OBJECTIVES:While extending working life is a key policy objective, its impact on population health is not fully understood. This study investigated the long-term effects of physical and psychological workloads as well as initial health-work status on healthy working life expectancy (HWLE), working life expectancy (WLE), and total life expectancy (TLE) at age 50. METHODS:Data were drawn from the Health and Retirement Study covering 1992-2022. The study population consisted of US adults aged ≥50 years. We implemented a multi-state life table approach based on continuous-time Markov models. Transition intensities between health and employment states were modeled to derive HWLE. Analyses were stratified by physical and psychological workload levels across three temporal cohorts. RESULTS:Over the study period, WLE increased significantly for both sexes, while TLE slightly declined. Conversely, HWLE decreased substantially across all groups and health states. Individuals in high physical workload groups experienced shorter WLE and HWLE compared to low workload groups. High psychological load was associated with a lower proportion of healthy working years, particularly among those with initial health limitations. CONCLUSIONS:The extension of working lives is occurring at the cost of healthy years. Physical and psychological workloads exert distinct but equally detrimental effects on the sustainability of a healthy working life. These findings underscore the urgent need for targeted workplace interventions to protect worker health, particularly for vulnerable groups in high-stress or physically demanding jobs.

Work serves as a critical means of obtaining resources, facilitating personal growth, realizing self-worth, and engaging in social interactions. However, work-related diseases pose significant threats to workers’ health and productivity, and impose considerable economic burdens. This article categorized work-related diseases into six major types, including musculoskeletal disorders, mental and behavioral disorders, cardiovascular and metabolic diseases, digestive system diseases, reproductive system diseases, and non-specific respiratory diseases, and summarized their risk factors, assessment methods, policy regulation, and prevention and control measures. Current research in this field predominantly relies on cross-sectional studies, which present limitations in causal inference and potential risks of bias. Future studies should expand sample sizes, optimize research designs, and establish multidimensional evaluation systems to comprehensively assess the health and economic impacts of work-related diseases. It is recommended to enhance the translation of research findings into practice, thereby providing a scientific basis for the occupational health protection system and promoting the well-being and sustainable development of the working population.

Low-level worker occupation fit (WOF) is the high-risk feature of occupational stress. In many industries, mental disorders are commonly associated with occupational stress. This study aimed to examine whether depressive and anxiety symptoms play a chain mediating role in the association between WOF and occupational stress. This study is a cross-sectional study and the stratified whole-population sampling was used to implement the survey of 1988 healthcare workers (HCWs) in four target hospitals. The measurement of WOF by the Worker-occupation fit inventory (WOFI) consists of three sub-scales, including characteristic fit (CF), need supply fit (NSF), and demand ability fit (DAF). The anxiety symptoms, depressive symptoms, and occupational stress were measured by the 21-item Depression, Anxiety, and Stress Scale (DASS-21). Descriptive statistics, Pearson correlation analysis, hierarchical regression models, and bootstrap methods were used for data analysis. The prevalence of occupational stress in this study was indicated to be 42.5

BackgroundCognitive impairment is increasingly prevalent in younger populations. The interplay between environmental exposures like noise and genetic susceptibility in dementia etiology remains unclear. This study investigated the combined effects of work-related cumulative noise exposure (WCNE) and genetic polymorphisms on cognitive performance.ObjectiveTo examine the relationships among WCNE, genetic factors (APOE rs429358/rs7412 and PS-1 rs165932), and lower cognitive performance (LCP), and to analyze the potential interaction.MethodsThis study included 523 workers from a health surveillance cohort in western China. WCNE was assessed for each participant. Genotyping was performed for APOE (rs429358/rs7412) and PS-1 (rs165932) polymorphisms. Cognitive function was evaluated via Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). The individual and combined effects of WCNE and genetic factors on LCP were analyzed.ResultsAPOE rs429358/rs7412 were not significantly associated with LCP. The PS-1 rs165932T allele (PS-1T) was associated with LCP (p < 0.05). The adjusted odds ratios (aORs) for LCP (evaluated by MMSE and MoCA) in the PS-1T group were 2.443 (95% CI: 1.149-5.195) and 2.065 (95% CI: 1.091-3.906), respectively. Age and WCNE had an interaction effect on the LCP for both MMSE and MoCA (p < 0.05), while PS-1T had an effect modification on the relationship between WCNE and LCP (p < 0.05).ConclusionsThese findings highlight the urgent need to identify and mitigate noise exposure risks in vulnerable populations. These findings also provide evidence for further mechanistic studies exploring how noise, aging, and genetic susceptibility contribute to cognitive impairment through underlying biological mechanisms.

