Type 2 diabetes mellitus and recurrent Tuberculosis: A retrospective cohort in Peruvian military workers.

The role played by type 2 diabetes mellitus (DM2) in the occurrence of recurrent tuberculosis is still uncertain. Military personnel are an occupational group with an increased risk for tuberculosis exposure due to their activities. Methods. We conducted a retrospective cohort to study the association between DM2 and recurrent TB in military workers who have been previously treated for tuberculosis at the Central Military Hospital in Lima, Peru, between 2016 and 2017. We evaluated the risk between DM2 and recurrent TB using Nelson-Aalen graphical analysis and Cox regression stratified by TB cured with hazard ratio (HR) calculation adjusted for confounders. Results. We evaluated 220 workers with a mean age of 23.2 ± 7.8 years (96.8 % male). DM2 and recurrent TB frequency were 11.8 % and 5.0 %, respectively. Those with DM (36.5 %) presented a greater proportion of recurrent TB than those without DM2 (10.5 %). The cumulative risk for recurrent TB increases faster among workers with DM2 (p = 0.025, LR chi-squared test). Cox regression stratified by type of cured TB did not show an association between DM2 and recurrent TB (HR: 3.67; 95 %CI: 1.00-13.46). Conclusion. The cumulative risk for recurrent TB increases faster in patients with DM than in those without DM2. DM2 is not associated with the time of apparition of recurrent TB in military workers.

Evaluación de la exposición ocupacional a Ciclofosfamida en nueve hospitales del Perú / Evaluation of occupational exposure to Cyclophosphamide in nine hospitals of Peru

Objetivos. Evaluar la exposición ocupacional a ciclofosfamida en nueve hospitales del Perú. Materiales y métodos. Estudio observacional de tipo transversal realizado durante el año 2010 en el cual se colectó muestras de orina de 24 h de 96 trabajadores de las unidades de mezclas oncológicas y servicios de oncología de nueve hospitales del Perú, la cuantificación de ciclofosfamida se realizó por la metodología de GC-MS ( Gas Cromathography-Mass Spectroscopy). Se realizó, además, muestreo de superficies de trabajo utilizando paños húmedos para la determinación de ciclofosfamida. Resultados. Se detectó la presencia de ciclofosfamida en orina en 67 trabajadores (concentración promedio de excreción: 74,2 ng/24 h), lo cual representa el 70% del total de la población evaluada. Basado en la excreción se puede clasificar la exposición total entre los hospitales, en términos de exposición alta (>18,9 ng/24 h), moderada (1,725 - 18,9 ng/24 h) y baja (<1,725 ng/24 h), con una frecuencia porcentual de 31,3; 26,0 y 42,7% respectivamente. Además, como parte de la evaluación ambiental, se encontró concentraciones de ciclofosfamida de 14,72, 14,98 y 5,12 ng/cm².Conclusiones. Se evidencia una contaminación por ciclofosfamida en las áreas donde se realizan los preparados oncológicos y la presencia de ciclofosfamida en muestras de orina de trabajadores expuestos a citostáticos.

Objetives. Evaluate occupational exposure to cyclophosphamide in nine hospitals of Peru. Materials and methods. Cross-cutting observational study conducted in 2010, for which 24-hour urine samples were obtained from 96 employees of the oncologic mixture units and oncology services of nine hospitals in Peru, the quantification of cyclophosphamide was done through the GC-MS methodology ( Gas Cromathography-Mass Spectroscopy). Additionally, working surfaces were tested by obtaining samples with wet wipes for identification of cyclophosphamide. Results. Cyclophosphamide was detected in urine samples in 67 employees (average concentration of excretion: 74.2 ng/24 h), accounting for 70% of the total population to be assessed. Based on the excretion, total exposure among hospitals can be classified as high level (>18.9 ng/24 h), moderate level (1,725 - 18.9 ng/24 h) and low level (<1,725 ng/24 h), with a percent incidence of 31.3; 26.0 and 42.7% respectively. Additionally, as part of the environmental evaluation, concentrations of cyclosphamide were found in 14.72, 14.98 and 5,12 ng/cm2. Conclusions. Contamination through cyclophosphamide in areas where oncological preparations are done and the presence of cyclophosphamide in urine samples of workers exposed to cytostatics substance were observed.

Daño genotóxico en trabajadores de minería artesanal expuestos al mercurio / Genotoxic damage among artisanal and small-scale mining workers exposed to mercury

