Quantitative Assessment of Asbestos Fibers in Abdominal Organs: A Scoping Review.

BACKGROUND: Quantification of asbestos fibers has been mainly performed in the lung but rarely in other organs. However, this may be relevant to understanding better translocation pathways and the oncogenic effects of asbestos on the human body. Electron microscopy is the best technology available to assess the type of fiber, dimensions, and distribution of asbestos fibers in different tissues and as a biomarker of cumulative dose. OBJECTIVES: This scoping review aims to summarize the findings of the studies in which asbestos fibers have been quantified by electron microscopy, occasionally associated with X-ray microanalysis, in normal and pathological tissue of ten abdominal organs. METHODS: A scoping review has been performed by searching articles that quantified asbestos fibers in abdominal organs by electron microscopy (Scanning- SEM or Transmission- TEM). RESULTS: The 12 selected studies included 204 cases, and 325 samples were analyzed. The colon and rectum, kidney, bladder, and abdominal lymph nodes were the organs with at least ten samples available with quantification of asbestos fibers. Asbestos fibers were detected in all the abdominal organs considered: the highest value (152,32 million fibers per gram of dry tissue) was found in the colon and was identified using STEM with EDS. CONCLUSION: The studies included were heterogeneous in terms of exposure and cases, type of samples, as well as analytical techniques, therefore we cannot confirm a specific pattern of distribution in any organ, based on the low homogeneity of the exposure status. The colon is the organ in which the number of fibers is the highest, probably because of exposure arising from both internal distribution of inhaled fibers and ingestion. Additional studies of the number of asbestos fibers in abdominal organs should be made to achieve better representativity.

Quantitative assessment of asbestos fibers in some normal and pathological extra-abdominal tissues-a scoping review.

BACKGROUND: Asbestos is a mineral present in nature and it has been used for years in numerous settings. Asbestos enters the bloodstream and lymphatic system mainly through breathing. OBJECTIVES: Studies with asbestos fiber's quantification in human tissues are scarce except for the lung. This article summarizes asbestos studies in some extra-abdominal tissues. METHODS: A scoping review of articles that quantified asbestos fibers in extra-abdominal tissues (lymph nodes, pharynx, larynx, trachea, heart) by electron microscopy (Scanning-SEM or Transmission-TEM) was performed. RESULTS: The 10 studies selected comprised 52 cases, out of whom 108 samples were analyzed. Mostly samples were lymph node tissues (102), followed by larynx (3) and myocardium (3). No studies were found that determined the presence of asbestos in the pharynx or trachea. The concentration of asbestos fibers detected in the lymph nodes was from 0.003 million fibers per gram of dry tissue (mfgdt) up to 7400 mfgdt, in the larynx the range was from 0.5 mfgdt up to 3.6 mfgdt, in myocardium no asbestos fibers were detected. DISCUSSION: The studies included were heterogeneous in terms of case and sample characteristics and analytical techniques. As subjects exposed to asbestos are often positive for fibers in thoracic lymph nodes, we suggest that whenever a human tissue sample is analyzed for asbestos presence, the relevant draining lymph node should be concomitantly studied.

Quantitative Assessment of Asbestos Fibers in Normal and Pathological Peritoneal Tissue-A Scoping Review.

Peritoneal tissue is the second most affected site by malignant mesothelioma linked to asbestos exposure. This scoping review aims to summarize the findings of the studies in which asbestos fibers in the peritoneum were quantified by electron microscopy, occasionally associated with spectroscopy, both in neoplastic and non-neoplastic tissue. The 9 studies selected comprised 62 cases, out of whom 100 samples were analyzed. Asbestos fibers were detected in 58 samples (58%). In addition, 28 cases had diagnosis of peritoneal mesothelioma. For 32 cases, a lung tumor sample was available: 28/32 samples analyzed presented asbestos fibers; 18/32 reported amphiboles with a range from not detected to 14.2 million fibers per gram of dry tissue (mfgdt); 18/32 reported chrysotile, with a range of 0 to 90 mfgdt. The studies were heterogeneous for type of samples, analytical technology, and circumstances of exposure to asbestos. To evaluate asbestos fibers in the peritoneum and to better understand the association between asbestos exposure and malignant peritoneal mesothelioma, it is desirable that the search for asbestos fibers becomes a routine process every time peritoneal tissue is accessible.

