Portrait of training and worker health surveillance actions in Santa Catarina.

Introduction: Since 2005, the Centro de Referência em Saúde do Trabalhador in the state of Santa Catarina has promoted several training in Vigilância em Saúde do Trabalhador for public health inspectors in the state, so that they can intervene in potentially sick work environments. Objectives: To evaluate the Vigilância em Saúde do Trabalhador actions carried out by the health surveillance agencies of the state of Santa Catarina and to verify the perception of inspectors regarding the technical preparation for the performance. Methods: Sample: 257 inspectors from 134 municipalities. Data collection: self-administered questionnaire sent to 733 state inspectors; the number of Vigilância em Saúde do Trabalhador actions planned and executed in 2018, extracted from the Pharos System. The study was cross-sectional, descriptive and with a convenience sample. Results: Most municipal workers' health surveillance did not carry out five Vigilância em Saúde do Trabalhador actions per month; most inspectors have difficulties in carrying out Vigilância em Saúde do Trabalhador actions and that they are related to organizational issues. There was no association between the variables training received and actions performed. Conclusions: It is inferred that the difficulties faced by inspectors may have contributed to the low number of Vigilância em Saúde do Trabalhador actions carried out. It is necessary to make structural and organizational advances in workers' health in the municipalities.

Introdução: O Centro de Referência em Saúde do Trabalhador do estado de Santa Catarina promove, desde 2005, diversas capacitações em Vigilância em Saúde do Trabalhador para os fiscais sanitaristas do estado, para que eles possam intervir nos ambientes de trabalho potencialmente adoecedores. Objetivos: Avaliar as ações de Vigilância em Saúde do Trabalhador realizadas pelas Vigilâncias Sanitárias do estado de Santa Catarina e verificar a percepção dos fiscais a respeito do preparo técnico para a atuação. Métodos: A amostra foi composta por 257 fiscais de 134 municípios. A coleta de dados foi feita por meio de questionário autoaplicável enviado aos 733 fiscais do Estado e do número de ações de Vigilância em Saúde do Trabalhador planejadas e executadas no ano de 2018, extraídas do Sistema Pharos. O estudo foi transversal, descritivo e com amostra de conveniência. Resultados: A maioria das vigilâncias em saúde do trabalhador municipais não realizaram cinco ações de Vigilância em Saúde do Trabalhador por mês; a maioria dos fiscais têm dificuldades na execução das ações de Vigilância em Saúde do Trabalhador e que elas se relacionam às questões organizacionais. Não foi verificada associação das variáveis capacitações recebidas e ações realizadas. Conclusões: Infere-se que as dificuldades enfrentadas pelos fiscais possam ter contribuído para o baixo número de ações de Vigilância em Saúde do Trabalhador realizadas. É necessário que se façam avanços estruturais e organizacionais da saúde do trabalhador nos municípios.

Challenges and Lessons from the COVID-19 Pandemic for Health Surveillance in Brazil: Reflections on Technologies, Models, and System Organization / Desafios e lições da pandemia de COVID-19 para a Vigilância em Saúde no Brasil: reflexões sobre tecnologias, modelos e organização do sistema

The term "health surveillance" encompasses a wide range of activities, including the monitoring and observation of illnesses and diseases. In this section, we will examine the most well-known aspect of health surveillance, namely the monitoring of communicable diseases. To illustrate our discussion, we will use the ongoing pandemic caused by the SARS-CoV-2 virus as a case study. As the text progresses, the focus shifts to an examination of technologies, models, and the structure of the system. The most severe epidemic of our era, classified as a pandemic due to its global impact, has compelled us to reflect on a multitude of disciplines. The resulting suffering should preclude any association with positive images, despite the opportunity to learn and, in some instances, observe the capacity of humans to act in solidarity. It is often observed that few things are as didactic as tragedies and mistakes. It is therefore important to explore them carefully to extract the necessary feedback to correct the course of action in health. In this text, we will discuss the conditions that led health surveillance in Brazil to fail miserably in its mission in the face of the emergency triggered by the novel coronavirus disease 2019. We will also present points that deserve attention in a restructuring of the health surveillance system.

