Exposure to volatile organic compounds, particulate matter and fungi in a composting plant

Composting is an important process of solid waste management and it can be used for treatment of a variety of different wastes (green waste, household waste, sewage sludge and more). This process aims to: 1. Reduce the volumes of waste and; 2. Create a valuable product which can be recycled as a soil amendment in agriculture and gardening. A natural self-heating process involving the biological degradation of organic matter under aerobic conditions. The handling of waste and compost is responsible for the release of airborne microorganisms and their compounds in the air. Possible contaminants: a) Dust; b) Mesophilic and thermophilic microorganisms; c) Volatile organic compounds; d) Endotoxins and mycotoxins…. Aim: assess exposure/contamination to: a) Volatile organic compounds (VOCs); b) Particulate matter (PM); c) Fungi. In a composting plant located in Lisbon. An additional goal was to identify the workplace with higher level of contamination. In a totally indoor composting plant. The composting operations consisted: 1º Waste already sorted is unloaded in a reception area; 2º Pretreatment - remove undesirable materials from the process (glass, rocks, plastics, metals…); 3º Anaerobic digestion; 4º Dehydration; 5º Open composting with forced aeration. All the process takes thirteen weeks.

A checklist for patient safety rounds at the care pathway level

Objective - To define a checklist that can be used to assess the performance of a department and evaluate the implementation of quality management (QM) activities across departments or pathways in acute care hospitals. Design - We developed and tested a checklist for the assessment of QM activities at department level in a cross-sectional study using on-site visits by trained external auditors. Setting and Participants - A sample of 292 hospital departments of 74 acute care hospitals across seven European countries. In every hospital, four departments for the conditions: acute myocardial infarction (AMI), stroke, hip fracture and deliveries participated. Main outcome measures - Four measures of QM activities were evaluated at care pathway level focusing on specialized expertise and responsibility (SER), evidence-based organization of pathways (EBOP), patient safety strategies and clinical review (CR). Results - Participating departments attained mean values on the various scales between 1.2 and 3.7. The theoretical range was 0-4. Three of the four QM measures are identical for the four conditions, whereas one scale (EBOP) has condition-specific items. Correlations showed that every factor was related, but also distinct, and added to the overall picture of QM at pathway level. Conclusion - The newly developed checklist can be used across various types of departments and pathways in acute care hospitals like AMI, deliveries, stroke and hip fracture. The anticipated users of the checklist are internal (e.g. peers within the hospital and hospital executive board) and external auditors (e.g. healthcare inspectorate, professional or patient organizations).