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Occupational health and safety are major concerns for health workers worldwide. Nurses working in resource-constrained areas are at higher risk of occupational hazards. The purpose of the study was to assess the knowledge, attitudes, and practices of nurses in a regional hospital in a resource-constrained area towards occupational health and safety. A descriptive cross-sectional survey was conducted using self-administered questionnaires among 136 nurses at a regional hospital in Ghana. The nurses were recruited from five hospital units using simple random sampling. The data were analysed using SPSS, where descriptive and inferential statistics were applied. Knowledge, attitude, and practice items were measured on a four-point Likert scale. Mean scores were computed for all the items in each domain, with higher mean scores indicating a favourable response towards occupational health and safety measures. A one-way analysis of variance (ANOVA) was conducted to compare mean Knowledge, attitude, and practice scores across demographic variables. A Post hoc analysis was conducted for variables with statistically significant scores. Additionally, Pearson correlation analysis was conducted to examine the relationships between knowledge, attitude, and practice (KAP) scores. All statistical tests were two-tailed, and the level of significance was set at p&#x2009;<&#x2009;.05. The study findings show that the participant had a high level of knowledge (94.1%) and a positive attitude (80.9%) towards occupational health and safety measures. However, practice was very low, with only 30.9% of the nurses demonstrating good occupational health and safety practices. The correlation analysis revealed a statistically significant positive relationship between knowledge and attitude (r&#x2009;=&#x2009;.507, p&#x2009;<&#x2009;.01), knowledge and practice (r&#x2009;=&#x2009;.433, p&#x2009;<&#x2009;.01), and attitude and practice (r&#x2009;=&#x2009;.656, p&#x2009;<&#x2009;.01). Additionally, a between-subject one-way ANOVA showed a statistically significant difference in knowledge [F(3,132)&#x2009;=&#x2009;4.05, p = .009], attitude [F(3,132)&#x2009;=&#x2009;7.18, p < .001], and practice [F(3,132)&#x2009;=&#x2009;3.91, p = .010] based on level of education. However, there were no significant differences in knowledge, attitudes, and practices regarding occupational health and safety measures across demographic characteristics. The study's findings indicate poor practices towards occupational health and safety. The management of health facilities and health regulatory authorities should institute measures, such as refresher training and monitoring systems, to promote occupational health and safety practices. Safety protocols should also be developed, and nurses should be encouraged to follow them.

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Pesticides are chemicals used in the agricultural, industrial, and public health sectors to increase crop productivity, prevent plant diseases, and reduce pest-related hazards. They can be classified as herbicides, insecticides, fungicides, and rodenticides based on the pests they target. Their active ingredients include organochlorines, organophosphorus compounds, carbamates, pyrethrins, and pyrethroids. Although the use of pesticides has provided significant benefits to humans, their widespread application has also led to the contamination of air, soil, water, and food systems. After application and distribution among air, water, soil, and biota, several processes control the fate and transport of pesticides in the environment, as well as their transformation through biological, chemical, and physical reactions. Humans and animals are exposed to pesticides through various pathways, including drinking contaminated water, consuming pesticide-contaminated food, and living in areas treated with pesticides. Both acute and chronic exposure to pesticides can cause several adverse health effects on the neurological, endocrine, and reproductive systems and may pose carcinogenic risks. This study provides a comprehensive review of research on the occurrence and fate of pesticides in the environment. It also presents the risks to human health associated with occupational and environmental exposure to pesticides. Available techniques for reducing pesticide-related risks are also discussed. This review showed that human, animal, and ecological health are interconnected and that, therefore, an integrated strategy such as the One Health approach is needed to effectively manage pesticide-related risks.

