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1.
Int J Pharm Compd ; 24(6): 519-527, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33217743

RESUMO

Finasteride is not commercially available in a liquid format, which stimulated the development of a stable and simple finasteride suspension formulation. The objectives of this work were to develop and test a finasteride suspension for 1) simplicity to compound, 2) pharmaceutical acceptability, 3) stability, and 4) potential for occupational exposure. The stability of commercial 5-mg finasteride tablets (50 mg/150 mL) was evaluated in water, Oral Mix, and OralMix SF in amber polyethylene terephthalate bottles at 25°C or 4°C. Additional stability studies were carried out using sugar-free Finasteride Powder USP in amber polyethylene terephthalate bottles and tablets in water in polypropylene oral syringes. On study days 0, 1, 3, 7, 14, 28, 38, 49, 63, and 90, the finasteride concentration was determined using a validated stability-indicating liquid chromatographic method. The potential occupational airborne exposure was evaluated by attempting to measure finasteride in 1000 liters of room air following shaking and nebulization. Finasteride suspension/dispersion formulations were prepared in water, Oral Mix, and Oral Mix SF from tablets and pure powder. All formulations retained more than 94.3% of the initial finasteride concentration, with 95% confidence, when stored for up to 90 days at room temperature or 4°C. Simulations of occupational exposure failed to demonstrate the presence of finasteride in room air following attempts to nebulize finasteride mixtures. We conclude that 333-µg/mL suspension/dispersions of finasteride in water or Oral Mix products will have more than 94.3% of the initial finasteride concentration remaining after 90 days, regardless of the formulation, container, or storage temperature. Although we could not detect finasteride in room air, given the analytical limits of the study, we estimate that exposure would unlikely exceed 3.6-µg/1000 liters of room air. Nevertheless, since current regulations are based on "no safe limit," use of primary engineering controls and personal protective equipment as appropriate is recommended.


Assuntos
Finasterida , Exposição Ocupacional , Administração Oral , Cromatografia Líquida de Alta Pressão , Composição de Medicamentos , Estabilidade de Medicamentos , Armazenamento de Medicamentos , Exposição Ocupacional/prevenção & controle , Suspensões
2.
BMJ Open Respir Res ; 7(1)2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33148778

RESUMO

INTRODUCTION: The COVID-19 pandemic has been characterised by significant in-hospital virus transmission and deaths among healthcare workers. Sources of in-hospital transmission are not fully understood, with special precautions currently reserved for procedures previously shown to generate aerosols (particles <5 µm). Pleural procedures are not currently considered AGPs (Aerosol Generating Procedures), reflecting a lack of data in this area. METHODS: An underwater seal chest drain bottle (R54500, Rocket Medical UK) was set up inside a 60-litre plastic box and connected via an airtight conduit to a medical air supply. A multichannel particle counter (TSI Aerotrak 9310 Aerosol Monitor) was placed inside the box, allowing measurement of particle count/cubic foot (pc/ft3) within six channel sizes: 0.3-0.5, 0.5-1, 1-3, 3-5, 5-10 and >10 µm. Stabilised particle counts at 1, 3 and 5 L/min were compared by Wilcoxon signed rank test; p values were Bonferroni-adjusted. Measurements were repeated with a simple anti-viral filter, designed using repurposed materials by the study team, attached to the drain bottle. The pressure within the bottle was measured to assess any effect of the filter on bottle function. RESULTS: Aerosol emissions increased with increasing air flow, with the largest increase observed in smaller particles (0.3-3 µm). Concentration of the smallest particles (0.3-0.5 µm) increased from background levels by 700, 1400 and 2500 pc/ft3 at 1, 3 and 5 L/min, respectively. However, dispersion of particles of all sizes was effectively prevented by use of the viral filter at all flow rates. Use of the filter was associated with a maximum pressure rise of 0.3 cm H2O after 24 hours of flow at 5 L/min, suggesting minimal impact on drain function. CONCLUSION: A bubbling chest drain is a source of aerosolised particles, but emission can be prevented using a simple anti-viral filter. These data should be considered when designing measures to reduce in-hospital spread of SARS-CoV-2.


