Hygiene

The broad variety of measures that governments worldwide took against the COVID-19 pandemic led to restrictions in our everyday life, including the practice of sports such as rowing. This study aimed to examine changes in the daily life of rowers and their rowing engagement. We distributed an online questionnaire in German among rowers in 2021. In total, 234 (48.7% females, mean age 45.01 years, SD 16.94) participants met the inclusion criteria. We found that the amount of time spent rowing was significantly lower during the COVID-19 crisis. Additionally, we detected a notable shift in the rowing landscape, with a marked increase in home-based training and a complete cessation of rowing activities. Moreover, the life satisfaction of both female and male rowers witnessed a significant decline during the pandemic when compared to before. The present findings showed that the pandemic led to far-reaching changes in sports activities among rowers. Most rowers had to deal with negative effects not only on their rowing engagement, but also on life satisfaction. In view of future pandemics, it becomes crucial to prioritize and ensure the continuity of active sports engagement, including that of rowers, in a safe and secure manner. Full article

The mandatory COVID-19 vaccination has been suggested as a strategy to increase vaccination uptake; however, there are doubts about its legitimacy as a measure. This study aimed to explore in depth the opinions of the Cypriot population regarding mandatory vaccination against COVID-19. Qualitative analysis of responses to an open-ended question was included as part of an anonymous, online, cross-sectional survey of the general population of Cyprus. A thematic analysis was performed by reading the responses and developing a coding frame. Descriptive analysis was performed on the sociodemographic and COVID-19-vaccine-related information. A total of 311 participants responded to the open-ended question, and the thematic analysis yielded two main themes: “Vaccination Perceptions and Challenges” and “Mandatory Vaccination Policies and Societal Impact.” Within these themes, participants expressed diverse opinions on universal and targeted mandatory vaccination, highlighting concerns about insufficient research, gaps in communication, and potential side effects. Views also varied on topics such as protective measures, interdisciplinary collaboration, vaccine side effects, human rights, and societal divisions. Criticisms encompassed political motives, skepticism towards the pandemic, and considerations of individual freedoms. In summary, the findings highlighted the intricate and varied perspectives surrounding the issue of mandatory COVID-19 vaccination, which can be valuable for policymakers and public health officials in designing targeted vaccination strategies. To optimize vaccination programs, policymakers and public health officials should prioritize trust, communication, and individual autonomy. Full article

Microbial colonization on various surfaces is a serious problem. Biofilms from these microbes pose serious health and economic threats. In addition, the recent global pandemic has also attracted great interest in the latest techniques and technology for antimicrobial surface coatings. Incorporating antimicrobial nanocompounds into materials to prevent microbial adhesion or kill microorganisms has become an increasingly challenging strategy. Recently, many studies have been conducted on the preparation of nanomaterials with antimicrobial properties against diseases caused by pathogens. Despite tremendous efforts to produce antibacterial materials, there is little systematic research on antimicrobial coatings. In this article, we set out to provide a comprehensive overview of nanomaterials-based antimicrobial coatings that can be used to stop the spread of contamination to surfaces. Typically, surfaces can be simple deposits of nanomaterials, embedded nanomaterials, as well as nanotubes, nanowires, nanocolumns, nanofibers, nanoneedles, and bio-inspired structures. Full article

Gastric cancer (GC) is a significant global public health problem. It is the third leading cause of cancer-related mortality despite its decline in incidence since the past five decades. The incidence of GC varies between regions, and this heterogeneity is attributed to multi-factors, including infectious, environmental, and genetic traits. Most of the GC cases are linked to Helicobacter pylori (H. pylori) infection. Understanding the etiology, epidemiology, and risk factors of GC is necessary for the prevention and targeted treatment of the disease. In this study, we synthesized published studies, including data from the “International Agency for Research on Cancer GLOBOCAN” to narratively provide an updated overview of the recent global trends, etiology, known risk factors, pathogenesis, hallmarks, treatment, and prevention of GC. One area that significantly advanced GC research was understanding the mechanisms by which H. pylori colonizes humans and mediates physiological, microbiological, immune, and histologic features of the gut. However, there are still gaps present in understanding the molecular mechanisms underlying the initiation and progression of GC. Full article

