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1.
Anesth Analg ; 132(1): 2-14, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33002929

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic created an extraordinary demand for N95 and similarly rated filtering facepiece respirators (FFR) that remains unmet due to limited stock, production constraints, and logistics. Interest in decontamination and reuse of FFR, a product class designed for single use in health care settings, has undergone a parallel surge due to shortages. A worthwhile decontamination method must provide effective inactivation of the targeted pathogen(s), and preserve particle filtration, mask fit, and safety for a subsequent user. This discussion reviews the background of the current shortage, classification, structure, and functional aspects of FFR, and potentially effective decontamination methods along with reference websites for those seeking updated information and guidance. The most promising techniques utilize heat, hydrogen peroxide, microwave-generated steam, or ultraviolet light. Many require special or repurposed equipment and a detailed operational roadmap specific to each setting. While limited, research is growing. There is significant variation between models with regard to the ability to withstand decontamination yet remain protective. The number of times an individual respirator can be reused is often limited by its ability to maintain a tight fit after multiple uses rather than by the decontamination method itself. There is no single solution for all settings; each individual or institution must choose according to their need, capability, and available resources. As the current pandemic is expected to continue for months to years, and the possibility of future airborne biologic threats persists, the need for plentiful, effective respiratory protection is stimulating research and innovation.


Assuntos
/prevenção & controle , Descontaminação , Contaminação de Equipamentos , Reutilização de Equipamento , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Exposição por Inalação/prevenção & controle , Exposição Ocupacional/prevenção & controle , /transmissão , Humanos , Exposição por Inalação/efeitos adversos , Exposição Ocupacional/efeitos adversos , Saúde do Trabalhador , Medição de Risco , Fatores de Risco
2.
Chemosphere ; 262: 128330, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33182093

RESUMO

Recently, there have been reports that many microplastics are found in the air, which has raised concerns about their toxicity. To date, however, only limited research has investigated the effects of micro(nano)plastics on human health, and even less the potential for inhalation toxicity. To fill this research gap, we investigated the potential inhalation toxicity of micro(nano)plastics using a modified OECD Guideline for Testing of Chemicals No. 412 '28-Day (subacute) inhalation toxicity study' using a whole-body inhalation system. Sprague-Dawley rats were exposed to three different exposure concentrations of polystyrene micro(nano)plastics (PSMPs), as well as control, for 14 days of inhalation exposure. After 14 days, alterations were observed on sevral endpoints in physiological, serum biochemical, hematological, and respiratory function markers measured on the samples exposed to PSMPs. However, no concentration-response relationships were observed, suggesting that these effects may not be definitively linked to exposure of PSMPs. On the other hand, the expression of inflammatory proteins (TGF-ß and TNF-α) increased in the lung tissue in an exposure concentration-dependent manner. The overall results indicate that 14-day inhalation exposure of PSMPs to rats has a more pronounced effect at the molecular level than at the organismal one. These results suggest that if the exposure sustained, alterations at the molecular level may lead to subsequent alterations at the higher levels, and consequently, the health risks of inhalation exposed micro(nano)plastics should not be neglected.


Assuntos
Exposição por Inalação/efeitos adversos , Pulmão/efeitos dos fármacos , Microplásticos/toxicidade , Nanopartículas/toxicidade , Poliestirenos/toxicidade , Aerossóis , Animais , Feminino , Humanos , Pulmão/metabolismo , Pulmão/patologia , Masculino , Microplásticos/farmacocinética , Nanopartículas/metabolismo , Organização para a Cooperação e Desenvolvimento Econômico , Tamanho da Partícula , Poliestirenos/farmacocinética , Ratos , Ratos Sprague-Dawley , Testes de Função Respiratória , Propriedades de Superfície
3.
Anesth Analg ; 132(1): 38-45, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33315602

