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2.
Nat Commun ; 11(1): 5064, 2020 10 08.
Artigo em Inglês | MEDLINE | ID: mdl-33033249

RESUMO

SARS-CoV-2 may pose an occupational health risk to healthcare workers. Here, we report the seroprevalence of SARS-CoV-2 antibodies, self-reported symptoms and occupational exposure to SARS-CoV-2 among healthcare workers at a large acute care hospital in Sweden. The seroprevalence of IgG antibodies against SARS-CoV-2 was 19.1% among the 2149 healthcare workers recruited between April 14th and May 8th 2020, which was higher than the reported regional seroprevalence during the same time period. Symptoms associated with seroprevalence were anosmia (odds ratio (OR) 28.4, 95% CI 20.6-39.5) and ageusia (OR 19.2, 95% CI 14.3-26.1). Seroprevalence was also associated with patient contact (OR 2.9, 95% CI 1.9-4.5) and covid-19 patient contact (OR 3.3, 95% CI 2.2-5.3). These findings imply an occupational risk for SARS-CoV-2 infection among healthcare workers. Continued measures are warranted to assure healthcare workers safety and reduce transmission from healthcare workers to patients and to the community.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/etiologia , Pessoal de Saúde/estatística & dados numéricos , Exposição Ocupacional/efeitos adversos , Pneumonia Viral/epidemiologia , Pneumonia Viral/etiologia , Adulto , Anticorpos Antivirais/sangue , Betacoronavirus/imunologia , Infecções por Coronavirus/patologia , Infecções por Coronavirus/transmissão , Estudos Transversais , Feminino , Hospitais , Humanos , Imunoglobulina G/sangue , Transmissão de Doença Infecciosa do Paciente para o Profissional , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/estatística & dados numéricos , Saúde do Trabalhador , Pandemias , Pneumonia Viral/patologia , Pneumonia Viral/transmissão , Estudos Soroepidemiológicos , Suécia/epidemiologia
3.
Ecotoxicol Environ Saf ; 203: 110989, 2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-32888600

RESUMO

AIM: The city of L'Aquila (central Italy) was hit by a strong earthquake in 2009 that caused the collapse of several buildings, deaths and injured people. In the following years, a great number of building sites were activated, building workers resulted intensely exposed and represent a relevant target for research on environmental mutagenesis and epidemiological surveillance. Cells of buccal mucosa are considered an appropriate site for early detecting of cytogenetic damage, since it represents the first barrier in inhalation or ingestion and can metabolize carcinogenic agents into reactive chemicals. Our study is aimed 1) at comparing the early genotoxic damage as measured by the buccal mucosa micronucleus test in two subgroups of workers defined by different occupational exposure and 2) at evaluating possible confounding variables such as lifestyle factors. METHODS AND RESULTS: A cross-sectional study was conducted in L'Aquila, on 24 outdoor workers (OWs) highly exposed on the construction sites and 26 indoor workers (IWs), all subjected to the compulsory occupational surveillance system, in the period 2017-2018. Buccal cells samples were collected and, based on the Micronucleus test, the exfoliated cells were classified in respect of nuclear changes observed. Moreover, a self-report questionnaire composed of 84 items, was administered to the workers. RESULTS: Significant differences were observed between Exp+ (OWs) and Exp- (IWs) in the number of the analyzed cells (expressed as mean value out of 1000 cells): respectively 954.46 vs 990.06 normal cells, (p < 0.001); 19.79 vs 4.95 micronucleated cells, as marker of chromosomal damage (p < 0.001); 13.93 vs 8.96 binucleated cells, as marker of failed cytokinesis (p < 0.001); 2.09 vs 1.18 karyolytic cells, as marker of cell death and damaged DNA (p < 0.05). According with a multivariate regression analysis, in addition to the job exposure (OW vs IW, beta = 12.221, p < 0.001), the only variable independently associated with an increase in Micronuclei (MNs) is the smoking habit (OWs vs IWs, beta = 6.683, p < 0.001) which, even if not associated with dust exposure, worsens cell integrity. Moreover, this worsening effect is weaker in workers not exposed to the site dust (moderation effect). Within social demographic factors, the high educational level only apparently seems to affect MNs number: even if unbalanced in favor of IWs vs OWs, this variable resulted a confounder, since its effect disappears when the interaction between these two factors is considered, because it is a covariate of smoking habit as well as of the job condition. CONCLUSION: Despite some limitation, our findings clearly confirm the role of occupational exposure as a marker of cytogenetic damage associated with MNs number in construction workers. Moreover, smoking status appears as the only other investigated factor independently associated to the outcome. The statistical model, in addition, highlights possible moderation and confounding effects, such as interaction between smoking and occupational exposure and the unbalanced school education level in workers. Micronucleus test in exfoliated buccal cells would be considered a suitable method for studying the early genotoxic damage in the construction occupational setting as well as in evaluating the efficacy of preventive practices.


