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Firefighters are severely impacted by climate events, yet they are an underexamined population with regard to climate change research. This systematic review aims to synthesize the existing literature on the psychological effects of wildfire events on firefighters and to discuss some of the major gaps in disaster research relating to first responders and their mental health. A thorough search of the existing literature through June 2023 on the topic of wildfires and first responder psychological health was conducted through the databases PubMed, PsychINFO, and Embase. This search yielded 13 final studies which met the exclusion and inclusion criteria for this review. The final studies consisted of populations that responded to wildfire events from four different countries (two from Israel, one from Canada, two from Greece, and eight from Australia). The data gathered by this review suggest that firefighters may experience many environmental and occupational exposures during wildfire suppression, which are linked to an increased risk of PTSD and other psychological symptoms even months after the event. This review brings to light the need for further research of the compounded effect of the environmental and psychological exposures of first responders and the potential psychological effects of those exposures. [ABSTRACT FROM AUTHOR]

Lead exposure has been shown to dysregulate physiological stress responses. However, few studies have investigated the effect of lead exposure on later heart rate variability (HRV), an indicator of a stress response, in large samples of children. Furthermore, the interaction between social environmental factors and lead exposure in childhood, which commonly co-occur, remains understudied. This study examined relationships between childhood lead exposure and early adolescent physiological stress responses at different levels of parental education. Participants were 406 children from Jintan, China. Blood lead levels (BLLs) and parental education data were collected at 3–5 years of age, and HRV outcomes assessed at 12 years via frequency domain measures (LF/HF ratio) collected during an induced stress test. Results show a significant interaction between parental education and BLLs at 3–5 years. This relationship was found to be most consistent for the interaction between BLLs and mother's years of education for both the planning (β = 0.12, p = 0.046) and speaking (β = 0.11, p = 0.043) phase of the stress task, suggesting that increasing years of mother's education may enhance the deleterious influence of lead exposure on the HRV frequency measure, LF/HF ratio. This research highlights the complexity in lead exposure induced outcomes. [ABSTRACT FROM AUTHOR]

Introduction: The degree to which opioid-induced hyperalgesia contributes to the pain experience of patients with chronic pain remains relatively undescribed. The objective of this pilot study was to determine if experimental pain responses improve in patients with chronic pain as they undergo a planned opioid taper. Methods: This was a prospective observational study. Seven patients with chronic neuropathic pain on at least 120 mg morphine equivalents/day were enrolled. The participants were followed over the course of an individualized opioid taper to a lower dose. Measures of experimental pain sensitivity, including indicators of central pain modulation, were collected on a biweekly basis; in addition, measures of function and quality of life were collected monthly. The effect of opioid taper on pain responses and functional outcomes over time were examined using longitudinal mixed-effects regression modeling and general linear regression modeling with regularization as a function of baseline dose, end dose, and taper rate. Results: In this small sample of patients undergoing highly individualized and variable opioid taper, the opioid taper was significantly associated with improved pain responses to the cold-pressor test, with the pain threshold on average increasing by 1.14 s every 6 weeks (p = 0.0084, 95% confidence interval [CI] for 6-week change 0.3039–2.0178) and pain tolerance on average increasing by 2.87 s every 6 weeks (p = 0.0026, 95% CI for 6-week change 1.02–4.7277). Taper-related changes in central pain modulation were not observed, although conditioned modulation trended toward improvement by the completion of opioid taper. Similarly, no declines in function and quality of life were observed with the opioid taper, suggesting stability despite decreased opioid dose. Conclusions: Opioid taper was associated with improvements in experimental pain responses without a decline in function and quality of life, suggestive of diminished opioid-induced hyperalgesia in this clinical sample. Trial Registration: ClinicalTrials.gov identifier, NCT03912298. [ABSTRACT FROM AUTHOR]

The article focuses on childhood lead exposure which is still a problem in many cities in the U.S. including Flint in Michigan. Topics include the sources of lead exposure, the confusing clinical guidelines for lead exposure, and the role of occupational health nurses in mitigating childhood lead exposure by educating workers and advocating for blood lead level testing.