Health, wellbeing, and the impact of Corona in older adults in Dresden, Germany: the LAB60+ study

Introduction

As the proportion of older people increases, it is necessary to evaluate their health and well-being to identify measures to promote healthy ageing. Moreover, the COVID-19 pandemic has impacted older adults’ health- not just through the infection itself, but also due to infection protection ordinances.

Methods

LAB60+ is a population-based cross-sectional study investigating, among other things, the physical and mental health of older adults. Residents of Dresden aged 60 years and older were invited to participate in the first half of 2021. Participants answered questions on their habits, health status and wellbeing, using, among others, the Short Form-8 Health Survey and the WHO wellbeing index.

Results

2399 people participated in the study (40% response). Participants assessed their physical health similar to the German population. The most common chronic conditions were hypertension (54%), chronic pain (32%) and osteoarthritis (31%). 42% of the participants were overweight and 20% were obese. One-fifth did not engage in physical activity: this number increased with age and decreased socioeconomic status. Participants reported lower levels of wellbeing compared to the German population (58 vs. 67 pts.). One-third had higher levels of depressiveness and half reported an increase in their experienced loneliness due to the pandemic. 34% participated in risky alcohol consumption, but it did not markedly change during the pandemic. The greatest negative impact of the pandemic on health behaviors was physical activity: more than one-third exercised less compared to the time before the pandemic.

Conclusions

Physical health was comparable to the German population, while depressivity was higher, perhaps due to the pandemic. Age-appropriate interventions should especially target an increase in physical activity. It is important to take measures to reduce the possible negative effects of the pandemic, such as increased loneliness or reduced physical activity.

Key messages

• This is the first study on health and wellbeing on older adults (60+ years) in the city of Dresden, Germany.

• The COVID-19 pandemic had a high impact on older adults’ physical activity and loneliness.

Occupational hazards and early retirement: German National Cohort (NAKO) baseline distributions

Background

Despite measures to ensure occupational safety, harmful workplace conditions that negatively impact worker health persist. The baseline assessment of the German National Cohort (NAKO) provides a basis for determining the prevalence of occupational hazards and early retirement (due to health reasons).

Methods

From 2014 to 2017, the NAKO examined 205,141 participants aged 20-69 years at 18 study centers across Germany. Working participants were asked about exposure to airborne particulates, occupational noise, evening and night work, sick days, presenteeism, and personal safety equipment use (respiratory masks, hearing protection). The assessment also included questions on retirement. We examined the distributions descriptively.

Results

A total of 84.2% (n = 172,766) participants were ever employed. Of these participants, 7.9% reported ever working in a job with dust or air particulate exposure where a respiratory mask was required for at least one year. However, nearly one-third (31.6%) of the particulate-exposed workers reported not having worn a mask. 11.4% worked at least a year in a job that required hearing protection, but 27.2% of noise-exposed workers did not comply with this safety measure. Over half of the workers sometimes worked between 6 and 10 pm, and 18.7% sometimes worked at night (11 pm to 6 am) in the last three months. On average, participants used 10.5 sick days in the previous year, and the 12-month prevalence of going to work sick at least one day (presenteeism) was 64.9%. Nearly one-fourth (24.4%; n = 9043) of retirees reported early retirement due to health reasons.

Conclusions

Hazardous working conditions were common, and there was only partial compliance with the use of available personal safety equipment and measures. The NAKO provides a basis for examining the distribution of occupational exposures in Germany, and future prospective data will permit an evaluation of the effectiveness of preventative regulations.

Key messages

Current and cumulative night shift work and subclinical atherosclerosis: results of the Gutenberg Health Study

PURPOSE

The study examines the association between exposure to current and cumulative night shift work and subclinical parameters of atherosclerosis.

METHODS

Participants of a population-based cohort study (the Gutenberg Health Study, N = 15,010) aged 35-64 years were examined at baseline (2007-2012). Investigations included measurements of arterial stiffness, vascular function [reactive hyperaemia (RH) index], and intima media thickness (IMT). Also, a complete job history (including up to 15 periods), occupational exposures, a variety of lifestyle, and dispositional variables were enquired.

RESULTS

Night shift work was performed by 1071 out of 8065 currently employed individuals. The strongest association after adjustment for age, sex, job complexity level, being a manager, overtime work, and noise appeared for more than 660 night shifts within the last 10 years and a significantly increased arterial stiffness of 0.33 m/s. This reflects a 4 % flow velocity increase for individuals with more than 660 night shifts compared to non-night workers. Regarding the entire professional life, night shift workers showed a significantly decreased vascular function by -0.054 RH index points by using the same adjustment. IMT values did not differ statistically from non-night workers. Lifestyle and dispositional factors showed an influence on all used subclinical atherosclerosis parameters.

CONCLUSIONS

The cross-sectional results demonstrate an association between night work and detrimental changes in the atherosclerotic process. The association is more pronounced with more years in night shift and is partly explained by lifestyle and dispositional factors. Longitudinal analyses are necessary to confirm the results.

