Search Results (2,382)

Background: Workplace violence (WPV) is a pervasive occupational hazard in healthcare that undermines staff safety and quality of care. In Bulgaria, WPV remains widespread and underreported, despite recent legislative initiatives. This study assessed healthcare professionals’ perceptions of the effectiveness of WPV prevention strategies and examined how prior exposure shapes these perceptions. Methods: A nationwide cross-sectional online survey was conducted in December 2024 with 944 healthcare professionals from multiple sectors. Participants rated the perceived effectiveness of 11 prevention strategies, including environmental/security measures, organizational, and national-level interventions, on a three-point scale. Friedman ANOVA with Kendall’s W assessed overall strategy rankings, while Mann–Whitney U tests with rank-biserial correlations compared specific effectiveness ratings between subgroups defined by WPV exposure (experienced or witnessed vs. not exposed in the previous 12 months). Results: In the previous 12 months, 34.7% of respondents reported direct WPV, and 43.4% had either experienced or witnessed incidents. Friedman ANOVA indicated significant differences in perceived effectiveness across strategies (Kendall’s W = 0.13), with stronger differentiation among violence-exposed respondents (W = 0.37) than among non-exposed respondents (W = 0.09). National-level interventions and security/response measures were consistently ranked the highest. Mann–Whitney tests showed significantly higher endorsement of most strategies among violence-exposed professionals, with large effect sizes for security measures and enforcement of sanctions. Conclusions: Bulgarian healthcare professionals view WPV prevention as requiring a multicomponent approach that integrates robust national policy with organizational and environmental measures. Direct exposure to violence is associated with stronger support for security-focused and national interventions. These findings inform context-specific, evidence-based WPV prevention programs for Bulgarian healthcare facilities. Full article

Foundries represent complex exposure scenarios where metals, particulate matter, and combustion by-products coexist, posing potential cumulative biological effects. Urinary metabolic profiles from 64 foundry workers and 78 residents living in surrounding areas were investigated using multivariate statistical modeling. Differences in urinary metabolite patterns were observed between the two groups, including lower levels of several amino acids (e.g., valine, alanine, tyrosine, and tryptophan) and tricarboxylic acid intermediates (e.g., citrate and succinate), together with higher levels of selected branched-chain amino acid catabolites (e.g., 3-hydroxyisobutyrate and erythro-2,3-dihydroxybutyrate) in workers. Variations in gut microbiota-related metabolites, such as phenylacetylglycine and p-cresol sulphate, were also detected. Based on these metabolic patterns, potential molecular mechanisms related to energy metabolism, oxidative stress and host–microbiome interaction are discussed as interpretative hypotheses. The comparison between workers and residents was interpreted, taking into account differences in demographic and lifestyle characteristics between groups. Overall, the results indicate that occupational exposure in foundries is associated with measurable differences in urinary metabolic profiles, demonstrating that the applied NMR-based metabolomic strategy is capable of capturing early biological effects and supporting its potential as a non-invasive and holistic biomonitoring tool for evaluating the health impact of complex occupational exposures. Full article

Solar ultraviolet radiation (UVR) is classified as a Group 1 carcinogen and poses a significant occupational hazard to outdoor workers. Despite preventive guidelines, adherence to protective measures remains inconsistent. This systematic review identified the protective measures adopted by healthy outdoor workers and assessed their adherence to and the effectiveness of these measures. Following the PRISMA 2020 statement, the review searched Scopus, Web of Science, and PubMed for peer-reviewed studies published between 2015 and 2025. Eligible studies included at least 100 healthy participants and evaluated preventive or protective measures against solar UVR. Independent reviewers extracted data and assessed risk of bias using the McMaster Critical Review Form. From 17,756 records, 51 studies met the inclusion criteria after screening and a subsequent snowballing process. The identified protective strategies clustered into physical, behavioural, and organisational categories. Adherence ranged from low to moderate, with structured interventions and employer support improving compliance. Sunscreen use remained low due to perceived inconvenience and lack of provision. Overall, the evidence revealed substantial variability in implementation and effectiveness across occupations. Strengthened regulations and integrated interventions combining education, personal protective equipment, and organisational measures are essential. Future research should prioritise longitudinal designs and objective indicators such as biomarkers and dosimetry. Full article

