Risco ambiental provocado por resíduos de medicamentos na cidade do Rio de Janeiro, Brasil, durante a pandemia por SARS-Cov19 / Environmental risk caused by drug waste in the city of Rio de Janeiro, Brazil, during the SARS-Cov19 pandemic

Resumo Foi avaliada a relação entre a distribuição de medicamentos usados na pandemia por SARS-COV-19 no município do Rio de Janeiro e o nível de risco ambiental estimado provocado por seus resíduos. Foi coletada a quantidade de medicamentos distribuídos pelas unidades de atenção primária à saúde (APS) entre 2019 e 2021. O quociente de risco (QR) correspondeu à razão entre a concentração ambiental preditiva estimada (PECest), obtida pelo consumo e excreção de cada fármaco, e a sua concentração preditiva não efetiva (PNEC). Os PECest da azitromicina e da ivermectina aumentaram entre 2019 e 2020, tendo uma queda em 2021 provavelmente devido ao desabastecimento. Já o da dexclorfeniramina (DEX) e da fluoxetina (FLU) tiveram uma queda, retornando o crescimento em 2021. Enquanto o PECest do diazepam (DIA) aumentou ao longo desses três anos, o etinilestradiol (EE2) diminuiu, possivelmente pela priorização da APS no tratamento da COVID-19. Os maiores QR foram de FLU, EE2 e AZI. O padrão de consumo desses medicamentos não refletiu seu risco ambiental, pois os mais consumidos possuem baixa toxicidade. Vale destacar que alguns dados podem estar subestimados devido ao incentivo que foi dado durante a pandemia para o consumo de determinados grupos de fármacos.

Abstract The relationship between the distribution of medicines used in the Pandemic by SARS-COV-19 in the municipality of Rio de Janeiro and the estimated level of environmental risk caused by their residues was evaluated. The amount of medicines distributed by primary health care (PHC) units between 2019 and 2021 were collected. The risk quotient (RQ) corresponded to the ratio between the estimated predictive environmental concentration (PECest) obtained by the consumption and excretion of each drug and its non-effective predictive concentration (PNEC). Between 2019 and 2020, the PECest of azithromycin (AZI) and ivermectin (IVE) increased between 2019 and 2020, with a decrease in 2021 probably due to shortages. Dexchlorpheniramine (DEX) and fluoxetine (FLU) fell, returning to growth in 2021. While the PECest of diazepam (DIA) increased over these 3 years, ethinylestradiol (EE2) decreased possibly due to the prioritization of PHC in the treatment of COVID-19. The largest QR were from FLU, EE2 and AZI. The consumption pattern of these drugs did not reflect their environmental risk because the most consumed ones have low toxicity. It is worth noting that some data may be underestimated due to the incentive given during the pandemic to the consumption of certain groups of drugs.

Agregación familiar para cardiopatía isquémica

RESUMEN Fundamento: la cardiopatía isquémica es una entidad nosológica de origen multifactorial con predisposición genética y susceptible a cambios ambientales. Objetivo: determinar la existencia de agregación familiar para cardiopatía isquémica en pacientes atendidos en consulta de cardiología en el Hospital General Docente Vladimir Ilich Lenin de Holguín. Métodos: se realizó un estudio observacional, analítico de casos y controles (estudio de agregación familiar). La muestra quedó conformada por 60 nuevos pacientes con el diagnóstico de cardiopatía isquémica (casos) y por otros 60 pacientes sin diagnóstico de enfermedad coronaria (controles), pareadas en la razón 1:1. Se emplearon como variables: sexo, edad, antecedentes familiares de cardiopatía isquémica y factores de riesgo ambientales. Se utilizó el estadígrafo Chi cuadrado. Luego se calculó el Odds Ratio para conocer la magnitud de asociación mediante la razón de productos cruzados. Resultados: en el grupo casos existió una mayor frecuencia en el antecedente familiar para cardiopatía isquémica, fue más elevada para los familiares de primer grado con 31 familiares y un 41,3 %. La hiperlipidemia se presentó como el factor de riesgo de mayor frecuencia con 36,7 % en el grupo casos y 37,1 % en el grupo controles. Se determinó un riesgo aproximadamente 4 veces mayor de padecer cardiopatía isquémica en aquellos individuos con historia familiar positiva de primer grado, mientras que los pacientes con hiperlipidemia tienen 4,8 más riesgo de padecer cardiopatía isquémica. Conclusiones: existe agregación familiar para cardiopatía isquémica y se mostró un riesgo mayor de enfermar los pacientes con historia familiar positiva para la enfermedad, principalmente con familiares de primer grado y con hiperlipidemia.

