Search

OBJECTIVE: to describe the profile of pregnant adolescents and their newborns in a municipality in southern Brazil. METHOD: this is a cross-sectional descriptive study. Data collection was performed on the basis of data from declarations of live births in the municipality between the months of January to December 2018. The data were analyzed with the aid of the SPSS version 21.0 program. To assess the association between numerical variables, Pearson or Spearman linear correlation tests were used. The level of significance adopted was 5% (p

Objetivo: conhecer a percepção da enfermagem sobre os fatores envolvidos na adesão e no abandono do tratamento da tuberculose. Método: estudo qualitativo, descritivo-exploratório realizado no Centro de Referência em Tuberculose no município de Porto Alegre no Rio Grande do Sul. Nove profissionais da enfermagem responderam à entrevista semiestruturada e foi realizada a análise de conteúdo de Bardin. Resultados: identificou-se quatro categorias temáticas: a organização do serviço e o papel da enfermagem no processo de trabalho; a raiz social da tuberculose; a consulta de enfermagem como artifício para o fortalecimento da adesão ao tratamento; rede de serviços como estratégia para reduzir o abandono do tratamento. Conclusão: os profissionais de enfermagem reconhecem sua responsabilidade na adesão ao tratamento da tuberculose e percebem no cotidiano de trabalho os fatores que influenciam o abandono. Reconhecem a necessidade de um trabalho em rede, intersetorial e de proteção social para o controle da doença.

Le role des facteurs environnementaux dans la progression dramatique des troubles metaboliques (syndrome metabolique, diabete type II, obesite) est incontestable. Aux facteurs environnementaux deja identifies (desequilibre energetique nutritionnel, sedentarite, facteurs psychosociaux), s'ajoutent desormais les polluants de la categorie des perturbateurs endocriniens (PE) presents dans l'alimentation (bisphenol A, phtalates, pesticides, PCB). Nous exposerons dans cette revue les resultats des etudes decrivant les alterations metaboliques induites par le bisphenol A, un des PE le plus repandu dans notre alimentation et impregnant plus de 95 % de la population, et ce, depuis plusieurs dizaines d'annees. Nous verrons, etudes epidemiologiques et experimentales a l'appui, comment le bisphenol A ne suit pas les standards classiques de la cytotoxicite. Il agit en effet a de tres faibles doses, largement en dessous de la dose journaliere admissible actuellement en vigueur (50 micro g/kg/j), sans suivre une relation lineaire dose/effet, et exerce des effets deleteres a des periodes critiques du developpement foetal et postnatal conduisant a l'âge adulte a des troubles metaboliques qui predisposent au syndrome metabolique, au surpoids et au diabete. Les recentes donnees acquises sur le role du bisphenol A sur l'activation de certains recepteurs independants des recepteurs aux estrogenes et sur certaines modifications epigenetiques transmises a la descendance lors de la gestation pourraient rendre compte des troubles metaboliques se developpant a l'âge adulte. Les connaissances recentes sur la toxicite du bisphenol A doivent, au titre du principe de precaution, alerter les agences sanitaires sur une revision drastique des normes d'exposition de ce polluant afin de proteger efficacement la population, en particulier les cibles particulierement sensibles (femmes enceintes, nouveau-nes, jeunes enfants).

As of the mid-19th century, most infectious disease epidemics have been fought and slowed down by taking action on the environment (water, housing, waste) and education. This constitutes the 1st public health revolution paradigm. As we face the current epidemic of chronic diseases and the failure of the dominant biomedical model to stop them, a 2nd public health revolution is needed. The vision for this 2nd public health revolution requires a new paradigm built upon an eco-systemic definition of health and the recognition of the legitimacy for citizen participation based on the precautionary principle.

Elsevier Science refused to publish a study of IBM workers that IBM sought to keep from public view. Occupational and environmental health (OEH) suffers from the absence of a level playing field on which science can thrive. Industry pays for a substantial portion of OEH research. Studies done by private consulting firms or academic institutions may be published if the results suit the sponsoring companies, or they may be censored. OEH journals often reflect the dominance of industry influence on research in the papers they publish, sometimes withdrawing or modifying papers in line with industry and advertising agendas. Although such practices are widely recognized, no fundamental change is supported by government and industry or by professional organizations.