Assuntos
Indústria da Construção , Dano ao DNA , Poeira , Mucosa Bucal/citologia , Exposição Ocupacional/efeitos adversos , Adulto , Estudos Transversais , Humanos , Itália , Masculino , Testes para Micronúcleos , Pessoa de Meia-Idade , Adulto Jovem
4.
Rev Saude Publica ; 54: 92, 2020 Sep 04.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32901756

RESUMO

OBJECTIVE: To describe the prevalence of self-reported exposure to chemical substances at work and its associated factors in a sample of Brazilian adults that participated in the National Health Survey, conducted between 2013 and 2014. METHODS: Our sample consisted of adults aged 18 years or older that answered question E1 of module E: "In the week of July 21-27, 2013 (reference week), did you work as regular employee or intern for at least an hour in any activity paid with cash?" Sociodemographic data, situation and health behaviors were analyzed with single and multivariate binary logistic regression. The model was adjusted by the variables of all groups, adopting a 5% significance level. The values of odds ratio (OR) and respective confidence intervals were obtained. RESULTS: Women (OR = 0.74; 95%CI 0.66-0.82) had a lower chance of exposure to chemicals. The highest chances were observed in groups with no instruction or that attended up to middle-school (OR = 1.77; 95%CI 1.50-2.08), high school (OR = 1.62; 95%CI 1.37-1.91), age between 25 and 54 years (OR = 1.26; 95%CI 1.07-1.48), current smokers (OR = 1.21; 95%CI 1.07-1.37), who reported tiredness (OR = 1.35; 95%CI 1.21-1.50), hearing difficulties (OR = 1.24; 95%CI 1.04-1.48) and who reported having suffered an accident at work (OR = 2.00; 95%CI 1.57-2.54). CONCLUSIONS: The unprecedented results cover the entire workforce. Positive associations with hearing loss, smoking and history of work accidents are consistent, as well as the inverse association with education level and gender differences. The absence of association with asthma was surprising. To fill gaps in investigations on chronic non-communicable diseases, we suggested improving the PNS collection instrument in the occupational dimension.


Assuntos
Comportamentos Relacionados com a Saúde , Exposição Ocupacional/efeitos adversos , Saúde do Trabalhador/estatística & dados numéricos , Local de Trabalho , Adulto , Brasil , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/estatística & dados numéricos , Prevalência , Autorrelato
6.
Acta Dermatovenerol Alp Pannonica Adriat ; 29(3): 115-122, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32975297

RESUMO

INTRODUCTION: This questionnaire study evaluates dermatological complaints that may arise due to hygiene measures and anxiety among healthcare professionals (HCPs) during the COVID-19 outbreak. METHODS: A total of 526 volunteers, consisting of doctors and nurses, participated. Demographic features, personal hygiene behavior, personal protective equipment (PPE) use, Hospital Anxiety and Depression Scale-Anxiety (HADS-A) parameters, and symptoms of various dermatological diseases (xerosis, eczema, acne, hair loss, palmar hyperhidrosis, xeromycteria, urticaria, aphthous stomatitis, and seborrheic dermatitis) were investigated. RESULTS: Although the frequency and severity of many dermatological complaints increased during the pandemic period, the most frequent increase was observed in the frequency of complaints suggesting xerosis and eczema. We found that complaints suggesting xerosis and eczema were seen on the hands 2.44 and 3.57 times, respectively, as a result of washing hands 10 times/day, and that handwashing times of 10 seconds or more significantly increased the risk of eczema (5.44 times). Another remarkable result was a fivefold increase in acne complaints among those using any mask. The severity of all complaints except hair loss and seborrheic dermatitis correlated significantly with HADS-A. CONCLUSIONS: Our study showed that the frequency and severity of some dermatological complaints increased in HCPs.