To evaluate the decontamination effect of Inspexx 210, a cold-water disinfectant containing peracetic acid and peroctanoic acid (0.16%), knives contaminated with E. coli ATCC 25922 and S. aureus ATCC 29213 as well as naturally contaminated knives collected from different slaughtering steps of an abattoir were examined. Treatment with Inspexx 210 for 15 s reduced mean E. coli counts by 5.95 log CFU/cm² and mean S. aureus counts by 6.24 log CFU/cm². Contamination of the knives first with fat and thereafter with the bacteria led to lower mean reductions of 5.52 log CFU/cm² for E. coli and 3.58 log CFU/cm² for S. aureus. Contamination first with blood and thereafter with the bacteria had the greatest negative impact on the inactivation effect, with mean reductions of 3.70 log CFU/cm² for E. coli and 1.55 log CFU/cm² for S. aureus. Rinsing the blood with tap water before contamination with S. aureus led to the reduction of 5.50 log CFU/cm². Treatment with Inspexx 210 was also assessed for naturally contaminated knives from an abattoir. After treatment under routine conditions, colony counts were 0.09 log CFU/cm² (pigs) and 0.35 log CFU/cm² (sheep) in the wet area and below detection limit (pigs) and 0.91 (sheep) in the clean area. This study shows that Inspexx 210 can be an adequate alternative to knife decontamination with 82 °C hot water, but pre-rinsing is recommended especially in dirty process steps with a high contamination of blood and fat. Full article

The reduced life cycle of electrical goods has contributed to a fast-growing occupational and environmental health issue arising from increased electronic waste (e-waste) in most developing countries. E-waste is processed informally in these countries, and in most cases, it is beyond the reach of official governance and is characterized by a lack of regulation, structure, and any form of license to operate. Assessing the implications of e-waste recycler safety knowledge, awareness, and practice levels is seen as a panacea for developing tailored interventions. We performed a cross-sectional study among 323 e-waste workers located in Agbogbloshie waste dumpsite, Accra, Ghana, to measure their knowledge, awareness, and practice, as well as their perceived safety and behavioral control. A significant negative correlation was found between participants safety knowledge and their safety practices (r (323) = −0.19, p < 0.01), as well as a similar correlation with perceived safety control among the study group (r (323) = −0.27, p < 0.01). In addition, the hygiene rating among the group was adjudged poor as there was no established relationship found with their perceived safety control. To help bridge the gap around e-waste workers safety knowledge, awareness, and practices, it is pertinent for local and international players to take into consideration the shared values and beliefs among the group and work alongside the group in developing a set of policies that will help improve their safety and health. Full article

Foodborne diseases pose a primary global health concern, affecting people across high- and low-income countries, with the less privileged often suffering the most. This research proposes the adoption of a Hygiene Rating Scheme (HRS) to help customers make informed decisions about where and what to eat. The scheme has already demonstrated success in countries such as the United States, Northern Ireland, Wales, and England in reducing the risk of foodborne diseases. This article highlights the significance of Nigeria embracing the HRS and its potential to combat foodborne diseases. Adopting the scheme will incentivize food business owners to improve their sanitary conditions and food quality by implementing Good Manufacturing Practices (GMPs). The scheme’s transparent inspection results make it easier for customers to choose higher-rated outlets, reducing the cost of disease outbreaks and promoting public health. In conclusion, the HRS provides a practical solution to addressing the issue of foodborne diseases and promoting food safety. Full article

With the increased uptake of the COVID-19 vaccination in 2021, universities resumed face-to-face classes and clinical placements. However, even with incentives, some individuals chose not to receive a vaccination due to personal beliefs and other reasons. Understanding motivations for vaccination uptake or vaccine hesitancy is important to help develop future public health strategies. Therefore, a cross-sectional online survey was carried out among students and staff in a UK university to assess the level of vaccination and explore their views on the acceptability of incentives that may encourage uptake. Almost three quarters (74.4%) of the sample had received at least one dose of a COVID-19 vaccine with a higher proportion of staff receiving a vaccine compared to students (80.0% vs. 70.6%, p < 0.001). Vaccine hesitancy or refusal was due to the perceived lack of research and knowledge of the potential long-term effects at the time of vaccination, religious, personal and ethical beliefs and feeling like vaccinations should not be used to restrict social events, travel and medical challenges. This study shows that university staff and students had a relatively high uptake of the COVID-19 vaccination. However, the findings indicate that nearly 20 percent were unsure or unwilling to take the vaccination, therefore suggesting that clearer information and motivational strategies are needed to support the roll out of new vaccines. Full article

