International Archives of Occupational and Environmental Health最新文献

{"title":"Early respiratory effects of long-term cement dust exposure: association with exercise capacity in asymptomatic workers.","authors":"Konstantinos Pigakis, Aggeliki Kontopodi, Vasileios Stavrou, Anastasios Philippou","doi":"10.1007/s00420-026-02247-x","DOIUrl":"https://doi.org/10.1007/s00420-026-02247-x","url":null,"abstract":"<p><strong>Purpose: </strong>Long-term occupational exposure to cement dust is associated with respiratory disease, yet early subclinical impairment may not be detected using conventional spirometry. This study aimed to investigate small airway dysfunction (SAD) as an early marker of respiratory effects and its association with exercise capacity in asymptomatic cement workers.</p><p><strong>Methods: </strong>We studied 500 non-smoking, non-asthmatic, non-atopic cement industry workers aged 35 years or older, with at least 10 years of occupational exposure to cement dust. Participants underwent spirometry, static lung volume measurements, impulse oscillometry (IOS) and cardiopulmonary exercise testing (CPET). Workers with evidence of SAD were compared to those with normal small airway function.</p><p><strong>Results: </strong>Small airway dysfunction was identified in a subset of workers despite preserved spirometry. The SAD group exhibited a 19.4% reduction in VO₂ peak compared to the non-SAD group (29 ± 2.3 vs. 36 ± 2.0 ml/kg/min, p < 0.05). This functional limitation was further characterised by a significantly lower breathing reserve (34% vs. 43%, p < 0.05) and increased ventilatory requirements during exercise.</p><p><strong>Conclusions: </strong>Subclinical respiratory impairment may occur in a significant proportion of asymptomatic workers with long-term exposure to cement dust. SAD may serve as an early functional marker of occupational lung disease. Conventional spirometry underestimates the functional impact of exposure; therefore, sensitive techniques should be integrated into occupational surveillance for early detection and support preventive workplace strategies.</p>","PeriodicalId":13761,"journal":{"name":"International Archives of Occupational and Environmental Health","volume":"99 9","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatigue, physical activity, and musculoskeletal burden in adults surveyed during the COVID-19 pandemic: a cross-sectional indirect-association analysis.","authors":"Barış Kılıç, Gülüşan Özgün Başıbüyük","doi":"10.1007/s00420-026-02246-y","DOIUrl":"https://doi.org/10.1007/s00420-026-02246-y","url":null,"abstract":"<p><strong>Objective: </strong>To examine the independent cross-sectional associations of fatigue and total physical activity with musculoskeletal burden and to estimate indirect associations through fatigue for prior COVID-19 infection, sex, and educational attainment.</p><p><strong>Methods: </strong>Questionnaire data were obtained from 400 community-dwelling adults aged ≥ 60 years surveyed in Antalya, Türkiye, in 2021. Physical activity, musculoskeletal discomfort, and fatigue were assessed using the Physical Activity Scale for the Elderly (PASE), the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ), and the Multidimensional Assessment of Fatigue. The Global Fatigue Index (GFI) was calculated for all participants. Regression models used heteroskedasticity-consistent (HC3) standard errors; robustness was examined with outcome transformation, winsorization, and influential-observation analysis. Indirect associations were estimated with 5,000 bootstrap samples.</p><p><strong>Results: </strong>The regression sample comprised 388 participants; 54.1% had a CMDQ score of zero. Higher GFI was associated with greater CMDQ burden (B = 3.114, SE = 0.566, p < 0.001), and this association remained positive across sensitivity analyses. PASE total was not associated with CMDQ in the primary model (B = - 0.053, p = 0.245), but its coefficient became significant after exclusion of influential observations (B = - 0.044, p = 0.027). Bootstrap 95% CIs for indirect estimates through GFI excluded zero for prior infection (15.55; 6.02-26.89), female sex (8.66; 1.49-17.55), and ordinal education (- 4.61; -9.68 to - 0.65).</p><p><strong>Conclusions: </strong>Fatigue showed a consistent concurrent association with musculoskeletal burden, whereas the association with total physical activity was less stable. The indirect estimates are cross-sectional and do not establish temporal or causal mediation.