Assuntos
Betacoronavirus , Tubos Torácicos , Infecções por Coronavirus/transmissão , Pessoal de Saúde , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Exposição Ocupacional/prevenção & controle , Pneumonia Viral/transmissão , Aerossóis , Drenagem , Filtração/instrumentação , Humanos , Pandemias , Tamanho da Partícula , Material Particulado
5.
J Prim Care Community Health ; 11: 2150132720969483, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33213266

RESUMO

BACKGROUND: Healthcare workers (HCWs) are faced with an elevated risk of exposure to SARS-COV-2 due to the clinical procedures they perform on COVID-19 patients. However, data for frontline HCWs level of exposure and risk of COVID-19 virus infection are limited. OBJECTIVE: We investigated the level of exposure and risk of COVID-19 virus infection among HCWs in COVID-19 treatment centers in Ghana. METHODS: A cross-sectional study was utilized in this study and HCWs were invited by convenience to participate in the study, 408 HCWs in 4 COVID-19 treatment centers participated in the study. Adherence to infection prevention and control (IPC) measures were used to categorized HCWs as low or high risk of COVID-19 virus infection. The WHO COVID-19 risk assessment tool was used to collect quantitative data from the study participants. RESULTS: There was a high (N = 328, 80.4%) level of occupational exposure to the COVID-19 virus. However, only 14.0% of the exposed HCWs were at high risk of COVID-19 virus infection. Healthcare workers who performed or were present during any aerosol-generating procedures (AGP) were 23.8 times more likely to be exposed compared to HCWs who did not perform or were absent during any AGP (AOR 23.83; 95% CI: 18.45, 39.20). High risk of COVID-19 virus infection was less likely among registered nurses (AOR = 0.09; 95% CI: 0.02, 0.60), HCWs who performed or were present during any AGP (AOR = 0.05; 95% CI: 0.01, 0.50) and HCWs with a master's degree qualification (AOR 0.06; 95% CI: 0.01, 0.63). CONCLUSION: Despite the high level of exposure to the COVID-19 virus among HCWs in the treatment centers, only 14.0% were at high risk of COVID-19 virus infection. To protect this group of HCWs, treatment centers and HCWs should continue to adhere to WHO and national IPC protocols in managing of COVID-19 cases.


Assuntos
Infecções por Coronavirus/etiologia , Pessoal de Saúde/estatística & dados numéricos , Pneumonia Viral/etiologia , Medição de Risco , Adulto , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Estudos Transversais , Feminino , Gana/epidemiologia , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/estatística & dados numéricos , Exposição Ocupacional/prevenção & controle , Exposição Ocupacional/estatística & dados numéricos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Gravidez , Medição de Risco/métodos , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
6.
Artigo em Inglês | MEDLINE | ID: mdl-33138254

RESUMO

Measurement of job stress and employees' commitment are few of the admired topics in the corporate world amongst business writers. With a principal aim to trial the blow of exposure to COVID-19 patients on doctors' job stress and commitment, in Pakistan; data have been collected through 7-10 min telephonic interview from voluntary participants and a sample of 129 responses were analyzed by Structure Equation Modeling-Partial Least Square (SEM-PLS) path modeling through Smart PLS 3.2. The results of the study indicated; direct positive & significant impact of Extent of Exposure on Job Stress while direct negative, significant association with Commitment. Job Stress also observed having direct negative impact on commitment. The Extent of Exposure-Job Stress relationship was also found stronger among group of doctors having Low level of Perceived Organizational Support and weaker among group of doctors having High level of Perceive Organizational support. Perceived Organizational Support showed a moderating effect on the Extent of Exposure-Job Stress relationship; while, Social Support showed no moderation. Researchers are required to investigate more and management of the medical services providers (both hospitals and government) needs to focus on doctors' perception about Organizational Support, as doctors show no concern about the support from society as long as their well-being is cared for by respective hospitals. This study is an effort to stimulate more empirical evidence towards the treating and handling of COVID-19 patients and the psychological well-being of doctors.


Assuntos
Infecções por Coronavirus/epidemiologia , Satisfação no Emprego , Estresse Ocupacional/psicologia , Médicos/psicologia , Pneumonia Viral/epidemiologia , Apoio Social , Betacoronavirus , Feminino , Humanos , Masculino , Exposição Ocupacional/prevenção & controle , Estresse Ocupacional/prevenção & controle , Cultura Organizacional , Paquistão/epidemiologia , Pandemias , Quarentena , Inquéritos e Questionários , Local de Trabalho
8.
Med Lav ; 111(5): 365-371, 2020 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-33124607

