Knowledge, Attitude and Practices Regarding Electronic Waste (e-waste) Management Among Users of Electronic Equipments Living in Lucknow City

Background: Contemporary society has led to the increasing use of electronic equipment that is very much responsible for the burden of electronic waste (e-waste). E-waste contains very hazardous substance that harms health and environmental conditions. There is no delicate mechanism for the management of e-waste in Lucknow city, Uttar Pradesh. This study assessed knowledge, practice, and awareness of e-waste management among residents of this city. Material and methods: The study was conducted amongst users of electronic equipment living in the Lucknow City of Uttar Pradesh. The study was a cross-sectional descriptive study. Multi-stage random sampling was done for the selection of participants for the study. A predesigned and pretested questionnaire was administered in a single setting for all phases. The total optimum sample size is 700 individuals who participated in the study. Data were entered in MS Excel 2016 and descriptive statistics such as frequencies and percentages were calculated, applying the chi-square test for association using R-4.2.1 Statistical software. Aim and objectives: To assess the knowledge, attitude and practices regarding the management of electronic waste among users of electronic equipment residing in Lucknow city. Results: Only 37% of users are aware that e-waste adversely affects health. Only 34.3% of users knew that e-waste should be given to the seller or manufacturer for recycling while rest told that it should be stored at home, sold to a scrap dealer, or disposed with normal waste. 87.3% users are not aware about e-waste govt guidelines. In the current study electronic and print media like television, radio and news paper were not found to be source of information for e-waste disposal. Conclusion: Education regarding the ill effects of e-waste is essential for people and awareness of proper disposal of e-waste is the need of the hour. Electronic and print media as well as companies producing electronic equipment should play a significant role to awaken the respondent about the disposal of e-waste

Microbial Quality and Public Health Risks of Selected Herbal Remedies Sold in Open Markets in Owerri Metropolis, South Eastern, Nigeria

Herbal medicines are presently widely used in developed and developing countries for health care due to their affordability, accessibility and availability. Objective: The microbial quality of selected herbal remedies sold in open markets in Owerri, South Eastern, Nigeria was studied. Methods: The samples were bulked according to type and then serially diluted. The spread plate technique was used in inoculating the samples on the appropriate culture medium and then incubated. Standard laboratory protocols for microbiological studies and biochemical tests were employed for the identification of the microorganisms present in the samples. Results: The presence of bacterial species namely Bacillus, Corynebacterium, Micrococcus, Enterococcus and Staphylococcus spp was recorded. They were all gram positive and bacterial counts ranged from 1.0 x 106 to 7.8 x 107cfu/ml. Fungal isolates included Mucor, Saccharomyces and Penicillium spp. and fungal counts ranged from 3.0x103 to 1.3x108 cfu/ml respectively. Conclusion: The presence of these microorganisms in herbal remedies do not only make them hazardous, but might also change the physical, chemical and natural properties of the herbal remedies by altering the contents of active ingredients or converting them to toxic products. The production and consumption of herbal remedies should be properly supervised and monitored to ensure that only good quality products get to the consumers.

Research progress of occupational hazards in plywood manufacturing / 中华劳动卫生职业病杂志

Occupational disease hazards in plywood manufacturing mainly include wood dust, formaldehyde, phenol, ammonia, noise, terpene, microorganisms, etc. The exposure is complex with multiple factors accompanied or coexisted. In the production process, these factors are exceeded, and mass occupational disease hazard events occurred among workers. Exposure to wood dust, formaldehyde, terpene, etc., put workers at increased risk of cancer. This article provides a review of this issue in order to provide a scientific basis for the prevention and control of occupational disease hazards in plywood manufacturing.

Waste management practices among dental surgery staff of major hospitals in Accra: a descriptive cross-sectional study

Introduction: the practice of dentistry in contemporary times produces considerable waste that could be harmful to individuals and the environment at large. In Ghana and many other jurisdictions, there are guidelines that outline how these wastes should be managed. This study was conducted to explore practices concerning dental waste management among dental surgery staff in some public facilities in Accra, Ghana. Methods: a descriptive cross-sectional study involving dental surgery staff of four major facilities in Accra was done. Overall, 124 staff from the selected facilities participated in the study, and 51 different dental surgeries were assessed. Data were collected using a structured questionnaire and an observation checklist. The questionnaire included questions on socio-demographics, as well as knowledge and practices regarding dental waste management. Results: there was unsatisfactory knowledge of waste disposal, while practices did not generally meet international recommendations and the Ministry of Health´s (MOH) guidelines. Though all respondents stored their sharp waste in puncture-proof containers, 98.4% did not label their clinical waste, while 62.9% would dispose of used X-ray fixers by pouring them down the drain. None of the 51 surgeries observed had more than one colour code available. Conclusion: there is a palpable need for education, monitoring, and empowerment concerning waste management in Ghana´s oral healthcare system.

