Revisión sistemática de literatura de la neumonía lipoidea exógena (nle) por exposición laboral

Objetivo Realizar una revisión sistemática de la neumonía lipoidea exógena (NLE) con el propósito de compactar y sintetizar los conocimientos fragmentados, así como el de informar el estado actual de este tema como riesgo laboral. Metodología La neumonía lipoidea es una condición poco común que resulta de la presencia de lípidos en el interior del espacio alveolar, se desconoce su actual incidencia. La neumonía lipoidea exógena se produce por aspiración o inhalación de sustancias oleosas, es una patología rara en pacientes sin enfermedades de base que predispongan a la broncoaspiración y cuando se presenta en individuos sanos se debe sospechar un origen ocupacional. Se realizó una revisión de literatura según la metodología estandarizada, incluyendo en la búsqueda: reporte de casos, descripciones de la enfermedad y el uso de técnicas diagnósticas. Las bases de datos fueron OVID además de GOOGLE ACADÉMICO; buscadores específicos: MEDLINE, CHEST, PUB MED, REDALYC, SCIELO, Europe PubMed Central (Europe PMC) y ELSEVIER. La búsqueda estuvo además, orientada por una serie de preguntas orientadoras sobre la neumonía lipoidea exógena (NLE) como riesgo laboral. Los artículos que cumplieron con los criterios de inclusión, se clasificaron de acuerdo con tipo de estudio, la calidad del artículo y finalmente se evaluaron con base en una lista de chequeo ajustada para este fin. Resultados Se seleccionó un total de 71 estudios incluyendo reporte de casos, descripciones de la enfermedad y técnicas diagnósticas; publicaciones provenientes de 21 países. Un total de 63 casos, 31 en mujeres (49,20%) y 32 en hombres (50,8%) fueron reportados; el 7,93% de los casos fueron atribuidos a la exposición de agentes en el ambiente laboral: combustibles, parafina/pintura/ pulverizaciones oleosas y diésel, ambientes propios de trabajadores de almacenes de pinturas y conductores de vehículos. Los síntomas de la neumonía lipoidea exógena (NLE) descritos fueron muy variables, puede cursar asintomática o con presencia de fiebre, disnea y tos irritativa; dolor torácico, en algunos casos hemoptisis, cianosis y pérdida de peso; El examen físico generalmente es normal, aunque puede revelar sibilancias o roncus. En pruebas de función respiratoria tales como la espirometría, se presenta un patrón restrictivo, además puede hallarse un descenso en la capacidad de difusión para el monóxido de carbono. En el hemograma puede detectarse leucocitosis con predominio de neutrófilos y aumento de la velocidad de sedimentación globular, hallazgos que también pueden ser producidos por una infección concomitante. Conclusiones Se destaca el hallazgo en la literatura de los diferentes agentes causales presentes en el ambiente laboral que pueden incidir en la aparición de la enfermedad: combustibles, parafina/pintura/ pulverizaciones oleosas y diésel, ambientes propios de trabajadores de almacenes de pinturas y conductores de vehículos. Se presentó neumonía lipoidea exógena (NLE) de tipo agudo después de 30 minutos a 24 horas de exposición masiva a aceites y sustancias oleosas, luego de de ocho meses a 9,5 años de inhalación continua secundaria. Los métodos más para de la diagnóstico enfermedad incluyen el lavado broncoalveolar (BAL), la biopsia de pulmón y la con radiografía torácica. Finalmente, es posible que en pacientes con neumonía lipoidea exógena, puedan presentarse complicaciones asociadas tales como: sobreinfección, fibrosis, retracción de las lesiones, cáncer de pulmón, bronconeumonías recurrentes e hipercalcemia.

Caracterización de la exposición ocupacional a formaldehído en trabajadores del sector salud y educación en Colombia 2004-2013.