RESUMO

BACKGROUND: During the Covid-19 outbreak, a recurrent subject in scientific literature has been brought back into discussion: whether surgical masks provide a sufficient protection against airborne SARS-CoV-2 infections. OBJECTIVES: The objective of this review is to summarize the available studies which have compared the respective effectiveness of surgical masks and filtering facepiece respirators  for the prevention of infections caused by viruses that are transmitted by the respiratory tract. METHODS: The relevant scientific literature was identified by querying the PubMed database with a combination of search strings. The narrower search string "(surgical mask *) AND (respirator OR respirators)" included all the relevant articles retrieved using broader search strategies. Of all the relevant articles found, seven systematic reviews were selected and examined. RESULTS: The currently available scientific evidence seems to suggest that surgical masks and N95 respirators/FFP2 confer an equivalent degree of protection against airborne viral infections. DISCUSSION: Since surgical masks are less expensive than N95 respirators but seem to be as effective in protecting against airborne infection and they are also more comfortable for the user, requiring less respiratory work, they should be the standard protective device for health care workers and especially for workers who carry out non-medical jobs. Filtering facepiece respirators, whose extended use is less comfortable for the wearer, may be preferred for procedures which require greater protection for a shorter time.


Assuntos
Infecções por Coronavirus/prevenção & controle , Máscaras , Exposição Ocupacional/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Dispositivos de Proteção Respiratória , Betacoronavirus , Humanos
9.
Med Lav ; 111(5): 404-410, 2020 Oct 31.
Artigo em Italiano | MEDLINE | ID: mdl-33124612

RESUMO

INTRODUCTION: During the Sars-Cov-2 pandemic, occupational health physicians worked to respond to different needs of workers, employers, and health authorities. In collaboration with the Prevention Department of the Veneto region of Italy, a survey was promoted in nine manufacturing companies in the province of Padua, to investigate the prevalence of asymptomatic SarsCov-2 virus and the immunological status of 1,267 workers. SCOPE: The study was aimed at verifying the effectiveness of measures to contain the virus spread among workers in the workplace as required by the agreement between the social partners signed on March 14, 2020. METHODS: The survey was carried out at workplaces by trained health physicians and almost all company workers enrolled on a voluntary basis. Each worker was tested for viral RNA using nasopharyngeal swab and for IgM and IgG antibodies by drawing venous or capillary blood, according to the availability of tests at that difficult period. RESULTS: Swab-positive workers were 0.3%, and subjects with positive serological tests were 1.6% of the total workers examined. DISCUSSION: The diagnostic test is based on the search for viral RNA through nasopharyngeal swab. To evaluate the immunological status of workers the CLIA or Elisa quantitative serological test should be preferred. Measures to contain the virus spreading at the workplace seem to be effective, as working settings do not entail any additional risk of SarsCov-2 infection.


Assuntos
Infecções por Coronavirus/prevenção & controle , Exposição Ocupacional/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Betacoronavirus , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Humanos , Itália/epidemiologia , Indústria Manufatureira , Pneumonia Viral/diagnóstico , Inquéritos e Questionários , Local de Trabalho
10.
J Drugs Dermatol ; 19(9): 858-864, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-33026745

RESUMO

As the coronavirus epidemic continues, a host of new cutaneous complications is seen on the faces of frontline healthcare workers wearing personal protective equipment on a daily basis. To minimize the risk of COVID-19 infection, healthcare workers wear tight-fitting masks that lead to an excessive amount of pressure on the facial skin. Mechanical pressure, mask materials, and perspiration can all lead to various types of cutaneous lesions such as indentations of the face, skin tears, post-inflammatory hyperpigmentation, ulceration, crusting, erythema, and infection. The objective of this article is to provide effective and straightforward recommendations to those health care providers using facial masks in order to prevent skin-related complications. J Drugs Dermatol. 2020;19(9):858-864. doi:10.36849/JDD.2020.5259.


