International Journal of Environmental Research and Public Health

Three therapeutic applications are presently prescribed in the radon spas in Gastein, Austria: exposure to radon in a thermal bath, exposure to radon vapor in an exposure chamber (vapor bath), and exposure to radon in the thermal gallery, a former mine. The radiological exposure pathways to human organs and tissues in these therapeutic radon applications are inhalation of radon and radon progeny via the lungs, radon transfer from water or air through the skin, and radon-progeny deposition on the skin in water or air. The objectives of the present study were to calculate radon and radon-progeny doses for selected organs and tissues for the different exposure pathways and therapeutic applications. Doses incurred in red bone marrow, liver, kidneys, and Langerhans cells in the skin may be correlated with potential therapeutic benefits, while doses to the lungs and the basal cells of the skin indicate potential carcinogenic effects. The highest organ doses among the three therapeutic applications were produced in the thermal gallery by radon progeny via inhalation, with lung doses of 5.0 mSv, and attachment to the skin, with skin doses of 4.4 mSv, while the radon contribution was less significant. For comparison, the primary exposure pathways in the thermal bath are the radon uptake through the skin, with lung doses of 334 μSv, and the radon-progeny attachment to the skin, with skin doses of 216 μSv, while the inhalation route can safely be neglected. Full article

PM₂.₅ pollution has gradually attracted people’s attention due to its important negative impact on public health in recent years. The influence of anthropogenic emission factors on PM₂.₅ concentrations is more complicated, but their relative individual impact on different emission sectors remains unclear. With the aid of the geographic detector model (GeoDetector), this study evaluated the impacts of anthropogenic emissions from different sectors on the PM₂.₅ concentrations of major cities in China. The results indicated that the influence of anthropogenic emissions factors with different emission sectors on PM₂.₅ concentrations exhibited significant changes at different spatial and temporal scales. Residential emissions were the dominant driver at the national annual scale, and the NO_X of residential emissions explained 20% (q = 0.2) of the PM₂.₅ concentrations. In addition, residential emissions played the leading role at the regional annual scale and during most of the seasons in northern China, and ammonia emissions from residents were the dominant factor. Traffic emissions play a leading role in the four seasons for MUYR and EC in southern China, MYR and NC in northern China, and on a national scale. Compared with primary particulate matter, secondary anthropogenic precursors have a more important effect on PM₂.₅ concentrations at the national or regional annual scale. The results can help to strengthen our understanding of PM₂.₅ pollution, improve PM₂.₅ forecasting models, and formulate more precise government control policy. Full article

COVID-19 was first identified in December 2019. As long as this type of coronavirus was new, the main way for governments to avoid the spread of the infection was enforced quarantine. Besides public health protection, quarantine can have a psychological impact on the residents, with main symptoms being angst, anxiety, depressive, and PTSD symptoms. As it has been found that character strengths can promote subjective wellbeing, the purpose of the study was to examine this relationship under the new situation of quarantine in the Greek population in adults who were in quarantine for at least two weeks. The total sample consisted of 354 participants who were aged 18–72-years-old. A total of 263 participants were women (74.3%), 91 were men (25.7%), and 94,6% of them were highly educated. The sample was a convenience sample. The tools used were PANAS) , PERMA) and finally VIA-114GR (). The data analysis was completed using SPSS software version 26.0 (IBM Corp. Released 2019. IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp) and EQS 6.1 (Multivariate Software Inc.: Encino, CA, USA, 2006). The results showed that love, curiosity, persistence, hope, and zest are strongly associated with subjective wellbeing, even in conditions such as quarantine, and can support specific aspects of it. Full article