Impacto de una intervención educativa en el conocimiento y manejo de residuos peligrosos biológico-infecciosos / Impact of an educational intervention on the knowledge and management of infectious biological hazardous waste

Introducción: el personal de enfermería tiene una participación fundamental en el manejo de los residuos peligrosos biológico-infecciosos (RPBI) durante la atención en salud, situación que hace indispensable el conocimiento respecto a la peligrosidad y riesgo en el manejo de estos residuos. Objetivo: evaluar el impacto de una intervención educativa acerca del conocimiento y manejo de RPBI, en el personal de enfermería de un hospital general regional. Metodología: estudio cuasi experimental, pretest/postest, prospectivo y longitudinal. Se realizó una intervención educativa, y antes y después de esta se aplicó un cuestionario para evaluar conocimientos relacionados con RPBI y una lista de cotejo del Modelo Institucional para la Prevención de Infecciones Nosocomiales (MIPRIN) para evaluar el manejo de RPBI. Resultados: la intervención educativa demostró un efecto positivo en los conocimientos del personal de enfermería en relación con el manejo de RPBI. En la evaluación pretest se obtuvo un porcentaje de conocimientos de 65.2% y en la postest fue de 78.3% (p < 0.001). Respecto al cumplimiento en el manejo de RPBI, hubo un incremento; sin embargo, no se puede atribuir a la intervención, puesto que se evaluó por servicio y no de manera directa con los participantes. Conclusión: la intervención educativa mostró cambios significativos en los conocimientos y el manejo de RPBI del personal de enfermería.

Introduction: Nursing staff represent an important percentage in the management of biological hazardous waste (BHW) during health care, a situation that makes this knowledge essential regarding the danger and risk in handling these wastes. Objective: To evaluate the impact of an educational intervention about the knowledge and management of BHW in the nursing staff of a regional general hospital. Methods: quasi-experimental, pre-test/post-test, prospective and longitudinal study. An educational intervention was carried out; before and after this intervention, a questionnaire was administered to evaluate knowledge related to BHW and a checklist of the Institutional Model for the Prevention of Nosocomial Infections (MIPRIN, according to its initials in Spanish) to evaluate the management of BHW. Results: The educational intervention showed a positive effect in the nursing staff's knowledge in relation to BHW. In the pre-test evaluation a knowledge percentage of 65.2% was obtained and in the post-test evaluation it was 78.3% (p < 0.001). Regarding compliance in the management of BHW there was an increase; however, it cannot be attributed to the intervention, since it was evaluated by service and not directly with the participants.

Satisfacción con la introducción del nuevo procedimiento de evaluación de riesgo biológico en laboratorios clínicos

Introducción: La evaluación de la satisfacción respecto al cambio introducido en el procedimiento de evaluación de riesgo biológico, aporta elementos para valorar su efectividad. Objetivo: Evaluar mediante la Técnica de Iadov el nivel de satisfacción como usuario del procedimiento de evaluación del riesgo biológico en laboratorios clínicos con enfoque en defensa en profundidad. Métodos: Se realizó un estudio descriptivo de corte transversal desde julio a diciembre del año 2021. El universo estuvo constituido por los 82 laboratorios clínicos de atención primaria de salud de La Habana y se trabajó con una muestra no probabilística de tres laboratorios con un total de 37 trabajadores; a partir de los criterios de inclusión: ser trabajador del laboratorio y aceptar participar en la investigación, como criterios de exclusión: personal de otros centros en prestación de servicio y alumnos en formación. Se utilizó el método de investigación empíricos (encuesta) y como método estadístico se utilizó el análisis porcentual. El procesamiento de la información se realizó mediante la Técnica de Iadov. Resultados: La encuesta de satisfacción reveló que el 78,6 % de la muestra expresó una máxima satisfacción, el 24,3 % más satisfecho que insatisfecho. Las preguntas abiertas (dos y cuatro de la encuesta) identificaron como aspecto que más gustaron, el propósito e interés de mejorar la etapa evaluación y gestión de riesgo, las etapas sucesivas del procedimiento permiten obtener una información detallada del estado de la bioseguridad y entre los aspectos que no gustaron se describe el análisis matemático. El índice de satisfacción grupal obtenido fue de 0,87. Conclusiones: El índice de satisfacción grupal de trabajadores de los laboratorios clínicos donde se aplicó el procedimiento de evaluación de riesgo biológico fue alto, lo que refleja la aceptación de la propuesta y reconocimiento de su pertinencia en el proceso de evaluación del riesgo biológico.

Introduction: The evaluation of satisfaction regarding the change introduced in the biological risk assessment procedure provides elements to assess its effectiveness. Objective: To evaluate through the Ladov technique the level of satisfaction as a user of the biological risk assessment procedure in clinical laboratories with a focus on defense in depth. Methods: A descriptive cross-sectional study was carried out in the period from July to December 2021. The universe consisted of the 82 clinical laboratories of primary health care in Havana and a non-probabilistic sample of 3 laboratories with a total of 37 workers; based on the inclusion criteria: being a laboratory worker and agreeing to participate in the research, as exclusion criteria: personnel from other centers providing services and students in training. The empirical research method (survey) was used and the percentage analysis was used as a statistical method. The processing of the information was carried out using the V.A. Iadov. Results: The satisfaction survey revealed that 78.6% of the sample expressed maximum satisfaction, 24.3% more satisfied than dissatisfied. The open questions (2 and 4 of the survey) identified as the aspect that they liked the most, the purpose and interest of improving the risk assessment and management stage, the successive stages of the procedure that allow obtaining detailed information on the state of biosafety y and among the aspects that they did not like, the mathematical analysis is described. The group satisfaction index obtained was 0.87. Conclusions: The group satisfaction index of clinical laboratory workers where the biological risk assessment procedure was applied was high, reflecting acceptance of the proposal and recognition of its relevance in the biological risk assessment process.