A vigilância em saúde, como vigilância de agravos e doenças, tem um escopo bastante amplo. Discutiremos aqui a face mais conhecida, que é a vigilância de doenças transmissíveis, e assumiremos como mote a pandemia causada pelo vírus SARS-CoV-2. No desenvolvimento do texto, a abordagem se amplia para uma reflexão sobre tecnologias, modelo e organização do sistema. A mais grave epidemia de nossa época, classificada como pandemia, por atingir simultaneamente todo o planeta, tem obrigado a reflexões que envolvem múltiplos campos do conhecimento. O sofrimento decorrente deve inibir a tentação de associá-la a qualquer imagem positiva, ainda que tenha havido oportunidade para aprender e, em algumas circunstâncias, testemunhar a capacidade humana de agir solidariamente. Poucas coisas são tão didáticas como tragédias e erros. Cabe explorá-los cuidadosamente e extrair a necessária retroalimentação para corrigir rumos da atuação em saúde. Neste texto, trataremos das condições que levaram a vigilância em saúde no Brasil a falhar fragorosamente em sua missão frente à emergência desencadeada pela doença do novo coronavírus 2019 e levantaremos pontos que merecem atenção em uma reestruturação do sistema de vigilância em saúde.

Tobacco and Nicotine Products Adverse Health Events: Findings From the FDA Safety Reporting Portal.

Introduction: The FDA oversees regulatory aspects of all U.S. tobacco products. Understanding the impact of emerging health trends and incidents associated with various tobacco and nicotine products is vital for public health. This study utilizes the FDA's Tobacco Product Problem Reports (TPPRs) to characterize and track adverse health events (AHEs) associated with tobacco and nicotine products over time, considering the impact of EVALI and the COVID-19 pandemic. Methods: FDA TPPRs from 2017-2022 provided information on AHEs related to various tobacco products. After data cleaning, 839 reports were categorized by two independent coders based on affected health category, frequency of AHEs reports, and proportion of AHEs per each health category. Additionally, variations in AHEs over time were assessed, considering major health events like EVALI and the COVID-19 pandemic. Results: Among the 839 reports, electronic cigarettes (e-cigarettes) were the primary product of concern, comprising 90.6% (n = 760) of all reports, surpassing traditional cigarettes (5.1%; n = 43) and other products. Notably, 45.6% of reports (n = 383) identified the neurological system as the most frequently mentioned health category, each reporting at least one AHE. This was followed by the respiratory (39.1%; n = 328) and digestive (10.7%; n = 90) systems. Among all reported AHEs, respiratory system issues were most frequent (25.9%; n = 512), closely followed by neurological (25.2%; n = 499) and digestive (6.6%; n = 131) concerns. Most reports occurred in 2019 (65.7%; n = 551), coinciding with the EVALI outbreak, with a subsequent decline post-Q3 2019, highlighting the potential impact of specific health crises on reporting trends. Conclusion: E-cigarettes dominated adverse health reports, particularly affecting the neurological and respiratory systems, with a peak in 2019. Our findings provide insights to regulatory entities and future research, enhancing understanding of AHEs in lesser-explored bodily systems, such as the neurological and digestive systems. This study emphasizes the need for ongoing and improved surveillance of emerging tobacco products to protect public health.

Epidemiology of sporadic and outbreak-associated hepatitis A infections in Ontario, Canada: A descriptive summary, 2015-2022.

Background: Hepatitis A is a disease of public health significance that typically causes acute, self-limiting infection. Understanding the risk factors and demographics associated with individual infections and outbreaks can guide public health communication and interventions. Objective: To assess the number of hepatitis A cases and outbreaks in Ontario from January 1, 2015, to November 22, 2022, and to identify common risk factors associated with sporadic and outbreak-associated infections in Ontario. Methods: Confirmed and probable hepatitis A cases reported between January 1, 2015, and November 22, 2022, were extracted from the Ontario electronic reporting system. Descriptive analyses were used to summarize and compare risk factors reported by sporadic and outbreak-associated hepatitis A cases. Annual rates of infection for individual public health units were calculated using annual population estimates for Ontario health regions. Results: During the study period, 938 cases of hepatitis A were reported in Ontario (an average annual rate of 0.9 cases per 100,000 population), with 31.3% (n=294) of cases linked to one of 18 unique outbreaks of hepatitis A. Four of 13 local outbreaks were associated with elementary school settings. Reported risk factors differed between sporadic cases (predominantly travel-related) and cases linked to known outbreaks (anal-oral contact, illicit drug use, diapering/assisting in toileting, close contact with a case). Rates of sporadic infection differed across public health units in Ontario over the study period. Conclusion: Public health interventions that aim to increase awareness of hepatitis A risk factors and increase vaccine uptake among those at increased risk of exposure could help to reduce the incidence of both locally acquired and travel-related sporadic infections and outbreaks.

