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Quality of life and work functionality in severe asthma patients: the impact of biological therapies 重症哮喘患者的生活质量和工作功能:生物疗法的影响
IF 3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-03-20 DOI: 10.1186/s12995-024-00406-9
Veruscka Leso, Claudio Candia, Daniela Pacella, Antonio Molino, Caterina Nocera, Mauro Maniscalco, Ivo Iavicoli
Severe asthma can cause poor health status, poor health-related quality of life (HRQoL) and an impaired functioning at work. However, to date, limited data are available on the impact of the biological therapies on such outcomes. Therefore, aim of the present study was to prospectively assess the clinical, quality of life and work functionality issues in severe asthma patients both at baseline and after 6 months of biological therapies and determine which individual, pathological and occupational factors can influence such parameters. Fifty-two patients were enrolled between December 2022 and June 2023. Patients’ personal, clinical, functional and occupational features were assessed. The Short Form Health Survey (SF-12), the Work Productivity and Activity Impairment (WPAI) questionnaire and the Work Ability Index (WAI) were employed to assess HRQoL, the employee’s productivity and perception of work ability, respectively. Among the enrolled patients, 30 (57.70%) were employed. Biological therapy induced a significant improvement in clinical and functional parameters, e.g., FEV1% (72 ± 12 vs.87 ± 13%; 72 ± 14 vs. 86 ± 14%), FVC% (92 ± 11 vs. 101 ± 11%; 90 ± 13 vs. 98 ± 14%) and FEV1/FVC (62 ± 11 vs. 71 ± 8%; 64 ± 9 vs. 70 ± 8%) in workers and non-workers, respectively (P < 0.001). Comparably, the perception of life quality significantly improved, as physical and mental health scores, in the overall cohort, increased from 40.7 ± 10.3 and 48.5 ± 8.5 to 46.8 ± 8.6 and 51.6 ± 6.4, respectively (P < 0.001). The work ability perception significantly improved from a moderate to a good one (34 ± 6 vs. 40 ± 6, P = 0.001). A significant reduction in the absenteeism (19 ± 15 vs. 3 ± 11%; P < 0.001) and presenteeism rate (53 ± 24 vs. 29 ± 26%; P < 0.001), and an improvement in daily (40 ± 27.5% vs. 28.9 ± 24.7%, P < 0.001, in the overall population) and work activities (57 ± 25 vs. 29 ± 27%, P < 0.001) was determined. Gender, age, symptoms control and pulmonary functionality were correlated with the physical and mental health perception, daily activity impairment and work ability. Our study pointed out that biological therapies improved clinical, general life and occupational outcomes in patients with severe asthma. The correlation between clinical aspects and psychological and occupational issues suggest the relevance for a multidisciplinary management of the disease for an effective participation of patients in the world of work.
