Prevalencia de neumoconiosis y su relación con medidas de higiene y seguridad industrial y niveles ambientales de carbón en minería subterránea en el departamento de Cundinamarca - Colombia, 2015

Introducción: La exposición en minas subterráneas a altos niveles de polvo de carbón está relacionada con patologías pulmonares. Objetivo: Determinar la prevalencia de neumoconiosis, medidas de higiene y seguridad industrial y su relación con niveles ambientales de carbón en trabajadores de minas de socavón en Cundinamarca. Materiales y Métodos: Estudio de corte transversal, en 215 trabajadores seleccionados mediante muestreo probabilístico estratificado con asignación proporcional. Se realizaron monitoreos ambientales, radiografías de tórax y encuestas con variables sociodemográficas y laborales. Se emplearon medidas de tendencia central y dispersión y la prueba de independencia ji-cuadrado de Pearson o pruebas exactas, con el fin de establecer las asociaciones. Resultados: El 99,5% de la población perteneció al género masculino, el 36,7% tenía entre 41-50 años, con un promedio de años de trabajo de 21,70 ± 9,99. La prevalencia de neumoconiosis fue de 42,3% y la mediana de la concentración de polvo de carbón bituminoso fue de 2,329670 mg/m3. El índice de riesgo de polvo de carbón presentó diferencias significativas en las categorías de bajo (p=0,0001) y medio (p=0,0186) con la prevalencia de neumoconiosis. El 84,2% reporto no usar mascarilla. No se presentan diferencias entre los niveles de carbón (p=0,194) con la prevalencia de neumoconiosis. Conclusiones: Se encontró una prevalencia de neumoconiosis de 42,3% en Cundinamarca. Se requiere contar con medidas de higiene y seguridad industrial efectivas para controlar el riesgo al que están expuestos los mineros de carbón por la inhalación de polvo de carbón.

Desenlace intrahospitalario temprano del trauma ocupacional agudo, atendido “Entre Semana/Fin de Semana”, en una institución hospitalaria de III nivel, Bogotá, 2007 -2010

Resumen Objetivo. El desenlace temprano del trauma ocupacional agudo (TOA) puede estar condicionado al desarrollo industrial local en relación con el momento de la semana donde se presente el evento, por lo que evaluamos las diferencias en los desenlaces clínicos tempranos de trabajadores que presentaron TOA en diferentes momentos de la semana. Metodología. Se realizó un estudio descriptivo retrospectivo utilizando una base de datos administrativa de trabajadores atendidos por TOA, entre enero/2007-diciembre/2010, en una institución hospitalaria de III nivel de Bogotá. Se comparó la distribución del TOA entre semana (ES) y en fin de semana (FdS) según variables sociodemográficas/clínicas y la mediana de estancia hospitalaria (EH), el riesgo de muerte o de un trauma específico. Resultados. Se incluyeron 65169 trabajadores, la mayoría hombres (78,4%), adultos jóvenes (83,7%), edad mediana 31 años, con razón de ingreso ES:FdS 3:1, predominantemente durante el día (81,3%). La EH mediana (horas) en FdS (0,48) fue mayor que ES (0,43) (p: 0,000) en general y al evaluar por las sub-categorías de sexo, grupo de edad, momento de ingreso, área de manejo y estado al alta. Se presentaron 35 muertes, con mayor riesgo (OR;IC95%) en el grupo 45-64 años (3,47;1,71-6,76), en los ingresados en la noche (3,27;1,64-6,40) o durante el FdS (4,57;1,25-18,4). Durante el FdS se identificó mayor riesgo de TOA con compromiso de Cabeza/Cuello, traumas múltiples y de causadas por vehículos en movimiento. Durante el FdS disminuyó la frecuencia de trabajadores atendidos por Ortopedia/Oftalmología/Cirugía General (p: < 0,05). Conclusión. Evidenciamos que los trabajadores ingresados por TOA durante el FdS presentaron mayor EH y riesgo de muerte; además se identificó una redistribución en el Servicio de atención en el FdS, con una baja frecuencia de atenciones prestadas por médicos especialistas.