Assuntos
Infecções por Coronavirus/epidemiologia , Eczema/epidemiologia , Dermatoses da Mão/epidemiologia , Pessoal de Saúde/estatística & dados numéricos , Corpo Clínico Hospitalar/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Adulto , Betacoronavirus , Feminino , Luvas Protetoras/estatística & dados numéricos , Humanos , Higiene , Masculino , Exposição Ocupacional/efeitos adversos , Pandemias , Inquéritos e Questionários , Turquia
7.
J Occup Health ; 62(1): e12168, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32951286

RESUMO

OBJECTIVE: The aim of the study was to evaluate the oral healthcare workers' concerns, perceived impact, and preparedness in COVID-19 pandemic. METHODS: This cross-sectional study was carried out at 10 different dental hospitals in Pakistan from March to June 2020. A 35 items valid and reliable questionnaire was used to assess the concerns, perceived impact, and preparedness of oral healthcare workers (OHCW) in COVID-19 pandemic. Chi-squared test and logistic regression were used for analysis. RESULTS: A total of 583 OHCW participated in this study. The odds of having the awareness about the risk of exposure and fear of getting infected, were greater in the clinical than non-clinical OHCW (OR: 52.6; OR: 15.9). For social network concerns, the clinical OHCW were more likely to be concerned about their colleagues (OR: 6.0). The clinical OHCW have greater odds of worrying about telling the family/friends about the risk exposed to (OR: 2.55), being avoided because of the job (OR: 3.20) and more likely to be feeling stressed (OR: 4.31). Less than 50% of the participants felt that their institutions are well prepared and only 12.6% had attended an infection control training session. Most participants practiced self-preparation such as buying masks and disinfection (94.3%, 98.3%). CONCLUSION: The majority of OHCW felt concerned about their risk of exposure to infection and falling ill from exposure and infecting friends/family. There is a need for training of infection control and PPE and minimizing fear and psychological impact on OHCW should be the priority in any preparedness and planning for combating COVID-19.


Assuntos
Infecções por Coronavirus/psicologia , Odontologia , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/psicologia , Pneumonia Viral/psicologia , Adulto , Betacoronavirus , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/efeitos adversos , Paquistão , Pandemias , Inquéritos e Questionários , Adulto Jovem
8.
J Laryngol Otol ; 134(8): 665-669, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32758319

RESUMO

BACKGROUND: ENT surgeons are likely to be at high risk of coronavirus disease 2019 exposure. METHODS: A national registry of UK ENT surgeons with suspected or confirmed coronavirus disease 2019 was created with the support of ENT UK. Voluntary entry was made by either the affected individual or a colleague, using a web-based platform. RESULTS: A four-month data collection period is reported, comprising 73 individuals. Coronavirus disease 2019 was test-confirmed in 35 respondents (47.9 per cent). There was a need for hospitalisation in two cases (2.7 per cent) and tragically one individual died. Symptom onset peaked in March. The majority suspected their exposure to have been in the workplace, with a significant proportion attributing their disease to a lack of personal protective equipment at a time before formal guidance had been introduced. CONCLUSION: The registry suggests that a significant number of ENT clinicians in the UK have contracted coronavirus disease 2019, and supports the need for tailored personal protective equipment guidance and service planning.


