bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact on ambient air pollution and asthma-related admissions of COVID-19 transport restrictions
Authors: Kelly C , Kenny P , O'Dwyer M , Quintyne KI 
Published: October 2022

Abstract

Exposure to air pollution is a known risk factor for asthma exacerbations, emergency attendances and hospitalisations. In Europe, the main source of air pollution is the transport industry, and so the COVID-19 transport restrictions provided an opportunity to examine if reduction in traffic had a demonstrable impact on ambient air quality and asthma-related admissions. Routinely collected data was used to conduct a retrospective population cohort study. The Environmental Protection Agency provided daily nitrogen dioxide (NO2) and particulate matter (PM) concentrations for Dublin, and all asthma-related admissions were collected from the Hospital In-Patient Enquiry system. The two years prior to the pandemic were compared with the period of transport restrictions (from March 2020). During the period of restrictions, there was a significant reduction in the mean number of daily asthma admissions (2.8 v 4.5 admissions p &lt; 0.001). There was also a significant decrease in mean daily concentrations in two pollutants: NO2 (16.7 v 24.0µg/m3 p &lt; 0.001) and PM2.5 (7.8 v 8.9µg/m3 p = 0.002). Only NO2 had a statistically significant correlation with asthma admissions (r = 0.132 p &lt; 0.001). Transport restrictions introduced to mitigate against COVID-19 led to improvements in air quality, as seen by the reductions in pollutant concentrations. Previously described associations between pollutants and asthma, would suggest that these improvements in air quality contributed to the reduction in asthma admissions. Whereas the primary source of NO2 is transport emissions, PM is made up of particles from multiple sources, which likely explains the lack of correlation between asthma admissions and PM. Public Health need to advocate for transport policies which can improve air quality, and as a result, public health.

Key messages
Environmental Health Literacy: an index to study its relations with pro-environmental behaviors
Authors: Carducci A , Fiore M , Lorini C , Federigi I , Verani M , Ferrante M , Bonaccorsi G 
Published: October 2022

Abstract

The citizen’ awareness about environmental health risks has been identified as an important determinant of citizens’ choices for the adoption of pro-environmental behaviors, but for its study simple measures to be applied in population studies are still lacking. The Environmental Health Literacy (EHL), is a recent sub-cathegory of health literacy, including functional, critical and interactive dimensions, that can be applied in surveys on environmental health risk perception and behaviors. The aim of our study was to elaborate and validate an EHL Index (ELHI) using data from a large multicenter survey carried out among 4778 students of different disciplines in 15 Italian Universities, with a self-administered anonymous questionnaire investigating risk perceptions, attitudes and behaviors towards environmental health risks and including a simple Functional Health Literacy test (FHL). From the original questionnaire of 56 items three sets of questions were selected to represent the three dimensions of health literacy (Functional, Critical or Interactive) and their outcomes were compared with the answers about FHL test and pro-environmental behaviors. The Principal Component Analysis was used to select the most representative questions that were then grouped in the EHLI. The index was significantly associated with both FHL test and behaviors questions. The ROC curve indicated a satisfying accuracy and was used to identify the best cut-off for ELHI. In conclusion the constructed ELHI can be considered reliable and useful for further population surveys in similar target people to plan communication interventions about environmental health risks and their prevention through individual choices.

Key messages
Effect of socio-economic deprivation on refugee health: a natural experiment study in Germany
Authors: Biddle L , Bozorgmehr K 
Published: October 2022

Abstract

Background
Characteristics of the place of residence have been proposed as a key determinant of physical and mental health, but so far, little experimental evidence exists. The quasi-random dispersal of refugees in Germany serves as a natural experiment to study the causal relationship between socio-economic deprivation and health as well as the impact of the social context on this relationship.

