Susana Viegas, Carla Martins, Edna Ribeiro, Carina Ladeira, Hermínia Pinhal, Ana Nogueira, Sílvia Santos, Ana Tavares, Bruno Costa Gomes, Catarina Maia Afonso, Henriqueta Louro, Maria João Silva
{"title":"HBM4EU chromates study: the Portuguese integrated and harmonized study on exposure to hexavalent chromium and related early effects.","authors":"Susana Viegas, Carla Martins, Edna Ribeiro, Carina Ladeira, Hermínia Pinhal, Ana Nogueira, Sílvia Santos, Ana Tavares, Bruno Costa Gomes, Catarina Maia Afonso, Henriqueta Louro, Maria João Silva","doi":"10.1093/annweh/wxae091","DOIUrl":"10.1093/annweh/wxae091","url":null,"abstract":"<p><p>In the scope of the European Union (EU) human biomonitoring initiative, a multicentric study on different occupational settings from several European countries was performed, to provide information on occupational exposure to hexavalent chromium [Cr(VI)], a known lung carcinogen. Biomonitoring approaches were used to obtain exposure data to support the implementation of new risk management measures and policy actions at the national and European levels. This work describes the Portuguese contribution to the study, which aimed to assess workers' exposure to Cr, by using exposure biomarkers (urinary chromium [U-Cr]), and industrial hygiene samples (air and hand wipes) and to link exposure to potential long-term health effects by using effect biomarkers. Exposure determinants influencing exposure were explored from the contextual information and human biomonitoring data. The ultimate goal of the study was to appraise the risk management measures contributing to minimize exposure and protect workers' health. Several occupational settings and activities were considered, including plating, welding, and painting. A control group from the Portuguese general population was also included. Data on age, sex, and smoking habits from both groups were considered in the statistical analysis. Information on the risk management measures available for workers was collected and used to identify the ones that mainly contributed to reduce exposure. Environmental monitoring and human biomonitoring revealed that painters were the highest exposed group. The use of respiratory protection equipment showed an influence on total U-Cr levels for workers involved in painting activities. Concerning early health effects, the painters presented also a significantly higher level of DNA and chromosomal damage in peripheral blood cells, as compared to the control group, suggesting a plausible association between exposure to Cr(VI) and early genotoxic effects. The results showed that workers are exposed to Cr(VI) in those occupational settings. These findings point to the need to improve the prevention and risk management measures and the implementation and enforcement of new regulatory actions at the national level.</p>","PeriodicalId":8362,"journal":{"name":"Annals Of Work Exposures and Health","volume":" ","pages":"147-159"},"PeriodicalIF":1.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evaluation of hand-arm vibration (HAV) exposure among groundskeepers in the southeastern United States.","authors":"Nathan Chen, Seunghyeon Yang, Jonghwa Oh","doi":"10.1093/annweh/wxae079","DOIUrl":"10.1093/annweh/wxae079","url":null,"abstract":"<p><strong>Objective: </strong>The objectives of this study were to evaluate daily hand-arm vibration (HAV) exposure among groundskeepers, characterize power tools used, and estimate lifetime cumulative HAV exposure dose.</p><p><strong>Methods: </strong>Seventeen groundskeepers and ten office workers employed at two US southeasterrn institutions were recruited as a target exposure group and a reference group, respectively. A 6-d exposure assessment of HAV was scheduled, and vibration dosimeters were used to obtain daily vibration exposure value, A(8). Information on power tools used and corresponding operation duration was recorded to assign the real-time vibration data collected from the dosimeters for tool characterization in terms of vibration total value (ahv) and frequency. Lifetime cumulative exposure dose, ahv-lifetime, was determined using ahv for all tools used and lifetime exposure duration obtained through a questionnaire.