Glycol ethers (GE) are a family of solvents, the use of which has increased dramatically since the 60's, in domestic and occupational mainly water-based products, such as paintings, inks, varnishes, cleaning agents. There are two subgroups: E series and P series. EGME, among the E series, is the reference substance. This is a reprotoxic chemical causing infertility and genital apparatus atrophy on both sexes, embryofetal toxicity through maternal exposure (malformation, growth alterations and functional deficits). European Union has classified nine other GE as reprotoxic. P series, with the beta isomers exception, has no specific reprotoxicity. Epidemiological studies published from the 80's onwards, have confirmed animal data (malformation, oligoazoospermia, spontaneous abortion, hypofertility). The effects can be observed even after the end of exposure. Risk assessment studies tend to prove that this massive exposure during several decades could have had an important impact on reproductive human health. Even if this exposure has considerably decreased since the last few years, a ban of reprotoxic GE, as required by two official bodies (CSC, CSHPF), seems necessary, due to the high risk level. Classification should be completed for some GE, not classified now (EGBE). Health assessment of past exposure should be carried out. Physicians should look after a possible glycol ethers responsibility when facing this kind of reprotoxic effects.

Glycol ethers (GE) are chemicals used since the 1930s as solvents in paints, inks, varnishes, and cleaning agents, mainly in water-based products, cosmetics, and drugs. World production approximates 1 million tons. Nineteen GE are produced or imported each year; over 1000 tons in European Union (EU) have been classified as high production volume chemicals (HPVCs). First animal data were published in 1971 and 1979 showing severe reprotoxicity for some GE. Two alerts were launched in the United States in 1982 and 1983, but the first partial GE regulation only occurred in 1993 in the EU. Although these chemicals may expose a very large population, basic toxicity data, more especially carcinogenicity, are still lacking (3/32 GE). However, experimental data were sufficient to lead developmental toxicity risk assessment since the early 1980s. Risk indices over 1000 have been calculated for consumers and workers exposed to reprotoxic GE in domestic and industrial activities. The first ban was decided in 1999 in France, but was only for drugs and cosmetics. Not surprisingly, since the late 1980s, human studies have found results similar to those in animal data: spontaneous abortions, malformations, testicular toxicity, and hematotoxicity. Despite this highly coherent set of data, and although substitution products are available, reprotoxic GE have been and still remain widely used in the world. The case of GE shows the failure of the present system based on a posteriori risk assessment. This pleads for the change of paradigm through the European REACH regulation based on the "No data, no market" principle. Ethics in REACH management should also be considered.

Cancer is one of the leading causes of mortality. However, it is necessary to analyze this disease from different perspectives. Cancer mortality maps are used by public health officials to identify areas of excess and to guide surveillance and control activities. However, the interpretation of these maps is difficult due to the presence of extremely unreliable rates, which typically occur for sparsely populated areas and/or less frequent cancers. The analysis of the relationships between health data and risk factors is often hindered by the fact that these variables are frequently assessed at different geographical scales. Geostatistical techniques that have enabled the process of filtering noise from the maps of cancer mortality and estimating the risk at different scales were recently developed. This paper presents the application of Poisson kriging for the examination of the spatial distribution of cancer mortality in the "Picardy region, France". The aim of this study is to incorporate the size and shape of administrative units as well as the population density into the filtering of noisy mortality rates and to estimate the corresponding risk at a fine resolution.

International audience; Analyzing the relationship between the environment and health has become a major focus of public health efforts in France, as evidenced by the national action plans for health and the environment. These plans have identified the following two priorities: - identify and manage geographic areas where hotspot exposures are a potential risk to human health; and - reduce exposure inequalities. The aim of this study is to develop a spatial stochastic multimedia exposure model for detecting vulnerable populations and analyzing exposure determinants at a fine resolution and regional scale. A multimedia exposure model was developed by INERIS to assess the transfer of substances from the environment to humans through inhalation and ingestion pathways. The RESPIR project adds a spatial dimension by linking GIS (Geographic Information System) to the model. Tools are developed using modeling, spatial analysis and geostatistic methods to build and discretize interesting variables and indicators from different supports and resolutions on a 1-km(2) regular grid. We applied this model to the risk assessment of exposure to metals (cadmium, lead and nickel) using data from a region in France (Nord-Pas-de-Calais). The considered exposure pathways include the atmospheric contaminant inhalation and ingestion of soil, vegetation, meat, egg, milk, fish and drinking water. Exposure scenarios are defined for different reference groups (age, dietary properties, and the fraction of food produced locally). The two largest risks correspond to an ancient industrial site (Metaleurop) and the Lille agglomeration. In these areas, cadmium, vegetation ingestion and soil contamination are the principal determinants of the computed risk.