Assuntos
Infecções por Coronavirus/transmissão , Doenças Profissionais/epidemiologia , Exposição Ocupacional/efeitos adversos , Otolaringologia/estatística & dados numéricos , Pneumonia Viral/transmissão , Cirurgiões/estatística & dados numéricos , Adulto , Idoso , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Pessoa de Meia-Idade , Pandemias , Equipamento de Proteção Individual/provisão & distribução , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Sistema de Registros , Autorrelato/estatística & dados numéricos , Inquéritos e Questionários , Reino Unido/epidemiologia , Local de Trabalho/normas , Local de Trabalho/estatística & dados numéricos
10.
Medicine (Baltimore) ; 99(34): e21908, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32846856

RESUMO

BACKGROUND: A meta-analysis was performed to evaluate the relationship between chronic obstructive pulmonary disease (COPD) and occupational dust exposure, and to provide a scientific basis for the prevention and treatment of COPD caused by occupational factors. METHODS: PubMed and Embase databases were used to search for original epidemiological literature related to theme. Both random and fixed effects models were used to calculate pooled odds ratios and their corresponding 95% confidence intervals. Review Manager was used to perform data analysis. RESULTS: Nine studies were included in the meta-analysis in accordance with the inclusion criteria. There was a significantly obvious correlation between occupational dust exposure and COPD of the population-based studies assessed in this article. The risk of developing COPD for workers exposed to dust was 1.51 times higher than for controls (I = 40%, 95% confidence interval: 1.27-1.79). The presence of publication bias was not found. CONCLUSION: The study provided evidence supporting the association between occupational dust exposure and the risk of developing COPD.


Assuntos
Poeira , Exposição por Inalação/efeitos adversos , Doenças Profissionais/complicações , Doença Pulmonar Obstrutiva Crônica/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Estudos Transversais , Humanos , Pessoa de Meia-Idade , Doenças Profissionais/epidemiologia , Exposição Ocupacional/efeitos adversos , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Doença Pulmonar Obstrutiva Crônica/prevenção & controle , Medição de Risco
11.
Medicine (Baltimore) ; 99(30): e21396, 2020 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-32791752

RESUMO

A large number of healthcare workers have been infected with coronavirus disease-2019 (COVID-19). We aimed to investigate their clinical and chest computed tomography (CT) characteristics.The clinical, laboratory test and CT features of 43 medical and hospital staff with confirmed COVID-19 (MP group, 26-70 years old) were retrospectively analyzed, and compared to 43 non-medical related patients (non-MP group, 26-71 years old). Follow-up CT characteristics were analyzed to assess the disease progression in the period of hospitalization.At admission, the main complaints of the MP group, including fever (81.4%), fatigue (48.8%) and cough (41.9%), were similar to the non-MP group. The C-reactive protein, erythrocyte sedimentation rate, and lactate dehydrogenase levels were higher in the non-MP group than the MP group (17.5 ±â€Š22.4 mg/L, 20.2 ±â€Š23.4 mm/H and 219 ±â€Š66U/L, respectively, P < .05). Ground-grass opacities, consolidation, interstitial thickening were common CT features of both groups. The severity of opacities on initial CT were less in the MP group (5.3 ±â€Š3.9 scores) than in the non-MP group (9.1 ±â€Š4.8 scores, P < .05). Before regular treatments, the sum score of the opacities showed weak to moderate correlations with duration, C-reactive protein, erythrocyte sedimentation rate and lactate dehydrogenase levels (R ranged from 0.341-0.651, P < .05). In the study time window, the duration from illness onset to when the most obvious pulmonary opacities were observed, according to CT findings, were similar in the MP group (13.3 ±â€Š6.6 days) and the non-MP group (13.8 ±â€Š5.1 days, P = .69). Mild to moderate anxiety and depression were observed in both groups.Despite greater knowledge of how to protect themselves than the general population, healthcare workers are also susceptible to COVID-19 infection. Occupational exposure is a very important factor. Healthcare workers have a higher vigilance about the infection in the early stage of the disease.


Assuntos
Betacoronavirus , Infecções por Coronavirus/diagnóstico por imagem , Doenças Profissionais/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional , Pulmão/diagnóstico por imagem , Pulmão/patologia , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/virologia , Exposição Ocupacional/efeitos adversos , Pandemias , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Estudos Retrospectivos
12.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(7): 1068-1071, 2020 Jul 10.
Artigo em Chinês | MEDLINE | ID: mdl-32741172