Saúde Socioambiental na Atenção Básica: conhecimento, formação e prática / Socio-environmental Health in primary care: knowledge, training and practice

RESUMO A exposição humana às substâncias e aos compostos químicos nocivos é uma realidade global que torna cada vez mais necessária a promoção da saúde às pessoas e comunidades expostas em seus territórios. Considerando que a Saúde Socioambiental observa o movimento dos agentes nocivos na interface ambiente-saúde-sociedade, buscou-se analisar o conhecimento, a formação e a prática das equipes da Atenção Básica com relação à Saúde Socioambiental, com foco na redução do adoecimento devido à exposição e à intoxicação por esses agentes. Utilizou-se a escala do tipo Likert sem ponto central validada por um grupo de 11 especialistas e 3 profissionais da Atenção Básica. Garantiu-se a existência de mínima dispersão com a administração do estudo e o cálculo do coeficiente de correção linear de Pearson; e boa confiabilidade por meio do teste de coeficiente de confiabilidade de Spearman-Brown, em que foi usado o Split-Half Method. A pesquisa revelou haver situação de conforto na dimensão conhecimento, perigo na dimensão formação, e atenção na dimensão prática. A formação é a única dimensão que, no resultado geral, demanda mudanças imediatas. Ainda que as dimensões conhecimento e prática profissional se apresentem, respectivamente, em situação de manutenção e aprimoramento, essas não se originam de instituições formais de ensino.

ABSTRACT Human exposure to harmful chemical substances and compounds is a global reality that makes health promotion increasingly necessary for the people and communities exposed in their area. Considering that socio-environmental health observes the movement of pollutants at the environment-health-society interface, an attempt was made to analyze the knowledge, training, and practice of primary care teams in relation to socio-environmental health, focusing on the reduction of diseases due to exposure and poisoning by these substances. A Likert-type scale without a central point was used, validated by a group of 11 specialists and 3 primary care professionals. Minimal dispersion was ensured by the application of the survey and the calculation of Pearson's linear correction coefficient and reliability was assessed by the Spearman-Brown's reliability coefficient, using the split-half method. The survey showed that the knowledge dimension was generally classified as in a safe situation, the training dimension as in a danger situation, and the practical dimension as in an alert situation. Training was the only dimension that required immediate change in the overall results. Although the knowledge and professional practice dimensions were in a situation of maintenance and improvement, respectively, they are not acquired in formal educational institutions.

Evaluation of dietary health risks of metals in peppers based on physiologically based extraction test / 环境与职业医学

Background The pollution of agricultural products and the health risks caused by metals have become a hot spot of social concern. As China's main economic agricultural products, peppers are essential for health risk assessment. Objective By exploring the enrichment of common metals in different varieties of peppers in major growing areas of China, a bioavailability-based approach is used to assess dietary health risks of common metals in groups with different characteristics. Methods Through random sampling method, dried pepper samples from major pepper growing areas of China were purchased from the market, and were divided into Hippophae, Capsicum annuum, Magnoliopsida, Capsicum frutescens var, and Capsicum by morphological taxonomy, and a total of 667 batches of peppers were collected. Six common metals arsenic (As), cadmium (Cd), lead (Pb), nickel (Ni), copper (Cu), and zinc (Zn) were evaluated; physiologically based extraction test was designed to estimate the bioavailability of the metals in peppers and their associated dietary health risks were assessed. Results The concentrations of metals Cd and Ni in pepper exceeded the limits of China, and the disqualification rates were 6.1% and 22.7% respectively. The other metals were within the safe range; there were differences in the concentrations of As, Cd, Pb, Cu, and Zn among different pepper varieties (P<0.05). The order of bioavailability of the six metals in pepper from high to low was As (57.9%)>Cd (43.07%)>Zn (42.74%)>Pb (38.04%)>Ni (31.97%)>Cu (31.4%). Based on bioavailability, when the metal concentration in pepper was at the median level, the order of hazard quotient of metals in pepper was Cu>Cd>As>Ni>Zn>Pb, and at the 90th quantile level, the order was Cd>As>Cu>Ni>Zn>Pb; the hazard quotient of single metal element and the total target hazard quotient of combined metal elements were both less than 1, and these indicators of adults were higher than those of children. Conclusion In the collected pepper samples, the non-carcinogenic health risks of single metal elements and multiple metal elements are in the safe range. Based on gastrointestinal bioavailability, the dietary health risk of pepper is further reduced.

