Transmission of Mycobacterium chimaera from Heater-Cooler Units during Cardiac Surgery despite an Ultraclean Air Ventilation System.

Heater-cooler units (HCUs) were recently identified as a source of Mycobacterium chimaera causing surgical site infections. We investigated transmission of this bacterium from HCUs to the surgical field by using a thermic anemometer and particle counter, videotape of an operating room equipped with an ultraclean laminar airflow ventilation system, and bacterial culture sedimentation plates in a nonventilated room. Smoke from the HCU reached the surgical field in 23 s by merging with ultraclean air. The HCU produced on average 5.2, 139, and 14.8 particles/min in the surgical field at positions Off, On/oriented toward, and On/oriented away, respectively. Culture plates were positive for M. chimaera <5 m from the HCU in the test room. These experiments confirm airborne transmission of M. chimaera aerosols from a contaminated HCU to an open surgical field despite ultraclean air ventilation. Efforts to mitigate infectious risks during surgery should consider contamination from water sources and airflow-generating devices.

Environmental tobacco smoke exposure, respiratory and cardiovascular health in restaurant and bar workers in Mexico

Environmental tobacco smoke (ETS) is a well established health hazard, being causally associated to lung cancer and cardiovascular disease. ETS regulations have been developed worldwide to reduce or eliminate exposure in most public places. Restaurants and bars constitute an exception. Restaurants and bar workers experience the highest ETS exposure levels across several occupations, with correspondingly increased health risks. In Mexico, previous exposure assessment in restaurants and bars showed concentrations in bars and restaurants to be the highest across different public and workplaces. Recently, Mexico developed at the federal level the General Law for Tobacco Control restricting indoors smoking to separated areas. AT the local level Mexico City developed the Law for the Protection of Non-smokers Health, completely banning smoking in restaurants and bars. Studies to assess ETS exposure in restaurants and bars, along with potential health effects were required to evaluate the impact of these legislative changes and to set a baseline measurement for future evaluations.^ A large cross-sectional study conducted in restaurants and bars from four Mexican cities was conducted from July to October 2008, to evaluate the following aims: Aim 1) Explore the potential impact of the Mexico City ban on ETS concentrations through comparison of Mexico City with other cities. Aim 2). Explore the association between ETS exposure, respiratory function indicators and respiratory symptoms. Aim 3). Explore the association between ETS exposure and blood pressure and heart rate.^ Three cities with no smoking ban were selected: Colima (11.5% smoking prevalence), Cuernavaca (21.5% smoking prevalence) and Toluca (27.8% smoking prevalence). Mexico City (27.9% smoking prevalence), the only city with a ban at the time of the study, was also selected. Restaurants and bars were randomly selected from municipal records. A goal of 26 restaurants and 26 bars per city was set, 50% of them under 100 m2. Each establishment was visited during the highest occupancy shift, and managers and workers answered to a questionnaire. Vapor-phase nicotine was measured using passive monitors, that were activated at the beginning and deactivated at the end of the shift. Also, workers participated at the beginning and end of the shift in a short physical evaluation, comprising the measurement of Forced Expiratory Volume in the first second (FEV1) and Peak Expiratory Flow (PEF), as well as blood pressure and heart rate.^ A total of 371 establishments were invited, 219 agreed to participate for a 60.1% participation rate. In them, 828 workers were invited, 633 agreed to participate for a 76% participation rate. Mexico City had at least 4 times less nicotine compared to any of the other cities. Differences between Mexico City and other cities were not explained by establishment characteristics, such as ventilation or air extraction. However, differences between cities disappeared when ban mechanisms, such as policy towards costumer's smoking, were considered in the models. An association between ETS exposure and respiratory symptoms (cough OR=1.27, 95%CI=1.04, 1.55) and respiratory illness (asthma OR=1.97, 95%CI=1.20, 3.24; respiratory illness OR=1.79, 95%CI=1.10, 2.94) was observed. No association between ETS and phlegm, wheezing or respiratory infections was observed. No association between ETS and any of the spirometric indicators was observed. An association between ETS exposure and increased systolic and diastolic blood pressure at the end of the shift was observed among non-smokers (systolic blood pressure beta=1.51, 95%CI=0.44, 2.58; diastolic blood pressure beta=1.50, 95%CI=0.72, 2.28). The opposite effect was observed in heavy smokers, were increased ETS exposure was associated with lower blood pressure at the end of the shift (systolic blood pressure beta=1.90, 95%CI=-3.57, -0.23; diastolic blood pressure beta=-1.46, 95%CI=-2.72, -0.02). No association in light smokers was observed. No association for heart rate was observed. ^ Results from this dissertation suggest Mexico City's smoking ban has had a larger impact on ETS exposure. Ventilation or air extraction, mechanisms of ETS control suggested frequently by tobacco companies to avoid smoking bans were not associated with ETS exposure. This dissertation suggests ETS exposure could be linked to changes in blood pressure and to increased respiratory symptoms. Evidence derived from this dissertation points to the potential negative health effects of ETS exposure in restaurants and bars, and provides support for the development of total smoking bans in this economic sector. ^