RESUMO

Objective: To investigate the dose-response relationship between the cumulative dust exposures to anthracite, bituminous coal, and lignite and the cumulative prevalence rates of pneumoconiosis due to the exposures, respectively and provide a basis for scientific development of occupational health standards. Methods: Investigation on the exposure to coal dust and pneumoconiosis prevalence was conducted in 9 state-owned coal mines. The cumulative anthracite, bituminous coal, and lignite dust exposure specific cumulative prevalence rates of pneumoconiosis were calculated by life table method, respectively. The linear regression equations were used to control the unilateral interval to obtain the exposure concentration limits of the respirable coal dust, respectively. Results: A total of 21 000 coal miners in the 9 coal mines were included in the study. The detection rates of pneumoconiosis in coal miners in anthracite, bituminous coal and lignite mines were 11.27%, 21.32%, and 6.00%. The average lengths of exposure to coal dust at pneumoconiosis onset were 20.12 years, 22.88 years, and 25.21 years, respectively and the dose-response relationships between the cumulative respirable coal dust exposure and the cumulative prevalence rates were all linear regression equations, which are y=5.788x-16.043 (R(2)=0.949), y=5.679x-16.837 (R(2)=0.904), and y=6.465x-19.573 (R(2)=0.944), respectively. Supposing that the safety coefficient is 1.2, when the cumulative prevalence rate of pneumoconiosis after 30 years of exposure to dust is not higher than 1%, the exposure concentration limits of the three types of respirable coal dust are 1.7, 2.3, and 3.9 mg/m(3), respectively. Conclusions: The results of this study shows that the detection rate of pneumoconiosis, the average length of exposure to coal dust at pneumoconiosis onset, and the exposure concentration limits of the respirable coal dust varied with coal types. In the case of the same cumulative level of coal dust exposure, the lower the coal volatiles is (i.e. the higher the carbon content is), the higher the cumulative prevalence rate of pneumoconiosis is (anthracite>bituminous coal>lignite). It is suggested to develop national occupational health standards of coal dust exposure according to the grades of coal.


Assuntos
Minas de Carvão , Carvão Mineral , Poeira , Doenças Profissionais/epidemiologia , Exposição Ocupacional/efeitos adversos , Exposição Ocupacional/estatística & dados numéricos , Pneumoconiose/epidemiologia , China/epidemiologia , Humanos , Risco
13.
Ecotoxicol Environ Saf ; 202: 110907, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-32800242

RESUMO

The impact of bioaerosols in municipal solid waste management is nowadays identified as a growing health concern worldwide. In this study, exposure to endotoxin in composting facilities and its association with lung function and clinical symptoms was investigated in Tehran municipal solid waste management complex (Aradkooh) as one of the largest solid waste management facilities in the Middle East. Airborne endotoxins were collected between June and July 2019 and the concentrations were determined by Limulus Amebocyte Lysate (LAL) method. Healthy workers with no history of respiratory disease were recruited and data on clinical symptoms (cough, phlegm, wheezing, dyspnea, fatigue, headache, eye irritation, runny nose, runny eyes, and sore throat) was obtained by the modified American Thoracic Society questionnaire, and spirometric measurement was performed by an expert. The binary logistic regression test was used and adjusted for confounding variables. The results didn't show any difference in lung function parameters (FEV1, FVC, FEV1/FVC, PEF, FEF25-75%), and most of the respiratory symptoms despite a relatively high difference in the concentration of endotoxin observed in air samples of different locations. Only the increased risk of cough (OR 10.5, 95% CI: 2.4 to 44.8 in the moderately exposed group and 7.8, 95% CI: 1.6 to 39.1 in highly exposed ones), fatigue (OR 3.7, 95% CI: 1.2 to 11.7), and headache (OR 6.02, 95% CI: 1.4 to 24.5) were found in the exposed groups compared to controls after adjusting for age, active and passive smoking. However, findings of the study might be underestimated due to some issues including healthy worker effect, intra and intersubject variability, and self-reporting bias, thereby the results should be interpreted with caution. Although we did not find any relationship, due to the high concentrations of endotoxins observed in some sites, it is recommended to consider some possible prevention measures such as using personal protective equipment to reduce the exposure of workers at an acceptable level.