El Formaldehído es una sustancia química de amplio uso a nivel mundial con efectos documentados en personas expuestas entre los cuales se destacan irritación de la piel, mucosas, tracto respiratorio y ojos. Según la Agencia Internacional para la Investigación del Cáncer (IARC) el formaldehido se encuentra clasificado en el grupo 1 como agente cancerígeno con suficiente evidencia de producir neoplasias en humanos. Los sectores industriales en Colombia que utilizan de forma frecuente el formaldehído incluyen los fabricantes de maderas, los servicios funerarios, y los sectores de salud y educación. El presente estudio de corte transversal pretende, con base en mediciones históricas (2004-2013) construir un perfil de exposición a formaldehído en trabajadores vinculados al sector de salud y educación en Colombia, divididos y analizados según actividades de trabajo similares (Patólogos, Histotecnólogos, Auxiliares de laboratorio, Docentes y Estudiantes), con el fin de establecer una línea base de diagnóstico para la orientación acciones dirigidas al control del riesgo. Con base en los hallazgos y soportados en estimadores estadísticos aplicables a los grupos de exposición, en general existe un tendencia de no conformidad al comparar los resultados aplicables con valores de referencia de larga duración definidos para el agente por autoridades internacionales. De forma complementaria se encontraron brechas significativas respecto a la implementación de controles administrativos y técnicos que sugieren circunstancias de exposición no controladas en los colectivos de interés.

Análisis del perfil sociodemográfico y competitivo del practicante de raids de aventura de ámbito nacional.

Resumen tomado de la publicación

Jardins Verticais : um contributo para os espaços verdes urbanos e oportunidade na reabilitação do edificado

O Homem tem privilegiado a vida no meio urbano, em detrimento do rural, por mais oportunidade de emprego e melhores condições de vida. As cidades cresceram de forma acelerada, sobretudo depois da Revolução Industrial do século XVIII, crescimento sem controlo, repercutindo-se num desajustado planeamento urbano, ambiental, humano, social e económico. De uma forma, as paisagens verdes e naturais, foram substituídas por densas manchas cinzentas de construção, criando afastamento crescente do Homem com a Natureza. Os Jardins Verticais poderão ter um papel fundamental revestindo de forma verde e natural as fachadas dos edifícios, numa tentativa de colmatar o afastamento entre ambos. Para além destes aspectos, os Jardins Verticais proporcionam inúmeras vantagens para o edifício, de que se destacam a eficiência energética e acústica, a protecção da estrutura do edificado ou a melhoria da qualidade do ar interior. Estes também importantes para a envolvente, como na redução do efeito ilha de calor, no aumento da biodiversidade, na melhoria da qualidade do ar exterior, mas sobretudo porque proporcionam ao Homem uma sensação de saúde e conforto, exclusivo da Natureza. Tendo em conta o estado de degradação do edificado nas grandes cidades, e tomando como exemplo particular a cidade do Porto, o recurso aos Jardins Verticais poderá ser uma solução viável para a reabilitação urbana, mudando a imagem de degradação, propondo uma imagem mais “verde” e contribuindo para o nível de sustentabilidade. Partindo deste pressuposto, propõe-se como aplicação do conhecimento adquirido no estudo desenvolvido e aqui apresentado, o recurso a Jardins Verticais como estratégia de reabilitação de edifícios da cidade do Porto. Inspirado na técnica e mestria de Patrick Blanc, resultou um “pormenor-tipo”, como base para a aplicação de Jardins Verticais no edificado social da cidade, experimentado em 10 estudos práticos, tirando-se partido das vantagens supra-mencionadas.

Particulate matter mass concentration (PM10) under different ventilation methods in classrooms

Recently, studies have shown that the classroom environment is very important for students' health and performance. Thus, the evaluation of indoor air quality (IAQ) in a classroom is necessary to ensure students' well-being. In this paper the emphasis is on airborne concentration of particulate matter (PM) in adult education rooms. The mass concentration of PM10 particulates was measured in two classrooms under different ventilation methods in the University of Reading, UK, during the winter period of 2008. In another study the measurement of the concentration of particles was accompanied with measurements of CO2 concentration in these classrooms but this study is the subject of another publication. The ambient PM10, temperature, relative humidity, wind speed and direction, and rainfall events were monitored as well. In general, this study showed that outdoor particle concentrations and outdoor meteorological parameters were identified as significant factors influencing indoor particle concentration levels. Ventilation methods showed significant effects on air change rate and on indoor/outdoor (I/O) concentration ratios. Higher levels of indoor particulates were seen during occupancy periods. I/O ratios were significantly higher when classrooms were occupied than when they were unoccupied, indicating the effect of both people presence and outdoor particle concentration levels. The concentrations of PM10 indoors and outdoors did not meet the requirements of WHO standards for PM10 annual average.