RESUMO

BACKGROUND: Numerous barrier devices have recently been developed and rapidly deployed worldwide in an effort to protect health care workers (HCWs) from exposure to coronavirus disease 2019 (COVID-19) during high-risk procedures. However, only a few studies have examined their impact on the dispersion of droplets and aerosols, which are both thought to be significant contributors to the spread of COVID-19. METHODS: Two commonly used barrier devices, an intubation box and a clear plastic intubation sheet, were evaluated using a physiologically accurate cough simulator. Aerosols were modeled using a commercially available fog machine, and droplets were modeled with fluorescein dye. Both particles were propelled by the cough simulator in a simulated intubation environment. Data were captured by high-speed flash photography, and aerosol and droplet dispersion were assessed qualitatively with and without a barrier in place. RESULTS: Droplet contamination after a simulated cough was seemingly contained by both barrier devices. Simulated aerosol escaped the barriers and flowed toward the head of the bed. During barrier removal, simulated aerosol trapped underneath was released and propelled toward the HCW at the head of the bed. Usage of the intubation sheet concentrated droplets onto a smaller area. If no barrier was used, positioning the patient in slight reverse Trendelenburg directed aerosols away from the HCW located at the head of the bed. CONCLUSIONS: Our observations imply that intubation boxes and sheets may reduce HCW exposure to droplets, but they both may merely redirect aerosolized particles, potentially resulting in increased exposure to aerosols in certain circumstances. Aerosols may remain within the barrier device after a cough, and manipulation of the box may release them. Patients should be positioned to facilitate intubation, but slight reverse Trendelenburg may direct infectious aerosols away from the HCW. Novel barrier devices should be used with caution, and further validation studies are necessary.


Assuntos
/terapia , Controle de Infecções/instrumentação , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Exposição por Inalação/prevenção & controle , Intubação Intratraqueal , Exposição Ocupacional/prevenção & controle , Equipamento de Proteção Individual , Aerossóis , Humanos , Exposição por Inalação/efeitos adversos , Intubação Intratraqueal/efeitos adversos , Manequins , Teste de Materiais , Exposição Ocupacional/efeitos adversos , Saúde do Trabalhador
4.
Respir Res ; 21(1): 327, 2020 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-33302921

RESUMO

Since the coronavirus disease 2019 (COVID-19) identified in Wuhan, Hubei, China in December 2019, it has been characterized as a pandemic by World Health Organization (WHO). It was reported that asymptomatic persons are potential sources of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We present an outbreak among health-care workers incited by a doctor who cared a patient with COVID-19 in a Hospital in Wuhan, Hubei, China, which indicates existence of super-spreader even during incubation period.


Assuntos
/transmissão , Portador Sadio , Período de Incubação de Doenças Infecciosas , Transmissão de Doença Infecciosa do Paciente para o Profissional , Exposição por Inalação/efeitos adversos , Exposição Ocupacional/efeitos adversos , /patogenicidade , Idoso , /virologia , China , Feminino , Humanos , Fatores de Tempo , Virulência
5.
Toxicol Appl Pharmacol ; 409: 115330, 2020 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-33166545

RESUMO

An investigation into the potential toxicological effects of fracking sand dust (FSD), collected from unconventional gas drilling sites, has been undertaken, along with characterization of their chemical and biophysical properties. Using intratracheal instillation of nine FSDs in rats and a whole body 4-d inhalation model for one of the FSDs, i.e., FSD 8, and related in vivo and in vitro experiments, the effects of nine FSDs on the respiratory, cardiovascular and immune systems, brain and kidney were reported in the preceding eight tandem papers. Here, a summary is given of the key observations made in the organ systems reported in the individual studies. The major finding that inhaled FSD 8 elicits responses in extra-pulmonary organ systems is unexpected, as is the observation that the pulmonary effects of inhaled FSD 8 are attenuated relative to forms of crystalline silica more frequently used in animal studies, i.e., MIN-U-SIL® 5. An attempt is made to understand the basis for the extra-pulmonary toxicity and comparatively attenuated pulmonary toxicity of FSD 8.