Methods
Refugees subject to dispersal policy (n = 1723) were selected from the nation-wide German IAB-SOEP-BAMF Panel from 2016 to 2018. The effect of German Index of Socioeconomic Deprivation quintiles (Q1-Q5) on change between baseline (t0) and follow-up (t1) in mental (mcs) and physical (pcs) health component scales of SF-12 were analysed using multi-level linear regression. Social context variables were included in a mediation analysis.

Results
Across quintiles, mental health improves (Δmcs=0.5) and physical health declines (Δpcs=-0.8) between t0 and t1. Fully adjusted models show a negative, dose-responsive relationship between deprivation and physical health, which is statistically significant for Q4 (coef. Q4vsQ1: -1.84, 95%CI: -3.50;-0.17). Models for mental health show an improvement in Q5 (coef. Q5vsQ1: 6.00, 95%CI: 1.70;10.31). Social context variables have no effect on physical health but slightly diminish the effect on mental health (coef. Q5vsQ1: 4.78, 95%CI: 0.65;8.90).

Conclusions
The quasi-random dispersal of refugees in Germany acts as a natural experiment to disentangle selection effects from the relationship between deprivation and health. Results suggest a negative effect of deprivation on physical health and a potential positive effect on mental health which can be partially explained by the social context. Limitations are the small sample sizes in deprived quintiles and short follow-up periods. This analysis can act as a magnifying glass for similar effects among other population groups, but causal paths need to be investigated further.

Key messages
Elevated risk of depression and anxiety disorder by „high strain“ occupations: a systematic review
Authors: Seidler A , Freiberg A , Drössler S , Hussenoeder FS , Conrad I , Riedel-Heller S , Starke K Romero , Schubert M 
Published: October 2022

Abstract

Background
Poor working conditions might lead to mental illness.

Methods
We performed a systematic review with meta-analyses as an update of a review published in 2013. We registered the study protocol with PROSPERO (registration number: CRD42020170032) and searched for epidemiological studies in MEDLINE, PsycINFO, and Embase. Two reviewers carried out independently all review steps including title-abstract screening, full-text screening, risk-of-bias assessment and data extraction. Discordances were solved by consensus. We determined the certainty of evidence using the GRADE-approach.

Results
Ten cohort studies with acceptable study quality examined the relationship between high job strain and the incidence of depression. In the “classic” demand-control-model, ‘high strain’ (combination of high demands and low control) is compared with ‘low strain’ (combination of low demands and high job control). For high strain, the risk of depression was elevated by 73%, the pooled effect estimate for the risk of depression was 1.73 (95% CI 1.32-2.27. In a dichotomous analysis (without dividing job strain into the four dimensions mentioned above), there was a doubled risk of depression with high job strain (pooled effect estimate=1.99, 95% CI 1.68-2.35). We found comparable risk estimates for men and women. The GRADE assessment revealed a high certainty of evidence of the association between job strain and depression. We also found a considerably increased risk of anxiety disorder among individuals prone to high job strain.

Conclusions
This systematic review finds a clear association between high job strain (high demands in combination with low control) and depression as well as anxiety disorders.
Acknowledgment: This study was financially supported by SUVA (Schweizerische Unfallversicherungsanstalt).

Key messages
Trajectories of part-time work and sickness absence among shift working healthcare employees
Authors: Ropponen A , Ervasti J , Härmä M 
Published: October 2022

Abstract

Background
Healthcare systems are facing major challenges due to population ageing, increased need for care, and economic challenges combined with staff shortage. The existing need for longer work careers combined with increasing turnover rates in healthcare highlights the need to understand working hours in association with work capacity and sustainable work careers. We aimed to investigate the concurrent changes in part-time work and sickness absence (SA) among healthcare employees without any SA spell &gt;14 days at baseline.

