Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 56.262
Filtrar
1.
Mil Med Res ; 7(1): 24, 2020 05 11.
Artículo en Inglés | MEDLINE | ID: mdl-32393381

RESUMEN

BACKGROUND: Many healthcare workers were infected by coronavirus disease 2019 (COVID-19) early in the epidemic posing a big challenge for epidemic control. Hence, this study aims to explore perceived infection routes, influencing factors, psychosocial changes, and management procedures for COVID-19 infected healthcare workers. METHODS: This is a cross-sectional, single hospital-based study. We recruited all 105 confirmed COVID-19 healthcare workers in the Zhongnan Hospital of Wuhan University from February 15 to 29, 2020. All participants completed a validated questionnaire. Electronic consent was obtained from all participants. Perceived causes of infection, infection prevention, control knowledge and behaviour, psychological changes, symptoms and treatment were measured. RESULTS: Finally, 103 professional staff with COVID-19 finished the questionnaire and was included (response rate: 98.1%). Of them, 87 cases (84.5%) thought they were infected in working environment in hospital, one (1.0%) thought their infection was due to the laboratory environment, and 5 (4.9%) thought they were infected in daily life or community environment. Swab of throat collection and physical examination were the procedures perceived as most likely causing their infection by nurses and doctors respectively. Forty-three (41.8%) thought their infection was related to protective equipment, utilization of common equipment (masks and gloves). The top three first symptoms displayed before diagnosis were fever (41.8%), lethargy (33.0%) and muscle aches (30.1%). After diagnosis, 88.3% staff experienced psychological stress or emotional changes during their isolation period, only 11.7% had almost no emotional changes. Arbidol (Umifenovir; an anti-influza drug; 69.2%) was the drug most commonly used to target infection in mild and moderate symptoms. CONCLUSION: The main perceived mode of transmission was not maintaining protection when working at a close distance and having intimate contact with infected cases. Positive psychological intervention is necessary.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/psicología , Infecciones por Coronavirus/transmisión , Personal de Salud/psicología , Control de Infecciones/métodos , Pandemias/prevención & control , Neumonía Viral/prevención & control , Neumonía Viral/psicología , Neumonía Viral/transmisión , Adulto , Betacoronavirus , China , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Exposición Profesional , Equipo de Protección Personal , Estrés Psicológico , Encuestas y Cuestionarios , Centros de Atención Terciaria , Adulto Joven
2.
Global Health ; 16(1): 46, 2020 05 15.
Artículo en Inglés | MEDLINE | ID: mdl-32414379

RESUMEN

Medical staff caring for COVID-19 patients face mental stress, physical exhaustion, separation from families, stigma, and the pain of losing patients and colleagues. Many of them have acquired SARS-CoV-2 and some have died. In Africa, where the pandemic is escalating, there are major gaps in response capacity, especially in human resources and protective equipment. We examine these challenges and propose interventions to protect healthcare workers on the continent, drawing on articles identified on Medline (Pubmed) in a search on 24 March 2020. Global jostling means that supplies of personal protective equipment are limited in Africa. Even low-cost interventions such as facemasks for patients with a cough and water supplies for handwashing may be challenging, as is 'physical distancing' in overcrowded primary health care clinics. Without adequate protection, COVID-19 mortality may be high among healthcare workers and their family in Africa given limited critical care beds and difficulties in transporting ill healthcare workers from rural to urban care centres. Much can be done to protect healthcare workers, however. The continent has learnt invaluable lessons from Ebola and HIV control. HIV counselors and community healthcare workers are key resources, and could promote social distancing and related interventions, dispel myths, support healthcare workers, perform symptom screening and trace contacts. Staff motivation and retention may be enhanced through carefully managed risk 'allowances' or compensation. International support with personnel and protective equipment, especially from China, could turn the pandemic's trajectory in Africa around. Telemedicine holds promise as it rationalises human resources and reduces patient contact and thus infection risks. Importantly, healthcare workers, using their authoritative voice, can promote effective COVID-19 policies and prioritization of their safety. Prioritizing healthcare workers for SARS-CoV-2 testing, hospital beds and targeted research, as well as ensuring that public figures and the population acknowledge the commitment of healthcare workers may help to maintain morale. Clearly there are multiple ways that international support and national commitment could help safeguard healthcare workers in Africa, essential for limiting the pandemic's potentially devastating heath, socio-economic and security impacts on the continent.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Personal de Salud , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Exposición Profesional/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , Betacoronavirus , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/transmisión , Brotes de Enfermedades/prevención & control , Personal de Salud/psicología , Humanos , Control de Infecciones , Salud Mental , Equipo de Protección Personal/provisión & distribución , Neumonía Viral/epidemiología , Neumonía Viral/transmisión
4.
PLoS One ; 15(5): e0233588, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32428031