Assuntos
Poluentes Ocupacionais do Ar/análise , Compostagem , Endotoxinas/análise , Exposição Ocupacional/estatística & dados numéricos , Doenças Respiratórias/epidemiologia , Adulto , Microbiologia do Ar , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/efeitos adversos , Testes de Função Respiratória/efeitos adversos , Sons Respiratórios , Doenças Respiratórias/etiologia , Poluição por Fumaça de Tabaco
14.
J Environ Public Health ; 2020: 2875297, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32774391

RESUMO

Introduction: Occupational injuries are occurrences arising out of, or in the course of, work which results in a fatal or nonfatal injury, e.g., a fall from a height or contact with moving machines. They pose psychological, behavioral, social, vocational, and economic problems. No previous studies have been conducted on the prevalence and associated risk factors of occupational injuries among workers in Bahir Dar Textile Share Company (SC). Therefore, this study aimed to assess the prevalence and associated risk factors of occupational injury in Bahir Dar Textile SC, Northwest Ethiopia. Methods: A cross-sectional study was conducted among employees of Bahir Dar Textile SC in 2019. Three hundred (195 males and 105 females) employees were selected using proportional simple random sampling from the spinning, weaving, finishing, engineering, and administration sections. Results: The one-year and the two-week occupational injury prevalences were 42.7% and 6.7%, respectively. The one-year report from all the respondents shows that abrasion (10.7%) and eye injury (7.7%) were the two top injuries, hands (12.7%) and eyes (7.7%) were the top injured body parts, and machines (22.7%) and falling/slipping (6.3%) caused most injuries. Statistically significant differences in injuries (p < 0.05) were observed due to variations in gender, job category, exposure to vibration, exposure to rays/welding sparks, and labor-intensive work. The weaving section was positively associated with occupational injuries at AOR = 4.497 and p=0.05. Conclusions: Occupational injuries prevalence is high over the last year. The major causes of injuries were machines and falling/slipping, while the major injuries were abrasions, eye injuries, sprains, and burns. The factors significantly associated with occupational injuries were male gender, job category, use of vibrating tools, high intensive work, and rays/welding sparks. Occupational safety and health training, use of personal protective equipment (PPE), and shifting employees from intensive works are recommended.


Assuntos
Traumatismos Ocupacionais/epidemiologia , Indústria Têxtil/estatística & dados numéricos , Adulto , Estudos Transversais , Etiópia/epidemiologia , Feminino , Humanos , Masculino , Exposição Ocupacional/efeitos adversos , Exposição Ocupacional/prevenção & controle , Exposição Ocupacional/estatística & dados numéricos , Saúde do Trabalhador , Traumatismos Ocupacionais/prevenção & controle , Prevalência , Fatores de Risco , Inquéritos e Questionários
15.
PLoS One ; 15(8): e0236600, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32756610

RESUMO

Cell therapy is a promising treatment. One of the key aspects of cell processing products is ensuring sterility of cell-processing facilities (CPFs). The objective of this study was to assess the environmental risk factors inside and outside CPFs. We monitored the temperature, humidity, particle number, colony number of microorganisms, bacteria, fungi, and harmful insects in and around our CPF monthly over one year. The temperature in the CPF was constant but the humidity fluctuated depending on the humidity outside. The particle number correlated with the number of entries to the room. Except for winter, colonies of microorganisms and harmful insects were detected depending on the cleanliness of the room. Seven bacterial and two fungal species were identified by PCR analyses. Psocoptera and Acari each accounted for 41% of the total trapped insects. These results provide useful data for taking the appropriate steps to keep entire CPFs clean.


Assuntos
Centros Médicos Acadêmicos/normas , Poluição do Ar em Ambientes Fechados/efeitos adversos , Terapia Baseada em Transplante de Células e Tecidos/normas , Monitoramento Ambiental , Microbiologia do Ar/normas , Bactérias/patogenicidade , Terapia Baseada em Transplante de Células e Tecidos/efeitos adversos , Humanos , Japão/epidemiologia , Exposição Ocupacional/efeitos adversos , Medição de Risco
16.
J Stroke Cerebrovasc Dis ; 29(9): 104981, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32807416

RESUMO

Coronavirus disease 19 (COVID-19) is an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this scenario, managing acute medical conditions, such as stroke, requires a timely treatment together with proper strategies that minimize the risk of infection spreading to health care workers and other patients. We report the case of a 79-year-old woman, who was admitted for a wake-up stroke due to occlusion of the left middle cerebral artery. She was treated outside the COVID-19-dedicated track of the hospital because she had no concomitant signs or symptoms suggestive of SARS-CoV-2 infection nor recent contact with other infected individuals. Post-mortem nasal and pharyngeal swab was positive for SARS-CoV-2 infection. We propose that hyperacute stroke patients should be tested for SARS-CoV-2 infection at admission and then managed as having COVID-19 until cleared by a negative result. We are aware that such measure results in some delay of the acute treatment of stroke, which could be minimal using well-exercised containment protocols.