</p><p><strong>Results: </strong>The individual groundskeepers' average A(8) ranged from 0.8 to 2.6 and from 1.0 to 2.6 m/s2 for the right hand and left hands, respectively. Among 11 power tools used by the groundskeepers, grass trimmers contributed the most to the vibration exposure. The average ahv of the individual tools ranged from 8.0 (chainsaws) to 1.9 m/s2 (seating mowers and handheld blowers) for the right hand and from 6.4 (push mowers) to 1.4 m/s2 (backpack blowers) for the left hand. The highest acceleration peak of grass trimmers, edgers, backpack blowers, pole saws, riding blowers, and hedgers was observed between 100 and 200 Hz while riding mowers, seating mowers, push mowers, and chainsaws showed the highest acceleration peak at lower frequencies (≤63.5 Hz). The groundskeepers' average ahv-lifetime was 76,520.6 and 61,955.5 h m/s2 for the right and left hands, respectively. The average ahv-lifetime of office workers was 2,306.2 and 2,205.8 h m/s2 for the right and left hands, respectively, which was attributed to personal hobby activities.</p><p><strong>Conclusion: </strong>Three groundskeepers' average A(8) reached 2.5 m/s2, the Action Limit recommended by the American Conference of Governmental Industrial Hygienists (ACGIH). The highest contribution to the vibration exposure was observed during grass trimmer operations with a major acceleration peak at 100 Hz. The groundskeepers' ahv-lifetime was 33 and 28 times higher for the right and left hands, respectively, than the office workers.</p>","PeriodicalId":8362,"journal":{"name":"Annals Of Work Exposures and Health","volume":" ","pages":"81-95"},"PeriodicalIF":1.8,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11979770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142520865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The leadup to the artificial stone ban in Australia.","authors":"Deborah C Glass, Ryan F Hoy","doi":"10.1093/annweh/wxae085","DOIUrl":"10.1093/annweh/wxae085","url":null,"abstract":"","PeriodicalId":8362,"journal":{"name":"Annals Of Work Exposures and Health","volume":" ","pages":"1-4"},"PeriodicalIF":1.8,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Managing SARS-CoV-2 transmission risk in workplace COVID-19 outbreaks. Correspondence.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1093/annweh/wxae086","DOIUrl":"10.1093/annweh/wxae086","url":null,"abstract":"","PeriodicalId":8362,"journal":{"name":"Annals Of Work Exposures and Health","volume":" ","pages":"114-115"},"PeriodicalIF":1.8,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Occupational exposure to aerosols in two French airports: multi-year lung function changes.","authors":"Léa Touri, Adeline Tarantini, Carey Suehs, Erika Nogué, Caroline Marie-Desvergne, Muriel Dubosson, Ambre Dauba, Jean-Luc Ravanat, Véronique Chamel, Michel Klerlein, Sébastien Artous, Dominique Locatelli, Sébastien Jacquinot, Pascal Chanez, Isabelle Vachier, Nicolas Molinari","doi":"10.1093/annweh/wxae087","DOIUrl":"10.1093/annweh/wxae087","url":null,"abstract":"<p><p>As differential exposure to airport-generated aerosols may affect employee lung function, the main objective of this study was to longitudinally evaluate spirometry measures among Air France employees. In addition, an exploratory exposure assessment to airport aerosol was performed in a small cohort of workers using personal monitoring devices. Change in lung function over a ~6.6-yr period was documented for office workers (n = 68) and mechanics (n = 83) at Paris-Roissy airport, France and terminal (n = 29), or apron (n = 35) workers at Marseille airport, France. Overall, an excessive decline in lung function was found for 24.75% of airport workers; excessive decline occurred more often for terminal workers (44.83%) as compared to mechanics (14.47%; P = 0.0056), with a similar tendency for apron workers (35.29%) as compared to mechanics (P = 0.0785). Statistically significant differences/tendencies were detected among the yearly rates of change for %-predicted values of forced expiratory volume in 1 s, forced vital capacity, peak expiratory flow, and from 25% to 75% forced expiratory flow. For the latter variables, the terminal and/or apron workers at Marseille