BACKGROUND: Only prospective cohort studies can capture changes in work conditions and their effects on health. Such studies are rare in bus drivers, despite their high rates of injuries and diseases. The three existing cohorts have limited exposure data, collected at baseline and thus uninformative on exposure and exposure-effect dynamics. Therefore, we aimed to develop the Swiss Transport Personnel Health Cohort (TRAPHEAC) and to anticipate and prevent potential bias. METHODS: To set up the study protocol, we first organized the stakeholder consultation and available data inventory. Second, we mapped the exposure-outcomes pairs to list the most prevalent occupational hazards, and conducted exposure measurement campaigns. Third, we built the Swiss Bus-Exposure Matrix for physical-chemical hazards and Bus-Ergonomics Matrix for visual and biomechanical constrains. These matrices contain 705 bus models operated in Switzerland since 1980 and enable assessing current and past exposure when merged with bus drivers' work histories. RESULTS: We opted for an original study design combining prospective cohort part starting at 2024 and a retrospective part with nested case-control studies. Bus drivers will be invited through three complementary channels: unions, companies, and social media. The eligibility screening, information, and consent form signature and registration will be conducted using the study web-site modules. Registered bus drivers will first receive a comprehensive inclusion questionnaire, then a yearly follow-up questionnaire to assess and update the drivers' work histories. Validated self-reported questionnaires will be used for assessing additional health outcomes (e.g., stress, sleep problems, musculoskeletal disorders, burnout) and individual, occupational and live-style related factors (e.g., personality, ICT use, physical activity). Hospital records (with diagnosed diseases, diagnosis dates and treatments) centralized since 2000 by the Swiss Federal Statics Office will be used for assessing disease prevalence, incidence and case-control status. Advanced statistical analysis will be conducted to address etiological and methodological questions (e.g., individual and joint causal effects of multiple exposures and exposure components; time-varying exposure and outcome variables and confounders mixtures). CONCLUSIONS The yearly assessment of both exposure and health outcomes should enable capturing changes in work conditions and their effects on bus drivers' health and well-being over time and facilitate the tailoring, implementation and evaluation of preventive interventions.
Humans ; Switzerland/epidemiology* ; Prospective Studies ; Occupational Exposure/statistics & numerical data* ; Occupational Diseases/epidemiology* ; Cohort Studies ; Motor Vehicles ; Research Design ; Retrospective Studies ; Case-Control Studies ; Occupational Health ; Adult ; Male ; Female

BACKGROUND: Previous studies have shown that old age and cold temperatures are risk factors for bathing-related accidents (BRAs) in Japan. The differences between outdoor and indoor temperatures are believed to depend on the housing type (detached houses or apartment buildings). This study aimed to investigate the associations between age, temperature, and BRAs according to housing type in Japan. METHODS: We included cases in which patients were transported by ambulance from domestic bathrooms between April 2016 and March 2022 in Nagoya city. Age-specific BRA incidence rates measured by 5-year age groups, temperature-specific age-adjusted standardized incidence rates (SIRs) for BRA calculated by temperature quintile groups, and the BRA risk regarding temperature based on a time-stratified case-crossover (CCO) design were compared between detached houses and apartment buildings. RESULTS: We observed 4,848 ambulance dispatches owing to BRAs (3,083 in detached houses and 1,765 in apartment buildings; SIR for detached houses compared to apartment buildings: 1.37; 95% confidence interval [CI]: 1.33-1.43). The ratio of detached houses to apartment buildings in the age-specific BRA incidence was almost the same in middle-aged people, but it significantly increased from the age of 70 years onward (incidence rate ratio for the 70-74-years age group: 1.74; 95% CI: 1.43-2.11). Temperature-specific SIR for detached houses compared to apartment buildings was not significantly different in the hottest temperature quintile but increased significantly in the other colder temperature quintiles (SIR in coldest quintile: 1.56; 95% CI: 1.47-1.66). BRA risk based on CCO design increased significantly with a decrease in temperature in detached houses (risk ratio [RR] for 3 °C: 1.25; 95% CI: 1.05-1.47), but not in apartment buildings (RR for 3 °C: 1.07; 95% CI: 0.86-1.34). CONCLUSIONS Detached houses had higher BRA incidence rates than apartments. Older age and lower temperatures, which are risk factors for BRAs, were more prevalent in detached houses than in apartment buildings. Thus, public health measures that focus on detached houses are necessary for preventing BRAs in Japan.
Humans ; Japan/epidemiology* ; Aged ; Middle Aged ; Housing/statistics & numerical data* ; Baths/adverse effects* ; Ambulances/statistics & numerical data* ; Male ; Adult ; Female ; Temperature ; Incidence ; Aged, 80 and over ; Young Adult ; Age Factors ; Adolescent ; Child, Preschool ; Infant ; Child ; Risk Factors ; Infant, Newborn ; Accidents, Home/statistics & numerical data*