The disinfection procedures aim to reduce the microbial load, but there are doubts about the risks of contamination spreading into the lumens of devices, such as three-way stopcocks (3-WS). This study aimed at an in vitro evaluation of the antibacterial procedure of manual friction of 3-WS intentionally contaminated and to determine the solution dispersion into the lumens. Laboratory experiments were developed in two steps: evaluation of bacterial spread through intentional contamination with Staphylococcus aureus and Pseudomonas aeruginosa, and alcohol dispersion into the 3-WS lumens. After manual friction of the 3-WS with saline solution at 0.85% (w/v) [control group], S. aureus and P. aeruginosa were isolated in the lumens of 55.6% and 27.8% of the devices, respectively. However, after the disinfection of the 3-WS with ethyl alcohol at 70% (w/v), there was no bacterial contamination in the lumens of the 3-WS. On the other hand, the solution dispersion (dye) into the lumens was evidenced by two different techniques: Durham tubes (5.6%) and swabs (46.3%). The manual friction of the 3-WS with ethyl alcohol at 70% demonstrated antibacterial efficacy, but it refers to reflections on the risk of solution diffusion into the venous network and the inherent clinical practice situations and patient safety. Full article

As the COVID-19 pandemic begins to abate and national public health systems are treating the SARS-CoV-2 virus as endemic, many public health measures are no longer mandated but remain recommended with voluntary participation. One of these is the wearing of fitted face masks, initially mandated to contain, or at least slow, the spread of SARS-CoV-2, which is primarily transmitted via aerosols emitted while breathing, coughing, or sneezing. Although the habit of once wearing fitted face masks recedes into memory for much of the population, so does the knowledge of the various types of masks that were once en vogue. To create a record for the future, this paper provides the first comprehensive documentation of the nature and range of fitted facemasks that circulated during the COVID-19 pandemic. Full article

This scoping review addresses bacterial contamination of antiseptics, low-level disinfectants, and hand hygiene products in healthcare settings in high-income countries. Over 70 years, 114 articles were found: 68 outbreaks, 13 pseudo-outbreaks and 33 cross-sectional surveys. Outbreaks affected median 29 (1–151) patients, extended for 26 (1–156) weeks and had a case fatality of 0.0% (0.0–60.0%). Most (72.8%) (pseudo-)outbreaks were caused by water-based chlorhexidine (CHG), quaternary ammonium compounds (QUAT) and the combination CHG–QUAT. Contaminating bacteria were nonfermentative Gram-negative rods (87.6% (pseudo-)outbreaks), mainly Burkholderia cepacia, Pseudomonas aeruginosa and Achromobacter spp.) and Enterobacterales (29.6%, 24/81), mostly Serratia spp.). Risk factors were at the level of the bacteria (natural resistance to CHG and QUAT), containers (design and functioning, presence of cork and cotton, biofilm formation), preparation (nonsterile water, overdilution) and practices (too long expiry dates, inappropriate container reprocessing, topping up of containers and deviation from procedures). Transmission occurred through direct contact (antiseptics), contact with semicritical items (disinfectants) and were handborne (soaps). During recent decades, reports of soap contaminated with Enterobacterales emerged and nationwide outbreaks of intrinsically contaminated CHG occurred. Outstanding issues comprise intrinsic contamination, implementation of antiseptic stewardship, the role of unit doses and sterile products, transmission studies, biofilm control and understanding healthcare providers’ perceptions. Full article

Ozone is a triatomic allotropic modification of oxygen with very high oxidation potential and strong antimicrobial properties, and can be used as a disinfecting agent. The aim of this work was to investigate the effectiveness of gaseous ozone in reducing the number of bacteria and the total biomass of E. coli biofilm using different methods of quantification and detection. Biofilm of all tested clinical isolates and standard strain was grown on ceramic tiles with dimensions of 1.0 × 1.0 cm over 24 h. These plates were then treated with gaseous ozone for 1 h. After washing, CFU/cm² was determined, ATP bioluminescence was measured with a luminometer, and the total biomass reduction was measured after crystal-violet staining. Gaseous ozone proved to be very effective in destroying the created bacterial biofilm on ceramic tiles. Treatment caused a reduction in total bacteria number of up to 2.00 log₁₀CFU/cm², followed by a reduction in total biomass of up to 61.40%. Inhibition rates varied from 35.80% to 99.41%, depending on the method of quantification used. All methods used in this study are effective in determining the anti-biofilm activity of gaseous ozone, but more research is needed. Full article

