Possible role of plasma ceruloplasmin and erythrocyte sedimentation rate in assessing compliance with occupational hygiene and safety practices in waste management workers.

OBJECTIVES: Work-related health and safety risks are common among waste management workers (WMWs). This study investigated the level of compliance with safety measures in relation to levels of inflammatory markers among WMWs in Sagamu, South-West Nigeria. MATERIALS AND METHODS: WMWs comprising 30 cart pushers (CPs) and 50 truck users (TUs) were recruited alongside 45 people from the normal population as control. Data on health complaints were obtained from questionnaire surveys. Inflammation was assessed by measuring plasma ceruloplasmin (Cp), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and albumin. RESULTS: WMWs exhibited a significantly higher prevalence of respiratory and gastrointestinal symptoms and poor compliance with health and safety measures. Significant (P < 0.001) differences were observed in the use of masks, hand gloves, protective clothing, and footwear between TUs and CPs. ESR, Cp, and CRP increased significantly (P < 0.001) by 145, 28.7, and 42.5% in TUs and by 164, 50.5, and 74.3% in CPs, respectively, relative to control. Negative correlation was observed between use of mask (r = -0.225, P < 0.01), use of gloves (r = -0.184, P < 0.05), and Cp and between ESR and washing of hands with soap (r = -0.185, P < 0.05). The use of goggles (r = +0.285, P < 0.001), washing of hands with soap (r = +0.203; P < 0.01), use of masks (r = +0.317, P < 0.001), and use of gloves correlated positively in WMWs. CONCLUSIONS: A higher prevalence of work-related symptoms and elevated inflammatory markers in WMWs was related to poor compliance with safety measures. ESR and Cp may be useful predictors of occupational hygiene and compliance with safety measures among Nigerian WMWs.

The CircumVent Project: a CPAP/O2 helmet solution for non-invasive ventilation using an implementation research framework.

BACKGROUND: Acute respiratory failure, a major cause of death in COVID-19, is managed with high-flow oxygen therapy via invasive mechanical ventilation. In resource-limited settings like Nigeria, the shortage of ventilators and oxygen supply makes this option challenging. Evidence-based non-invasive alternatives to mechanical ventilation such as the use of continuous positive airway pressure (CPAP) devices exist, but there have been concerns that non-invasive ventilation may expose healthcare workers to infection from aerosolized dispersion of SARS-CoV-2. We propose to evaluate the feasibility, adaptability and acceptability of a CPAP/O2 helmet solution for non-invasive ventilation among patients with COVID-19 and health workers in eight COVID-19 treatment and isolation centers in Nigeria. METHODS: The study will occur in 4 stages: (1) convene a Steering Committee of key stakeholders and recruit implementation sites; (2) use the integrated Promoting Action on Research Implementation in Health Services (i-PARiHS) framework to guide a needs assessment of treatment centers' capacity to use high-flow oxygen therapy to treat COVID-19 patients and utilize the findings to develop an implementation strategy for the use of a CPAP/O2 helmet solution; (3) build infrastructure to support training and data monitoring processes and to develop implementation protocols to evaluate the adaptability of the strategy for the use of the CPAP/O2 helmet; and (4) train health workers, distribute a CPAP/O2 helmet solution for non-invasive ventilation, pilot test the implementation strategy, and assess feasibility of its use and acceptability that includes monitoring altered risk of SARS-CoV-2 infection among healthcare workers. DISCUSSION: The CPAP/O2 helmet solution for non-invasive ventilation in Nigeria can serve as a scalable model for resource-poor countries, and beyond the COVID-19 pandemic, has the potential to be deployed for the treatment of pneumonia and other respiratory diseases. TRIAL REGISTRATION: NCT04929691. Registered June 18, 2021-retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04929691.

Patterns, severity, and management of maxillofacial injuries in a suburban South Western Nigeria tertiary center.

BACKGROUND: Trauma remains a leading cause of maxillofacial injury globally. Changing etiological factors and patterns of maxillofacial injury continue to be reported and are largely modulated by socio-geographic and environmental factors. It is important to have an in-depth understanding of the pattern and etiology in a particular region before effective preventive measures can be developed. AIM: The aim was to evaluate the patterns, etiological factors, and management of maxillofacial injuries in Ogun state, Nigeria. MATERIALS AND METHODS: A prospective descriptive cohort study of all consecutive patients that presented with maxillofacial injuries at our center between January and December 2013. Information about demographic data, types of maxillofacial and associated injury, etiology of injury, treatment received and complications were collected and analyzed. RESULTS: Seventy patients presented with maxillofacial injury during the study period with a male to female ratio of 4:1. The age range was 9 months to 60 years with a mean of 30.11 ± standard deviation 14.97 years. Majority of the facial fractures were due to motorcycle related crashes. There were 57.1% mandibular fractures and 55.7% middle third fractures. Closed reduction with maxillo-mandibular fixation was the major method of treatment of facial fractures. Postoperative complications were observed in 11.4% of patients. CONCLUSION: Road traffic crashes (RTCs) remain the leading etiological factor of maxillofacial injuries in our center. Enforcement of stricter traffic regulations and possibly replacement of motorcycles with tricycles for commercial transportation may help to reduce the incidence of RTCs.

Adenosine deaminase activity and immunoglobulin levels as potential systemic biomonitors of occupational hazards and health status in municipal solid waste management workers.

Immune status of waste management workers (WMW) with underlying systemic inflammation was assessed to identify useful immune-related biomarkers of occupational health and safety. Clinical history of WMW revealed high prevalence of respiratory symptoms alongside gastrointestinal and musculoskeletal complaints relative to control. Systemic inflammation, characterized by significant (p<0.001) elevation of erythrocyte sedimentation rate and C-reactive protein, was associated with marked increase in concentration and prevalence of IgA (p<0.05), IgG (p<0.01) and adenosine deaminase activity (ADA) (p<0.01) in WMW. Haematological changes include significant (p<0.01) increase in lymphocytes, monocytes and total leukocytes. Eosinophils also increased significantly (p<0.001) while haemoglobin, packed cell volume and neutrophil decreased significantly (p<0.05). Receiver operating characteristic curve and multivariate analyses revealed ADA (p<0.002) and IgG (p<0.05) as important immune markers respectively for assessing sub-clinical effects of occupational exposure. Our data suggest ADA and IgG as useful immune health and safety indicators in WMW.