Bisphenol A (BPA) is a ubiquitous disruptor. It has been shown, that after exposure during gestation, BPA can induce several chronic diseases (cancer, reproductive troubles, behavioral troubles, diabetes and obesity). The aim of the study was to analyze whether eviction from BPA sources in food could diminish population exposure. 48 volunteers have given urinary samples before and after a one week eviction. The population impregnation levels are significantly high, as 87.5 % of the studied population, which corroborates other biomonitoring surveys. Contrary to all expectations, such a decrease following food withdrawal has not been systematically achieved. Several hypotheses have been cited to account for this result ant to more specifically account for the numerous other possible sources of poisoning. It is therefore essential that BPA levels should be clearly indicated on all products containing the substance with an aim to identifying the best way of securing withdrawal for the population, pending enforcement of October 12, 2011 law banning BPA in plastic food packagings., Le Bisphénol A (BPA) est un perturbateur endocrinien ubiquitaire, dont il a été démontré qu'il peut induire, principalement à la suite d'une exposition pendant la gestation, plusieurs types de maladies chroniques (cancer, troubles de la reproduction, troubles du comportement, diabète et obésité). L'objectif de l'étude était de déterminer si l'éviction des principales sources alimentaires de Bisphénol A diminuait l'imprégnation d'une population. Un groupe de 48 volontaires a fait l'objet d'un dosage urinaire avant et après une semaine d'éviction des sources identifiées. Le taux d'imprégnation de la population est très élevé puisque 87,5 % de la population étudiée est imprégnée, ce qui corrobore d'autres études. Contre toute attente, la diminution après éviction alimentaire n'a pas été systématiquement obtenue. Plusieurs hypothèses sont évoquées pour expliquer ce résultat et en particulier les nombreuses autres sources possibles d'intoxication. Il apparaît indispensable que la présence de Bisphénol A soit clairement indiquée sur tous les produits en contenant afin de permettre à la population une meilleure éviction en attendant que la loi du 12 octobre 2011 interdisant le BPA dans les emballages alimentaires ne prenne effet.

The exposure of workers to methylene chloride and phenol in an aeronautical workshop was measured during stripping of paint from a Boeing B 747. Methylene chloride exposure was measured during two work days by personal air sampling, while area sampling was used for phenol. During paint stripping operations, methylene chloride air concentrations ranged from 299.2 mg/m3 (83.1 ppm) to 1888.9 mg/m3 (524.7 ppm). The exposures to methylene chloride calculated for an 8-h work day ranged from 86 mg/m3 (23.9 ppm) to 1239.5 mg/m3 (344.3 ppm). In another aeronautical workshop, exposure to organic solvents, especially ethylene glycol monoethylether acetate (EGEEA), was controlled during the painting of an Airbus A 320. The external exposure to solvents and EGEEA was measured by means of individual air sampling. The estimation of internal exposure to EGEEA was made by measuring its urinary metabolite, ethoxyacetic acid (EAA). Both measurements were made during the course of 3 days. The biological samples were taken pre- and post-shift. During painting operations, methyl ethyl ketone, ethyl acetate, n-butyl alcohol, methyl isobutyl ketone, toluene, n-butyl acetate, ethylbenzene, xylenes and EGEEA were detected in working atmospheres. For these solvents, air concentrations ranged from 0.1 ppm to 69.1 ppm. EGEEA concentrations ranged from 29.2 mg/m3 (5.4 ppm) to 150.1 mg/m3 (27.8 ppm). For biological samples, the average concentrations of EAA were 108.4 mg/g creatinine in pre-shift and 139.4 mg/g creatinine in post-shift samples. Despite the fact that workers wore protective respiratory equipment during paint spraying operations, EEA urinary concentrations are high and suggest that percutaneous uptake is the main route of exposure for EGEEA.(ABSTRACT TRUNCATED AT 250 WORDS)

SUMMARYAims– To highlight the major discrepancies that emerged between evidence and routine practice in the framework of the SIEP-DIRECT's Project (DIscrepancy betweenRoutine practice andEvidence in psychiatricCommunityTreatments onSchizophrenia). The Project was conducted in 19 Italian mental health services (MHS), with the aims of: a) evaluating the appropriateness of the NICE Guidelines for Schizophrenia in the Italian context, b) developing and testing a set of 103 indicators that operationalised preferred clinical practice requirements according to the NICE Guidelines, and c) evaluating their actual application in Italian MHSs.Methods– The indicators investigated five different areas: common elements in all phases of schizophrenia; first episode treatment; crisis treatment; promoting recovery; the aggressive behaviour management.Results– The NICE recommendations examined were judged in most instances to be appropriate to the Italian MHS context, and the indicators fairly easy to use. The more severe and frequently encountered evidence-practice discrepancies were: lack of written material, guidelines, and information to be systematically provided to users; lack of intervention monitoring and evaluation; difficulty in implementingspecific and structured forms of intervention; difficulty in considering patients' family members as figures requiring targeted support themselves and who should also be regularly involved in the patient care process.Conclusions– The key actions to be undertaken to favour implementation of evidence-based routine practices are: focussing on mental illness onset and family support/involvement in care; planning training activities aimed at achieving specific treatment goals; encouraging MHS participation in evaluation activities; identifying thresholds for guideline application and promoting specific guideline implementation actions; and activating decision making and resource allocationprocesses that rely more strictly on evidence and epidemiological assessment. These considerations are of value for rethinking the model of community psychiatry in Italy as well as in other countries.Declaration of Interest: None.

