Formaldehyde in indoor air: a public health problem?

Formaldehyde was the first air pollutant, which already in the 1970s emerged as a specifically non-industrial indoor air quality problem. Yet formaldehyde remained an indoor air quality issue and the formaldehyde level in residential indoor air is among the highest of any indoor air contaminant. Formaldehyde concentrations in 4 different indoor settings (schools, office buildings, new dwellings and occupied dwellings) in Portugal were measured using Photo Ionization Detection (PID) equipment (11,7 eV lamps). All the settings presented results higher than the reference value proposed by Portuguese legislation. Furthermore, occupied dwellings showed 3 units with results above the reference. We could conclude that formaldehyde presence is a reality in monitored indoor settings. Concentration levels are higher than the Portuguese reference value for indoor settings and these can indicate health problems for occupants.

Health related quality of life in patients with refractory chronic heart failure undergoing cardiac resynchronization: type of therapeutic response

The benefits of cardiac resynchronization therapy (CRT) in the health-related quality of life (HRQL) are largely demonstrated in selected patients with severe congestive heart failure (CHF). However, the differences between responders and non-responders, with regard to the effect of CRT in the various dimensions that constitute HRQL are still a matter of discussion. Objective: To evaluate the impact of CRT on the HRQL of patients with CHF refractory to optimal pharmacological therapy, within 6 months after CRT. Methods: 43 patients, submitted to successful implantation of CRT, were evaluated in hospital just before intervention and in the outpatient clinic within 6 months after CRT. HRQL was analyzed based on the Kansas City Cardiomyopathy Questionnaire (KCCQ). Patients were classified as super-responders (ejection fraction of left ventricle - LVEF - ≥45% post-CRT), n=15, responders (sustained improvement in functional class and LVEF increased by 15%), n=19, and non-responders (no clinical or LVEF improvement), n=9. Results: In the group of super-responders, CRT was associated with an improvement in HRQL for the various fields and sums assessed (ρ<0.05); in responders, CRT has been associated with an improvement of HRQL in the various fields and sums, except in the self-efficacy dimension (ρ<0.05); in non-responders, CRT was not associated with improvement of HRQL. Conclusion: In a population with severe CHF undergoing CRT, the patients with clinical and echocardiographic positive response, obtained a favorable impact in all dimensions of HRQL, while the group without response to CRT showed no improvement. These data reinforces the importance of HRQL as a multidimensional tool for assessment of benefits in clinical practice.

Looking the organization's "backstages": political leadership in health organizations

Although leadership investigation has become for the last years an election topic with major relevance on organizational studies and accepting peacefully the general idea that organizations are freeland for politics, all these acceptances run against a kind of “fear” from the academy scholars on approaching the political leaderships’ singularities on organizations. Indeed, when we cross over both phenomena we verify that the absence and weaknesses towards the unique characteristics of political leadership on work scenarios are becoming sharped regarding to their predictors, their workers and their organizations, even if we left aside its moderator variables.

Occupational exposure to volatile organic compounds in the Portuguese printing industry

In the printing industry, volatile organic compounds main sources are the uses of organic solvents, fountain solutions and cleaning agents. Nowadays, one circumstance which might confuse the exposure reality is that the majority of solvents which are often used have a faint odour. Therefore, the conditions at offset printing in regard to solvent exposure may seem acceptable to workers. Fortunately, general ventilation and local exhaust systems have also become more common, and new printing machines, often with automatic cleaning, have entered the market. The health effects of volatile organic solvents are dependent on the chemicals involved but, normally, are associated with affecting the nervous system, the liver and also the kidneys. The purpose of this study was to document the conditions regarding exposure to volatile organic compounds in an offset printing unit and to permit identify task with higher exposure and with priority for preventive measures application. Exposure assessment was done before and after installation of general ventilation and local exhaust equipments and during printing and cleaning procedure.

Occupational exposure to perchloroethylene in Portuguese dry-cleaning stores

Perchloroethylene (also known as tetrachloroethylene) is a solvent that has been a mainstay of the dry cleaning industry for decades. Since 1995 the International Agency for Research on Cancer considers that dry cleaning entails exposures that are possibly carcinogenic to humans (Group 2B). Meanwhile, the same institution classified perchloroethylene as probably carcinogenic to humans (Group 2A). Some industries have begun using alternative cleaning methods that do not require the use of perchloroethylene. However, in Portugal this solvent is still the most common dry-cleaning agent. An exploratory study was developed that aimed to find the occupational exposure to perchloroethylene in four Portuguese dry-cleaning stores. Activities involving higher exposure and variables that promote exposure were also investigated. Real-time measurements of volatile organic compounds concentrations were performed using portable equipment (MultiRAE, RAE Systems model – calibrated by isobutylene).