BACKGROUND: Psychological issues and work-related violence are the main challenges faced by medical staff. The situation has become even more prevalent during the COVID-19 pandemic.OBJECTIVE: This research aimed to analyze the relationships among work-related violence, occupational stress and psychological distress and to further identify the direct or indirect effects of violence on psychological distress.METHODS: A total of 1,765 medical staff members were surveyed using the Kessler Psychological Distress Scale and Revised Occupational Stress Inventory. Work-related violence was assessed using a self-made 5-question questionnaire. STATA 14.0 and Amos 21.0 software were used for correlation analysis, variance analysis, and structural equation modeling analysis.RESULTS: A total of 66.1% of the medical staff suffered workplace violence, and 61.2% witnessed workplace violence. The psychological distress score (Kessler 10 Scale) of the medical staff was 22.7 +/- 7.67. The psychological strain score and physical strain score were 26.8 +/- 7.14 and 24.2 +/- 6.51, respectively. Work-related violence (suffered: beta= 0.467; witnessed: beta= 0.258) and occupational stress (psychological strain: beta= 0.269; physical strain: beta= 0.317) were predictors of psychological distress, and social support (beta= -0.265) was a protective factor. Work-related violence and social support had both direct and indirect effects on psychological distress, and the intermediate factor was occupational stress. The total effects of suffered workplace violence and witnessed workplace violence were 0.181 and 0.092, respectively, and the total effect of social support was -0.262.CONCLUSIONS: Work-related violence may exacerbate symptoms of occupational stress and psychological distress. Reducing workplace violence and protecting medical staff from work-related violence are extremely important aspects of mental health prevention.

Infectious diseases remain a major global health challenge. However, long-term trends of acute infectious diseases in Sichuan Province, an area in southwest China with a high disease burden, are limited. This study examines trends in 23 acute infectious diseases over two decades to provide evidence for evaluating prevention strategies and informing future preparedness efforts. We obtained disease incidence and demographic data from the China Information System for Disease Control and Prevention and the National Bureau of Statistics. We analyzed 23 notifiable acute infectious diseases in Sichuan Province from 2005 to 2024, stratifying patterns by sex, age, region, and season. We used Joinpoint regression to assess temporal trends and calculate the average annual percentage change (AAPC). We evaluated spatial trends via trend surface analysis in ArcGIS 10.7.0. Statistical analyses were performed using R 4.4.1 and the Joinpoint Regression Program 5.4.0, setting statistical significance at p < 0.05. From 2005 to 2024, Sichuan recorded incidence and mortality rates of 305.78 and 0.13 per 100,000 people, respectively, for the 23 acute infectious diseases. Excluding hand, foot, and mouth disease and seasonal influenza, the overall incidence rate of the remaining 21 diseases increased (AAPC: 3.4