University hospital employees face role-specific stressors that can impair mental well-being and work-related vitality. While worksite health promotion programs show potential for improving mental well-being by targeting lifestyle behaviors, most target single professions or hospital subunits, and evidence for mental well-being and work-related vitality remains mixed. Mobile apps offer unique advantages for delivering such worksite health promotion programs hospital-wide. However, accessible interventions tailored to a diverse workforce are lacking. This study aimed to investigate the feasibility of an app-based worksite health promotion program (the Recharge360 program [The Recharge Company]) targeting multiple lifestyle behaviors, including a team-based competition element, for improving mental well-being and work-related vitality of hospital employees over a 5-month follow-up period by evaluating two objectives: (1) the implementation process of the program, and (2) the preliminary effects of the program on mental well-being and work-related vitality. We included 532 employees (mean age 43, SD 12 y; n=482, 91% women; n=480, 90% highly educated) from a university hospital in Amsterdam, the Netherlands. The study had a single-arm, longitudinal pretest-posttest design lasting 5 months, during which employees participated in the 5-day Recharge360 program (Recharge week) 3 times-in weeks 1, 9, and 17. At baseline (T0) and after each Recharge week (T1-T3), we assessed mental well-being, work ability, need for recovery, and task performance. The process was evaluated by assessing recruitment, attrition, and survey completion rates, and the degree of participation. Preliminary effects were evaluated by linear mixed model regression analyses to assess changes in mental well-being and work-related vitality between baseline and follow-up. Recruitment appeared feasible, but attrition rates were high (up to 70% in the final Recharge week), and the degree of participation decreased over time. We showed statistically significant, albeit small, increases in well-being at T3 (unstandardized &#x3b2; coefficient=2.08, 95% CI 0.33-3.84), with progressively larger improvements in the analyses among those who started at least 1, 2, and all 3 Recharge weeks (unstandardized &#x3b2; coefficient=3.27, 95% CI 1.09-5.45). Results for work-related vitality were mixed. The need for recovery remained unchanged, task performance increased slightly at T3 (unstandardized &#x3b2; coefficient=0.16, 95% CI 0.07-0.24). Work ability showed a small, but statistically significant, decline across follow-up (unstandardized &#x3b2; coefficient=-0.46, 95% CI -0.64 to -0.29). This app-based worksite health promotion program might be feasible to implement in a university hospital setting and shows potential to slightly improve mental well-being, but primarily for a selective group of highly educated, health-conscious women. While these findings support further investigation in a randomized controlled trial in similar university hospital settings, they also highlight the need for more participatory study designs to improve the tailoring of program components and engagement of underrepresented groups, as well as for a supportive culture and population-based approaches at the organizational level.

Problematic social media use (PSMU) has become a critical public health concern. However, little is known about how the associations between PSMU, mental health, and substance use differ depending on participation in distinct types of extracurricular activities. The objective of this study is to examine how the associations between PSMU, mental health, and substance use vary across network models that include different types of extracurricular activities. A representative sample of 14,588 Czech adolescents (50.69% boys, mean age 13.6&#x2009;&#xb1;&#x2009;1.7 years) was used from the 2022 Health Behaviour in School-aged Children study. A network analysis based on undirected mixed graphical models was used to assess the associations. Separate networks for each extracurricular activity type were estimated and compared. When individual sports were included in the network, the association between alcohol use and PSMU was no longer observed. In both the community-based activities and individual sports networks, the previously observed positive association between irritability and PSMU-related family conflicts (w&#x2009;=&#x2009;0.05) was absent, and the association between irritability and social media escapism was weaker (w&#x2009;=&#x2009;0.08 &#x2192; 0.03). Only sports-related activity types were negatively associated with losing interest in extracurricular activities due to PSMU, particularly individual sports (w&#x2009;=&#x2009;-&#x2009;0.10). Conversely, community-based activities were positively associated with PSMU-related deception and family conflicts (w&#x2009;=&#x2009;0.05). However, no notable differences in the network structure were observed for artistic activities or team sports. The study underscores the contrastive nature of extracurricular activities and highlights the need for more nuanced approaches when examining their role in PSMU.

