Contributo para a construção de um code set da classificação internacional de funcionalidade, incapacidade e saúde, para terapeutas ocupacionais, em unidades de cuidados continuados integrados

A CIF é uma ferramenta universal desenvolvida pela OMS que permite a classificação de funcionalidade e incapacidade, através de uma visualização global do que condiciona o desempenho do indivíduo na concretização de atividades e na participação em ocupações. A ideologia da CIF e os seus componentes interrelacionam-se com a essência da TO, indo ao encontro dos modelos da profissão. As UCCI constituem uma atualidade em Portugal e o terapeuta ocupacional é um dos profissionais obrigatórios na equipa multidisciplinar destas unidades. Atendendo à relevância internacional da CIF, à sua ligação com a TO e à necessidade de tornar a CIF operacional na prática clínica diária dado que é uma ferramenta complexa e extensa, é objetivo deste estudo contribuir para a construção de um code set da CIF para terapeutas ocupacionais que exercem funções em UCCI, especificamente em UC, UMDR e ULDM. Para a concretização desta investigação, utilizou-se a técnica de Delphi, que envolveu duas rondas. Na primeira ronda foi possível contar com a participação de 37 terapeutas ocupacionais experientes na área, uma vez que exercem funções em UCCI, e na segunda ronda contou-se com a participação de 20 elementos. Obtiveram consenso na última ronda de Delphi um total de 96 categorias, constituindo esta listagem uma proposta de code set para UCCI. No que se refere às tipologias de unidades, 69 categorias obtiveram consenso em UC, 91 em UMDR e 41 em ULDM. Concluiu-se que a criação de code sets poderá constituir uma mais-valia em contexto de equipa multidisciplinar das UCCI, sendo uma forma de tornar a CIF operacional na prática clínica diária.

Escoamento de superfície e vulnerabilidade às cheias no concelho da Ribeira Grande (São Miguel, Açores)

Dissertação de Mestrado, Geologia do Ambiente e Sociedade, 8 de Maio de 2015, Universidade dos Açores.

Avaliação e substituição de produtos químicos no sector BOF da Swedwood Portugal

A crescente preocupação com aspectos ambientais tornou-se uma questão incontornável para as empresas. Assim, a legislação aplicável obriga a maior controlo de qualquer tipo de perigo que ponha em causa a saúde humana ou o ambiente. Deste modo, a Swedwood Portugal é obrigada a implementar algumas medidas de controlo dos produtos químicos. Assim, os objectivos deste estágio curricular fundamentamse em identificar, avaliar e substituir ou minimizar os impactos dos produtos químicos (PQ’s) que, de acordo com especificações REACH (Regulamento da Comissão Europeia, relativo a Registo, Avaliação, Autorização e restrição de substâncias Químicas) e da Swedwood Internacional não podem ser utilizados. Como tal, o trabalho descrito nesta dissertação foi dividido em várias etapas. A primeira etapa consistiu em identificar todos os PQ’s utilizados no sector Board On Frame (BOF) da Swedwood Portugal. Feito este inventário, foi então criada uma base de dados em formato Microsoft Office Access que permitiu compilar a informação mais relevante dos PQ’s, para uma consulta mais simples e expedita, substituindo a já existente e desactualizada base de dados de PQ’s em formato Microsoft Office Excel. No total foram inventariados 243 PQ’s. Contudo, não foi possível obter as Fichas de Segurança de todos e, por isso, apenas 185 foram registados na base de dados. Estes 185 PQ’s existentes no sector BOF da Swedwood Portugal, foram submetidos a uma avaliação das substâncias que os compõem de acordo com uma ferramenta informática criada pela Swedwood Internacional – Substitution Evaluation Key (SEK). Esta ferramenta usa três listas europeias de substâncias químicas que permitem a avaliação de produtos químicos indirectos: Substances of Very High Concern (SVHC) da Agência Europeia de Produtos Químicos (ECHA), Substitute It Now (SIN) da ChemSec (Organização sueca dedicada ao ambiente) e PRIO da Agência Sueca de Produtos Químicos (Kemi). As três listas incluem substâncias de carácter de tal forma perigoso que a sua utilização deve ser restringida ou até eliminada. Logo, os PQ’s indirectos que contenham substâncias presentes em, pelo menos, uma destas listas devem ser imediatamente substituídos por outros cuja avaliação seja positiva. Por outro lado, para produtos químicos directos, as restrições encontram-se numa especificação imposta pela IKEA, IOS-MAT-0066. Concluída a avaliação, foi então necessário encontrar alternativas viáveis aos PQ’s avaliados negativamente. Como tal, a primeira abordagem consistiu em contactar os fabricantes dos PQ’s a substituir de modo a que estes pudessem apresentar as suas próprias alternativas. Caso estes não apresentassem alternativas viáveis, então contactarse- iam novos fornecedores. Dos 185 PQ’s registados na base de dados e avaliados, 30 produtos químicos indirectos existentes nas fábricas não obedeciam aos critérios impostos pela SEK, estando os produtos químicos directos todos de acordo com as imposições da IOS-MAT-0066. Os 30 PQ’s indirectos do Sector BOF da Swedwood Portugal que incluem as substâncias químicas com carácter perigoso apresentam características Cancerígenas, Mutagénicas e tóxicas para a Reprodução (CMR), irritantes e/ou sensibilizantes e perigosas, a longo prazo, para o ambiente. Para estes PQ’s foram apresentadas alternativas viáveis no que concerne a impactos para a saúde ou para o ambiente e os respectivos custos associados (admitindo quantidades mínimas vendidas). Contudo, não foi possível em tempo útil testar estas alternativas no funcionamento da empresa de modo a avaliar a sua eficiência técnica.