Objetivos. Determinar el daño genotóxico en trabajadores de una minería artesanal expuestos a mercurio. Materiales y métodos. Estudio observacional de corte transversal, en el cual se evaluaron trabajadores expuestos a mercurio (n=83), de quienes se colectaron células por hisopado bucal para su posterior tinción, revisión microscópica y recuento de micronúcleos y otras alteraciones nucleares. También se colectó orina de 24 h para la determinación de mercurio inorgánico. Resultados. El 68,7% de las personas estudiadas fueron de sexo masculino, la media de edad fue de 43 ± 12,4 años (rango: 16-76). El tiempo promedio de exposición ocupacional a mercurio fue de 12,1 ± 6,7 años, y el contacto con mercurio fue de 4,1 ± 3,6 kg por persona por día. El 93% de los evaluados no utilizaban equipos de protección personal durante la manipulación del mercurio. Los resultados del monitoreo biológico evidenciaron que el 17% de los evaluados presentaron concentraciones de mercurio en orina mayor a los 2,5 µg/L; siendo este valor el límite de detección de la técnica de medición utilizada. Los resultados de la evaluación genotóxica evidenciaron que el 15% de las personas con exposición laboral a mercurio presentaron micronúcleos en células de epitelio bucal; hallándose otros indicadores de alteración nuclear como los puentes nucleoplásmicos, gemaciones y binucleaciones, que también son considerados como eventos genotóxicos asociados a la exposición por agentes de riesgo físico o químico. Conclusiones. El hallazgo de micronúcleos en células del epitelio bucal reflejan daño genotóxico asociado a la exposición laboral por mercurio utilizado en las actividades de minería artesanal.

Objectives. To determine the genotoxic damage among artisanal and small-scale mining workers exposed to mercury. Materials and methods. Observational cross-sectional study which evaluated mercury-exposed workers (n=83), whose cells were collected by mouth swab for further staining, microscopic observance, micronuclei count, and other nuclear alterations. 24-hour urine was also collected for the determination of inorganic mercury. Results. 68.7% of participants were male, the mean age being 43 ± 12,4 years (range: 16-76). The average time of occupational exposure to mercury was 12,1 ± 6,7 years, and the contact with mercury was 4,1 ± 3,6 kg per person per day. 93% of participants failed to wear personal protection gear while handling mercury. Results of biological monitoring showed that 17% of participants had concentrations of mercury in urine higher than 2,5 µg/L, this value being the detection limit of the measurement technique used. Results of the genotoxic evaluation evidenced that 15% of people with labor exposure to mercury presented micronuclei in mouth epithelial cells, and other indicators of nuclear alteration such as nucleoplasmic bridges, gemmation and binucleation were found, which are also considered genotoxic events associated to the exposure of physical or chemical risk agents. Conclusions. The finding of micronuclei in mouth epithelial cells reflects genotoxic damage associated to the labor exposure of mercury used in artisanal and small-scale mining activities.

[Evaluation of occupational exposure to cyclophosphamide in nine hospitals of Peru]. / Evaluación de la exposición ocupacional a Ciclofosfamida en nueve hospitales del Perú

OBJECTIVES: Evaluate occupational exposure to cyclophosphamide in nine hospitals of Peru. MATERIALS AND METHODS: Cross-cutting observational study conducted in 2010, for which 24-hour urine samples were obtained from 96 employees of the oncologic mixture units and oncology services of nine hospitals in Peru, the quantification of cyclophosphamide was done through the GC-MS methodology ( Gas Cromathography-Mass Spectroscopy). Additionally, working surfaces were tested by obtaining samples with wet wipes for identification of cyclophosphamide. RESULTS: Cyclophosphamide was detected in urine samples in 67 employees (average concentration of excretion: 74.2 ng/24 h), accounting for 70% of the total population to be assessed. Based on the excretion, total exposure among hospitals can be classified as high level (>18.9 ng/24 h), moderate level (1,725 - 18.9 ng/24 h) and low level (<1,725 ng/24 h), with a percent incidence of 31.3; 26.0 and 42.7% respectively. Additionally, as part of the environmental evaluation, concentrations of cyclosphamide were found in 14.72, 14.98 and 5,12 ng/cm2. CONCLUSIONS: Contamination through cyclophosphamide in areas where oncological preparations are done and the presence of cyclophosphamide in urine samples of workers exposed to cytostatics substance were observed.

[Genotoxic damage among artisanal and small-scale mining workers exposed to mercury]. / Daño genotóxico en trabajadores de minería artesanal expuestos al mercurio.

OBJECTIVES: To determine the genotoxic damage among artisanal and small-scale mining workers exposed to mercury. MATERIALS AND METHODS: Observational cross-sectional study which evaluated mercury-exposed workers (n=83), whose cells were collected by mouth swab for further staining, microscopic observance, micronuclei count, and other nuclear alterations. 24-hour urine was also collected for the determination of inorganic mercury. RESULTS: 68.7% of participants were male, the mean age being 43 ± 12,4 years (range: 16-76). The average time of occupational exposure to mercury was 12,1 ± 6,7 years, and the contact with mercury was 4,1 ± 3,6 kg per person per day. 93% of participants failed to wear personal protection gear while handling mercury. Results of biological monitoring showed that 17% of participants had concentrations of mercury in urine higher than 2,5 µg/L, this value being the detection limit of the measurement technique used. Results of the genotoxic evaluation evidenced that 15% of people with labor exposure to mercury presented micronuclei in mouth epithelial cells, and other indicators of nuclear alteration such as nucleoplasmic bridges, gemmation and binucleation were found, which are also considered genotoxic events associated to the exposure of physical or chemical risk agents. CONCLUSIONS: The finding of micronuclei in mouth epithelial cells reflects genotoxic damage associated to the labor exposure of mercury used in artisanal and small-scale mining activities.