Besides having physiological functions and general toxic effects, many metal ions can cause allergic reactions in humans. We here review the immune events involved in the mediation of metal allergies. We focus on nickel (Ni), cobalt (Co) and palladium (Pd), because these allergens are among the most prevalent sensitizers (Ni, Co) and immediate neighbors in the periodic table of the chemical elements. Co-sensitization between Ni and the other two metals is frequent while the knowledge on a possible immunological cross-reactivity using in vivo and in vitro approaches remains limited. At the center of an allergic reaction lies the capability of a metal allergen to form T cell epitopes that are recognized by specific T cell receptors (TCR). Technological advances such as activation-induced marker assays and TCR high-throughput sequencing recently provided new insights into the interaction of Ni²⁺ with the αβ TCR-peptide-major histocompatibility complex (pMHC) interface. Ni²⁺ functionally binds to the TCR gene segment TRAV9-2 or a histidine in the complementarity determining region 3 (CDR3), the main antigen binding region. Thus, we overview known, newly identified and hypothesized mechanisms of metal-specific T cell activation and discuss current knowledge on cross-reactivity. Full article

Background: A spinal cord injury (SCI) is a traumatic event that affects every aspect of life: physical, mental, economic, and social. The main aim of this study was to investigate self-efficacy, quality of life, and their correlations among outstanding athletes who have suffered spinal cord injuries, and to determine whether these individuals have specific psychological characteristics that contribute to a better quality of life. Methods: The study involved nine athletes with at least national-level achievements in sports prior to an SCI. Participation in the study consisted of an interview via an online communicator, followed by an online questionnaire consisting of a personal questionnaire and two scales: The World Health Organization Quality of Life Scale (WHOQoL-BREF), and the General Self-Efficacy Scale (GSES). Results: Spearman’s correlation showed a correlation between general self-efficacy, perception of quality of life, and satisfaction with own physical health, as well as psychological resources and environmental support. Conclusions: Involvement in an environment that was important to the injured person before the accident, in either a passive (in the absence of functional capacity) or active form, promotes a greater sense of self-efficacy and good QoL, regardless of the time that has passed since the accident, and despite high levels of pain or secondary health issues. To fill the gap in professional long-term healthcare services for athletes after SCIs, intervention programs should be considered that support self-efficacy, which is an important factor that can be subject to improvement. Full article

Despite a huge body of literature revealing that the effect of environmental, social and governance (ESG) scores on a firms' financial performance and value, it lacks the empirical research on the nexus between corporate sustainable growth and ESG risk in the existing research. The paper aims to examine the nexus between ESG risk and corporate sustainable growth. This study utilizes a quantile regression approach to explore how ESG risk affects corporate sustainable growth (proxied by sustainable growth rate, SGR). The ordinary least squares estimation results confirm that ESG significantly negatively affects corporate sustainable growth. The quantile regression results reveal ESG risk has a significant negative effect on corporate sustainable growth in the upper quantiles of SGR, but not in the lower and median quantiles. The results show that the impact of ESG risk on the corporate sustainable growth is asymmetric and affected by the distribution of SGR. Furthermore, the research results identify that the negative relationship between ESG risk and corporate sustainable growth is particularly apparent for firms in environmentally sensitive industries. This study greatly contributes to existing literature, as with this detailed knowledge, managers can make decisions based on these associations and identify the most lucrative course of action. Full article

Despite several guidelines published by the World Health Organization (WHO) and national authorities, there is a general increase in the number of healthcare workers (HCWs) contracting tuberculosis. This review sought to evaluate the compliance of the HCWs toward tuberculosis preventive measures (TPMs) in their workplace. Both electronic databases and manual searches were conducted to retrieve articles regarding the compliance of HCWs in the workplace published from 2010 onwards. Independent reviewers extracted, reviewed, and analyzed the data using the mixed methods appraisal tool (MMAT) 2018, comprising 15 studies, 1572 HCWs, and 249 health facilities. The results showed there was low compliance toward TPMs in the workplace among HCWs and health facilities from mostly high-burden tuberculosis countries. The failure to comply with control measures against tuberculosis was mainly reported at administrative levels, followed by engineering and personnel protective control measures. In addition, low managerial support and negative attitudes of the HCWs influenced the compliance. Further studies are needed to elucidate how to improve the compliance of HCWs toward the preventive measures against tuberculosis in order to reduce the disease burden among HCWs worldwide. Full article