Associations of education and income with hazardous drinking among postpartum women in Japan: results from the TMM BirThree Cohort Study

BACKGROUND@#Although the postpartum period is suggested to provide an ideal opportunity for interventions to prevent hazardous drinking, evidence on the associations of education and income with hazardous drinking during this period is limited, including in Japan.@*METHODS@#We analyzed data from 11,031 women who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study in Japan. Hazardous drinking was defined as ethanol intake of ≥20 g/day 1 year after delivery. We conducted multiple logistic regression analyses to examine whether educational attainment or equivalent household income was associated with hazardous drinking, adjusting for age, parity, drinking status during pregnancy, work status, postpartum depression, breastfeeding, and income/education. We also conducted stratified analyses by income and education groups.@*RESULTS@#The prevalence of hazardous drinking 1 year after delivery was 3.6%. Lower education was associated with hazardous drinking; the odds ratio (95% confidence interval) of high school education or lower compared with university education or higher was 2.17 (1.59-2.98). Lower income was also associated with hazardous drinking, but this association disappeared after further adjustments for education; the odds ratios (95% confidence intervals) of the lowest compared with highest level of income were 1.42 (1.04-1.94) and 1.12 (0.81-1.54), respectively. A significant interaction was detected; lower education and lower income were associated with increased risks of hazardous drinking only in a lower income group and lower education group, respectively.@*CONCLUSIONS@#Postpartum women with lower education and lower income had higher risks of hazardous drinking in Japan.

Availability and storage of hazardous products in households in the metropolitan region of manaus: a population-based survey, 2015 / Disponibilidade e armazenamento de produtos perigosos em domicílios da região metropolitana de manaus: estudo de base populacional, 2015

ABSTRACT Objective: The availability of hazardous products in households increases the risks of poisoning. The present study aimed to assess the frequency and associated factors of the availability and storage of hazardous products in residences in the metropolitan region of Manaus. Methods: Population-based and cross-sectional study conducted in 2015 with adults selected with three-stage probabilistic sampling. Participants were interviewed face-to-face. Prevalence ratio (PR) of the presence of hazardous products (presence of chumbinho [illegal anti-cholinesterase rodenticide], artisanal cleaning products, and unsafe storage of these products and medications) and 95% confidence intervals (95%CI) were calculated with Poisson regression with robust variance, weighted by the complex sampling method adopted. Results: A total of 4,001 participants was included, of which 53.0% (95%CI 51.5-54.6) reported presence of hazardous products in their households, 36.3% (95%CI 34.8-37.8) had unsafe storage, 16.2% (95%CI 15.1-17.4) had artisanal cleaning products, and 8.2% (95%CI 7.4-9.1) had chumbinho. Households with children ≤5 years old had safer storage (PR=0.78; 95%CI 0.71-0.86) and more artisanal products (PR=1.30; 95%CI 1.11-1.51). Presence of artisanal products was higher in lower educational levels (PR=2.20; 95%CI 1.36-3.57) and lower economic classifications (PR=1.63; 95%CI 1.25-2.13). Conclusions: Over half of the households in the metropolitan region of Manaus kept hazardous products; one-third stored them unsafely. Artisanal cleaning products and chumbinho were frequently present. Households with children had safer storage of products, and socioeconomic factors affected the availability of such hazardous products.

RESUMO Objetivo: A disponibilidade de produtos perigosos em domicílios aumenta os riscos de intoxicações. Este estudo objetivou avaliar a frequência e os fatores associados à disponibilidade e armazenamento de produtos perigosos em residências da Região Metropolitana de Manaus. Métodos: Estudo transversal de base populacional realizado em 2015 com adultos selecionados por amostragem probabilística em três estágios. Os participantes foram entrevistados pessoalmente. A razão de prevalência (RP) da presença de produtos perigosos (presença de chumbinho [rodenticida anticolinesterase ilegal], produtos de limpeza artesanais e armazenamento inseguro desses produtos e de medicamentos) e intervalos de confiança de 95% (IC95%) foram calculados por regressão de Poisson com variância robusta, ponderada pela amostragem complexa adotada. Resultados: 4.001 participantes foram incluídos, dos quais 53,0% (IC95% 51,5-54,6) reportaram a presença de produtos perigosos em seus domicílios, 36,3% (IC95% 34,8-37,8) apresentaram armazenamento inseguro, 16,2% (IC95% 15,1-17,4) possuíam produtos de limpeza artesanais e 8,2% (IC95% 7,4-9,1) possuíam chumbinho. Os domicílios com crianças menores de 5 anos apresentaram armazenamento mais seguro (RP=0,78; IC95% 0,71-0,86) e mais produtos artesanais (RP=1,30; IC95% 1,11-1,51). Presença de produtos artesanais foi maior em menores níveis de escolaridade (RP=2,20; IC95% 1,36-3,57) e menores classificações econômicas (RP=1,63; IC95% 1,25-2,13). Conclusões: Mais da metade dos domicílios da Região Metropolitana de Manaus possuía produtos perigosos; um terço os armazenava sem segurança. Produtos de limpeza artesanais e chumbinho estavam frequentemente presentes. Os domicílios com crianças apresentaram armazenamento mais seguro de produtos e fatores socioeconômicos afetaram a disponibilidade de tais produtos perigosos.