Workers’ exposure to silica dust is a global occupational and public health concern and is particularly prevalent in Southern Africa, mainly because of inadequate dust control measures. It is worsened by the high prevalence of HIV/AIDS, which exacerbates tuberculosis and other occupational lung diseases. The prevalence of silicosis in the region ranges from 9 to 51%; however, silica dust exposure levels and controls, especially in the informal mining sector, particularly in artisanal small-scale mines (ASMs), leave much to be desired. This is important because silicosis is incurable and can only be eliminated by preventing worker exposure. Additionally, several studies have indicated inadequate occupational health and safety policies, weak inspection systems, inadequate monitoring and control technologies, and inadequate occupational health and hygiene skills. Furthermore, there is a near-absence of silica dust analysis laboratories in southern Africa, except in South Africa. This protocol aims to systematically evaluate the effectiveness of respirable dust and respirable crystalline silica dust exposure evaluation and control methodology for the mining industry. The study will entail testing the effectiveness of current dust control measures for controlling microscale particles using various exposure dose metrics, such as mass, number, and lung surface area concentrations. This will be achieved using a portable Fourier transform infrared spectroscope (FTIR) (Nanozen Industries Inc., Burnaby, BC, Canada), the Nanozen DustCount, which measures both the mass and particle size distribution. The surface area concentration will be analysed by inputting the particle size distribution (PSD) results into the Multiple-Path Particle Dosimetry Model (MPPD) to estimate the retained and cleared doses. The MPPD will help us understand the sub-micron dust deposition and the reduction rate using the controls. To the best of our knowledge, the proposed approach has never been used elsewhere or in our settings. The proposed approach will reduce dependence on highly skilled individuals, reduce the turnaround sampling and analysis time, and provide a reference for regional harmonised occupational exposure limit (OEL) guidelines as a guiding document on how to meet occupational health, safety and environment (OHSE) requirements in ASM settings. Therefore, the outcome of this study will influence policy reforms and protect hundreds of thousands of employees currently working without any form of exposure prevention or protection. Full article

Cancer cases have been estimated that will increase in the next years with consequent increase of antineoplastic (AD) drug treatments and workers handling these hazardous chemicals. We aimed to evaluate genotoxic/oxidative effects of AD exposure by fpg-comet assay on a large size sample of workers (214 exposed and 164 controls) involved in preparation; administration, including Hyperthermic intraperitoneal chemotherapy (HIPEC) and pressurized intraperitoneal aerosol chemotherapy (PIPAC); and disposal. With the final aim to identify suitable early biomarkers of genotoxic effect useful to health surveillance, we correlated fpg-comet assay (blood) and Buccal Micronucleus Cytome (BMCyt) assay data. Fpg-comet parameters resulted higher in the exposed group vs. controls, demonstrating direct and oxidative DNA damage in workers handling ADs. Fpg-comet direct DNA damage and genotoxic parameters of BMCyt assay demonstrated a weak statistically significant correlation. This cross-sectional study is one of the few available evaluating both direct and oxidative DNA damage due to ADs on a large sample size of workers and correlating fpg-comet and BMCyt assay results. It highlights the need to evaluate genotoxic effects by both the biomarkers and furnishes a contribution to their validation. Moreover, we demonstrate for the first time oxidative DNA damage on workers performing HIPEC and PIPAC administration. Full article

Background/Objectives: Fluoroscopy-guided procedures are widely used across surgical and interventional specialties but expose operators to ionizing radiation with associated stochastic and deterministic effects. The aim is to characterize occupational radiation exposure, evaluate the effectiveness of shielding strategies, assess long-term cancer risks, and identify compliance patterns. Methods: This structured narrative review summarizes evidence on operator dose, shielding effectiveness, compliance with protective practices, and long-term cancer risk. A search of PubMed, Scopus, Embase, and Web of Science (limited to January 2000–March 2024) identified 62 records; 27 full texts were reviewed, and 16 studies met the inclusion criteria. Results: Across studies, unshielded chest exposure averaged 0.08–0.11 mSv per procedure, and eye exposure averaged 0.04–0.05 mSv. Lead aprons reduced exposure by about 90% at 0.25 mm and 99% at 0.5 mm, thyroid collars reduced neck dose by 60–70%, and lead glasses reduced ocular dose 2.5–4.5-fold. Compliance with aprons and thyroid collars was high, whereas lead glasses and lower-body shielding were inconsistently used. Limited epidemiologic data suggested a higher cancer burden in exposed surgeons, and Biologic Effects of Ionizing Radiation (BEIR) VII–based modeling projected increased lifetime risks of solid cancers in chronically exposed operators. Conclusions: Protective equipment substantially reduces operator dose, but exposure variability and inconsistent shielding practices persist and justify standardized monitoring, stronger enforcement of radiation safety protocols, and longitudinal studies. Full article