Assuntos
Poluentes Atmosféricos/efeitos adversos , Exposição por Inalação/efeitos adversos , Areia/química , Administração por Inalação , Animais , Poeira , Fraturamento Hidráulico , Masculino , Exposição Ocupacional/efeitos adversos , Ratos , Dióxido de Silício/efeitos adversos
6.
Toxicol Appl Pharmacol ; 409: 115329, 2020 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-33181145

RESUMO

Hydraulic fracturing ("fracking") is a process in which subterranean natural gas-laden rock is fractured under pressure to enhance retrieval of gas. Sand (a "proppant") is present in the fracking fluid pumped down the well bore to stabilize the fissures and facilitate gas flow. The manipulation of sand at the well site creates respirable dust (fracking sand dust, FSD) to which workers are exposed. Because workplace exposures to FSD have exceeded exposure limits set by OSHA, a physico-chemical characterization of FSD along with comprehensive investigations of the potential early adverse effects of FSDs on organ function and biomarkers has been conducted using a rat model and related in vivo and in vitro experiments involving the respiratory, cardiovascular, immune systems, kidney and brain. An undercurrent theme of the overall hazard identification study was, to what degree do the health effects of inhaled FSD resemble those previously observed after crystalline silica dust inhalation? In short-term studies, FSD was found to be less bioactive than MIN-U-SIL® 5 in the lungs. A second theme was, are the biological effects of FSD restricted to the lungs? Bioactivity of FSD was observed in all examined organ systems. Our findings indicate that, in many respects, the physical and chemical properties, and the short-term biological effects, of the FSDs share many similarities as a group but have little in common with crystalline silica dust.


Assuntos
Poluentes Ocupacionais do Ar/efeitos adversos , Exposição por Inalação/efeitos adversos , Areia/química , Administração por Inalação , Animais , Poeira , Humanos , Fraturamento Hidráulico , Exposição Ocupacional/efeitos adversos , Ratos , Dióxido de Silício/efeitos adversos
7.
Dermatol Ther ; 33(6): e14528, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33174266

RESUMO

Given the current lack of a therapeutic vaccine for coronavirus disease 2019 (COVID-19), preventive measures including mask wearing are crucial in slowing the transmission of cases. However, prolonged wearing of protective respirators, medical and fabric masks can easily generate excessive sweating, moisture and friction. Closed and warm environments heighten the skin's permeability and sensitivity to physical or chemical irritants, leading to chronic cumulative irritant contact dermatitis or, rarely, even allergic contact dermatitis. Although not representing a life-threatening condition, contact dermatitis can have a significant impact on emergency management, as it is potentially able to reduce work performance and create emotional discomfort due to the involvement of evident body areas. To minimize the skin breakdown, adherence to standards on wearing protective and safe equipments and avoidance of overprotection should be performed. At the same time, some measures of skin care are recommended. Here, we offer some tips on how to prevent and manage contact dermatitis due to masks not only in health care workers, but also in the general population during this COVID-19 outbreak.


Assuntos
/prevenção & controle , Dermatite de Contato/prevenção & controle , Dermatite Ocupacional/prevenção & controle , Dermatoses Faciais/prevenção & controle , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Exposição por Inalação/prevenção & controle , Máscaras/efeitos adversos , Higiene da Pele , Administração Cutânea , Corticosteroides/administração & dosagem , Antialérgicos/administração & dosagem , Antibacterianos/administração & dosagem , Dermatite de Contato/diagnóstico , Dermatite de Contato/etiologia , Dermatite Ocupacional/diagnóstico , Dermatite Ocupacional/etiologia , Dermatoses Faciais/diagnóstico , Dermatoses Faciais/etiologia , Humanos , Exposição por Inalação/efeitos adversos , Saúde do Trabalhador , Fatores de Proteção , Medição de Risco , Fatores de Risco , Resultado do Tratamento
8.
Toxicol Appl Pharmacol ; 409: 115300, 2020 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-33141058

