The effect of extreme cold temperatures on the risk of death in the two major Portuguese cities

It is well known that meteorological conditions influence the comfort and human health. Southern European countries, including Portugal, show the highest mortality rates during winter, but the effects of extreme cold temperatures in Portugal have never been estimated. The objective of this study was the estimation of the effect of extreme cold temperatures on the risk of death in Lisbon and Oporto, aiming the production of scientific evidence for the development of a real-time health warning system. Poisson regression models combined with distributed lag non-linear models were applied to assess the exposure-response relation and lag patterns of the association between minimum temperature and all-causes mortality and between minimum temperature and circulatory and respiratory system diseases mortality from 1992 to 2012, stratified by age, for the period from November to March. The analysis was adjusted for over dispersion and population size, for the confounding effect of influenza epidemics and controlled for long-term trend, seasonality and day of the week. Results showed that the effect of cold temperatures in mortality was not immediate, presenting a 1–2-day delay, reaching maximumincreased risk of death after 6–7 days and lasting up to 20–28 days. The overall effect was generally higher and more persistent in Lisbon than in Oporto, particularly for circulatory and respiratory mortality and for the elderly. Exposure to cold temperatures is an important public health problem for a relevant part of the Portuguese population, in particular in Lisbon.

Air fungal contamination in ten hospitals’ food units from Lisbon

A descriptive study was developed to monitor air fungal contamination in ten food units from hospitals. Fifty air samples of 250 litres were collected through impaction method. Samples were collected in food storage facilities, kitchen, food plating, canteen and also, outside premises, since this is the place regarded as reference. Simultaneously, environmental parameters were also monitored, including temperature and relative humidity through the equipment Babouc, LSI Sistems and according to the International Standard ISO 7726.

Monitorização de indicadores na fase pré-analítica: Avaliação Externa da Qualidade

O Programa Nacional de Avaliação Externa da Qualidade (PNAEQ), inserido na Unidade de Avaliação Externa da Qualidade, foi criado em 1978 como sendo uma das atribuições do Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA) de Lisboa, Portugal. A sua missão é promover, organizar e coordenar programas de avaliação externa da qualidade (AEQ) para laboratórios que exerçam atividade no setor da saúde. O primeiro programa de AEQ do PNAEQ para avaliação da Fase Pré-Analítica foi distribuído em 2007. Os ensaios são pluridisciplinares, podendo incluir o envio de amostras para avaliação das condições para processamento (aceitação ou rejeição, preparação, acondicionamento), a simulação de requisições médicas, a resposta a questionários, a interpretação de casos-estudo, o levantamento de dados (auditorias ou monitorização de indicadores) ou a realização de chamadas anónimas (“cliente mistério”). O PNAEQ disponibiliza ainda 4 programas em colaboração com a Labquality Oy (Flebotomia e POCT, Química Clínica, Microbiologia e Gases no Sangue) e 1 programa com a ECAT Foundation (Hemostase). A fase préanalítica é a que absorve o maior número de erros na análise de amostras biológicas, representando 40% a 70% de todas as falhas ocorridas no processamento analítico (Codagnone et al, 2014). A principal razão está na dificuldade em controlar as variáveis pré-analíticas, uma vez que esta fase envolve inúmeras atividades não automatizadas como a colheita, o manuseamento, o transporte e a preparação das amostras. O principal objetivo na monitorização de indicadores na fase pré-analítica é conhecer o estado atual de alguns aspetos desta fase extra-analítica, quantificando os erros de cada laboratório e comparando-o com os restantes participantes, procurando detetar as causas que mais afetam este processo.

Modelação do efeito do frio extremo na saúde da população de Lisboa: contributos para um sistema de vigilância e alerta

Palestra efetuada a convite no espaço dedicado a “Talentos em Ciências”.

Is there a relation between environmental exposure to teratogenic substances during pregnancy and congenital anomalies in the newborn? A pilot study in Portugal

Background: Maternal occupation as a proxy of environmental exposure has been consistently associated with specific congenital anomalies (CA) in the foetus and newborn. On the other hand, geographical location of the mother such as place of residence and place of work have not been used as proxy for environmental exposures during pregnancy. We designed a pilot study aiming to investigate the association between maternal place of residence and workplace during pregnancy and CA in Portugal. Methods: Cases and controls are identified in the maternity unit. Cases are all live births with at least one CA delivered in the Barreiro hospital located in a heavy industrial area near Lisboa. Controls are the two normal births following each case. Residents outside the study area, stillbirths and women who decline to participate or are incapable of giving consent are excluded. A health professional interviews the mothers using a questionnaire adapted from the registry form of the Portuguese national registry of CA and includes information on places during pregnancy (residence, workplace, leisure), and demographic characterization as place of birth, infant sex, weight, description of CA, age of mother, ethnicity, maternal birth place. Maternal health and obstetric history, education, smoking, alcohol, drugs and medication use is also collected as potential confounders. Results: The pilot study started in January 2016 and at the moment two cases and four controls have been recruited without refusals. The study will continue to be implemented and it is proposed to start in other hospital units during 2016.