Airborne micro- and nanoplastic particles (MNPs) are increasingly recognized as a potential occupational exposure hazard, yet substance-specific workplace data remain limited. This study quantified airborne MNP concentrations during polyester microfiber production using a correlative SEM–Raman approach that enabled chemical identification and size-resolved particle characterization. The aerosol mixture at the workplace was dominated by sub-micrometer particles, with PET—handled onsite—representing the main process-related MNP type, and black tire rubber (BTR) forming a substantial background contribution. Across both sampling periods, total MNP particle number concentrations ranged between 6.2 × 10⁵ and 1.2 × 10⁶ particles/m³, indicating consistently high particle counts. In contrast, estimated MNP-related mass concentrations were much lower, with PM₁₀ levels of 12–15 µg/m³ and PM_2.5 levels of 1.3–1.6 µg/m³, remaining well below applicable occupational exposure limits and near or below 8 h-equivalent WHO guideline values. Comparison with earlier workplace and indoor studies suggests that previously reported concentrations were likely underestimated due to sampling strategies with low efficiency for small particles. Moreover, real-time optical measurements substantially underestimated particle number and mass in this study, reflecting their limited suitability for aerosols dominated by small or dark particles. Overall, the data show that workplace MNP exposure at the investigated site is driven primarily by very small particles present in high numbers but low mass. The findings underscore the need for substance-specific, size-resolved analytical approaches to adequately assess airborne MNP exposure and to support future development of MNP-relevant occupational health guidelines. Full article

Particulate atmospheric pollution poses a global threat to human health. Metals enter the body through inhalation attached to these particles. Certain vulnerable groups are more susceptible to toxicity because of age, physiological changes, and chronic and metabolic diseases and also workers because of high and cumulative exposure to metals. A narrative review was conducted to examine the effects of key metals—arsenic, cadmium, chromium, copper, lead, mercury, manganese, nickel, vanadium, and zinc—on vulnerable populations, analyzing articles published over the past decade. Some of these metals are essential for humans; however, excessive levels are toxic. Other non-essential metals are highly toxic. Shared mechanisms of toxicity include competing with other minerals, oxidative stress and inflammation, and interacting with proteins and enzymes. Prenatal and childhood exposures are particularly concerning because they can interfere with neurodevelopment and have been associated with epigenetic changes that have long-term effects. Occupational exposure has been studied, but current exposure limits for specific metals appear dangerous, emphasizing the need to revise these standards. Older adults, pregnant women, and individuals with metabolic diseases are among the least studied groups in this review, underscoring the need for more research to understand these populations better and create effective public health policies. Full article

Exposure to plant protection products (pesticides) is common among agricultural workers and may represent an underrecognized cause of mucocutaneous disease. We conducted a descriptive cross-sectional survey in agricultural communities in southern Thailand (August–November 2025) to estimate the prevalence, clinical characteristics, and dermatology-specific quality-of-life impact of pesticide-attributed symptoms. Agricultural workers with pesticide use or exposure within the preceding 12 months were recruited via convenience sampling; participants provided consent and completed standardized interviewer-administered questionnaires assessing demographics, pesticide exposure history and application practices, personal protective equipment (PPE) use, self-reported cutaneous and mucosal symptoms (ocular and oral/nasal), and the Dermatology Life Quality Index (DLQI). Of the 354 eligible individuals, 228 participated in the study, and 226 were included in the analyses. The median age was 54 years (interquartile range [IQR], 15), and 82.7% were male. Overall, 14.6% reported pesticide-attributed cutaneous symptoms, 5.3% reported ocular mucosal symptoms, and 0.4% reported oral/nasal mucosal symptoms. Cutaneous manifestations were predominantly symptoms occurring after exposure, with pruritic, erythematous eruptions affecting the arms and hands that typically resolved within 1–7 days after cessation of exposure. Among symptomatic participants, the median DLQI was 0.5 (IQR 3.0); however, DLQI scores were significantly higher among participants who reported pesticide-attributed cutaneous symptoms (p < 0.001) and ocular symptoms (p < 0.001). These findings suggest that pesticide-associated mucocutaneous effects are generally mild yet clinically meaningful, underscoring the need to strengthen PPE training, risk communication, and occupational health surveillance in agricultural settings. Full article