严重哮喘可导致健康状况不良、与健康相关的生活质量(HRQoL)低下以及工作功能受损。然而,迄今为止,有关生物疗法对这些结果的影响的数据十分有限。因此,本研究旨在前瞻性地评估重症哮喘患者在基线和接受生物疗法 6 个月后的临床、生活质量和工作功能问题,并确定哪些个人、病理和职业因素会影响这些参数。52 名患者于 2022 年 12 月至 2023 年 6 月期间入组。对患者的个人、临床、功能和职业特征进行了评估。采用简表健康调查(SF-12)、工作生产率和活动障碍(WPAI)问卷和工作能力指数(WAI)分别评估患者的 HRQoL、员工的生产率和对工作能力的感知。入组患者中有 30 人(57.70%)有工作。生物疗法显著改善了工人和非工人的临床和功能参数,如FEV1%(72 ± 12 vs. 87 ± 13%;72 ± 14 vs. 86 ± 14%)、FVC%(92 ± 11 vs. 101 ± 11%;90 ± 13 vs. 98 ± 14%)和FEV1/FVC(62 ± 11 vs. 71 ± 8%;64 ± 9 vs. 70 ± 8%)(P < 0.001)。相比之下,生活质量感知明显改善,总体组群的身体和心理健康得分分别从 40.7 ± 10.3 和 48.5 ± 8.5 提高到 46.8 ± 8.6 和 51.6 ± 6.4(P < 0.001)。工作能力感知明显改善,从中等提高到良好(34 ± 6 vs. 40 ± 6,P = 0.001)。缺勤率(19 ± 15 vs. 3 ± 11%;P < 0.001)和旷工率(53 ± 24 vs. 29 ± 26%;P < 0.001)明显降低,日常活动(40 ± 27.5% vs. 28.9 ± 24.7%,P < 0.001,总体人群)和工作活动(57 ± 25 vs. 29 ± 27%,P < 0.001)得到改善。性别、年龄、症状控制和肺功能与身心健康感知、日常活动障碍和工作能力相关。我们的研究表明,生物疗法可改善重症哮喘患者的临床、一般生活和职业状况。临床方面与心理和职业问题之间的相关性表明,对疾病进行多学科管理对于患者有效参与工作具有重要意义。
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引用次数: 0
Hand eczema and skin complaints in particulate matter-exposed occupations - firefighters, chimney sweepers, and ferrosilicon smelter workers in Norway 挪威消防员、烟囱清扫工和硅铁冶炼厂工人接触颗粒物职业的手部湿疹和皮肤问题
IF 3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-03-14 DOI: 10.1186/s12995-024-00407-8
Krister Aune Teigen, Anje Christina Höper, Solveig Føreland, Merete Åse Eggesbø, Marit Nøst Hegseth
The objective was to investigate self-reported hand eczema, and skin complaints at other skin locations among workers exposed to particulate matter, especially ultrafine particles. We conducted a cross-sectional study on workers from one ferro-silicon smelter plant, eight chimney sweeper stations and one firefighter station across Norway. Participants answered an extended version of the Nordic Occupational Skin Questionnaire (NOSQ-2022), with additional questions about whole-body skin complaints and visible dust deposition. Results are presented as descriptive data using firefighters as reference group. Odds ratio (OR) was calculated using logistic regression on lifetime prevalence of hand eczema adjusted for potential confounders and mediators. P-values were calculated using likelihood ratio test against the crude OR. A total of 186 participants answered the questionnaire: 74 chimney sweepers, 52 firefighters and 60 smelter workers. Participation rate was 95.0, 94.5 and 63.6%, respectively. Lifetime prevalence of hand eczema was 9.5, 9.6, and 28.3%, respectively. The point prevalence of hand eczema was 1.4, 1.9 and 10.0%, respectively. We estimated OR for lifetime hand eczema in smelter workers to 4.36 [95% CI: 1.31–14.43, p = 0.016] and for lifetime skin complaints in other locations to 2.25 [95% CI: 0.98–5.18, p = 0.058]. The lifetime prevalence of skin complaints at other locations was 18.9, 23.1 and 40.0%, respectively. The point prevalence was 14.9, 9.6 and 16.7%, respectively. These estimates were not statistically significant but indicates that smelter workers have more skin complaints also at other locations. This study reports a more than four-fold increased risk of hand eczema in smelter workers, and possibly a higher risk of skin complaints in other body locations, compared to the other occupations. Longitudinal studies with larger population are needed to verify the marked increased risk of eczema among smelters and establish causation.