</p>","PeriodicalId":13761,"journal":{"name":"International Archives of Occupational and Environmental Health","volume":"99 9","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heat-induced genomic instability in the workplace: integrated assessment of oxidative stress burden and expression of DNA repair genes.","authors":"Eman Mahmoud Khalifa, Marwa Abdelgwad, Rateba Said Mohammed, Mona Abdallah Ramadan","doi":"10.1007/s00420-026-02242-2","DOIUrl":"10.1007/s00420-026-02242-2","url":null,"abstract":"<p><strong>Objective: </strong>To elucidate the mechanistic pathways linking occupational heat exposure to adverse cellular outcomes among smelter workers and to quantify its effects on systemic oxidative stress biomarkers and the transcriptional modulation of genes controlling DNA repair and redox homeostasis.</p><p><strong>Methods: </strong>This cross‑sectional study included 93 male workers from an aluminum production facility: 47 heat‑exposed employees and 46 administrative non-exposed personnel. Environmental monitoring was conducted using the Wet Bulb Globe Temperature (WBGT) index. Medical and occupational histories were captured via a structured questionnaire. Serum levels of malondialdehyde (MDA) and 8‑hydroxy‑2'‑deoxyguanosine (8‑OHdG), as well as the enzymatic activities of superoxide dismutase (SOD), glutathione peroxidase (GPx), and total antioxidant capacity (TAC), were determined. Expression of human NADPH oxidase‑1 (hNOX1), microRNA‑34a (miR‑34a), 8‑oxoguanine DNA glycosylase‑1 (OGG1), and sirtuin‑3 (SIRT3) was evaluated by quantitative RT‑PCR.</p><p><strong>Results: </strong>WBGT levels in maintenance, forging, and furnace areas exceeded recommended threshold limit values. Compared with the control group, heat‑exposed subjects exhibited significantly elevated concentrations of both MDA and 8‑OHdG. Conversely, antioxidant parameters, namely SOD, GPx, and TAC, demonstrated statistically significant declines (p < 0.001). Furthermore, molecular analysis indicated a notable increase in hNOX1 and miR‑34a gene expression, while OGG1 and SIRT3 were significantly downregulated in exposed workers (p < 0.001). MDA showed a strong positive correlation with 8‑OHdG (p < 0.001), age (p = 0.009), and employment duration, whereas SIRT3 showed a weak positive correlation with OGG1 (p = 0.05).</p><p><strong>Conclusion: </strong>Occupational heat exposure was associated with oxidative stress, DNA damage, and altered expression of DNA repair and redox‑regulatory genes, indicating compromised cellular defense mechanisms among smelter workers.</p>","PeriodicalId":13761,"journal":{"name":"International Archives of Occupational and Environmental Health","volume":"99 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and risk factors of hand/wrist/forearm eczema among migrant workers in Qassim, Saudi Arabia.","authors":"Juliann Saquib, Abdul Rahman Suleman, Ahmed Dickson, Idris Sula, Mohammed A Charbat, Mohamed Abdelnasser Ismail, Shoroq M T Alamin, Zienab Yasser, Heba Ramadan, Rahaf Aldawish, Samar Aldoush, Abdulrahman Almazrou, Nazmus Saquib","doi":"10.1007/s00420-026-02244-0","DOIUrl":"10.1007/s00420-026-02244-0","url":null,"abstract":"<p><strong>Purpose: </strong>Migrant workers may be vulnerable to occupational hand eczema because of their exposure to skin irritants at the workplace. However, Saudi-specific data is limited. We aimed to estimate the one-year prevalence of hand/wrist/forearm eczema and identify associated factors among migrant workers in Saudi Arabia.</p><p><strong>Methods: </strong>We conducted a cross-sectional study of 2,123 migrant workers from seven occupations (auto repair, city and hospital cleaning, construction, food service, hairdressing, and poultry production). Trained multilingual interviewers administered a structured questionnaire on sociodemographic characteristics, lifestyle, and health conditions. Hand/wrist/forearm eczema was assessed using the validated Nordic Occupational Skin Questionnaire-Short Version. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>The mean age of participants was 35 years (SD 9), and 85.3% were men. The one-year prevalence of self-reported hand/wrist/forearm eczema was 4.2%. In the multivariable analyses, women had significantly higher odds of eczema than men (OR 7.7, 95% CI 2.7-21.8). Current smoking (OR 2.3, 95% CI 1.1-4.8), poor diet (OR 2.4, 95% CI 1.3-4.5), and intermediate physical activity (OR 2.3 95% CI 1.2-4.3) were independently associated with eczema. Compared with restaurant workers, city cleaners (OR 10.8), poultry factory workers (OR 9.3), construction workers (OR 6.3), and auto-repair workers (OR 5.8) had substantially higher odds of eczema (p values < 0.05).