Oxidative Leaching of metals from electronic waste with solutions based on quaternary ammonium salts

The treatment of electric and electronic waste (WEEE) is a problem which receives ever more attention. An inadequate treatment results in harmful products ending up in the environment. This project intends to investigate the possibilities of an alternative route for recycling of metals from printed circuit boards (PCBs) obtained from rejected computers. The process is based on aqueous solutions composed of an etchant, either 0.2 M CuCl2.2H2O or 0.2 M FeCl3.6H2O, and a quaternary ammonium salt (quat) such as choline chloride or chlormequat. These solutions are reminiscent of deep eutectic solvents (DES) based on quats. DES are quite similar to ionic liquids (ILs) and are used as well as alternative solvents with a great diversity of physical properties, making them attractive for replacement of hazardous, volatile solvents (e.g. VOCs). A remarkable difference between genuine DES and ILs with the solutions used in this project is the addition of rather large quantities of water. It is shown the presence of water has a lot of advantages on the leaching of metals, while the properties typical for DES still remain. The oxidizing capacities of Cu(II) stem from the existence of a stable Cu(I) component in quat based DES and thus the leaching stems from the activity of the Cu(II)/Cu(I) redox couple. The advantage of Fe(III) in combination with DES is the fact that the Fe(III)/Fe(II) redox couple becomes reversible, which is not true in pure water. This opens perspectives for regeneration of the etching solution. In this project the leaching of copper was studied as a function of gradual increasing water content from 0 - 100w% with the same concentration of copper chloride or iron(III) chloride at room temperature and 80ºC. The solutions were also tested on real PCBs. At room temperature a maximum leaching effect for copper was obtained with 30w% choline chloride with 0.2 M CuCl2.2H2O. The leaching effect is still stronger at 80°C, b ut of course these solutions are more energy consuming. For aluminium, tin, zinc and lead, the leaching was faster at 80ºC. Iron and nickel dissolved easily at room temperature. The solutions were not able to dissolve gold, silver, rhodium and platinum.