我们的目的是调查暴露于微粒物质(尤其是超细微粒)的工人自我报告的手部湿疹和其他皮肤部位的皮肤问题。我们对挪威一家硅铁冶炼厂、八个烟囱清扫站和一个消防员站的工人进行了横断面研究。参与者回答了北欧职业皮肤调查问卷(NOSQ-2022)的扩展版,并回答了有关全身皮肤不适和可见粉尘沉积的附加问题。结果以消防员为参照组,以描述性数据的形式呈现。采用逻辑回归法计算手部湿疹终生患病率的比值比(OR),并对潜在的混杂因素和中介因素进行调整。P值通过似然比检验与粗略OR进行比较计算得出。共有 186 名参与者回答了问卷:74 名烟囱清扫工、52 名消防员和 60 名冶炼工人。参与率分别为 95.0%、94.5% 和 63.6%。手部湿疹的终生患病率分别为 9.5%、9.6% 和 28.3%。手部湿疹的点流行率分别为 1.4%、1.9% 和 10.0%。我们估计,冶炼厂工人终生手部湿疹的发病率为 4.36 [95% CI:1.31-14.43,p = 0.016],其他地点终生皮肤投诉的发病率为 2.25 [95% CI:0.98-5.18,p = 0.058]。其他部位皮肤投诉的终生患病率分别为 18.9%、23.1% 和 40.0%。点流行率分别为 14.9%、9.6% 和 16.7%。这些估计值没有统计学意义,但表明冶炼厂工人在其他地点也有更多的皮肤投诉。本研究报告显示,与其他职业相比,冶炼工人患手部湿疹的风险增加了四倍多,而且身体其他部位皮肤不适的风险也可能更高。需要对更多的人群进行纵向研究,以验证冶炼工人患湿疹的风险明显增加,并确定其因果关系。
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引用次数: 0
Correction: Acute occupational exposures reported to the Dutch Poisons Information Center: a prospective study on the root causes of incidents at the workplace. 更正:向荷兰毒物信息中心报告的急性职业接触:关于工作场所事故根源的前瞻性研究。
IF 3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-02-14 DOI: 10.1186/s12995-024-00404-x
Anja P G Wijnands, Irma de Vries, Tim Verbruggen, Maxim P Carlier, Dylan W de Lange, Saskia J Rietjens
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引用次数: 0
Differences in upper body posture between patients with lumbar spine syndrome and healthy individuals under the consideration of sex, age and BMI. 在考虑性别、年龄和体重指数的情况下,腰椎综合症患者与健康人上半身姿势的差异。
IF 3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-02-14 DOI: 10.1186/s12995-024-00405-w
Fabian Holzgreve, Celine Nazzal, Rasem Nazzal, Rejane Golbach, David A Groneberg, Christian Maurer-Grubinger, Eileen M Wanke, Daniela Ohlendorf

Background: Work-related forced postures, such as prolonged standing work, can lead to complaints in the lower back. Current research suggests that there is increased evidence of associations between patients with low back pain (LBP) and reduced lordosis in the lumbar spine and generally less spinal tilt in the sagittal plane. The aim of this study is to extend the influence of LBP to other parameters of upper body posture in standing, taking into account the rotational and frontal planes.

Methods: The study included a no-LBP group (418 males, 412 females, aged 21-65 years) and an LBP group (138 subjects: 80 females, 58 males, aged 18-86 years) with medically diagnosed lumbar spine syndrome (LSS). The "ABW BodyMapper" back scanner from ABW GmbH in Germany was used for posture assessment using video raster stereography. Statistical analyses employed two-sample t-tests or Wilcoxon-Mann-Whitney-U tests to assess the relationship between the LBP/no-LBP groups and back posture parameters. Linear and logarithmic regressions were used with independent variables including group, sex, height, weight and body mass index (BMI). Significance level: α = 0.05 (95% confidence).

Results: The regression analysis showed that sagittal parameters of the spine (sagittal trunk decline, thoracic and lumbar bending angle, kyphosis and lordosis angles) depend primarily on sex, age, BMI, height and/or weight but not on group membership (LBP/no-LBP). In the shoulder region, a significant dependency between group membership and scapular rotation was found. In the pelvic region, there were only significant dependencies in the transverse plane, particularly between pelvic torsion and BMI, weight, height and between pelvic rotation and group membership, age and sex.

Conclusion: No difference between the patients and healthy controls were found. In addition, sex appears to be the main influencing factor for upper body posture. Other influencing factors such as BMI, height or weight also seem to have a significant influence on upper body posture more frequently than group affiliation.