BACKGROUND: Technological innovations in the public transport sector are increasingly leveraged to support the goals of environmental sustainability and public health. Eco-driving assistance (EDA) systems represent one such intervention, aimed at reducing fuel consumption, emissions, and operating costs while improving passenger comfort. However, the potential unintended impacts of EDA technologies on driver health and well-being remain understudied. The EDA Trial, part of the EU-funded INTERCAMBIO project, seeks to evaluate whether the use of EDA systems may introduce new psychosocial stressors for professional drivers, with implications for occupational and public health. METHODS: The EDA tested in this trial is called "NAVIG". Buses will be assigned randomly. Operating EDA-equipped vehicle will be considered as intervention condition, operating vehicle without EDA as control. Each participant will be monitored for 10 working days maximum to accumulate at least 5 intervention shifts during the trial. Heart rate variability (HRV) will be continuously recorded during working hours to assess autonomous stress responses. The root mean square of successive differences (RMSSD) will be averaged over intervention and control shifts to enable within-subject comparisons between intervention and control conditions. Subjective stress levels will be evaluated using the self-report instruments: Cohen's perceived stress scale at baseline and visual analogous scale at baseline and daily. Moreover, neuroendocrine stress biomarkers (salivary cortisol and cortisone) will be collected repeatedly across shifts, as additional outcomes. Mixed-effects models with participant's ID as a random effect variable will be used to compare stress outcomes between EDA and non-EDA driving conditions. Models will be adjusted for potential confounders. RESULTS: A sample size of 26-40 participants was estimated to provide 80% power (α = 0.05) to detect differences of 12-15% between conditions. Ethical approval was obtained from the Swissethics (CER-VD 2024-01573), and participant recruitment is ongoing, with 27 drivers enrolled as of June 2025. CONCLUSIONS: This study will provide empirical evidence on the potential health trade-offs associated with implementing eco-driving technologies in real-world settings. By assessing physiological and psychological stress responses to EDA, the trial supports a more integrated approach to environmental technology evaluation-one that considers not only energy efficiency but also the health and sustainability of the workforce. TRIAL REGISTRATION The trial was registered in the ClinicalTrials.gov database (NCT06688721).
Humans ; Automobile Driving/psychology* ; Stress, Psychological ; Motor Vehicles ; Adult ; Male ; Randomized Controlled Trials as Topic ; Female

Fusobacterium nucleatum is an opportunistic pathogenic bacterium that can be enriched in colorectal cancer tissues, affecting multiple stages of colorectal cancer development. The two-component system plays an important role in the regulation and expression of genes related to pathogenic resistance and pathogenicity. In this paper, we focused on the CarRS two-component system of F. nucleatum, and the histidine kinase protein CarS was recombinantly expressed and characterized. Several online software such as SMART, CCTOP and AlphaFold2 were used to predict the secondary and tertiary structure of the CarS protein. The results showed that CarS is a membrane protein with two transmembrane helices and contains 9 α-helices and 12 β-folds. CarS protein is composed of two domains, one is the N-terminal transmembrane domain (amino acids 1-170), the other is the C-terminal intracellular domain. The latter is composed of a signal receiving domain (histidine kinases, adenylyl cyclases, methyl-accepting proteins, prokaryotic signaling proteins, HAMP), a phosphate receptor domain (histidine kinase domain, HisKA), and a histidine kinase catalytic domain (histidine kinase-like ATPase catalytic domain, HATPase_c). Since the full-length CarS protein could not be expressed in host cells, a fusion expression vector pET-28a(+)-MBP-TEV-CarS_cyto was constructed based on the characteristics of secondary and tertiary structures, and overexpressed in Escherichia coli BL21-Codonplus(DE3)RIL. CarS_cyto-MBP protein was purified by affinity chromatography, ion-exchange chromatography, and gel filtration chromatography with a final concentration of 20 mg/ml. CarS_cyto-MBP protein showed both protein kinase and phosphotransferase activities, and the MBP tag had no effect on the function of CarS_cyto protein. The above results provide a basis for in-depth analysis of the biological function of the CarRS two-component system in F. nucleatum.
Humans ; Histidine Kinase/metabolism* ; Fusobacterium nucleatum/metabolism* ; Automobiles ; Protein Kinases/genetics* ; Escherichia coli/metabolism* ; Colorectal Neoplasms