We conducted a systematic review of healthcare-associated outbreaks and cross-sectional surveys related to the contamination of antiseptics, disinfectants, and hand hygiene products in healthcare settings in low- and middle-income countries (PROSPERO CRD42021266271). Risk of bias was assessed by selected items of the ORION and MICRO checklists. From 1977 onwards, 13 outbreaks and 25 cross-sectional surveys were found: 20 from Asia and 13 from Africa. Products most associated with outbreaks were water-based chlorhexidine, chlorhexidine-quaternary ammonium compound combinations (7/13), and liquid soap products (4/13). Enterobacterales (including multidrug-resistant Enterobacter cloacae, Klebsiella pneumoniae, and Serratia marcescens) and non-fermentative Gram-negative rods were found in 5 and 7 outbreaks and in 34.1% and 42.6% of 164 isolates, respectively, from cross-sectional surveys. Risk factors included preparation (place, utensils, or tap water high and incorrect dilutions), containers (reused, recycled, or inadequate reprocessing), and practices (topping-up or too long use). Potential biases were microbiological methods (neutralizers) and incomplete description of products’ identity, selection, and denominators. External validity was compromised by low representativeness for remote rural settings and low-income countries in sub-Saharan Africa. Outstanding issues were water quality, biofilm control, field-adapted containers and reprocessing, in-country production, healthcare providers’ practices, and the role of bar soap. A list of “best practices” to mitigate product contamination was compiled. Full article

The aim of this study was to assess the associations between HIV status, SARS-CoV-2 infection, increase in use of psychoactive substances and oral ulcers among people who use psychoactive substances. This was a secondary analysis of the data of 1087 people who used psychoactive substances collected during the first wave of the COVID-19 pandemic. The data extracted were confounding (age, sex, the highest level of education attained, employment status, emotional distress status), dependent (oral ulcers) and independent (SARS-CoV-2 infection, increase in alcohol consumption, smoking and use of other psychoactive substances, living with HIV) variables. A multivariate logistic regression model was constructed to determine the associations between the dependent and independent variables after adjusting for the confounding variables. Participants who had a history of SARS-CoV-2 infection (AOR:10.37) and people living with HIV (AOR:1.91) had higher odds of reporting oral ulcers. The finding suggests that people who used psychoactive substances, had COVID-19 and lived with HIV were at increased risk for oral ulcers during the first wave of the COVID-19 pandemic. Increased use of psychoactive substances was not associated with a significant increase in the risk for oral ulcers. Further research is needed to better understand the reasons for these findings. Full article

Good access and appropriate use of Water, Sanitation and Hygiene (WASH) is important in the control, elimination and eradication of a number of neglected tropical diseases (NTDs). Poor WASH access and use may explain continued high trachoma prevalence in Nabilatuk district, Uganda. This study aimed to investigate the level of WASH access and use through different WASH data collection methods and the triangulation of their results. A mixed-methods cross-sectional study was conducted in 30 households in Nabilatuk district, from 10 households in each of three nomadic villages. The data collection methods used were: (1) direct observations of routine WASH behaviours; (2) structured quantitative household questionnaires; (3) demonstrations of specific WASH behaviours. With regards to access, observations indicated less WASH access and use compared with questionnaire responses: the questionnaire indicated all households had access to an improved water source, but 70% had a >30-min round-trip, and no households had access to an improved latrine, whereas some observations indicated longer water collection times. In terms of behaviour, there were also differences between the data collection methods, with demonstrations revealing knowledge of good practice, such as thorough handwashing, but this was not routinely observed in the observations. Further systematic investigation of barriers to appropriate WASH access and use in the local context is needed, as is the development of feasible, valid and reliable WASH access and use assessment methods for use in national NTD programmes. Full article

