57.2 {+/-}15.7) years, with the majority (145; 51.2%) being aged > 59 years. Most patients, 203 (71.7%), were females, while 176 (62.2%) were married, and 142 (50.2%) were overweight. The prevalence of MC on the lumbar spine among patients with a history of low back pain was 66.4% (n=188). Among patients with lumbar spine MC, the majority, 112 (59.6%), were aged over 59 years, and 125 (66.5%) had lumbar spine MC type II, which was the most predominant compared to other types of MC. Conclusion Modic changes on the lumbar spine are prevalent in adult patients with low back pain, particularly those over 59 years, with type II being the most common. Healthcare professionals and policymakers should recognize Modic changes as clinically relevant findings that require consideration in the management of patients with a history of low back pain rather than dismissing them as mere incidental or coincidental observations.