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    “We just keep pushing through”: a mixed-method study on musculoskeletal discomfort and mental well-being among nurses in resource-limited settings
    (BioMed Central Ltd, 2025-12-01) Patangia B; Srinivasan PM; Lee MCC
    Background: Nurses in under-resourced settings frequently report high levels of musculoskeletal (MSK) discomfort, which significantly affects their mental well-being. While workplace strain is well documented, the combined impact of physical burden and institutional neglect remains underexplored in these environments. Aim: The study aims to examine the prevalence of MSK discomfort and its association with psychological well-being among nurses in under-resourced healthcare environments in Northeast India, and to explore the experiential and structural factors contributing to these occupational health risks. Methods: A sequential mixed-methods study design was employed, following an explanatory approach. The study commenced with a survey to gather quantitative data. Quantitative data were collected from 216 nurses using the Extended Nordic Musculoskeletal Questionnaire (Extended-NMQ) and the WHO-5 Well-Being Index, the results of which informed the development of subsequent interview questions. Semi-structured interviews were then conducted with 11 nurses to capture experiential and structural factors. This structure enabled deeper contextual understanding and facilitated triangulation across data types. Results: Among the participants, 47.2% reported experiencing lower back pain, followed by discomfort in the knees (27.3%) and upper back (25%). Higher levels of MSK discomfort were significantly associated with employment in the public sector and more than ten years of work experience. A strong negative correlation was observed between MSK discomfort and mental well-being. Thematic analysis revealed key stressors: physical depletion, emotional exhaustion, organizational apathy, and limited healthcare access. In response to these challenges, nurses often relied on self-management due to insufficient institutional support. Triangulated findings underscored how structural deficiencies intensified both physical and psychological strain among nurses. Conclusions: There is an urgent need for evidence-based occupational health interventions to address ergonomic, psychosocial, and institutional challenges, particularly in low-resource healthcare settings, to safeguard the well-being of frontline nursing staff. This study offers novel understanding from a high-need yet under-researched geographic context, namely the northeastern states of India, bridging empirical gaps in MSK health literature through the integration of experiential and structural factors. Clinical trial number: Not applicable.
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    Chemicals, noise and occupational hearing health in South Africa: A mapping study
    (AOSIS, 2020-03-10) Pillay M
    Background: Chemical exposure leading to ototoxicity is a fresh challenge for occupational healthcare in South Africa. Objectives: The critical question is: ‘what is known about occupational ototoxic chemicals with or without noise exposure in South Africa?’ Method: This qualitative, mapping study was completed with published (peer-reviewed) and grey literature from 1979-2019. Data was analysed using the Preferred Reporting Items for Systematic reviews and Meta-Analyses: extension for Scoping Reviews and the Nursing and Allied Health Resources Section subcommittee on Mapping the Literature of Nursing and Allied Health (adapted). Numerical analysis of article type was completed, but the primary focus was on capturing patterns/trends using thematic analysis and ideology critique. Results: The African Journal of Disability, African Journal of Primary Health Care and Family Medicine, South African Medical Journal, The South African Journal of Communication Disorders [SAJCD] and Health SA Gesondheid) were included with the SAJCD containing one relevant item and seventeen other items were analysed. Research focusses on the mining sector (gold) in Gauteng, and ototoxic medication (tuberculosis and/or human immunodeficiency virus) take precedence. In KwaZulu-Natal, the focus is on commerce and industry across formal and informal sectors. There are no governmental policies that refer to chemical ototoxicity. Occupational hearing loss is configured exclusively on the meme that noise exposure is the only toxin. Conclusion: Chemical exposures are only just beginning to be recognised as ototoxic in South Africa. Hearing conservation programmes should always serve the workers’ interests and never bow down to the econometric interests of employers.
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    Cancer incidence in agricultural workers: Findings from an international consortium of agricultural cohort studies (AGRICOH).