The aim of the present study was to create spatial and spatio-temporal patterns of cutaneous malignant melanoma (MM) incidence in Upper Silesia, Poland, using the largest MM database (<4K cases) in Central Europe, focusing on the agricultural sector. The data comprised all the registered cancer cases (C43, according to the International Classification of Diseases after the 10th Revision) between the years 2004–2013 by the Regional Cancer Registries (RCRs) in Opole and Gliwice. The standardized incidence ratios (SIRs), spatio-temporal growth rates (GRs), and disease cluster relative risks (RRs) were estimated. Based on the regression coefficients, we have indicated irregularities of spatial variance in cutaneous malignant melanoma, especially in older women (≥60), and a possible age-migrating effect of agricultural population density on the risk of malignant melanoma in Upper Silesia. All the estimates were illustrated in choropleth thematic maps. Full article

Employees’ emotional exhaustion caused by their leaders has significant consequences for both individuals and organizations. Identifying the roles of intra-organizational emotional labor is important to prevent employees’ emotional exhaustion. This study examined the relationships between ethical leadership, followers’ emotional labor toward leaders, and emotional exhaustion using Hobfoll’s conservation of resources theory. Data collected from 259 employees working in South Korea were analyzed using regression and SEM. The results indicate that ethical leadership was negatively related to followers’ emotional exhaustion. It is demonstrated that ethical leadership has a significant indirect relationship with followers’ emotional exhaustion through three types of emotional labor strategies; genuine display, faked display, and suppressed display. Through genuine display and suppressed display, ethical leadership had an indirect and negative relationship with followers’ emotional exhaustion, whereas ethical leadership and followers’ emotional exhaustion showed a positive indirect relationship through faked display. We discuss the implications and limitations of this research and future research directions. Full article

Vaporizers (e-cigarettes) are the most common smoking cessation aids in Switzerland, but we do not know what information customers receive in vape shops. We surveyed vape-shop managers to find out what recommendations they make to their customers. An interdisciplinary group developed the questionnaire. Respondents self-reported their smoking history, demographics, and the recommendations they thought they would give to hypothetical customers in clinical vignettes. We also queried if they collaborated with health care professionals. Of those contacted, 53.8% (70/130) of vape-shop managers responded, and 52.3% (68/130) were included in the final analysis. Managers were mostly male and ex-smokers who switched to vaporizers; 60.3% would encourage a hypothetical smoker with high nicotine dependence to start with the highest possible nicotine concentration when switching to vaporizers. For this smoker, 36.9% would recommend high (≥15 mg/ml), 32.3% medium (6–14 mg/mL), and 3.1% low (1–5 mg/mL) nicotine concentrations. The rest adapted their recommendations to fit the customer or device; 76.5% reported that physicians referred customers to them, and 78.8% would attend a course given by experts in the field of vaporizers and smoking cessation. Vape-shop managers varied widely in the recommendations they gave customers. Most reported ongoing collaboration with health care professionals and were interested in improving their counselling skills through training. Full article

In the context of increasing urbanization and associated economic, social and environmental challenges, cities have increasingly acknowledged the importance of urban parks in delivering social, economic and environmental benefits to the population. The importance has been demonstrated also during the COVID-19 pandemic that generated lockdowns and reduced the capacity of urban inhabitants in accessing such benefits. The present study aims to determine how the presence in urban parks was reflected on social media during the pandemic period of 2020. We examined Instagram posts associated with a sample of eight urban parks in Bucharest, Romania and also the entire history of Google reviews between January and August 2020. The selection of parks was made according to their size, location in Bucharest, previous reported number of visitors and profile of attractiveness. Results revealed that the peak period of the COVID-19 pandemic and the first initiation of the lockdowns strongly affected the recreation and leisure activities that people performed almost daily in the parks of Bucharest. Reviews and comments of the population were not that focused on the pandemic even after the restrictions were lifted, but they evidenced the positive and negative aspects of each park. Our results can represent a useful instrument for local administrations in determining both the flow of visitors but also their perceptions towards the endowments, landscape and most important management of urban parks. Full article