ABSTRACT Background: ischemic heart disease is a nosological entity of multifactorial origin with genetic predisposition and susceptible to environmental changes. Objective: to determine the existence of familial aggregation for ischemic heart disease in patients seen in the cardiology clinic at the Vladimir Ilich Lenin General Teaching Hospital in Holguín. Methods: an analytical observational study of cases and controls (family aggregation study) was carried out. The sample was made up of 60 new patients with a diagnosis of ischemic heart disease (cases) and another 60 patients without a diagnosis of coronary heart disease (controls), paired in a 1:1 ratio. The following variables were used: sex, age, family history of ischemic heart disease and environmental risk factors: smoking, hyperlipidemia, high blood pressure and sedentary lifestyle. The Chi square statistician was used by the Mantel-Haenszel method. The odds ratio (OR) was then calculated to determine the magnitude of association through the ratio of cross products. Results: in the case group there was a higher frequency in the family history for ischemic heart disease, being higher for first degree relatives with 31 relatives and 41.3 %. Hyperlipidemia was the most frequent risk factor with 36.7 % in the case group and 37.1 % in the control group. An approximately 4-fold increased risk of suffering from ischemic heart disease was determined in those individuals with a positive first-degree family history, while patients with hyperlipidemia have a 4.8 times greater risk of suffering from ischemic heart disease. Conclusions: there is family aggregation for ischemic heart disease and a higher risk of getting sick was shown in patients with a positive family history for the disease, mainly with first-degree relatives and with hyperlipidemia.

Factores sociales y ambientales relacionados con el asma bronquial en niños de los consultorios 1 y 2 de Caonao, Cienfuegos

RESUMEN Fundamento el asma bronquial es un importante problema de salud y causa frecuente de morbimortalidad. En su génesis influyen factores humanos, sociales, ambientales y económicos. Objetivo: identificar factores sociales y ambientales relacionados con la severidad del asma bronquial en niños, atendiendo a sus características clínicas y demográficas. Métodos se realizó un estudio descriptivo de corte transversal en 46 niños con asma bronquial pertenecientes a los consultorios médicos 1 y 2 del policlínico Área VIII de Cienfuegos, durante el período de noviembre 2019 a mayo de 2020. Se utilizaron variables sociales y demográficas. Resultados: predominó el sexo masculino; las edades entre 13-16 y 17-19 años fueron las más afectadas, en ambos grupos con antecedentes familiares de asma. Estuvieron expuestos al hábito de fumar de familiares 31 infantes y se relacionó con las crisis moderadas persistentes. La mayoría de los niños necesitó tratamiento farmacológico. Predominó el hacinamiento que influyó en la aparición de infecciones respiratorias. Prevalecieron las familias moderadamente funcionales, hubo un predominio de las viviendas clasificadas de regulares. Conclusiones: existe relación directa entre la severidad de las manifestaciones clínicas del asma y los factores de riesgo que las condicionan. Se requiere de un trabajo educativo sistemático para su prevención.

ABSTRACT Background: bronchial asthma is an important health problem and a frequent cause of morbidity and mortality. Human, social, environmental and economic factors influence its genesis. Objective: to identify social and environmental factors related to the severity of bronchial asthma in children, based on their clinical and demographic characteristics. Methods: a descriptive cross-sectional study was carried out in 46 children with bronchial asthma belonging to medical offices 1 and 2 of the Area VIII polyclinic in Cienfuegos, from November 2019 to May 2020. Social and demographic variables were used. Results: the male sex predominated; ages between 13-16 and 17-19 years old were the most affected, in both groups with a family history of asthma. 31 infants were exposed to the smoking habit of family members and it was related to persistent moderate crises. Most of the children required pharmacological treatment. Overcrowding prevailed, which influenced the appearance of respiratory infections. Moderately functional families prevailed, there was a predominance of dwellings classified as regular. Conclusions: bronchial asthma requires systematic educational work for its prevention. There is a direct relationship between the severity of the clinical manifestations and the risk factors that condition it.

