Environmnetal Health

Evidence indicates that exposure to high levels of noise adversely affects human health, and these effects are dependent upon various factors. In hospitals, there are many sources of noise, and high levels exert an impact on patients and staff, increasing both recovery time and stress, respectively. The goal of this pilot study was to develop, implement, and evaluate the effectiveness of a training program (TP) on noise reduction in a neonatal intensive care unit (NICU) by comparing the noise levels before and after the implementation of the program. In total, 79 health professionals participated in the study. The measurements of sound pressure levels took into account the layout of the unit and locations of the main sources of noise. General results indicated that LAeq levels before implementation of the training program were often excessive, ranging from 48.7 ± 2.94 dBA to 71.7 ± 4.74 dBA, exceeding international guidelines. Similarly, following implementation of the training prog...

The suitability of Listeria innocua 2030c, a tetracycline-resistant strain, to be used as an indicator for replacing Listeria monocytogenes in challenge studies with cold-smoked ®sh was ascertained. L. innocua 2030c was compared to serovars 4b and 1/2c of L. monocytogenes, the major types isolated from Portuguese cold-smoked ®sh products. Growth curves at 30°C, growth/survival patterns at 30°C under exposure to dierent times and concentrations of ozone and sensitivity to Carnobacterium divergens V41 and C. piscicola V1 and their bacteriocins V41 and V1, were determined. No important dierences between L. innocua 2030c and L. monocytogenes 4b and 1/2c were found, therefore L. innocua 2030c can be considered a suitable indicator for replacing those L. monocytogenes strains in challenge studies.

This study was conducted to evaluate the efficacy of gaseous ozone exposure on Listeria innocua 2030c growth during cold-smoke processing of Oncorhynchus mykiss (salmon-trout). Three sets of experiments were performed: inoculation with L. innocua 2030c followed by a 20 min ozone exposure were applied to (a) fresh salmon-trout after filleting, (b) to fresh whole fish, and (c) to fresh whole fish after removal of the fish slime. In sets (a) and (b) fillets were subsequently cold-smoked but not in set (c). The ozone concentration inside the exposure chamber after 20 min reached 0.1 • 10 À3 g/l. Counts of L. innocua 2030c were performed after treatment for sets (a), (b) and (c), after smoking and weekly during 21 days in vacuum packs at 5°C, for sets (a) and (b). Sampling for total Aerobic Plate Counts (APC) of non-inoculated samples was also performed in set (a). The percentage of salt in the water phase, peroxide values and the effect of treatment on sensory properties of cold-smoked salmon-trout fillets were also determined in the first and second set. In the first set, a decrease of less than 1 log 10 in L. innocua numbers occurred on ozone treated samples in all sampling occasions. APC was slightly lower on fresh fillets after treatment and on smoked fillets at 3 weeks of storage at 5°C (less than 1 log 10 CFU/g). In the second set, a reduction greater than 1 log 10 L. innocua/g occurred on smoked fillets at the end of the storage period. In the third set, the slime removal resulted in a 1 log 10 L. innocua/g reduction on fresh treated samples. Ozone treatment had no significant (p > 0.05) effect on L. innocua counts on samples compared to those on untreated fish. In both sets, no significant differences among ozone treated/untreated samples were noticeable by sensory evaluation (p > 0.05).

Hospital facilities are normally very complex, which combined with patient requirements promote conditions for potential development of uncomfortable working conditions. Thermal discomfort is one such example. This study aimed to determine levels of thermal comfort, sensations, and preferences, from a field investigation conducted in two sterilization services (SS) of two hospitals from Porto and Aveiro, Portugal. The analytical determination and interpretation of thermal comfort was based upon assumptions of ISO 7726:1998 and ISO 7730:2005. The predicted mean vote (PMV) and predicted percentage of dissatisfaction (PPD) indices were obtained by measurement and estimation of environmental and personal variables, respectively, and calculated according to ISO 7730 equations. The subjective variables were obtained from thermal sensation (subjective PMV) and affective assessment (subjective PPD), reported by a questionnaire based upon ISO 10551:1995. Both approaches confirmed thermal dis...

Surveillance of drinking water quality is extremely important to human health, assuming greater relevance in hospital environments, especially to those individuals who are immunocompromised. This study is aimed to determine the effect of increasing free chlorine (Cl) concentration in a hospital water network in regard to water quality monitoring and microbial growth control, between 2010 and 2013 in Porto. The average of free Cl concentration in the period under analysis showed some heterogeneity per floor, varying between 0.84 and 1.25 mg/L. In addition, there was a rise in proportion of samples that exceeded WHO guidelines (free Cl 0.5 mg/L), particularly in the last two years of the same period. With respect to microbial analysis, 22.4% of the samples were positive for Legionella spp., 6.4% for Pseudomonas aeruginosa, 15% and 30.4% for aerobic plate counts at 36 and 22 C, respectively. The proportion of positive samples decreased throughout the period under analysis, in particular for Legionella spp. (41.7% in 2010 vs. non-detectable in 2013) and P. aeruginosa (10.8% in 2010 vs. 3.3% in 2013). These results are in accordance with the gradual rise in free Cl concentration (0.78 § 0.94 mg/L in 2010 vs. 1.16 § 0.51 mg/L in 2013). In conclusion, a suitable plan for drinking water quality was instituted which resulted in reducing microbiological growth in the waterwork network, improving public health protection. However, the detection of critical points associated with lower levels of free Cl were found on certain floors/points-of-use, requiring the need to improve the monitoring water treatment system and/or implementation of additional technologies.