BackgroundHigh-intensity noise is associated with noise-induced hearing loss (NIHL). There is also evidence that noise exposure is related to cognitive impairment. This research aimed to analyze the associations and potential pathways of cumulative noise exposure (CNE), hearing loss and cognitive impairment.MethodsA total of 560 research subjects were included in this research from May 2021 to April 2022 in western China. The demographic features, occupational features, and CNE were investigated and examined. Hearing loss was evaluated according to the National standard GB/T 7583–1987 of China. The Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to assess cognitive function. Structural equation modeling (SEM) was used to analyze the potential pathways and specific effect sizes of CNE, hearing loss and cognitive impairment.ResultsThe mean age of the research subjects was 34.3 (SD, 9.89). Men accounted for 96.4% (540/560) and women accounted for 3.6% (20/560). A total of 62.3% (349/560) held a college degree or above. The regression analysis showed that high dose CNE was related to MMSE (β = −1.069 (−1.539, −0.600)) and MoCA (β = −1.040 (−1.726, −0.355)) scores. The monaural threshold weighted value of the right ear (MTWVR) greater than 40 dB was associated with both MMSE (β = −1.183 (−2.033, −0.333)) and MoCA (β = −1.420 (−2.647, −0.193)) scores. The monaural threshold weighted value of the left ear (MTWVL) greater than 40 dB was also associated with MMSE (β = −1.540 (−2.389, −0.690)) and MoCA (β = −1.685 (−2.915, −0.456)) scores. The SEM result (Model C) showed that the standard effect of CNE- hearing loss path, CNE-MMSE path, and hearing loss-MMSE path were 0.142 (p < 0.001), −0.151 (p < 0.001), and −0.030 (p = 0.376). The Model D showed that the standard effect of CNE- hearing loss path, CNE- MoCA path, and hearing loss- MoCA path were 0.143 (p < 0.001), −0.048 (p = 0.267), and − 0.050 (p = 0.047). The CNE had only a direct effect on the MMSE score. Conversely, the CNE had only an indirect effect on the MoCA score, while hearing loss was borderline associated with MoCA. The total effects of CNE on MMSE and MoCA scores were −0.151 and −0.007, respectively.ConclusionJob-related noise exposure is not only associated with NIHL but also with early cognitive impairment in occupational groups. However, there is not enough evidence indicating that NLHL mediates the associations.

Maternal abortion and miscarriage are significant contributors to the global burden of maternal health conditions. Iron deficiency remains a critical risk factor, significantly impacting reproductive health outcomes, particularly in low socio-demographic index (SDI) regions. This study aims to assess long-term trends in the incidence, mortality, and disability-adjusted life years (DALYs) of maternal abortion and miscarriage from 1990 to 2021 using the Global Burden of Disease (GBD) 2021. Additionally, we evaluate the role of iron deficiency as a risk factor and project future burden estimates up to 2051. Utilizing the GBD 2021 dataset across 204 countries and territories, the study retrospectively analyzed long-term trends in maternal abortion and miscarriage from 1990 to 2021. Joinpoint regression was applied to identify temporal trends in age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR). An age-period-cohort (APC) model was used to assess the independent effects of age, period, and cohort, while future projections were generated using Bayesian age-period-cohort (BAPC) modeling. In 2021, the global ASIR of maternal abortion and miscarriage was 1001.64 per 100,000 population (95

Background Mental disorders in occupational populations pose significant health and economic burdens, but there exists a lack of practical and objective biomarkers for occupational mental health monitoring. Our study aims to explore the correlation between high-density lipoprotein (HDL)-related inflammatory markers and negative psychological symptoms in occupational populations. We also seek to evaluate the potential application effectiveness of these indicators as biomarkers for identifying the impact of mental health on occupational populations. Moreover, the indicators found in this study can be used as indicators for identifying high-risk groups prone to inflammatory responses caused by negative psychological symptoms. Methods Our study adopted a cross-sectional design with a combination of questionnaires and biochemical index tests for 1920 eligible occupational populations. The Depression Anxiety Stress Scales-21 (DASS-21) was used to measure participants' levels of anxiety, depression, and stress. Collect individual and occupational characteristics of survey respondents through self-administered questionnaires. Blood samples are also collected to measure high-density lipoprotein cholesterol levels and peripheral blood cell counts. We employed statistical analyses including correlation analysis, Receiver Operating Characteristic (ROC) curve analysis, and univariate and multivariate regression. Results The final sample size included in the analysis was 1,434. The results showed that stress, anxiety, and depressive symptoms were significantly correlated with all four HDL-related inflammatory indices (p < 0.05). Especially for MHR, compared to those without symptoms, individuals experiencing stress, anxiety, or depression had an OR of 2.75 (95% CI: 1.90, 3.99), 3.27 (95% CI: 2.25, 4.78), and 3.02 (95% CI: 2.08, 4.40) for abnormally high levels, respectively. In addition, subgroup analyses showed that lower monthly incomes, longer working hours and frequent night shifts might be promoting factors for elevated HDL-related inflammatory levels. Receiver Operating Characteristic (ROC) analysis further demonstrated that PHR and MHR exhibit good predictive ability for all three psychological symptoms, with AUC values exceeding 0.6. Notably, for individuals with over 30 years of work experience, the predictive performance AUC is even higher, reaching above 0.7. Conclusion The results of this study suggest that PHR and MHR are expected to be potential biomarkers for identifying health problems caused by negative psychological symptoms in occupational groups, providing valuable information for occupational mental health assessment. Preventive measures should be implemented for high-risk groups, including those with low income, long working hours, and frequent night shifts, to mitigate potential health impacts.