Methods
Annual working hour and SA data from 23 hospital districts and cities in Finland for 2008-2019 (172 922 employees with at least one work shift in any year). The sample was restricted to 20274 employees with ≤31 work shifts/year in 3 consequent years during the follow-up and without any SA spell &gt;14 days at baseline in 2008. Part-time work/year (yes/no), SA months/year, and nightwork/year (% of nightwork of all shifts) as time varying covariate were used in the group-based trajectory models examining the concurrent changes. Models for age groups (in 2008 and categorized into &lt; 25 years of age, ≥25 and &lt;40 years, ≥40 and &lt;55 years, and &gt;55 years) will be considered later.

Results
A five-trajectory solution identified groups for “stable full-time work without SA” (56.8%), “increasing part-time work and stable very low SA” (13.5%), “slight increase both in part-time work and SA” (16.5%), “steep increase in part-time work and reversed low U-shape in SA months” (5.0%), and “stable part-time work and low SA” (8.2%) across 2009-2019.

Conclusions
These initial findings indicate that while most employees work full-time without SA, those who transfer from working full-time to part-time during follow-up from 2009 to 2019 seem to have low SA. Thus, part-time work may promote work capacity, and accompanied by part-time work disability benefits, offer a tool for employers to support sustainable working life and to keep older employees at work.

Key messages
Risk of first musculoskeletal disorder in Danish occupational fishermen – a register-based study
Authors: Remmen LN , Christiansen DH , Herttua K , Berg-Beckhoff G 
Published: October 2022

Abstract

Background
Occupational fishery increase risk of musculoskeletal disorders due to a combination of heavy workloads and strenuous settings. Scarce and inconsistent knowledge exists on work-related risk factors despite high prevalence is evident. The aim was to determine work-related risk factors for the first diagnosis of musculoskeletal disorders in Danish occupational fishermen.

Methods
This study was a register-based cohort study. We extracted data the from Nationwide Danish registers on work affiliation and health data for all persons registered as occupational fishermen between 1994 and 2017. Job titles were retrieved from the Danish Occupational Cohort with eXposure (DOC*X). Time-to-event analysis using cox regression with age as timescale was applied.

Results
Among 15.739 fishermen, forty percent (n = 6.218 cases) experienced first musculoskeletal disorder during 82.2 million person-years of follow-up. Adjusted gender-stratified analysis showed that male fishermen, who worked less than 5 years and more than 15 years had the highest significant risks of MSD (HR 2.40 (95%CI: 2.06, 2.80), HR: 2.40 (95%CI: 1.76, 2.35)) respectively, compared to working more than 20 years. In males, more years in workforce, a captain education and working part time significantly protected against first MSD, while shifting trades above three times increased risk. Women had estimates with greater uncertainties due to their small numbers in the industry.

Conclusions
A high incidence of musculoskeletal disorders was found in Danish occupational fishermen between 1994-2017. Findings suggest a bimodal relationship between occupational fishermen seniority level and their risk of musculoskeletal disorder, where highest risk was seen at five years in trade, afterwards from lower estimate slowly increasing with accumulating years until highest occupational seniority, compared to more than twenty years in trade. Continued development actions of preventive measures are suggested.

Key messages
The causal effect of switching from precarious to standard employment on mortality in Sweden
Authors: Matilla-Santander N , Matthews AA , Gunn V , Muntaner C , Kreshpaj B , Wegman DH , Jonsson J , Bodin T , Consortium PPWR 
Published: October 2022

Abstract

Background
Precarious employment (PE) is a well-known social determinant of health and health inequalities, yet the effect of PE on mortality has not been explored sufficiently and high-quality longitudinal studies are lacking. When studying this effect, several methodological factors must be considered, one of them being the immortal time bias or prevalent user bias. A framework that helps us overcome these biases is the target trial. Therefore, the aim of this study is to estimate the causal effect of switching from precarious to standard employment (SE) on the 12-year risk of all-cause mortality among precariously employed workers aged 20-55 in Sweden.