RESUMEN

OBJECTIVE: There is limited evidence of work-related transmission in the emerging coronaviral pandemic. We aimed to identify high-risk occupations for early coronavirus disease 2019 (COVID-19) local transmission. METHODS: In this observational study, we extracted confirmed COVID-19 cases from governmental investigation reports in Hong Kong, Japan, Singapore, Taiwan, Thailand, and Vietnam. We followed each country/area for 40 days after its first locally transmitted case, and excluded all imported cases. We defined a possible work-related case as a worker with evidence of close contact with another confirmed case due to work, or an unknown contact history but likely to be infected in the working environment (e.g. an airport taxi driver). We calculated the case number for each occupation, and illustrated the temporal distribution of all possible work-related cases and healthcare worker (HCW) cases. The temporal distribution was further defined as early outbreak (the earliest 10 days of the following period) and late outbreak (11th to 40th days of the following period). RESULTS: We identified 103 possible work-related cases (14.9%) among a total of 690 local transmissions. The five occupation groups with the most cases were healthcare workers (HCWs) (22%), drivers and transport workers (18%), services and sales workers (18%), cleaning and domestic workers (9%) and public safety workers (7%). Possible work-related transmission played a substantial role in early outbreak (47.7% of early cases). Occupations at risk varied from early outbreak (predominantly services and sales workers, drivers, construction laborers, and religious professionals) to late outbreak (predominantly HCWs, drivers, cleaning and domestic workers, police officers, and religious professionals). CONCLUSIONS: Work-related transmission is considerable in early COVID-19 outbreaks, and the elevated risk of infection was not limited to HCW. Implementing preventive/surveillance strategies for high-risk working populations is warranted.


Asunto(s)
Infecciones por Coronavirus/transmisión , Exposición Profesional/estadística & datos numéricos , Neumonía Viral/transmisión , Asia/epidemiología , Infecciones por Coronavirus/epidemiología , Humanos , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/virología , Pandemias , Neumonía Viral/epidemiología
6.
Indian J Med Res ; 151(2 & 3): 177-183, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32362643

RESUMEN

Preparedness for the ongoing coronavirus disease 2019 (COVID-19) and its spread in India calls for setting up of adequately equipped and dedicated health facilities to manage sick patients while protecting healthcare workers and the environment. In the wake of other emerging dangerous pathogens in recent times, such as Ebola, Nipah and Zika, it is important that such facilities are kept ready during the inter-epidemic period for training of health professionals and for managing cases of multi-drug resistant and difficult-to-treat pathogens. While endemic potential of such critically ill patients is not yet known, the health system should have surge capacity for such critical care units and preferably each tertiary government hospital should have at least one such facility. This article describes elements of design of such unit (e.g., space, infection control, waste disposal, safety of healthcare workers, partners to be involved in design and plan) which can be adapted to the context of either a new construction or makeshift construction on top of an existing structure. In view of a potential epidemic of COVID-19, specific requirements to handle it are also given.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , Infecciones por Coronavirus/epidemiología , Brotes de Enfermedades , Personal de Salud , Humanos , Exposición Profesional , Neumonía Viral/epidemiología , Administración de la Seguridad
9.
Mutat Res ; 850-851: 503152, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32247560

RESUMEN

The aim of the present study was to assess the oxidative stress level and chromosomal damage induced by occupational exposure to low dose ionizing radiation (LDIR). Two hundred and eighteen hospital workers occupationally exposed to LDIR were included in this study, along with 118 healthy age- and gender-comparable controls. Occupational dosimetry records were collected over the last year and revealed that the accumulated annual dose for each hospital worker was below the permissible limit of the International Commission on Radiological Protection (ICRP). The individuals' oxidative and antioxidative status were determined by measuring the activities of copper zinc-superoxide dismutase (CuZn-SOD), glutathione peroxidase (GSH-Px), catalase (CAT) enzymes, and the levels of malondialdehyde (MDA) in erythrocytes. The effect of radiation on chromosomal integrity was measured by the frequency of micronuclei (MN) formation using the cytokinesis block technique. Our results showed that the activities of CuZn-SOD and CAT enzymes and MDA levels observed in the hospital workers were higher than those in the controls (p < 0.05). We did not find significant difference in GSH-Px enzyme activity between the two groups (p = 0.247). A higher frequency of MN was found in exposed groups than in the controls [3(1-5) ‰ versus 2(0.75-4) ‰; p<0.001]. The difference was significant for males (p = 0.012), but not females (p = 0.14). Multiple linear regression analysis showed differences in the oxidant activities and MN frequency between hospital workers and controls adjusted for age, gender, smoking status and drinking status. Correlation analysis indicated that the frequency of MN was positively associated with MDA levels (p < 0.05). Altogether, these results support the detrimental effects of chronic low dose radiation in humans, which involves the induction of oxidative stress and chromosomal damage.