Anestesia regional y periférica guiada por ultrasonido en el paciente critico

El presente trabajo es un capítulo de libro titulado “Anestesia Regional y Periférica Guiada por Ultrasonido en el Paciente Crítico” que será incluido en la última edición del libro “Manual de Ultrasonido en Terapia Intensiva y Emergencias” cuyo editor es el Doctor José de Jesús Rincón Salas y que será publicado por la Editorial Prado de México para distribución latinoamericana desde dicho país. Por solicitud del editor y teniendo en cuenta el enfoque del libro, el presente trabajo está dirigido a estudiantes de formación, médicos graduados y especialistas en las áreas de cuidado intensivo, anestesiología, dolor, medicina interna y medicina de urgencias. Tiene como propósito empapar de conocimientos necesarios y prácticos en anestesia regional a personas que usualmente no han tenido contacto con la anestesia regional, pues desafortunadamente sólo en los últimos años ha sido posible que la anestesia regional haya comenzado a salir de las salas de cirugía, ámbito donde ha estado confinada tradicionalmente. El lenguaje utilizado es sencillo y el capítulo ha sido escrito para que sea fácil de leer y consultar, dejando así mensajes muy claros sobre la utilidad, viabilidad e implicaciones que tiene el uso de anestesia regional guiada por ultrasonido en cuidado intensivo. Los autores esperamos que de esta manera, el presente capítulo permita continuar superando los obstáculos que se interponen entre los invaluables beneficios de la anestesia regional y los pacientes de cuidado intensivo que necesitan de ella.

Development and validation of the Occupational Hardiness Questionnaire

Resumen tomado de la publicaci??n

Mortality salience, political orientation and minimization of terrorists??? secondary emotions

Resumen tomado de la publicaci??n

Cancer mortality inequalities in urban areas: a Bayesian small area analysis in Spanish cities

Intra-urban inequalities in mortality have been infrequently analysed in European contexts. The aim of the present study was to analyse patterns of cancer mortality and their relationship with socioeconomic deprivation in small areas in 11 Spanish cities

Relation between temperature and mortality in thirteen Spanish cities

In this study we examined the shape of the association between temperature and mortality in 13 Spanish cities representing a wide range of climatic and socio demographic conditions. The temperature value linked with minimum mortality (MMT) and the slopes before and after the turning point (MMT) were calculated. Most cities showed a V-shaped temperature-mortality relationship. MMTs were generally higher in cities with warmer climates. Cold and heat effects also depended on climate: effects were greater in hotter cities but lesser in cities with higher variability. The effect of heat was greater than the effect of cold. The effect of cold and MMT was, in general, greater for cardio-respiratory mortality than for total mortality, while the effect of heat was, in general, greater among the elderly

Combined Analysis of the Short-Term Effects of Photochemical Air Pollutants on Mortality within the EMECAM Project

In recent years, some epidemiologic studies have attributed adverse effects of air pollutants on health not only to particles and sulfur dioxide but also to photochemical air pollutants (nitrogen dioxide and ozone). The effects are usually small, leading to some inconsistencies in the results of the studies. Furthermore, the different methodologic approaches of the studies used has made it difficult to derive generic conclusions. We provide here a quantitative summary of the short-term effects of photochemical air pollutants on mortality in seven Spanish cities involved in the EMECAM project, using generalized additive models from analyses of single and multiple pollutants. Nitrogen dioxide and ozone data were provided by seven EMECAM cities (Barcelona, Gijón, Huelva, Madrid, Oviedo, Seville, and Valencia). Mortality indicators included daily total mortality from all causes excluding external causes, daily cardiovascular mortality, and daily respiratory mortality. Individual estimates, obtained from city-specific generalized additive Poisson autoregressive models, were combined by means of fixed effects models and, if significant heterogeneity among local estimates was found, also by random effects models. Significant positive associations were found between daily mortality (all causes and cardiovascular) and NO2, once the rest of air pollutants were taken into account. A 10 μg/m3 increase in the 24-hr average 1-day NO2 level was associated with an increase in the daily number of deaths of 0.43% [95% confidence interval(CI), –0.003–0.86%] for all causes excluding external. In the case of significant relationships, relative risks for cause-specific mortality were nearly twice as much as that for total mortality for all the photochemical pollutants. Ozone was independently related only to cardiovascular daily mortality. No independent statistically significant relationship between photochemical air pollutants and respiratory mortality was found. The results in this study suggest that, given the present levels of photochemical pollutants, people living in Spanish cities are exposed to health risks derived from air pollution

Comparing meta-analysis and ecological-longitudinal analysis in time-series studies: a case study of the effects of air pollution on mortality in three Spanish cities