Healthcare workers, epidemic biological risks - recommendations based on the experience with COVID-19 and Ebolavirus.

Infectious disease outbreaks frequently cause illness and death among Healthcare Workers (HCWs). We compare strategies from recent, past and ongoing outbreak measures used to protect HCWs, including those facing additional challenges such as racial disparities, violence and stigmatization. Outbreaks and pandemics superimposed on countries with preexisting crises have also affected emergency response to these viral outbreaks. Strategies to protect HCWs include adherence to recommended infection prevention and control measures; new technology such as rapid point-of-care tests and remote monitoring; adopting national public health preparedness plans to ensure the supply and allocation of PPE, staff, and testing supplies; occupational health and mental health support services. Lessons learned from recent pandemics should be used by Infection Prevention and Control and Occupational Health staff to refine preparedness plans to protect HCWs better.

Quantitative Assessment of Asbestos Fibers in Normal and Pathological Pleural Tissue-A Scoping Review.

BACKGROUND: pleural mesothelioma is a rare cancer in the general population, but it is more common in subjects occupationally exposed to asbestos. Studies with asbestos fiber quantification in pleural tissue are scarce: for this reason, we aimed at undertaking a scoping review to summarize the evidence provided by studies in which asbestos fibers were determined by electron microscopy (SEM or TEM) in human pleural tissues, whether normal or pathologic. MATERIALS AND METHODS: A scoping review of articles that quantified asbestos fibers in human pleural tissue (normal or pathologic) by electron microscopy (SEM or TEM), in subjects with asbestos exposure (if any) was performed. RESULTS: The 12 studies selected comprised 137 cases, out of which 142 samples were analyzed. Asbestos fibers were detected in 111 samples (78%) and were below the detectable limit in 31 samples (22%). The concentration of asbestos fibers detected in the positive samples was distributed from as low as 0.01 mfgdt (millions of fibers per gram of dry tissue) up to 240 mfgdt. However, the minimum concentration of fibers overlaps in the three types of tissues (normal pleura, pleural plaque, mesothelioma) in terms of magnitude; therefore, it is not possible to distinguish a definite pattern which differentiates one tissue from the other. CONCLUSIONS: The studies included were heterogeneous as to the representativeness of the samples and analytical techniques; the possibility of false negatives must be considered. It would be desirable to systematically search for asbestos fibers to fill the knowledge gap about the presence of asbestos fibers in normal or pathological pleural tissue in order to better understand the development of the different pleural diseases induced by this mineral.

Proposed Mitigation and Adaptation Strategies Related to Climate Change: Guidance for OEM Professionals.

Climate change is an urgent challenge amplified by socioeconomic factors that demands thoughtful public health responses from OEM professionals. This guidance statement from the American College of Occupational and Environmental Medicine focuses on the different strategies that these health professionals can implement to protect workers from health impacts associated with climate change hazards, foster workplace resilience in the face of rapidly changing environments, and take the necessary steps to mitigate the effects of global climate change.

Where to Find Evidence-Based Information on Occupational Safety and Health?

Background: Occupational Safety and Health (OSH) professionals must base their advice and interventions on evidence from science, in balance with their expertise, and with workers' and other stakeholders' values and preferences. Evidence-based professional practice is one of the remedies against misinformation creating confusion and distrust in the society. Objectives: To present, for OSH professionals, an overview and critical considerations about concepts, strategies, and tools needed for an accurate search for evidence-based information. Methods: Information sources have been collected and discussed as a base for a documented vision on knowledge questions, online information sources, search engines, databases, and tools. Results: Every search should start with a carefully phrased question. To help finding a reliable answer, potential evidence-based online sources are presented. Systematic reviews and original scientific articles are regarded as primary sources. Secondary and tertiary sources are discussed, such as practice guidelines, point-of-care summaries, advisory reports, quality websites or apps, Wikipedia, quality videos, and e-lessons. To find sources, adequate use of search engines and databases is required. Examples are discussed briefly, such as PubMed/MEDLINE, Virtual Health Library, NICE, Cochrane Library, Cochrane Work, Google (Scholar), and YouTube. Conclusions: Evidence-based practice in OSH must be stimulated, relying mainly on trusted online sources. The breadth of appropriate information sources is wider than described in most publications. Search engines facilitate the finding of quality reports, videos, e-courses, and websites. Such sources can be explored by well-trained professionals to complement the use of scientific articles, reviews, point-of-care summaries, and guidelines. Adequate use of online information sources requires awareness, motivation, and skills in professionals and educators. To date, the quality of skills in searching is low, thus a more adequate education is crucial. The quality of sources, search engines, and databases will be considered more thoroughly in another study. International collaboration is profitable and needs new drivers.