generally had significantly faster lung function decline as compared to office workers and/or mechanics in Paris, although the latter were exposed to a higher level of elemental carbon. No relation between lung function decline and exposure to airport tarmac environments was evidenced. Multivariate exploration of individual variables representing sex, smoking, atopy, respiratory disease, residential PM2.5 pollution, the peak size of particles in lung exhalates or exhaled carbon monoxide at the time of follow-up failed to explain the observed differences. In conclusion, this study documents the first evidence of excessive lung function decline among certain airport workers in France, although the identification of emission sources (environmental factors, aircraft exhaust, etc) remains challenging.</p>","PeriodicalId":8362,"journal":{"name":"Annals Of Work Exposures and Health","volume":" ","pages":"17-33"},"PeriodicalIF":1.8,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ane Berger Bungum, Sandra Søgaard Tøttenborg, Luise Mølenberg Begtrup, Kajsa Ugelvig Petersen, Maja Søndergård Worm, Jens Peter Bonde, Annett Dalbøge, Martin Byskov Kinnerup, Else Toft Würtz, Henrik Albert Kolstad, Vivi Schlünssen, Christine Cramer, Karin Biering, Kent Jacob Nielsen, Esben Meulengracht Flachs
{"title":"Risk of SARS-CoV-2 infection in healthcare workers with insufficient use of personal protective equipment in Denmark.","authors":"Ane Berger Bungum, Sandra Søgaard Tøttenborg, Luise Mølenberg Begtrup, Kajsa Ugelvig Petersen, Maja Søndergård Worm, Jens Peter Bonde, Annett Dalbøge, Martin Byskov Kinnerup, Else Toft Würtz, Henrik Albert Kolstad, Vivi Schlünssen, Christine Cramer, Karin Biering, Kent Jacob Nielsen, Esben Meulengracht Flachs","doi":"10.1093/annweh/wxae075","DOIUrl":"10.1093/annweh/wxae075","url":null,"abstract":"<p><strong>Aim: </strong>The aim was to evaluate the role of insufficient use of personal protective equipment (PPE) in SARS-CoV-2 transmission risk for healthcare workers (HCW) during the COVID-19 pandemic.</p><p><strong>Methods: </strong>Prospective study within the COBRA cohort, including 15,127 HCW. Daily assessment of insufficient use of PPE, defined as self-reported PPE failure or noncompliance, in relation to SARS-CoV-2 infection ascertained by polymerase chain reaction (PCR) test. Statistical analysis involved calculating incidence rate ratios with 95% confidence intervals (CI).</p><p><strong>Results: </strong>The included HCW contributed to 780,515 risk days including 67,723 d (8.7%) with insufficient PPE use and 133 events (positive PCR test). Self-reported insufficient use of PPE was slightly associated with infection with COVID-19 in HCW, but the data were statistically consistent with parameter values ranging from a protective effect to a to a doubling in risk (IRR 1.3, 95% CI 0.8; 2.3). Sensitivity analyses restricted to high-risk departments and to a period with a sufficient supply of PPE and a fully developed testing system, respectively, confirmed these findings.</p><p><strong>Conclusion: </strong>Insufficient use of PPE among HCW during the pandemic in Denmark was uncommon but associated with a slightly increased risk of COVID-19 among HCW. However, the findings are uncertain due to the limited number of cases and the potential for misclassification bias stemming from the self-reported nature of the exposure.</p>","PeriodicalId":8362,"journal":{"name":"Annals Of Work Exposures and Health","volume":" ","pages":"96-103"},"PeriodicalIF":1.8,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fiona Hore-Lacy, Stella May Gwini, Christina Dimitriadis, Javier Jimenez-Martin, Ryan F Hoy, Jane Fisher, Malcolm R Sim, Karen Walker-Bone, Deborah C Glass
