Annals of Global Health最新文献

Background: Despite decades of efforts to prevent heat stress, it remains a major health risk to workers in the construction industry. This health risk has been exacerbated by the rising ambient temperatures from climate change, as well as the increased susceptibility to heat stress in an aging workforce. Objective: To develop a tailored occupational safety management framework for heat stress prevention in construction, advancing workers' health, safety, and well-being. Methods: We built on the findings of a systematic review and analyzed a large industrial company's current heat stress prevention program through stakeholder engagement, evidence-based practices, and gap analysis. We reviewed the American Conference of Governmental Industrial Hygienists Threshold Limit Values, the International Standard Organization, and country-specific standards and used the National Institute for Occupational Safety and Health (NIOSH) recommended criteria as a benchmark. Gaps were identified by comparing existing measures to best practices. Findings: Most Wet-bulb Globe Temperature (WBGT) measurements (24.4°C-53.7°C) from the systematic review were collected over short durations without accounting for rest breaks, potentially underestimating or overestimating workers' heat stress and heat-related injuries/illnesses (HRIs) risks. Rest breaks did not follow the WBGT values, which is crucial for mitigating heat stress. Water consumption from the systematic review was below the NIOSH recommendations, with no electrolytes provided. Working 10 h/day, 13 days/two weeks, increases fatigue levels, significantly impacting workers' sleep quality and HRI risks. Conclusion: Preventing heat stress, addressing heat stress management gaps, and advancing construction workers' health, safety, and well-being require stakeholder involvement at all levels.

Introduction: Our case study was conducted across healthcare facilities in Kilifi and Nairobi, where perinatal adolescents were screened for depression. Objective: The relationship of environmental monitoring in addressing mental health needs of vulnerable perinatal adolescent populations was explored. Methods: We installed outdoor air quality sensors at two facilities in Nairobi-Kangemi and Kariobangi North health centers-and two in Kilifi-Mtwapa and Vipingo health centers-and installed sensors in two households of two perinatal adolescents. Community health workers monitored air quality and noise levels data, collecting experiential data on stress and mood from perinatal adolescents. Findings: Air quality monitoring revealed site-specific variations in PM_2.5 concentrations. Kariobangi Health Center recorded the highest mean concentration of 29.45 µg/m³, exceeding the WHO 2021 annual guideline of 5 µg/m³ indicating substantially degraded air quality. Kangemi Health Center was next (21.27 µg/m³), followed by Mtwapa (15.34 µg/m³) and Vipingo (12.52 µg/m³). Noise monitoring revealed consistently elevated exposure in healthcare settings. At Kangemi Health Center, mean noise levels reached 52.2 dB (median: 53.5 dB), surpassing the WHO guideline for hospital settings (<35-40 dB). Household-level air quality monitoring highlighted significant operational challenges: sensor deployment constraints, difficulties in ensuring continuous temporal coverage, and substantial intra-day variability-underscoring the need for improved monitoring design and calibration strategies. Conclusions: We tested air and noise monitoring deployment as a lever for strengthening the health system and a strategy for improved patient care and mental well-being. We trained community health workers and youth leaders in a task-shifting model to collect environmental health data. Our approach sought to ease the deployment of environmental monitoring in a sustainable data collection process. However, both mitigation, targeting reduction in sources of pollution, and adaptation efforts focused on coping with the effects of air and noise pollution on vulnerable populations within primary care need concerted efforts.

Background: Occupational diseases (ODs) remain a major public health concern. Despite advances in occupational health (OH), many workers remain at risk due to insufficient preventive measures and limited access to specialized care. Objective: This study aimed to evaluate the sociodemographic and occupational characteristics of patients attending an ODs outpatient clinic in Türkiye and to assess associated risk factors. Methods: We retrospectively analyzed data from 326 patients in a descriptive observational study. Variables included age, sex, work duration, income, education, personal protective equipment (PPE) use, and diagnosis. Findings: The mean age was 48.1 years, and 89.3% of participants were male. ODs were diagnosed in 42.3% of patients, with pneumoconiosis being the most common (34.1%). Longer employment duration significantly increased risk (OR: 1.06; 95% CI: 1.03-1.09; p < 0.001). Income was also significant: both below- (OR: 2.79; 95% CI: 1.20-6.49; p = 0.017) and above-minimum-wage earners (OR: 2.52; 95% CI: 1.00-6.37; p = 0.050) had a higher risk. Most participants reported dust (79.4%) and ergonomic exposures (77.6%). Consistent mask use was 12.0% and hearing protection 7.7%. PPE use was insufficient in smaller workplaces but relatively higher in larger ones. Women began working later than men (26.2 vs. 17.3 years; p < 0.001). Most participants (85.9%) had social security coverage, yet 16% worked after retirement. Discussion: Improving OH practices, particularly in small enterprises where PPE use is inadequate, expanding worker training and workplace inspections, and ensuring access to OH services for self-employed individuals are critical for effective prevention of ODs. Additionally, addressing socioeconomic factors such as income disparities may further reduce occupational disease risk.