Objective:To explore the risk factors for developing chronic pulmonary heart disease in patients with pneumoconiosis.Methods:The medical records of pneumoconiosis patients admitted to an occupational disease hospital in Sichuan Province between January 2012 and November 2021 were collected. Kaplan-Meier (K-M) method, or product-limit method, was used to plot the incidence curves of pulmonary heart disease in the pneumoconiosis patients. Cox proportional hazard regression model was used to analyze the influencing factors associated with chronic pulmonary heart disease in patients with pneumoconiosis.Results:A total of 885 pneumoconiosis patients were included in this study. The follow-up time was 12 to 115 months and the median follow-up time was 43 months. A total of 138 patients developed chronic pulmonary heart disease and the incidence density of pulmonary heart disease was 38.50/1000 person-years. Multivariate Cox proportional hazard regression analysis showed that the influencing factors of pneumoconiosis inpatients developing chronic pulmonary heart disease included the following, being 50 and older (hazard ratio [HR]=1.85, 95% confidence interval [CI]: 1.25-2.74), stage Ⅲ pneumoconiosis (HR=2.43, 95% CI: 1.48-4.01), resting heart rate≥100 beats/min (HR=2.62, 95% CI: 1.63-4.21), the complication of chronic obstructive pulmonary disease (COPD) (HR=4.52, 95% CI: 2.12-9.63), underweight (HR=2.40, 95% CI: 1.48-3.87), overweight and obesity (HR=0.54, 95% CI: 0.34-0.86), and triacylglycerol (TG) (HR=0.69, 95% CI: 0.49-0.99).Conclusion:Old age, stage Ⅲ pneumoconiosis, high resting heart rate, low BMI, and the complication of COPD are risk factors for chronic pulmonary heart disease in pneumoconiosis patients, while overweight and obesity and TG are protective factors. Early identification of the risk factors and the adoption of the corresponding prevention measures are the key to preventing chronic pulmonary heart disease in patients with pneumoconiosis.

Objective To review the principles and methods of cohort studies and the current development of major occupational cohort studies in China, in order to provide suggestions and ideas for the design of follow-up programs for newly established occupational population cohort studies. Methods Using the search terms including “occupational + cohort”,“occupational + follow-up”, “workers + cohort”, and “workers + follow-up”, we extensively searched for published articles of occupational cohort in the China National Knowledge Infrastructure, Wanfang Data, and the Chinese medical journal fulltext database from the time of inclusion until June 2022. Results A total of 3 129 records were retrieved and 275 research articles met the inclusion criteria. After data extraction and summarization of the included articles, 127 cohort studies targeting occupational population were finally determined. Conclusion Many large occupational cohort studies have been carried out in China, with abundant findings obtained. With the development of technology and further research needs, it is necessary to further explore the health effects of occupational environmental factors and to monitor associated biomarkers.

Objective To explore the effect of pomegranate peel extract on early lung inflammation in mice exposed to silica. Methods C57BL/6J mice were randomly divided into a blank control group, silicon dioxide（SiO 2 ） model group and intervention groups including low, medium and high doses of pomegranate peel extracts（0.27, 0.55 and 1.1 mg/g）. The blank control group was given 0.1 ml normal saline by tracheal perfusion, and 100 μl SiO 2 suspension（50 mg/ml） transtracheally in the other groups at one time. And then, pomegranate peel extracts were gavaged into the low, medium, and high intervention groups daily. Accordingly, the blank control group and the model group were administered equivalent treatment using saline for 28 days. The histopathological characteristics of the lung were observed by HE staining and Masson staining. The expression levels of hydroxyproline and interleukin-1 beta（IL-1β） in lung tissue were detected using the ELISA method. Bronchoalveolar lavage fluid microbial diversity, and species composition analysis were detected by using 16SrDNA sequencing data. The statistical analyses used were one-way analysis of variance（ANOVA）, Metastats difference analysis and linear discriminant analysis（LDA）. Results Compared with the blank control group, the body weight of the intervention groups was decreased（F=3.489, P=0.017）, HE staining and Masson staining of lung tissue in the model group showed destruction of alveolar structure, inflammatory cell plethora, and severe fibrotic hyperplasia. The content of hydroxyproline（HYP）（t=-6.300, P=0.000 2） and the expression level of IL-1β（t=-13.71, P＜0.000 1） in the lung tissues of the model group significantly increased. Compared with the blank control group, the degree of the relative abundance in Pseudomonadales（F=10.250, P=0.002 5） and Erysipelotrichales（F=6.077, P=0.015） decreased in the model group after being exposed to silica. Conclusion Pomegranate peel extracts could have the potential effect of alleviating lung inflammation caused by silica dust. The abundance and species diversity in the lung flora of mice were altered after exposure to silica dust, pomegranate peel extract has a potential function on changing the structure of its flora.

尘肺病是影响我国职业人群健康最主要的职业性肺部疾病,其预防、诊断、治疗和康复尚缺乏系统性的研究,国内外开展的尘肺队列研究多以接尘作为观察起点,以发病或死亡作为结局,缺乏精细化的尘肺病临床队列研究.本课题以国家临床重点专科职业病科为依托,建立华西职业性尘肺病专病队列,以循证医学证据为基础,通过专家论证建立尘肺病队列入组标准,招募尘肺病患者入组,并开展长期随访,收集入组对象的基线信息、职业暴露信息、诊疗信息,同时采集血液、肺灌洗液等生物样本,在此基础上搭建尘肺病队列多模态数据动态采集及管理信息系统.根据大型人群队列终点事件长期随访技术规范,数据安全及数据处理技术规范,中国人类遗传资源管理要求,对队列观察对象开展连续、规范地追踪随访,为尘肺病发病、诊疗及预后的系统性多组学多模态研究提供支撑.精细化的华西职业性尘肺队列还将为尘肺纤维化机制的深入研究、靶向药物开发及尘肺病的精准诊疗提供研究平台.本文主要针对华西职业性尘肺病队列的研究设计和初步结果做简要介绍.

目的 分析医务工作者职业幸福感在职业紧张和抑郁症状关系间的中介效应.方法 采用分层整群抽样,选取某省4家医院医务工作者为研究对象,使用抑郁-焦虑-紧张量表(DASS-21量表)和自行设计的可视化评分调查医务工作者职业紧张、抑郁症状和职业幸福感水平,采用逐步回归法和结构方程模型分析职业幸福感对职业紧张和抑郁症状关系间的中介作用.结果 1 988名医护工作者职业紧张和抑郁症状阳性检出率分别为42.5％(845/1 988)、43.5％(864/1 988).医务工作者抑郁症状与职业紧张呈正相关(r=0.794,P＜0.001),与职业幸福感呈负相关(r=-0.443,P＜0.001),职业幸福感与职业紧张呈负相关(r=-0.352,P＜0.001).中介效应分析显示,职业幸福感在职业紧张和抑郁症状间具有中介效应,中介效应值为0.054(BCa 95％CI:0.066～0.423),中介效应占比为7.4％.结论 医务工作者的职业紧张可直接作用于抑郁症状,也可通过职业幸福感间接作用于抑郁症状,职业幸福感在职业紧张和抑郁症状间具有部分中介的作用,但主要以直接作用为主.