背景:与工作有关的强迫姿势,如长时间站立工作,可导致腰部不适。目前的研究表明,有越来越多的证据表明,腰背痛(LBP)患者与腰椎前凸减少、矢状面脊柱倾斜度普遍较低之间存在关联。本研究的目的是将腰背痛的影响扩展到站立时上半身姿势的其他参数,同时考虑到旋转平面和前方平面:研究对象包括无腰椎病组(418 名男性,412 名女性,年龄 21-65 岁)和经医学诊断患有腰椎综合症(LSS)的腰椎病组(138 名受试者:80 名女性,58 名男性,年龄 18-86 岁)。德国 ABW 公司生产的 "ABW BodyMapper "背部扫描仪采用视频光栅立体成像技术进行姿势评估。统计分析采用双样本t检验或Wilcoxon-Mann-Whitney-U检验来评估腰椎病组/无腰椎病组与背部姿势参数之间的关系。使用线性回归和对数回归,自变量包括组别、性别、身高、体重和体重指数(BMI)。显著性水平:α = 0.05(95% 置信度):回归分析表明,脊柱的矢状参数(躯干矢状下滑、胸椎和腰椎弯曲角度、脊柱后凸和前凸角度)主要取决于性别、年龄、体重指数、身高和/或体重,但与组别成员(LBP/无 LBP)无关。在肩部区域,发现组别成员资格与肩胛骨旋转之间存在显著的相关性。在骨盆区域,只有在横向平面上存在显著的依赖关系,尤其是骨盆扭转与体重指数、体重、身高之间,以及骨盆旋转与组别成员、年龄和性别之间:结论:未发现患者与健康对照组之间存在差异。此外,性别似乎是上半身姿势的主要影响因素。其他影响因素(如体重指数、身高或体重)对上半身姿势的影响似乎也比所属群体更明显。
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引用次数: 0
Stunt performers’ reluctance to self-report head trauma: a qualitative study 特技演员不愿自我报告头部创伤:一项定性研究
IF 3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-01-31 DOI: 10.1186/s12995-024-00401-0
Jeffrey A. Russell, Elizabeth A. Beverly, Lori J. Stewart, Leslie P. McMichael, Ariana B. Senn
Mild traumatic brain injuries receive voluminous attention in the research literature, but this is confined almost entirely to sports and military contexts. As an occupation, performing stunts in film, television, and entertainment places the head at high risk of repetitive impact and whiplash, but stunt performers do not enjoy the same level of healthcare supervision and access as that provided to sports participants. Therefore, the aim of this study was to evaluate stunt performers’ qualitative perceptions of reporting and management of head trauma in their industry. After giving their informed consent, 87 motion picture and television stunt performers responded to a query about their views of ways to improve how stunt performers’ occupational head trauma—specifically head impacts and head whips that could cause a concussion—are reported and managed. We analyzed their responses via content and thematic analyses. Two researchers independently marked and categorized key words, phrases, and texts to identify codes that described participants’ comments. They then revised, discussed, and resolved coding discrepancies through consensus to establish inter-coder reliability. Next, we identified thematic patterns that described participants’ understanding of the stunt performer industry and what must change to facilitate reporting of head trauma. We derived themes from data that occurred multiple times, both within and across short answer responses. We identified three primary themes cited by the stunt performers as needs in their industry: (1) Need to Reduce the Stigma of Reporting a Stunt-Related Injury, (2) Need to Eliminate the “Cowboy Culture,” and (3) Need to Improve the Quality of the Work Environment. Stunt performers are crucial members of a global entertainment industry valued at approximately US$100 billion annually. A large segment of the world’s population consumes their work in motion pictures, television, and live entertainment. When they are given an anonymous opportunity to speak, stunt performers offer insight into and recommendations for industry changes—primarily cultural and educational in nature—that could improve their physical and mental health, career longevity, and employability when they are confronted with head trauma.