There is an underrepresentation of Latinos in smoking cessation clinical trials. This study describes the feasibility and effectiveness of recruiting Latino smokers in the U.S. from an emergency department (ED) patient registry into a randomized smoking cessation clinical trial. Recruitment occurred from the Hackensack University Medical Center ED. Potential participants were contacted from a patient registry. The primary outcome was whether the participant responded to a call or text. Secondary outcomes included the best day of the week, week of the month, and time of day to obtain a response. Of the 1680 potential participants, 1132 were called (67.5%), while 548 (32.5%) were texted. For calls, response rate was higher compared to text (26.4% vs 6.4%; p < 0.001). More participants were interested in the study when contacted by calls compared to text (11.4% vs. 1.8%) and more participants were enrolled in the study when contacted by calls compared to text (1.1% vs. 0.2%). Regression models showed that ethnicity, age, time of day, and week of the month were not significantly associated with response rates. Recruitment of Latinos from an ED patient registry into a smoking cessation clinical trial is feasible using call and text, although enrollment may be low. Full article

The benefits of rapport between interviewers and respondents, in terms of recruiting the latter and motiving them to participate in research, have been generally endorsed. However, there has been less clarity with regard to the association between rapport and data quality. In theory, rapport could be beneficial if it motivates people to give complete and honest responses. On the other hand, efforts to maintain rapport by exhibiting pleasing and socially desirable behaviour could well be detrimental to data quality. In a large longitudinal epidemiological sample, generalized estimating equations (GEE) analyses were used to examine the association between rapport and the following three quality indicators: missing responses, responses to sensitive questions, and consistency of responses. The results of these analyses indicate an association between a high level of rapport and fewer missing responses. In contrast, we found more socially desirable responses for the high-rapport group. Finally, the high-rapport group did not differ from the low-rapport group in terms of the consistency of their responses. Full article

Resilience is an important issue in urban development, and community resilience (CR) is the most typical representative in building urban resilience, which has become the forefront of international resilience research. This paper presents a bibliometric and visual analysis of community resilience research collected from the WoS Core Collection database over the past two decades. H-index, citation frequency, centrality and starting year were adopted to analyze the research objects by bibliometric tools including CiteSpace, VOSviewer, and Gephi. The national and institutional characteristics of macro-geographical distribution and the characteristics of disciplines, journals, authors, and author cooperation of micro-knowledge network distribution were revealed. Finally, the potential research directions of community resilience in the future were discussed. The results show that there are three stages in community resilience research. Seven intellectual bases constitute the research background for community resilience, including social capital mechanism, the evolution of resilience knowledge, earthquake resistance and disaster mitigation, substance abuse, resilient development in rural communities, resilience-building in the least-developed countries, and emergency preparedness. Our analysis shows that the hottest community resilience research topics are the concept of resilience, climate resilience, the social capital mechanism, macro-environment and disaster-reduction policies, and an evaluation index system for community resilience. Full article

The purpose of this study is to identify inequities in the distribution of socioeconomic determinants of health within Poland and their impact on the health status of Poles, as measured by mortality rate. We hypothesised that (1) there are inequities in the socioeconomic characteristics within geographically defined population groups and (2) some socioeconomic determinants of health have a particularly strong impact on the health status of Poles. Poland is administratively divided into three levels: voivodeships, powiats and gminas. We used a dataset covering all 380 powiats in Poland for the year 2018. We employed a two-stage nested Theil index and Herfindahl–Hirschman Index. In order to identify which of these determinants has the strongest impact on health, we conducted a regression analysis. The study revealed some inequities in the distribution of socioeconomic determinants of health. The mortality rate can be partly understood from variations within voivodeships in the distribution of health determinants. Important national inequalities were found in the case of two determinants, which simultaneously proved their significant impact on Poles’ health in the regression analysis. Thus, type of employment and access to modern infrastructure should be of particular concern for public authorities. Full article

The present study examines the association between physical activity (PA) participation modes (i.e., family, friends, club members, and alone), PA volumes (i.e., intensity and duration), gender, and injury. A total of 9000 Koreans aged 10–89 years participated in the Korean Survey of Citizens’ Sports Participation project. However, participants who did not respond to a question regarding PA participation modes (n = 2429) and those under 18 years old (n = 489) were excluded from this study. Analysis of variance (ANOVA) was used to compare the groups’ characteristics and the association between PA participation modes and injury was demonstrated by conducting multinomial logistic regression analysis. The risk of injury was significantly higher in the friend and club member groups than in the alone group. In addition, PA intensity and gender were critical risk factors of injury, while PA duration showed no significant results. The results indicated a strong association between PA participation modes, PA intensity, gender, and injury, and an interesting finding is that more injuries derived from a higher intensity of PA, not from a longer duration of PA. Therefore, this present study directly documented that considerable attention should be placed on the factors that affect injuries, such as gender and PA intensity, to prevent unpredictable injury and encourage potential participants to exercise with diverse participation modes and appropriate intensity. Full article