Working in Venezuela: How the Crisis has Affected the Labor Conditions.

BACKGROUND: Venezuela, the country with the largest oil reserves in the world, is facing the worst economic, social and political crisis in its history; which has notably affected the quality of life of the workforce and the entire population. OBJECTIVES: Identify and analyze the main social factors derived from the Venezuelan crisis, which are affecting the workers' health and working conditions. METHODS: Document study. Several sources of information from the last twenty years were consulted, ranging from public statistics and reports, newspaper articles, and results of scientific research. The information gathered was carefully studied to ensure that only reliable sources were used to ultimately reach valid conclusions. RESULTS: Both workers from the formal and informal sector and their families are struggling to fulfill their basic needs. Low salaries and soaring inflation have resulted in a dramatic reduction in the purchasing power of the people. General violence and high prices of basic goods are some of the major problems affecting workers both inside and outside of their working environment. Being a formal employee is no longer a guarantee for an acceptable quality of life. As a result, over 1.6 million Venezuelans have left their country since 2015 in a migration crisis never seen before in Latin America. CONCLUSION: Quality of life and wellbeing of most of the Venezuelan population has being deteriorated in the last 5 years and Occupational Safety and Health (OSH) is not a priority for enterprises in the middle of the economic emergency and general deterioration of daily life.Despite the relevance of this problem, research on the subject is very limited. Recent and pertinent data is needed to properly identify and measure the risks and negative consequences that workers and families are exposed caused by the ongoing crisis.

Bachaqueros: un trabajo del mercado negro venezolano / Bachaqueros: a Venezuelan black market job

RESUMEN: 24. En Venezuela, dentro del sector informal, surge un nuevo fenómeno laboral categorizado como una práctica socioeconómica de características delictivas que está en contra de la Ley de Precios Justos, que lleva por nombre "bachaqueo"; esta actividad se caracteriza por la reventa de productos de primera necesidad a precios que superan hasta 100 veces, o más, su valor oficial. 25. 26. Esta investigación realizó una revisión hemerográfica y de la literatura científica relacionada con el fenómeno del bachaqueo, el mercado negro y la economía informal. 27. 28. El bachaqueo, al posibilitar el autoempleo es difícil de erradicar debido a la rápida obtención de ingresos, además de permitir la libertad de horario y la evasión de impuestos. Las personas que realizan este tipo de actividad constituyen una población susceptible de padecer enfermedades relacionadas con su ocupación debido a los múltiples factores de riesgo a los que se exponen, además de su exclusión del Sistema de Seguridad Social y la falta de acceso a servicios de Seguridad y Salud en el Trabajo. 29. 30. Basados en experiencias previas, sumado a la disponibilidad cada vez menor de productos regulados a precios falsamente bajos en el mercado venezolano, estimamos que la fuerza del fenómeno llama do bachaqueo, pudiese tender a disminuir.

ABSTRACT: 35. In Venezuela, within the informal sector, a new labor phenomenon is categorized as a socioeconomic practice of illegal characteristics that goes against the "Ley de Precios Justos" (Fair Prices Law), called "bachaqueo". This activity is characterized by the resale of basic products at prices that exceed up to 100 times, or more, their official value. 36. 37. This research carried out a review of news and scientific literature related to the phenomenon of "bachaqueo", the black market and the informal economy. 38. 39. The "bachaqueo", by enabling self-employment, is difficult to elimi nate due to the incentives created by rapid incomes, time flexibility and tax evasion. People who carry out these activities constitute a population susceptible to suffer occupational diseases due to the multiple risk factors to which they are exposed, in addition to their exclusion from the Social Security System and the lack of access to services of Occupational Security and Health. 40. 41. Based on previous experiences, added to increased scarcity of regu lated products in the Venezuelan market, we estimate that the strength of this fenomenon called "bachaqueo" might tend to decrease.