People’s need for information and communication concerning health has emerged from many sources, even for important aspects related to the COVID-19 pandemic. The challenges of those who want to respond to this need are mainly related to which design characteristics could better support their aim. Thus, this article first examines a selected list of examples of different approaches of interventions targeted at citizens aimed at increasing health knowledge. Successively our recent experience regarding a new tool developed to support people’s health by promoting communication about citizens’ approach towards pharmaceuticals is discussed. In addition, here we propose that a similar methodological approach may be useful also to highlight people's critical issues and suggestions regarding health care system, i.e., factors that could play a pivotal role in a pandemic scenario. Our experience in the local context through an integrated strategy can be useful to address key factors concerning people’s approach to medicines, and approach to health care system even during a pandemic scenario. Overall these examples of past experience show how some approaches could support the understanding of suitable future, community-level, interventions to enhance information and communication about health and care. Full article

Golf is a very popular outdoor sport played worldwide by people from various socio-economic backgrounds. During the COVID-19 pandemic, lockdowns and quarantine restrictions led to closures of indoor and outdoor sport facilities and thus also affected the access to golf courses. This study aimed at elucidating perceptions of golfers regarding the impact of the crisis on their sport. We surveyed a sample of golfers in German-speaking countries (primarily Austria and Germany) from March to June 2021. A content analysis on golfers’ responses (n = 923) to an open-ended question on their feelings and engagement in alternative ways of physical activity in light of closed sport facilities was performed. More than 23% of the comments concerned negative feelings on how the pandemic impacted the surveyed golfers, especially due to reluctance to accept the closure of outdoor sports facilities. Almost all participants stated to perform alternative outdoor sports, mostly hiking, biking, walking, and running. In times of a pandemic, public spaces should be designed to allow for safe physical activity to maintain a mentally and physically fit population. In this context, policy makers should provide hygiene concepts that allow for minimal disturbance of sport routines, especially in regard to outdoor sports such as golf. Full article

The COVID-19 pandemic is a source of mental stress, particularly for special populations. The present study identified the associations between emotional distress and HIV status among adults in 152 countries during the first wave of the pandemic. This was a cross-sectional study that gathered data via an online survey carried out between July and December 2020. The dependent variable was emotional distress (frustration/boredom, anxiety, depression, loneliness, anger, or grief/feeling of loss), and the independent variable was HIV status (positive or negative). The confounding factors were sociodemographic variables (age, sex, education level, and employment status). Multivariable logistic regression analyses were performed to assess the associations between the independent and dependent variables after adjusting for confounders. Of the 16,866 participants, 905 (5.4%) reported living with HIV. Of these, 188 (20.8%) felt frustrated/bored, 238 (26.3%) anxious, 160 (17.7%) depressed, 148 (16.4%) lonely, 84 (9.3%) angry, and 53 (5.9%) grief/a sense of loss. Individuals living with HIV had higher odds of feeling anxious (AOR:1.64), depressed (AOR:1.80), and lonely (AOR:1.35) when compared to people living without HIV. This study reveals that the COVID-19 pandemic can exacerbate emotional stress for those living with HIV, and the system in which COVID-19 impacts emotional health among different sociodemographic groups introduces further complexities regarding this observed effect. Full article

Listeria monocytogenes is an ubiquitously occurring foodborne bacterial pathogen known to contaminate foods during the production processes. To assess the presence and persistence of L. monocytogenes in Danish ready-to-eat (RTE) food production companies in response to a Listeria awareness campaign, the production environment of selected companies were sampled in 2016 and in 2020. Whole genome sequencing (WGS) was performed to characterize the isolates (n = 50, plus 35 isolates obtained from the routine surveillance during 2016–2020), including investigation of the presence of virulence, persistence and resistance genes. The number of companies that tested positive by culture was 17/39 (43.6%) in 2016 and 11/34 (32.4%) in 2020, indicating a limited effect of the campaign. WGS analyses of the 85 isolates showed that the most common sequence types (STs) were ST8 and ST121. The single nucleotide polymorphism (SNP) analysis showed that isolates coming from the same company and belonging to the same ST exhibited <10 SNP differences regardless of the sampling year and whether the samples came from the environment or products, indicating the persistence of the specific STs. Several prevalent STs were found in clinical cases concurrently, including genetically similar isolates. This highlights the issue of persistent L. monocytogenes in the food production environment and the need for improved risk communication and mitigation strategies. Full article