Comparison of fungal contamination between hospitals and companies food units

A descriptive study was developed to compare air and surfaces fungal contamination in ten hospitals’ food units and two food units from companies. Fifty air samples of 250 litres through impaction method were collected from hospitals’ food units and 41 swab samples from surfaces were also collected, using a 10 by 10 cm square stencil. Regarding the two companies, ten air samples and eight surface samples were collected. Air and surface samples were collected in food storage facilities, kitchen, food plating and canteen. Outdoor air was also collected since this is the place regarded as a reference. Simultaneously, temperature, relative humidity and meal numbers were registered. Concerning air from hospitals’ food units, 32 fungal species were identified, being the two most commonly isolated genera Penicillium sp.

Risk assessment of exposure to multiple mycotoxins in food

Moulds may produce a diversity of toxins such as aflatoxins, ochratoxins, trichothecenes, zearalenone, fumonisins and others. Although toxicological, environmental and epidemiological studies have addressed the problem of these toxins one by one, more than one mycotoxin are found usually in the same contaminated food. Risk assessment for humans potentially exposed to multimycotoxins suffers very much from the lack of adequate food consumption data. Furthermore, for a given mycotoxin, synergism and antagonism with other mycotoxins, found in the same food commodities, are not taken into account. Aflatoxin B1 and ochratoxin A belong to the most frequently occurring mycotoxins. This has repeatedly been demonstrated, however, normally, the risk resulting from their simultaneous occurrence is not considered. A descriptive study was developed to monitor air fungal contamination in one hospital food unit.

Exposure assessment: the influence of environmental monitoring methodology

Exposure assessment is an important step of risk assessment process and has evolved more quickly than perhaps any aspect of the four-step risk paradigm (hazard identification, exposure assessment, dose-response analysis, and risk characterization). Nevertheless, some epidemiological studies have associated adverse health effects to a chemical exposure with an inadequate or absent exposure quantification. In addition to the metric used, the truly representation of exposure by measurements depends on: the strategy of sampling, random collection of measurements, and similarity between the measured and unmeasured exposure groups. Two environmental monitoring methodologies for formaldehyde occupational exposure were used to assess the influence of metric selection in exposure assessment and, consequently, in risk assessment process.

Are air-borne mycotoxins a public health concern in Portugal?

Introduction - Microscopic filamentous fungi, under suitable environmental conditions, can lead to the production of highly toxic chemical substances, commonly known as mycotoxins. The most widespread and studied mycotoxins are metabolites of some genera of moulds such as Aspergillus, Penicillium and Fusarium. Quite peculiar conditions may influence mycotoxin biosynthesis, such as climate, geographical location, cultivation practices, storage and type of substrate. Toxicity has been extensively investigated for the most important mycotoxins, such as aflatoxins, ochratoxin A and Fusarium toxins, and much information derived from toxicokinetics in animal models has also been obtained. The adverse effects are mainly related to genotoxicity, carcinogenicity, mutagenicity, teratogenicity and immunotoxicity. Aim of the study - To identify fungal species able to produce important mycotoxins in different Portuguese settings.

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.

Fungal contamination of poultries litter: a public health problem

Exposure to certain fungi can cause human illness. Fungi cause adverse human health effects through three specific mechanisms: generation of a harmful immune response (e.g., allergy or hypersensitivity pneumonitis); direct infection by the fungal organism; by toxic-irritant effects from mold byproducts, such as mycotoxins. In Portugal there is an increasingly industry of large facilities that produce whole chickens for domestic consumption and only few investigations have reported on fungal contamination of the poultry litter. The material used for poultry litter is varied but normally can be constitute by: pine shavings; sawdust of eucalyptus; other types of wood; peanut; coffee; sugar cane; straw; hay; grass; paper processed. Litter is one of the most contributive factors to fungal contamination in poultries. Spreading litter is one of the tasks that normally involve higher exposure of the poultry workers to dust, fungi and their metabolites, such as VOC’s and mycotoxins. After being used and removed from poultries, litter is ploughed into agricultural soils, being this practice potentially dangerous for the soil environment, as well for both humans and animals. The goal of this study was to characterize litter’s fungal contamination and also to report the incidence of keratinophilic and toxigenic fungi.