Proinflammatory and regulatory cytokines and chemokines in infants with uncomplicated and severe Plasmodium falciparum malaria

Cytokine and chemokine levels were studied in infants (<5 years) with uncomplicated (MM) and severe malaria tropica (SM), and in Plasmodium falciparum infection-free controls (NEG). Cytokine plasma levels of interleukin (IL)-10, IL-13, IL-31 and IL-33 were strongly elevated in MM and SM compared to NEG (P<0·0001). Inversely, plasma concentrations of IL-27 were highest in NEG infants, lower in MM cases and lowest in those with SM (P<0·0001, NEG compared to MM and SM). The levels of the chemokines macrophage inflammatory protein (MIP3)-α/C-C ligand 20 (CCL20), monokine induced by gamma interferon (MIG)/CXCL9 and CXCL16 were enhanced in those with MM and SM (P<0·0001 compared to NEG), and MIP3-α/CCL20 and MIG/CXCL9 were correlated positively with parasite density, while that of IL-27 were correlated negatively. The levels of 6Ckine/CCL21 were similar in NEG, MM and SM. At 48-60 h post-anti-malaria treatment, the plasma concentrations of IL-10, IL-13, MIG/CXCL9, CXCL16 and MIP3-α/CCL20 were clearly diminished compared to before treatment, while IL-17F, IL-27, IL-31 and IL-33 remained unchanged. In summary, elevated levels of proinflammatory and regulatory cytokines and chemokines were generated in infants during and after acute malaria tropica. The proinflammatory type cytokines IL-31 and IL-33 were enhanced strongly while regulatory IL-27 was diminished in those with severe malaria. Similarly, MIP3-α/CCL20 and CXCL16, which may promote leucocyte migration into brain parenchyma, displayed increased levels, while CCL21, which mediates immune surveillance in central nervous system tissues, remained unchanged. The observed cytokine and chemokine production profiles and their dynamics may prove useful in evaluating either the progression or the regression of malarial disease.

The European standard series in 9 European countries, 2002/2003 - First results of the European Surveillance System on Contact Allergies

Since January 2001, the European Surveillance System on Contact Allergies (ESSCA), supported by European Union funding (contract QLK4-CT-2001-00343), has started to collect patch-test data. This comprises a standardized clinical history and the patch-test results using the European standard series, from 17 centres in 9 European countries listed above. In 2002 and 2003, 10 511 patients' test results have been pooled and analysed. The anamnestic data partly reflect the subspecialties of some centres. The most common allergen was nickel sulfate (17.3%); however, large international variations were observed. The prevalence of contact allergy to Myroxylon pereirae resin (balsam of Peru) (5.8%) is coming close to the frequency found with the fragrance mix (6.4%). Regarding contact allergy to chromium compounds, different frequencies were noted in the 2 centres focused on occupational dermatitis (2.3% in the FIOH versus 7.4% in the Nofer Institute). These most likely reflect the beneficial effect of addition of ferrous sulfate in one, but not the other country. As differences may partly be due to different patch-test reading, standardization may need to be refined further. By providing post-marketing surveillance in the field of contact allergy, ESSCA will meet its objective of increased consumer safety across Europe.

The European standard series in 9 European countries, 2002/2003 -- first results of the European Surveillance System on Contact Allergies

Since January 2001, the European Surveillance System on Contact Allergies (ESSCA), supported by European Union funding (contract QLK4-CT-2001-00343), has started to collect patch-test data. This comprises a standardized clinical history and the patch-test results using the European standard series, from 17 centres in 9 European countries listed above. In 2002 and 2003, 10 511 patients' test results have been pooled and analysed. The anamnestic data partly reflect the subspecialties of some centres. The most common allergen was nickel sulfate (17.3%); however, large international variations were observed. The prevalence of contact allergy to Myroxylon pereirae resin (balsam of Peru) (5.8%) is coming close to the frequency found with the fragrance mix (6.4%). Regarding contact allergy to chromium compounds, different frequencies were noted in the 2 centres focused on occupational dermatitis (2.3% in the FIOH versus 7.4% in the Nofer Institute). These most likely reflect the beneficial effect of addition of ferrous sulfate in one, but not the other country. As differences may partly be due to different patch-test reading, standardization may need to be refined further. By providing post-marketing surveillance in the field of contact allergy, ESSCA will meet its objective of increased consumer safety across Europe.

A multifactorial analysis of concurrent patch-test reactions to nickel, cobalt, and chromate

BACKGROUND

Previous research indicates that positive patch tests to nickel (II) sulphate, cobalt (II) chloride and potassium dichromate commonly occur together.

METHODS

To further examine the relationship between nickel, cobalt, chromate, and the factors that may potentially be related to concurrent sensitizations to two or all three metal allergens, data from the Information Network of Dermatology Departments have been investigated.

RESULTS

Women had a higher conditional odds of concurrent nickel-cobalt (OR = 6.80; 95% CI: 5.65-8.19) and nickel-chromate (OR = 2.13; 95% CI: 1.67-2.72) reactions than men. Construction workers had a significantly higher odds of cobalt-chromate reactions (OR = 13.89; 95% CI: 10.36-18.64), while the odds of isolated cobalt allergy was only 0.92 (95% CI: 0.48-1.74). Patients with underlying atopic eczema/dermatitis syndrome had a 40-90% higher chance of any positive outcome, which involved chromate. Polysensitization, defined as the number of positive reactions to standard series substances other than nickel, cobalt, and chromate, was also significantly associated with the concurrent reactions; moreover, steady and significant effect gradients were noted.

CONCLUSIONS

This research confirms the occupational nature of cobalt-chromate concurrent reactions, in particular, in construction workers. Polysensitization, which is considered to represent susceptibility to delayed-hypersensitivity in general, is also associated with the concurrent reactions to the metals. Hence, not only coupled exposure, but also individual susceptibility may be responsible for concurrent reactions to metals in man.