Renee N Carey’s research while affiliated with Curtin University and other places

Exposure to respirable crystalline silica (RCS) is known to increase the risk of the development of silicosis, in addition to lung cancer and other diseases. While much evidence of the link between underground tunnel construction and the resultant development of silicosis exists, limited information is available on the levels of occupational exposure to RCS or the prevalence of RCS-related disease in tunnelling in Australia. Publicly available RCS exposure data were sourced from the construction of 3 major Queensland tunnelling projects between 2007 and 2013. Statistical evaluation was performed to estimate RCS exposure, and together with estimates of workforce size and risk estimates, the future excess number of silicosis and lung cancer in that tunnelling workforce were estimated. In a cohort of around 2,000 workers who serviced the Queensland tunnel projects, it was estimated that between 20 and 30 cases of lung cancer and between 200 and 300 cases of silicosis would develop over their lifetime as a result of exposure to RCS. This paper highlights the likely future burden of disease, the need for case-finding and better control measures to reduce RCS exposure in this high-risk cohort.

Objective To identify factors influencing the completion of a three-dose course of weekly intramuscular benzathine penicillin G injections by adults and adolescents with syphilis of unknown duration or late syphilis. Methods We searched medical literature databases for studies reporting on factors influencing treatment completion by patients with syphilis aged 10 years or older and studies involving health professionals administering syphilis treatment. Studies could use quantitative, qualitative or mixed methods approaches. We conducted a systematic review following the JBI Manual for Evidence Synthesis method. Findings We identified 24 eligible studies, of which 20 (83%) were published in 2010 or later, 19 (79%) focused on pregnant women, seven (29%) were conducted in Brazil, six (25%) in the United States of America and three (12%) in China. Health-care system-related factors influencing the noncompletion of treatment included the limited supply of, and limited access to, medication and inadequate follow-up systems. Other common factors were patients presenting late to antenatal services and social and economic factors, such as transportation barriers and a low educational level. Conclusion A comprehensive systems approach is needed to increase the treatment completion rate for syphilis of unknown duration and late syphilis. Health service interventions, such as improving patient management systems, should be supplemented by actions to address social inequalities and shortages in the supply of benzathine penicillin G. Research is needed to understand barriers to treatment completion in high-income countries and among priority groups, including Indigenous people and men who have sex with men.

Background Mesothelioma is a cancer of growing global incidence, especially in developing countries, with unique complex psychosocial impacts on patients and their carers. Aims To provide a comprehensive understanding of the psychosocial needs of people living with pleural mesothelioma and family carers. Methods A mixed methods design with 61 semi‐structured interviews and psychometrically validated questionnaires to assess pleural mesothelioma patients' ( n = 36) quality of life and frailty and carers' ( n = 25) caregiving experiences, quality of life, and pre‐loss prolonged grief symptoms. Results People with mesothelioma (29 men, 7 women, aged 46–89 years) indicated moderate quality of life; 18 (50%) met criteria for frailty. Current carers (21 women, 4 men; aged 41–79 years) generally reported positive caregiving experiences and high quality of life; 5 (20%) scored in the range indicative of risk for prolonged grief disorder. Four themes were generated: a desire for tailored information with bespoke detail, assistance to coordinate tasks of treatment, improved social and peer support, and effective psychological services. Needs varied, with main concerns being about breaking the news to spouses/children, the impact of the disease and death on family, loss of personal future, managing psychological symptoms, and avoiding burden. Conclusions These specific and unmet psychosocial needs provide a strong basis for individualised care pathways to address these needs via the integration of psychology into the multidisciplinary care team and the development and evaluation of mental health and wellbeing interventions for mesothelioma patients and carers. Doing so will reduce psychosocial distress and improve residual vitality.

Background Artificial ultraviolet radiation (UVR) is produced during welding and can cause damage to both the eyes (ocular) and the skin (dermal). We aimed to investigate the protection used by welders to reduce their exposure to ocular and dermal UVR. Methods We conducted a cross-sectional online survey in Australia that asked welders about their welding tasks and the control measures they used to protect against UVR exposure. Results There were 634 respondents, of whom 411 undertook welding themselves, 36 supervised other welders, and 130 both supervised and welded. Dermal UVR exposure occurred in 7.8% of welders and 14.4% of supervisors, whereas ocular UVR exposure occurred in 16.8% of welders and 33.1% of supervisors. The use of personal control measures was much lower among supervisors than welders; however, the presence of warning signs or barriers was reported more often by supervisors. Conclusions Despite the well-known acute and chronic effects of exposure to UVR from welding, there are still many welders and supervisors who do not use adequate protection.