</p><p><strong>Conclusion: </strong>Occupation emerged as one of the strong correlates of hand/wrist/forearm eczema. Additionally, modifiable lifestyle (poor diet, smoking, and low physical activity) and female gender were associated with eczema.</p>","PeriodicalId":13761,"journal":{"name":"International Archives of Occupational and Environmental Health","volume":"99 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An integrated EFMEA-Fine-Kinney-PLS-SEM framework for health, safety and environmental risk management in Urban solid waste transfer stations.","authors":"Song Toan Pham Phu, Cuong Le Dinh, Huyen Truong Ngoc","doi":"10.1007/s00420-026-02241-3","DOIUrl":"10.1007/s00420-026-02241-3","url":null,"abstract":"<p><strong>Purpose: </strong>Urban waste transfer stations serve as critical infrastructure within municipal solid waste management systems, yet they introduce complex, interconnected health, safety, and environmental (HSE) risks.</p><p><strong>Method: </strong>This study proposes a novel, integrated framework combining Environmental Failure Mode and Effects Analysis (EFMEA), the Fine-Kinney method, and Partial Least Squares Structural Equation Modeling (PLS-SEM) to systematically identify, prioritize, and validate HSE risks. The framework was demonstrated through a case study of two municipal waste transfer stations in Da Nang, Vietnam, utilizing a comprehensive census survey of 110 personnel and secondary operational data.</p><p><strong>Results: </strong>The risk analysis and structural modeling yielded three distinct sets of findings. First, regarding environmental risks (EFMEA), hazards such as hazardous gas emissions and biological contamination were predominantly categorized as \"medium,\" signaling a critical need for enhanced containment control. Second, regarding occupational safety risks (Fine-Kinney), technical and mechanical hazards were generally maintained at \"low\" levels, indicating the effective impact of universal safety training at the stations. Third, PLS-SEM modeling analysis demonstrated that External Factors (β = 0.372, t-value = 4.672), Law and Regulation (β = 0.303, t-value = 3.145), and the Working Environment (β = 0.202, t-value = 2.332) exert significant associations with the adherence to and execution of HSE standards.</p><p><strong>Conclusion: </strong>These findings suggest that enhancing HSE performance in countries with similar developing contexts necessitates robust regulatory enforcement and external stakeholder pressure alongside improvements in physical working conditions. This research provides a scientific foundation for decision-makers to develop evidence-based roadmaps for sustainable risk management in urban waste infrastructure with comparable operational and regulatory profiles.</p>","PeriodicalId":13761,"journal":{"name":"International Archives of Occupational and Environmental Health","volume":"99 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Which algorithm hurts most? Differential associations of task allocation, scheduling, and performance monitoring with worker well-being across 27 EU countries.","authors":"Xingyao Xiao, Yihong Cheng","doi":"10.1007/s00420-026-02239-x","DOIUrl":"10.1007/s00420-026-02239-x","url":null,"abstract":"<p><strong>Objectives: </strong>Algorithmic management (AM) is rapidly diffusing from platform work into traditional sectors, yet empirical evidence on its implications for worker psychosocial well-being remains limited and often treats AM as a unitary construct. This study investigates whether three distinct AM functions (algorithmic task allocation, scheduling, and performance monitoring) exhibit differential associations with multiple dimensions of worker psychosocial well-being.</p><p><strong>Methods: </strong>We analysed European Working Conditions Survey 2024 data on 26 224 workers in 27 EU countries. Outcomes included the WHO-5 Well-Being Index (0-100), self-reported stress, emotional exhaustion, loneliness, sleep problems, and anxiety. Linear regression models with country fixed effects controlled for demographics, occupation, workplace size, and digital tool use. Robustness checks included random intercept multilevel models, within-occupation subgroup analyses, and stratification by national digitalisation regime.