轻度脑外伤在研究文献中受到大量关注,但这几乎完全局限于体育和军事领域。作为一种职业,电影、电视和娱乐节目中的特技表演使头部面临重复撞击和鞭打的高风险,但特技表演者却无法享受与体育运动参与者同等的医疗保健监督和服务。因此,本研究旨在评估特技演员对其行业中头部创伤的报告和管理的定性看法。在获得知情同意后,87 名电影和电视特技表演人员回答了一项询问,即他们对如何改善特技表演人员职业性头部创伤(特别是可能导致脑震荡的头部撞击和头部鞭打)的报告和管理有何看法。我们通过内容和主题分析对他们的回答进行了分析。两名研究人员独立对关键词、短语和文本进行标记和分类,以确定描述参与者评论的代码。然后,他们对编码差异进行修改、讨论并达成共识,以建立编码者之间的可靠性。接下来,我们确定了主题模式,这些模式描述了参与者对特技表演行业的理解,以及为促进头部外伤报告而必须做出的改变。我们从简答回答内部和简答回答之间多次出现的数据中得出了主题。我们确定了特技表演者作为其行业需求的三个主要主题:(1) 需要减少报告与特技相关伤害的耻辱感,(2) 需要消除 "牛仔文化",以及 (3) 需要提高工作环境的质量。特技演员是全球娱乐产业的重要成员,该产业每年的产值约为 1000 亿美元。世界上大部分人口都在电影、电视和现场娱乐中消费他们的作品。当特技表演人员获得匿名发言的机会时,他们会就行业变革(主要是文化和教育方面的变革)提出见解和建议,从而改善他们的身心健康、职业寿命以及在遇到头部创伤时的就业能力。
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引用次数: 0
Occupational exposure to crystalline silica in a sample of the French general population 法国普通人群样本中的结晶二氧化硅职业接触情况
IF 3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-01-31 DOI: 10.1186/s12995-024-00402-z
Pierre-Marie Wardyn, Jean-Louis Edme, Virginie de Broucker, Nathalie Cherot-Kornobis, David Ringeval, Philippe Amouyel, Annie Sobaszek, Luc Dauchet, Sébastien Hulo
To describe the proportions of subjects exposed to crystalline silica and the sectors of activity concerned between 1965 and 2010 in a sample of the general French population. We included 2942 participants aged 40 to 65 years, recruited at random from electoral rolls, from the French general population in the cross-sectional ELISABET study between 2011 and 2013. The proportions of subjects exposed to crystalline silica and their sectors of activity were determined on the basis of their career history and the use of the Matgéné job-exposure matrix. In the total sample, occupational exposure to crystalline silica was found for 291 subjects (9.9%) between 1965 and 2010, with a predominance of men (20.2% of exposed subjects among men (282 out of 1394) versus 0.6% among women (9 out of 1548)). The highest proportion of participants exposed to crystalline silica was reached in 1980 with 6.1% and then decreases to 4.4% in 2010. Among men, the most frequently exposed sectors of activity were manufacture of basic metals (41.5% of exposed men (117 out of 282)), specialised construction activities (23.1% of exposed men (65 out of 282)) and construction of buildings (14.2% of exposed men (40 out of 282)). Although the proportion of workers exposed to crystalline silica has been decreasing since the 1980s, it is still significant at least until 2010, particularly in the construction sector, and further research is needed to improve the monitoring of workers who are or have been exposed to crystalline silica.
描述1965年至2010年间法国普通人群样本中暴露于结晶二氧化硅的受试者比例和相关活动部门。我们从选民名册中随机抽取了2942名年龄在40岁至65岁之间的法国普通人群参加2011年至2013年间的横断面ELISABET研究。我们根据受试者的职业经历,并使用 Matgéné 工作接触矩阵,确定了受试者接触晶体二氧化硅的比例及其从事的行业。在所有样本中,发现有 291 名受试者(9.9%)在 1965 年至 2010 年期间接触过结晶二氧化硅,其中男性占多数(在接触过结晶二氧化硅的受试者中,男性占 20.2%(1394 人中有 282 人),女性占 0.6%(1548 人中有 9 人))。1980 年,接触晶体二氧化硅的人数比例最高,为 6.1%,2010 年降至 4.4%。在男性中,最常接触结晶矽的行业是基本金属制造(占接触人数的 41.5%(282 人中有 117 人))、专业建筑活动(占接触人数的 23.1%(282 人中有 65 人))和建筑施工(占接触人数的 14.2%(282 人中有 40 人))。尽管自 20 世纪 80 年代以来,接触晶体二氧化硅的工人比例一直在下降,但至少到 2010 年,这一比例仍然很高,尤其是在建筑行业。
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引用次数: 0
Exploring the working conditions of disabled employees: a scoping review 探索残疾雇员的工作条件:范围界定审查
IF 3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-01-30 DOI: 10.1186/s12995-023-00397-z
Sophie Teborg, Lena Hünefeld, Tomke S. Gerdes
Disabled people are often overlooked in considerations about work design, which contributes to their exclusion from the labor market. This issue also reflects within research, as the body of knowledge on the working conditions of disabled employees remains relatively limited. A scoping review was conducted to assess the research landscape concerning the working conditions of disabled employees. Five databases have been searched, focusing on relevant studies published between 2017 and 2022. One hundred fourteen studies were included in the review. It was found that social aspects of work appeared within a substantial portion of the examined studies. Furthermore, it became evident that the interplay of accessibility and flexibility provides an important dynamic to make work design both inclusive and feasible. The recurrent prominence of social aspects, accessibility, and flexibility across the studies shows common challenges and potentials within the work situation of disabled employees. This suggests avenues for future research and inclusive work design.