The objective of this paper is to introduce a diVerent approach, called the ecological-longitudinal, to carrying out pooled analysis in time series ecological studies. Because it gives a larger number of data points and, hence, increases the statistical power of the analysis, this approach, unlike conventional ones, allows the complementation of aspects such as accommodation of random effect models, of lags, of interaction between pollutants and between pollutants and meteorological variables, that are hardly implemented in conventional approaches. Design—The approach is illustrated by providing quantitative estimates of the short-termeVects of air pollution on mortality in three Spanish cities, Barcelona,Valencia and Vigo, for the period 1992–1994. Because the dependent variable was a count, a Poisson generalised linear model was first specified. Several modelling issues are worth mentioning. Firstly, because the relations between mortality and explanatory variables were nonlinear, cubic splines were used for covariate control, leading to a generalised additive model, GAM. Secondly, the effects of the predictors on the response were allowed to occur with some lag. Thirdly, the residual autocorrelation, because of imperfect control, was controlled for by means of an autoregressive Poisson GAM. Finally, the longitudinal design demanded the consideration of the existence of individual heterogeneity, requiring the consideration of mixed models. Main results—The estimates of the relative risks obtained from the individual analyses varied across cities, particularly those associated with sulphur dioxide. The highest relative risks corresponded to black smoke in Valencia. These estimates were higher than those obtained from the ecological-longitudinal analysis. Relative risks estimated from this latter analysis were practically identical across cities, 1.00638 (95% confidence intervals 1.0002, 1.0011) for a black smoke increase of 10 μg/m3 and 1.00415 (95% CI 1.0001, 1.0007) for a increase of 10 μg/m3 of sulphur dioxide. Because the statistical power is higher than in the individual analysis more interactions were statistically significant,especially those among air pollutants and meteorological variables. Conclusions—Air pollutant levels were related to mortality in the three cities of the study, Barcelona, Valencia and Vigo. These results were consistent with similar studies in other cities, with other multicentric studies and coherent with both, previous individual, for each city, and multicentric studies for all three cities

Cancer mortality inequalities in urban areas: a Bayesian small area analysis in Spanish cities [correcció]

After publication of this work in 'International Journal of Health Geographics' on 13 january 2011 was wrong. The map of Barcelona in Figure two (figure 1 here) was reversed. The final correct Figure is presented here

Occupational hearing conservation in a rural woodworking company

This paper discusses a study to evaluate noise exposure and hearing thresholds of workers in a small woodworking company in a rural area.

Movies as a source of non-occupational noise exposure

This paper examines the noise levels of movies and whether or not movie theater sound levels may be hazardous to audience members.

Relationships among audiological measurements, tinnitus measurements and self-reported hearing handicap in subjects with occupational hearing loss

This paper discusses a study of workman's compensation claims and relationships among audiological measures, tinnitus and self-reported hearing handicap.

Workers' compensation for occupational hearing loss: what we know or don't know

This papers looks at workers' compensation laws for each state to determine if there have been any updates in the laws since a 2000 survey by Dobie and Megerson. The study also examines what information is available to audiologists testing patients in workers' compensation claims.

Collaboration between infection control and occupational health in three continents: a success story with international impact

Globalization has been accompanied by the rapid spread of infectious diseases, and further strain on working conditions for health workers globally. Post-SARS, Canadian occupational health and infection control researchers got together to study how to better protect health workers, and found that training was indeed perceived as key to a positive safety culture. This led to developing information and communication technology (ICT) tools. The research conducted also showed the need for better workplace inspections, so a workplace audit tool was also developed to supplement worker questionnaires and the ICT. When invited to join Ecuadorean colleagues to promote occupational health and infection control, these tools were collectively adapted and improved, including face-to-face as well as on-line problem-based learning scenarios. The South African government then invited the team to work with local colleagues to improve occupational health and infection control, resulting in an improved web-based health information system to track incidents, exposures, and occupational injury and diseases. As the H1N1 pandemic struck, the online infection control course was adapted and translated into Spanish, as was a novel skill-building learning tool that permits health workers to practice selecting personal protective equipment. This tool was originally developed in collaboration with the countries from the Caribbean region and the Pan American Health Organization (PAHO). Research from these experiences led to strengthened focus on building capacity of health and safety committees, and new modules are thus being created, informed by that work. The products developed have been widely heralded as innovative and interactive, leading to their inclusion into “toolkits” used internationally. The tools used in Canada were substantially improved from the collaborative adaptation process for South and Central America and South Africa. This international collaboration between occupational health and infection control researchers led to the improvement of the research framework and development of tools, guidelines and information systems. Furthermore, the research and knowledge-transfer experience highlighted the value of partnership amongst Northern and Southern researchers in terms of sharing resources, experiences and knowledge.