Occupational Safety and Health in Venezuela.

INTRODUCTION: Venezuela has pioneered a preventive-focused and comprehensive movement for Occupational Safety and Health (OSH) in Latin America. However, despite being an oil-rich country, it has some of the lowest salaries for their workers and highest levels of hyperinflation, devaluation, crime, and violence of the world. OBJECTIVES: Review the current status and challenges on relevant aspects of OSH in Venezuela. METHODS: Review of literature and documents from national governments, UN agencies, NGOs, and the Venezuelan government concerning OSH and related topics since 1986. RESULTS: Reformed in 2005, the Organic Law on Prevention, Conditions and Environment (LOPCYMAT) was a fundamental moment of change for OSH. Factors which have impacted OSH the strongest are (i) the creation of the National Institute of Occupational Safety and Health (INPSASEL) and (ii) the socioeconomic crisis Venezuela is going through. Venezuela's laws are innovative and yet non-compliance is enormous. Almost half of the population works in the informal sector. Following the International Labor Office projections, 5 people die per day in Venezuela due to occupational accidents or diseases, making health and safety at work a luxury rather than a right. The quality of life for the average worker has deteriorated, affecting not only health but the overall well-being of all Venezuelans. The political and socio-economic situation has led to a mass exodus of more than 1.6 million highly qualified and talented professionals. Many statistics concerning OSH are not updated and are unreliable regarding occupational accidents and diseases. CONCLUSIONS: There is a substantial difference between what is written to protect individual Venezuelans in the workplace and the reality of workplace conditions. Substantial governmental actions are needed in the immediate future to improve occupational safety and health of Venezuelan workers.

Tensión muscular percibida en operarias de máquinas de moldeo por inyección de plástico / Perceived muscle tension in female workers of plastic injection molding machines

OBJETIVO: Identificar la incidencia de Tensión Muscular Percibida (TMP) según edad, antigüedad y tipo de jornada en operarias de máquinas de moldeo por inyección de plástico. MÉTODOS: se aplicó el cuestionario Nórdico Estandarizado a 86 de 128 trabajadoras con mínimo 1 año de antigüedad. RESULTADOS: Según el estudio transversal, el 84,9% de trabajadoras presentó TMP, con mayor incidencia en aquellas de 40 años de edad o más (90,2%), y mayor aun en el grupo de 6 a 10 años de antigüedad en el puesto (93,2%). Respecto al tipo de jornada laboral, la mayor incidencia de TMP fue en trabajadoras del horario nocturno (95,2%). El segmento corporal más afectado fue el cuello (63%), seguido por hombros y manos/muñecas (60,3%, respectivamente), y columna lumbar (50,7%). Del total de operarias con TMP, el 64,4% refirió impedimento para el desempeño de su trabajo en el último año, mientras que el 80,8% indicó manifestaciones corporales durante la última semana. CONCLUSIONES: No hubo significancia estadística de TMP con respecto a edad (X2 = 1,798; p > 0,05) o jornadas de trabajo (X2 = 3,636; p > 0,05), pero sí en relación con antigüedad (X2 = 13,881; p < 0,05). Las posturas estáticas y movimientos repetitivos pueden ser algunos factores de riesgo ocupacionales causales de TMP.

OBJECTIVE: To identify relationships between Perceived Muscular Tension (PMT), age, time-on-job, and labor shifts for female operators of plastic molding injection machines. METHODS: a standardized Nordic questionnaire was administered to 86 of the 128 workers with at least 1 year on job. RESULTS: Cross-sectional study, of an average population of 39.9 years of age, yielded 84.9% of workers affected with PMT, with a higher incidence amongst individuals 40 years or older (90.2%). The highest incidence of affected individuals was noticed in the group with 6 to 10 years on the job (93.2%). With regards to work shift, the highest prevalence of TMP was amongst night shift workers (95.2%). Regarding the affected body part; neck (63%), followed by: (i) shoulders and (ii) hands / wrists (both with 60.3%), and lower back (50.7%). From those that reported PMT, 64.4% reported some impairment in the performance of their work duties in the past year, while 80.8% indicated having symptoms during the immediately preceding week. CONCLUSIONS: as it relates to PMT, there is no statistical significance for the variables age (X2 = 1.798, p > 0.05) or work shift (X2 = 3.636, p > 0.05). However, time-on-job (X2 = 13.881; p < 0.05) has statistical relevance.