Assuntos
Betacoronavirus/isolamento & purificação , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infarto da Artéria Cerebral Média/terapia , Nariz/virologia , Faringe/virologia , Pneumonia Viral/diagnóstico , Idoso , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Diagnóstico Tardio , Evolução Fatal , Feminino , Humanos , Infarto da Artéria Cerebral Média/diagnóstico , Infarto da Artéria Cerebral Média/fisiopatologia , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Exposição Ocupacional/efeitos adversos , Pandemias , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Valor Preditivo dos Testes , Fatores de Risco , Índice de Gravidade de Doença
17.
J Stroke Cerebrovasc Dis ; 29(9): 105010, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32807425

RESUMO

Aneurysmal subarachnoid hemorrhage (SAH) patients require frequent neurological examinations, neuroradiographic diagnostic testing and lengthy intensive care unit stay. Previously established SAH treatment protocols are impractical to impossible to adhere to in the current COVID-19 crisis due to the need for infection containment and shortage of critical care resources, including personal protective equipment (PPE). Centers need to adopt modified protocols to optimize SAH care and outcomes during this crisis. In this opinion piece, we assembled a multidisciplinary, multicenter team to develop and propose a modified guidance algorithm that optimizes SAH care and workflow in the era of the COVID-19 pandemic. This guidance is to be adapted to the available resources of a local institution and does not replace clinical judgment when faced with an individual patient.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/terapia , Procedimentos Clínicos/organização & administração , Prestação Integrada de Cuidados de Saúde/organização & administração , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Exposição Ocupacional/prevenção & controle , Equipamento de Proteção Individual/provisão & distribução , Pneumonia Viral/terapia , Hemorragia Subaracnóidea/terapia , Algoritmos , Protocolos Clínicos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Humanos , Exposição Ocupacional/efeitos adversos , Saúde do Trabalhador , Pandemias , Segurança do Paciente , Pneumonia Viral/diagnóstico , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Fatores de Risco , Hemorragia Subaracnóidea/diagnóstico , Virulência , Fluxo de Trabalho
18.
PLoS One ; 15(8): e0236694, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32745138

RESUMO

Methyl bromide (MB) is a fumigant that has been widely used for killing pests on plants in trade, soils, and structures worldwide due to its excellent permeability and insecticidal effect; however, MB should be replaced because it is an ozone-depleting substance. It is well-known that MB is highly toxic and hazardous to workers, but the effects of exposure in asymptomatic workers have not been explored. The purpose of this study is to investigate the impact of MB fumigation on the health of fumigators at a sensitive level. The electroencephalogram (EEG) and urinary bromide ion levels of 44 fumigators (the study group) and 20 inspectors (the control) were measured before and after fumigation work from February to August 2019 in Busan, Korea. The mean post-work concentration of bromide ion (18.311 µg/mg CRE) in the fumigators was significantly increased from the pre-work level (7.390 µg/mg CRE) (P<0.001). The fumigator post-work median frequencies (MDF) and alpha-to-theta ratios (ATR) of EEG index were significantly decreased compared to the pre-work values (P<0.05 for all indices). In contrast, there were no significant differences in inspector EEG indices and urinary bromide ion. The urinary bromide ion levels in all the subjects were negatively correlated with MDF (P = 0.032). In conclusion, fumigators' EEG indices and urinary bromide ion suggested that occupational exposure to MB negatively affected the health of workers, although the workers were asymptomatic.