The rapid expansion of artificial intelligence (AI) and work digitalization is transforming occupational environments, introducing new psychosocial risks while also creating potential opportunities for improving workplace well-being. However, current evidence remains fragmented and heterogeneous. This scoping review aimed to map and synthesize the existing scientific and grey literature on the impact of AI and work digitalization on mental health, well-being, and psychosocial risks among adult workers. A scoping review was conducted following the Arksey and O'Malley framework and reported according to PRISMA-ScR guidelines. A comprehensive search was performed across multiple databases (PubMed, Scopus, Web of Science, ScienceDirect, Scielo, LILACS, Dialnet, and Google Scholar) and grey literature sources from international occupational health organizations. Studies published between 2016 and 2026 in English and Spanish were included. A total of 43 sources (23 scientific articles and 20 grey literature documents) were analyzed using thematic synthesis. The review explicitly distinguishes between AI-specific occupational exposures and broader digitalization processes to improve conceptual clarity. AI and digitalization were consistently associated with multiple psychosocial risks, including technostress, work intensification, job insecurity, reduced autonomy, and blurred work-life boundaries. Algorithmic management and digital monitoring emerged as key drivers of stress, anxiety, and burnout. However, potential benefits were also identified, such as increased efficiency, flexibility, and professional development, particularly when supported by adequate training and organizational resources. The impact of digitalization was context-dependent and unevenly distributed, disproportionately affecting older workers, lower-skilled employees, and vulnerable groups. Digital and AI literacy emerged as key protective factors. AI and work digitalization represent complex and context-dependent determinants of occupational mental health, with both risks and opportunities depending on organizational, technological, and individual factors. These findings highlight the need for human-centered implementation strategies, strengthened regulatory frameworks, and targeted preventive interventions to mitigate psychosocial risks in digitalized work environments. Given the heterogeneity of the available evidence, findings should be interpreted as exploratory.

BackgroundActive learning methods have gained increasing attention in the field of Occupational Safety and Health (OSH) training due to their potential to enhance learner engagement, knowledge retention, and practical skill development. However, to date, there is limited research that systematically evaluates the application and effectiveness of active learning methodologies in OSH training, particularly with regard to their impact on knowledge retention, behavioural change, and the practical transfer of learning to workplace safety practices.ObjectiveThis review explores a range of active methodologies, such as problem-based learning, project-based learning, simulations, storytelling, virtual reality, augmented reality and immersive virtual reality, with the aim of identifying their effectiveness, key benefits, and implementation challenges.MethodsThis systematic review followed Preferred Reported Items for Reviews and Meta-Analyses (PRISMA) guidelines.ResultsA total of 21 peer-reviewed studies were examined and organised according to their aims, training methods, results, opportunities, and challenges. The findings suggest that immersive technologies and experiential approaches are increasingly adopted to address the limitations of traditional training methods. Despite their positive impact on motivation and learning outcomes, several obstacles remain, including high financial and technical demands and institutional resistance.ConclusionsThis review provides relevant insights for professionals and decision-makers seeking to innovate OSH training practices and calls for further empirical research to support the broader application of active learning strategies in this context.

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This study outlines the revision and content validity process for the Domestic and Community Skills Assessment, Third Edition (DACSA-3). The DACSA-3 is an occupational therapy instrumental activities of daily living (IADL) assessment, which can be used to assess a person with a mental health condition. The DACSA-3 was developed by considering past development and research, technology changes, and current occupational therapy theories. Nine content experts (occupational therapists with mental health experience) were involved in a qualitative and quantitative review of the DACSA-3 to establish content validity using the content validity ratio (CVR) and content validity index (CVI), with recommended minimum thresholds of 0.78. The DACSA-3 was reviewed by two content reviewers (professionals with lived mental health experience) to ensure that recovery oriented language was included. The Initial Interview was retained and updated. The Supporting Interview was removed, because it lacked construct validity. The Observation Checklist was renamed to Context List and updated to include environmental and personal factors that may influence task performance. The Objective Assessment subtests were updated and reduced from 17 to 14 subtests. The money handling, personal presentation, and postage handling subtests were removed, because they were no longer relevant or did not fit the occupational category of IADL. The scoring criteria for each subtest were improved by aligning with the rating scale definitions to prevent discrepancies between ratings and clinical judgement. The CVR of DACSA-3 items ranged from 0.78 to 1.00, and the CVI of the DACSA-3 was 0.98. The DACSA-3 is a revised, contemporary occupational therapy assessment of IADL, which has content validity. The CVR and CVI exceeded the minimum recommended thresholds, and thus, the content validity of the DACSA-3 was established. Modifications were made to the DACSA-3 to reduce the administration time and it no longer contains a screening tool. This study describes how the Domestic and Community Skills Assessment, Third Edition (DACSA&#x2010;3) was updated. The DACSA&#x2010;3 is an occupational therapy test. It can be used to measure the living skills of people with a mental health condition. The update considered earlier research, changes in tasks over time, and current occupational therapy theories. Two content reviewers checked the test to ensure current mental health language was used. Nine occupational therapists then reviewed it step by step to confirm that it was a good measurement of living skills. The Initial Interview was kept and updated. The Supporting Interview was removed because it was not considered a good measurement. The Observation Checklist was renamed the Context List and updated. The subtests were reduced from 17 to 14. The money handling, personal presentation, and postage handling subtests were removed. They were no longer relevant or did not fit with other living skills. The scoring was also improved to reduce differences between ratings and therapist judgement. Overall, the DACSA&#x2010;3 is a current test of living skills. It takes less time to complete and no longer includes a screening tool.