Knowledge and use of personal protective equipment by nursing professionals during the Covid-19 pandemic / Conocimiento y uso de equipo de protección individual por profesionales de enfermería durante la Pandemia de COVID-19 / Conhecimento e uso de equipamentos de proteção individual por profissionais de enfermagem durante pandemia da Covid-19

ABSTRACT Objective: To explore the knowledge and use of personal protective equipment by nursing professionals of Primary Health Care during the Covid-19 pandemic. Method: This is an exploratory study of a non-probabilistic sample developed in Basic Health Units in the city of Picos, Piauí, Brazil. Data were collected between June and August 2020, by phone call, following a semi-structured script, with responses recording and transcription. For material analysis, the software IRaMuTeQ was used for statistical textual analyses: Descending Hierarchical Classification, similarity analysis, and word cloud. Results: From the corpus of 6,873 words and 832 lexical units, three categories were created: (1) motivations and barriers for use (20.9%); (2) handling of personal protective equipment (classes 5 and 4) with 25% and 21.6%, respectively, and (3) measures to protect users and health professionals (classes 3 and 5) with 17.6% and 14.9%. Conclusion: The nursing professionals interviewed demonstrated that they did not have sufficient knowledge for the proper use of the equipment, which could compromise their integrity and that of the patient as a subject who receives unsafe care.

RESUMEN Objetivo: Explotar el conocimiento y el uso de equipos de protección individual por profesionales de enfermería de la Atención Básica durante la pandemia de Covid-19. Método: Estudio exploratorio de muestreo no probabilístico desarrollado en Unidades Básicas de Salud del municipio de Picos, Piauí, Brasil. Los datos fueron recolectados entre junio y agosto de 2020, por llamadas telefónicas, siguió texto semiestructurado, con grabación y transcripción de las respuestas. Para el análisis del material, se utilizó el software IRaMuTeQ para los análisis textuales estadísticos: Clasificación Descendente Jerárquica, análisis de similitud y nube de palabras. Resultados: Del corpus de 6.873 palabras y 832 unidades lexicales fueron constituidas tres clases: (1) motivaciones y barreras para el uso (20,9%); (2) manipulación de los equipos de protección individual (clases 5 y 4) con 25% y 21,6%, respectivamente, y (3) medidas para protección de usuarios y profesionales de salud (clases 3 y 5) con 17,6% y 14,9%. Conclusión: Los profesionales de enfermería entrevistados demostraron no poseer conocimiento suficiente para el uso adecuado de los equipos, lo que puede comprometer su integridad y la del paciente como sujeto que recibe el cuidado no seguro.

RESUMO Objetivo: Explorar o conhecimento e o uso de equipamentos de proteção individual por profissionais de enfermagem da Atenção Básica durante pandemia da Covid-19. Método: Estudo exploratório de amostra não probabilística desenvolvido em Unidades Básicas de Saúde do município de Picos, Piauí, Brasil. Os dados foram coletados entre junho e agosto de 2020, por ligação telefônica, seguindo roteiro semiestruturado, com gravação e transcrição das respostas. Para análise do material, utilizou-se o software IRaMuTeQ para as análises textuais estatísticas: Classificação Hierárquica Descendente, análise de similitude e nuvem de palavras. Resultados: Do corpus de 6.873 palavras e 832 unidades lexicais foram constituídas três categorias: (1) motivações e barreiras para o uso (20,9%); (2) manipulação dos equipamentos de proteção individual (classes 5 e 4) com 25% e 21,6%, respectivamente, e (3) medidas para proteção de usuários e profissionais de saúde (classes 3 e 5) com 17,6% e 14,9%. Conclusão: Os profissionais de enfermagem entrevistados demonstraram não possuir conhecimento suficiente para o uso adequado dos equipamentos, o que pode comprometer sua integridade e a do paciente como sujeito que recebe o cuidado não seguro.

Laboratory chemical waste: hazard classification by GHS and transport risk / Resíduos químicos laboratoriais: classificação de perigo pelo GHS e risco no transporte

ABSTRACT OBJECTIVES: To identify and evaluate, based on the Globally Harmonized System of Classification and Labelling of Chemicals (GHS) and the legislation of the Agência Nacional de Transportes Terrestres (ANTT - National Agency for Terrestrial Transport), the hazards arising from chemical waste generated in research laboratories in the health area. METHODS: Chemical residues generated in two medical research laboratories of the Faculdade de Medicina da Universidade de São Paulo were inventoried, from November 2017 to April 2019, and classified according to the GHS (hazard statements) and the ANTT transport legislation (risk classes), to determine the dangers coming from the respective substances and mixtures. RESULTS: In total, we identified 40 substances or mixtures with classification by the GHS indicating 36 hazard statements, 27 of which related to human health. According to the legislation established by ANTT, we found 16 cases of hazard associated with flammability, 15 cases related to toxicity and 12 cases related to corrosivity. CONCLUSIONS: Chemical residues generated in the laboratories studied are diversified in terms of their hazard characteristics, implying the possibility of exposure to severe risks to workers, students and the environment. The correct identification of these residues is a primary factor for reducing exposure to risks.