Assuntos
Brometos/urina , Fumigação/efeitos adversos , Hidrocarbonetos Bromados/toxicidade , Inseticidas/toxicidade , Exposição Ocupacional/efeitos adversos , Adulto , Eletrocardiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
19.
J Infect ; 81(4): 621-624, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32735893

RESUMO

BACKGROUND: Care homes have been disproportionately affected by the COVID-19 pandemic and continue to suffer large outbreaks even when community infection rates are declining, thus representing important pockets of transmission. We assessed occupational risk factors for SARS-CoV-2 infection among staff in six care homes experiencing a COVID-19 outbreak during the peak of the pandemic in London, England. METHODS: Care home staff were tested for SARS-COV-2 infection by RT-PCR and asked to report any symptoms, their contact with residents and if they worked in different care homes. Whole genome sequencing (WGS) was performed on RT-PCR positive samples. RESULTS: In total, 53 (21%) of 254 staff were SARS-CoV-2 positive but only 12/53 (23%) were symptomatic. Among staff working in a single care home, SARS-CoV-2 positivity was 15% (2/13), 16% (7/45) and 18% (30/169) in those reporting no, occasional and regular contact with residents. In contrast, staff working across different care homes (14/27, 52%) had a 3.0-fold (95% CI, 1.9-4.8; P<0.001) higher risk of SARS-CoV-2 positivity than staff working in single care homes (39/227, 17%). WGS identified SARS-CoV-2 clusters involving staff only, including some that included staff working across different care homes. CONCLUSIONS: SARS-CoV-2 positivity was significantly higher among staff working across different care homes than those who were working in the same care home. We found local clusters of SARS-CoV-2 infection between staff only, including those with minimal resident contact. Infection control should be extended for all contact, including those between staff, whilst on care home premises.


Assuntos
Infecções por Coronavirus/epidemiologia , Instituição de Longa Permanência para Idosos/estatística & dados numéricos , Corpo Clínico/estatística & dados numéricos , Casas de Saúde/estatística & dados numéricos , Exposição Ocupacional/efeitos adversos , Pneumonia Viral/epidemiologia , Betacoronavirus/genética , Infecções por Coronavirus/transmissão , Inglaterra/epidemiologia , Genoma Viral/genética , Humanos , Controle de Infecções/métodos , Londres/epidemiologia , Pandemias , Pneumonia Viral/transmissão , Sequenciamento Completo do Genoma
20.
PLoS One ; 15(8): e0236736, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32785269

RESUMO

Quantifying the association between lifetime exposures and the risk of developing a chronic disease is a recurrent challenge in epidemiology. Individual exposure trajectories are often heterogeneous and studying their associations with the risk of disease is not straightforward. We propose to use a latent class mixed model (LCMM) to identify profiles (latent classes) of exposure trajectories and estimate their association with the risk of disease. The methodology is applied to study the association between lifetime trajectories of smoking or occupational exposure to asbestos and the risk of lung cancer in males of the ICARE population-based case-control study. Asbestos exposure was assessed using a job exposure matrix. The classes of exposure trajectories were identified using two separate LCMM for smoking and asbestos, and the association between the identified classes and the risk of lung cancer was estimated in a second stage using weighted logistic regression and all subjects. A total of 2026/2610 cases/controls had complete information on both smoking and asbestos exposure, including 1938/1837 cases/controls ever smokers, and 1417/1520 cases/controls ever exposed to asbestos. The LCMM identified four latent classes of smoking trajectories which had different risks of lung cancer, all much stronger than never smokers. The most frequent class had moderate constant intensity over lifetime while the three others had either long-term, distant or recent high intensity. The latter had the strongest risk of lung cancer. We identified five classes of asbestos exposure trajectories which all had higher risk of lung cancer compared to men never occupationally exposed to asbestos, whatever the dose and the timing of exposure. The proposed approach opens new perspectives for the analyses of dose-time-response relationships between protracted exposures and the risk of developing a chronic disease, by providing a complete picture of exposure history in terms of intensity, duration, and timing of exposure.


Assuntos
Asbestos/efeitos adversos , Neoplasias Pulmonares/induzido quimicamente , Neoplasias Pulmonares/epidemiologia , Exposição Ocupacional/efeitos adversos , Fumar/efeitos adversos , Adulto , Idoso , Doença Crônica/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco
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