Caracterización geográfica de la exposición a fluoruros en Colombia, mediante uso de fuentes de información de vigilancia en salud pública, durante 2012 ­ 2018 / Geographic characterization of fluorides exposure in Colombia, using public health surveillance information sources, during 2012 ­ 2018

Objetivo: caracterizar geográficamente, en territorio colombiano, las fuentes de agua potable y los índices colectivos de fluorosis dental que indican exposición a fluoruro a nivel comunitario. Métodos: se realizó un estudio descriptivo a partir de dos fuentes de información: el Subsistema de Información de Vigilancia de Calidad de Agua Potable (SIVICAP) y el Sistema de Vigilancia en Salud Pública (Sivigila). Los análisis se realizaron desde 2012 hasta 2018, implementando ponderación de los riesgos por exposición a fluoruro en agua para determinar los siguientes niveles de riesgo: sin riesgo, riesgo para fluorosis dental y riesgo para fluorosis esquelética. Se cálculo el índice colectivo de fluorosis (ICF) dental y se presentaron los resultados en mapas geográficos. Resultados: los departamentos de Nariño, Boyacá, Quindío, Valle del Cauca y Cundinamarca presentaron el mayor número de muestras de agua analizadas (60,5 %); 14 presentaron concentraciones superiores a 4 ppm y 10 municipios concentraciones entre 1,01 y 4 ppm. La vigilancia centinela de la exposición a flúor mostró que 3 municipios presentaron ICF >3, lo que significa un riesgo muy grave. En cuanto al riesgo grave se encontraron 52 municipios de 21 departamentos, principalmente en la región Andina y Caribe. Nariño fue el departamento con mayor número de municipios en riesgo grave. Conclusiones: se identificaron riesgos ambientales en agua, y biológicos por altos índices colectivos de fluorosis dental, que, espacialmente, se ubican en la región Andina, aunque los riesgos en agua se pueden explicar porque en esta región se realiza con mayor frecuencia vigilancia de calidad del agua.

Objective: To geographically characterize in colombian territory, drinking water sources and the collective indices of dental fluorosis which indicate fluoride exposure at the community level. Methods: A descriptive study was carried out from two sources of information: the drinking water quality surveillance information subsystem (SIVICAP) and the public health surveillance system (Sivigila). The analyzes were performed from 2012 to 2018, weighting the risks for exposure to fluoride in water, to determine the following risk levels: no risk, dental fluorosis risk and risk for skeletal fluorosis. The collective dental fluorosis index (ICF) was calculated, the results were represented on geographical maps. Results: the departments of Nariño, Boyacá, Quindío, Valle del Cauca and Cundinamarca presented the highest number of water samples (60.5%). 14 municipalities had concentrations above 4 ppm, and 10 municipalities had concentrations between 1.01 and 4 ppm. Sentinel surveillance of fluoride exposure showed that three municipalities presented ICF> 3, meaning a very serious risk. Regarding serious risk, 52 municipalities from 21 departments were found, mainly in the Andean and Caribbean region. Nariño was the department with the highest number of municipalities at serious risk. Conclusions: environmental risks in water and biological risks were identified due to high collective indices of dental fluorosis, which are spatially located in the Andean region. The risks in water can be explained because in this region water quality surveillance is carried out more frequently.

Intensidade de ruídos e conscientização da equipe de enfermagem no centro de materiais e esterilização / Noise intensity and raising awareness of the nursing team at the Materials and Sterilization Center / Intensidad de ruido y conciencia del personal de enfermería del Centro de Materiales y Esterilización

Objetivo: Identificar a intensidade sonora, por meio de decibéis (dB), no Centro de Material e Esterilização (CME) e orientar os colaboradores quanto à importância dos protetores auriculares como equipamento de proteção individual (EPI). Método: Trata-se de um estudo descritivo, do tipo relato de experiência. Utilizou-se o aplicativo Sound Meter para medir a intensidade de ruído no CME. A pesquisa foi realizada em hospital de grande porte de São Paulo, no período de uma semana, em 2018. Resultados: Os ruídos mais intensos foram mensurados no expurgo (93,0 dB), na área de preparo (92,3 dB), nas áreas de esterilização a baixa temperatura (91,6 dB) e a vapor (87,9 dB), diferentemente da percepção dos colaboradores. A conscientização da equipe deu-se por exposição dos resultados mensurados e discussão sobre importância do EPI. Conclusão: Verificaram-se ruídos mais intensos nas áreas de trabalho com maior número de maquinários, e houve divergência entre a intensidade do ruído mensurado e o percebido pelo profissional. Medidas educativas reflexivas são necessárias para a conscientização sobre a importância e adesão ao uso do EPI.