The Finnish Institute of Occupational Health (FIOH) has received support from the World Health Organization (WHO) and the International Labor Office (ILO) to publish the African Newsletter on Occupational Health and Safety. The African Newsletter on Occupational Health and Safety should not be a medium for industry propaganda, or the source of misinformation among the workers of Africa. Instead, FIOH should provide the same level of scientific information in Africa that it does in Finland and other developed countries.

There is a lack of data on environmental benzene exposure in children. In this study, we compared personal benzene exposure and inhalation uptake in a group of children to those of their parents. We also compared levels of urinary benzene metabolites, trans,trans-muconic acid (MA) and hydroquinone (HQ), for those two groups, and assessed the correlation between personal benzene exposure and urinary MA and HQ concentrations. The study was performed on 21, 2-3-year-old children and their parents recruited on a voluntary basis among non-smokers from the three largest day-care centers of the town of Rouen in France. Average benzene concentrations were measured over 5 consecutive days with diffusive samplers. The following simultaneous measurements were carried out: personal exposure of the parents, concentrations inside and outside the day care centers, and inside the volunteer's bedrooms. Morning and evening urine samples were collected during the same period. Benzene personal exposure levels were 14.4+/-7.7 microg/m(3) and 11.09+/-6.15 microg/m(3) in parents and children, respectively. Benzene inhalation uptake estimates were 2.51+/-1.23 microg/kg/day in the group of parents and 5.68+/-3.17 microg/kg/day in the group of children. Detectable levels of MA and HQ were found in 85% and 100% of the samples, respectively. Intra-individual variation of urinary MA and HQ concentrations expressed as a coefficient of variation (CV) ranged from 63 to 232% and from 13 to 144%, respectively. Mean values of MA and HQ (in mg/g creatinine) were 1.6- and 1.8-fold higher in the group of children than in the group of parents (P=0.008 and P0.0001, respectively). Significant correlations between metabolites levels and benzene were not found.

Exposure to airborne pollutants can result in adverse health effects. Acute symptoms can for instance comprise of irritation of the eyes or of the respiratory tract (called sensory irritation). In a recent case, health problems were reported in a French school and supposedly attributed to the presence of airborne irritant pollutants. Based on measured concentrations, the risk of developing the described health effects was assessed.Numerous airborne sensory irritants (aldehydes, organic acids, volatile organic compounds (VOCs), SO2, NH3) were identified and quantified in the indoor air by using active and passive sampling and online monitoring techniques. Reference values based on toxicological properties of compounds (sensory irritants) were taken from the literature. If not available, tentative values were specially developed for this purpose. Concentrations of all sensory irritants remain below their corresponding guideline values and are comparable to literature data. It was concluded that the risk of developing sensory irritation due to the presence of the studied compounds is negligible. This holds both for individual compounds and for the mixture of studied compounds. Limitations of the employed sampling strategy, and of existing sampling and analytical techniques, which do not allow for analysing more reactive compounds—which are strong sensory irritants—may play a role. New sampling techniques need to be developed. Psychosocial factors (group behaviour, increased attention to sensory irritation) should also be taken into account when dealing with health complaints on sensory irritation. Keywords: Airborne sensory irritants, Exposure, Mixtures, Risk assessment, Weighted sum parameter

Blood and tissue fibrinolysis were studied in 70 patients(p.) with recurrent venous thrombosis. The fibrinolytic activity and the release of plasminogen activators “fibrinolytic capacity” by 10 min. venous occlusion were detected by using acetate-buffered diluted clot lysis time, euglobulin lysis time and resuspended euglobulin precipitate on unheated fibrin plates. Plasminogen activator content in the wall of superficiel hand veins in 40 p, was measured by Pandolfi’s modified histochemical technique. Our studies showed a significantly low content of plasminogen activators in the vessel walls in, more then 60% of p. in good correlation with blood defective fibrinolytic activity and/or capacity.