RESUMO OBJETIVOS: Identificar e avaliar, com base no Sistema Globalmente Harmonizado de Classificação e Rotulagem de Produtos Químicos (GHS) e na legislação da Agência Nacional de Transportes Terrestres (ANTT), os perigos provenientes dos resíduos químicos gerados em laboratórios de pesquisa na área de saúde. MÉTODOS: Resíduos químicos gerados em dois Laboratórios de Investigação Médica da Faculdade de Medicina da Universidade de São Paulo foram inventariados, no período de novembro de 2017 a abril de 2019, e classificados conforme o GHS (frases de perigo) e a legislação de transportes da ANTT (classes de risco), para determinação dos perigos provenientes das respectivas substâncias e misturas. RESULTADOS: No total, foram identificadas 40 substâncias ou misturas, cuja classificação pelo GHS indicou 36 frases de perigo, sendo 27 relacionadas à saúde humana. De acordo com a legislação estabelecida pela ANTT, foram encontrados 16 casos de periculosidade associada à inflamabilidade, 15 casos relacionados à toxicidade e 12 casos relativos à corrosividade. CONCLUSÕES: Resíduos químicos gerados nos laboratórios estudados são diversificados quanto a suas características de periculosidade, implicando a possibilidade de exposição a riscos severos aos trabalhadores, aos estudantes e ao ambiente. A correta identificação desses resíduos é fator primordial para diminuição da exposição aos riscos.

Redistributing deaths by ill-defined and unspecified causes on cancer mortality in Brazil

ABSTRACT OBJECTIVE to discuss the impact four different redistribution strategies have on the quantitative and temporal trends of cancer mortality assessment in Brazil. METHODOLOGY This study used anonymized and georeferenced data provided by the Brazilian Ministry of Health (BMoH). Four different approaches were used to conduct the redistribution of ill-defined deaths and garbage codes. Age-standardized mortality rates used the world population as reference. Prais-Winsten autoregression allowed the calculation of region, sex, and cancer type trends. RESULTS Death rates increased considerably in all regions after redistribution. Overall, Elisabeth B. França's and the World Health Organization methods had a milder impact on trends and rate magnitudes when compared to the Global Burden of Disease (GBD) 2010 method. This study also observed that, when the BMoH dealt with the problem of redistributing ill-defined deaths, results were similar to those obtained by the GBD method. The redistribution methods also influenced the assessment of trends; however, differences were less pronounced. CONCLUSIONS Since developing a comparative gold standard is impossible, matching global techniques to local realities may be an alternative for methodological selection. In our study, the compatibility of the findings suggests how valid the GBD method is to the Brazilian context. However, caution is needed. Future studies should assess the impact of these methods as applied to the redistribution of deaths to type-specific neoplasms.

Imobilização de metais pesados presentes nos resíduos de quartzito por meio da incorporação em argamassas com substituição total do agregado natural / Immobilization of heavy metals present in quartzite residues through incorporation in mortars with total substitution of the natural aggregate

RESUMO Este trabalho objetivou imobilizar metais pesados presentes nos resíduos de quartzito por meio da incorporação em argamassas em substituição total ao agregado natural. Dois tipos de resíduos foram utilizados: os resíduos de fragmentação das aparas (QS) e os do pó de serragem (QP). Os resíduos foram caracterizados por fluorescência de raios X, difração de raios X e ensaios de toxidade conforme metodologia da Norma Brasileira (NBR) 10005, da NBR 10006 e do Toxicity Characteristic Leaching Procedure (TCLP) 1311. Então, foram analisadas composições de argamassas contendo cimento, cal e os resíduos (QS, QP) utilizando-se a técnica de delineamento de mistura, determinando os melhores traços, o melhor tipo de cura (imersa ou úmida) e, posteriormente, avaliando a resistência dos corpos de prova após cura. A caracterização do resíduo de quartzito revelou a presença de vários metais pesados e extratos lixiviados em contato com a água, classificando-o como resíduo de Classe I — Perigoso. Os resultados indicam que as composições determinadas foram capazes de imobilizar os metais pesados presentes nos resíduos de quartzitos, bem como resultou em argamassas com resistências mecânicas superiores a 2 MPa. Por fim, mostrou-se que essa técnica de solubilização e estabilização dos contaminantes presentes nos resíduos de quartzito é uma alternativa tecnologicamente viável e ambientalmente adequada para a destinação final desses resíduos.

ABSTRACT This work aims to immobilize heavy metals present in the quartzite residues by means of the incorporation in mortars in total substitution to the natural aggregate. Two types of residues were used: quartzite sand (QS) and powder (QP). The residues were characterized by x-ray fluorescence, x-ray diffraction, and toxicity tests according to the methodology of the NBR 10005, 10006 and Toxicity Characteristic Leaching Procedure (TCLP) 1311. Then, compositions of mortar containing cement, lime and residues (QS, QP) were analyzed using technique of designing the mixture, determining the best mixture, the best type of cure (immersed or wet), and subsequently evaluated at resistance of the body of evidences after curing. The characterization of quartzite residue revealed the presence of multiple heavy metals and leached extracts in contact with the water, classifying it a Class I-Hazardous waste. Regarding the production of mortars, the results indicated that the compositions determined were able to immobilize the heavy metals present in the quartzite residues, as well as resulted in mortars with mechanical resistances higher than 2 MPa. Finally, it was shown that this technique of solubilization and stabilization of contaminants present in quartzite residues is a technologically viable and environmentally adequate alternative for the final destination of these residues.