Assuntos
Infecções por Coronavirus/prevenção & controle , Dermatoses Faciais/etiologia , Traumatismos Faciais/etiologia , Máscaras/efeitos adversos , Pandemias/prevenção & controle , Equipamento de Proteção Individual/efeitos adversos , Pneumonia Viral/prevenção & controle , Infecções por Coronavirus/epidemiologia , Eritema/etiologia , Eritema/fisiopatologia , Exantema/etiologia , Exantema/fisiopatologia , Dermatoses Faciais/fisiopatologia , Traumatismos Faciais/epidemiologia , Traumatismos Faciais/fisiopatologia , Feminino , Saúde Global , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Exposição Ocupacional/prevenção & controle , Saúde do Trabalhador , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Medição de Risco
11.
Int J Occup Environ Med ; 11(4): 196-209, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33098404

RESUMO

BACKGROUND: Clinical students are at increased risk of exposure to blood-borne pathogens. However, little has been documented about their exposure to blood and body fluids and their knowledge of post-exposure prophylaxis (PEP) in high-HIV burden settings, such as Nigeria. OBJECTIVE: To determine the prevalence and predictors of BBF exposure and knowledge about PEP among medical and allied health students in northern Nigeria. METHODS: In a cross-sectional study, 273 clinical students were asked to complete structured questionnaires. The prevalence of BBF exposure was determined. Binary logistic regression was used to determine the independent predictors of BBF exposure. RESULTS: The majority of the respondents (98.2%) had heard about PEP; 26.0% (n=71) had adequate knowledge about PEP. 76 (27.8%) of the 273 respondents reported accidental exposure to HIV. 230 (84.2%) respondents had positive attitude toward HIV PEP. Of those who had had accidental exposure to HIV (n=76), only 13% (n=10) received PEP. The level of knowledge about PEP was predicted by previous training (aOR 0.43, 95% CI 0.23 to 0.80 ["no" vs "yes"]), year of training (aOR 4.10, 95% CI 1.60 to 10.47 [6th vs 4th year]), course of study (aOR 4.69, 95% CI 2.06 to 10.68 ["allied health" vs "clinical medicine"]) and religion (aOR 5.39, 95% CI 1.40 to 20.71 ["non-Muslim" vs "Muslim"]). Similarly, accidental exposure was independently predicted by respondents' sex (aOR 2.55, 95% CI1.36 to 4.75 ["female" vs "male"]), age (aOR 2.54, 95% CI 1.06 to 6.15 ["25-29" vs "20-24" years]), ethnicity (aOR 2.15, 95% CI1.10 to 5.14 ["others" vs "Hausa/Fulani"]), course of study (aOR 0.06, 95% CI 0.01 to 0.38 ["allied health" vs "clinical medicine"]), and previous PEP training (aOR 0.39, 95% CI 0.20 to 0.78 ["no" vs "yes"]). CONCLUSION: One in four clinical students reported exposure to BBF. Most students expressed a positive attitude toward PEP, but knowledge and uptake of PEP was sub-optimal. We recommend strengthening training curricula for infection control and prevention and enhancing protocols for timely post-exposure evaluation and follow up for all exposure incidents.


Assuntos
Líquidos Corporais/virologia , Conhecimentos, Atitudes e Prática em Saúde , Exposição Ocupacional/prevenção & controle , Adulto , Estudos Transversais , Feminino , Infecções por HIV/prevenção & controle , Humanos , Masculino , Nigéria , Exposição Ocupacional/efeitos adversos , Profilaxia Pós-Exposição/métodos , Prevalência , Estudantes de Medicina/psicologia , Inquéritos e Questionários
12.
Aust J Gen Pract ; 49(11): 728-732, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33123703

RESUMO

BACKGROUND: General practitioners (GPs) have some of the highest rates of mortality from COVID-19 among healthcare workers. SARS-CoV-2 has unique properties that place GPs at particular risk. OBJECTIVE: The aim of this article is to discuss the nose-related features of SARS-CoV-2 that place GPs at risk, and to make recommendations pertinent to the safety and protection of primary healthcare physicians. DISCUSSION: The highest viral load of SARS-CoV-2 is in the nose and nasopharynx. It is often highest early in the illness, before the development of symptoms. Further, SARS-CoV-2 replicates and continues to shed in the nasopharynx long after the virus is no longer detectable in the lower respiratory tract. This places any physician performing examinations on, or procedures involving, the upper respiratory tract at risk for contracting COVID-19. New-onset hyposmia and dysgeusia are indicators for COVID-19 and should be included in screening protocols.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Clínicos Gerais/estatística & dados numéricos , Controle de Infecções , Cavidade Nasal/virologia , Nasofaringe/virologia , Transtornos do Olfato/virologia , Pandemias , Pneumonia Viral , Austrália , Betacoronavirus/isolamento & purificação , Betacoronavirus/fisiologia , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Transmissão de Doença Infecciosa/prevenção & controle , Humanos , Controle de Infecções/instrumentação , Controle de Infecções/métodos , Controle de Infecções/normas , Mucosa Nasal/metabolismo , Exposição Ocupacional/prevenção & controle , Exposição Ocupacional/estatística & dados numéricos , Pandemias/prevenção & controle , Equipamento de Proteção Individual/provisão & distribução , Pneumonia Viral/mortalidade , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Guias de Prática Clínica como Assunto , Atenção Primária à Saúde/normas , Gestão de Riscos , Carga Viral
13.
BMJ Open Respir Res ; 7(1)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33023899