Toxicology of metals and metalloids

Metal toxicology is one of the oldest areas of study of toxicology and one of the oldest environmental problems. Metals and metalloids are toxic elements at the top of the priority list of hazardous substances of the Agency for Toxic Substances and Disease Registry (ATSDR). However, several gaps of knowledge still exist that are related to their toxicity, mainly concerning the mechanisms of action. This special issue affords the opportunity to bring together the results of nine papers covering several aspects of the toxicology of metals and metalloids in in vitro and in vivo experimental models, as well as in exposed populations.

Removal of Cd(II), Zn(II) and Pb(II) from aqueous solutions by brown marine macro algae: kinetic modelling

Specific marine macro algae species abundant at the Portuguese coast (Laminaria hyperborea, Bifurcaria bifurcata, Sargassum muticum and Fucus spiralis) were shown to be effective for removing toxic metals (Cd(II), Zn(II) and Pb(II)) from aqueous solutions. The initial metal concentrations in solution were about 75–100 mg L−1. The observed biosorption capacities for cadmium, zinc and lead ions were in the ranges of 23.9–39.5, 18.6–32.0 and 32.3–50.4 mg g−1, respectively. Kinetic studies revealed that the metal uptake rate was rather fast, with 75% of the total amount occurring in the first 10 min for all algal species. Experimental data were well fitted by a pseudo-second order rate equation. The contribution of internal diffusion mechanism was significant only to the initial biosorption stage. Results indicate that all the studied macro algae species can provide an efficient and cost-effective technology for eliminating heavy metals from industrial effluents.

Optimization of Cu(II) biosorption onto ascophyllum nodosum by factorial design methodology

A Box–Behnken factorial design coupled with surface response methodology was used to evaluate the effects of temperature, pH and initial concentration in the Cu(II) sorption process onto the marine macroalgae Ascophyllum nodosum. The effect of the operating variables on metal uptake capacitywas studied in a batch system and a mathematical model showing the influence of each variable and their interactions was obtained. Study ranges were 10–40ºC for temperature, 3.0–5.0 for pH and 50–150mgL−1 for initial Cu(II) concentration. Within these ranges, the biosorption capacity is slightly dependent on temperature but markedly increases with pH and initial concentration of Cu(II). The uptake capacities predicted by the model are in good agreement with the experimental values. Maximum biosorption capacity of Cu(II) by A. nodosum is 70mgg−1 and corresponds to the following values of those variables: temperature = 40ºC, pH= 5.0 and initial Cu(II) concentration = 150mgL−1.

Cytostatics occupational exposure: genotoxic effects assessment

The use of cytostatics drugs in anticancer therapy is increasing. Health care workers can be occupationally exposed to these drugs classified as carcinogenic, mutagenic or teratogenic. Workers may be exposed to this drug, being in the hospital settings the main focus dwelled upon the pharmacy, and nursing personnel. Although the potential therapeutic benefits of hazardous drugs outweigh the risks of side effects for ill patients, exposed health care workers can have the same side effects with no therapeutic benefit. The exposure to these substances is epidemiologically linked to cancer and nuclear changes detected by the cytokinesis-block micronucleus test (CBMN). This method is extensively used in molecular epidemiology, since it determines several biomarkers of genotoxicity, such as micronuclei (MN), which are biomarkers of chromosomes breakage or loss, nucleoplasmic bridges (NPB), common biomarkers of chromosome rearrangement, poor repair and/or telomeres fusion, and nuclear buds (NBUD), biomarkers of elimination of amplified DNA.

Biomonitorization in hospital settings with cytostatics occupational exposure

Exposure in a hospital setting is normally due to the use of several antineoplastic drugs simultaneously. Nevertheless, the effects of such mixtures at the cell level and on human health in general are unpredictable and unique due to differences in practice of hospital oncology departments, in the number of patients, protection devices available, and the experience and safety procedures of medical staff. Health care workers who prepare or administer hazardous drugs or who work in areas where these drugs are used may be exposed to these agents in the air, on work surfaces, contaminated clothing, medical equipment, patient excreta, and other surfaces. These workers include specially pharmacists, pharmacy technicians, and nursing personnel. Exposures may occur through inhalation resulting from aerosolization of powder or liquid during reconstitution and spillage taking place while preparing or administering to patients, through Cytokinesis-block micronucleus test (CBMN) is extensively used in biomonitoring, since it determines several biomarkers of genotoxicity, such as micronuclei (MN), which are biomarkers of chromosomes breakage or loss, nucleoplasmic bridges (NPB), common biomarkers of chromosome rearrangement, poor repair and/or telomeres fusion, and nuclear buds (NBUD), biomarkers of elimination of amplified DNA.