Background: With the increasing severity of the aging population and the rise in the number of female smokers, the prevalence of chronic obstructive pulmonary disease (COPD) among women continues to rise. Relevant research on what impact this situation exerts on the disease burden of COPD and its changing trends among women is currently lacking. Methods: Data on female COPD burden were extracted from the Global Burden of Disease database for the years between 1990 and 2021. The trend of burden was evaluated by using percentage changes. Predicted trends for the years after 2021 were assessed by utilizing the Bayesian age-period-cohort (BAPC) model. Results: In 2021, the global numbers of women with COPD were 112.7 million, with 1.6 million deaths and 34.7 million disability-adjusted life years (DALYs). The corresponding Age-standardized rate (ASRs) (per 100,000 population) were 2468.2, 34.1, and 750.6, respectively. Over the past 32 years, the age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) dropped by 36.9% and 35.0%, respectively. Among the five socio-demographic index (SDI) regions, in 2021, the low-middle SDI region had the highest age-standardized prevalence rate (ASPR), ASMR, and ASDR, at 2817.0 per 100,000 population, 70.7 per 100,000 population, and 1424.1 per 100,000 population, respectively. The BAPC analysis indicated that the number of women with COPD is expected to rise over the next 30 years, while ASPR, ASMR, and ASDR are projected to decline. Conclusions: Although the ASPR, ASMR, and ASDR of female COPD patients have decreased from 1990 to 2021, the corresponding number of cases has been increasing, which reminds us that female COPD is indeed a public health issue that cannot be ignored. In the future, when formulating COPD prevention and control strategies, the special characteristics of female patients must be fully considered to reduce the disease burden of female COPD.

Background: Mobile health (mHealth) tools are replacing paper-based surveys for frontline health workers, promising speed and cost-effectiveness. Yet, in low- and middle-income settings, there is scope for research on the accuracy of the information captured. Objectives: To assess the quality of socio-demographic and economic data collected through the mHealth platform by BRAC (the largest non-profit in Bangladesh) Shasthya Kormis or SKs (frontline health workers), and to identify reasons for data gaps. Methods: A mixed-methods study (2021) analyzed secondary mHealth records for 388 households drawn via two-stage cluster sampling from the catchment areas of 30 randomly selected SKs working across 61 districts. Descriptive statistics in R quantified missing values and irregular entries in household registration, visits, and member forms. Complementary insights were obtained from 24 in-depth interviews with SKs; transcripts were thematically coded using an iteratively refined codebook. Findings: Core demographic variables were largely complete, but considerable gaps persisted: national ID/birth ID (84% missing), phone numbers (77%), household assets (39-70%), and land-size data. Several explanations were deduced: reluctance of community members to share sensitive information, sometimes to secure social benefits; recall or estimation difficulties for ages and land measurements; and operational barriers: poor connectivity, offline notetaking, and syncing errors that deterred submission in a timely manner. Conclusions: While mHealth simplifies nationwide community data collection in this case, data quality is affected by social hesitancy, recall bias, and technical issues.

Introduction: Household air pollution from domestic solid fuel use remains a global public health concern, particularly in low-income communities. This study assessed associations between household fuel use, indoor air pollution, and respiratory health outcomes in two Mpumalanga communities in South Africa. Methods: A cross-sectional study was conducted in KwaZamokuhle and eMzinoni between July 2019 and February 2020. Indoor PM_2‧5 concentrations were measured using Airmetrics MiniVol samplers and TSI DustTrak II monitors. We carried out household surveys, lung function tests and allergen sensitivity testing and performed multivariable logistic regression to assess associations between indoor pollutant exposure and respiratory health outcomes. Results: Indoor and ambient PM_2‧5 concentrations in KwaZamokuhle were more than twice as high as those in eMzinoni, exceeding both national standards and WHO Air Quality Guidelines. Coal use for heating was more prevalent in KwaZamokuhle and appeared directly related to elevated PM_2‧5 levels. Approximately 9% of participants exhibited signs of obstructive airway disease, and 25% had positive results for allergen sensitisation. Although the associations between PM_2‧5 levels, solid fuel use and measured respiratory outcomes did not reach statistical significance, consistent trends in the expected direction were observed, suggesting a potential relationship that warrants longitudinal studies with larger sample sizes. Conclusion: These findings suggest complex, possibly nonlinear relationships between indoor air pollution and respiratory health effects. The study underscores the urgent need for a greater use of clean energy alternatives and increased public awareness about the risks of household air pollution in low-income South African communities.