Emerging infectious diseases have been frequently observed. The occurrence of infectious diseases is highly uncertain because of the unpredictability of pathogen, the complexity of occurrence time and site, and the characteristics of transmission. Early detection and immediate implementation of effective interventions within a reasonable time are the keys to preventing pandemics.[1] However, due to the insufficiency of the traditional surveillance and early warning, which relied heavily on passive reporting by healthcare institutions,[2] the early warning time lags behind the risk factor identification, syndrome differentiation (pneumonia of unknown cause), and suspected case confirmation of the infectious disease at the gateway of clustered cases. This paper aimed to face the challenges mentioned above and propose a universal epidemic intelligence model to establish a novel infectious disease surveillance and early warning system based on the trinity of surveillance and detection, risk assessment, and early warning. Detection refers to multi-source heterogeneous data collection and multi-channel surveillance, which is different from the single channel used in traditional surveillance. The data and information needed for surveillance and detection can be obtained using the epidemiological triangle that encompasses three types of information: Pathogens, hosts, and the environment. During the global coronavirus disease 2019 (COVID-19) pandemic, epidemiological surveys of wastewater based on sewage surveillance had an important role, and the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in sewage sludge preceded the detection of cases.‍[3] Previous studies have found some transmissible intestinal viruses, such as poliovirus, adenovirus, norovirus, rotavirus, and hepatitis A virus. Surveillance and detection data can be collected through multi-channel surveillance. Information sources can be divided into risk factors and syndromic information in terms of the data application [Figure 1]. By analyzing the data of active and passive surveillance, the direct or indirect contributing factors of the occurrence and development of the disease, as well as the possible etiological clues, could be identified. For instance, the species, quantity, distribution, and seasonal changes of the vector, which can affect the occurrence and spread of plague, epidemic hemorrhagic fever, malaria, dengue fever, filariasis, influenza, monkeypox, and other infectious diseases, can be regarded as crucial early warning indicators of the disease. Natural disasters such as droughts, floods, tsunamis, and earthquakes could lead to outbreaks of infectious diseases. The spread of respiratory infections may be accelerated in dense populations, especially those with wide mobility and low vaccination rates, thus increasing the risk of outbreaks, especially during major events or holidays.Figure 1: Trinity of the infectious disease surveillance and early warning. Conceptual view of the epidemic intelligence trinity. None of the elements were exhausted. (A) The structure of the trinity. (B) Part 1: Surveillance and detection. (C) Part 2: Risk assessment. (D) Part 3: Early warning.The time nodes of the index information significantly influence the timely discovery of a disease. Frequently, the extensive use of the combinations of multi-source or multiple data dramatically improves the sensitivity of detecting disease outbreaks. Before a hospital visit, the first node may be the increased risk factors. For instance, the appropriate temperature, rainfall, and other factors increase the number of mosquitoes, before an outbreak of dengue fever. The pathogen may be detected accidentally upon admission to quarantine, physical examination at medical institutions, or by other unrelated tests. Prior to visiting the hospital or emergence of clinical symptoms, the infected person could search online and purchase over-the-counter medications. Aggregated absenteeism occurs among students and employees, while the positive results of community sewage pathogen detection are obtained. Data acquisition methods include grabbing, pushing, and collecting. The acquisition methods should consider not only the surveillance efficiency but also the feasibility under objective conditions. For example, data from public opinion on the internet, doctors' forums, migration information, and demographic information are obtained mainly by grabbing. Data from medical institutions, such as imaging, laboratory, and outpatient and emergency, are obtained mainly by pushing or collecting. Risk assessment refers to the multi-point triggering of intelligence and comprehensive risk assessments, which differs from the single trigger. Based on surveillance data, identifying unexpected early warning signals of infectious diseases aim to discover and identify the occurrence or development trends of infectious diseases by using a model analysis or the detection of abnormalities such as rare pathogens and novel pathogens according to the judgment of professional institutions and experts. Based on traditional surveillance techniques, advanced and newly developed modern data analysis techniques should be supplemented. According to the different data characteristics, the anomaly signal analysis methods are basically data-driven models, such as clustering analysis, decision tree analysis, Bayesian network, neural network, deep learning, and other algorithms, which can analyze multi-modal data, including graphic data, natural language information, video, audio, counting and measuring data. In addition, there is a parameter-driven model represented by the infectious disease transmission dynamic model. According to the different dimensions of the clustering analysis, clustering early warning models can be categorized into temporal and spatial types. Regarding the different data characteristics, anomaly signal analysis methods include data-driven and parameter-driven models.[4] The term "early warning" refers to early warning reports and dissemination mechanisms. If an unexpected signal is confirmed to indicate intolerable risk, it is necessary to inform all relevant stakeholders and take immediate prevention and control actions to minimize the health and social hazards. According to the International Health Regulations in 2005 (IHR 2005), a case of infectious disease with severe public health impacts (such as smallpox, poliomyelitis caused by wild strains, human influenza caused by a new sub-type virus, and severe acute respiratory syndrome [SARS]) or an outbreak of a disease with severe social impacts (such as cholera, pneumonic plague, yellow fever, viral hemorrhagic fever, West Nile fever, or dengue fever) detected by the national surveillance system should be reported to the World Health Organization (WHO) within 24 h.[5] It would be beneficial if health administrative departments consider issuing early warnings or notifications to professional and technical institutions, the public, and international stakeholders. This could be based on factors such as the scale of the disease occurrence, its severity, risk assessment outcomes, and specific disease characteristics. Therefore, in line with local laws, regulations, and guidelines, early warning information shall be reported to the administrative departments by the discovering person or entity to enable the most rapid joint prevention and control, information communication, coordination of resources, and the formulation of appropriate preventive measures. Based on the epidemic intelligence trinity, there are five key suggestions as follows: First, surveillance and detection data can be collected through multi-channel surveillance. Sewage surveillance could be incorporated into future surveillance for emerging infectious diseases and serve as a vital channel for active surveillance, especially for intestinal infectious diseases. New surveillance based on earlier nodes should be established, such as medicine purchases, search query data, and work absenteeism. In addition to traditional passive surveillance, a more active surveillance method should be applied. Second, modern techniques to support multi-point triggering should be established. Research and application of modern technologies, such as information technology and mathematical analysis models, are encouraged to supplement traditional surveillance technology. Further, a comprehensive risk assessment of abnormal signs of the disease should be performed by establishing a risk assessment model of infectious diseases according to the disease characteristics and the environment. Third, based on the epidemic intelligence trinity model, information sharing and trust architectures should be considered globally to enable better preparation for future pandemics and epidemics. Countries and regions need to improve surveillance channels within the acceptance of conditions, and advanced approaches could be fully used for pathogen surveillance as the basis of early warning technology. Support and cooperation mechanisms need to be established in countries with unfavorable technical, economic, and social conditions. Fourth, transition mechanisms between the epidemic and non-epidemic periods, such as the preparedness of reserve medical staff training, and Fangcang shelter hospital planning, should be established, along with the trinity model. Infectious diseases do not recognize geopolitical borders, and addressing their challenges requires individuals worldwide to come together and work as one, thereby establishing better preparedness for the next pandemic, better early detection and responses for emerging infectious diseases, and achieving the ultimate goal of public health and population medicine. Fifth, systematic considerations should be taken to achieve integration of the three, inter-connected parts. Detection is the basis of risk assessment provided by multi-source data from multi-channel surveillance information for multi-point triggering of an early warning. Finally, the ultimate goal underlying the provision of timely information to the public as well as relevant international agencies is the enabling of a cooperative and timely response to future outbreaks. Funding This study was supported by a grant from the CAMS Innovation Fund for Medical Sciences (No. 2021-I2M-1-044) and the Natural Science Foundation of China (No.82320108018). Conflicts of interest None.

