ABSTRACT
Outdoor carbon monoxide comes mainly from vehicular emissions, and high concentrations occur in areas with heavy traffic congestion. CO binds to hemoglobin, forming carboxyhemoglobin (COHb), and reduces oxygen delivery. We investigated the link between the adverse effects of CO on the respiratory system using COHb as a marker for chronic CO exposure. We examined the relationship between acute respiratory infections (ARIs) and COHb concentrations in school-age children living in urban and suburban areas of Quito, Ecuador. We selected three schools located in areas with different traffic intensities and enrolled 960 children. To adjust for potential confounders we conducted a detailed survey. In a random subsample of 295 children, we determined that average COHb concentrations were significantly higher in children attending schools in areas with high and moderate traffic, compared with the low-traffic area. The percentage of children with COHb concentrations above the safe level of 2.5% were 1, 43, and 92% in low-, moderate-, and high-traffic areas, respectively. Children with COHb above the safe level are 3.25 [95% confidence interval (CI), 1.65-6.38] times more likely to have ARI than children with COHb < 2.5%. Furthermore, with each percent increase in COHb above the safety level, children are 1.15 (95% CI, 1.03-1.28) times more likely to have an additional case of ARI. Our findings provide strong evidence of the relation between CO exposure and susceptibility to respiratory infections.
Subject(s)
Air Pollutants/adverse effects , Carbon Monoxide/adverse effects , Carboxyhemoglobin/analysis , Environmental Exposure , Respiratory Tract Infections/etiology , Acute Disease , Child , Ecuador , Female , Humans , Male , Prospective Studies , Urban Population , Vehicle EmissionsABSTRACT
Se realizó una investigación descriptiva,prospectiva y transversal para obtener un estimado de los costos de la capacitación de los recursos humanos de la salud en el Hogara de Ancianos de Pinar del rio en el mes de Febrero del 2002.El universo estuvo constituido por 30 asistenters a pacientes y 24 enfermeras que representan el 88.8 porciento del total y dos profesores.Para la determinación de los costos tangibles se realizarón encuestas semiestructuradas a administrativos del hogar,asi como a los cursitas y profesores,obteniendose como resultado un costo total de $7797.7 y un costo unitario de $14.7,lo que demuestra que la modalidad de la Educacion Permanente con la capacitación en el puesto de trabajo permite aumentar la eficiencia ya que disminuyeron los costos totales en $378 y el unitario en $33.En relación con los costos intangibles tanto los estudiantes como los profesores mostraron satisfacción con los conocimientos recibidos y brindados en aras de elevar la calidad en la atención a los ancianos(AU)