Asunto(s)
Antioxidantes/metabolismo , Aberraciones Cromosómicas/efectos de la radiación , Exposición Profesional/efectos adversos , Estrés Oxidativo/efectos de la radiación , Adulto , Antioxidantes/efectos de la radiación , Catalasa/sangre , Femenino , Glutatión Peroxidasa/sangre , Hospitales , Humanos , Masculino , Malondialdehído/sangre , Registros Médicos , Persona de Mediana Edad , Dosis de Radiación , Radiación Ionizante , Radiometría , Superóxido Dismutasa-1/sangre
11.
Medicine (Baltimore) ; 99(14): e19565, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32243374

RESUMEN

Findings on the association between cotton dust exposure and lung cancer risk in epidemiologic studies have been inconsistent. Therefore, we conducted a meta-analysis of data from observational studies to quantify this association.PubMed, EMBASE, and the Cochrane library databases were searched for observational studies with data on cotton dust exposure and lung cancer risk. Studies that reported adjusted relative risks (RRs) with 95% confidence intervals (CIs) of lung cancer associated with cotton dust exposure were included. Subgroup analyses were conducted according to key characteristics.Fifteen studies involving a total of 73,812 individuals were included in the meta-analysis. Combining estimates from all the 15 observational studies, cotton dust exposure was associated with a decreased risk of lung cancer (combined RR, 0.78; 95% CI, 0.66-0.91; P = .002). Pooled estimates of multivariate RRs by gender were 0.71 (95% CI, 0.58-0.88; P = .001) among males, based on 7 studies, and 0.77 (95% CI, 0.67-0.89; P < .001) among females, based on 9 studies. Further analyses examining the influence of a single study on the results by omitting a study at each turn yielded a range of RR from 0.74 to 0.82.Our meta-analysis indicates that cotton dust exposure is associated with a decreased risk of lung cancer.


Asunto(s)
Fibra de Algodón/análisis , Polvo/análisis , Neoplasias Pulmonares/epidemiología , Exposición Profesional/análisis , Industria Textil , Factores de Edad , Humanos , Estudios Observacionales como Asunto , Factores de Riesgo , Factores Sexuales
14.
Int J Infect Dis ; 94: 156-163, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32251790

RESUMEN

Hong Kong has been recently attacked by the coronavirus disease-2019 (COVID-19). In late January 2020, it's shown a steadily increasing trend of confirmed cases. There is a 257 in total infected cases confirmed including 4 deaths until 20th of March 2020. To prevent further outbreak of COVID-19, this article discusses the current understanding of COVID-19 and compares with the outbreak of SARS-CoV-2 in 2003 of Hong Kong from the causes, transmission, symptoms, diagnosis, treatments and preventions to study for an applicable measurement to control COVID-19.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , Virus del SRAS , Síndrome Respiratorio Agudo Grave , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/terapia , Infecciones por Coronavirus/transmisión , Brotes de Enfermedades/prevención & control , Personal de Salud , Hong Kong , Humanos , Exposición Profesional , Neumonía Viral/epidemiología , Neumonía Viral/terapia , Neumonía Viral/transmisión , Síndrome Respiratorio Agudo Grave/epidemiología , Síndrome Respiratorio Agudo Grave/terapia , Síndrome Respiratorio Agudo Grave/transmisión
17.
PLoS One ; 15(4): e0232452, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32343747