BACKGROUND: Although the Job Content Questionnaire (JCQ-22) has been translated into numerous languages and applied in various countries, its cultural applicability in China remains unclear. OBJECTIVE: To adjust the JCQ-22 for cross-cultural use and optimize the scoring method for suitability for Chinese working populations. METHODS: We first used the original JCQ-22 questionnaire to measure occupational stress. Cross-cultural adjustment involved reorganization of scale items (adjusted-I scale) and deletion of inefficient redundant items during reorganization of scale items (adjusted-II scale). Structural validity and the relationship between stress and health outcomes (insomnia and self-conscious symptoms) before and after adjustment were compared. RESULTS: Exploratory factor analysis revealed that the two-factor cumulative variance contribution rate of job demand and control of the adjusted-II scale was 52.47%, compared with 48.44% and 48.44% in the original version and adjusted-I scale, respectively. Among the 16 fitness indicators in confirmatory factor analysis, 9 items of the adjusted-II scale met the standard, compared with 4 items of the original and adjusted-I scales. The Pearson's correlation coefficients between occupational stress and insomnia as well as self-conscious symptoms from the adjusted-II scale were 0.15 and 0.32, respectively, which were higher than those of the original scale (0.10 and 0.20). Receiver operating characteristic analysis revealed that the adjusted-II scale exhibited a better area under the curve and Youden index values than the original scale. CONCLUSION: The adjusted-II scale exhibited superior structural validity with more reasonable health outcome predictions and fewer items, making it more suitable for measuring occupational stress in Chinese populations.