Background: Due to the COVID-19 pandemic, health care for patients who experienced out-of-hospital cardiac arrest (OHCA) has been suboptimal. Objective: To describe the demographic, clinical, and logistical characteristics of patients who experienced OHCA during the peak of the COVID-19 pandemic. Design: Descriptive study. Participants: 136 males and 58 females, aged 8 days to 89 years old, who experienced OHCA and were subsequently sent to the emergency department of Southern Philippines Medical Center (SPMC). Setting: Southern Philippines Medical Center, Davao City, March 15 to December 31, 2020. Main outcome measures: Demographic, clinical, and logistical characteristics of patients. Main results: Of the 194 patients, 149 (76.80%) experienced OHCA at home. Among them, 42 (21.65%) received initial CPR at the scene, with 36 (85.71%) of these procedures performed by ambulance crews. Only one (0.52%) patient received automated extracorporeal defibrillation performed by a bystander. There were 147 (75.77%) patients who were transported by private vehicles. The average times for dispatch, response and turnaround of the emergency medical services (EMS) were 8 minutes, 19 minutes, and 56 minutes, respectively. Of the 194 patients, 176 (90.72%) were transported without ongoing resuscitation. Upon arrival at the emergency department, 184 (94.84%) patients had unknown arrest rhythm. Only one (0.52%) patient had a return of spontaneous circulation and was admitted to the ICU. All the other patients expired within 10 to 15 minutes upon arriving at the emergency department. Conclusion In this study, most OHCAs happened at home, with few receiving CPR at the scene, primarily from ambulance crews. The average EMS response time was 19 minutes. Most patients were transported from the scene without ongoing resuscitation, and had an unknown arrest rhythm upon arrival at the emergency department. All patients expired shortly after arriving at the emergency department.
Resuscitation ; Ambulances

The wound mechanism, injury characteristics and treatment principles of anti-armored vehicle ammunition against armored crew in the past 20 years are summarized in this paper. Shock vibration, metal jet, depleted uranium aerosol and post armor breaking effect are the main factors for wounding armored crew. Their prominent characteristics are severe injury, high incidence of bone fracture, high rate of depleted uranium injury, and high incidence of multiple/combined injuries. During the treatment, attention must be paid on that the space of armored vehicle is limited, and the casualties should be moved outside of the cabin for comprehensive treatment. Especially, the management of depleted uranium injury and burn/inhalation injury are more important than other injuries for the armored wounds.
Humans ; Uranium/analysis* ; Respiratory Aerosols and Droplets ; Motor Vehicles ; Burns/therapy* ; Multiple Trauma

Introduction: Road traffic accidents are a growing public health burden, especially in the low- and middle-income countries (LMICs). With resource scarcity, road traffic injuries may lead to poor quality of life among survivors, or deaths at worst. Victims of crashes involving transportations are gendered; therefore, there may be differences in the trends and characteristics of injuries sustained by men and women related to road crash. Objectives: This study aimed to determine the factors related to severity of road crashes among women road users in the Philippines from 2008 to 2017. Methods: We conducted a retrospective review of clinical records of women patients involved in road crash at the Trauma Division, Department of Surgery of the Philippine General Hospital (PGH) for the ten-year period, January 1, 2008 to December 31, 2017. Data were extracted from the electronic patient records in Integrated Surgical Information System (ISIS). Results: From 2008 to 2017, 926 of the road crash victims brought to PGH were women. There was an increasing trend, with the years 2015 to 2017 accounting for half of the total cases (55.62%). The highest cases of women patient admissions were also recorded during the months of June and July (5.61%). The CALABARZON region (11.23%) and National Capital Region (8.21%) had the highest admissions. The patients were most commonly pedestrians (12.20%) and involved in collisions (13.50%) or vehicle involvement (13.17%). The most common vehicle involved was a motorcycle (9.72%) followed by car and vans (1.62%). Only a small proportion of women patients used helmets (3.33%) and seatbelts (0.12%). The median length of hospital stay of women patients was 5 days. The most commonly sustained injuries among patients were multiple (83.65%), external (43.72%), extremity (33.15%), head and neck (23.47%), and face (21.58%) injuries. Among these, injuries to the extremity had the highest average length of hospital stay (16.04 ± 31.28 days) while external and head and neck injuries had the shortest (10.81 ± 33.42 days). Multinomial regression showed that women patients who suffered from head and neck, and abdominal injuries had increased odds of dying by 4.94 times (CI: 2.158-11.302, p < 0.05), and 3.33 times (CI:1.235-9.02, p < 0.05), respectively, compared to those who did not suffer said injuries. Conclusion There is a significant number of women involved in road crashes in the Philippines, and therefore, there is a need for directed policies on female road users as vulnerable road users.
Accidents ; Women ; Motor Vehicles ; Length of Stay ; Hospitalization