在考虑工作设计时,残疾人往往被忽视,这导致他们被排斥在劳动力市场之外。这个问题也反映在研究中,因为有关残疾员工工作条件的知识体系仍然相对有限。为了评估有关残疾雇员工作条件的研究情况,我们进行了一次范围界定审查。我们检索了五个数据库,重点关注 2017 年至 2022 年间发表的相关研究。144 项研究被纳入综述。研究发现,工作的社会方面出现在相当一部分受检研究中。此外,显而易见的是,无障碍和灵活性的相互作用为工作设计的包容性和可行性提供了重要的动力。社会因素、无障碍环境和灵活性在各项研究中的反复出现表明,残疾员工的工作环境面临着共同的挑战和潜力。这为今后的研究和包容性工作设计提供了途径。
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引用次数: 0
The environmental health impacts of Russia’s war on Ukraine 俄罗斯对乌克兰战争对环境健康的影响
IF 3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-01-05 DOI: 10.1186/s12995-023-00398-y
Daniel Hryhorczuk, Barry S. Levy, Mykola Prodanchuk, Oleksandr Kravchuk, Nataliia Bubalo, Alex Hryhorczuk, Timothy B. Erickson
Russia’s invasion of Ukraine in February 2022 ignited the largest armed conflict in Europe since World War II. Ukrainian government agencies, civil society organizations, and international agencies have gathered an unprecedented amount of data about the impact of war on the environment, which is often the silent victim of war. We review these data and highlight the limitations of international governance for protection of the environment during time of war. We performed an integrative review of academic, institutional, and media information resources using the search terms “Ukraine”, “Russia”, “war”, “environment”, “health”, “human rights”, “international humanitarian law”, “international human rights law”, “ecocide”, and “war crimes”. Nearly 500,000 military personnel have been killed or wounded during the war, and more than 30,000 civilians have been killed or injured. Indirect health effects of the war have likely accounted for an even greater amount of civilian morbidity and mortality. The war has displaced more than 11 million people. Russia’s military forces have caused extensive damage to civilian infrastructure. The war has devastated Ukraine’s economy and reduced food and energy security in many countries. The war has caused more than $56.4 billion in damage to the environment. There has been widespread chemical contamination of air, water, and soil, and 30% of Ukraine has been contaminated with landmines and unexploded ordnance. Landscape destruction, shelling, wildfires, deforestation, and pollution have adversely affected 30% of Ukraine’s protected areas. Russia’s seizure of the Zaporizhzhia Nuclear Power Plant and destruction of the Nova Kakhovka Dam have posed risks of long-term environmental catastrophe. Most of these environmental impacts threaten human health. In addition to enormous human costs, Russia’s war on Ukraine has had devastating impacts on the natural environment and the built environment. International law mandates that methods of warfare must be implemented with due regard to the protection and preservation of the natural environment. A just and lasting peace necessitates, among other requirements, rebuilding and restoration of Ukraine’s natural environment and built environment. The environmental consequences of all wars need to be investigated and more effective measures need to be implemented to protect the environment during war.