Environmental sustainability in superior education: case study of Lisbon College of Health Technology

Over the centuries there has been a growing trend of societies and it is possible to verify their economic growth. This growth has provided an increased pressure on natural resources, often over-reaching the boundaries of each country, which has called into question the level of environmental sustainability in different countries. Sustainability is understood as a complex concept involving ecological, social, economic dimensions and temporal urban processes. Therefore, Firmino (2009) suggests that the ecological footprint (EF) allows people to establish dependency relations between human activities and the natural resources required for such activities and for the absorption of waste generated. According to Bergh & Verbruggen (1999) the EF is an objective, impartial and one-dimensional indicator that enables people to assess the sustainability. The Superior Schools have a crucial role in building the vision of a sustainable future as a reality, because in transmitting values and environmental principles to his students, are providing that they, in exercising his professional activity, make decisions weighing the environmental values. This ensures improved quality of life. The present study aims to determine the level of environmental sustainability of the Academic Community of Lisbon College of Health Technology (ESTeSL), by calculating the EF, and describe whether a relation between Footprint and various socio-demographic characteristics of the subjects.

Air contaminants in animal production: the poultry case

A descriptive study was developed in order to assess air contamination caused by fungi and particles in seven poultry units. Twenty seven air samples of 25 litters were collected through impaction method. Air sampling and particle concentration measurement were performed in the pavilions’ interior and also outside premises, since this was the place regarded as reference. Simultaneously, temperature and relative humidity were also registered. Regarding fungal load in the air from the seven poultry farms, the highest value obtained was 24040 CFU/m3 and the lowest was 320 CFU/m3. Twenty eight species/genera of fungi were identified, being Scopulariopsis brevicaulis (39.0%) the most commonly isolated species and Rhizopus sp. (30.0%) the most commonly isolated genus. From the Aspergillus genus, Aspergillus flavus (74.5%) was the most frequently detected species. There was a significant correlation (r=0.487; p=0.014) between temperature and the level of fungal contamination (CFU/m3). Considering contamination caused by particles, in this study, particles with larger dimensions (PM5.0 and PM10) have higher concentrations. There was also a significant correlation between relative humidity and concentration of smaller particles namely, PM0.5 (r=0.438; p=0.025) and PM1.0 (r=0.537; p=0.005). Characterizing typical exposure levels to these contaminants in this specific occupational setting is required to allow a more detailed risk assessment analysis and to set exposure limits to protect workers’ health.

Comparison of indoor and outdoor fungi and particles in poultry units

A descriptive study was developed in order to compare indoor and outdoor air contamination caused by fungi and particles in seven poultry units. Twenty eight air samples of 25 litters were collected through the impaction method on malt extract agar. Air sampling and particles concentration measurement were done in the interior and also outside premises of the poultries’ pavilions. Regarding the fungal load in the air, indoor concentration of mold was higher than outside air in six poultry units. Twenty eight species / genera of fungi were identified indoor, being Scopulariopsis brevicaulis (40.5%) the most commonly isolated species and Rhizopus sp. (30.0%) the most commonly isolated genus. Concerning outdoor, eighteen species/genera of fungi were isolated, being Scopulariopsis brevicaulis (62.6%) also the most isolated. All the poultry farms analyzed presented indoor fungi different from the ones identified outdoors. Regarding particles’ contamination, PM2.5, PM5.0 and PM10 had a statistically significant difference (Mann-Whitney U test) between the inside and outside of the pavilions, with the inside more contaminated (p=.006; p=.005; p=.005, respectively). The analyzed poultry units are potential reservoirs of substantial amounts of fungi and particles and could therefore free them in the atmospheric air. The developed study showed that indoor air was more contaminated than outdoors, and this can result in emission of potentially pathogenic fungi and particles via aerosols from poultry units to the environment, which may post a considerable risk to public health and contribute to environmental pollution.

Fungal contamination of poultry litter: a public health problem

Although numerous studies have been conducted on microbial contaminants associated with various stages related to poultry and meat products processing, only a few reported on fungal contamination of poultry litter. The goals of this study were to (1) characterize litter fungal contamination and (2) report the incidence of keratinophilic and toxigenic fungi presence. Seven fresh and 14 aged litter samples were collected from 7 poultry farms. In addition, 27 air samples of 25 litters were also collected through impaction method, and after laboratory processing and incubation of collected samples, quantitative colony-forming units (CFU/m3) and qualitative results were obtained. Twelve different fungal species were detected in fresh litter and Penicillium was the most frequent genus found (59.9%), followed by Alternaria (17.8%), Cladosporium (7.1%), and Aspergillus (5.7%). With respect to aged litter, 19 different fungal species were detected, with Penicillium sp. the most frequently isolated (42.3%), followed by Scopulariopsis sp. (38.3%), Trichosporon sp. (8.8%), and Aspergillus sp. (5.5%). A significant positive correlation was found between litter fungal contamination (CFU/g) and air fungal contamination (CFU/m3). Litter fungal quantification and species identification have important implications in the evaluation of potential adverse health risks to exposed workers and animals. Spreading of poultry litter in agricultural fields is a potential public health concern, since keratinophilic (Scopulariopsis and Fusarium genus) as well as toxigenic fungi (Aspergillus, Fusarium, and Penicillium genus) were isolated.