Ventilation rates in schools and pupil’s performance using computerized assessment tests

Research shows that poor indoor air quality (IAQ) in school buildings can cause a reduction in the students’ performance assessed by short-term computer-based tests; whereas good air quality in classrooms can enhance children's concentration and also teachers’ productivity. Investigation of air quality in classrooms helps us to characterise pollutant levels and implement corrective measures. Outdoor pollution, ventilation equipment, furnishings, and human activities affect IAQ. In school classrooms, the occupancy density is high (1.8–2.4 m2/person) compared to offices (10 m2/person). Ventilation systems expend energy and there is a trend to save energy by reducing ventilation rates. We need to establish the minimum acceptable level of fresh air required for the health of the occupants. This paper describes a project, which will aim to investigate the effect of IAQ and ventilation rates on pupils’ performance and health using psychological tests. The aim is to recommend suitable ventilation rates for classrooms and examine the suitability of the air quality guidelines for classrooms. The air quality, ventilation rates and pupils’ performance in classrooms will be evaluated in parallel measurements. In addition, Visual Analogue Scales will be used to assess subjective perception of the classroom environment and SBS symptoms. Pupil performance will be measured with Computerised Assessment Tests (CAT), and Pen and Paper Performance Tasks while physical parameters of the classroom environment will be recorded using an advanced data logging system. A total number of 20 primary schools in the Reading area are expected to participate in the present investigation, and the pupils participating in this study will be within the age group of 9–11 years. On completion of the project, based on the overall data recommendations for suitable ventilation rates for schools will be formulated.

Ventilation rates in schools

Research shows that poor indoor air quality in school buildings can cause a reduction in the students' performance assessed by short term computer based tests; whereas good air quality in classrooms can enhance children's concentration and also teachers' productivity. Investigation of air quality in classrooms helps us to characterise pollutant levels and implement corrective measures. Outdoor pollution, ventilation equipment, furnishings, and human activities affect indoor air quality. In school classrooms the occupancy density is high (1.8 to 2.4 m(2)/person) compared to offices (10 m(2) /person). Ventilation systems expend energy and there is a trend to save energy by reducing ventilation rates. We need to establish the minimum acceptable level of fresh air required for the health of the occupants. This paper describes a project which will aim to investigate the effect of indoor air quality and ventilation rates on pupils' performance and health using psychological tests. The aim is to recommend suitable ventilation rates for classrooms and examine the suitability of the air quality guidelines for classrooms.

Verification of design calculations of a wind catcher/tower natural ventilation system with performance testing in real building

A wind catcher/tower natural ventilation system was installed in a seminar room in the building of the School of Construction Management and Engineering, the University of Reading in the UK . Performance was analysed by means of ventilation tracer gas measurements, indoor climate measurements (temperature, humidity, CO2) and occupant surveys. In addition, the potential of simple design tools was evaluated by comparing observed ventilation results with those predicted by an explicit ventilation model and the AIDA implicit ventilation model. To support this analysis, external climate parameters (wind speed and direction, solar radiation, external temperature and humidity) were also monitored. The results showed the chosen ventilation design provided a substantially greater ventilation rate than an equivalent area of openable window. Also air quality parameters stayed within accepted norms while occupants expressed general satisfaction with the system and with comfort conditions. Night cooling was maximised by using the system in combination with openable windows. Comparisons of calculations with ventilation rate measurements showed that while AIDA gave reasonably correlated results with the monitored performance results, the widely used industry explicit model was found to over estimate the monitored ventilation rate.

Failure of a control strategy for a hybrid air-conditioning and wind catchers/towers system at Bluewater shopping malls in Kent

Purpose – To evaluate the control strategy for a hybrid natural ventilation wind catchers and air-conditioning system and to assess the contribution of wind catchers to indoor air environments and energy savings if any. Design/methodology/approach – Most of the modeling techniques for assessing wind catchers performance are theoretical. Post-occupancy evaluation studies of buildings will provide an insight into the operation of these building components and help to inform facilities managers. A case study for POE was presented in this paper. Findings – The monitoring of the summer and winter month operations showed that the indoor air quality parameters were kept within the design target range. The design control strategy failed to record data regarding the operation, opening time and position of wind catchers system. Though the implemented control strategy was working effectively in monitoring the operation of mechanical ventilation systems, i.e. AHU, did not integrate the wind catchers with the mechanical ventilation system. Research limitations/implications – Owing to short-falls in the control strategy implemented in this project, it was found difficult to quantify and verify the contribution of the wind catchers to the internal conditions and, hence, energy savings. Practical implications – Controlling the operation of the wind catchers via the AHU will lead to isolation of the wind catchers in the event of malfunctioning of the AHU. Wind catchers will contribute to the ventilation of space, particularly in the summer months. Originality/value – This paper demonstrates the value of POE as indispensable tool for FM professionals. It further provides insight into the application of natural ventilation systems in building for healthier indoor environments at lower energy cost. The design of the control strategy for natural ventilation and air-conditioning should be considered at the design stage involving the FM personnel.

