Overuse injuries in sports are common and include stress fracture and musculoskeletal inflammation. Vitamin D is important in bone metabolism and exerts anti‐inflammatory effects, and it may be protective against those injuries. The objective was to evaluate the association between vitamin D status and sport injuries. This systematic review was conducted according to the PRISMA statement. We used systematic literature search in PubMed, Embase, Cochrane and Sportdiscus until the 28th of June 2020. We included observational and randomized studies assessing vitamin D status. Sport injuries were defined as stress fractures or musculoskeletal injuries. A meta‐analysis was performed with stress fracture as outcome. In total 16 articles were included, 7 investigating stress fractures, and 9 investigating musculoskeletal injuries. Regarding stress fractures, serum vitamin D levels below 30 ng/mL appeared to be associated with an increased risk of stress fractures, and the meta‐analysis showed increased odds ratio for stress fracture with vitamin D insufficiency. Regarding musculoskeletal injuries only two studies found that low serum vitamin D levels were associated with musculoskeletal injuries. Low serum vitamin D levels are associated with an enhanced risk of stress fractures, while no conclusion can be made regarding musculoskeletal injuries.
BackgroundOutdoor workers can be exposed to relatively high levels of ultraviolet radiation and are at risk of developing occupational skin cancer. Implementing the use of sun protection in outdoor workers at work is therefore important. The objective of this follow-up study was to evaluate the effect of a multicomponent intervention to improve the use of sun protection in Danish outdoor workers.MethodA total of 237 Danish outdoor workers were asked to complete surveys in 2016/17 and in 2020. Multicomponent interventions, between surveys, included information on skin cancer risk and use of sun protection, personal dosimetry and skin examination for signs of photodamage and skin cancer. Survey items on awareness of occupational skin cancer risk and perceived importance of sun protection as well as availability and use of sun protection at work were compared and analyzed in relation to the multicomponent intervention.ResultsOverall, the use of sun protection at work increased significantly (composite score [95% CI] 4.0 [3.7, 4.3] in 2016/17 and 4.6 [4.3, 4.9] in 2020, p < 0.001). Sunscreen was by far the biggest contributor, and the only type of sun protection used at work, which changed significantly (often/always use 37% in 2016/17 and 52% in 2020, p < 0.001). The biggest influence on the increased use of sun protection at work seemed to be a significant increase in the awareness of occupational skin cancer risk (moderate/high 43% in 2016/17 and 63% in 2020, p < 0.001) and perceived importance of sun protection at work (moderate/high 69% in 2016/17 and 83% in 2020, p < 0.001).ConclusionThe results of this study indicate that awareness of occupational skin cancer risk as well as the perceived importance and use of sun protection at work in Danish outdoor workers may be improved by means of multicomponent intervention.
Plasmodium knowlesi has been reported as an emerging infection throughout the Southeast Asian region, especially in the Malaysian state of Sabah, where it accounts for the majority of the malaria cases reported. We present a case of P. knowlesiinfection in a Danish woman returning from a short trip to Malaysian Borneo. The patient spent 14 days in forested areas of Sabah and fell ill after returning to Denmark in November 2022. Microscopy of blood smears revealed 0.8% infected erythrocytes, but due to the atypical morphological presentation, a conclusive species identification was made by molecular methods. The patient was treated successfully with artemisinin-based combination therapy. Plasmodium knowlesi is a potentially fatal infection, and taking the increasing travel activity into consideration after the coronavirus disease 2019 (COVID-19) pandemic, P. knowlesishould be a differential diagnosis in patients with travel-associated illness returning from highly endemic Southeast Asian areas.
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