Análise de erros de prescrição de morfina e tramadol em idosos: uma proposta de melhorias / Analysis of prescription errors of morphine and tramadol in the elderly: a proposal for improvements

RESUMO Este trabalho tem como objetivo identificar a prevalência de erros de prescrição de morfina solução injetável e tramadol solução injetável de pacientes com idade igual ou superior a 60 anos, hospitalizados na Unidade de Internação Adulto do Hospital Universitário (HU) Canoas. Trata-se de um estudo observacional descritivo retrospectivo, de caráter quantitativo. Foram utilizadas 496 prescrições contendo os medicamentos morfina solução injetável e tramadol solução injetável. A coleta de dados foi realizada no período de abril e maio de 2018. Os dados foram repassados para uma planilha do software Microsoft Excel, para análise de frequência. Das 496 prescrições avaliadas, foram encontrados 130 (26,21%) erros de prescrição demedicamentos,sendo 49 erros envolvendo morfina e 81 envolvendotramadol. Se tratando de pacientes idosos em uso de analgésicos opioides, a inclusão do farmacêutico na equipe multiprofissional para a avaliação das prescrições,aumentaria agarantiado sucesso terapêutico e da segurança do paciente.

This study aims to identify the prevalence of prescription errors of injectable solution morphine and tramadol solution of patients aged 60 years or more, hospitalized in the Adult Hospitalization Unit of the University Hospital (HU) Canoas. This is a descriptive retrospective, quantitative, observational study. We used 496 prescriptions containing the drugs morphine solution for injection and tramadol solution for injection. Data collection was performed in the period of April and May, 2018. The data were transferred to a Microsoft Excel spreadsheet for frequency analysis. Of the 496 prescriptions evaluated, 130 (26.21%) medication prescription errors were found, 49 errors involving morphine and 81 involving tramadol. In the case of elderly patients using opioid analgesics, the inclusion of the pharmacist in the multiprofessional team to evaluate the prescriptions would increase the guarantee of therapeutic success and patient safety.

Research progress on health effects of aniline / 中华预防医学杂志

Aniline is one of the important chemical raw materials in daily life and the chemical industry. Aniline exposure might occur through intact skin, respiratory tract and digestive tract. It could pose negative impacts on many organs and systems of the human body, including toxicity or carcinogenicity to blood, liver, and spleen. This paper summarized the direct effects of aniline on human health and the indirect hazards of aniline on human health through environmental pollution and discussed the future research directions of aniline-induced health hazards.

Investigation and Study on Occupational Exposure for Hazardous Drugs of Healthcare Workers in Shaanxi Province and Relative Cognition Level / 中国药房

OBJECTIVE：To understand the situation of healthcar e workers’occupational exposure of hazardous drugs （chemotherapeutic drugs and antiviral drug ）and relative cognition level ，and to provide reference for improving the level of occupational protection. METHODS ：During Oct. 2018 to Mar. 2019，healthcare workers from 12 hospitals of different levels and different departments in Shaanxi province were selected as respondents to conduct a self-designed questionnaire survey. Information we surveyed contained baseline characteristics ，hazardous drugs exposure ，physical health status ，and occupational protection. Valid questionnaires were collected and analyzed statistically. RESULTS ：A totally of 1 848 questionnaires were sent out ，and 1 767 questionnaires were collected ，including 95 were pharmacists ，100 were physicians ，and 1 572 were nurses. The frequency of diarrhea and menstrual disorders in healthcare workers with long-term exposure to antiviral drugs （antiviral drug exposure group ） and cross-exposure to antiviral drugs and chemotherapeutic drugs （cross-exposure group ）were significantly higher than unexposed group （P＜0.05）. The incidence of routine blood abnormalities in cross-exposure group ，antiviral drug exposure group and healthcare workers with long-term exposure to chemotherapy drugs （chemotherapy drug exposure group ） was higher than unexposed group by 9.13％，5.50％ and 12.34％，respectively. 84.7％ of the respondents had little knowledge of hazardous drugs ， and 8.15％ of the respondents had never received occupational protection training. Additionally ，the ratio of healthcare workers receiving occupational protection training in the cross-exposure group was significantly higher than unexposed group （P＜0.05）， and the ratio of healthcare workers receiving occupational protection training in antiviral drug exposure group were significantly lower than unexposed group （P＜0.05）. CONCLUSIONS ：Long-term exposure to hazardous drugs will cause certain occupational hazards to healthcare workers. It is necessary to improve healthcare workers ’awareness of self-protection ，increase the input of hospitals in occupational protection training and establish occupational protection standards in order to improve the current situation of occupational protection of healthcare workers.

Research progress on health effects of aniline / 中华预防医学杂志

Aniline is one of the important chemical raw materials in daily life and the chemical industry. Aniline exposure might occur through intact skin, respiratory tract and digestive tract. It could pose negative impacts on many organs and systems of the human body, including toxicity or carcinogenicity to blood, liver, and spleen. This paper summarized the direct effects of aniline on human health and the indirect hazards of aniline on human health through environmental pollution and discussed the future research directions of aniline-induced health hazards.