    (Elsevier Ltd, 2021-12) Togawa K; Leon ME; Lebailly P; Beane Freeman LE; Nordby K-C; Baldi I; MacFarlane E; Shin A; Park S; Greenlee RT; Sigsgaard T; Basinas I; Hofmann JN; Kjaerheim K; Douwes J; Denholm R; Ferro G; Sim MR; Kromhout H; Schüz J
    BACKGROUND: Agricultural work can expose workers to potentially hazardous agents including known and suspected carcinogens. This study aimed to evaluate cancer incidence in male and female agricultural workers in an international consortium, AGRICOH, relative to their respective general populations. METHODS: The analysis included eight cohorts that were linked to their respective cancer registries: France (AGRICAN: n = 128,101), the US (AHS: n = 51,165, MESA: n = 2,177), Norway (CNAP: n = 43,834), Australia (2 cohorts combined, Australian Pesticide Exposed Workers: n = 12,215 and Victorian Grain Farmers: n = 919), Republic of Korea (KMCC: n = 8,432), and Denmark (SUS: n = 1,899). For various cancer sites and all cancers combined, standardized incidence ratios (SIR) and 95% confidence intervals (CIs) were calculated for each cohort using national or regional rates as reference rates and were combined by random-effects meta-analysis. RESULTS: During nearly 2,800,000 person-years, a total of 23,188 cancers were observed. Elevated risks were observed for melanoma of the skin (number of cohorts = 3, meta-SIR = 1.18, CI: 1.01-1.38) and multiple myeloma (n = 4, meta-SIR = 1.27, CI: 1.04-1.54) in women and prostate cancer (n = 6, meta-SIR = 1.06, CI: 1.01-1.12), compared to the general population. In contrast, a deficit was observed for the incidence of several cancers, including cancers of the bladder, breast (female), colorectum, esophagus, larynx, lung, and pancreas and all cancers combined (n = 7, meta-SIR for all cancers combined = 0.83, 95% CI: 0.77-0.90). The direction of risk was largely consistent across cohorts although we observed large between-cohort variations in SIR for cancers of the liver and lung in men and women, and stomach, colorectum, and skin in men. CONCLUSION: The results suggest that agricultural workers have a lower risk of various cancers and an elevated risk of prostate cancer, multiple myeloma (female), and melanoma of skin (female) compared to the general population. Those differences and the between-cohort variations may be due to underlying differences in risk factors and warrant further investigation of agricultural exposures.
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    Noise in early childhood education centres: the effects on the children and their teachers : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy at Massey University, Wellington, New Zealand
    (Massey University, 2008) McLaren, Stuart Joseph
    Although the effects of noise on children’s learning in school classrooms is well documented, there is very little on the effects of noise on preschool children. There are strict legal requirements for the daily noise exposure an adult worker can received in the workplace but nothing to control the noise children can receive in school and early education. There is also little or no data on how sound affects a child, compared to an adult. The early years of life are critical for the development of speech, hearing and auditory processes, as well as being the most vulnerable time for middle ear infections. This work sets out to determine the typical noise levels in early childhood centres and the effects on a range of children and their teachers. Reverberation times in most centres were found to well exceed the 0.6 seconds prescribed by the Australasian standard for schools and learning spaces. Very high levels of noise were recorded in a number of centres with a significant number of children and staff members, exceeding the maximum daily sound exposure of 100% permitted for workers in industry. A range of special needs children were identified as being particularly at-risk to noise, with the most adverse outcomes reported for those experiencing sensory integration disorder. Yet, even though high levels of noise were recorded, the majority of respondents in a survey of teachers rated the lack of sufficient space for the number of children present as the main issue, and inclement weather as the greatest environmental condition contributing to noise (by confining children indoors, especially over long periods of time). Hearing tests on the children were not permitted under the strict human ethics criteria to which this study had to conform, but simple hearing tests on a small group of teachers, revealed that hearing loss could be a serious occupational health issue. The legal issues of noise control and management in early childhood education have been addressed in this thesis, current legal frameworks reviewed, and recommendations presented for future consideration.
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    The perceived effects of work on health of rubber farmers in southern Thailand : a dissertation presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Nursing, Massey University, Palmerston North, New Zealand
    (Massey University, 2008) Boonphadh, Piyaporn
    This study was conducted in a rubber farming community in Southern Thailand with rubber farmers and their first-line public healthcare providers as the study informants. The study aims were to first, explore perceived effects of work exposures in rubber farming on rubber farmers’ health, second, identify decisions made in response to the effects of work exposures on health, and third, determine influencing factors on the construction of the perception and the process of decision making. Data were obtained using ethnographic research methods, underpinned by an interpretative paradigm. Unstructured interviews and participant observation were employed as the principal means of data collection. Together with the primary methods of data collection, note taking (fieldnotes, fieldwork personal journal, and photographs) and reviewing/analysing existing documents were employed. While data were being collected, initial data analysis was carried out to make sense of information gained and direct further steps of the data collection. After terminating the data collection, ethnographic data analysis suggested by Spradley (1979, 1980) was used to determine themes to meet the aims of the study. The study findings reveal that individual rubber farmers and healthcare providers construct perceptions of effects of rubber farming on rubber farmers’ health and decisions on the actions taken to manage the rubber farmers’ work-related health problems based on their own accounts of compounding factors. Among factors identified, discrepancies between health policy and its practice, coupled with the existence of a hierarchy of power-superior-inferior relationships among individual levels of health authority-emerge as the most powerful factors, inducing the emergence of other factors. Recommendations made as a result of this study draw attention mainly to the minimisation of the discrepancies between health policies and their implications, and the establishment of partnership status among authorised health agencies and between health agencies and rubber farmers in order to improve the quality of occupational safety and health services provided to the rubber farmers.