Development and evaluation of a health literacy scale for parasitic diseases.

BACKGROUND: Parasitic diseases remain a serious public health problem in China. Health education aimed at disseminating health-related knowledge and promoting healthy behaviours, plays a crucial role in the prevention and control of parasitic diseases. This study aims to develop a tool to measure the parasitic disease health literacy of residents in China. METHODS: Scale development was based on qualitative and quantitative methods. Qualitative method included focus group discussions and Delphi consultations. A methodological design with multistage sampling and a pilot study was used to evaluate the questionnaire. The scale's reliability was tested using Cronbach's α and split-half reliability, while its construct validity was assessed using confirmatory factor analysis. The scale's passing score was determined using the receiver operating characteristic curve. A cross-sectional survey was conducted in six districts of the prefecture of Jiangsu and residents aged 14-69 years in the participating townships were randomly selected based on their location. RESULTS: The health literacy indicator system for parasitic diseases included 3 first-level, 9 s-level and 23 third-level indicators. The 23-item questionnaire demonstrated good internal consistency (Cronbach's alpha = 0.774) and split-half reliability (Spearman-Brown coefficient = 0.778). The questionnaire's passing score was 60. A total of 990 valid questionnaires were collected from participants in three cities. The percentage of participants with health literacy regarding parasitic diseases was 15.8%. Their scores were influenced by age, income, employment, and educational level. CONCLUSIONS: Health literacy of parasitic diseases is an integrated indicator rather than just knowledge or behavior information. The correlation between knowledge and behavior is weak. The capacity for healthy behavior of parasitic disease is associated with the location and culture of the city. For neglected diseases, it is important for people to talk positively about their behaviors with a doctor.

Basic Reproduction Number (R0), Doubling Time, and Daily Growth Rate of the COVID-19 Epidemic: An Echological Study.

Introduction: In infectious diseases, there are essential indices used to describe the disease state. In this study, we estimated the basic reproduction number, R0, peak level, doubling time, and daily growth rate of COVID-19. Methods: This ecological study was conducted in 5 provinces of Iran. The daily numbers of new COVID-19 cases from January 17 to February 8, 2020 were used to determine the basic reproduction number (R0), peak date, doubling time, and daily growth rates in all five provinces. A sensitivity analysis was conducted to estimate epidemiological parameters. Result: The highest and lowest number of deaths were observed in Hamedan (657 deaths) and Chaharmahal and Bakhtiari (54 deaths) provinces, respectively. The doubling time of confirmed cases in Kermanshah and Hamedan ranged widely from 18.59 days (95% confidence interval (CI): 17.38, 20) to 76.66 days (95% CI: 56.36, 119.78). In addition, the highest daily growth rates of confirmed cases were observed in Kermanshah (0.037, 95% CI: 0.034, 0.039) and Sistan and Baluchestan (0.032, 95% CI: 0.030, 0.034) provinces. Conclusion: In light of our findings, it is imperative to tailor containment strategies to the unique epidemiological profiles of each region in order to effectively mitigate the spread and impact of COVID-19. The wide variation in doubling times underscores the importance of flexibility in public health responses. By adapting measures to local conditions, we can better address the evolving dynamics of the pandemic and safeguard the well-being of communities.

Work-related injuries and illnesses (WRII) presenting to Illinois hospitals, 2017-2021: The importance of emergency department (ED) data.