RESUMO

Patients with COVID-19 often need therapeutic interventions that are considered high aerosol-generating procedures. These are either being performed by healthcare providers with potentially inadequate personal protective equipment or the procedures are being delayed until patients clear their viral load. Both scenarios are suboptimal. We present a simple, cost-effective method of creating a portable negative pressure environment using equipment that is found in most hospitals to better protect healthcare providers and to facilitate more timely care for patients with COVID-19.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Exposição Ocupacional/prevenção & controle , Salas Cirúrgicas/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Campos Cirúrgicos , Aerossóis , Humanos , Pressão , Sucção
15.
Anesth Analg ; 131(5): 1342-1354, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33079853

RESUMO

Many health care systems around the world continue to struggle with large numbers of SARS-CoV-2-infected patients, while others have diminishing numbers of cases following an initial surge. There will most likely be significant oscillations in numbers of cases for the foreseeable future, based on the regional epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Less affected hospitals and facilities will attempt to progressively resume elective procedures and surgery. Ramping up elective care in hospitals that deliberately curtailed elective care to focus on SARS-CoV-2-infected patients will present unique and serious challenges. Among the challenges will be protecting patients and providers from recurrent outbreaks of disease while increasing procedure throughput. Anesthesia providers will inevitably be exposed to SARS-CoV-2 by patients who have not been diagnosed with infection. This is particularly concerning in consideration that aerosols produced during airway management may be infective. In this article, we recommend an approach to routine anesthesia care in the setting of persistent but variable prevalence of SARS-CoV-2 infection. We make specific recommendations for personal protective equipment and for the conduct of anesthesia procedures and workflow based on evidence and expert opinion. We propose practical, relatively inexpensive precautions that can be applied to all patients undergoing anesthesia. Because the SARS-CoV-2 virus is spread primarily by respiratory droplets and aerosols, effective masking of anesthesia providers is of paramount importance. Hospitals should follow the recommendations of the Centers for Disease Control and Prevention for universal masking of all providers and patients within their facilities. Anesthesia providers should perform anesthetic care in respirator masks (such as N-95 and FFP-2) whenever possible, even when the SARS-CoV-2 test status of patients is negative. Attempting to screen patients for infection with SARS-CoV-2, while valuable, is not a substitute for respiratory protection of providers, as false-negative tests are possible and infected persons can be asymptomatic or presymptomatic. Provision of adequate supplies of respirator masks and other respiratory protection equipment such as powered air purifying respirators (PAPRs) should be a high priority for health care facilities and for government agencies. Eye protection is also necessary because of the possibility of infection from virus coming into contact with the conjunctiva. Because SARS-CoV-2 persists on surfaces and may cause infection by contact with fomites, hand hygiene and surface cleaning are also of paramount importance.


Assuntos
Anestesia , Betacoronavirus/patogenicidade , Infecções por Coronavirus/prevenção & controle , Infecção Hospitalar/prevenção & controle , Controle de Infecções , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Exposição por Inalação/prevenção & controle , Intubação Intratraqueal , Exposição Ocupacional/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Aerossóis , Anestesia/efeitos adversos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Infecção Hospitalar/diagnóstico , Infecção Hospitalar/transmissão , Infecção Hospitalar/virologia , Contaminação de Equipamentos/prevenção & controle , Dispositivos de Proteção dos Olhos , Higiene das Mãos , Interações Hospedeiro-Patógeno , Humanos , Exposição por Inalação/efeitos adversos , Intubação Intratraqueal/efeitos adversos , Exposição Ocupacional/efeitos adversos , Saúde do Trabalhador , Segurança do Paciente , Equipamento de Proteção Individual , Pneumonia Viral/diagnóstico , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Fatores de Proteção , Dispositivos de Proteção Respiratória , Medição de Risco , Fatores de Risco , Vestimenta Cirúrgica
16.
PLoS One ; 15(10): e0239587, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33006973

