Search Results (6,396)

Endometriosis is a chronic and often debilitating condition whose symptoms extend beyond pelvic pain to include fatigue, gastrointestinal and urinary complaints, menstrual irregularities, and reduced work capacity. These symptoms are typically framed within medical or occupational health discourse, yet little attention has been paid to how they are socially interpreted within workplace relationships. Drawing on the workplace bullying literature alongside qualitative research on the lived experience of endometriosis, this conceptual review proposes that endometriosis-related symptoms are minimized through two interconnected mechanisms: symptom fragmentation, in which the disease’s varied and cyclical presentations are perceived as unrelated complaints rather than expressions of one chronic illness, and identity pathologization, in which the resulting pattern of absence and reduced capacity is reattributed to the worker’s character rather than her condition. The review further situates these mechanisms within the broader literature on women-to-women workplace bullying and examines how humor may function as a socially deniable vehicle for mistreatment. Three anonymized vignettes drawn from clinical practice illustrate each mechanism in isolation and in combination, tracing the self-reinforcing loop through which fragmentation and pathologization sustain one another over time. Practical implications are offered for occupational health practice, managerial training, anti-bullying policy, and clinical care. The aim is not to psychologize endometriosis, but to contextualize suffering that currently falls between medical, organizational, and psychological frameworks—and to prevent the gradual transformation of illness into stigma and of symptoms into moral judgment. Full article

Background: Hypertension is a major contributor to cardiovascular morbidity and mortality globally, with particularly poor control in disadvantaged communities. Although awareness is generally high, sustaining lifestyle changes and treatment adherence remains difficult. This study examined socioeconomic, behavioural, and health system factors associated with hypertension management and explored the role of community-engaged health education in strengthening primary health care. Methods: A cross-sectional descriptive study was conducted among 107 adults with hypertension attending public primary health care facilities. Data were collected using structured questionnaires covering socioeconomic status, health system access, medication adherence, lifestyle practices, and knowledge and attitudes. Descriptive statistics summarized participant characteristics, while chi-square tests and multivariable logistic regression identified factors associated with clinic attendance, dietary adherence, lifestyle practices, and self-management. Results: Awareness of hypertension (86.9%) and trust in clinic care (91.6%) were high; however, a clear knowledge practice gap was evident. Although 79.4% acknowledged the importance of lifestyle changes, only 45.8% followed a hypertension-specific diet. Structural barriers included low income (39.3% earning <R3 000/month) and long distances to clinics (46.7% living ≥5 km away). Health worker advice strongly predicted dietary adherence (OR = 6.36, p = 0.001), lifestyle adherence (OR = 4.24, p = 0.006), and overall self-management (OR = 12.46, p = 0.024), whereas knowledge alone did not. Conclusions: Hypertension management is constrained more by structural and health system factors than by lack of awareness. Strengthening primary health care counselling and community-based health education may improve sustained lifestyle change and outcomes. Full article

Cervical cancer remains the leading cause of cancer-related mortality among women in Nepal, where national screening coverage is approximately 16%. This study evaluated the feasibility of a community-based, door-to-door self-sampling strategy for high-risk human papillomavirus (hrHPV) detection in an urban municipality of central Nepal and assessed hrHPV prevalence, genotype distribution, screening outcomes, and associated demographic factors. A cross-sectional study was conducted between September 2023 and May 2024 in Ward No. 3 of Lalitpur Metropolitan City. Women aged 30–60 years were recruited through trained community health workers, provided education and home-based self-sampling kits, and completed a demographic questionnaire. Dry cervical swabs from 418 participants were tested for hrHPV. Women with positive results underwent visual inspection with acetic acid (VIA), followed by colposcopy, biopsy when indicated, and thermal ablation for confirmed precancerous lesions. Overall participation was 64.1%, and hrHPV prevalence was 10.3%. Non-16/18 hrHPV genotypes predominated (55.8%), followed by HPV16 (20.9%). Women aged > 50 years were more likely to be hrHPV- and VIA-positive (OR = 7.39, p = 0.02). Six pre-cancer cases were identified: five cervical intraepithelial neoplasia (CIN1) and one CIN3 case. Community-based hrHPV self-sampling was found to be feasible and achieved effective linkage to triage and treatment, supporting its consideration for strengthening cervical cancer screening in Nepal. Full article