Abstract Objectives Numbers of studies have shown that human aging is related to environmental factors, among which workplace is an important living environment in people's life. However, there is still a lack of causal exploration research on the effect of workplace factors on human aging. From the perspective of genetic polymorphism, we explore the association between human aging and risk factors in the workplace,and the possible pathways of aging caused by risk factors in the workplace. Methods To systematically explore the association between workplace risk factors and aging, we used a two-sample Mendelian randomization method to examine the association of nine common workplace risk factors with telomere length and accelerated DNA methylation GrimAge clock. We used the corresponding single nucleotide polymorphisms screened as instrumental variables to enable causal associations between exposing to workplace factors and aging. Results According to our tests, "Heavy physical work" and "Noise" are associated with telomere length, which shows statistics as OR [95% CI] = -0.136[-0.229, -0.043], p = 0.004 and the OR [95% CI] = 0.014 [0.002, 0.027], p = 0.025) respectively. Meanwhile, the P value of the phenotype "Asbestos" was close to 0.05 (P = 0.059), and the OR value was OR [95%CI] = -1.098[-2.241, 0.044].The factor "diesel exhaust"(ukb-d-22615_2) associated with GrimAge acceleration was OR [95%CI] = 8.238[-0.023, 16.450], p = 0.05. Conclusions Our finding suggests that there existing causal relationship between workplace exposure to risk factors (noise, heavy physical activity, fuel engine exhaust) and aging.

Person-environment fit (PEF) theory, one of the foundational theories of occupational stress, has primarily found applications in organizational behavior and human resource management. Given the alignment between the definition of occupational stress and the essence of PEF, we introduced the concept of worker-occupation fit (WOF). To validate our theoretical model, the development of an instrument to measure WOF becomes imperative. The Worker-Occupation Fit Inventory (WOFI) comprises three dimensions: personal trait fit (PTF), need-supply fit (NSF) and demand-ability fit (DAF). Job-related mental disorders (JRMDs) were assessed using the DASS-21. During the pre-investigation, items of the WOFI underwent screening through classic test theory (CTT) analysis. In the formal investigation, item response theory (IRT) analysis was employed to evaluate the selected items. The relationship between WOF and JRMD was verified by Pearson’s correlation analysis and multiple logistic regression analysis. The initial version consisted of 26 items. Three common factors were extracted by exploratory factor analysis (EFA): 6 items were included in the PTF, 6 items were included in the NSF, 4 items were included in the DAF, and 10 items were deleted because of unacceptable factor loadings. The confirmatory factor analysis (CFA) verified the structure of the WOFI with χ2/df = 1.822, CFI = 0.947, and SRMSR = 0.056. The Cronbach's alpha coefficients of the PTF, NSF, and DAF were 0.91, 0.92, and 0.80, respectively. In IRT analysis, the discrimination values of all items ranged from 1.25 to 2.53, and the difficulty values of all items ranged from -6.28 to 1.30 (with no difficulty of reversal). The WOF was negatively related to job-related stress (r = -0.34, p<0.001), anxiety (r = -0.37, p<0.001), and depression (r = -0.41, p<0.001). The multiple logistic regression analysis suggested that a high level of WOF was a protective factor against job-related mental disorders, with ORs all less than 1 (p<0.001), and a low level of WOF was a risk factor for job-related mental disorders, with ORs all more than 1.0 (p<0.001). The results of CTT and IRT analysis indicated that the WOFI exhibits reliability and validation. The WOF effectively predicted job-related mental disorders. Subsequent studies will delve into the influence of WOFI on diverse professions and various health outcomes.

人才是健康中国国家战略的基础,新时代对高层次应用型公共卫生人才培养提出了高质量要求.构建国内高层次应用型公共卫生人才路径举措,以期为我国高层次应用型公共卫生人才培养提供借鉴.应用文献研究获取我国和美国公共卫生教育信息,归纳我国高层次应用型公共卫生人才培养的背景、现状和内涵,总结美国高层次应用型公共卫生人才培养的经验和启示,提出我国高层次应用型公共卫生人才的路径举措.我国可从宏观社会生态和微观路径的角度展开高层次应用型公共卫生人才培养,具体微观路径可从教育理念、培养方案、师资队伍、培养模式、评价机制入手,推进公共卫生教育质量提升.