Objective: To identify the sound intensity, through decibels (dB), in the Materials and Sterilization Center (MSC) and to guide employees on the importance of ear protectors as personal protective equipment (PPE). Method: This is a descriptive and case report study. Sound Meter application was used to measure noise intensity in the MSC. Research was carried out in a large hospital in São Paulo City, for one week, in 2018. Results: The most intense noises were measured in the purge (93.0 dB), in the preparation area (92.3 dB), in sterilization areas at low temperature (91.6 dB), and steam sterilization (87.9 dB) different from the perception of collaborators. The team's awareness was based on the exposure of the measured results and discussion about the importance of PPE. Conclusion: There were more intense noises in the work areas with a higher number of machinery, and there was a divergence between the intensity of noise measured and that perceived by the professional. Reflective educational measures are needed to raise awareness about the importance of adhering to PPE.

Objetivo: Identificar la intensidad sonora, mediante decibeles (dB), en el Centro de Material y Esterilización (CME) y orientar a los empleados sobre la importancia de los protectores auditivos como equipo de protección personal (EPP). Método: Se trata de un estudio descriptivo, del tipo informe de caso, La aplicación Sound Meter fue utilizada para medir la intensidad del ruido en el CME. La investigación se llevó a cabo en un gran hospital de São Paulo, durante una semana, en 2018. Resultados: Los ruidos más fuertes se midieron en la purga (93,0 dB), em el área de preparación (92,3 dB), en las áreas de esterilización a baja temperatura (91,6 dB) y vapor (87,9 dB), diferente a la percepción de los empleados. El equipo tomó conciencia al exponer los resultados medidos y discutir la importancia del EPI. Conclusión: Hubo ruido más intenso en las áreas de trabajo con mayor número de máquinas y hubo divergencia entre la intensidad del ruido medido y el percibido por el profesional. Las medidas educativas reflexivas son necesarias para sensibilizar sobre la importancia y adherencia al uso del EPI.

Agregación familiar en individuos con hipertensión arterial esencial y factores de riesgo / Family Aggregation in Individuals with Essential Arterial Hypertension and Risk Factors

RESUMEN Fundamento: la hipertensión arterial es la elevación constante de las cifras de tensión arterial con un origen poligénico y mutifactorial. Es la hipertensión arterial una enfermedad de alta incidencia y prevalencia a nivel mundial. Objetivo: demostrar la agregación familiar para hipertensión arterial esencial y factores de riesgo en individuos afectados. Método: se realizó una investigación observacional, analítica, longitudinal y retrospectiva, de caso/ control a partir de la consulta de referencia para enfermedades crónicas no transmisibles en Banes, provincia Holguín durante el período octubre 2019 marzo 2020. El universo abarcó la totalidad de individuos diagnosticados y sus familias. Por muestreo aleatorio simple, se obtuvo la muestra de 91 casos. Se conformó el grupo control a razón de 3:1 que incluyó 273 individuos. Fueron cumplidos los requisitos bioéticos. Se aplicaron criterios de inclusión/exclusión. Fueron utilizados los estadígrafos: Chi cuadrado, Odd Ratio (OR), incluidos p e intervalo de confianza. Se operacionalizaron las variables: edad, sexo, grado de consanguinidad y factores de riesgo. Se obtuvo el árbol genealógico. Resultados: los grupos de edades 56-65 años y 66 años y más, resultaron los más afectados. Predominó el sexo masculino (53,9 %). Los familiares de primer y segundo grado de consanguinidad mostraron la mayor incidencia de la enfermedad. Se encontró asociación entre la enfermedad y el antecedente familiar de esta (X2=321,4), con un riesgo incrementado para los familiares de los casos respecto a los controles (OR=10,93). Los factores de riesgo predominantes fueron: tabaquismo (OR=2,18) y el antecedente familiar de enfermedad (OR=0,74). Se demostró la asociación de factores de riesgo con la enfermedad (X2=176,9). Conclusiones: la hipertensión arterial esencial es una enfermedad multifactorial, compleja y poligénica con agregación familiar demostrada.