Background In Australia, the alcohol industry exposes young people to over 40,000 advertisements a year on social media platforms such as Instagram. Research has linked exposure to alcohol advertising to earlier initiation of drinking among young people, increasing the risk of injury. Ever present is an ‘aquatic alcogenic environment’ whereby drinking in and around water is normalised through environmental influences including alcohol advertising. Objective This research investigates content posted on the Instagram accounts of popular alcohol brands, marketing strategies used, and extent to which aquatic settings and activities are featured. Methods We identified five alcohol brands across a range of commonly consumed drink categories (e.g. cider) used by young people in Western Australia. Using a study-specific Instagram account, the pages of each brand were accessed. Account details and the 20 most recent posts from each account were documented. Variables included: number of posts, number of followers and accounts following, use of age-gating, date posted, number of likes and comments, and caption. Each image and caption were then coded using a framework developed for this study. This framework captured aquatic locations and activities featured, adherence to advertising code standards, and the use of advertising themes and marketing elements. Results A total of 99 posts and 176 individual images were captured. Alcoholic beverages were shown in 53.4% of all images. Aquatic locations featured in 21.6% of images and aquatic activities, including surfing (17.0%). The use of aquatic locations and activities varied significantly by brand (p<0.001). The use of advertising themes and marketing elements varied among brands, with images featuring happiness and fun (22.2%), logos and branding (76.1%), and mateship (22.7%). Only 21.6% of images contained an age restriction or warning, although all accounts were age-gated. Conclusions Popular social media platforms have provided alcohol companies with easy access, inexpensive ways to promote alcohol to young people. Alcohol brands used highly stylised imagery that associate alcohol with fun and friendship circles and promote the use of alcohol in and around water, leading to the potential for increased risk-taking behaviour and water-related injury.

Issues The surrounding social and commercial context, including alcohol advertising, heavily influences alcohol consumption. Alcohol use is a major risk factor for both fatal and non‐fatal drowning, particularly for young people. Approach We conducted a scoping review to explore the peer‐reviewed literature on the use of alcohol by young people (aged 15–34 years) in the context of aquatic environments. Five electronic academic databases were searched for English‐language studies conducted in high‐income countries and published in the last 15 years (since 2008). The MetaQAT framework was used to assess methodological quality of included studies. Key Findings The review included a total of 24 studies, including those addressing the prevalence of and/or risk factors for alcohol use in aquatic environments among young people ( n = 13); the epidemiology of alcohol‐related unintentional drowning in young people ( n = 9); and interventions to reduce alcohol‐related harm around water ( n = 3). Findings suggest that young people commonly consume alcohol around water, particularly young men. We found multiple influences on this behaviour, including the perception of risk, location of aquatic activity and presence of others, particularly peers. Implications Understanding the literature addressing alcohol use around water among young people will assist in identifying and setting priorities for drowning prevention, including the need to mitigate the effects of alcohol advertising which promotes drinking in and around water. Conclusion There is a clear imperative to address the use of alcohol by young people in aquatic environments. These findings have key implications for public health policy, advocacy and practice.

INTRODUCTION Mounting evidence suggests that electronic cigarettes (e-cigarettes) are extensively promoted and marketed using social media, including through user-generated content and social media influencers. This study explores how e-cigarettes are being promoted on Instagram, using a case-study approach, and the extent to which Meta’s Restricted Goods and Services Policy (Meta’s policy) is being applied and enforced. METHODS We identified the accounts followed by an Australian Instagram influencer who primarily posts e-cigarette-related content. The main foci of these 855 accounts were coded and 369 vaping-focused accounts were identified. These vaping-focused accounts were then further coded by two trained coders. RESULTS All (n=369; 100.0%) of the vape content posted by these accounts was positive in sentiment. One-third of the vape accounts (n=127; 34.4%) had a shared focus, indicating that vape content may permeate into other online communities through shared interests. A total of 64 accounts (17.3%) potentially violated Meta’s policy by attempting to purchase, sell, raffle or gift e-cigarette products. CONCLUSIONS The findings of this study suggest that pro-vaping information is available and accessible on Instagram. Much of the content identified in this study promoted the purchase or gifting of e-cigarette products and potentially violates Meta’s policy. Greater regulation and/or stronger enforcement of e-cigarette content on social media platforms such as Instagram is necessary to prevent the ongoing promotion of these harmful products.

Background Exposure to welding fume is associated with adverse effects on worker health. The use of various control measures can reduce levels of exposure and the resulting health effects. However, little is known about the factors that may influence workers' use of control measures in the workplace and their perceived intervention needs. This study aimed to investigate workers' and other stakeholders' views on ways to improve the use of welding fume control measures in Australian workplaces. Methods We conducted a series of online focus group discussions and individual interviews with participants who have some occupational involvement in welding, whether as workers, employers or industry representatives, union representatives, or regulators. A semi-structured question guide was used, and all discussions and interviews were recorded and transcribed for analysis. Results Five focus group discussions and five individual interviews were conducted with a total of 21 participants. Three major themes emerged. The first addressed the current awareness of welding fume harms and concern about exposure; the second focussed on the current use of control measures, and barriers and facilitators to their use; and the last centred around intervention needs and the contents of a potential effective intervention. Conclusion Improving the use of control measures to prevent exposure to welding fume requires knowledge around the barriers and facilitators of control, use, and the intervention needs of stakeholders. This study has provided such knowledge, which will facilitate the design and implementation of an intervention to reduce welding fume exposure and ultimately protect the health of workers.