OBJECTIVES: Research characterizing work-related injuries and illnesses (WRII) has predominantly focused on inpatients and deaths, despite evidence that 4% of WRII are admitted as inpatients and deaths are less than 0.2% of acute WRII. Our aim is to determine the usefulness of incorporating emergency department (ED) hospital data into current occupational health surveillance systems. METHODS: Data on ED and admitted WRII treated in Illinois hospitals from 2017 to 2021 were analyzed. Demographic characteristics, primary diagnosis, procedures undertaken, and unique patient estimates are described. Multivariable logistic regression models were developed to evaluate predictors of treatment in the ED and multivariable median regression models determined associations of total hospital charges. RESULTS: Between 2017 and 2021 there were 488,033 hospital presentations (95.9% nonadmissions) for WRII in Illinois, equating to a crude annual population rate of 1502.1/100,000. Non-Hispanic Whites (NHW) were disproportionately treated for illnesses, while Hispanic or Latino workers were disproportionately treated for injuries. African-Americans had the highest rate of ED emergent presentations (incident rate ratio [IRR] = 1.3, ref = NHW) and were less likely to be admitted for emergent presentations (IRR = 0.7, ref = NHW). ED presentations were more likely to be female, present with an injury, and at a rural, versus urban, hospital. Radiological investigations compromised the majority of procedures for nonadmitted patients (n = 403,317), and 94.8% were coded for a body region CONCLUSION: Between 2017 and 2021 in Illinois, there were nearly 500,000 hospital visits charged to workers' compensation totaling over US$ four billion. ED data provide additional insights into work-related chronic conditions, health disparities, and the usage of diagnostic and therapeutic procedures for WRII.

Respiratory virus detection and sequencing from negative SARS-CoV-2 rapid antigen tests.

Genomic epidemiology offers important insight into the transmission and evolution of respiratory viruses. We used metagenomic sequencing from negative SARS-CoV-2 antigen tests to identify a wide range of respiratory viruses and generate full genome sequences, offering a streamlined mechanism for broad respiratory virus genomic surveillance.

A roadmap for assessing the diagnostic usefulness of neurosensory testing and an updated method for exposure assessment among vibration-exposed workers in northern Sweden.

Workers who use handheld vibrating machines such as grinders, hammers and chainsaws expose themselves to hand-arm vibration (HAV). Exposure to HAV may cause injuries to both the neurological and the vascular system. The occupational health services (OHS) in Sweden use a formal guideline for secondary prevention focusing on early detection of vibration-related injuries. The guide includes several screening tools, such as a screening questionnaire, clinical examinations, and laboratory tests. There are no studies, to our knowledge, on the diagnostic value of the separate items on symptoms in the screening questionnaire in relation to the laboratory tests or the clinical examinations performed during a medical examination among patients exposed to HAV. Furthermore, the recently presented ISO standard for HAV measurements (ISO/TR 18,750) has only been tested for vascular injuries and not neurological injuries. This research roadmap aims to evaluate separate items in a screening questionnaire on neurological symptoms in relation to laboratory and clinical tests among HAV exposed workers in the Arctic region of Northern Sweden. It also covers a comparison of the dose-response of the current ISO 5349-1 measurement standard and the new suggested standard ISO/TR 18,750 with the neurosensory outcomes. This manuscript describes the study rationale, design, methods, and significance.

Optimizing next-generation sequencing efficiency in clinical settings: analysis of read length impact on cost and performance.

BACKGROUND: The expansion of sequencing technologies as a result of the response to the COVID-19 pandemic enabled pathogen (meta)genomics to be deployed as a routine component of surveillance in many countries. Scaling genomic surveillance, however, comes with associated costs in both equipment and sequencing reagents, which should be optimized. Here, we evaluate the cost efficiency and performance of different read lengths in identifying pathogens in metagenomic samples. We carefully evaluated performance metrics, costs, and time requirements relative to choices of 75, 150 and 300 base pairs (bp) read lengths in pathogen identification. RESULTS: Our findings revealed that moving from 75 bp to 150 bp read length approximately doubles both the cost and sequencing time. Opting for 300 bp reads leads to approximately two- and three-fold increases, respectively, in cost and sequencing time compared to 75 bp reads. For viral pathogen detection, the sensitivity median ranged from 99% with 75 bp reads to 100% with 150-300 bp reads. However, bacterial pathogens detection was less effective with shorter reads: 87% with 75 bp, 95% with 150 bp, and 97% with 300 bp reads. These findings were consistent across different levels of taxa abundance. The precision of pathogen detection using shorter reads was comparable to that of longer reads across most viral and bacterial taxa. CONCLUSIONS: During disease outbreak situations, when swift responses are required for pathogen identification, we suggest prioritizing 75 bp read lengths, especially if detection of viral pathogens is aimed. This practical approach allows better use of resources, enabling the sequencing of more samples using streamlined workflows, while maintaining a reliable response capability.