Methods
We emulated the target trial as a series of 11 target trials (starting at any year between 2005 and 2016), such that each individual may participate in multiple trials using Swedish register data (N = 251274). We classified individuals as: a) workers that at baseline (start) move from PE to SE and then followed while in SE or b) continuation of PE over follow-up. All-cause mortality was measured from 2006 to 2017. We pooled data for all 11 emulated trials and used pooled logistic regression to estimate intention-to-treat effects via hazard ratios and standardized survival curves.

Results
The following results are preliminary. Individuals that continued on PE were 185,480 and those that initiated SE were 65,794. Over the 12-year follow-up, 1553 individuals died. The estimated observational analogue of the intention-to-treat 12-year survival difference for all cause-mortality between workers that continued on PE and those that initiated SE was of -0.2%, and the HR:0.82, 95%CI:0.72-0.94.

Conclusions
The following conclusions are preliminary. According to our results, we find indication that shifting from PE to SE decreased the risk of death. Our study highlights the crucial role of decent employment conditions for health.

Key messages
Fed up: a qualitative investigation on the influencing factors of food insecurity in the Azores
Authors: Freiheit R , Leão T 
Published: October 2022

Abstract

Background
In 2019, over 1 billion people experienced food insecurity. In the Azores, a 9-island archipelago in the Atlantic Ocean, 13.4% of its population perceived food insecurity, the highest regional rate in Portugal (10.1%). These geographical limitations paired with high unemployment and low education rates, may challenge their access to nutritious food. It is still unclear how these (and other) contextual factors may affect access and availability to food in this remote area, and how they interact with individual determinants.

Methods
Data collection was conducted in early 2022 with 13, in-depth, 1:1 semi-structured interviews regarding topics of food consumption and supply in the Azores. Non-probability sampling was used, with use of purposive and snowball sampling. We included key-stakeholders currently living in the islands or working in a role related to the islands (i.e., in healthcare, supply chain, agriculture, etc.). We performed a thematic analysis with an inductive-deductive iterative analysis.

Results
Participants identified several challenges related to access and availability of food. Vegetables, fruit and fish can be scarce and are subject to seasonal variation. There are clear regional disparities in access to food, with more isolated islands having less variety, quality and quantity of healthy foods available. Its topography and weather limit agricultural practices and transportation, but education, culture, and policies subsidizing the production of meat and dairy were also identified as important barriers to local production of fruits and vegetables.

Conclusions
Food insecurity is a public health concern in this outermost EU region. If topography and geography limit the production and access of nutritious foods, economic and agricultural policies are a leading theme of concern to highlight. The solution for food insecurity thus demands an interdisciplinary dialogue to better adjust future policies in the Azores and in similar regions.

Key messages
Healthcare accessibility since and during Covid-19 pandemic among older individuals in Europe
Authors: Mikelsone M , Reine I 
Published: October 2022

Abstract

Ensuring access to healthcare is critical to prevent illnesses and maintain health and functional abilities for older individuals. The Covid-19 pandemic is a major global public health threat that challenges healthcare availability and accessibility. The objective of the study was to compare healthcare accessibility for older individuals since and during Covid-19 pandemic. The study was based on a sample of individuals from wave 8 Covid-19 add-on and wave 9 Covid-19-add-on of the Survey of Health, Ageing and Retirement in Europe (SHARE) in the period from 2020 till 2021. The sample size was 44043 respondents from 26 European countries. Descriptive statistics, Chi-square and McNemar test was performed. Overall, in 2021 there is a statistically significant decrease in proportion of respondents who forwent medical treatment (from 12% to 8%, in Latvia from 14,6% to 7%), postponed medical appointment due to Covid-19 (from 27% to 13%, in Latvia from 14,6% to 3,2%) and to whom appointment was denied by healthcare facility due to Covid-19 (from 5,3% to 4,5%, in Latvia from 6.9% to 3,3%) (p &lt; 0.001). More often forwent medical appointment in 2021 was reported from females as well as respondents younger than 75 years, with good or very good self-rated health status and with less or no limitations due to health. Forwent medical treatment was reported more often from respondents with diabetes and hypertension. Results indicate that remote consultations are used more often than in 2020 (number of remote consultations varied between 1 and more than 100) and more often were reported by younger respondents (50-74 years). No significant association was found in self-rated health changes since and during Covid-19 pandemic for respondents who reported healthcare accessibility issues. As those issues were reported also by individuals with poor or fair self-rated health status and serious health conditions it can lead to a more rapid decline in health and functional abilities in the future.

