Rhonda Spencer-Hwang, DrPH; Xochitl Torres, MPH; Johanny Valladares, MBA; Marco...

Ambient air pollutants are known risk factors for cardiovascular disease (CVD) morbidity and mortality with significant racial disparities. However, few studies have explored racial differences among highly susceptible subpopulations, such as renal transplant recipients (RTRs). Despite improvements in quality of life after transplantation, CVD remains the major cause of mortality, especially among Black recipients. This study aimed to evaluate potential racial differences in the association between long-term levels of PM_2.5 and the risk of all-cause, total CVD, and coronary heart disease (CHD) mortality among RTRs. This retrospective study consists of 93,857 non-smoking adults who received a renal transplant between 2001 and 2015. Time-dependent Cox regression was used to assess the association between annual concentrations of PM_2.5 and mortality risk. In the multivariable-adjusted models, a 10 μg/m³ increase in ambient PM_2.5 levels found increased risk of all-cause (HR = 3.45, 95% CI: 3.08–3.78), CVD (HR = 2.38, 95% CI: 1.94–2.92), and CHD mortality (HR = 3.10, 95% CI: 1.96–4.90). Black recipients had higher risks of all-cause (HR = 4.09, 95% CI: 3.43–4.88) and CHD mortality (HR = 6.73, 95% CI: 2.96–15.32). High levels of ambient PM_2.5 were associated with all-cause, CVD, and CHD mortality. The association tended to be higher among Black recipients than non-Blacks.

Context: Since the initial outbreak of COVID-19, health professionals—both clinical health care, as well as public health concentrations—have faced tremendous pressures. A growing body of literature indicates the pandemic has magnified already prevalent burnout rates among clinical health professionals and to what extent for public health professionals remains to be determined. Objective: This study purpose is to conduct a systematic review of literature examining burnout prevalence among public health professionals before and during the COVID-19 pandemic—nationally and internationally—with identification of potential risk factors. Design: We conducted a literature search in PubMed, EMBASE, PsycINFO, SocINDEX, and ClinicalKey since inception through April 4, 2023. Inclusion criteria included peer-reviewed, original research studies (qualitative or quantitative), in English, assessing prevalence of, or risk factors for, burnout in public health professionals. Two authors independently screened abstracts, titles, full report of studies and abstracted data related to burnout. This review was conducted using Joanna Briggs Institute Systematic Reviews guidelines and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines with narrative synthesis. Protocol for this review registered on PROSPERO (CRD42023424468). Results: Of 3327 health-related articles mentioning burnout, 15 met inclusion criteria (11 quantitative and 4 qualitative) with 10 in international settings and 5 in US majority of quantitative studies were from international settings and only 1 in United States. Seventy-eight percent of studies that included prevalence data, exhibited a burnout prevalence greater than 50% (with a range of 19%-81%). The pandemic likely heightened (13% increase) already elevated burnout prevalence. Major risk factors identified included overwork, lack of support, changing roles, and full-time employment status, though many risk factors had not been studied in the United States. Conclusions: Burnout is prevalent among public health professionals, nationally and internationally, and likely heightened by the COVID-19 pandemic. More research is warranted assessing burnout among differing public health concentrations and interventions developed. Public health is an essential framework for protecting and promoting health nationally and internationally, and we need to ensure and support solidity of that framework.

Air pollution is a significant health threat around the world. Young children are a more vulnerable population. Environmental Protection Agency (EPA) and World Health Organizations (WHO) guidelines may not adequately protect them. Given children’s rapid growth, it is important to review studies, consider the weight of evidence, and identify knowledge gaps. Our purpose was to conduct a systematic literature review of epidemiological studies of adverse health outcomes not previously considered; specifically, we reviewed evidence for traffic-related air pollution (TRAP) CO, NO₂, SO₂, O₃, PM₁₀, and PM_2.5 in children ≤ 5 years in age, with special attention to adverse effects occurring within current air pollutant guidelines. Data sources are electronic search of PubMed, MEDLINE, and Google Scholar. Articles on air pollutants and additional health outcomes in children (0–5 years), between Jan. 1997 and Dec. 2018. Search included terms such as “air pollution, children, and adverse effects”. Fifty-two studies met the inclusion criteria. Seven (7) health outcome categories were identified: respiratory diseases; developmental disorders; allergies, eczema, and allergic rhinitis; ear infections; cancer; obesity; and others, with greatest associations for respiratory and developmental disorders. Strongest findings were for NO₂, O₃, PM₁₀, and PM_2.5, and most health effects reviewed occurred within WHO limits. Our findings are pertinent for health professionals, researchers, government officials, and others to collaboratively support policy efforts toward exposure reductions for pregnant women and children to prevent acute and chronic diseases. This is critical for building a culture of health and ensuring health equity for vulnerable populations.