RESUMO

Hydraulic fracturing (fracking) is a process used to recover oil and gas from shale rock formation during unconventional drilling. Pressurized liquids containing water and sand (proppant) are used to fracture the oil- and natural gas-laden rock. The transportation and handling of proppant at well sites generate dust aerosols; thus, there is concern of worker exposure to such fracking sand dusts (FSD) by inhalation. FSD are generally composed of respirable crystalline silica and other minerals native to the geological source of the proppant material. Field investigations by NIOSH suggest that the levels of respirable crystalline silica at well sites can exceed the permissible exposure limits. Thus, from an occupational safety perspective, it is important to evaluate the potential toxicological effects of FSD, including any neurological risks. Here, we report that acute inhalation exposure of rats to one FSD, i.e., FSD 8, elicited neuroinflammation, altered the expression of blood brain barrier-related markers, and caused glial changes in the olfactory bulb, hippocampus and cerebellum. An intriguing observation was the persistent reduction of synaptophysin 1 and synaptotagmin 1 proteins in the cerebellum, indicative of synaptic disruption and/or injury. While our initial hazard identification studies suggest a likely neural risk, more research is necessary to determine if such molecular aberrations will progressively culminate in neuropathology/neurodegeneration leading to behavioral and/or functional deficits.


Assuntos
Inflamação/induzido quimicamente , Inflamação/metabolismo , Exposição por Inalação/efeitos adversos , Areia/química , Sinapses/efeitos dos fármacos , Sinapses/metabolismo , Aerossóis/efeitos adversos , Animais , Biomarcadores/metabolismo , Barreira Hematoencefálica/efeitos dos fármacos , Barreira Hematoencefálica/metabolismo , Poeira , Monitoramento Ambiental/métodos , Fraturamento Hidráulico/métodos , Masculino , Exposição Ocupacional/efeitos adversos , Ratos , Ratos Sprague-Dawley
9.
J Vis Exp ; (164)2020 10 22.
Artigo em Inglês | MEDLINE | ID: mdl-33165327

RESUMO

Close to 14% of adults in the United States were reported to smoke cigarettes in 2018. The effects of cigarette smoke (CS) on lungs and cardiovascular diseases have been widely studied, however, the impact of CS in other tissues and organs such as blood and bone marrow remain incompletely defined. Finding the appropriate system to study the effects of CS in rodents can be prohibitively expensive and require the purchase of commercially available systems. Thus, we set out to build an affordable, reliable, and versatile system to study the pathologic effects of CS in mice. This whole-body inhalation exposure system (WBIS) set-up mimics the breathing and puffing of cigarettes by alternating exposure to CS and clean air. Here we show that this do-it-yourself (DIY) system induces airway inflammation and lung emphysema in mice after 4-months of cigarette smoke exposure. The effects of whole-body inhalation (WBI) of CS on hematopoietic stem and progenitor cells (HSPCs) in the bone marrow using this apparatus are also shown.


Assuntos
Modelos Animais de Doenças , Exposição por Inalação/efeitos adversos , Fumaça/efeitos adversos , Produtos do Tabaco/efeitos adversos , Animais , Exposição por Inalação/análise , Camundongos , Enfisema Pulmonar/induzido quimicamente
10.
Artigo em Inglês | MEDLINE | ID: mdl-33054532

RESUMO

Perfluoroisobutyronitrile (C4F7N) is a new eco-friendly gas insulation medium that has potential to replace the most greenhouse gas sulfur hexafluoride (SF6) used in power industry. In order to ensure the engineering application safety, an in-depth assessment of the acute inhalation toxicity of C4F7N gas mixture is required. This article revealed gender differences in male and female mice after exposure to C4F7N and the physiological recovery characteristics of surviving mice by means of 4 h acute inhalation toxicity tests, hematological determinations and histopathological examination. Comparative analysis on the toxicity of C4F7N on mice and rats is also evaluated. We find that the LC50 of C4F7N for male and female mice is 1175 ppm (4 h), 1380 ppm (4 h) and female ones are more tolerant to C4F7N. Mice that exposed to 1000 ppm C4F7N for 4 h could survive and return to their normal state after the 14-day observation period without irreversible damage. The toxic effect duration of C4F7N on rats is longer than that of mice. Relevant results revealed the acute inhalation toxicity of C4F7N systematically and provided fundamental reference for inhalation safety protection and engineering application.


Assuntos
Poluentes Atmosféricos/toxicidade , Gases/toxicidade , Exposição por Inalação/efeitos adversos , Nitrilos/toxicidade , Animais , Feminino , Gases de Efeito Estufa , Dose Letal Mediana , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Ratos , Hexafluoreto de Enxofre , Testes de Toxicidade Aguda
11.
Toxicol Appl Pharmacol ; 409: 115284, 2020 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-33068619

RESUMO

Hydraulic fracturing creates fissures in subterranean rock to increase the flow and retrieval of natural gas. Sand ("proppant") in fracking fluid injected into the well bore maintains fissure patency. Fracking sand dust (FSD) is generated during manipulation of sand to prepare the fracking fluid. Containing respirable crystalline silica, FSD could pose hazards similar to those found in work sites where silica inhalation induces lung disease such as silicosis. This study was performed to evaluate the possible toxic effects following inhalation of a FSD (FSD 8) in the lung and airways. Rats were exposed (6 h/d × 4 d) to 10 or 30 mg/m3 of a FSD collected at a gas well, and measurements were performed 1, 7, 27 and, in one series of experiments, 90 d post-exposure. The following ventilatory and non-ventilatory parameters were measured in vivo and/or in vitro: 1) lung mechanics (respiratory system resistance and elastance, tissue damping, tissue elastance, Newtonian resistance and hysteresivity); 2) airway reactivity to inhaled methacholine (MCh); airway epithelium integrity (isolated, perfused trachea); airway efferent motor nerve activity (electric field stimulation in vitro); airway smooth muscle contractility; ion transport in intact and cultured epithelium; airway effector and sensory nerves; tracheal particle deposition; and neurogenic inflammation/vascular permeability. FSD 8 was without large effect on most parameters, and was not pro-inflammatory, as judged histologically and in cultured epithelial cells, but increased reactivity to inhaled MCh at some post-exposure time points and affected Na+ transport in airway epithelial cells.


Assuntos
Exposição por Inalação/efeitos adversos , Pulmão/efeitos dos fármacos , Exposição Ocupacional/efeitos adversos , Areia/química , Administração por Inalação , Animais , Poeira , Células Epiteliais/efeitos dos fármacos , Fraturamento Hidráulico/métodos , Masculino , Cloreto de Metacolina/farmacologia , Ratos , Ratos Sprague-Dawley , Mucosa Respiratória/efeitos dos fármacos , Dióxido de Silício/efeitos adversos , Traqueia/efeitos dos fármacos
12.
Toxicol Appl Pharmacol ; 409: 115282, 2020 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-33068622

RESUMO

Hydraulic fracturing ("fracking") is used in unconventional gas drilling to allow for the free flow of natural gas from rock. Sand in fracking fluid is pumped into the well bore under high pressure to enter and stabilize fissures in the rock. In the process of manipulating the sand on site, respirable dust (fracking sand dust, FSD) is generated. Inhalation of FSD is a potential hazard to workers inasmuch as respirable crystalline silica causes silicosis, and levels of FSD at drilling work sites have exceeded occupational exposure limits set by OSHA. In the absence of any information about its potential toxicity, a comprehensive rat animal model was designed to investigate the bioactivities of several FSDs in comparison to MIN-U-SIL® 5, a respirable α-quartz reference dust used in previous animal models of silicosis, in several organ systems (Fedan, J.S., Toxicol Appl Pharmacol. 00, 000-000, 2020). The present report, part of the larger investigation, describes: 1) a comparison of the physico-chemical properties of nine FSDs, collected at drilling sites, and MIN-U-SIL® 5, a reference silica dust, and 2) a comparison of the pulmonary inflammatory responses to intratracheal instillation of the nine FSDs and MIN-U-SIL® 5. Our findings indicate that, in many respects, the physico-chemical characteristics, and the biological effects of the FSDs and MIN-U-SIL® 5 after intratracheal instillation, have distinct differences.


Assuntos
Poluentes Ocupacionais do Ar/efeitos adversos , Exposição por Inalação/efeitos adversos , Pulmão/efeitos dos fármacos , Areia/química , Silicose/etiologia , Traqueia/efeitos dos fármacos , Animais , Modelos Animais de Doenças , Poeira , Fraturamento Hidráulico/métodos , Masculino , Exposição Ocupacional/efeitos adversos , Pneumonia/induzido quimicamente , Quartzo/efeitos adversos , Ratos , Ratos Sprague-Dawley , Dióxido de Silício/efeitos adversos
13.
Sci Rep ; 10(1): 16324, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33004983

RESUMO

Clinical impact of fine particulate matter (PM2.5) air pollution on incident atrial fibrillation (AF) had not been well studied. We used integrated machine learning (ML) to build several incident AF prediction models that include average hourly measurements of PM2.5 for the 432,587 subjects of Korean general population. We compared these incident AF prediction models using c-index, net reclassification improvement index (NRI), and integrated discrimination improvement index (IDI). ML using the boosted ensemble method exhibited a higher c-index (0.845 [0.837-0.853]) than existing traditional regression models using CHA2DS2-VASc (0.654 [0.646-0.661]), CHADS2 (0.652 [0.646-0.657]), or HATCH (0.669 [0.661-0.676]) scores (each p < 0.001) for predicting incident AF. As feature selection algorithms identified PM2.5 as a highly important variable, we applied PM2.5 for predicting incident AF and constructed scoring systems. The prediction performances significantly increased compared with models without PM2.5 (c-indices: boosted ensemble ML, 0.954 [0.949-0.959]; PM-CHA2DS2-VASc, 0.859 [0.848-0.870]; PM-CHADS2, 0.823 [0.810-0.836]; or PM-HATCH score, 0.849 [0.837-0.860]; each interaction, p < 0.001; NRI and IDI were also positive). ML combining readily available clinical variables and PM2.5 data was found to predict incident AF better than models without PM2.5 or even established risk prediction approaches in the general population exposed to high air pollution levels.


Assuntos
Fibrilação Atrial/etiologia , Exposição por Inalação/efeitos adversos , Aprendizado de Máquina , Material Particulado/efeitos adversos , Idoso , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/epidemiologia , Feminino , Humanos , Incidência , Masculino , Tamanho da Partícula , Material Particulado/análise , Análise de Regressão , República da Coreia/epidemiologia , Fatores de Risco
14.
Artigo em Inglês | MEDLINE | ID: mdl-33093772

RESUMO

Background: Forms of interstitial pneumonia secondary to exposure to an air-contaminant are varied and so far, insufficiently described. Objectives/Methods: We report here a case of a 57-year-old patient managed in our department for the exploration of MRC grade 2 dyspnoea and interstitial pneumonia. He mentioned multiple occupational and domestic exposures such as hens' excrements, asbestos and metal particles; he also had a previous history of smoking. Results: High-resolution computed tomography showed ground glass opacities predominating in posterior territories and surrounding cystic lesions or emphysematous destruction. The entire etiological assessment revealed only macrophagic alveolitis with giant multinucleated cells on the bronchoalveolar lavage. A surgical lung biopsy allowed us to refine the diagnosis with evidence of desquamative interstitial pneumonia and pulmonary granulomatosis. Finally, the analysis of the mineral particles in the biopsy revealed abnormally high rates of Zirconium and Aluminium. We were therefore able to conclude to a desquamative interstitial pneumonia associated with pulmonary granulomatosis linked to metal exposure (Aluminium and Zirconium). The clinical, functional and radiological evolution was favorable after a systemic corticosteroid treatment with progressive decay over one year. Conclusion: This presentation reports the first case to our knowledge of desquamative interstitial pneumonitis related to exposure to Zirconium and the third one in the context of Aluminium exposure. The detailed analysis of the mineral particles present on the surgical lung biopsy allows for the identification of the relevant particle to refine the etiological diagnosis, to guide the therapeutic management and to give access to recognition as an occupational disease. (Sarcoidosis Vasc Diffuse Lung Dis 2020; 37 (1): 79-84).


Assuntos
Alumínio/efeitos adversos , Granuloma do Sistema Respiratório/induzido quimicamente , Exposição por Inalação/efeitos adversos , Doenças Pulmonares Intersticiais/induzido quimicamente , Pulmão/efeitos dos fármacos , Zircônio/efeitos adversos , Corticosteroides/administração & dosagem , Alumínio/análise , Biópsia , Granuloma do Sistema Respiratório/diagnóstico , Granuloma do Sistema Respiratório/tratamento farmacológico , Granuloma do Sistema Respiratório/metabolismo , Humanos , Pulmão/química , Pulmão/diagnóstico por imagem , Pulmão/patologia , Doenças Pulmonares Intersticiais/diagnóstico , Doenças Pulmonares Intersticiais/tratamento farmacológico , Doenças Pulmonares Intersticiais/metabolismo , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Zircônio/análise
15.
Ecotoxicol Environ Saf ; 206: 111417, 2020 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-33010596

RESUMO

OBJECTIVE: Find the correlation between particulate matter (PM) and biomarkers related to blood coagulation, offer medical evidence to sensitive indicators and carry out early diagnosis of cardiovascular diseases. METHOD: A combination of computer and manual retrieval was used to search for the keywords in PubMed (584 records), Cochrane Library (28 records), Web of Science (162 records) and Embase (163 records). Finally, a total of 25 articles were included in this meta-analysis. Stata 13.0 was applied to examine the heterogeneity among the studies and to calculate the combined effect estimates, percent variation (%) and 95% CI by selecting corresponding models. Additionally, sensitivity analysis and publication bias test were also conducted. RESULTS: Meta-analysis indicated that there was an association between PM2.5 exposure (per 10 µg/m3 increase) and fibrinogen. With the increase of PM2.5 exposure (per 10 µg/m3 increase), the content of fibrinogen revealed a high level (2.26%; 95% CI: 1.08-3.44%); and the increase of UFPs exposure (per 5000/cm3 increase) was correlated with some biomarkers such as cell surface antigen and protein ligand including ICAM-1, sCD40L, P-selectin, E-selectin and PAI-1 that indirectly related to blood coagulation, yielding a percent variation of 10.83% (95% CI: 3.49%-18.17%). CONCLUSION: This meta-analysis expounded that PM-related biomarkers were associated with blood coagulation, and the relationship with fibrinogen was much stronger.


Assuntos
Poluentes Atmosféricos/toxicidade , Coagulação Sanguínea/efeitos dos fármacos , Exposição por Inalação/efeitos adversos , Material Particulado/toxicidade , Poluentes Atmosféricos/análise , Biomarcadores/sangue , Fibrinogênio/análise , Humanos , Tamanho da Partícula , Material Particulado/análise
17.
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
18.
Nanotoxicology ; 14(9): 1241-1257, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32909499

RESUMO

This review aims to elucidate the current knowledge and future research needs regarding the hazard potential of nanocellulose to human health. Growing interest from research and industry alike has led to increasing likelihood of human contact to the material via various exposure routes. Although a number of comprehensive reviews on human health hazards of nanocellulose have been conducted, this paper brings new insights as it systematically analyzes and quantitatively assesses the results of in vivo and in vitro tests in terms of investigated endpoints, tested concentration ranges, physicochemical properties, surface modifications and source of the tested nanocellulose, exposure route, and cell lines used. The quality of the studies is further inspected based on various established criteria. Considering the rapid development of nanocellulose-based products and the novelty of the material, human health studies remain scarce. By assessing those that have been conducted, patterns and gaps were identified that will be helpful to guide future research. The results show that there are still significant uncertainties remaining, particularly regarding in vivo testing, with pulmonary exposure showing some cause for concern. Although a substantial number of in vitro studies have been undertaken, results are often conflicting. The detected effects could not be directly attributed to size of nanoparticles, cell lines, surface modifications or tested concentrations. This may also be linked to the varying quality of the studies. This review ends by identifying key gaps to help pave the way for future research and ensure the safe development and use of nanocellulose.


Assuntos
Celulose/toxicidade , Substâncias Perigosas/toxicidade , Nanopartículas/toxicidade , Animais , Celulose/química , Substâncias Perigosas/química , Humanos , Exposição por Inalação/efeitos adversos , Nanopartículas/química , Exposição Ocupacional/efeitos adversos , Tamanho da Partícula , Propriedades de Superfície
19.
Nanotoxicology ; 14(9): 1213-1226, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32924690

RESUMO

Nanodiamonds have been suggested as biocompatible materials and are suitable for various biomedical applications, but little is known about how to synthesize safer nanodiamonds. Herein, seven different detonation-synthesized nanodiamonds (DNDs) with sequential sp3/sp2 carbon ratios were assembled by controlling the chemical purification parameters and the role of sp3/sp2 carbon ratio on the toxicity of DNDs was investigated. Carbon black and nickel oxide nanoparticles were used as reference particles. The intrinsic reactive oxygen species (ROS) generation potential of DNDs was estimated by a 2'7'-dichlorofluorescein diacetate (DCFH-DA) assay, and these values showed a good negative correlation with the sp3/sp2 carbon ratios, which implies that ROS generation increased as the sp3/sp2 carbon ratio decreased. As a model to investigate inflammogenic potential of DND samples, a rat intratracheal instillation model was used as the lung is very sensitive to nanoparticle exposures. The sp3/sp2 carbon ratios or the estimated values of ROS generation potential showed excellent linear correlations with the number of neutrophils and pro-inflammatory cytokines in bronchoalveolar lavage fluid at 24 h after instillation. Treatment of DND samples to THP-1 derived macrophages also showed that the sp3/sp2 carbon ratios or the estimated values of ROS generation potential were closely related with the toxicity endpoints such as cell viability and pro-inflammatory cytokines. Taken together, these data demonstrate that the sp3/sp2 carbon ratio is the key determinant for the toxicity of DNDs, which can be a useful tool for the safer-by-design approach of DNDs and the safety assessment of carbon nanoparticles.


Assuntos
Carbono/toxicidade , Exposição por Inalação/efeitos adversos , Pulmão/efeitos dos fármacos , Nanodiamantes/toxicidade , Espécies Reativas de Oxigênio/metabolismo , Animais , Líquido da Lavagem Broncoalveolar/química , Líquido da Lavagem Broncoalveolar/imunologia , Carbono/química , Sobrevivência Celular/efeitos dos fármacos , Sobrevivência Celular/imunologia , Citocinas/metabolismo , Feminino , Humanos , Pulmão/imunologia , Pulmão/metabolismo , Pulmão/patologia , Macrófagos/efeitos dos fármacos , Macrófagos/imunologia , Macrófagos/metabolismo , Nanodiamantes/química , Níquel/química , Níquel/toxicidade , Tamanho da Partícula , Ratos , Ratos Wistar , Propriedades de Superfície , Células THP-1
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