Objective: To analyze the mortality level and tendency of road traffic injury in Shandong province from 2012 to 2020. Methods: Based on the data of road traffic deaths from the cause of death registration system in Shandong province from 2012 to 2020, the mortality rates of road traffic injury were calculated by sex, age, area, and injury type. The mortality was standardized based on the age structure of the Chinese population in the sixth Population Census in 2010. The annual percent change (APC) and average annual percent change (AAPC) of the mortalities and the standarized mortalities were calculated by using Joinpoint regression model, and the trends were also examined. Results: In 2020, the crude mortality of road traffic injury in Shandong Province was 15.58/100 000, and the standardized mortality was 12.90/100 000. From 2012 to 2020, the standardized mortality of road traffic injury in Shandong province showed a downward trend with AAPC of -5.4%. The standardized mortality of middle-south mountain areas, male and children aged 0-14 years in Shandong showed a significantly decreasing trend with AAPC of -6.8%, -6.1% and -6.0%, respectively. The standardized mortality of people aged 65 years and over did not decrease significantly, but the number of deaths increased significantly by 50.96% in 2020 (5 780 cases), compared with those in 2012 (3 829 cases). The standardized mortality of pedestrian and motorcyclists decreased significantly with AAPC of -7.5% and -6.7%, respectively. There was no significant change in the standardized mortality among people who rode motor vehicles or bicycles. Conclusion: From 2012 to 2020, the standardized mortality of road traffic injury in Shandong Province showed an obvious downward trend, but the standardized mortality of people aged 65 years and over did not decrease significantly. In the future, it is still necessary to take government-led, multi-sectoral collaboration, with a focus on comprehensive preventive measures, to further reduce road traffic injury mortality.
Accidents, Traffic ; Asian People ; Child ; Government ; Humans ; Male ; Mortality ; Motor Vehicles

The development of burn units in our country is now undergoing a trend of geographic centralization and regionalization. To solve the problems like severe burn patients are too far away from burn units, overloaded operation in regional burn centers when mass burn accidents happen, and growing requirement for aeromedical transportation, etc., it is now the top priority to improve national aeromedical transportation system for burn patients. Expert teams from Chinese Burn Association, National Aeromedical Rescue Base, and China Association for Disaster & Emergency Rescue Medicine discussed and reached a consensus on the key points of aeromedical transportation of burn patients, including organizational structure, staff and materials, and three links before, during, and after aeromedical transportation. The consensus aims to provide guidance for a safe, efficient, and standardized operation of aeromedical transportation for burn patients in China.
Accidents ; Air Ambulances ; Burn Units ; Consensus ; Disasters ; Humans

Objective: To explore the prevalence and risk factors of neck musculoskeletal diseases (MSDs) of welders among an automobile factory. Methods: In June 2019, a cluster random sampling method was used to select 677 electric welders from an automobile manufacturing plant in Shiyan City as the survey objects, and a questionnaire survey was conducted using the "Musculoskeletal Disorders Questionnaire" to analyze the prevalence and influencing factors of neck MSDs, and used logistic regression to analyze the relationship between the influencing factors and the prevalence of cervical MSDs. Results: The prevalence rate of MSDs in neck of welders was 54.8% (371/677) . The exposure rate of occupational factors, from high to low, were neckin a bent formord porsure was 71.6% (486/677) , repetitive head movements was 55.1% (373/677) , working in uncomfortable postures was 48.7% (330/677) and neck twisted was 46.8% (317/677) respectively. Sex, age, educational level, length of service, smoking, neck tilt, neck twist, working in uncomfortable posture and head repetitive movements were the risk factors of neck MSDs (P<0.05) . Multiple logistic regression analysis showed that, the main influencing factors of neck MSDs were sex, education level, age, length of service, smoking, neck tilt, working in uncomfortable posture (OR = 2.11, 2.03, 1.83, 1.21, 1.78, 1.90, 1.58, 95%CI: 1.28~3.48、1.47~2.81、1.33~2.52、1.03~1.41、1.22~2.60、1.28~2.83、1.11~2.27, P<0.05) , rest had protective effect on neck MSDs (OR= 0.38, 95%CI: 0.17~0.88, P<0.05) . Conclusion: Welders in automobile factory was highly exposed to occupational risk factors for neck MSDs. Occupational risk factors such as neck in a bent forward posture, working in an uncomfortable posture, prolonged siting, repetitive head movement should be the focus of intervention.
Automobiles ; Cross-Sectional Studies ; Humans ; Metal Workers ; Musculoskeletal Diseases/epidemiology* ; Occupational Diseases/epidemiology* ; Prevalence ; Risk Factors ; Surveys and Questionnaires