Use of solvent extraction to remediate soils contaminated with hydrocarbons

The main objective of this research is to exploit the possibility of using an ex situ solvent extraction technique for the remediation of soils contaminated with semi-volatile petroleum hydrocarbons. The composition of the organic phase was chosen in order to form a single phase mixture with an aqueous phase and simultaneously not being disturbed (forming stable emulsions) by the soil particles hauling the contaminants. It should also permit a regeneration of the organic solvent phase. As first, we studied the miscibility domain of the chosen ternary systems constituted by ethyl acetate–acetone–water. This system proved to satisfy the previous requirements allowing for the formation of a single liquid phase mixture within a large spectrum of compositions, and also allowing for an intimate contact with the soil. Contaminants in the diesel range within different functional groups were selected: xylene, naphthalene and hexadecane. The analytical control was done by gas chromatography with FID detector. The kinetics of the extractions proved to be fast, leading to equilibrium after 10 min. The effect of the solid–liquid ratio on the extraction efficiency was studied. Lower S/L ratios (1:8, w/v) proved to be more efficient, reaching recoveries in the order of 95%. The option of extraction in multiple contacts did not improve the recovery in relation to a single contact. The solvent can be regenerated by distillation with a loss around 10%. The contaminants are not evaporated and they remain in the non-volatile phase. The global results show that the ex situ solvent extraction is technically a feasible option for the remediation of semi-volatile aromatic, polyaromatic and linear hydrocarbons.

A perspective on LCA application in site remediation services: critical review of challenges

The remediation of contaminated sites supports the goal of sustainable development but may also have environmental impacts at a local, regional and global scale. Life cycle assessment (LCA) has increasingly been used in order to support site remediation decision-making. This review article discusses existing LCA methods and proposed models focusing on critical decisions and assumptions of the LCA application to site remediation activities. It is concluded that LCA has limitations as an adequate holistic decisionmaking tool since spatial and temporal differentiation of non-global impacts assessment is a major hurdle in site remediation LCA. Moreover, a consequential LCA perspective should be adopted when the different remediation services to be compared generate different site’s physical states, displacing alternative post-remediation scenarios. The environmental effects of the post-remediation stage of the site is generally disregarded in the past site remediation LCA studies and such exclusion may produce misleading conclusions and misdirected decision-making. In addition, clear guidance accepted by all stakeholders on remediation capital equipment exclusion and on dealing with multifunctional processes should be developed for site remediation LCA applications.

Ecotoxicological aspects related to the presence of pharmaceuticals in the aquatic environment

Pharmaceuticals are biologically active and persistent substances which have been recognized as a continuing threat to environmental stability. Chronic ecotoxicity data as well as information on the current distribution levels in different environmental compartments continue to be sparse and are focused on those therapeutic classes that are more frequently prescribed and consumed. Nevertheless, they indicate the negative impact that these chemical contaminants may have on living organisms, ecosystems and ultimately, public health. This article reviews the different contamination sources as well as fate and both acute and chronic effects on non-target organisms. An extensive review of existing data in the form of tables, encompassing many therapeutic classes is presented.