Exposure to nitrogen oxide (NOx) in underground mining workings poses a significant threat to the health and safety of workers, while NOx emissions also represent an important environmental challenge associated with the operation of diesel-powered mining equipment. This article provides an overview of primary and secondary methods for limiting emissions and reducing exposure to NOx under underground mining conditions. The primary methods include intensified ventilation, extended ventilation time after blasting, the use of low-emission fuels, and modifications to combustion engines, including exhaust gas recirculation (EGR). The secondary methods include the use of exhaust gas purification technologies such as photocatalysis, oxidation catalysts (DOCs), selective catalytic reduction (SCR), and nitrogen oxide traps (LNTs). The presented solutions were compared in terms of NOx reduction efficiency, implementation costs, technical requirements, and practical applicability in underground workings. The most effective strategies in the short and long term were identified, taking into account the growing role of machine park electrification as a potentially sustainable solution to reducing emissions at their sources. Additionally, an SWOT analysis of NOx emission reduction methods designed for deep underground ore mines was conducted, enabling assessment of their strengths and weaknesses as well as opportunities and threats related to their implementation. The results can support the selection of NOx emission reduction methods that take into account environmental protection, worker safety, technical possibilities, and implementation costs and thus contribute to more sustainable underground mining. Full article

The integration of occupational safety and health protection with workplace efforts to promote worker health and well-being is a well-established concept, progressively formalized through the CDC-NIOSH Total Worker Health^® (TWH) program. This scoping review aimed to map and describe the implementation and evaluation methods used in TWH approaches across occupational settings. Scopus, Web of Science, and PubMed were searched using predefined search strings based on “Total Worker Health” and “Total Worker Health approach”. The original search was conducted in January 2023 and was updated in July 2026 using the same databases and search strategies. Eligible studies were peer-reviewed articles written in English that addressed the application, implementation, assessment, or evaluation of TWH approaches in occupational settings. Sixty studies identified in the original search were fully charted and summarized using descriptive frequency tables. The updated search retained eight additional recent studies, which were reported separately and additionally charted across a focused set of core methodological domains. Across the original corpus and the updated studies, substantial heterogeneity was observed in occupational sectors, study aims, intervention components, assessment methods, analytical approaches, and reporting formats. The main tools used to evaluate TWH aspects and interventions were surveys, questionnaires, interviews, meetings, focus groups, training activities, and mixed-methods evaluations. No single standardized model for implementing or evaluating TWH approaches emerged from the mapped literature; however, more consistent reporting of implementation processes, assessment tools, study populations, and analytical approaches may improve comparability, reproducibility, and transferability across occupational settings. Full article

Occupational exposure to blood and body fluids (OEBBF) continues to represent an important public health problem due to the associated medical, social and economic consequences. Young healthcare workers are at high risk of OEBBF because of their lack of experience, hesitation before performing a task and the nature of the task performed. This study aims to comparatively evaluate the knowledge, attitudes and perceptions on OEBBF among students from the Faculty of Medicine and the Faculty of Dental Medicine at Carol Davila University of Medicine and Pharmacy, Bucharest, Romania, during the 2021–2022 academic year in order to facilitate the adaptation of educational materials used in training programs. Out of the 911 students who completed the questionnaire, 55% (502) correctly identified hepatitis B virus (HBV) as having the highest risk of transmission after an OEBBF, with statistically significantly higher percentages among Dental Medicine students (152; 60% vs. 350; 53%; p = 0.003). However, lower percentages of Dental Medicine students recognized the protective concentration of antibodies against HBV (173; 68% vs. 536; 82%; p < 0.001) or reported knowing to be vaccinated against hepatitis B (110; 43% vs. 459; 70%; p < 0.001). Additionally, higher percentages of Dental Medicine students reported not having an antibodies concentration measurement since they started their clinical practice (206; 81% vs. 439; 67%; p < 0.001). If an OEBBF were to occur, 43% (391) reported that they would induce bleeding, either instinctively (210; 23%) or because they considered it necessary (181; 20%). Ninety-three students (10%) reported at least one past OEBBF; 59 (63%) reported it to their supervisors. Statistically significantly higher percentages of Dental Medicine students reported a high perceived risk of exposure compared to Medicine students (117; 46% vs. 202; 31%; p < 0.001), with the finding supported by univariable and multivariable analyses. In conclusion, the reporting frequency of past OEBBF in our study population was low. However, enhanced efforts are required to improve knowledge and awareness regarding OEBBF risk and preventive measures. Additionally, efforts should focus on assessing the level of protection against hepatitis B among Dental Medicine students and on promoting timely reporting to ensure appropriate post-exposure management. Full article