</p><p><strong>Results: </strong>The three AM dimensions showed qualitatively different patterns. Algorithmic task allocation was not associated with adverse outcomes and was inversely associated with anxiety ([Formula: see text], [Formula: see text]). By contrast, algorithmic scheduling showed the strongest associations with emotional exhaustion ([Formula: see text], [Formula: see text]) and loneliness ([Formula: see text], [Formula: see text]), while performance monitoring showed the strongest associations with stress ([Formula: see text], [Formula: see text]) and anxiety ([Formula: see text], [Formula: see text]). The WHO-5 index showed no overall association with AM ([Formula: see text], [Formula: see text]), consistent with offsetting dimension-specific associations. All patterns held across occupation groups and across high- and low-digitalisation countries.</p><p><strong>Conclusions: </strong>Not all algorithmic management functions are equally associated with poorer worker well-being. Algorithmic scheduling and performance monitoring warrant priority in occupational psychosocial risk assessments, while general well-being instruments may underestimate dimension-specific adverse associations and should be complemented by specific indicators.</p>","PeriodicalId":13761,"journal":{"name":"International Archives of Occupational and Environmental Health","volume":"99 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A hierarchical model of multidimensional safety culture and its influence on safety performance: evidence from structural equation modelling.","authors":"Hafiz Rahim, Rahmat Dapari, Mohd Ramadan Ab Hamid, Qamarul Nazrin Harun, Nazri Che Dom","doi":"10.1007/s00420-026-02240-4","DOIUrl":"10.1007/s00420-026-02240-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Safety culture is widely recognised as a critical determinant of occupational safety performance; however, its multidimensional structure remains insufficiently validated as an integrated higher-order construct. This study aimed to (i) validate a multidimensional second-order safety culture model comprising psychological, behavioural, and situational dimensions; (ii) examine the structural relationships among these dimensions and their influence on safety performance; and (iii) identify demographic and organisational predictors associated with safety culture outcomes across Malaysian industries.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A cross-sectional study was conducted among 40 safety and health subject matter experts representing the oil and gas, manufacturing, service, education, and regulatory sectors in Malaysia. Data were collected using a previously validated Safety Culture Questionnaire. The instrument demonstrated good internal consistency with Cronbach's alpha values ranging from 0.78 to 0.90. Structural Equation Modelling (SEM) was applied to assess the hierarchical relationships among psychological, behavioural, and situational safety dimensions, while random-effects regression analysis was used to identify significant predictors of safety outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The measurement model demonstrated satisfactory reliability and convergent validity, with Composite Reliability (CR) values ranging from 0.82 to 0.86 and Average Variance Extracted (AVE) values ranging from 0.55 to 0.60. Situational Safety exhibited the strongest construct performance (CR = 0.86; AVE = 0.60), followed by Psychological Safety (CR = 0.84; AVE = 0.58) and Behavioural Safety (CR = 0.82; AVE = 0.55). Safety rule compliance showed the highest standardised loading (λ = 0.736), while safety attitude (λ = 0.502) and safety training (λ = 0.391) emerged as the strongest indicators of psychological and behavioural safety, respectively. Random-effects regression analysis revealed that Master's degree holders (β = 0.10, p = 0.01), PhD holders (β = 0.12, p = 0.02), Safety and Health Practitioners (β = 0.10, p = 0.01), and individuals actively involved in occupational safety and health activities (β = 0.10, p = 0.01) reported significantly higher safety outcomes. Behavioural and situational dimensions demonstrated stronger contributions to safety performance than psychological factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study empirically validates a hierarchical multidimensional safety culture model comprising psychological, behavioural, and situational dimensions. The findings demonstrate that behavioural practices and situational workplace conditions are the primary drivers of safety performance, while psychological factors provide an important attitudinal foundation. The validated model offers a robust evidence base for developing targeted, multi-level interventions to strengthen safety culture and improve occupational safety ","PeriodicalId":13761,"journal":{"name":"International Archives of Occupational and Environmental Health","volume":"99 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occupational thermal exposure and perceived thermal load in naturally ventilated polyhouses: a field-based exposure-modeling study under dry-humid conditions.","authors":"Rahul Jain, Reema Jain, Chinmay Pancholi, Kunj Bihari Rana, Makkhan Lal Meena","doi":"10.1007/s00420-026-02243-1","DOIUrl":"10.1007/s00420-026-02243-1","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated occupational thermal exposure and perceived thermal load among agricultural workers in naturally ventilated polyhouses under dry-humid climatic conditions using a worker-centered analytical framework integrating field-based environmental measurements, worker-reported thermal sensation vote (TSV), Bayesian modelling, and interpretable machine-learning analyses.</p><p><strong>Methods: </strong>A cross-sectional field study included 154 independent worker observations collected during routine agricultural activities. Workplace air temperature, globe temperature, relative humidity, and air velocity were measured, and workers reported TSV. Agreement between predicted mean vote (PMV) and TSV was assessed using correlation, Bland-Altman, intraclass correlation coefficient (ICC), Wilcoxon signed-rank, and receiver operating characteristic (ROC) analyses. Bayesian linear regression, accumulated local effects, feature interaction analysis, and SHapley Additive exPlanations (SHAP) were used to identify determinants of perceived thermal load.</p><p><strong>Results: </strong>Workers were routinely exposed to thermally demanding conditions, with 48.4% reporting thermal sensations outside the conventional thermal acceptability range. PMV showed modest correlation with TSV (Pearson's r = 0.246; Spearman's ρ = 0.338) and moderate agreement (ICC = 0.671), but poor discrimination of thermal acceptability (area under ROC curve = 0.39). Bayesian regression identified metabolic workload (MET) as the strongest positive predictor of perceived thermal load, whereas SHAP ranked age, body mass index, predicted percentage dissatisfied, and MET as the most influential predictors.</p><p><strong>Conclusion: </strong>Worker-reported TSV provides valuable information to conventional steady-state thermal comfort indices for occupational heat assessment in naturally ventilated polyhouses. Integrating Bayesian modelling with interpretable machine-learning techniques offers a transparent worker-centered framework for occupational heat assessment under real agricultural working conditions.</p>","PeriodicalId":13761,"journal":{"name":"International Archives of Occupational and Environmental Health","volume":"99 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving adaptation in male high-altitude workers through pressurization: a randomized controlled trial on sleep architecture.","authors":"Xuzheng Shan, Shiyun Li, Qin Deng, Jinhui Wen, Yingming Wang, Siyue Chen, Minjia Lin, Xin Liu, Xiangyang Miao, Huang Huang","doi":"10.1007/s00420-026-02229-z","DOIUrl":"10.1007/s00420-026-02229-z","url":null,"abstract":"<p><strong>Background: </strong>Sleep disruption at high altitude, driven by hypobaric hypoxia, is prevalent among occupational cohorts and adversely affects health, safety, and cognitive performance. While oxygen supplementation improves nocturnal hypoxia, it does not replicate the integrated physiological stimulus of true altitude descent. This study investigated the effects of simulated, stepwise altitude descent via nocturnal pressurization on sleep in acclimatized workers residing at high altitude.