In January 1946, the Journal of Industrial Hygiene and Toxicology published "A Health Survey of Pipe Covering Operations in Constructing Naval Vessels." This cross-sectional epidemiological study is one of the most consequential in the history of industrial hygiene and occupational medicine as it errantly concluded that insulation work on ships using asbestos-containing materials was "&#x2026;not a dangerous occupation." As a consequence of this innocuous conclusion, the U.S. Navy and others neglected to protect insulators and other employees from asbestos dust for the next 25 years, leading to an epidemic of asbestos-related diseases in active and retired workers. Subsequently, attorneys and expert witnesses used this exculpating conclusion to mount "state of the art/science" defenses for asbestos manufacturers in tort actions, arguing that their clients relied on this publication when they failed to protect their own employees from asbestos or warn their customers of the hazard. Both the industrial hygiene and the medical components of this study were deeply flawed. The successor publisher to the original journal has refused to consider retracting this paper, so this catastrophic blunder may remain a part of the literature, available to asbestos tort defense attorneys and their experts. Publishing industry policies and precedent related to retracting very old articles are reviewed.

Prostate cancer treatment can disrupt working life, yet there is limited understanding of how men experience work during and after treatment. This review aimed to synthesise qualitative evidence on prostate cancer survivors' work-related experiences. We searched Ovid MEDLINE, Embase, PsycINFO, CINAHL, and Google Scholar for qualitative research reporting men's work experiences during or after prostate cancer treatment. Screening, quality appraisal, and thematic synthesis followed PRISMA guidelines and the Joanna Briggs Institute Critical Appraisal Tool. The review was registered on PROSPERO (CRD420251083779). Eleven studies involving 302 men were included. Six themes emerged: return-to-work timing and trajectories; financial pressures; support systems; treatment side effects and stigma; adjustments and adaptations; and work identity, values, and priorities. Men described variable return-to-work pathways, influenced by treatment effects such as incontinence. Workplace and family support helped facilitate work participation, while men adapted responsibilities to accommodate health needs. Work held multifaceted meaning, serving as a source of identity and coping, although some men reprioritised their identities toward health and family goals. Men's return to work after prostate cancer is shaped by treatment effects, workplace flexibility, and social support, within the workplace and from family and community support services. Evidence on interventions to support reintegration is limited, highlighting the need for tailored occupational and survivorship strategies. Returning to work involves balancing personal health, workplace demands, and social responsibilities. Survivors can benefit from proactively communicating needs to employers, seeking tailored workplace adjustments, and leveraging support networks to sustain meaningful work participation.

Zoonotic diseases disproportionately burden settings where humans and livestock coexist, yet community-level knowledge, attitudes, and practices (KAP) remain poorly characterized in West Africa. This study aimed to assess KAP regarding zoonotic diseases and document household biosecurity gaps among livestock-keeping community members in Ada East Distrct in Ghana. A concurrent mixed-methods design was employed, integrating a quantitative cross-sectional survey with a qualitative focus group discussion. Livestock-keeping adults were recruited from five health facilities in Ada East District. A structured survey measured knowledge, attitudes, and livestock-handling practices. Composite KAP scores were dichotomized using a modified Bloom's cutoff (&#x2265;60%). Multivariable logistic regression analyses were conducted to identify factors associated with good knowledge, positive attitudes, and good practices. A focus group discussion (FGD) explored perceptions of transmission, livestock management, and outbreak preparedness. Among 252 survey participants, 66.3% demonstrated good overall knowledge of zoonotic diseases; however, only 10.6% had good knowledge of Ebola virus disease symptoms. Positive attitudes were observed in 44.0% of respondents, while 86.9% reported good livestock-handling practices. Education beyond primary school was independently associated with higher odds of good knowledge (adjusted odds ratio (aOR) 1.97, 95% confidence intervals (CI) 1.05-3.69). Animal-related occupations were associated with lower odds of positive attitudes (aOR 0.46, 95% CI 0.25-0.85) but higher odds of good practices (aOR 3.58, 95% CI 1.26-11.8). FGD (n&#x2009;=&#x2009;8) identified bats and sick animals as transmission sources, described economic barriers, and expressed variable beliefs regarding prevention and stigma. These findings highlight the need for locally tailored, One Health-oriented risk communication and biosecurity interventions targeting groups with lower educational attainment and limited access to animal health services.