Background: Lifestyle behaviors and psychosocial factors are key determinants of cardiometabolic health across the life course. Beyond traditional risk factors, emerging evidence suggests that chronic stress and burnout may influence metabolic risk through behavioral pathways such as physical inactivity and poor diet. However, their joint contribution to type 2 diabetes risk in working populations remains insufficiently understood. Objectives: Our objectives were to examine the joint contribution of lifestyle habits, sociodemographic factors, and burnout to type 2 diabetes risk, and to explore potential behavioral pathways linking psychosocial stress to metabolic risk in a large adult population. Methods: A cross-sectional study was conducted in 92,480 Spanish workers undergoing routine occupational health assessments between 2021 and 2023. Type 2 diabetes risk was assessed using validated tools (FINDRISC, QDScore, CANRISK). Lifestyle indicators included adherence to the Mediterranean diet and physical activity levels; burnout was assessed using the Burnout Assessment Tool (BAT). Multivariable logistic regression models were used to evaluate associations between determinants and diabetes risk. Mediation analyses were performed to assess the contribution of lifestyle behaviors to the association between burnout and diabetes risk, and predictive performance analyses evaluated the incremental value of burnout. Results: Burnout was independently associated with a higher probability of moderate-to-high diabetes risk across all screening tools. Exploratory cross-sectional mediation analyses indicated that lifestyle behaviors, particularly physical inactivity and low adherence to the Mediterranean diet, statistically accounted for approximately 45% of the observed association. Adding burnout to the models significantly improved discrimination and reclassification of moderate-to-high diabetes-risk classification. In addition, higher diabetes risk was consistently observed among individuals from lower socioeconomic groups and those with unhealthy lifestyle profiles. Conclusions: Lifestyle behaviors and psychosocial stress were associated with estimated diabetes risk across adulthood. Burnout was independently associated with a higher probability of moderate-to-high diabetes-risk classification, with exploratory analyses suggesting that lifestyle behaviors may statistically account for part of this association. These cross-sectional findings highlight the potential relevance of considering both behavioral and psychosocial factors when studying cardiometabolic risk in working populations, while prospective studies are needed to establish temporal and causal relationships. Full article

The mining industry in Ghana, despite its economic significance, continues to grapple with occupational health and safety (OHS) issues, which include but are not limited to high accident rates and a largely reactive approach to safety. In this study, current practices in OHS management are assessed and a model is developed that reflects the interdependencies and associations between workplace hazards, accidents, health effects and preventative actions in a probabilistic fashion. A quantitative analytical design was employed and a sample of 298 workers, safety officers and supervisors from mines were surveyed. The data were analysed using Principal Component Analysis (PCA) to derive latent OHS factors, K-modes clustering and Hierarchical Clustering to classify worker safety profiles, and a Bayesian Network model was employed to investigate probabilistic dependencies. Three major OHS dimensions emerged from PCA: perceived adequacy of safety measures, formal training exposure, and safety resources. Three distinct worker profiles were identified, suggesting that the provision of physical safety equipment does not necessarily reflect perceived operational safety. Moreover, the Bayesian Network model indicated a conditional dependency between workers’ reported health issues and formal accident reporting, and that high hazard environments more than double the probability of an accident occurring (from 0.216 to 0.453). The results indicate that the industry is now operating in an incident-based manner. In order to mitigate the likelihood of accidents, management needs to move towards anticipatory safety management systems, which involve proactive health monitoring, equipment maintenance, and implementation of safety policies in practice. Full article