Experiences on using closed-loop control systems for smoke control

The main objective of ventilation systems in case of fire is the reduction of the possible consequences by achieving the best possible conditions for the evacuation of the users and the intervention of the emergency services. In the last years, the required quick response of the ventilation system, from normal to emergency mode, has been improved by the use of automatic and semi-automatic control systems, what reduces the response times through the support to the operators decision taking, and the use of pre-defined strategies. A further step consists on the use of closedloop algorithms, which takes into account not only the initial conditions but their development (air velocity, traffic situation, etc), optimizing the quality of the smoke control process

Experiences on the specification of algorithms for fire and smoke control in road tunnels

The main objective of ventilation systems in case of fire is the reduction of the possible consequences by achieving the best possible conditions for the evacuation of the users and the intervention of the emergency services. The required immediate transition, from normal to emergency functioning of the ventilation equipments, is being strengthened by the use of automatic and semi-automatic control systems, what reduces the response times through the help to the operators, and the use of pre-defined strategies. A further step consists on the use of closed-loop algorithms, which takes into account not only the initial conditions but their development (air velocity, traffic situation, etc.), optimizing smoke control capacity.

Análise de métodos para aplicação de ventilação natural em projetos de edificações em Natal-RN

Natural ventilation is an efficient bioclimatic strategy, one that provides thermal comfort, healthful and cooling to the edification. However, the disregard for quality environment, the uncertainties involved in the phenomenon and the popularization of artificial climate systems are held as an excuse for those who neglect the benefits of passive cooling. The unfamiliarity with the concept may be lessened if ventilation is observed in every step of the project, especially in the initial phase in which decisions bear a great impact in the construction process. The tools available in order to quantify the impact of projected decisions consist basically of the renovation rate calculations or computer simulations of fluids, commonly dubbed CFD, which stands for Computational Fluid Dynamics , both somewhat apart from the project s execution and unable to adapt for use in parametric studies. Thus, we chose to verify, through computer simulation, the representativeness of the results with a method of simplified air reconditioning rate calculation, as well as making it more compatible with the questions relevant to the first phases of the project s process. The case object consists of a model resulting from the recommendations of the Código de Obras de Natal/ RN, customized according to the NBR 15220. The study has shown the complexity in aggregating a CFD tool to the process and the need for a method capable of generating data at the compatible rate to the flow of ideas and are discarded during the project s development. At the end of our study, we discuss the necessary concessions for the realization of simulations, the applicability and the limitations of both the tools used and the method adopted, as well as the representativeness of the results obtained

Análise de componentes arquitetônicos para potencialização da ventilação natural com ênfase em captadores de vento

The building envelope is the principal mean of interaction between indoors and environment, with direct influence on thermal and energy performance of the building. By intervening in the envelope, with the proposal of specific architectural elements, it is possible to promote the use of passive strategies of conditioning, such as natural ventilation. The cross ventilation is recommended by the NBR 15220-3 as the bioclimatic main strategy for the hot and humid climate of Natal/RN, offering among other benefits, the thermal comfort of occupants. The analysis tools of natural ventilation, on the other hand, cover a variety of techniques, from the simplified calculation methods to computer fluid dynamics, whose limitations are discussed in several papers, but without detailing the problems encountered. In this sense, the present study aims to evaluate the potential of wind catchers, envelope elements used to increase natural ventilation in the building, through CFD simplified simulation. Moreover, it seeks to quantify the limitations encountered during the analysis. For this, the procedure adopted to evaluate the elements implementation and efficiency was the CFD simulation, abbreviation for Computer Fluid Dynamics, with the software DesignBuilder CFD. It was defined a base case, where wind catchers were added with various settings, to compare them with each other and appreciate the differences in flows and air speeds encountered. Initially there has been done sensitivity tests for familiarization with the software and observe simulation patterns, mapping the settings used and simulation time for each case simulated. The results show the limitations encountered during the simulation process, as well as an overview of the efficiency and potential of wind catchers, with the increase of ventilation with the use of catchers, differences in air flow patterns and significant increase in air speeds indoors, besides changes found due to different element geometries. It is considered that the software used can help designers during preliminary analysis in the early stages of design