From Fax to Secure File Transfer Protocol: The 25-Year Evolution of Real-Time Syndromic Surveillance in England.

The purpose of syndromic surveillance is to provide early warning of public health incidents, real-time situational awareness during incidents and emergencies, and reassurance of the lack of impact on the population, particularly during mass gatherings. The United Kingdom Health Security Agency (UKHSA) currently coordinates a real-time syndromic surveillance service that encompasses 6 national syndromic surveillance systems reporting on daily health care usage across England. Each working day, UKHSA analyzes syndromic data from over 200,000 daily patient encounters with the National Health Service, monitoring over 140 unique syndromic indicators, risk assessing over 50 daily statistical exceedances, and taking and recommending public health action on these daily. This English syndromic surveillance service had its origins as a small exploratory pilot in a single region of England in 1999 involving a new pilot telehealth service, initially reporting only on "cold or flu" calls. This pilot showed the value of syndromic surveillance in England, providing advanced warning of the start of seasonal influenza activity over existing laboratory-based surveillance systems. Since this initial pilot, a program of real-time syndromic surveillance has evolved from the single-system, -region, -indicator pilot (using manual data transfer methods) to an all-hazard, multisystem, automated national service. The suite of systems now monitors a wide range of syndromes, from acute respiratory illness to diarrhea to cardiac conditions, and is widely used in routine public health surveillance and for monitoring seasonal respiratory disease and incidents such as the COVID-19 pandemic. Here, we describe the 25-year evolution of the English syndromic surveillance system, focusing on the expansion and improvements in data sources and data management, the technological and digital enablers, and novel methods of data analytics and visualization.

Activity pattern of Tityus serrulatus (Scorpiones: Buthidae) in an urban area in the state of São Paulo, Brazil.

Tityus serrulatus Lutz & Mello (Scorpiones: Buthidae) is a scorpion endemic to Brazil adapted to synanthropic life, colonising and proliferating in the most populous urban areas in the country. Here, we evaluated its activity pattern in an urban cemetery in the municipality of Americana, state of São Paulo, Brazil. Additionally, we tested the effects of species reproduction and climatic seasons on the activity pattern. The Saudade Municipal Cemetery was sampled between 17:00 and 22:00 h during 455 nights from April 2006 to December 2013. The circular mean and the peak of activity were quantified for the total number of specimens, and for specimens with and without broods. Activity patterns were inferred using a rosette diagram. Circular analysis of variance was used to investigate if activity patterns changed across climatic seasons (wet and dry seasons). A total of 25,969 records (467 specimens with broods) were obtained in the field. The circular mean varied between 19:44 and 19:48 h, and the peak of activity occurred between 18:00 and 20:00 h for all groups. Peaks of activity differed from that recorded under laboratory conditions (between 21:00 and 23:00 h). Activity patterns did not differ for specimens with broods, suggesting that the reproductive condition does not alter the species activity pattern. The activity pattern differed between wet and dry seasons for all specimens and specimens without broods, but differences were small and probably biologically irrelevant, probably because the species tolerates a wide variation in abiotic conditions. Deepening the knowledge of the behaviour activity of T. serrulatus can have practical applications for health surveillance agencies, aiming to increase the effectiveness of scorpion control in urban areas.