Background: Technostress has emerged as a growing occupational health concern in increasingly digitalized workplaces. Although its psychological consequences have been extensively investigated, little is known about its potential association with metabolic health and insulin resistance. This study aimed to evaluate the relationship between technostress and insulin resistance risk using four validated surrogate markers in a large cohort of Spanish workers. Methods: A cross-sectional study was conducted among 104,175 Spanish workers who underwent routine occupational health assessments. Technostress was assessed using a 15-item questionnaire covering five technostress dimensions and was analyzed using four operational categories (low, moderate, high, and very high). Insulin resistance risk was assessed using the triglyceride–glucose (TyG) index, TyG-body mass index (TyG-BMI), the metabolic score for insulin resistance (METS-IR), and the single-point insulin sensitivity estimator (SPISE). Sociodemographic characteristics, lifestyle habits, anthropometric measurements, and biochemical parameters were also recorded. Modified Poisson regression with robust variance estimation was used to estimate crude and adjusted prevalence ratios (PRs) for increased insulin resistance risk according to technostress level. Firth penalized logistic regression was additionally performed as a sensitivity analysis to address sparse-data bias and separation. Results: Higher technostress levels were associated with progressively less favorable anthropometric and metabolic profiles. The prevalence of increased insulin resistance risk rose significantly across technostress categories for all markers evaluated (p < 0.001). For TyG, prevalence increased from 3.8% in the low technostress group to 54.3% in the very high technostress group. Corresponding increases were observed for TyG-BMI (0.2% to 78.2%), METS-IR (0.0% to 45.2%), and elevated SPISE-IR values (0.0% to 57.5%). After adjustment for age, sex, educational level, physical activity, adherence to the Mediterranean diet, and smoking status, higher technostress remained associated with a higher prevalence of increased insulin resistance risk. A clear graded cross-sectional pattern was observed, with the strongest associations found among workers reporting very high technostress. Conclusions: Higher technostress was associated with a higher prevalence of increased insulin resistance risk according to TyG, the primary outcome, with a clear graded cross-sectional pattern across technostress categories. Associations were also observed for the secondary BMI-containing indices (TyG-BMI, METS-IR, and SPISE-IR), which should be interpreted as complementary rather than independent evidence. Given the cross-sectional design and the pronounced clustering of technostress with adiposity and lifestyle characteristics, residual confounding cannot be excluded and causal inference is not possible. Full article

Background/Objectives: Hepatitis A virus (HAV) infection is a relevant biological risk in some occupational settings and has long been discussed as an occupational health concern among municipal waste collection workers. Data on HAV seroprevalence and vaccination history in this occupational group remain limited in Italy. This study investigated HAV seroprevalence, self-reported vaccination history, and factors associated with HAV seropositivity among waste collection workers in Sardinia. Methods: This retrospective cross-sectional study analyzed HAV seroprevalence and self-reported vaccination history among 326 workers in Sardinia, Italy, using occupational health surveillance data (2017–2024). Recorded variables included age, sex, smoking habits, years of service, work setting, vaccination status, and serological results. Chi-square and Mann–Whitney U tests assessed group differences; logistic regression identified factors independently associated with HAV seropositivity. Results: HAV seroprevalence was 44.2%; only 0.9% of participants reported previous HAV vaccination. Multivariable analysis identified older age, but not years of service, as independently associated with HAV seropositivity once age was modeled as a continuous variable—a pattern more consistent with birth-cohort differences in lifetime HAV exposure than with cumulative occupational exposure. Worksite 7 showed a higher prevalence ratio of HAV seropositivity relative to the reference site, but this finding was based on a small subsample and should be considered exploratory; observed worksite-level differences may reflect organizational rather than geographic factors. Conclusions: Older age, rather than occupational tenure, was independently associated with HAV seropositivity among Sardinian waste workers, a pattern consistent with birth-cohort differences in lifetime exposure. The high seroprevalence and very low vaccination uptake highlight the need to strengthen prevention through improved vaccination access, awareness, and better integration of occupational and public health strategies. Full article