俄罗斯于 2022 年 2 月入侵乌克兰,引发了欧洲自二战以来最大规模的武装冲突。乌克兰政府机构、民间社会组织和国际机构收集了大量有关战争对环境影响的数据,而环境往往是战争的沉默受害者。我们回顾了这些数据,并强调了国际治理在战时保护环境方面的局限性。我们以 "乌克兰"、"俄罗斯"、"战争"、"环境"、"健康"、"人权"、"国际人道法"、"国际人权法"、"生态灭绝 "和 "战争罪 "为搜索关键词,对学术、机构和媒体信息资源进行了综合审查。战争期间有近 50 万军人伤亡,3 万多平民伤亡。战争对健康的间接影响可能导致更多平民发病和死亡。战争导致 1100 多万人流离失所。俄罗斯军队对民用基础设施造成了广泛破坏。战争破坏了乌克兰的经济,降低了许多国家的粮食和能源安全。战争对环境造成的破坏超过 564 亿美元。空气、水和土壤普遍受到化学污染,乌克兰 30% 的地区受到地雷和未爆弹药的污染。景观破坏、炮击、野火、森林砍伐和污染对乌克兰 30% 的保护区造成了不利影响。俄罗斯夺取 Zaporizhzhia 核电站和破坏新卡霍夫卡大坝,带来了长期环境灾难的风险。这些环境影响大多威胁着人类健康。除了巨大的人员损失,俄罗斯对乌克兰的战争还对自然环境和建筑环境造成了破坏性影响。国际法规定,战争方法的实施必须适当考虑保护和维护自然环境。公正持久的和平除其他要求外,还必须重建和恢复乌克兰的自然环境和建筑环境。需要对所有战争的环境后果进行调查,并采取更有效的措施在战争期间保护环境。
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引用次数: 0
Pulmonary function assessment after COVID-19 in vaccinated healthcare workers 对接种 COVID-19 疫苗的医护人员进行肺功能评估
IF 3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-12-15 DOI: 10.1186/s12995-023-00400-7
Lorenzo Ippoliti, Luca Coppeta, Giuseppina Somma, Giuseppe Bizzarro, Francesco Borelli, Teresa Crispino, Cristiana Ferrari, Ilaria Iannuzzi, Andrea Mazza, Agostino Paolino, Andrea Magrini, Antonio Pietroiusti
COVID-19 typically presents with flu-like symptoms due to the viral infection itself. The most severe cases are characterised by lung damage, an important factor in fatal outcome due to alveolar damage. In some cases, patients develop a long COVID with persistent symptoms of chest pain and fatigue. Causes, including organ damage or inflammation, are being investigated. Clinical outcomes are variable and permanent lung damage is not fully understood, while vaccination is effective against severe infection but its effect on respiratory function in mild cases remains uncertain. This retrospective study aims to analyse changes in lung function in HCWs who had COVID-19 between 2020 and 2022, comparing their spirometric test results before and after the pandemic and taking into account their vaccination status. 321 HCWs were included in the study. The study examined spirometric parameters both before and after the pandemic, and all measured outcomes except the FEV1/FVC ratio showed a significant decrease during the study period. We then assessed the association between SARS-CoV-2 infection and changes in lung function parameters, analysing infections in 2020, 2021 and 2022 separately. We found a statistically significant difference in Forced vital capacity (FVC) between infected and non-infected subjects in 2020 and 2021, but not in 2022. To evaluate the protective effect of SARS-CoV-2 vaccination on respiratory function, a linear regression analysis was performed using changes in FVC, Forced expiratory volume in 1 s (FEV1), FVC/FEV1 ratio and Peak expiratory flow (PEF) as dependent variables. The analysis showed that the decline in FVC was significantly lower in subjects who had been vaccinated prior to infection. The study concludes that subclinical SARS-CoV-2 infections in 2020 and 2021 worsened respiratory parameters (FVC and FEV1), but vaccination protected against these effects. Even healthy individuals with previous infections showed respiratory changes, with vaccination providing protection, especially for FVC decline. This highlights the importance of vaccinating healthcare workers against COVID-19.