The increasing adoption of highly glazed façades in contemporary office building has improved daylight penetration but has also intensified glare risk and sunlight overexposure in Mediterranean climates, with direct implications for occupant visual comfort and environmental sustainability. While daylight optimization has been widely discussed, fewer studies have examined how façade morphology systematically shapes the balance between daylight sufficiency and visual comfort in Mediterranean island contexts. This study investigates the relationship between façade configuration, daylight availability, and glare performance in office buildings in Northern Cyprus using climate-based daylight simulation. Six façade morphologies are evaluated across a range of window-to-wall ratios (WWR) using EN 17037-aligned criteria and metrics, including spatial daylight autonomy (sDA), annual sunlight exposure (ASE), and daylight glare probability (DGP). Usable daylight is not simply a function of more glass. As WWR increases, fully glazed façades in Mediterranean conditions tend to admit excessive direct sun and intensify glare, so daylight becomes less workable even when illuminance is high. Instead, hybrid and adaptive morphologies that control lighting through a combined approach of shade, diffusion, and redirection provide the most dependable performance, reducing both overexposure and glare while ensuring sufficient daylight sufficiency. The findings also indicate a distinct turning point at about 50–55% WWR, beyond which performance is mostly dependent on the façade’s ability to modulate its morphology and further glass offers minimal advantage. Based on this, the article suggests a contextual framework to encourage façade options for Mediterranean office environments that are more sustainable, aesthetically pleasing, and climate-responsive. Full article

Musculoskeletal disorders (MSDs) remain one of the most persistent occupational health challenges in the U.S. construction industry, where physically demanding tasks such as heavy lifting, kneeling, and working in awkward postures contribute to elevated injury rates. This study aims to identify significant job-related determinants of MSDs in construction-sector occupations. By integrating publicly available datasets from the Survey of Occupational Injuries and Illnesses (SOII) and the Occupational Information Network (O*NET) datasets, a stepwise multiple regression analysis was conducted on 344 occupation-condition observations representing 86 construction occupations, yielding a final model that explained 49% of the variance. Ten significant predictors of MSD events were identified and classified as either risk amplifiers or mitigators. Amplifiers included factors such as exposure to noise, disease, hazardous conditions, and time pressure, all of which heightened MSD risk, while mitigators—such as reduced cramped-space exposure and regulated work environments—were associated with lower risk. MSDs resulting from sprains, strains, or tears accounted for 62.8% of all cases, frequently leading to days away from work (36.3%) or job restrictions (26.5%). The findings underscore that ergonomic risk in construction extends beyond physical strain to include scheduling, equipment design, and work organization. These results provide actionable insights for employers and safety professionals to redesign tools, optimize task rotation, and implement realistic work pacing strategies, ultimately reducing MSD incidence and improving productivity in this high-risk sector. Full article

Background/Objectives: Neck pain is highly prevalent among dentists and has been linked to occupational exposure and cervical degeneration. However, the relationship between cervical MRI findings and symptoms remains inconsistent. This study aimed to explore MRI-based cervical structural profiles in active dentists and examine their associations with neck pain, disability, and participant characteristics. Methods: A cross-sectional study was conducted in 57 practicing dentists. Participants reported neck pain and completed the Numeric Pain Rating Scale and the Neck Disability Index (NDI). Cervical MRI scans were assessed by an experienced musculoskeletal radiologist. An exploratory hierarchical cluster analysis (complete linkage, Euclidean distance) was applied using MRI degenerative variables to identify structural profiles, followed by bivariate comparisons with clinical and occupational factors. Results: Degenerative MRI findings were common (disc bulging, 66.7%; disc herniation, 54.4%). Two MRI-based profiles were identified, one characterized by a higher burden of degenerative findings (including disc and facet changes) (70.2%), and another with fewer/milder degenerative features (29.8%). Neck pain and NDI scores ≥ 20 were more frequent in the higher-degeneration profile (p = 0.001 and p = 0.004, respectively). Age showed a non-linear pattern, with younger dentists reporting pain despite milder MRI changes, whereas older dentists showed more degeneration with fewer symptoms. Conclusions: In this exploratory study, individual MRI findings were not independently associated with neck pain, while a higher overall burden of degenerative changes tended to co-occur with greater symptom reporting and disability. These findings should be interpreted as hypothesis-generating and warrant confirmation in larger, longitudinal studies. Full article