RESUMO

Resource-deprived coastal peri-urban settlements in Southern Ghana are characterized by indiscriminate solid waste disposal and open defecation practices. Persons engaged in waste handling in such communities perform their activities with little or no personal protective equipment. They are thus confronted with the risk of faecal pollution of the hands and other bodily parts. A mixed method approach was used to investigate 280 waste handlers performing different activities to estimate recent faecal pollution of their hands and to observe the utilization of personal protective equipment and sanitation/hygiene facilities during work. The log concentration of E. coli on hands of waste handlers after work (8.60 ± 4.20 CFU/hand, mean ± standard deviation) was significantly higher compared with the E. coli log concentration before work (2.95 ± 1.89 CFU/hand, mean ± standard deviation) (p<0.001). The odds of faecal pollution was significantly higher (aOR 4.2; 95% CI: 1.9-9.1) for workers aged 35 years and above compared with those less than 35 years; and for workers at public toilet facilities (aOR 3.0; 95% CI: 1.0-8.4) compared with those who worked for private waste handling companies. Female workers were, however, 60% less likely (aOR 0.4; 95% CI: 0.2-0.8) to experience faecal pollution of their hands compared with males. The workers had limited access to water and sanitation and hygiene facilities, and about one-fifth (n = 59; 21.1%) did not use personal protective equipment during work. Waste handlers should be provided and instructed in proper use of personal protective equipment, have access to sanitation facilities and adopt improved hygiene behaviour to avoid the risk of faecal pollution and associated disease risk.


Assuntos
Fezes , Exposição Ocupacional , Eliminação de Resíduos , Adulto , Carga Bacteriana , Defecação , Poluição Ambiental/prevenção & controle , Escherichia coli/isolamento & purificação , Fezes/microbiologia , Feminino , Gana , Mãos/microbiologia , Humanos , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/prevenção & controle , Fatores de Risco , Toaletes , População Urbana
18.
New Solut ; 30(3): 237-248, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33121368

RESUMO

The World Health Organization's (WHO) workplace health and safety guidelines on COVID-19 are unacceptably complacent in parts, patently dangerous in others, and contain serious gaps. Omissions include no mention of the essential role of labor inspection and enforcement, and a lack of recognition of potential interactions with other workplace hazards. WHO also omitted discussion of the necessity for wider employment protections to make safety and safe behavior a realistic prospect. Potential risks in outdoor work and the need to address the impact of job segregation related to inequalities in health outcomes are also absent. WHO's advice influences national practice, official guidance, and binding rules.The International Trade Union Confederation has assessed the flaws in WHO's arguments and has prepared a critique so they are understood and can be challenged.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Saúde do Trabalhador/normas , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Local de Trabalho/normas , Organização Mundial da Saúde/organização & administração , Betacoronavirus , Humanos , Sindicatos/normas , Exposição Ocupacional/prevenção & controle , Exposição Ocupacional/normas
19.
Aust J Gen Pract ; 49(10): 656-661, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33015681

RESUMO

BACKGROUND: Patients with red eyes frequently present to general practitioners (GPs). Although infrequent, some patients with COVID-19 may present with features typical of viral conjunctivitis. SARS-CoV-2 is expressed at a low rate in tears, which may be a source of infection to GPs caring for patients at high risk of COVID­19. OBJECTIVE: The aims of this article are to outline: 1) ophthalmic complications of SARS-CoV-2 infection, 2) triage and management of patients with potential COVID-19 conjunctivitis, and 3) triage and management of patients with red eyes during the current COVID-19 pandemic. DISCUSSION: It is important that GPs: 1) have a high index of suspicion that patients with apparently typical viral conjunctivitis may have an uncommon presentation of COVID-19 illness, 2) develop appropriate telephone triage systems to reduce patient consultations, and 3) foster relationships with their ophthalmologist and optometrist colleagues who can provide phone advice, guidance on treatment initiation and definitive care when necessary.


Assuntos
Betacoronavirus/isolamento & purificação , Conjuntivite , Infecções por Coronavirus , Controle de Infecções , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Pandemias , Pneumonia Viral , Triagem/métodos , Comorbidade , Conjuntivite/diagnóstico , Conjuntivite/epidemiologia , Conjuntivite/virologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/terapia , Diagnóstico Diferencial , Técnicas de Diagnóstico Oftalmológico , Clínicos Gerais , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Exposição Ocupacional/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/fisiopatologia , Pneumonia Viral/terapia , Lágrimas/virologia
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