Objective: This paper aims to provide a step-by-step guide for organizing humanitarian cochlear implant missions (HCIMs). Methods: A panel of experienced professionals collaborated through informal, focused group discussions to create this comprehensive guide for organizing HCIMs. It includes a flowchart, a checklist, and detailed descriptions of each step, offering a clear and structured framework for the process. Subsequently, additional advisors were invited to evaluate this outline and provide their input. Results: All participants approved the final version after the outline was improved. This guide proposes the following eight steps: (1) aim and funding, (2) project study, (3) preparation, (4) local system setup (local team recruitment and patient recruitment), (5) pilot campaign, (6) full-scale campaign, (7) On-site process, and (8) follow-up. Thirteen items are specified across the eight main steps in a detailed checklist. All participants approved the final version after the outline was improved. Conclusion: The proposed good practice guide (GPG) includes a flowchart and a checklist that provides a comprehensive manual for establishing, conducting, and organizing international HCIMs. Understanding the process that is expected to be followed when planning an international HCIMs enables the involved parties to organize and assign tasks and create a schedule that allows them to finish their tasks on time and with the best quality. This guide could be a basis to describe an organized process, resulting in professional and distinguished campaigns.

Introduction: Microplastics, plastic particles <5 mm in size, are a new class of environmental pollutants and have a role in systemic and oral health. Their implication in the pathogenesis of periodontal diseases has only recently been addressed. Objective: This review will discuss recent evidence of the modes of action by which microplastics may be involved in the onset and development of periodontal diseases. Methods: A systematic search of PubMed, Scopus, and Web of Science was performed up to May 2025 using keywords "microplastics," "nanoplastics," "oral health," "periodontal disease," "oxidative stress," "dysbiosis," "DNA damage response," and "immune response" in the title, abstract, or keywords. According to PRISMA guidelines, 235 articles were retrieved, and 210 remained after duplicates were discarded. A total of 150 were removed after title/abstract screening. Sixty full-text articles were reviewed, and 30 were included in the qualitative synthesis. Results: The existing evidence indicates that microplastics may induce periodontal pathology via several potential mechanisms, including (i) mechanical irritation of the surface of the gingival tissues, (ii) emission of toxic additives that cause oxidative stress, (iii) activation of DNA damage response (DDR) pathways, (iv) imbalance in the microbial community, and (v) immune regulation. These pathways intersect to enhance inflammation, tissue destruction, and dysbiosis, which culminate in the progression of periodontal disease. Conclusions: It is suggested that microplastics are one of the potential epiphenomena of periodontal diseases. However, original experimental data are limited, especially with reference to immunological interactions. Future in-vitro and clinical investigations are urgently needed to confirm these mechanistic hypotheses and to foster preventive and therapeutic approaches.

Background: The Kulawa village, a hard-to-reach community in Bauchi State, Nigeria, was visited by an NGO initially for mass HIV and malaria screenings. However, it was discovered that women remained isolated at home despite facing maternal health challenges such as prolonged labor and other pregnancy complications. These issues were worsened by climate change, particularly during annual floods, which created severe barriers to accessing healthcare, leaving the community dependent on traditional birth attendants (TBAs) and distant health centers. Objective: The case study aims to present health access challenges exacerbated by climate change and the implementation of sustainable local healthcare workforce strategies that improve maternal healthcare adaptation in the Kulawa community. Methods: The NGO engaged community stakeholders to discuss the health impacts of climate change, especially during flooding and emphasized early health-seeking behaviors. The community supported the course by donating land where the community clinic was built. The NGO also initiated a community education program, identifying 15 young children (ages 13-15) and providing them with the resources needed to pursue healthcare education, with the long-term goal of creating a sustainable local health workforce. Findings: Fifteen children aged 13-15 were supported with bicycles, books, and extra lessons, eventually passed their high school examinations, and proceeded to medical and health professional training. Fourteen graduated from healthcare professions and were initially engaged in voluntary services and eventually employed by the Bauchi Local Government Health Authority. Their deployment to their community significantly improved health outcomes. Discussion: This case signifies the role of climate change adaptation in healthcare. The Kulawa community transformed from traditional practices to a resilient health system through education, community engagement, and capacity building. The initiative highlights the effectiveness of culturally sensitive, community-driven approaches in addressing health risks posed by climate change.

Climate and health science is a rapidly growing, interdisciplinary field and holds importance during intergovernmental climate adaptation and mitigation policy negotiations. The 29th session of the Conference of the Parties (COP) to the United Nations Framework Convention on Climate Change (UNFCCC) convened stakeholders for negotiations and scientific discourse. This viewpoint presents insights gained by the authors' participation at COP29 focused on health and climate. The authors analyze the evolving integration of health into the UNFCCC process, dissect the contributions and the role of the Research and Independent Non‑Governmental Organizations (RINGOs), a constituency to achieve this endeavor, and identify the key gaps in public health research and the policy dialogue that persist in climate negotiations. In the context of bridging research with policy discourse, we define the role of and opportunities to engage meaningfully for young scientists in shaping climate and health within the UNFCCC framework, as well as advancing climate and health science.