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BACKGROUND: The COVID-19 pandemic has posed unprecedented challenges, particularly for healthcare workers (HCWs). The prolonged struggles exposed the HCWs to a variety of stressors, potentially leading to burnout. Emotional exhaustion is widely recognized as the core component of burnout. This research aims to conceptualize and develop an emotional exhaustion screening questionnaire through literature review, validation, and accuracy testing. METHOD: A literature review of questionnaires and extraction of items on emotional exhaustion were performed in June 2022. We proceed with the face validity of the items by experts. The items with good content validity ratio and index were selected and reworded to suit the context of HCWs working during the COVID-19 pandemic. A pilot test of the questionnaire was done in the Central University Hospital of Asturias (HUCA) from October to December 2022 with a sample of 148 HCWs from the ORCHESTRA cohort to determine its reliability, convergent validity, and accuracy. RESULTS: Our literature review identified 15 validated questionnaires. After exclusion, 32 items were sent for content validation by experts, yielding five final items that proceeded with the pilot test. Resulting in a Cronbach's alpha-coefficient of .83 for the scale and .78 for dichotomous responses, demonstrating good internal consistency and convergent validity. The result of our accuracy test yielded sensitivity (90.6%) and specificity (91.6%) for the OEEQ scale; and sensitivity (88.7%) and specificity (89.5%) for OEEQ dichotomous responses. CONCLUSION: This study developed and validated the ORCHESTRA Emotional Exhaustion Questionnaire, demonstrating the questionnaire's clarity, relevance, and comprehensibility in screening emotional exhaustion among HCWs.

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Understanding antibody persistence concerning multimorbidity is crucial for vaccination policies. Our goal is to assess the link between multimorbidity and serological response to SARS-CoV-2 nine months post-first vaccine. We analyzed Healthcare Workers (HCWs) from three cohorts from Italy, and one each from Germany, Romania, Slovakia, and Spain. Seven groups of chronic diseases were analyzed. We included 2941 HCWs (78.5% female, 73.4% ≥ 40 years old). Multimorbidity was present in 6.9% of HCWs. The prevalence of each chronic condition ranged between 1.9% (cancer) to 10.3% (allergies). Two regression models were fitted, one considering the chronic conditions groups and the other considering whether HCWs had diseases from ≥2 groups. Multimorbidity was present in 6.9% of HCWs, and higher 9-months post-vaccine anti-S levels were significantly associated with having received three doses of the vaccine (RR = 2.45, CI = 1.92-3.13) and with having a prior COVID-19 infection (RR = 2.30, CI = 2.15-2.46). Conversely, lower levels were associated with higher age (RR = 0.94, CI = 0.91-0.96), more time since the last vaccine dose (RR = 0.95, CI = 0.94-0.96), and multimorbidity (RR = 0.89, CI = 0.80-1.00). Hypertension is significantly associated with lower anti-S levels (RR = 0.87, CI = 0.80-0.95). The serological response to vaccines is more inadequate in individuals with multimorbidity.

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BACKGROUND AND AIM: Polycyclic aromatic hydrocarbons (PAHs) are the products of incomplete combustion or pyrolysis of various organic materials. Their ubiquity in the environment leads to measurable levels of exposure. However, the exposure varies strongly between different regions in Europe. Some PAHs with four or more rings are suspected to be human carcinogens. Therefore, the occupational and/or environmental exposure to PAHs may cause a significant health risk. The aim of the study was to evaluate current levels of PAH exposure in defined groups of workers. METHODS: The industrial sites selected in this survey involved PAHs originating from coal tar pitch, carbon black, bitumen, and rubber fumes. Based on the historical data, the sites were expected to exhibit quantifiable levels of exposure to PAHs. The total study population consisted of 139 persons: 108 workers (85 males and 23 females) workers were occupationally exposed in aluminium production, the production of graphite electrodes, road construction, or the rubber forming industry and 31 control individuals in two groups. RESULTS: The highest concentrations ­ 8-hour time-weighted average (TWA) levels (sum of 16 components according to the EPA list), as expected, were found in the aluminium production plant (55.15 µg.m−3) and production of graphite electrodes (54.25 µg.m−3). The lowest concentrations were found in personal air samples of road construction workers (1.93 µg.m−3). The concentrations of 1-hydroxypyrene as a pyrene metabolite (1-OHP) in the urine of the exposed group of workers were found in levels 0.74 µmol.mol−1 creatinine before the exposure and 2.27 µmol.mol−1 creatinine after the exposure (arithmetic mean values). 1-OHP concentrations in post-shift urine samples were highly correlated with the total airborne PAHs concentrations and pyrene concentrations in air. The correlation coefficients (rS) between 1-OHP concentration and pyrene or total PAHs in air were 0.710 and 0.752 (p < 0.05). This statistical analysis confirmed the effect of the occupational exposure to PAHs and pyrene on body burden in workers. However, a modifying effect of gender, smoking habits, dietary intake, genetically modified metabolism, and the use of medication on the toxicokinetics of pyrene was not determined as significant. CONCLUSION: Based on the results a strong correlation between the concentration of 1-OHP in urine as an exposure biomarker and the concentration of pyrene or PAH was affirmed.

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The activities of the kraft pulp-mill in Ruzomberok have great impact on ambient air quality in the town and the neighboring villages. The malodorous sulfur compounds adversely contribute to the overall emission profile. The reduced sulfur proportion forms the inorganic and organic compounds containing sulfur atoms in their lowest oxidation condition (S2-). The total sulfur proportion reduced includes hydrogen sulfide, mercaptans, dimethyl sulfide, dimethyl disulfide and other sulfur compounds. Hydrogen sulfide (H2S)--as mentioned above--is of prime importance. The kraft pulp-mill has measured of hydrogen sulfide contained in ambient air since 2002. The environmental samples were collected in 7 localities in all their selection based on the geographic, climatic and demographic factors. Four exposure localities in the Ruzomberok neighborhood, have been defined by the specified criteria. Exposure assessment was made for each exposure locality by determination of the average daily inhalation dose. The average concentration of H2S reached 5.8 microg x m(-3) in the most polluted locality (Cernová, 2003). To complete the health risk assessment, the standard risk characterization procedure was made by the Hazard Quotient (HQ) calculation for hydrogen sulfide exposure. The highest level of HQ, almost 7, was identified in the event of a worst case exposure scenario (using the 95% concentrations), as for exposure group C. Statistically significant decrease of reported H2S levels was noted during the entire measurement period (-0.25/year, p < 0.001).

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