Asthma is a common chronic condition in childhood. Household secondhand smoke exposure (SHSe) from caregiver smoking is a major, modifiable contributor to poor asthma control. Previous reviews of SHSe interventions have focused broadly on indoor environmental or health outcomes for the general population. The impact of such interventions on pediatric asthma has yet to be systematically reviewed. We aimed to synthesize evidence regarding the effectiveness of caregiver secondhand smoke interventions for improving pediatric asthma outcomes and identify gaps to guide future intervention research. Following Joanna Briggs Institute methods and Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards, we systematically searched PubMed, PsycINFO, CINAHL, Web of Science, and EMBASE. Eligible studies had no publication date restrictions, tested an intervention targeting household SHSe, and reported pediatric asthma-related outcomes. Randomized and quasi-experimental designs were included. Reviewers independently screened records, extracted data, and assessed risk of bias using the Cochrane Risk of Bias tools for randomized and nonrandomized trials. Of 9,832 records screened, 14 studies spanning 13 distinct interventions met the inclusion criteria. Except for 1 study with a single-group pretest-posttest design, all studies were randomized controlled trials. Overall risk of bias was low to moderate, with only 1 study deemed to be at critical risk. Interventions were typically home-based, delivered by health professionals, and incorporated asthma or SHSe education. Nine included a behavioral counseling component, and 6 incorporated caregiver feedback on SHSe. Six interventions improved subjective asthma indicators, such as symptom control, functional status, and unscheduled health care utilization; objective lung function improvements were not found. Behaviorally focused interventions that integrated caregiver feedback with education had the greatest success in reducing short-term SHSe and improving pediatric asthma outcomes. Evidence for long-term benefits remains poor. Lack of homogeneity in intervention content, measurement, and follow-up periods limits comparability. Future longitudinal trials with standardized measurement tools and diverse racial, ethnic, and socioeconomic populations are warranted.

Zoonotic tuberculosis (zTB) remains a blind spot in TB control, sustained less by biological rarity than by diagnostic and surveillance design. Brazil illustrates this gap: despite endemic bovine TB and sustained zoonotic transmission risks, zTB is rarely identified because it is not actively targeted. We show that only two human zTB cases were notified between 2013 and 2024 following introduction of reporting, and six cases are described in the literature. Further detection of mono-pyrazinamide resistance may represent undiagnosed zTB, but diagnostic gaps prevent estimation. By outlining current diagnostic paths, we argue that the human-centric diagnostics obscures occupational, foodborne, and animal-linked infection. Emerging subnational One Health initiatives demonstrate that integrated animal-human surveillance is feasible. Therefore, we propose a risk-based, One Health diagnostic protocol for zTB within the Brazilian public health system, and argue that without structural and policy adaptation, human-TB elimination strategies will continue to exclude zTB by design, not only in Brazil.

Food processing and pharmaceutical sectors demand the finding of new chemical substances from either natural and microbial origin to be applied in commercial products and formulations. However, such industries seek non-conventional solutes and substances that may not only provide improved properties to the new commercial product but also offer health benefits to the consumers. Currently, ectoine, which is a microbial-derived extremolyte, has been identified, produced and extracted with the purpose of new applications in food, cosmetical and pharmaceutical health care formulations. However, despite there is deep research toward its production via biotechnological approaches, recent reports suggest that its purification and isolation represent a current challenge due to its intracellular presence and the complexity of the microbial fermentation system. To date, there is no universal recovery strategy toward such valuable substance, even if the research community is aware of the great potential of this substance, needed solutions for its purification for post-application are still under rigorous investigation. Therefore, the core of this review paper focuses on analyzing the progress toward this tough recovery and isolation of ectoine from different biotechnological systems, giving a critical discussion on the reported cases of the study and relevant strategies involving several downstream processing stages.