Key messages
Professionals’ roles in the hospital discharge of older adults in 3 Nordic cities: a vignette study
Authors: Liljas AEM , Pulkki J , Jensen NK , Burström B , Keskimäki I , Andersen I , Jämsen E , Agerholm J 
Published: October 2022

Abstract

Background
The hospital discharge process of older adults in need of both medical and social care post hospitalisation requires extensive care coordination. Cooperation and continuity between involved care providers are essential, however, existing care systems including the Nordic care systems, are poorly designed to provide health and social care to patients with complex health and social care needs which increases the risk of certain groups not receiving optimal care.

Aim and methods
This study aims to examine and compare what roles, responsibility and actions nurses take in the hospital discharge process of older adults with complex care needs in three Nordic cities: Copenhagen (Denmark), Stockholm (Sweden) and Tampere (Finland). A vignette study consisting of three fictive cases was conducted face-to-face with nurses in Copenhagen (n = 11), Stockholm (n = 16) and Tampere (n = 8). Participants were identified through the researchers’ networks and snowball sampling. The vignettes represent older patients with age-related medical conditions of which one also has cognitive loss and one looks after their partner with dementia. The cases further include differences in the home help received by their children, physical obstacles in their homes and unwillingness of becoming a burden to the system. A thematic approach is used for the data analysis.

Results and conclusions
Preliminary results suggest that the informants’ roles and engagement in the coordination and collaboration may differ both within and between the systems studied, and that they take responsibility beyond their job roles particularly if the patient has no close relatives. The study is of public health importance as it identifies gaps in how the care is organised in the three welfare states targeted. It also sheds light on the complexities of providing universal care in ageing societies where a growing proportion of older adults have both medical and social care needs.

Key messages
Hustle: Experiences of making work ‘work’ for non-standard and precariously employed workers in NYC
Authors: Cuervo I , Ahonen EQ , Vignola EF , Davis L , Baron S 
Published: October 2022

Abstract

Background
Precarious and non-standard employment (NSE) has negative implications for workers’ health. As part of a six-country comparative mixed methods case study, this research explores US-based workers’ experiences in NSE and its influences on their health and well-being in a context of weak labor regulations and social welfare programs.

Methods
To understand US policy context, we analyzed country-level labor regulatory and social protection frameworks using 2019 Organization for Economic Cooperation and Development data. To understand workers’ experiences, we conducted in-depth interviews with NSE workers in various occupations in New York City (N = 40) between January and May 2021. We recruited and screened eligibility via Facebook advertisements and an online questionnaire, respectively. We used deductive and inductive thematic analysis for interview data.

Results
With heavy reliance on market competition in the US, minimal state regulation and flexible labor markets create less secure employment along with limited government-funded social supports. Workers’ experiences center on the Hustle, i.e., figuring out how to make NSE work for them and their families. They lack healthcare coverage and have low expectations of other supportive employment and social protections (e.g., paid leave). While NSE payoffs (e.g., perceived flexibility) were common for most, almost all experience NSE tradeoffs (e.g., job insecurity and instability) that create stress and overwork, negatively implicating overall health and well-being. These impacts differ by access to resources associated with social location (e.g., immigration status). COVID-19 exacerbated these experiences.

Discussion
Low expectations of supportive policies of US workers in NSE are linked to the individualized hustle, as they attempt to counter NSE tradeoffs often relying on family to fill those gaps. Over-reliance on privatization for social supports such as healthcare coverage can be detrimental to workers’ health.

Key messages