Andrea Kaifie

Background: Racial discrimination is associated with negative mental health outcomes among students, yet it remains understudied at German universities. Methods: In a period of two months in 2022 a cross-sectional study was conducted at a German university using an anonymous bilingual online questionnaire for data collection. Results: Among 179 students who had experienced racial discrimination in their lives, 106 (59.2%) reported it at their university. Students and teaching staff were the most frequently reported aggressors. International students were identified to be especially vulnerable. The study group displayed high average scores in the Patient Health Questionnaire (PHQ): 8.1 (SD = 5.9) for anxious, 10.0 (SD = 6.8) for depressive and 8.9 (SD = 6.2) for somatic symptoms. At least moderate symptom severity (score ≥ 10) for anxiety, depression and somatization was found in 31.7%, 47.0% and 40.5% respectively. For anxiety, a score ≥ 10 was significantly more prevalent in the group that experienced racial discrimination at university compared to the group that did not (41.8% vs. 18.9%) ( p < 0.05). Comparable differences were found for somatization symptoms (53.8% vs. 23.5%) ( p < 0.01). Regarding depression, a similar trend was observed (54.5% vs. 37.3%), though not statistically significant ( p = 0.06). Conclusion: The findings imply that experiencing racial discrimination in university is associated with higher levels of anxiety and somatization with a similar trend for depression. As this research field remains understudied, further qualitative and longitudinal research is required.

Percutaneous penetration is an important human exposure route, but it is influenced by multiple factors and can vary greatly between different substances and exposure conditions. Furthermore, skin characteristics such as thickness of different anatomic sites may have an effect on percutaneous absorption. Despite a potential relevance for safety measures, little is yet known for occupationally relevant skin sites, like hands. We conducted a human in vivo study aiming to identify the effect of anatomic sites on percutaneous absorption of 2-phenoxyethanol. Two human volunteers were dermally exposed to 2-phenoxyethanol (loading dose: 0.2 mg/cm ² skin) at seven different anatomic skin sites with areas of 200 and 400 cm ² , respectively. Blood and urine samples were collected and analyzed for 2-phenoxyethanol and its two main metabolites up to 48 h post-exposure. Relative absorption ratios showed moderate site differences ranging from 0.89 to 1.64 (compared to the forearm) as the overall renal recovery was between 23 and 43% of applied 2-phenoxyethanol. Inter-individual variability was in a similar range. A notable influence of the exposed site could, however, be observed for the penetration speed which was highest at the forehead and neck, and slowest at the hand palms. Differing ratios of unmetabolized 2-phenoxyethanol and its main metabolite found in blood point to a site-depending intradermal metabolism. This study revealed major findings concerning the velocity of percutaneous penetration at different skin sites, which is relevant for adequate skin protection. The obtained data broaden the knowledge about site-related variations in percutaneous absorption and thus can improve future toxicological evaluations.

Dermal exposure to polycyclic aromatic hydrocarbons (PAHs) and UV irradiation in occupational and environmental settings poses a health risk by inducing skin toxicity, including immunomodulatory effects. This study investigated the effects of benzo[a]pyrene (B[a]P), a well-characterized PAH, at three concentrations (0.04 nM, 4 nM, and 4 µM) and UV irradiation on human monocytic U937 cells, employing both single and combined exposure scenarios. An integrated metabolomics and toxicological approach was utilized to assess cellular responses, with a focus on understanding the immunometabolic effects of these exposures. Our findings revealed that only the highest B[a]P concentration in combination with UV irradiation resulted in significant metabolic dysregulation and impaired cellular function. Notably, we observed a pronounced downregulation of glutaminolysis, a critical metabolic pathway for cellular energy production and biosynthesis. This was evidenced by decreased levels of glutamate and key intermediates within the tricarboxylic acid cycle (e.g., succinate, fumarate, malate, and citrate), as well as reduced levels of glycine, a precursor for glutathione synthesis. In parallel, toxicological assays revealed increased levels of oxidative stress markers, lipid peroxidation, and enhanced DNA damage. Furthermore, the combined exposure led to alterations in tryptophan metabolism and dysregulation of lipid species, particularly sphingolipids and phosphatidylinositols. These findings lead us to propose the hypothesis that metabolic disruption, specifically the impairment of glutaminolysis, initiated a cascade of events, including increased oxidative stress, lipid peroxidation, and ultimately, ferroptosis in our study. Our results indicate that the combined exposure to UV irradiation and B[a]P can induce immunometabolic reprogramming and significantly contribute to the pathogenesis of inflammatory skin diseases.