Twitter's "EDTWT" community constitutes a prominent online space for eating disorder (ED) discourse, yet large-scale computational characterization remains limited. To characterize EDTWT behavioral patterns, emotional dynamics, thematic structure, and develop automated content classification methods through computational analysis of a three-year dataset. We analyzed 48,341 tweets from 18,587 users (January 2022-February 2025). Analyses included engagement patterns, temporal dynamics, clinical keyword prevalence, multi-method sentiment analysis (TextBlob, VADER, clinical affect lexicons), topic modeling (LDA, NMF), and ensemble-based multi-label classification. User engagement followed a highly skewed distribution in which a small number of highly active users generated the majority of content (62.1% of users posted only once, while the top 10% produced 48.9% of all content), suggesting that a concentrated subset of users may warrant particular clinical attention. Temporal patterns showed a 7.5-fold difference in posting volume between Friday night peaks and Tuesday morning troughs, with consistent nocturnal peaks between 21:00 and 23:00. Clinical keywords appeared in 26.6% of tweets (body image 14.4%, restrictive eating 6.7%, recovery 4.3%). Sentiment was slightly positive (M=0.060, SD=0.282) with moderate subjectivity (M=0.298). Topic modeling revealed ten themes including calorie tracking (13.2%), Spanish (9.7%) and Polish (8.2%) subcommunities, and recovery discourse (9.4%). An ensemble of automated classifiers trained to categorize eating disorder content achieved strong performance (macro F1=0.753, &#x3ba;=0.703, where higher values indicate better classification accuracy), outperforming a biomedical-domain language model by 21.4% on the least frequently occurring content categories. EDTWT exhibits complex heterogeneity with coexisting pro-ED content, recovery discourse, and culturally-specific subcommunities. The concentration of activity among a small number of highly active users enables efficient identification of individuals who may be at elevated risk and in need of targeted support. Automated classification enables scalable content monitoring for digital mental health surveillance and evidence-based platform moderation. This study examined three years of Twitter posts from the eating disorder community known as EDTWT. We analyzed nearly 50,000 tweets from over 18,000 users to understand how people use this online space. We found that a small group of very active users creates most of the content, while many people only post once. Posting activity peaks on Friday nights and late evenings, times when people may feel particularly vulnerable. About one-quarter of tweets mentioned eating disorder symptoms like body image concerns or restrictive eating, though recovery-related content was also present. The community includes people from different countries, with notable Spanish and Polish-speaking groups. Surprisingly, many posts expressed positive emotions, often related to achieving weight loss goals rather than overall wellbeing. We developed computer tools that can automatically identify different types of eating disorder content, which could help social media platforms and mental health professionals monitor these communities more effectively. Our findings suggest that online eating disorder communities are complex spaces where harmful content exists alongside recovery support, requiring thoughtful approaches to both protect vulnerable individuals and preserve helpful peer connections.

Environmental microorganisms are sensitive indicators of aquatic ecosystem disturbance, yet their links with river eco-health remain poorly understood. We investigated water quality, bacterial and fungal communities and socioeconomic factors across source, suburban and urban sections of the Minjiang River. Water quality and microbial diversity exhibited clear spatial gradients consistent with agricultural, industrial and residential activities. Proteobacteria dominated urban bacterial communities, Actinobacteria prevailed in suburban areas and Armatimonadetes were associated with intensive human activities. Fungal assemblages also showed spatial differentiation, with Chytridiomycota dominating upstream, Ascomycota midstream and Basidiomycota downstream. At the genus level, CL500-29 marine group and hgcI-clade were enriched upstream, whereas Limnohabitans and Flavobacterium dominated downstream; Septoria prevailed upstream, while Mycosphaerella, Didymella and Ampelomyces were more abundant downstream. Multivariate analyses (PCA, RDA, Mantel tests) identified TP, TN and DO as key drivers of bacterial communities, while COD, BOD5 and DO primarily shape fungal distributions. Socioeconomic factors, including GDP per capita and population density, also contributed significantly. Predicted functional profiles based on OTUs showed spatial differences in microbial metabolic potential. This study provides a preliminary spatial analysis linking water quality, human activities and microbial communities in an urban river system.