</p><p><strong>Methods: </strong>In a 5-week randomized controlled trial, 24 male workers residing at 3500 m were allocated to a Pressurization group (n = 12) or a Control group (n = 12). The Pressurization group slept in a pressurized environmental simulator at sequentially lower simulated altitudes (3000 m, 2500 m, then 2000 m) over three weeks, while both groups worked at 3500 m during the day. The Control group remained at ambient 3500 m throughout. Sleep architecture and nocturnal oxygen saturation (SpO₂) were monitored weekly. Linear mixed-effects models assessed the effects of Group, Time, and their interaction.</p><p><strong>Results: </strong>A significant Group × Time interaction was observed for nocturnal oxygenation (Mean SpO₂: F(4,88) = 28.36, p < 0.001; Minimum SpO₂: F(4,88) = 7.16, p < 0.001). The Pressurization group showed dose-dependent increases in Mean and Minimum SpO₂, peaking at the 2000 m simulated altitude. Concurrently, the Pressurization group exhibited a significant increase in deep sleep percentage at 2000 m (Group × Time effect: 3.25%, p = 0.010) and a marked reduction in the arousal index (ArI) at 2500 m and 2000 m (- 5.42 and - 7.01 events/h, respectively, p < 0.001). Epworth Sleepiness Scale scores also decreased significantly in the Pressurization group during descent (p < 0.01). No significant changes were observed in total sleep time, Rapid Eye Movement sleep, or wake time percentage.</p><p><strong>Conclusion: </strong>Nocturnal pressurization simulating stepwise descent to lower altitudes significantly improves nocturnal oxygenation, consolidates deep sleep, reduces sleep fragmentation, and alleviates daytime sleepiness in high-altitude workers. This intervention, which mimics the combined barometric and hypoxic stimulus of true descent, presents a distinct and promising non-pharmacological strategy for managing sleep disturbances in occupational settings at high altitude.</p>","PeriodicalId":13761,"journal":{"name":"International Archives of Occupational and Environmental Health","volume":"99 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13601125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between work stressors, measured by the demand-control-support and effort-reward-imbalance models, and diurnal cortisol concentrations in saliva.","authors":"Sigurd Mikkelsen, Julie Lyng Forman, Johan Hviid Andersen, Esben Meulengracht Flachs, Matias Brødsgaard Grynderup, Åse Marie Hansen, Linda Kaerlev, Henrik Albert Kolstad, Reiner Rugulies, Stinna Skaaby, Jane Frølund Thomsen, Jens Peter Bonde","doi":"10.1007/s00420-026-02209-3","DOIUrl":"10.1007/s00420-026-02209-3","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic exposure to work-related mental stressors has been linked to higher risk of disease, possibly mediated by effects on the normal diurnal cortisol concentration pattern due to allostatic overload. The purpose of this study was to examine if the diurnal cortisol pattern changed with exposure to work-related stressors according to the demand-control-support (DCS) and the effort-reward-imbalance (ERI) stress models.</p><p><strong>Methods: </strong>In 2007, 4467 Danish public service employees participated in a study on job stress and mental health, and 3217 were reexamined in 2009, using identical methods. DCS and ERI-exposures were assessed from self-administered questionnaires. Cortisol concentrations were assessed from saliva samples, one in the morning and one in the evening. Saliva sampling time distributions enabled us to estimate exposure effects on cortisol concentration patterns for the first two hours after awakening and for nine hours in the evening, and on the peak-to-nadir slope. Associations between the exposures and the diurnal cortisol pattern were examined by linear mixed model analyses, separately for DCS- and ERI-exposures, with mutual adjustment for main and composite variables of the stress model and a large set of potential confounders.</p><p><strong>Results: </strong>DCS- and ERI-exposures were not associated with changes in the diurnal cortisol pattern. In contrast, many associations between potential confounders and cortisol were statistically significant, including the diurnal slope pattern assessed from saliva sampling times.</p><p><strong>Conclusions: </strong>We found no support for the hypothesis that DCS- or ERI- exposures are associated with changes of the diurnal pattern of cortisol concentrations in saliva samples.</p>","PeriodicalId":13761,"journal":{"name":"International Archives of Occupational and Environmental Health","volume":"99 7","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}