Tityus serrulatus Lutz & Mello (Scorpiones: Buthidae) é um escorpião endêmico do Brasil adaptado à vida sinantrópica, colonizando e proliferando nas áreas urbanas mais populosas do país. Aqui avaliamos seu padrão de atividade em um cemitério urbano no município de Americana, estado de São Paulo, Brasil. Adicionalmente, testamos os efeitos da reprodução da espécie e das estações climáticas sobre o padrão de atividade. O Cemitério Municipal da Saudade foi amostrado entre 17:00 h e 22:00 h durante 455 noites, de abril de 2006 a dezembro de 2013. A média circular e o pico de atividade foram quantificados para o número total de espécimes, espécimes com e sem ninhadas. Os padrões de atividade foram inferidos usando um diagrama de roseta. Análises de variância circular foram utilizadas para investigar se os padrões de atividade mudavam com as estações climáticas (estações chuvosa e seca). Um total de 25.969 registros (467 espécimes com ninhadas) foram obtidos em campo. A média circular variou entre 19:44 h e 19:48 h e o pico de atividade ocorreu entre 18:00 h e 20:00 h para todos os grupos. Os picos de atividade diferiram dos registados em condições de laboratório (entre 21:00 h e 23:00 h). Os padrões de atividade não diferiram para os espécimes com ninhadas, sugerindo que a condição reprodutiva não altera o padrão de atividade da espécie. O padrão de atividade diferiu entre as estações chuvosa e seca para todos os espécimes e os espécimes sem ninhadas, mas as diferenças foram pequenas e provavelmente biologicamente irrelevantes, provavelmente porque a espécie tolera uma grande variação nas condições abióticas. Preencher lacunas sobre o comportamento de T. serrulatus pode ter aplicações práticas para órgãos de vigilância sanitária, visando aumentar a eficácia do controle de escorpiões em áreas urbanas.

Poor Work Ability Is Associated with Workplace Violence in Nurses: A Two-Wave Panel Data Analysis.

Healthcare personnel must deal with two problems of growing importance: violence in the workplace and the loss of work ability due to the aging of the workforce. Our objective was to evaluate, with a two-wave perspective design, the relationships of work ability, social support, and occupational stress with workplace violence in nurses. In an Italian public health company, we asked nurses to self-assess their work ability using the Work Ability Index (WAI) and we analyzed the relationship between this indicator and the violence experienced in the previous and following years. A total of 321 out of 344 nurses (99.3%) participated. In a logistic regression model, the WAI score was a significant protective factor for violence experienced in the previous year (OR = 0.94 CI95% = 0.90; 0.98 p < 0.01) and in the following year (OR = 0.88 CI95% = 0.84; 0.92 p < 0.01). In a hierarchical logistic regression model, social support acted as a protective factor (OR = 0.87 CI95% = 0.79; 0.95 for violence experienced in the previous year), while occupational stress was a significant determinant of the risk of aggression (OR = 3.65 CI95% = 1.90; 7.03 in the previous year, OR = 3.54 CI95% = 1.801; 6.947 in the following year). The difficulties that nurses encounter in carrying out their growing work demands in an environment that is not promptly adapted to their changing physical and mental states can lead to an increased risk of violence. Prevention of workplace violence should include organizational and ergonomic measures that reduce stress and increase staff support and work ability.

Leisure Screen Time and Food Consumption among Brazilian Adults.

BACKGROUND: Screen time, involving activities like watching television (TV), and using tablets, mobile phones, and computers (electronic devices), is associated with the consumption of unhealthy foods. This study aimed to analyze the association between prolonged leisure screen time and healthy and unhealthy food consumption indicators among Brazilian adults (≥18 years). METHODS: Data from the National Health Survey (NHS), conducted in 2019 (n = 88,531), were used. Prolonged leisure screen time (screen time ≥ 3 h/day) was analyzed in three dimensions: watching TV; use of electronic devices; and total screen time (TV and electronic devices). Food consumption was analyzed in two dimensions: healthy (in natura and minimally processed foods) and unhealthy (ultra-processed foods). Poisson regression models were used to calculate prevalence ratios (crude and adjusted (PRa)) by sociodemographic factors (sex, age, schooling, income, area of residence, and race/color) and health factors (weight status, self-rated health, and presence of noncommunicable disease), to assess the association between prolonged screen time and food consumption indicators. RESULTS: Among Brazilian adults, the prevalence of prolonged screen time was 21.8% for TV and 22.2% for other electronic devices for leisure. The highest frequency of watching TV for a prolonged time was observed among women, older adults, and those with a lower income and schooling. Prolonged use of electronic devices was more common among young adults and those with intermediate schooling and income. Prolonged screen time was associated with an unhealthy diet, due both to the higher consumption of unhealthy foods (PRa = 1.35 for TV, PRa = 1.21 for electronic devices, and PRa = 1.32 for both types) and the lower consumption of healthy foods (PRa = 0.88 for TV, PRa = 0.86 for electronic devices, and PRa = 0.86 for both). CONCLUSIONS: Prolonged screen time was negatively associated with the consumption of healthy foods and favored the consumption of unhealthy foods among Brazilian adults.