Heat affects farmworker health and productivity. As occupational heat exposure intensifies, cooling devices that extract body heat could protect farmworkers. Companies already market many such technologies to athletes. However, few studies have evaluated their effectiveness, particularly among farmworkers, for whom field-feasibility, workflow integration, and cost-at-scale are critical. In this commentary, we first describe how heat affects farmworker health and review current heat illness prevention standards. We then highlight how cooling devices can augment existing measures and underscore the critical need to test their effectiveness, adaptability, and cost-benefit among farmworkers. Advancing this work requires addressing valid yet surmountable research barriers and building trusted partnerships among researchers, farmworkers, employers, and policymakers. As heat interrupts an increasing number of workdays over time, effective cooling strategies during outdoor work will prove critical to sustaining our nation's food supply.

Gestational environmental chemical exposures are widespread. Some chemicals are known to adversely affect birth outcomes, but many remain understudied. To evaluate associations of gestational exposure to a priori identified chemicals in 10 classes with birth outcomes in a large, diverse US cohort. In the prospective Environmental influences on Child Health Outcomes Cohort study, 5318 mother-child pairs were enrolled from January 1, 2000, to December 31, 2021, with data on gestational urinary chemical concentrations, gestational age at birth, and birth weight. Statistical analysis was performed from January 2024 to February 2026. In single, midgestation (median, 25 weeks [IQR, 21-30 weeks]) urine samples, concentrations of 113 analytes (chemicals or their metabolites) from 10 chemical classes were simultaneously measured: fungicides and herbicides (n&#x2009;=&#x2009;11), insecticides (n&#x2009;=&#x2009;20), halogenated phenols (n&#x2009;=&#x2009;5), organophosphate esters (n&#x2009;=&#x2009;10), benzophenones (n&#x2009;=&#x2009;6), bisphenols (n&#x2009;=&#x2009;14), parabens (n&#x2009;=&#x2009;6), antimicrobials (n&#x2009;=&#x2009;2), phthalates or alternative plasticizers (n&#x2009;=&#x2009;32), and polycyclic aromatic hydrocarbons (PAHs) (n&#x2009;=&#x2009;7). Linear mixed-effects regression models with a random effect for site were used to estimate covariate-adjusted differences in gestational age at birth (days) and birth weight-for-gestational age (BW-GA) z scores per IQR increase in urinary analyte concentrations. In secondary analyses, odds ratios (ORs) for preterm birth and small for gestational age (SGA) were estimated. In the sample of 5318 mother-child pairs, most infants (2667 female [50%]; median gestational age at birth, 39.0 weeks [IQR, 38.0-40.0 weeks]) were born to college-educated (67% [3218 of 4785]), parous (56% [2815 of 5007]) mothers (median age at delivery, 30.7 years [IQR, 26.1-34.3 years]). A total of 43 of 113 analytes (38%) were detected in 50% or more of samples. Multiple phthalates or alternative plasticizers were associated with younger gestational age at birth or lower BW-GA z scores; for example, summed diisononyl phthalate metabolites were associated with a 0.6-day (95% CI, -1.0 to -0.1 days) younger gestational age (preterm birth OR, 1.16 [95% CI, 1.01-1.34]), and summed phthalate or alternative plasticizers were associated with a 0.06 (95% CI, -0.11 to -0.02) lower BW-GA z score (SGA OR, 1.09 [95% CI, 0.93-1.27]). Two halogenated phenols, benzophenone 8, bisphenol F, and several PAHs were associated with lower BW-GA z scores; for example, 1- and 9-hydroxphenanthrene were associated with a 0.04 (95% CI, -0.08 to -0.01) lower BW-GA z score (SGA OR, 1.13 [95% CI, 1.01-1.27]). This large cohort study of diverse US pregnancies found widespread exposure to 10 classes of environmental chemicals, many of which were associated with differences in gestational age at birth or lower BW-GA z scores. These findings indicate that reducing gestational exposure to chemicals, particularly phthalates or alternative plasticizers and PAHs, could promote healthy deliveries and better child outcomes.