RESUMEN

INTRODUCTION: With the global spread of COVID-19, there is a compelling public health interest in quantifying who is at increased risk of contracting disease. Occupational characteristics, such as interfacing with the public and being in close quarters with other workers, not only put workers at high risk for disease, but also make them a nexus of disease transmission to the community. This can further be exacerbated through presenteeism, the term used to describe the act of coming to work despite being symptomatic for disease. Quantifying the number of workers who are frequently exposed to infection and disease in the workplace, and understanding which occupational groups they represent, can help to prompt public health risk response and management for COVID-19 in the workplace, and subsequent infectious disease outbreaks. METHODS: To estimate the number of United States workers frequently exposed to infection and disease in the workplace, national employment data (by Standard Occupational Classification) maintained by the Bureau of Labor Statistics (BLS) was merged with a BLS O*NET survey measure reporting how frequently workers in each occupation are exposed to infection or disease at work. This allowed us to estimate the number of United States workers, across all occupations, exposed to disease or infection at work more than once a month. RESULTS: Based on our analyses, approximately 10% (14.4 M) of United States workers are employed in occupations where exposure to disease or infection occurs at least once per week. Approximately 18.4% (26.7 M) of all United States workers are employed in occupations where exposure to disease or infection occurs at least once per month. While the majority of exposed workers are employed in healthcare sectors, other occupational sectors also have high proportions of exposed workers. These include protective service occupations (e.g. police officers, correctional officers, firefighters), office and administrative support occupations (e.g. couriers and messengers, patient service representatives), education occupations (e.g. preschool and daycare teachers), community and social services occupations (community health workers, social workers, counselors), and even construction and extraction occupations (e.g. plumbers, septic tank installers, elevator repair). CONCLUSIONS: The large number of persons employed in occupations with frequent exposure to infection and disease underscore the importance of all workplaces developing risk response plans for COVID-19. Given the proportion of the United States workforce exposed to disease or infection at work, this analysis also serves as an important reminder that the workplace is a key locus for public health interventions, which could protect both workers and the communities they serve.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Exposición Profesional/efectos adversos , Ocupaciones/estadística & datos numéricos , Neumonía Viral/epidemiología , Betacoronavirus , Humanos , Pandemias , Salud Pública , Factores de Riesgo , Estados Unidos/epidemiología , Lugar de Trabajo
19.
MMWR Morb Mortal Wkly Rep ; 69(15): 472-476, 2020 Apr 17.
Artículo en Inglés | MEDLINE | ID: mdl-32298249

RESUMEN

On February 26, 2020, the first U.S. case of community-acquired coronavirus disease 2019 (COVID-19) was confirmed in a patient hospitalized in Solano County, California (1). The patient was initially evaluated at hospital A on February 15; at that time, COVID-19 was not suspected, as the patient denied travel or contact with symptomatic persons. During a 4-day hospitalization, the patient was managed with standard precautions and underwent multiple aerosol-generating procedures (AGPs), including nebulizer treatments, bilevel positive airway pressure (BiPAP) ventilation, endotracheal intubation, and bronchoscopy. Several days after the patient's transfer to hospital B, a real-time reverse transcription-polymerase chain reaction (real-time RT-PCR) test for SARS-CoV-2 returned positive. Among 121 hospital A health care personnel (HCP) who were exposed to the patient, 43 (35.5%) developed symptoms during the 14 days after exposure and were tested for SARS-CoV-2; three had positive test results and were among the first known cases of probable occupational transmission of SARS-CoV-2 to HCP in the United States. Little is known about specific risk factors for SARS-CoV-2 transmission in health care settings. To better characterize and compare exposures among HCP who did and did not develop COVID-19, standardized interviews were conducted with 37 hospital A HCP who were tested for SARS-CoV-2, including the three who had positive test results. Performing physical examinations and exposure to the patient during nebulizer treatments were more common among HCP with laboratory-confirmed COVID-19 than among those without COVID-19; HCP with COVID-19 also had exposures of longer duration to the patient. Because transmission-based precautions were not in use, no HCP wore personal protective equipment (PPE) recommended for COVID-19 patient care during contact with the index patient. Health care facilities should emphasize early recognition and isolation of patients with possible COVID-19 and use of recommended PPE to minimize unprotected, high-risk HCP exposures and protect the health care workforce.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/transmisión , Transmisión de Enfermedad Infecciosa de Paciente a Profesional , Personal de Hospital , Neumonía Viral/diagnóstico , Neumonía Viral/transmisión , Adulto , California/epidemiología , Infecciones por Coronavirus/epidemiología , Femenino , Hospitalización , Humanos , Masculino , Persona de Mediana Edad , Exposición Profesional , Pandemias , Equipo de Protección Personal/estadística & datos numéricos , Personal de Hospital/estadística & datos numéricos , Neumonía Viral/epidemiología , Medición de Riesgo
20.
Mutat Res ; 852: 503159, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32265039

RESUMEN

Dental technicians may be chronically exposed to methyl methacrylate (MMA), used in the production of dental prostheses. We have studied whether occupational exposure to MMA affects genotoxicity biomarkers such as 8-OHdG formation, comet assay, and buccal micronucleus frequency. MMA exposure was assessed via ambient air analysis. Although no significant differences between exposed and non-exposed individuals were seen with respect to blood genotoxicity measurements, we found a higher level of buccal-cell anomalies in the exposed group.


Asunto(s)
Cementos para Huesos/toxicidad , Técnicos Dentales , Metilmetacrilato/toxicidad , Micronúcleos con Defecto Cromosómico/efectos de los fármacos , Mucosa Bucal/efectos de los fármacos , 8-Hidroxi-2'-Desoxicoguanosina/sangre , Adulto , Estudios de Casos y Controles , Ensayo Cometa , Daño del ADN , Femenino , Humanos , Masculino , Pruebas de Micronúcleos , Mucosa Bucal/citología , Exposición Profesional/análisis
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA