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1.
Am J Public Health ; 110(10): 1480-1484, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32816551

RESUMO

Hurricane Katrina caused unprecedented flood damage to New Orleans, Louisiana, and has been the costliest hurricane in US history. We analyzed the environmental and public health outcomes of Hurricane Katrina by using Internet searches to identify epidemiological, sociodemographic, and toxicological measurements provided by regulatory agencies.Atmospheric scientists have now warned that global warming will increase the proportion of stronger hurricanes (categories 4-5) by 25% to 30% compared with weaker hurricanes (categories 1-2).With the new $14.6 billion Hurricane Storm Damage Risk Reduction System providing a 100-year storm surge-defensive wall across the Southeast Louisiana coast, New Orleans will be ready for stronger storms in the future.


Assuntos
Meio Ambiente , Saúde Ambiental , Inundações , Substâncias Perigosas/análise , Tempestades Ciclônicas , Fungos , Gasolina/análise , Substâncias Perigosas/efeitos adversos , Humanos , Metais Pesados/análise , Metais Pesados/toxicidade , Nova Orleans , Saúde Pública
2.
Food Chem Toxicol ; 145: 111687, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32805343

RESUMO

Coronavirus disease 2019 (COVID-19) and previous pandemics have been viewed almost exclusively as virology problems, with toxicology problems mostly being ignored. This perspective is not supported by the evolution of COVID-19, where the impact of real-life exposures to multiple toxic stressors degrading the immune system is followed by the SARS-CoV-2 virus exploiting the degraded immune system to trigger a chain of events ultimately leading to COVID-19. This immune system degradation from multiple toxic stressors (chemical, physical, biological, psychosocial stressors) means that attribution of serious consequences from COVID-19 should be made to the virus-toxic stressors nexus, not to any of the nexus constituents in isolation. The leading toxic stressors (identified in this study as contributing to COVID-19) are pervasive, contributing to myriad chronic diseases as well as immune system degradation. They increase the likelihood for comorbidities and mortality associated with COVID-19. For the short-term, tactical/reactive virology-focused treatments are of higher priority than strategic/proactive toxicology-focused treatments, although both could be implemented in parallel to reinforce each other. However, for long-term pandemic prevention, toxicology-based approaches should be given higher priority than virology-based approaches. Since current COVID-19 treatments globally ignore the toxicology component almost completely, only limited benefits can be expected from these treatments.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Substâncias Perigosas/efeitos adversos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Infecções por Coronavirus/etiologia , Infecções por Coronavirus/psicologia , Estilo de Vida Saudável , Humanos , Pneumonia Viral/etiologia , Pneumonia Viral/psicologia , Quarentena
3.
Rev Environ Health ; 35(2): 85-109, 2020 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-32543458

RESUMO

The National Institutes of Health (NIH), National Institute of Environmental Health Sciences (NIEHS) Hazardous Substances Basic Research and Training Program [Superfund Research Program (SRP)] funds transdisciplinary research projects spanning the biomedical and environmental sciences to address issues related to potentially hazardous substances. We used a case study approach to identify how SRP-funded basic biomedical research has had an impact on society. We examined how transdisciplinary research projects from the SRP have advanced knowledge and led to additional clinical, public health, policy, and economic benefits. SRP basic biomedical research findings have contributed to the body of knowledge and influenced a broad range of scientific disciplines. It has informed the development of policies and interventions to reduce exposure to environmental contaminants to improve public health. Research investments by the SRP have had a significant impact on science, health, and society. Documenting the benefits of these investments provides insight into how basic research is translated to real-world applications.


Assuntos
Saúde Ambiental/estatística & dados numéricos , Substâncias Perigosas/efeitos adversos , Pesquisa Interdisciplinar/estatística & dados numéricos , Humanos , National Institute of Environmental Health Sciences (U.S.) , Estados Unidos
4.
Environ Health ; 19(1): 25, 2020 03 03.
Artigo em Inglês | MEDLINE | ID: mdl-32122363

RESUMO

Food packaging is of high societal value because it conserves and protects food, makes food transportable and conveys information to consumers. It is also relevant for marketing, which is of economic significance. Other types of food contact articles, such as storage containers, processing equipment and filling lines, are also important for food production and food supply. Food contact articles are made up of one or multiple different food contact materials and consist of food contact chemicals. However, food contact chemicals transfer from all types of food contact materials and articles into food and, consequently, are taken up by humans. Here we highlight topics of concern based on scientific findings showing that food contact materials and articles are a relevant exposure pathway for known hazardous substances as well as for a plethora of toxicologically uncharacterized chemicals, both intentionally and non-intentionally added. We describe areas of certainty, like the fact that chemicals migrate from food contact articles into food, and uncertainty, for example unidentified chemicals migrating into food. Current safety assessment of food contact chemicals is ineffective at protecting human health. In addition, society is striving for waste reduction with a focus on food packaging. As a result, solutions are being developed toward reuse, recycling or alternative (non-plastic) materials. However, the critical aspect of chemical safety is often ignored. Developing solutions for improving the safety of food contact chemicals and for tackling the circular economy must include current scientific knowledge. This cannot be done in isolation but must include all relevant experts and stakeholders. Therefore, we provide an overview of areas of concern and related activities that will improve the safety of food contact articles and support a circular economy. Our aim is to initiate a broader discussion involving scientists with relevant expertise but not currently working on food contact materials, and decision makers and influencers addressing single-use food packaging due to environmental concerns. Ultimately, we aim to support science-based decision making in the interest of improving public health. Notably, reducing exposure to hazardous food contact chemicals contributes to the prevention of associated chronic diseases in the human population.


Assuntos
Contaminação de Alimentos/análise , Embalagem de Alimentos/métodos , Substâncias Perigosas/efeitos adversos , Humanos , Plásticos/efeitos adversos
5.
Rev Environ Health ; 35(2): 111-122, 2020 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-32126018

RESUMO

The National Institute of Environmental Health Sciences (NIEHS) Superfund Basic Research and Training Program (SRP) funds a wide range of projects that span biomedical, environmental sciences, and engineering research and generate a wealth of data resulting from hypothesis-driven research projects. Combining or integrating these diverse data offers an opportunity to uncover new scientific connections that can be used to gain a more comprehensive understanding of the interplay between exposures and health. Integrating and reusing data generated from individual research projects within the program requires harmonization of data workflows, ensuring consistent and robust practices in data stewardship, and embracing data sharing from the onset of data collection and analysis. We describe opportunities to leverage data within the SRP and current SRP efforts to advance data sharing and reuse, including by developing an SRP dataset library and fostering data integration through Data Management and Analysis Cores. We also discuss opportunities to improve public health by identifying parallels in the data captured from health and engineering research, layering data streams for a more comprehensive picture of exposures and disease, and using existing SRP research infrastructure to facilitate and foster data sharing. Importantly, we point out that while the SRP is in a unique position to exploit these opportunities, they can be employed across environmental health research. SRP research teams, which comprise cross-disciplinary scientists focused on similar research questions, are well positioned to use data to leverage previous findings and accelerate the pace of research. Incorporating data streams from different disciplines addressing similar questions can provide a broader understanding and uncover the answers to complex and discrete research questions.


Assuntos
Saúde Ambiental/estatística & dados numéricos , Substâncias Perigosas/efeitos adversos , Disseminação de Informação , Pesquisa Interdisciplinar/estatística & dados numéricos , National Institute of Environmental Health Sciences (U.S.) , Exposição Ambiental , Humanos , Saúde Pública , Estados Unidos
6.
PLoS One ; 15(3): e0229869, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32187200

RESUMO

Until the 1980s, the limited research on alcohol and other drug (AOD) use among sexual minority women (SMW) focused on alcohol and used samples recruited from gay bars, resulting in inflated estimates of hazardous drinking. Over the past several decades the number of AOD studies with SMW has increased dramatically. To characterize this literature, we conducted a scoping review to answer the following questions: What do we know, and what are the gaps in research about AOD use among SMW? We searched multiple electronic databases (Medline [PubMed], CINAHL, PsycInfo, and Web of Science) for peer-reviewed research articles about AOD use among adult SMW published between January 1, 2000 and May 31, 2017. After duplicates were removed the search identified 4,204 articles. We reviewed the titles and abstracts and removed articles that did not meet inclusion criteria. We used full-text review of the remaining 229 articles to make a final determination regarding inclusion and we retained 181 articles for review. Although the quantity of AOD research with SMW has grown substantially, the great majority of studies have been conducted in the United States (US) and most focus on hazardous drinking; relatively little research has focused on other drugs. In addition, although there has been marked improvement in theories and methods used in this research, many gaps and limitations remain. Examples are the lack of longitudinal research; reliance on samples that tend to over-represent white, well-educated, and relatively young women; sparse attention to mechanisms underlying the disproportionately high rates of AOD use among SMW; and the absence of intervention research. In general, more high-quality research on SMW's use of AODs is needed, but gaps and limitations are particularly large in non-western countries. Addressing these research gaps and limitations is essential for providing information that can be used to develop more effective prevention and early intervention strategies, as well as for informing policies that can help to reduce risky drinking and drug misuse among SMW.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Alcoolismo/epidemiologia , Minorias Sexuais e de Gênero , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/fisiopatologia , Alcoolismo/fisiopatologia , Feminino , Substâncias Perigosas/efeitos adversos , Homossexualidade Feminina , Humanos , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Saúde da Mulher , Adulto Jovem
7.
Int J Pharm Compd ; 24(1): 30-36, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32023214

RESUMO

United States Pharmacopeia Chapter <800>, concerned with the handling of hazardous drugs in healthcare settings, requires that any entity handling such drugs maintain a hazardous drug list. While this list must include any drug found on the latest NIOSH List of Antineoplastic and Other Hazardous Drugs in Health Settings, entities are expected to include other drugs and substances of concern. The intent of this article is to provide concrete information concerning articles of personal protective equipment, as well as guidance as to where and how they should be donned, used, and removed. This information will cover every aspect of handling hazardous drugs from receipt to disposal, most certainly including both sterile and nonsterile compounding.


Assuntos
Antineoplásicos , Substâncias Perigosas/efeitos adversos , Exposição Ocupacional , Antineoplásicos/efeitos adversos , Antineoplásicos/química , Segurança Química/normas , Substâncias Perigosas/química , Exposição Ocupacional/prevenção & controle , Exposição Ocupacional/normas , Equipamento de Proteção Individual , Controle de Qualidade
8.
Artigo em Inglês | MEDLINE | ID: mdl-31947535

RESUMO

(1) Background: Hazardous substances in surgical smoke that is generated during laser or electrosurgery pose a potential health hazard. In Germany, the Technical Rules for Hazardous Substances (TRGS 525) have included recommendations for appropriate protective measures since 2014. Up to now, no empirical data has been available on the extent to which recommendations have been implemented in practice. (2) Methods: In 2018, 7089 surgeons in hospitals and outpatient practices were invited by email to participate in an online survey. In addition, 219 technical assistants were interviewed. The questionnaire dealt with knowledge of, and attitudes toward, the hazard potential of surgical smoke, as well as the availability and actual use of protective measures. Furthermore, manufacturers and distributors of smoke extraction devices were asked to give their assessment of the development of prevention in recent years. (3) Results: The survey response rate was 5% (surgeons) and 65% (technical assistant staff). Half of all surgeons assumed that there were high health hazards of surgical smoke without taking protective measures. Operating room nurses were more often concerned (88%). Only a few felt properly informed about the topic. The TRGS recommendations had been read by a minority of the respondents. In total, 52% of hospital respondents and 65% of the respondents in outpatient facilities reported any type of special suction system to capture surgical smoke. One-fifth of respondents from hospitals reported that technical measures had improved since the introduction of the TRGS 525. Fifty-one percent of the surgeons in hospitals and 70% of the surgeons in outpatient facilities "mostly" or "always" paid attention to avoiding surgical smoke. The most important reason for non-compliance with recommendations was a lack of problem awareness or thoughtlessness. Twelve industrial interviewees who assessed the situation and the development of prevention in practice largely confirmed the prevention gaps observed; only slight developments were observed in recent years. (4) Conclusions: The low response rate among surgeons and the survey results both indicate a major lack of interest and knowledge. Among other measures, team interventions with advanced training are needed in the future.


Assuntos
Exposição Ocupacional/prevenção & controle , Salas Cirúrgicas/estatística & dados numéricos , Fumaça/prevenção & controle , Eletrocirurgia/efeitos adversos , Alemanha , Substâncias Perigosas/efeitos adversos , Terapia a Laser/efeitos adversos , Exposição Ocupacional/análise , Exposição Ocupacional/legislação & jurisprudência
9.
Disaster Med Public Health Prep ; 14(1): 111-118, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31996271

RESUMO

OBJECTIVE: When 2017 Hurricane Harvey struck the coastline of Texas on August 25, 2017, it resulted in 88 fatalities and more than US $125 billion in damage to infrastructure. The floods associated with the storm created a toxic mix of chemicals, sewage and other biohazards, and over 6 million cubic meters of garbage in Houston alone. The level of biohazard exposure and injuries from trauma among persons residing in affected areas was widespread and likely contributed to increases in emergency department (ED) visits in Houston and cities receiving hurricane evacuees. We investigated medical surge resulting from these evacuations in Dallas-Fort Worth (DFW) metroplex EDs. METHODS: We used data sourced from the North Texas Syndromic Surveillance Region 2/3 in ESSENCE to investigate ED visit surge following the storm in DFW hospitals because this area received evacuees from the 60 counties with disaster declarations due to the storm. We used the interrupted time series (ITS) analysis to estimate the magnitude and duration of the ED surge. ITS was applied to all ED visits in DFW and visits made by patients residing in any of the 60 counties with disaster declarations due to the storm. The DFW metropolitan statistical area included 55 hospitals. Time series analyses examined data from March 1, 2017-January 6, 2018 with focus on the storm impact period, August 14-September 15, 2017. Data from before, during, and after the storm were visualized spatially and temporally to characterize magnitude, duration, and spatial variation of medical surge attributable to Hurricane Harvey. RESULTS: During the study period overall, ED visits in the DFW area rose immediately by about 11% (95% CI: 9%, 13%), amounting to ~16 500 excess total visits before returning to the baseline on September 21, 2017. Visits by patients identified as residing in disaster declaration counties to DFW hospitals rose immediately by 127% (95% CI: 125%, 129%), amounting to 654 excess visits by September 29, 2017, when visits returned to the baseline. A spatial analysis revealed that evacuated patients were strongly clustered (Moran's I = 0.35, P < 0.0001) among 5 of the counties with disaster declarations in the 11-day window during the storm surge. CONCLUSIONS: The observed increase in ED visits in DFW due to Hurricane Harvey and ensuing evacuation was significant. Anticipating medical surge following large-scale hurricanes is critical for community preparedness planning. Coordinated planning across stakeholders is necessary to safeguard the population and for a skillful response to medical surge needs. Plans that address hurricane response, in particular, should have contingencies for support beyond the expected disaster areas.


Assuntos
Tempestades Ciclônicas/estatística & dados numéricos , Mapeamento Geográfico , Capacidade de Resposta ante Emergências/normas , Adolescente , Adulto , Cidades/estatística & dados numéricos , Feminino , Substâncias Perigosas/efeitos adversos , Substâncias Perigosas/análise , Humanos , Masculino , Distribuição de Poisson , Vigilância da População/métodos , Capacidade de Resposta ante Emergências/estatística & dados numéricos , Texas/epidemiologia
10.
Curr Environ Health Rep ; 6(4): 256-268, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31734812

RESUMO

PURPOSE OF REVIEW: Electronic waste (e-waste) is a global public health challenge. E-waste recycling workers may be exposed to chemical, physical, ergonomic, and psychosocial hazards. This review provides an overview of recent research on occupational exposures in e-waste recycling and work-related health effects that can impact e-waste workers. RECENT FINDINGS: E-waste workers are exposed to a variety of chemicals including metals, particulates, persistent organic compounds, and flame retardants. Exposure varies according to job task with higher exposures observed for dismantling and burning e-waste. Exposure to job stress and physical hazards (e.g., noise) also occurs. Many studies have measured workers' exposure in the e-waste recycling industry; fewer have investigated health effects. Biological measures were reported more often than external exposure measures. In order to protect workers, efforts are required to better understand exposures and their health effects. Removing hazardous materials from electronic equipment and reducing e-waste production would benefit workers, communities, and the environment.


Assuntos
Resíduo Eletrônico/efeitos adversos , Substâncias Perigosas/efeitos adversos , Doenças Profissionais/etiologia , Exposição Ocupacional/efeitos adversos , Reciclagem , Substâncias Perigosas/análise , Humanos , Doenças Profissionais/epidemiologia , Exposição Ocupacional/análise , Saúde Pública
12.
Artigo em Inglês | MEDLINE | ID: mdl-31623297

RESUMO

The articles in this special issue on New Directions in Environmental Communication in the International Journal of Environmental Research and Public Health present new research and perspectives on engaging communities impacted by Superfund sites-the hazardous waste sites that have been identified by the U.S. Environmental Protection Agency (EPA) as needing cleanup. In particular, these articles focus on the community engagement cores (CECs) that work with affected communities as part the Superfund Research Program at the National Institute of Environmental Health Sciences (NIEHS). The purpose of this closing article is to highlight important themes evident across the eight articles in the special issue. When considered together, the findings reveal important lessons learned about community engagement and environmental communication, but also reveal that much more remains to be known. Recommendations are made for how these teams can continue to practice, reflect on, and research community engagement in ways that build toward a better understanding and implementation of best practices.


Assuntos
Relações Comunidade-Instituição/tendências , Exposição Ambiental/efeitos adversos , Substâncias Perigosas/efeitos adversos , Locais de Resíduos Perigosos , National Institute of Environmental Health Sciences (U.S.) , Saúde Pública , Humanos , Estados Unidos
13.
Integr Environ Assess Manag ; 15(6): 909-916, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31535774

RESUMO

Alternatives assessment is gaining traction as a systematic method to support the informed substitution of chemicals of concern. The 2nd International Symposium on Alternatives Assessment, on 1-2 November 2018, convened nearly 150 professionals from government agencies, industry, consultant firms, academia, and advocacy organizations to advance a greater understanding of the evolving methods, practices, and challenges in the use of alternatives assessment. This article reviews highlights and lessons from the symposium, including 1) notable advances in methods, 2) shared insights from practitioners on best practices as well as inherent tensions and challenges, and 3) research and practice needs in the field that can be addressed by organizations such as the newly launched Association for the Advancement of Alternatives Assessment. Being interdisciplinary in nature, the establishment of educational frameworks across disciplines and inclusion of diverse expertise in hazard and exposure assessments, life cycle impacts considerations, design principles, and economic and engineering evaluations will ensure continued growth of the field. Integr Environ Assess Manag 2019;00:1-8. © 2019 SETAC.


Assuntos
Poluentes Ambientais/efeitos adversos , Substâncias Perigosas/efeitos adversos , Medição de Risco/métodos , Humanos
14.
Artigo em Inglês | MEDLINE | ID: mdl-31450793

RESUMO

The National Institute of Environmental Health Sciences Superfund Research Program (SRP) funds university-based, solution-oriented research to understand how hazardous substances contribute to disease and how to prevent exposures to these hazardous substances. A unique aspect of the SRP is that, beyond the biomedical, environmental sciences, and engineering research projects, SRP-funded centers are required to include community engagement to build partnerships with affected communities and research translation to communicate and facilitate the use of research findings. The SRP views both as effective ways to inform and advance science for protection of public health. The purpose of community engagement within the centers is to ensure bidirectional communication between the researchers and the community, identify best practices and activities in community engagement for prevention and intervention activities, enhance knowledge, and support the needs of the communities impacted by hazardous waste sites. The SRP views research translation as communicating and facilitating the use of research findings emanating from the center in a manner most appropriate for their application and for the advancement of a center's research objectives. The SRP has a strong history of seeking opportunities to work with communities and stakeholders, by translating and sharing research findings in an impactful and informative manner with long-lasting benefits to improve public health.


Assuntos
Exposição Ambiental/efeitos adversos , Substâncias Perigosas/efeitos adversos , National Institute of Environmental Health Sciences (U.S.) , Exposição Ambiental/análise , Substâncias Perigosas/análise , Humanos , Saúde Pública , Apoio à Pesquisa como Assunto , Pesquisa Médica Translacional , Estados Unidos
15.
Integr Environ Assess Manag ; 15(6): 895-908, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31283083

RESUMO

Chemical hazard assessment (CHA), which aims to investigate the inherent hazard potential of chemicals, has been developed with the purpose of promoting safer consumer products. Despite the increasing use of CHA in recent years, finding adequate and reliable toxicity data required for CHA is still challenging due to issues regarding data completeness and data quality. Also, collecting data from primary toxicity reports or literature can be time consuming, which promotes the use of secondary data sources instead. In this study, we evaluate and characterize numerous secondary data sources on the basis of 5 performance attributes: reliability, adequacy, transparency, volume, and ease of use. We use GreenScreen for Safer Chemicals v1.4 as the CHA framework, which defines the endpoints of interest used in this analysis. We focused upon 34 data sources that reflect 3 types of secondary data: chemical-oriented data sources, hazard-trait-oriented data sources, and predictive data sources. To integrate and analyze the evaluation results, we applied 2 multicriteria decision analysis (MCDA) methodologies: multiattribute utility theory (MAUT) and stochastic multiobjective acceptability analysis (SMAA). Overall, the findings in this research program allow us to explore the relative importance of performance criteria and the data source quality for effectively conducting CHA. Integr Environ Assess Manag 2019;00:1-14. © 2019 SETAC.


Assuntos
Técnicas de Apoio para a Decisão , Poluentes Ambientais/efeitos adversos , Substâncias Perigosas/efeitos adversos , Medição de Risco/métodos , Qualidade de Produtos para o Consumidor , Humanos , Reprodutibilidade dos Testes
16.
Emerg Med J ; 36(8): 456-458, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31217181

RESUMO

INTRODUCTION: Recent terror attacks and assassinations involving highly toxic chemical weapons have stressed the importance of sufficient respiratory protection of medical first responders and receivers. As full-face respirators cause perceptual-motor impairment, they not only impair vision but also significantly reduce speech intelligibility. The recent introduction of electronic voice projection units (VPUs), attached to a respirator, may improve communication while wearing personal respiratory protection. OBJECTIVE: To determine the influence of currently used respirators and VPUs on medical communication and speech intelligibility. METHODS: 37 trauma anaesthetists carried out an evaluation exercise of six different respirators and VPUs including one control. Participants had to listen to audio clips of a variety of sentences dealing with scenarios of emergency triage and medical history taking. RESULTS: In the questionnaire, operators stated that speech intelligibility of the Avon C50 respirator scored the highest (mean 3.9, ±SD 1.0) and that the Respirex Powered Respiratory Protective Suit (PRPS) NHS-suit scored lowest (1.6, 0.9). Regarding loudness the C50 plus the Avon VPU scored highest (4.1, 0.7), followed by the Draeger FPS-7000-com-plus (3.4, 1.0) and the Respirex PRPS NHS-suit scored lowest (2.3, 0.8). CONCLUSIONS: We found that the Avon C50 is the preferred model among the tested respirators. In our model, electronic voice projection modules improved loudness but not speech intelligibility. The Respirex PRPS NHS-suit was rated significantly less favourably in respect of medical communication and speech intelligibility.


Assuntos
Comunicação , Socorristas/estatística & dados numéricos , Desenho de Equipamento/normas , Substâncias Perigosas/efeitos adversos , Ventiladores Mecânicos/efeitos adversos , Desenho de Equipamento/estatística & dados numéricos , Desenho de Equipamento/tendências , Humanos , Inteligibilidade da Fala , Inquéritos e Questionários , Avaliação da Tecnologia Biomédica/métodos , Avaliação da Tecnologia Biomédica/estatística & dados numéricos , Reino Unido , Ventiladores Mecânicos/estatística & dados numéricos , Ventiladores Mecânicos/tendências , Qualidade da Voz
17.
PLoS One ; 14(6): e0217757, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31216296

RESUMO

PURPOSE: Electron radiotherapy is a labor-intensive treatment option that is complicated by the need for field shaping blocks. These blocks are typically made from casting Cerrobend alloys containing lead and cadmium. This is a highly toxic process with limited precision. This work aims to provide streamlined and more precise electron radiotherapy by 3D using printing techniques. METHODS: The 3D printed electron cutout consists of plastic shells filled with 2 mm diameter tungsten ball bearings. Five clinical Cerrobend defined field were compared to the planned fields by measuring the light field edge when mounted in the electron applicator on a linear accelerator. The dose transmitted through the 3D printed and Cerrobend cutouts was measured using an IC profiler ion chamber array with 6 MeV and 16 MeV beams. Dose profiles from the treatment planning system were also compared to the measured dose profiles. Centering and full width half maximum (FWHM) metrics were taken directly from the profiler software. RESULTS: The transmission of a 16MeV beam through a 12 mm thick layer of tungsten ball bearings agreed within 1% of a 15 mm thick Cerrobend block (measured with an ion chamber array). The radiation fields shaped by ball bearing filled 3D printed cutout were centered within 0.4 mm of the planned outline, whereas the Cerrobend cutout fields had shift errors of 1-3 mm, and shape errors of 0.5-2 mm. The average shift of Cerrobend cutouts was 2.3 mm compared to the planned fields (n = 5). Beam penumbra of the 3D printed cutouts was found to be equivalent to the 15 mm thick Cerrobend cutout. The beam profiles agreed within 1.2% across the whole 30 cm profile widths. CONCLUSIONS: This study demonstrates that with a proper quality assurance procedure, 3D-printed cutouts can provide more accurate electron radiotherapy with reduced toxicity compared to traditional Cerrobend methods.


Assuntos
Neoplasias/radioterapia , Impressão Tridimensional , Tungstênio/uso terapêutico , Elétrons , Substâncias Perigosas/efeitos adversos , Substâncias Perigosas/uso terapêutico , Humanos , Chumbo/efeitos adversos , Chumbo/uso terapêutico , Método de Monte Carlo , Neoplasias/patologia , Aceleradores de Partículas , Cintilografia , Radioterapia , Dosagem Radioterapêutica , Planejamento da Radioterapia Assistida por Computador/métodos
19.
J Environ Public Health ; 2019: 1925863, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31061662

RESUMO

Globally, nail salons represent a fast expanding industry and often with low-income cosmeticians. In general, cosmeticians have limited access to safety information about the hazardous materials they handle, which would potentially enable them to minimize workplace exposures. The problem is much pronounced in low- and middle-income countries due to weaknesses in regulation of the industry. We investigated determinants of exposures to hazardous materials among nail cosmeticians in Kampala District, Uganda. We employed a cross-sectional study design among a random sample of 243 participants. The sociodemographic characteristics, education and training status, knowledge about routes of exposure to hazardous chemicals, and personal protective material use of cosmeticians were assessed through face-to-face interviews. Most cosmeticians were aged 18-34 years, and more males were engaged in this work than females. Also, 82.7% believed inhalation was the major exposure route for the chemicals they handled. Participants who had attained secondary-level education and above were over three times more likely to wear masks (AOR = 3.19, 95% CI 1.58-6.41) and gloves (AOR = 3.48, 95% CI 1.55-7.81) and over two times more likely to use aprons (AOR = 2.50, 95% CI 1.18-5.32). Participants who had ever received safety training on hazardous chemicals were more likely to wear all four personal protective equipment: masks (AOR = 3.21, 95% CI 1.61-6.42), gloves (AOR = 4.23, 95% CI 2.05-8.75), goggles (AOR = 4.14, 95% CI 1.25-13.65), and aprons (AOR = 2.73, 95% CI 1.25-5.96). Participants who had spent more than two years in the nail cosmetics business were more likely to wear masks (AOR = 3.37, 95% CI 1.64-6.95). With the increasing demand for nail cosmetics, and many people in urban areas of low-income countries engaging in this industry, there is need for training and better workplace policies to promote a healthier urban workforce dealing in cosmetics.


Assuntos
Indústria da Beleza/estatística & dados numéricos , Cosméticos/química , Substâncias Perigosas/efeitos adversos , Exposição Ocupacional/estatística & dados numéricos , Adolescente , Adulto , Indústria da Beleza/educação , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Saúde do Trabalhador , Equipamento de Proteção Individual/estatística & dados numéricos , Fatores de Risco , Uganda , Adulto Jovem
20.
Ann Work Expo Health ; 63(5): 488-504, 2019 05 21.
Artigo em Inglês | MEDLINE | ID: mdl-31051043

RESUMO

BACKGROUND: European directives stipulate that French employers take all available measures to reduce the use of carcinogenic, mutagenic, and reprotoxic (CMR) chemicals. Our study explores the trends for the various control measures that are available to employees exposed to CMR agents, at two time points (2003 and 2010). METHODS: Our study assessed data from the 2003 and the 2010 French national cross-sectional survey of occupational hazards (SUMER). The availability of collective protections (source-based controls and general ventilation) and personal protective equipment (PPE) was explored. Trends in the availability of protective measures were studied using multilevel logistic regressions. RESULTS: Exposure situations without any protective measures decreased considerably between 2003 and 2010 (29.9% versus 17.9%, respectively). The increase in the proportion of exposure situations involving source-based controls (e.g. an isolation chamber and local exhaust ventilation) was, however, much less. Multiple regression analysis showed that the protection strategies depended on the job characteristics (e.g. work schedules, the employment contract, and the occupation) as well as the size of the company. There were noticeable changes between 2003 and 2010. For example, differences in protections available between full-time and part-time workers disappeared in the 7-year period, whereas those between executives/managers and other employees increased, as did the gaps between large and small companies. CONCLUSIONS: Although the overall increase in exposure situations involving protective measures masks a number of differences in exposure between employee categories, it is a step in the right direction. Source-based controls appeared to be implemented more for exposures with the longest durations, and PPE was very often combined with collective protections, which is what is currently recommended.


Assuntos
Carcinógenos , Substâncias Perigosas/efeitos adversos , Mutagênicos/efeitos adversos , Exposição Ocupacional/prevenção & controle , Saúde do Trabalhador/tendências , Adulto , Estudos Transversais , Feminino , França , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Ocupações/estatística & dados numéricos , Equipamento de Proteção Individual/normas , Ventilação/normas
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