{"title":"Measuring improvements in occupational health and safety in the artificial stone benchtop industry.","authors":"Fiona Hore-Lacy, Stella May Gwini, Christina Dimitriadis, Javier Jimenez-Martin, Ryan F Hoy, Jane Fisher, Malcolm R Sim, Karen Walker-Bone, Deborah C Glass","doi":"10.1093/annweh/wxae084","DOIUrl":"10.1093/annweh/wxae084","url":null,"abstract":"<p><strong>Objectives: </strong>Workers in the stone benchtop industry in Australia are at high risk of silicosis due to exposure to respirable crystalline silica (RCS) from the dry processing of artificial stone. In Victoria, Australia, a multifaceted response including education, regulatory changes, inspection site visits, and occupational health screening programme began in 2019. We aimed to review the success of this approach to safety practices in the industry.</p><p><strong>Methods: </strong>Data were available from 2 sources: first, responses provided by workers during their occupational health screening (2019 to 2024), which included a systematic occupational history. Jobs examined included roles in the stone benchtop industry with RCS exposure and were analysed in relation to reported safety practices pre and postregulatory changes in August 2019, which prohibited unrestricted dry cutting. Second, data were obtained from the Regulator describing the numbers of visits to industry worksites and the numbers and types of compliance notices issued between 2018 and 2024.</p><p><strong>Results: </strong>In total, 1921 jobs from 1007 workers were eligible for analysis, of which 869 were prior to the 2019 regulatory change and 557 commenced after. The proportion of workers reporting \"never\" dry cutting rose from 17.3% to 67.2% (P < 0.001), use of recommended ventilation and respirator increased from 26.0% to 36.5% (P < 0.001), and 44.9% to 86.5% (P < 0.001), respectively. Of the 543 worksites visited (2757 site visits in total), 352 (64.8%) received at least one compliance notice and the types of notices varied over time. Administrative controls/housekeeping and health monitoring notices were the most common in 2019 to 2021 but tools/equipment notices increased substantially in 2022 onwards.</p><p><strong>Discussion: </strong>Prior to the changes, a large proportion of jobs involved unrestricted dry processing of artificial stone with inadequate protection. After the changes, practices improved although some jobs continued to involve dry processing without adequate control of dust.</p><p><strong>Conclusions: </strong>This multifaceted approach vastly improved safety practices in the stone benchtop industry over 5 years. These data are relevant to occupational health and safety professionals and regulators in countries where artificial stone is used and potentially for implementation of new measures in response to a new workplace hazard in future.</p>","PeriodicalId":8362,"journal":{"name":"Annals Of Work Exposures and Health","volume":" ","pages":"5-16"},"PeriodicalIF":1.8,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142725071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Toluwanimi M Oni, Sanjeewa Gamagedara, Evan L Floyd
{"title":"Desorption efficiency and holding capacity of acid-treated filters for nicotine sampling in vape shops.","authors":"Toluwanimi M Oni, Sanjeewa Gamagedara, Evan L Floyd","doi":"10.1093/annweh/wxae080","DOIUrl":"10.1093/annweh/wxae080","url":null,"abstract":"<p><p>Efficient sampling materials are essential for assessing nicotine levels in vape shops and other settings where nicotine exposures may exist. Two different treatments of Whatman glass fiber type A (GF/A) filters (sodium bisulfate treated and citric acid treated) were evaluated for nicotine capture, desorption efficiency, and holding capacity using Gas Chromatography-Mass Spectrometry (GC-MS). The Filters were treated with 0.8 mL of 0.1 M sodium bisulfate or citric acid solution and oven-dried (80 °C) for 30 min. Nicotine was desorbed off the filters using a modified analytical method. The average nicotine desorption efficiency for sodium bisulfate-treated GF/A filters (98.4%) was significantly higher than that of citric acid-treated GF/A filters (60.9%) over a range of 1-100 µg nicotine. Sodium bisulfate-treated and citric acid-treated GF/A filters experienced a 10% nicotine breakthrough after being dosed with about 550 and 2,750 µg of nicotine, respectively compared to 75 µg for untreated GF/A filters. Citric acid-treated GF/A filters had a much greater nicotine-holding capacity, but nicotine desorption from citric acid-treated GF/A filters was below the recommended criteria. Therefore, we recommend that sodium bisulfate-treated GF/A filters are employed for sample of nicotine with the GC-MS method.