Shift work has been linked to health disorders, decreases in workers’ safety and productivity, and poor family and social relationships. However, the relationship between this type of work and the incidence of psychosocial health disorders is not yet well characterized. This study aims to analyse the impact of the shift work in the prevalence of the burnout syndrome, anxiety, depression and stress. A total of 175 workers from the production sector of a metalworking industry, operating in three different shifts (morning, afternoon and night), participated in the study. The burnout syndrome was assessed with the Shirom-Melamed Burnout Measure and the anxiety, depression and stress were measured through the Depression Anxiety Stress Scales (DASS). The obtained levels of burnout syndrome and stress were low, while anxiety and depression exhibited higher levels. Contrary to what was expected, the morning shift presented higher levels of psychosocial health disorders. However, no signific...

Biological collections are central in understanding and preserving life on Earth. In Brazil, the most representative collections are kept by natural history museums, whose primary focus is in invertebrates, vertebrates and vascular plants. Only a few institutions keep repositories in different kingdoms. The Oswaldo Cruz Foundation (Fiocruz), established in 1900, is a strategic public health institution of the Ministry of Health of Brazil. As such, Fiocruz is responsible for a wide range of activities, from basic research to the development and production of vaccines, drugs, reagents and diagnostic kits. Its biological collections were soon established in the expeditions made by naturalists and physicians seeking integrated knowledge of the fauna, flora and tropical diseases. Since then, they have been part of the institutional policy. In a few decades, those collections were already in the forefront of basic and applied research on tropical parasitic and infectious diseases. Current...

The "NeoNoise Project: Integrated Approach to Minimize Sound Pressure Levels in Neonatal Intensive Care Units" is being conducted by the Research Group on Occupational and Environmental Health of the Research Center on Health and Environment in neonatal intensive care units, since exposure to sound pressure levels in these spaces has been recognized as a factor that influences the quality and well-being of the occupants (workers and others), as well as the recovery of premature infants who are hospitalized. This work reports the rationale and the design of the NeoNoise project as well as the methods used for data collection. A brief review on the results published and available for the scientific community is also made. In general, NeoNoise project intends to make an integration of all relevant factors, with the intention of presenting a guiding document to change the working practices and occupant's behaviors. So far, this study provided data on sound pressure levels by objective and subjective approaches, as well as information about the exposure factors and sensitivity of the occupants to noise.

An agar medium containing histidine or tyrosine incubated anaerobically was used for detecting the decarboxylating activity of bacteria isolated from Portuguese vacuum-packed cold-smoked fish during chilled storage. The capacity of each bacterial isolate to produce histamine and tyramine was studied at 25 and 5°C incubated for 48 h and 10 days, respectively. More strains produced histamine and tyramine at 25°C compared with 5°C although lactic acid bacteria (LAB) strains exhibited similar results at the two different temperatures. Tyramine was produced by majority of the isolates tested although very low concentrations were produced at 5°C as confirmed by high-pressure liquid chromatography (HPLC). Tyrosine-agar was shown to be a good indicator medium for detection of bacteria that produced high levels of tyramine, since typical colonies surrounded by a translucent halo were easily recognised. LAB identified as Lc. Lactis lactis 1 and Carnobacterium divergens were detected as tyramine-producing bacteria. Acinetobacter spp. and Pseudomonas spp., isolated from all Portuguese smoked fish products, were negative on histidine-agar, but HPLC identified considerable quantities of histamine produced in a broth medium.

An agar medium containing histidine or tyrosine incubated anaerobically was used for detecting the decarboxylating activity of bacteria isolated from Portuguese vacuum-packed cold-smoked fish during chilled storage. The capacity of each bacterial isolate to produce histamine and tyramine was studied at 25 and 5°C incubated for 48 h and 10 days, respectively. More strains produced histamine and tyramine at 25°C compared with 5°C although lactic acid bacteria (LAB) strains exhibited similar results at the two different temperatures. Tyramine was produced by majority of the isolates tested although very low concentrations were produced at 5°C as confirmed by high-pressure liquid chromatography (HPLC). Tyrosine-agar was shown to be a good indicator medium for detection of bacteria that produced high levels of tyramine, since typical colonies surrounded by a translucent halo were easily recognised. LAB identified as Lc. Lactis lactis 1 and Carnobacterium divergens were detected as tyramine-producing bacteria. Acinetobacter spp. and Pseudomonas spp., isolated from all Portuguese smoked fish products, were negative on histidine-agar, but HPLC identified considerable quantities of histamine produced in a broth medium.