ABSTRACT Background: arterial hypertension is the constant elevation of blood pressure figures with a polygenic and multifactorial origin. Hypertension is a disease of high incidence and prevalence worldwide. Objective: to demonstrate the familial aggregation for essential arterial hypertension and risk factors in affected individuals. Method: an observational, analytical, longitudinal and retrospective case / control investigation was carried out from the reference consultation for chronic non-communicable diseases in Banes, Holguín province during the period from October 2019 to March 2020. The universe covered all individuals diagnosed and their families. By simple random sampling, the sample of 91 cases was obtained. The control group was formed at a ratio of 3:1 which included 273 individuals. Bioethical requirements were met. Inclusion / exclusion criteria were applied. The following statistics were used: Chi square, Odd Ratio (OR), including p and confidence interval. The variables were operationalized: age, sex, degree of consanguinity, and risk factors. The genealogical tree was obtained. Results: the age groups 56-65 years and 66 years and over, were the most affected. The male sex predominated (53.9 %). First and second-degree relatives of consanguinity showed the highest incidence of the disease. An association was found between the disease and its family history (X2 = 321.4) with an increased risk for relatives of the cases compared to the controls (OR = 10.93). The predominant risk factors were: smoking (OR = 2.18) and family history of disease (OR = 0.74). The association of risk factors with the disease was demonstrated (X2 = 176.9). Conclusions: essential arterial hypertension is a multifactorial, complex and polygenic disease with demonstrated familial aggregation.

Agregación familiar y factores de riesgo de cáncer de mama en individuos afectados / Family Aggregation and Risk Factors for Breast Cancer in Affected Individuals

RESUMEN Fundamento el cáncer de mama es una enfermedad sistémica, multifactorial, polimorfa que se desarrolla en mujeres sin antecedentes familiares de la enfermedad. La posibilidad de herencia familiar se describe en 15-20 % de los casos. Objetivo: determinar la agregación familiar para cáncer de mama y los factores de riesgo asociados a este padecimiento. Método: se realizó un estudio analítico, retrospectivo, tipo caso y control, a partir de individuos que acudieron a la consulta municipal de riesgo genético, ubicada en el Policlínico Universitario César Fornet Frutos del municipio Banes, provincia Holguín en el período julio-diciembre de 2019 con el objetivo de comprobar la existencia o no de agregación familiar del cáncer de mama. Por muestreo aleatorio simple, se obtuvo la muestra conformada por 47 casos y 141 controles. Las variables operacionalizadas fueron: antecedentes personales y familiares de enfermedad oncológica, edad, menarquia, edad a la menopausia, ingestión de píldora anticonceptiva, edad de nacimiento de primer hijo, lactancia materna, ingestión de alcohol, hábito de fumar, historia familiar. Se aplicó un cuestionario diseñado a los fines del estudio. El cálculo de Chi cuadrado y Odds Ratio permitieron estimar asociación entre variables y la magnitud de asociación. Resultados: predominó el grupo de edad de 60-69 años. Los factores de riesgo hábito de fumar (OR=4,1), la ingestión de píldora anticonceptiva (OR=3,1), y el alcohol (OR=2,8) presentaron la mayor asociación a la enfermedad. Se propuso una estrategia de asesoramiento genético a partir de los resultados. Conclusiones: la confluencia de factores genéticos y ambientales, determina la agregación familiar del cáncer de mama.

ABSTRACT Foundation: breast cancer is a systemic, multifactorial, polymorphic disease that develops in women with no family history of the disease. The possibility of family inheritance is described in 15-20 % of cases. Objective: to determine the family aggregation for breast cancer and the risk factors associated with this disease. Method: an analytical, retrospective, case-control type study was carried out, from individuals who attended the municipal genetic risk consultation located at the César Fornet Frutos University Polyclinic, Banes municipality, Holguín province in the period July-December 2019 aimed at verifying the existence or not of family aggregation of breast cancer. By simple random sampling, the sample consisting of 47 cases and 141 controls was obtained. The sample, consisting of 47 cases and 141 controls, was obtained by simple random sampling. The variables were: personal and family history of oncological disease, age, menarche, age at menopause, contraceptive pill ingestion, first child age of birth, breastfeeding, alcohol intake, smoking, family history. A questionnaire designed for the purposes of the study was applied. The Chi square calculation and Odds Ratio allowed estimating association between variables and the magnitude of association. Results: the age group of 60-69 years prevailed. The risk factors for smoking (OR = 4.1), ingestion of the contraceptive pill (OR = 3.1), and alcohol (OR = 2.8) had the highest association with the disease. A genetic counseling strategy was proposed based on the results. Conclusions: confluence of genetic and environmental factors determines family aggregation of breast cancer.