</p>","PeriodicalId":8362,"journal":{"name":"Annals Of Work Exposures and Health","volume":" ","pages":"104-108"},"PeriodicalIF":1.8,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Exposure to cooking fumes in cafeteria workers in Korean schools: a pilot study.","authors":"Daesung Lim, Yong Min Cho","doi":"10.1093/annweh/wxae078","DOIUrl":"10.1093/annweh/wxae078","url":null,"abstract":"<p><strong>Objectives: </strong>This study measured cooking fumes to which workers in school cafeterias may be exposed.</p><p><strong>Methods: </strong>The measurement items were respirable dust, formaldehyde, and carbon monoxide. A total of 111 samples were obtained from 55 schools. Data on variables such as school size and daily cooking oil usage were collected. Correlation and association analysis were performed.</p><p><strong>Results: </strong>The median of concentrations of respirable dust was 38.37 µg/m3 (min-max: 20.73-49.71 µg/m3). The concentrations of formaldehyde and carbon monoxide also showed levels that did not exceed 20% for occupational exposure limits. The increase in school size was significantly correlated with the increase in daily cooking oil usage and had a significant correlation with respirable dust concentration (Spearman's correlation coefficient, 0.36; P <0.05). The linear regression test results adjusting for other variables were also similar.</p><p><strong>Conclusions: </strong>Cooking food by frying at high heat using cooking oil can increase the exposure of kitchen workers to respirable dust.</p>","PeriodicalId":8362,"journal":{"name":"Annals Of Work Exposures and Health","volume":" ","pages":"109-113"},"PeriodicalIF":1.8,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nestor Lögdal, Sven Svensson, Jennie Jackson, Svend Erik Mathiassen, Gunnar Bergström, David M Hallman
{"title":"Do job demands and resources differ between permanent and temporary eldercare workers in Sweden?","authors":"Nestor Lögdal, Sven Svensson, Jennie Jackson, Svend Erik Mathiassen, Gunnar Bergström, David M Hallman","doi":"10.1093/annweh/wxae077","DOIUrl":"10.1093/annweh/wxae077","url":null,"abstract":"<p><strong>Introduction: </strong>Eldercare organizations face high sickness absence rates and staff turnover and rely heavily on temporary workers to fill staffing gaps. Temporary workers may experience differences in job demands and resources compared with permanent workers, but this has been largely understudied.</p><p><strong>Objective: </strong>To compare perceived job demands and resources between permanent and temporary Swedish eldercare workers.</p><p><strong>Methods: </strong>Permanent and temporary eldercare workers in a Swedish municipality were invited to answer a digital survey on work environment conditions. Differences between permanent and temporary workers in job demands and resources were analyzed using multivariate analysis of variance adjusted for age, sex, place of birth, and percent of full-time work and univariate analyses were conducted to consider differences in specific factors.</p><p><strong>Results: </strong>A total of 1076 permanent and 675 temporary workers received the survey, and the final study sample included 451 permanent and 151 temporary workers. Multivariate analyses revealed that temporary workers reported statistically significant lower job demands compared to permanent workers, but no statistically significant differences in resources were found between the groups. Univariate analyses showed that temporary workers reported lower quantitative demands, perceived exertion, and time spent bending forward, than permanent workers. These data suggest comparable support across groups, but a higher workload among permanent workers.</p><p><strong>Conclusion: </strong>Our findings indicate that temporary workers experienced lower job demands than permanent workers, but that no notable difference was found in resources. Interventions aimed at distributing job demands more evenly among eldercare workers with different employment forms may be necessary.</p>","PeriodicalId":8362,"journal":{"name":"Annals Of Work Exposures and Health","volume":" ","pages":"71-80"},"PeriodicalIF":1.8,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}