Geographical and occupational aspects of leptospirosis in the coffee-triangle region of Colombia, 2007-2011.

BACKGROUND: There are few studies occupationally profiling as well as using Geographic information system (GIS) to map human leptospirosis. There are no detailed, municipality-level, epidemiological maps in Colombia neither in South America. We developed such maps for the Coffee-triangle region, Colombia and assess some occupational issues. METHODS: surveillance cases data (2007-2011) were used to estimate the annual incidence rates (cases/100,000 population) of leptospirosis to develop the first maps of disease in the 53 municipalities of the Coffee-triangle region of Colombia. GIS used was Kosmo(®) 3.1. Five thematic maps were developed according to municipalities and years. Using labor official information, analyses between agriculture (harvested areas) with disease occurrence was done (linear regression). RESULTS: Between 2007 and 2011, 786 cases were reported (77.8% from one department, Risaralda), for a cumulated rate of 32.18 cases/100,000 population. The highest rate was reported in the less developed municipality of one department (Pueblo Rico, Risaralda) with 1535.05 cases/100,000 population (187 cases, 2009). Armenia (Quindio department capital city), reported 23.41 cases/100,000pop (2011). In those patients with identified occupations, 33.3% were agriculture workers, finding a significant relationship between the number of cases in 2008 and the harvested area by municipality (r(2)=0.48; p=0.0083). CONCLUSION: one of the 53 municipalities contributed with almost a quarter of the cases. Agriculture was significantly associated with the incidence. Use of GIS-based epidemiological maps allow to focus actions in prevention and control for risk zones for leptospirosis which still represents a significant issue in the region and Colombia, particularly in agriculture workers.

Riesgos laborales en trabajadores de barberías y peluquerías de economía informal: Caracas, Venezuela / Occupational hazards in barbershops and hairdressers workers of informal economy: Caracas, Venezuela

En Venezuela el sector informal de barberías y peluquerías constituye una fuente de absorción de mano de obra desocupada, que tiene algunas ventajas respecto a ingresos y flexibilización laboral, pero por otro lado es un sector desprotegido y con accesos limitados o nulos a servicios de seguridad y salud laboral, lo que dificulta la inclusión en programas de prevención de accidentes de trabajo y enfermedades ocupacionales. En este estudio observacional transversal y descriptivo se aplicó "la encuesta de las condiciones de trabajo y salud en América Latina del Center for International Health" y se analizaron las actividades de 40 trabajadores de barberías y peluquerías: 50% del género masculino y 50% femenino, 85% con edades comprendidas entre 20-49 años. De ellos, 65% manipulaban productos químicos, 62,5% utilizaban el secador y/o máquina de afeitar, 87,5% habían sufrido al menos una lesión en su área de trabajo y 100% refirió adoptar bipedestación prolongada, hacer movimientos repetitivos y presentar algún tipo de trastorno músculo-esquelético, cuyos síntomas más frecuentes fueron dorsalgias y lumbalgias con 37,5% y 32,5% respectivamente. Por otro lado, las várices en miembros inferiores fueron la segunda causa de morbilidad reportada.

Some of the barbershops and hair saloons -belonging to the informal sector- are a source of employment which takes in unoccupied work force. This workers have some advantages concerning to income and work flexibility, but in the other hand it is an unprotected sector with limited or nonexistent access to Occupational, Safety and Health services. This situation makes difficult to include them in labor accident occupational disease prevention programs. A cross-sectional and descriptive study was carried out in which 40 barbershop and hair saloon workers were surveyed. Their activities were analyzed, employing the "survey of work and health conditions in Latin America of the Center for International Health". Of these workers, 50% were male and 50% female, and 85% were between 20 to 49 years old. 65% used chemical products, 62,5% used hair dryers and/or shaving machines, 87,5% had suffered some form of workplace injury, and all of them admitted to have adopted prolonged standing postures, to make repetitive movements, suffering at least from any musculoskeletal disorder. The second disease reported were varicose veins.