The Brazilian version of the Home Falls and Accidents Screening Tool (HOME FAST): translation, cross-cultural adaptation, validation and reliability / Versão brasileira do Home Falls and Accidents Screening Tool (HOME FAST): tradução, adaptação transcultural, validação e confiabilidade

Abstract Objective: to translate and cross-culturally adapt the Home Falls and Accidents Screening Tool - HOME FAST into Brazilian Portuguese and to evaluate its construct validity and intra-and inter-rater reliability. Method: a cross-sectional study was carried out that included older people aged 60 years or older. Translation and cross-cultural adaptation were carried out in the following stages: 1. Translation, 2. Synthesis, 3. Back translation, 4. Expert panel (review and pre-final version), 5. Pre-testing, 6. Analysis by the expert panel and the final version of the instrument. The Berg Balance Scale - BBS was used to test construct validity (Spearman correlation coefficient). Additionally, intra-and inter-rater reliability analysis was conducted using the Intraclass Correlation Coefficient (ICC) and the Bland-Altman plot. Results were considered significant at p<0.05. Results: the HOME FAST-Brazil was applied to 53 older people with a mean age of 71(5) years; 79% (42) of whom were female and 21% (11) of whom were male. The translation and cross-cultural adaptation process resulted in similar versions among translations. The correlation of the total score of HOME FAST-Brazil with the BBS was ρ=-0.241, p=0.041. The reliability rate was ICC=0.99 and 0.92 (intra-and inter-rater, respectively). Conclusion: The HOME FAST-Brazil, translated and cross-culturally adapted to Brazilian Portuguese, was shown to have construct validity and excellent intra-and inter-rater reliability.

Resumo Objetivo: traduzir e adaptar transculturalmente o Home Falls and Accidents Screening Tool - HOME FAST para o português brasileiro e avaliar sua validade de construto e confiabilidade intra e inter avaliador. Método: Trata-se de um estudo transversal que incluiu idosos com idade igual ou superior a 60 anos. O processo para a tradução e adaptação transcultural seguiu as etapas: 1. Tradução, 2. Síntese, 3. Retrotradução, 4. Comitê de especialistas (revisão e versão pré-final), 5. Pré-teste, 6. Análise pelo comitê de especialistas e versão final do instrumento. A Escala de Equilíbrio de Berg - EEB foi usada para testar a validade de construto (Coeficiente de Correlação de Spearman). Adicionalmente, para análise da confiabilidade intra e inter avaliador foi utilizado o Coeficiente de Correlação Intraclasse (CCI) e o diagrama de Bland-Altman. Os resultados foram considerados significativos quando p<0,05. Resultados: O HOME FAST-Brasil foi aplicado em 53 idosos com média de idade de 71(5) anos, sendo 79% (42) mulheres e 21% (11) homens. O processo de tradução e adaptação transcultural resultou em versões similares entre as traduções. A correlação entre a pontuação total do HOME FAST-Brasil com a EEB foi ρ=-0,241, p=0,041. Os valores dos testes de confiabilidade foram CCI=0,99 e 0,92 (intra e inter avaliador, respectivamente). Conclusão: O HOME FAST-Brasil, traduzido e adaptado transculturalmente para o português brasileiro, apresentou validade de construto e excelente confiabilidade inter e intra-avaliador.