Assessing the Attitude of Medical Workers to Anti-Cancer Drug Exposure Measures by an Awareness Survey / 医薬品情報学

Objective: The importance of occupational exposure control in cancer therapy is widely recognized, and measurement of anti-cancer drug exposure during preparation, as well as comprehensive measures, including administrative control, patients’ excrements, and environmental pollution, among others, are becoming important. The Osaka Women’s and Children’s Hospital introduced the closed system drug transfer device (CSTD) for administering anticancer drugs, and conducted consistent exposure measures from preparation to disposal. We simultaneously conducted an awareness survey on anti-cancer drug exposure measures for health care workers,observed the changes in their awareness and behavior, and examined the issues that constantly challenge anti-cancer drug exposure measures.Method: We surveyed doctors, nurses, and pharmacists who handle anticancer drugs belonging to the Osaka Women’s and Children’s Hospital from March 2018 to October 2018. The questionnaire was anonymous and was collected within one week after distribution. In the questionnaire survey, we obtained permission to present the contents on paper and orally.Results: The questionnaire response rate was approximately 70%. Following the training and introduction sessions, the participants had an improved understanding of Hazardous Drugs and CSTD. The introduction of the workshops on anti-cancer drug exposure measures and CSTD encouraged the nurses to reflect on the exposure measures and revisit the manuals on in-hospital treatment with anti-cancer drugs; however, there was little or no change in the behavior of the pharmacists.Discussion: Since nurses work primarily in the field of patient care, their awareness of anti-cancer drugs has gradually declined, and it was observed that procedures for exposure control were not being followed. In order to ensure that anti-cancer drug exposure measures are properly observed, pharmacists need to take initiatives and conduct in-hospital workshops once every six months. It is also necessary to educate the medical staff about electronic devices in order to ensure their easy participation in workshops and encourage e-learning.

Nivel de seguridad en el manejo de los productos químicos peligrosos en la comunidad Mantilla / Security level in the management of hazardous chemical products in Mantilla community

Introducción: El manejo responsable de los productos químicos peligrosos tiene relación directa con el conocimiento, comprensión y percepción de riesgo que tengan los individuos involucrados. Objetivo: Evaluar el nivel de seguridad en el manejo de los productos químicos peligrosos en la comunidad Mantilla y compararlo con el estudio que se realizó en la comunidad Pogolotti-Finlay-Belén en La Habana, entre 2013-2015. Métodos: Investigación descriptiva exploratoria, que se realizó en el Consejo Popular Mantilla de Arroyo Naranjo en 2016, con una población de 1338 practicantes sistemáticos en el manejo de los productos químicos peligrosos. Se escogió una muestra no probabilística de 200 personas, que se seleccionaron de forma intencional. Se confeccionó una lista de verificación para evaluar el nivel de seguridad, con objetivos específicos y contenidos para esta comunidad. Se evaluaron los aspectos de seguridad, se determinaron los perfiles de riesgo con el software ASeC, y se realizó un análisis de sensibilidad en la comunidad Mantilla. Se efectuó un estudio comparativo entre los resultados del análisis de sensibilidad para la comunidad de Mantilla y la de Pogolotti-Finlay-Belén mediante diagrama de Venn. Resultados: Los resultados por aspectos de seguridad en la comunidad de Mantilla fueron evaluados de negativos y no mostraron diferencias significativas con los obtenidos en la comunidad de Pogolotti-Finlay-Belén. Conclusiones: La identificación de los focos de peligro en la comunidad Mantilla resultó crítica. Ambas comunidades no demostraron la capacidad funcional para enfrentar una emergencia y desconocen las acciones y consecuencias que tiene para la población y el medio ambiente los accidentes con productos químicos peligrosos(AU)

Introduction: Responsible management of hazardous chemical products has direct relation with the knowledge, comprehension and perception of the risk that the individuals involved have. Objective: To evaluate the safety level in the management of hazardous chemical products in Mantilla community, Havana, Cuba and compare it with the assessment performed in Pogolotti-Finlay-Belén community of the same province, from 2013 to 2015. Methods: Exploratory-descriptive research conducted in Mantilla community, Arroyo Naranjo municipality, Havana, Cuba in 2016, over a population of 1338 systematic practitioners in the handling of hazardous chemical products. The sample was of 200 people; and it was non-probabilistically and intentionally selected. An exhaustive checklist was prepared for applying the safety level assessment method with specific objectives and contents for the community. The safety aspects were assessed, the risk profile was determined by using ASeC software, and a sensitivity analysis for Mantilla community was performed. A comparison of the sensitivity analysis results was also carried out for both Mantilla and Pogolotti-Finlay-Belén communities using the Venn diagram. Results: The results by safety aspects of Mantilla community were assessed with negative values. When compared them with the results obtained on a previous research in the Pogolotti-Finlay-Belén community, some irrelevant differences where obtained. Conclusions: The hazard focus identification in Mantilla community became critical. Both communities didn't show functional capability for facing an emergency, and they didn't know what actions and consequences could have an accident related to hazardous chemical products in the population and the environment(AU)