Heterogeneous kinetics of the reduction of chromium (VI) by elemental iron

Zero valent iron (ZVI) has been extensively used as a reactive medium for the reduction of Cr(VI) to Cr(III) in reactive permeable barriers. The kinetic rate depends strongly on the superficial oxidation of the iron particles used and the preliminary washing of ZVI increases the rate. The reaction has been primarily modelled using a pseudo-first-order kinetics which is inappropriate for a heterogeneous reaction. We assumed a shrinking particle type model where the kinetic rate is proportional to the available iron surface area, to the initial volume of solution and to the chromium concentration raised to a power ˛ which is the order of the chemical reaction occurring at surface. We assumed α= 2/3 based on the likeness to the shrinking particle models with spherical symmetry. Kinetics studies were performed in order to evaluate the suitability of this approach. The influence of the following parameters was experimentally studied: initial available surface area, chromium concentration, temperature and pH. The assumed order for the reaction was confirmed. In addition, the rate constant was calculated from data obtained in different operating conditions. Digital pictures of iron balls were periodically taken and the image treatment allowed for establishing the time evolution of their size distribution.

Contribution of hospital effluents to the load of pharmaceuticals in urban wastewaters: Identification of ecologically relevant pharmaceuticals

The impact of effluent wastewaters from four different hospitals: a university (1456 beds), a general (350 beds), a pediatric (110 beds) and a maternity hospital (96 beds), which are conveyed to the same wastewater treatment plant (WWTP), was evaluated in the receiving urban wastewaters. The occurrence of 78 pharmaceuticals belonging to several therapeutic classes was assessed in hospital effluents and WWTP wastewaters (influent and effluent) as well as the contribution of each hospital in WWTP influent in terms of pharmaceutical load. Results indicate that pharmaceuticals are widespread pollutants in both hospital and urban wastewaters. The contribution of hospitals to the input of pharmaceuticals in urban wastewaters widely varies, according to their dimension. The estimated total mass loadings were 306 g d− 1 for the university hospital, 155 g d− 1 for the general one, 14 g d− 1 for the pediatric hospital and 1.5 g d− 1 for the maternity hospital, showing that the biggest hospitals have a greater contribution to the total mass load of pharmaceuticals. Furthermore, analysis of individual contributions of each therapeutic group showed that NSAIDs, analgesics and antibiotics are among the groups with the highest inputs. Removal efficiency can go from over 90% for pharmaceuticals like acetaminophen and ibuprofen to not removal for β-blockers and salbutamol. Total mass load of pharmaceuticals into receiving surface waters was estimated between 5 and 14 g/d/1000 inhabitants. Finally, the environmental risk posed by pharmaceuticals detected in hospital and WWTP effluents was assessed by means of hazard quotients toward different trophic levels (algae, daphnids and fish). Several pharmaceuticals present in the different matrices were identified as potentially hazardous to aquatic organisms, showing that especial attention should be paid to antibiotics such as ciprofloxacin, ofloxacin, sulfamethoxazole, azithromycin and clarithromycin, since their hazard quotients in WWTP effluent revealed that they could pose an ecotoxicological risk to algae.

Accounting for the dissociating properties of organic chemicals in LCIA: an uncertainty analysis applied to micropollutants in the assessment of freshwater ecotoxicity

In life cycle impact assessment (LCIA) models, the sorption of the ionic fraction of dissociating organic chemicals is not adequately modeled because conventional non-polar partitioning models are applied. Therefore, high uncertainties are expected when modeling the mobility, as well as the bioavailability for uptake by exposed biota and degradation, of dissociating organic chemicals. Alternative regressions that account for the ionized fraction of a molecule to estimate fate parameters were applied to the USEtox model. The most sensitive model parameters in the estimation of ecotoxicological characterization factors (CFs) of micropollutants were evaluated by Monte Carlo analysis in both the default USEtox model and the alternative approach. Negligible differences of CFs values and 95% confidence limits between the two approaches were estimated for direct emissions to the freshwater compartment; however the default USEtox model overestimates CFs and the 95% confidence limits of basic compounds up to three orders and four orders of magnitude, respectively, relatively to the alternative approach for emissions to the agricultural soil compartment. For three emission scenarios, LCIA results show that the default USEtox model overestimates freshwater ecotoxicity impacts for the emission scenarios to agricultural soil by one order of magnitude, and larger confidence limits were estimated, relatively to the alternative approach.