The HOME FAST BRAZIL self-report version: translation and transcultural adaptation into Brazilian Portuguese

Abstract Objective: To translate and cross-culturally adapt the Home Falls and Accidents Screening Tool Self-report Into Brazilian Portuguese and to correlate with the history of falls. Methods: The translation and transcultural adaptation process followed international parameters. The Home Falls and Accidents Screening Tool Brazil Self-report, the Mini-Mental State Examination and the history of falls were applied to 10 elderly in the pre-test and to 41 in the final. Demographic and anthropometric data were also evaluated. Spearman correlation coefficient was performed. Results: The participants considered the questionnaire easy to understand and did not report any doubts to answer the final version. There was significant correlation between: Home Falls and Accidents Screening Tool Brazil Self-report score and number of falls (p = 0.31, p = 0.02) and the lighting and bathroom domains with presence of falls at home (p = 0.44, p = 0.00 and p = 0.33, p = 0.02, respectively). The questionnaire indicated fall's risk scoring, 10(±2). Conclusion: The Home Falls and Accidents Screening Tool Brazil Self-report showed to be comprehensible and feasible tool for self-assessment of domiciliary falls risk in Brazilian older people. The scores indicated fall's risk and were associated with the history of falls.(AU)

Possible radioprotective effect of folic acid supplementation on low dose ionizing radiation-induced genomic instability in vitro.

Ionizing radiation (IR) induces DNA damage through production of single and double-strand breaks and reactive oxygen species (ROS). Folic acid (FA) prevents radiation-induced DNA damage by modification of DNA synthesis and/or repair and as a radical scavenger. We hypothesized that in vitro supplementation with FA will decrease the sensitivity of cells to genetic damage induced by low dose of ionizing radiation. Annexin V, comet and micronucleus assays were performed in cultured CHO cells. After 7 days of pre-treatment with 0, 100, 200 or 300 nM FA, cultures were exposed to radiation (100 mSv). Two un-irradiated controls were executed (0 and 100 nM FA). Data were statistically analyzed with X2-test and linear regression analysis (P 0.05). We observed a significantly decreased frequency of apoptotic cells with the increasing FA concentration (P <0.05). The same trend was observed when analyzing DNA damage and chromosomal instability (P <0.05 for 300 nM). Only micronuclei frequencies showed significant differences for linear regression analysis (R2=94.04; P <0.01). Our results have demonstrated the radioprotective effect of folic acid supplementation on low dose ionizing radiation-induced genomic instability in vitro; folate status should be taken into account when studying the effect of low dose radiation in environmental or occupational exposure.

Existing test data for the Act on Registration & Evaluation, etc. of Chemical Substances

OBJECTIVES: In this study, the possibility of using existing test data provided in Korea and elsewhere for the registration of chemical substances was examined. Data on 510 chemical substances that are among the first subject to registration under the “Act on the Registration and Evaluation, etc. of Chemical Substances (K-REACH)” were analyzed. METHODS: The possibility of using existing data from 16 reference databases was examined for 510 chemical substances notified in July 2015 as being subject to registration. RESULTS: Test data with the reliability required for the registration of chemical substances under the K-REACH constituted 48.4% of the required physicochemical characteristics, 6.5% of the required health hazards, and 9.4% of the required environmental hazards. CONCLUSIONS: Some existing test data were not within the scope of this research, including data used for registration in the European Union (EU). Thus, considering that 350 of these 510 species are registered in EU Registration, Evaluation, Authorisation & Restriction of Chemicals, more test data may exist that can be utilized in addition to the data identified in this study. Furthermore, the K-REACH states that non-testing data (test results predicted through Read Across, Quantitative Structure- Activity Relationships) and the weight of evidence (test results predicted based on test data with low reliability) can also be utilized for registration data. Therefore, if methods for using such data were actively reviewed, it would be possible to reduce the cost of securing test data required for the registration of chemical substances.

Existing test data for the Act on Registration & Evaluation, etc. of Chemical Substances

OBJECTIVES: In this study, the possibility of using existing test data provided in Korea and elsewhere for the registration of chemical substances was examined. Data on 510 chemical substances that are among the first subject to registration under the “Act on the Registration and Evaluation, etc. of Chemical Substances (K-REACH)” were analyzed. METHODS: The possibility of using existing data from 16 reference databases was examined for 510 chemical substances notified in July 2015 as being subject to registration. RESULTS: Test data with the reliability required for the registration of chemical substances under the K-REACH constituted 48.4% of the required physicochemical characteristics, 6.5% of the required health hazards, and 9.4% of the required environmental hazards. CONCLUSIONS: Some existing test data were not within the scope of this research, including data used for registration in the European Union (EU). Thus, considering that 350 of these 510 species are registered in EU Registration, Evaluation, Authorisation & Restriction of Chemicals, more test data may exist that can be utilized in addition to the data identified in this study. Furthermore, the K-REACH states that non-testing data (test results predicted through Read Across, Quantitative Structure- Activity Relationships) and the weight of evidence (test results predicted based on test data with low reliability) can also be utilized for registration data. Therefore, if methods for using such data were actively reviewed, it would be possible to reduce the cost of securing test data required for the registration of chemical substances.