A persistent obstacle to sustainable food consumption is that people intend to buy responsibly more often than they actually do. This study builds on a theory of planned behavior (TPB) model extended in two directions. It traces attitude, subjective norm, and perceived behavioral control back to organic food attributes and health consciousness, and it carries intention through to purchasing behavior while testing whether trust moderates that final step. We fitted it to survey responses from 516 Chinese office workers using partial least squares structural equation modeling. Intrinsic attributes, extrinsic attributes, and health consciousness were positively associated with attitude and perceived behavioral control, but none was significantly associated with subjective norm. Together, the three cognitions accounted for 43.1% of the variance in purchase intention. Both purchase intention and perceived behavioral control significantly predicted purchasing behavior. Trust had a positive direct association with purchasing behavior and positively moderated its relationship with purchase intention. The simple slope at high trust was about 2.43 times the slope at low trust. Credible certification, transparent supply chains, and visible organic food consumption may support purchasing. Full article

Introduction: As seasonal influenza vaccination coverage among healthcare workers (HCWs) in Serbia remains suboptimal, we aimed to identify HCW beliefs associated with their intention to receive seasonal influenza vaccine (“vaccination intention”) in the season 2024/2025. Methods: In a cross-sectional survey conducted in 2024, healthcare institutions were selected from a national registry, using multi-stage sampling stratified by geographical region and healthcare level. All consenting HCWs present on the survey day self-completed questionnaires. Five dichotomised Health Belief Model constructs were assessed: perceived susceptibility to influenza, perceived disease severity, perceived vaccination benefits, perceived physical and psychological barriers, and perceived cues for action (recommendation by another HCW, someone close, or a supervisor). The association of vaccination intention (yes/no/undecided) with Health Belief Model constructs, demographic and occupational factors were assessed using multinomial logistic regression. Results: Of 1919 respondents, 30% declared positive vaccination intention, 52.5% no intention, and 17.5% were undecided. Compared with no intention, positive vaccination intention was associated with perceived self-benefit (aOR = 6.22, CI = 3.49–11.08), perceived patient benefit (aOR = 2.26, CI = 1.48–3.45), perceived susceptibility (aOR = 3.26, CI = 2.19–4.86), and perceived vaccine safety (aOR = 2.95, CI = 1.93–4.50). Participants were more likely to be undecided than reject vaccination if they experienced higher perceived susceptibility (aOR = 2.93, CI = 1.89–4.54), perceived influenza as severe (aOR = 2.04, CI = 1.30–3.21), perceived patient benefits (aOR = 1.77, CI = 1.14–2.74), or recalled receiving a recommendation from another HCW (aOR = 2.63, CI = 1.17–5.85). Conclusions: HCWs’ positive vaccination intention was associated with beliefs relevant for personal health and patient benefits. The undecided group showed a distinct pattern of beliefs warranting their separate analysis and specific approaches. Full article