Post occupancy evaluation of a building employing windcatchers for summer ventilation

A combined windcatcher and light pipe (SunCatcher) was installed in the seminar room at the University of Reading, UK. Monitoring of indoor environment in real weather conditions was conducted to evaluate the application of windcatchers for natural ventilation. In addition, a subjective occupancy survey was undertaken. External weather conditions and internal indoor air quality indicators were recorded. The “tracer-gas decay” method using SF6 was used to establish air change rate for various conditions. The results indicated that the ventilation rate achieved through the windcatcher depends on the difference between internal and external air temperatures, and on wind speed and direction, in agreement with other published work in the area. The indoor air quality parameters were found to be within acceptable levels when the windcatcher was in operation. The measured air change rate was between 1.5ac/h and 6.8ac/h. Occupants’ questionnaires showed 75 per cent satisfaction with the internal conditions and welcomed the installation of the systems in UK buildings.

The air distribution index as an indicator for energy consumption and performance of ventilation systems

This paper deals with the energy consumption and the evaluation of the performance of air supply systems for a ventilated room involving high- and low-level supplies. The energy performance assessment is based on the airflow rate, which is related to the fan power consumption by achieving the same environmental quality performance for each case. Four different ventilation systems are considered: wall displacement ventilation, confluent jets ventilation, impinging jet ventilation and a high level mixing ventilation system. The ventilation performance of these systems will be examined by means of achieving the same Air Distribution Index (ADI) for different cases. The widely used high-level supplies require much more fan power than those for low-level supplies for achieving the same value of ADI. In addition, the supply velocity, hence the supply dynamic pressure, for a high-level supply is much larger than for low-level supplies. This further increases the power consumption for high-level supply systems. The paper considers these factors and attempts to provide some guidelines on the difference in the energy consumption associated with high and low level air supply systems. This will be useful information for designers and to the authors' knowledge there is a lack of information available in the literature on this area of room air distribution. The energy performance of the above-mentioned ventilation systems has been evaluated on the basis of the fan power consumed which is related to the airflow rate required to provide equivalent indoor environment. The Air Distribution Index (ADI) is used to evaluate the indoor environment produced in the room by the ventilation strategy being used. The results reveal that mixing ventilation requires the highest fan power and the confluent jets ventilation needs the lowest fan power in order to achieve nearly the same value of ADI.

Investigation of air quality, comfort parameters and effectiveness for two floor-level air supply systems in classrooms

The method of distributing the outdoor air in classrooms has a major impact on indoor air quality and thermal comfort of pupils. In a previous study, ([11] Karimipanah T, Sandberg M, Awbi HB. A comparative study of different air distribution systems in a classroom. In: Proceedings of Roomvent 2000, vol. II, Reading, UK, 2000. p. 1013-18; [13] Karimipanah T, Sandberg M, Awbi HB, Blomqvist C. Effectiveness of confluent jets ventilation system for classrooms. In: Idoor Air 2005, Beijing, China, 2005 (to be presented).) presented results for four and two types of air distribution systems tested in a purpose built classroom with simulated occupancy as well as computational fluid dynamics (CFD) modelling. In this paper, the same experimental setup has been used to investigate the indoor environment in the classroom using confluent jet ventilation, see also ([12]Cho YJ, Awbi HB, Karimipanah T. The characteristics of wall confluent jets for ventilated enclosures. In: Proceedings of Roomvent 2004, Coimbra, Portugal, 2004.) Measurements of air speed, air temperature and tracer gas concentrations have been carried out for different thermal conditions. In addition, 56 cases of CFD simulations have been carried to provide additional information on the indoor air quality and comfort conditions throughout the classroom, such as ventilation effectiveness, air exchange effectiveness, effect of flow rate, effect of radiation, effect of supply temperature, etc., and these are compared with measured data.