Measuring exercise variables is one of the most important points to consider to maximize physiological adaptations. High-intensity interval training (HIIT) is a useful method to improve both cardiovascular and neuromuscular performance. The 30–15_IFT is a field test reflecting the effort elicited by HIIT, and the final velocity reached in the test is used to set the intensity of HIIT during the training session. In order to have a valid measure of the velocity during training, devices such as GPS can be used. However, in several situations (e.g., indoor setting), such devices do not provide reliable measures. The aim of the study was to predict exact running velocity during the 30–15_IFT using accelerometry-derived metrics (i.e., Player Load and Average Net Force) and heart rate (HR) through a machine learning (ML) approach (i.e., Support Vector Machine) with a leave-one-subject-out cross-validation. The SVM approach showed the highest performance to predict running velocity (r = 0.91) when compared to univariate approaches using PL (r = 0.62), AvNetForce (r = 0.73) and HR only (r = 0.87). In conclusion, the presented multivariate ML approach is able to predict running velocity better than univariate ones, and the model is generalizable across subjects. Full article

This study was conducted to identify the association between experiencing bullying victimization and suicidal ideation and behaviors, so as to identify the influencing factors on suicidal ideation, suicide plans, and suicide attempts among Korean adolescents. This study analyzed data from the Korean Psychosocial Anxiety Survey. The survey used nationally representative samples of Korean adolescents aged 14 to 18 years old. The experience of bullying victimization negatively influenced suicidal ideation and suicide plans, but not suicide attempts. This influence was reduced, but still remained after controlling depression, anxiety, relationships with family, relationships with teachers and friends, and social support. Influencing factors differed with suicidal ideation, plans, and attempts. Anxiety was the only factor associated with all stages of suicidality. When developing future interventions, health providers need to consider the differences in the factors associated with each stage of suicidality in adolescents. Full article

Objective: To investigate the association between dietary patterns with frailty phenotypes in an elderly Chinese population. Methods: A cross-sectional study was performed in 780 Shanghai suburban elders aged 65–74 in 2019. Dietary data were collected using a food frequency questionnaire. Adherence to a priori dietary patterns, including the Chinese Healthy Eating Index (CHEI), Dietary Approaches to Stop Hypertension (DASH) diet and Mediterranean Diet (MD) were calculated. Three a posteriori dietary patterns were identified by factor analysis, namely, “protein-rich”; “vegetables”; and “sugar, oil, and condiments”. Frailty was defined using the Fried frailty phenotype scale. Ordinal multiple logistic regression was applied to examine the associations between dietary patterns and frailty prevalence. Results: The prevalences of pre-frailty and frailty were 47.69% and 3.85%, respectively. Participants with a higher DASH score had a lower frailty prevalence in the sex- and age-adjusted models of the 780 subjects (OR = 0.97 (95% CI: 0.94–0.99), p < 0.05). The association slightly strengthened in the multivariate adjusted model of the 555 subjects after excluding the participants with chronic diseases may influence frailty (OR = 0.96 (95% CI: 0.92–1.00), p < 0.05). High “protein-rich” dietary pattern scores were negatively associated with frailty prevalence in the multivariate adjusted model of the 780 subjects (OR = 0.82 (95% CI: 0.69–0.98), p < 0.05). The association attenuated in the sex- and age-adjusted model of the 555 subjects (OR = 0.84 (95% CI: 0.69–1.00, p = 0.056). Conclusion: A better diet quality as characterized by DASH and “protein-rich” was associated with a reduced prevalence of frailty in Shanghai suburban elders. The correlation of CHEI, MD or a posteriori dietary patterns with the development of frailty in Chinese older people remains to be explored. Full article