Exposure to chemical irritants in laboratory and medical environments poses significant health risks to workers, particularly in relation to asthma-like symptoms. Routine cleaning practices, which often involve the use of strong chemical agents to maintain hygienic settings, have been shown to contribute to respiratory issues. Laboratories, where chemicals such as hydrochloric acid and ammonia are frequently used, represent an underexplored context in the study of occupational asthma. While much of the research on chemical exposure has focused on industrial and high-risk occupations or large cohort populations, less attention has been given to the risks in laboratory and medical environments, particularly for professional cleaning staff. Given the growing reliance on cleaning agents to maintain sterile and safe workspaces in scientific research and healthcare facilities, this gap is concerning. This study developed an exploratory simulation tool, using a simulated cohort based on key demographic and exposure patterns from foundational research, to assess the impact of chemical exposure from cleaning products in laboratory environments. Four supervised machine learning models were applied to evaluate the relationship between chemical exposures and asthma-like symptoms: (1) Decision Trees, (2) Random Forest, (3) Gradient Boosting, and (4) XGBoost. High exposures to hydrochloric acid and ammonia were found to be significantly associated with asthma-like symptoms, and workplace type also played a critical role in determining asthma risk. This research provides a data-driven framework for assessing and predicting asthma-like symptoms in professional cleaning workers exposed to cleaning agents and highlights the potential for integrating predictive modeling into occupational health and safety monitoring. Future work should explore dose–response relationships and the temporal dynamics of chemical exposure to further refine these models and improve understanding of long-term health risks. Full article

Ensuring the safe, efficient, and economically viable operation of irrigation and drainage infrastructures is essential for long-term system resilience. This field-based study presents a comparative evaluation of the semi-quantitative William T. Fine (WF) method and a simplified probability–consequence (SM) approach applied in the Lis Valley Irrigation and Drainage Association (Leiria, Portugal). Monthly on-site observations of routine maintenance and conservation activities were conducted between January 2023 and December 2024, covering eight main operation types and resulting in 87 distinct occupational risk scenarios (N = 87). The mean Hazard Risk Score (HRS) was 88.9 ± 51.1, corresponding predominantly to “Substantial” risk levels according to the William T. Fine classification (HRS = 70–200). Both methods consistently identified the highest-risk activities—tractor rollover, work at height, and boat-based removal of aquatic plants. Quantitative differences emerged for medium and chronic hazards; WF produced a wider dispersion of risk scores across tasks, while the SM aggregated most hazards into a limited number of intervention classes (74% classified as Intervention Level II and 26% as Level III). These differences reflect complementary methodological limitations; WF requires greater data input and expert judgment but offers finer prioritization, whereas SM enables rapid field application but tends to group ergonomic and low-intensity hazards when consequences are not immediately observable. Based on these findings, a combined assessment framework is proposed, integrating the discriminative capacity of WF with the operational simplicity of SM. Recommended mitigation measures include targeted personal protective equipment, task rotation, focused training, and technology-assisted monitoring to reduce worker exposure. The methodology is readily replicable for Water Users’ Associations with similar operational contexts and supports evidence-based decision-making for sustainable irrigation management. From a sustainability perspective, this integrated risk assessment framework supports safer working conditions, more efficient maintenance planning, and informed policy decisions for the long-term management of irrigation and drainage infrastructures. Full article

The buccal micronucleus cytome assay (BMCyt) is a validated, non-invasive biomonitoring method used to detect early genotoxic and cytotoxic changes linked to environmental and occupational exposures. Healthcare workers, especially nurses and dentists, are routinely exposed to genotoxic agents such as anesthetic gases, cytotoxic drugs, ionizing radiation, and heavy metals. This study compared seven cytological biomarkers in exfoliated buccal cells from female nurses, dentists, and teachers to assess multivariate cytogenetic differences and potential occupational influences. Samples were collected from 32 nurses, 41 dentists, and 47 teachers, and 3000 cells per participant were evaluated for micronuclei (MN) and six additional nuclear abnormalities. Group differences were examined using MANOVA and permutation MANOVA, followed by pairwise tests, and visualized with Principal Component Analysis (PCA). Significant multivariate differences were found between nurses and both dentists and teachers (p = 0.003), supported by permutation tests, while dentists and teachers did not differ. PCA explained 56% of the variance and showed apparent clustering of nurses. Chromatin condensation and MN were the main contributors to group separation. Nurses had significantly higher MN (p ≤ 0.001) and karyorrhexis (p ≤ 0.0004) than dentist and teachers. Overall, nurses showed a distinct cytogenetic profile consistent with greater genotoxic susceptibility. Full article