Monitoring the sleep health of adults: a scoping review of routine national surveillance systems.

Study Objectives: The aims of this review were to identify existing national surveillance systems monitoring one or more domains of sleep health in adults, and to describe the specific sleep health indicators used. Methods: We systematically searched the gray and peer-reviewed literature for routinely conducted cross-sectional and longitudinal nationally representative health surveys that included the assessment of at least one domain of sleep health. The methodology involved: (1) targeted searches of the websites of national and international health agencies and statistics departments for 199 countries, (2) country-specific customized internet searches, and (3) country-specific electronic database searches of PubMed. Results: A total of 19 762 records were identified from both the gray and peer-reviewed literature. Sleep health surveillance at the national level was conducted by 51 countries (25.6%) across 69 national health surveys. Sleep quality (96.1% of countries that surveilled sleep) was the most frequently assessed followed by sleep duration (27.5%), sleep medication use (25.5%), sleep disorders (17.6%), daytime alertness (15.7%), sleep satisfaction (15.7%), and sleep timing (7.8%). Additionally, 34.8% of the surveys utilized multiple sleep health indicators. Conclusions: This study identified three significant gaps in the coverage of sleep health within national surveillance systems. Limited population sleep data in low- and middle-income countries, inconsistent use of sleep-related items in surveys and questionnaires, and substantial variability in the definitions of sleep health indicators. Advocacy for the inclusion of sleep health within national surveillance systems may be warranted given the important role sleep plays in public health.

Determination of toxicological relevant arsenic species in urine by hydride generation microwave-induced plasma optical emission spectrometry.

An analytical method for the determination of toxicological relevant species of arsenic in urine was developed and validated using hydride generation microwave-induced emission spectrometry (HG-MP-AES). This strategy can be used as an alternative to HG-HPLC-ICP-MS considered as a reference technique for arsenic speciation. This procedure is notably less expensive than other techniques and sample preparation and requires only a few steps.•Hydride generation with MP-AES detection has proven to be an effective technique for measuring arsenic metabolites in urine, which is relevant for occupational monitoring and health risk assessment purposes.•This method offers simplicity and cost-effectiveness, serving as an alternative to classical analytical procedures typically used for arsenic analysis in urine.•The methodology has been successfully applied for the purpose of workers' health surveillance.

Triagem otoneurológica em trabalhadores expostos à altura / Otoneurological screening in workers exposed to height / Triaje otoneurológica en trabajadores expuestos a la altura

O trabalho em altura está entre as principais causas de acidentes ocupacionais no Brasil e é o fator que apresenta o maior risco de morte no ambiente laboral. Objetivo: Avaliar a presença de sinais e sintomas otoneurológicos em trabalhadores expostos à altura, no Distrito Federal. Método: Trata-se de um estudo observacional, transversal, de triagem otoneurológica, com 46 trabalhadores da construção civil, expostos à altura, localizados no Distrito Federal. Resultados: 52,2% dos participantes apresentaram alterações significativas no teste de Fukuda e correlação estatisticamente relevante (valor-p< 0.05) entre a média da idade e as queixas de tontura e desequilíbrio. Conclusão: A triagem mostrou-se uma ferramenta prática rápida, de baixo custo e eficaz para avaliar as queixas, sinais, sintomas e alterações otoneurológicas que podem comprometer a segurança do trabalhador quanto ao risco de queda.