In NICU, systematic exposure to sound pressure levels above the recommended can affect both neonates and staff. This study aimed to evaluate the sound pressure levels in three Portuguese NICU and the noise perception of staff. The measurements were performed with a sound level meter, considering the location of the main sources of noise and the layout of the units. A questionnaire was applied to assess noise perception of professionals. The staff classified the environment (regarding noise) as "slightly uncomfortable" (41.1%) and 48.4% considered it as "acceptable." In addition, the majority (55.5%) considered "equipment" as the most annoying source of noise. The results showed that noise levels were excessive in all the evaluated areas of the NICUs, exceeding international guidelines, with the levels ranging between 48.7 dBA to 71.7 dBA. Overall, there is a need for more research in order to verify the effectiveness of some actions and strategies to re...

The feeding of infants in hospital involves use of powdered infant milk formulas, which, may not be totally sterile, require the implementation of a set of procedures for control and monitoring circuitry implemented in any area of preparation. Milk-based formulas have been identified as a potential vehicle of emergent microorganism, Enterobacter sakazakii. The proliferation of cases of E. sakazakii infections in neonatology services, has led European and U.S. authorities to put in question the preparation of food in health institutions and to revise its guidelines. This microorganism can survive for long periods of idle time on formula milk powder until there is reconstitution of the product with water during preparation. The implementation of HACCP (Hazard Analysis of Critical Control Points) and GMP (Good Manufacturing Practice) in a hospital came to promote improved quality and safety in food preparation, being the preparation of infant formula milk powder a special status.

Studies on microbial characterization of cold-smoked salmon and salmon trout during cold storage were performed on samples available in the Portuguese market. Samples were also classified microbiologically according to guidelines for ready-to-eat (RTE) products. Further investigations on sample variability and microbial abilities to produce tyramine and histamine were also performed. The coefficient of variation for viable counts of different groups of microorganisms of samples collected at retail market point was high in the first 2 wk of storage, mainly in the Enterobacteriaceae group and aerobic plate count (APC), suggesting that microbiological characteristics of samples were different in numbers, even within the same batch from the same producer. This variation seemed to be decreased when storage and temperature were controlled under lab conditions. The numbers of Enterobacteriaceae were influenced by storage temperature, as indicated by low microbial numbers in samples from co...

Prematurity and low birth weight of newborns lead to the need of a special care in neonatal units, and their permanence in these places can be extended for a long period. Indoor environmental conditions, such noise levels above the recommended, may induce some risks, not only for the newborns development, but also for health care staff. This literature review aims to examine the studies related to noise in neonatal intensive care units to understand the sources and effects of noise, as well as some strategies to reduce noise exposure. The search strategy included an electronic search in databases (ISI Web of Knowledge and PubMed) of scientific articles published in English/Portuguese between 2000-2017. Studies providing data on noise levels found in the neonatal units, the effects on health of newborns and staff and the measures to minimize these effects were included. The exclusion criteria were as follows: duplicate printings; nonEnglish/Portuguese language; editorials, letters, p...

The design of neonatal intensive care units (NICU) influences both patient safety and clinical outcomes as well as the acoustic conditions. In NICU exposure to sound pressure levels above the recommended can affect both neonates and healthcare staff. This study aimed to evaluate the sound pressure levels and to assess noise perception of professionals in a NICU before and after structural modifications and layout redesign. The measurements were performed with a sound level meter. A questionnaire was given to staff before and after the intervention. The opinion of healthcare staff regarding noise in NICU was better after the intervention, when compared with the responses previously given. The results showed that noise levels were excessive in the NICU (before and after), exceeding the international recommendations, with the levels ranging between 46.6 dBA to 57.8 dBA before and 52.0 dBA to 54.0 dBA after intervention. Overall, there is a need for more research in order to verify the effectiveness of some actions and strategies to reduce the impact of noise in NICU.

Children’s play paints, an attractive tool for preschool activities, can be classified in artist paints (gouaches, acrylics, watercolors, fingerpaints) and face paints. These products composition is not always known since not all are required to bear their ingredients in the label packaging. The present study aimed to characterize the children’s play paints available in schools and retail stores and also to assess the practices involved in the acquisition, handling and storage of these products by schools and that may have impact on the product quality and safety. For this purpose were studied paints from 8 schools and 7 retail stores from Porto (Portugal), in a total of 17 popular brands. The results shows that the label information differs from product type, taking into account the legal requirements applied to each one (artist paints or face paints). The main hazards stated in the products label are related with the possibility of ingestion of small pieces that are part of the pr...

Prematurity and low birth weight of newborns lead to the need of a special care in neonatal units, and their permanence in these places can be extended for a long period. Indoor environmental conditions, such noise levels above the recommended, may induce some risks, not only for the newborns development, but also for health care staff. This literature review aims to examine the studies related to noise in neonatal intensive care units to understand the sources and effects of noise, as well as some strategies to reduce noise exposure. The search strategy included an electronic search in databases (ISI Web of Knowledge and PubMed) of scientific articles published in English/Portuguese between 2000-2017. Studies providing data on noise levels found in the neonatal units, the effects on health of newborns and staff and the measures to minimize these effects were included. The exclusion criteria were as follows: duplicate printings; nonEnglish/Portuguese language; editorials, letters, p...