由于病毒感染本身的原因,COVID-19 通常会出现类似流感的症状。最严重的病例以肺部损伤为特征,肺泡损伤是导致死亡的重要因素。在某些病例中,患者会出现长期的 COVID,并伴有持续的胸痛和疲劳症状。目前正在研究其原因,包括器官损伤或炎症。临床结果不尽相同,永久性肺损伤尚未完全明了,而疫苗接种对严重感染有效,但对轻症病例呼吸功能的影响仍不确定。这项回顾性研究旨在分析 2020 年至 2022 年期间接种 COVID-19 的高危工人肺功能的变化,比较他们在大流行前后的肺功能测试结果,并考虑他们的疫苗接种情况。研究共纳入了 321 名医护人员。研究对大流行前后的肺活量参数进行了检测,除 FEV1/FVC 比值外,所有测量结果在研究期间都出现了显著下降。然后,我们评估了 SARS-CoV-2 感染与肺功能参数变化之间的关联,分别分析了 2020 年、2021 年和 2022 年的感染情况。我们发现,在 2020 年和 2021 年,感染者和非感染者的用力肺活量(FVC)有明显的统计学差异,但在 2022 年则没有。为了评估接种 SARS-CoV-2 疫苗对呼吸功能的保护作用,我们以 FVC、1 秒内用力呼气容积 (FEV1)、FVC/FEV1 比率和呼气峰流速 (PEF) 的变化作为因变量,进行了线性回归分析。分析结果显示,在感染前接种过疫苗的受试者的 FVC 下降幅度明显较低。该研究得出结论,2020 年和 2021 年的亚临床 SARS-CoV-2 感染会使呼吸参数(FVC 和 FEV1)恶化,但接种疫苗可抵御这些影响。即使是既往感染过SARS-CoV-2的健康人也会出现呼吸系统变化,而接种疫苗则能提供保护,尤其是在FVC下降方面。这凸显了医护人员接种 COVID-19 疫苗的重要性。
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引用次数: 0
Healthy working in inclusive companies – a study protocol of the GAIN project 包容性企业中的健康工作--GAIN 项目研究方案
IF 3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-12-15 DOI: 10.1186/s12995-023-00399-x
Fabian Holzgreve, Bettina Bredereck, Christopher Heim, Britta Weber, Rolf Ellegast, David A. Groneberg, Christian Gaum, Daniela Ohlendorf
The research project GAIN (working healthy in inclusion companies) deals with the topics of health and work in inclusive companies. Due to a great need for research on (occupational) health (e.g. physical and mental health status) and workplace design in companies employing people with disabilities, this project pursues the primary goal of generating information for the development and implementation of health-preserving measures within the framework of occupational health and safety, and risk assessment, for employees with and without impairments in inclusive companies. Within the framework of the project, the employees of three inclusive companies will be examined with the help of an interdisciplinary and triangulative approach. Using quantitative and qualitative methods, specific physical workloads and hazards will be investigated by means of baseline screening methods and measurement techniques, specifically among employees with physical disabilities and impairments. In the statistical analysis, descriptive methods will be used to record the current state, while inferential statistical methods will be used to evaluate health maintenance measures. Inferential statistics for continuous data with confidence intervals based on the statistical parametric mapping (SPM) method will also be performed. The significance level will be set at 5%. Qualitative methods will be used to analyse structures and working conditions within the companies, with particular attention to the specific construction of the relationship between work, health and disability. The structures in inclusion companies must be specifically designed to support and promote the understanding of work and health in relation to the idea of one’s own body, its positioning in space and its performance. These characteristics are to be identified in the course of the project and bundled into best-practice recommendations. Furthermore, it is the aim of the research project to derive recommendations for action at its conclusion and to present further advice for the promotion of health in inclusive companies.
GAIN(包容性企业中的健康工作)研究项目涉及包容性企业中的健康和工作问题。由于对雇用残疾人的公司的(职业)健康(如身体和精神健康状况)和工作场所设计的研究需求巨大,该项目追求的主要目标是在职业健康和安全以及风险评估的框架内,为包容性公司中的残障和非残障员工制定和实施健康保护措施提供信息。在该项目框架内,将采用跨学科和三角测量法对三家包容性公司的员工进行调查。将采用定量和定性方法,通过基线筛查方法和测量技术,特别是在有身体残疾和损伤的员工中,对特定的体力工作负荷和危害进行调查。在统计分析中,将使用描述性方法来记录现状,而推论性统计方法将用于评估健康维护措施。此外,还将对连续数据进行推断统计,并根据统计参数图法(SPM)得出置信区间。显著性水平设定为 5%。将采用定性方法分析公司内部的结构和工作条件,特别关注工作、健康和残疾之间关系的具体构建。包容公司的结构必须是专门为支持和促进对工作与健康的理解而设计的,并与自己的身体、身体在空间中的定位及其表现相关联。这些特点将在项目过程中加以确定,并纳入最佳做法建议中。此外,研究项目的目的是在项目结束时提出行动建议,并为在包容性企业中促进健康提出进一步的建议。
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引用次数: 0
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Journal of Occupational Medicine and Toxicology
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