Evaluation of ventilation performance in public spaces.

Smoking restrictions in the workplace and increased health consciousness at home have seen a sizable reduction in the number of spaces where smoking is permissible. The aim of this study was to investigate the effects of ventilation in public houses, one of the few remaining public spaces where smoking is still socially acceptable. Little is known about the situation with shared occupancies, where relatively large areas are intended to accommodate both smokers and non-smokers. This study clearly identifies potential problems with a simplistic design approach to ventilation and its effectiveness in the context of shared occupancy spaces. A computational fluid dynamics code has been used to model airflows with the aim of identifying inefficiencies in existing ventilation systems.

Análise de métodos para aplicação de ventilação natural em projetos de edificações em Natal-RN

Natural ventilation is an efficient bioclimatic strategy, one that provides thermal comfort, healthful and cooling to the edification. However, the disregard for quality environment, the uncertainties involved in the phenomenon and the popularization of artificial climate systems are held as an excuse for those who neglect the benefits of passive cooling. The unfamiliarity with the concept may be lessened if ventilation is observed in every step of the project, especially in the initial phase in which decisions bear a great impact in the construction process. The tools available in order to quantify the impact of projected decisions consist basically of the renovation rate calculations or computer simulations of fluids, commonly dubbed CFD, which stands for Computational Fluid Dynamics , both somewhat apart from the project s execution and unable to adapt for use in parametric studies. Thus, we chose to verify, through computer simulation, the representativeness of the results with a method of simplified air reconditioning rate calculation, as well as making it more compatible with the questions relevant to the first phases of the project s process. The case object consists of a model resulting from the recommendations of the Código de Obras de Natal/ RN, customized according to the NBR 15220. The study has shown the complexity in aggregating a CFD tool to the process and the need for a method capable of generating data at the compatible rate to the flow of ideas and are discarded during the project s development. At the end of our study, we discuss the necessary concessions for the realization of simulations, the applicability and the limitations of both the tools used and the method adopted, as well as the representativeness of the results obtained

Análise de componentes arquitetônicos para potencialização da ventilação natural com ênfase em captadores de vento

The building envelope is the principal mean of interaction between indoors and environment, with direct influence on thermal and energy performance of the building. By intervening in the envelope, with the proposal of specific architectural elements, it is possible to promote the use of passive strategies of conditioning, such as natural ventilation. The cross ventilation is recommended by the NBR 15220-3 as the bioclimatic main strategy for the hot and humid climate of Natal/RN, offering among other benefits, the thermal comfort of occupants. The analysis tools of natural ventilation, on the other hand, cover a variety of techniques, from the simplified calculation methods to computer fluid dynamics, whose limitations are discussed in several papers, but without detailing the problems encountered. In this sense, the present study aims to evaluate the potential of wind catchers, envelope elements used to increase natural ventilation in the building, through CFD simplified simulation. Moreover, it seeks to quantify the limitations encountered during the analysis. For this, the procedure adopted to evaluate the elements implementation and efficiency was the CFD simulation, abbreviation for Computer Fluid Dynamics, with the software DesignBuilder CFD. It was defined a base case, where wind catchers were added with various settings, to compare them with each other and appreciate the differences in flows and air speeds encountered. Initially there has been done sensitivity tests for familiarization with the software and observe simulation patterns, mapping the settings used and simulation time for each case simulated. The results show the limitations encountered during the simulation process, as well as an overview of the efficiency and potential of wind catchers, with the increase of ventilation with the use of catchers, differences in air flow patterns and significant increase in air speeds indoors, besides changes found due to different element geometries. It is considered that the software used can help designers during preliminary analysis in the early stages of design