News from occupational medicine: ICOH appoints Andrea Kaifie-Pechmann as National Secretary of Germany The International Commission on Occupational Health (ICOH) has appointed Professor Andrea Kaifie-Pechmann as National Secretary for Germany. Ms. Kaifie-Pechmann is the Director of the Institute and Polyclinic for Occupational, Social, and Environmental Medicine in Erlangen, head of the company medical service there, a specialist in occupational medicine, a specialist in general medicine, and holds a Master of Science in Public Health with a focus on epidemiology and prevention. In the following interview, she answers a few questions about her new role.

In highly dioxin exposed populations, an elevated cancer risk and cancer mortality has been described. Environmental background exposure and cancer risk has not been analyzed systematically, so far. We conducted a structured review in order to identify relevant studies. Using the PECO scheme we included altogether 13 studies from initially 4,983 articles. Epidemiological data from the included studies did not indicate an increased risk of cancer or increased cancer mortality for all cancer, breast cancer, and sarcoma caused by dietary intake of dioxins. For Non-Hodgkin`s lymphoma, the study situation was in parts inconsistent showing for example an increased risk for DL-PCBs in one study and for furans in another study. Several studies evaluating the effect of dietary dioxin exposure and elevated cancer risk or cancer mortality did not observe a clear association. For Non-Hodgkin`s lymphoma further investigations are needed due to inconsistent results among the studies.

Objectives: Increasing heatwaves pose a significant health risk. This study investigates the impact of heatwaves on staff in outpatient care services in a large city in western Germany. Methods: A cross-sectional survey was conducted from March to June 2023, which targeted the managers of 78 outpatient nursing services. The 33-item questionnaire addressed attitudes toward climate change, health impacts on patients and staff, and potential measures to improve working conditions during heatwaves. Results: Of the 40 services that participated, 90% had not received training on climate adaptation, 38% felt uninformed about heat-related measures, and 50% requested more time for caregiving duties during heatwaves. Guidelines for heatwaves were supported by 78% of participants, and 75% wanted more heat-protection training. Conclusions: Outpatient care services require more active involvement in heat-protection planning to safeguard staff as heatwaves become more frequent.

Primary care and occupational medicine as team play – opportunities and challenges of sector-connecting care in the living environment Cross-sectoral healthcare plays a central role in providing people with holistic and continuous care. In particular, the cooperation between general practitioners and occupational physicians plays a crucial role here.

Background/Objectives: A person-under-train (PUT) incident is a traumatic event for train drivers that can result in serious health consequences. This systematic review aimed to identify and synthesize evidence on these health effects, including post-traumatic stress disorder (PTSD), sickness absence (SA), and other related mental health outcomes. Methods: Following the PECO scheme, we searched the PubMed, Web of Science, and Embase databases for studies published between 1980 and 2021. We included cross-sectional, case–control, prospective, and interventional studies focusing on train drivers exposed to PUT incidents. Data synthesis followed PRISMA guidelines, with quality appraisal using the Downs and Black checklist. Results: The search was conducted on 22 September 2022, resulting in 3673 records. Nine studies were included, involving a total of 3425 participants. PTSD prevalence ranged from 0% to 55.3%, depending on study design and timing of data collection. Risk factors included repeated exposure, lack of social support, and proximity to the victim. SA varied widely, with durations ranging from 1 day to over 6 months. Drivers frequently reported depression, somatoform disorders, and other long-term psychological impacts. Conclusions: PUT incidents significantly affect the mental health of train drivers and their ability to return to work, frequently leading to extended sickness absence. The timely identification of at-risk individuals and the implementation of best-practice interventions could mitigate long-term effects. Future research should explore standardized follow-up periods to improve comparability.