Background/Objectives: Musculoskeletal disorders (MSDs) represent a significant occupational health concern among medical laboratory workers (MLWs) worldwide. However, in cross-sectional epidemiological assessments, these are more accurately characterized as self-reported musculoskeletal symptoms (MSSs). Despite growing awareness of physical ergonomic risk factors, the multifactorial etiology of these symptoms, such as psychosocial factors, remains incompletely understood in research laboratory settings. Consequently, this study aimed to determine the prevalence of MSSs among MLWs in a Malaysian research institute, assess physical ergonomic risk in their daily tasks, and evaluate the empirical association between MSSs and psychosocial work engagement. Methods: A cross-sectional study was conducted among MLWs at a Malaysian medical research institute. The 12-month prevalence of self-reported MSSs was assessed using the Nordic Musculoskeletal Questionnaire. Physical ergonomic risk was evaluated utilizing the Rapid Entire Body Assessment (REBA). Psychosocial work engagement was measured using the 17-item Utrecht Work Engagement Scale. Results: A total of 115 MLWs participated, with 73 (63.5%) reporting MSSs. The neck had the highest complaints (n = 43, 37.4%), followed by the lower back (n = 35, 30.4%) and shoulders (n = 33, 28.7%). Multivariable modified Poisson Generalized Estimating Equations revealed that physical ergonomic risk (REBA) was significantly associated with symptoms in the shoulder, upper back, and lower back. Female sex was independently correlated with the overall prevalence of MSSs (aPR = 1.39; 95% CI = 1.14–1.68), with marked associations observed for the neck and knees. Psychosocially, high “absorption” in work was significantly associated with upper back symptom prevalence (aPR = 1.57; 95% CI = 1.15–2.14). Conclusions: Ergonomic strain demonstrates a strong association with axial and shoulder symptoms among MLWs, while demographic characteristics and cumulative tenure correlate with specific extremity symptoms. Paradoxically, high psychological absorption emerges as a distinct correlate of upper back symptoms, likely due to prolonged postural neglect during deep concentration. Occupational health programs may benefit from combining targeted ergonomic accommodations with strategies designed to mitigate the potential physical vulnerabilities of highly absorbed personnel. Full article

Polyendocrine metabolic ovarian syndrome (PMOS) is the most common endocrine disorder in working women. Workplace screening could contribute to the early diagnosis and treatment of this chronic condition. Fertile women who participated in a 2022 health food promotion campaign and had suspected eating disorders, overweight/obesity, metabolic abnormalities, sleep problems, or mental health concerns were interviewed about PMOS symptoms during their in-office medical examination. Twenty-eight of the 1170 women examined had symptoms of suspected PMOS. By 2023, 21 of these diagnoses had been confirmed by specialists. The prevalence of newly diagnosed PMOS among the women of childbearing age was 2.7% (CI95% 1.7; 4.2). The confirmation rate of the clinical suspicion of PMOS was 75% (CI95% 55.1; 89.3). Female workers with newly identified PMOS had a significantly higher frequency of eating disorders than their pre-menopausal colleagues and higher body mass index values, higher glycemia, and higher cholesterol values. PMOS patients also had higher depression symptom scores than other workers of childbearing age. In conclusion, with a short interview during mandatory medical examinations, the occupational physician can make a significant contribution to the diagnosis of PMOS, thereby hopefully improving the quality of life of women and reducing damage to their health. Full article

While there has been an increase in publications on environmental sustainability in agriculture, the labor aspect of sustainable agriculture remains insufficiently addressed in scientific literature. Migrant seasonal farmworkers (MSFWs) are fundamental to food production, yet often labor under hazardous conditions. This systematic review, conducted in accordance with PRISMA guidelines, synthesizes findings from fourteen peer-reviewed studies across multiple countries that utilized validated health-related quality of life (HRQoL) instruments. This review focuses exclusively on studies employing validated health-related quality of life (HRQoL) instruments, which, while essential for methodological rigor, limited the number of eligible studies. The search was expanded to five major databases to maximize coverage. The review aims to describe the working and living conditions of MSFWs, examine the effects of these hazards on their HRQoL, and explore broader implications for the sustainability of agriculture. The most prevalent detrimental conditions identified include chemical pesticide exposure, underpayment of wages, poor living and working environments, and inadequate labor legislation. Across diverse agricultural contexts, the review confirms the universality of poor working conditions and their consistent negative impacts on farmworker health, wellbeing, and the sustainability of the sector. Addressing the exploitation of migrant farmworkers is essential not only for realizing their rights but also for achieving social, environmental, and economic sustainability in agriculture worldwide. The findings underscore the urgent need for policy reforms to improve labor protections, working conditions, and access to health services for this vulnerable workforce. Full article