Bamboo flowering and its impact on the Adis of Upper Siang District of Arunachal Pradesh, India.

Bamboo flowering is always associated with rise of rodent population and ultimately famine. Bamboo flowering not only causes famine, it also deprive people from getting bamboo raw materials for daily use as well as for commercial purpose. The present paper is an attempt to highlight the impact of bamboo flowering on the Adis (a tribe of Arunachal Pradesh), of Upper Siang district, Arunachal Pradesh, India. It focuses on the impact of bamboo flowering and how the local people are dealing with this problems. It also highlights the consequences of bamboo flowering.

Risk factors and safety measures in the operation room

Hospital personnel are subject to various occupational hazards. Along with the development of modern medicine, novel and diverse medical appliances have been introduced to enhance the safety of the hospital environment. But paradoxically, some advancement of the appliances have led to exposure to greater risk for the personnel in the operation room. In the past, the greatest risk factor in the operation room was outbreak of fire and explosion, but the risk of explosion has vanished by the development of nonexplosive anesthetics. However, newly introduced electrical appliances and unknown infectious diseases appear to be new risk factors affecting health workers in the operation room. The goal of this review is to investigate the current risk factors and thereby prepare suitable preventive methods. We have reviewed the main occupational hazards affecting health workers in the operation room: accidents such as fires, explosions, electrical accidents; exposure to residual anesthetic gas; radiation; various infections; drug dependencies.

Legal regulations of medical waste management / 中华医院管理杂志

Medical wastes are highly risky as infectious substances or hazardous chemical substances, if out of control, will cause serious environmental pollution and spread of diseases, directly jeopardizing human health. In consideration of such hazards of medical wastes, Chinese laws have made strict regulations on their management, which however fall short in terms of their rigorousness. In the era to build a resource-saving and environment-friendly society, it is imperative to establish and improve an effective mechanism for the regulation of medical wastes, to further improve China's legal system of medical waste management and to upgrade the law enforcement on it.

Hebei Spirit oil spill exposure and acute neuropsychiatric effects on residents participating in clean-up work / 한국역학회지

OBJECTIVES: Hebei Spirit oil spill accident has brought about the worst coastal oil contamination in Korean history. Following the accident, residents and volunteers, number exceeding a million from nationwide, were exposed to chemicals from the crude oil itself and dispersants, including volatility organic compounds (VOCs), polycyclic aromatic hydrocarbons (PAHs), and heavy metals through the clean-up works over months. This study was undertaken to investigate the effect of clean-up work on the peripheral nerve function and psychologic status of the residents after a prolonged exposure to clean-up work after the oil spill exposure. METHODS: We performed a study on the residents of Jango-do Island, Chungnam, on 5 and 12 January 2008, six to eight weeks after the accident. A questionnaire on general characteristics, Korean Beck Depression Inventory (K-BDI), color vision test (Lanthony desaturated D-15 test), and vibration perception threshold test were done. Among 210 residents with 30 years or older, 63 (30%) finished questionnaires and completed at least one among K-BDI, color vision test, or vibration perception threshold test. Descriptive statistics was done on the residents. RESULTS: The residents participated in clean-up work for average 20 days, max 30 days, during 6 weeks following the accident. Average work hours were 7.4 hours per day, max 10 hours. On K-BDI, 21 (33.3%) had a severe depressive state. Mean color confusion index was 1.29 in the right and 1.20 in the left. Mean vibration perception threshold was 3.69 VU (right) and 3.55 VU (left), respectively. DISCUSSIONS AND CONCLUSIONS: Compared to literature report, the residents had higher depression scale. Color vision threshold was not higher compared to general population near an industrial complex. Vibration perception threshold was significantly higher than the residents of similar age living near an abandoned mine in southern coastal area only in the age group of forties. These suggests there is some evidence of neuropsychiatric effect related to oil cleaning work and a mid- and long-term study of the oil exposure health effects with continuous monitoring should be done for the exposed residents in the affected area.