Working at height is among the leading causes of occupational accidents in Brazil and is the factor that presents the greatest risk of death in the workplace. Objective: To evaluate the presence of otoneurological signs and symptoms in workers exposed to heights in the Federal District. Method: This is an observational, cross-sectional study of otoneurological screening, with 46 construction workers exposed to heights, located in the Federal District. Results: 52.2% of the participants had significant alterations in the Fukuda test and a statistically relevant correlation (p-value < 0.05) between the mean age and complaints of dizziness and unbalance. Conclusion: The screening proved to be a quick, low-cost and effective practical tool to assess complaints, signs, symptoms, and otoneurological changes that may jeopardize the safety of the worker as to the risk of falling.

El trabajo en altura está entre las principales causas de accidentes laborales en Brasil y es el factor que presenta mayor riesgo de muerte en el lugar de trabajo. Objetivo: Evaluar la presencia de signos y síntomas otoneurológicos en trabajadores expuestos a la altura, en el Distrito Federal. Método: Se trata de un estudio observacional, transversal, de triaje otoneurológico, con 46 trabajadores de la construcción, expuestos a la altura, ubicados en el Distrito Federal. Resultados: el 52,2% de los participantes mostró cambios significativos en el test de Fukuda y una correlación estadísticamente relevante (valor p < 0,05) entre la edad promedio y las quejas de mareos y desequilibrio. Conclusión: El screening demostró ser una herramienta práctica rápida, de bajo costo y efectiva para evaluar quejas, signos, síntomas y cambios otoneurológicos que podrían comprometer la seguridad del trabajador frente al riesgo de caída.

Linking Maternal and Child Health Data to Enhance Public Health Surveillance and Implement Sustainable Interventions.

Our initiative aims to enhance the public health informatics infrastructure for surveillance of maternal and child health (MCH) using data captured from electronic health records (EHRs), public health information systems, and administrative health data. Our work includes development, validation, and application of linkage algorithms across records for mothers and children; integration of data across myriad sources; design of routine surveillance reports; and design of longitudinal studies to examine determinants and outcomes in MCH populations. Our work is conducted in partnership with governmental public health agencies, health care providers, academic institutions, and community-based organizations. Future work will build on the enhanced informatics infrastructure to draw from additional public health data sources and/or expand surveillance efforts to include prioritized MCH outcomes. We will further translate knowledge gained from surveillance into action, working with our partners to improve and sustain better MCH equitably in our population.

Surveillance of Disease Outbreaks Using Unsupervised Uni-Multivariate Anomaly Detection of Time-Series Symptoms.

Effectively identifying deviations in real-world medical time-series data is a critical endeavor, essential for early surveillance of disease outbreaks. This paper demonstrates the integration of time-series anomaly detection techniques to develop surveillance systems for disease outbreaks. Utilizing data from Sweden's telephone counseling service (1177), we first illustrate the trends in physical and mental symptoms recorded as contact reasons, offering valuable insights for outbreak detection. Subsequently, an advanced anomaly detection technique is applied incrementally to these time-series symptoms as univariate and multivariate approaches to assess the effectiveness of a machine learning-based method on early detection of the COVID-19 outbreak.

Piloting wastewater-based surveillance of norovirus in England.

Wastewater-based epidemiology (WBE) gained widespread use as a tool for supporting clinical disease surveillance during the COVID-19 pandemic. There is now significant interest in the continued development of WBE for other pathogens of clinical significance. In this study, approximately 3,200 samples of wastewater from across England, previously collected for quantification of SARS-CoV-2, were re-analysed for the quantification of norovirus genogroup I (GI) and II (GII). Overall, GI and GII were detected in 93% and 98% of samples respectively, and at least one of the genogroups was detected in 99% of samples. GI was found at significantly lower concentrations than GII, but the proportion of each genogroup varied over time, with GI becoming more prevalent than GII in some areas towards the end of the study period (May 2021 - March 2022). Using relative strength indices (RSI), it was possible to study the trends of each genogroup, and total norovirus over time. Increases in norovirus levels appeared to coincide with the removal of COVID-19 related lockdown restrictions within England. Local Moran's I analyses indicated several localised outbreaks of both GI and GII across England, notably the possible GI outbreak in the north of England in early 2022. Comparisons of national average norovirus concentrations in wastewater against concomitant norovirus reported case numbers showed a significant linear relationship. This highlights the potential for wastewater-based monitoring of norovirus as a valuable approach to support surveillance of norovirus in communities.