Biomass-fuelled improved cookstove intervention to prevent household air pollution in Northwest Ethiopia: a cluster randomized controlled trial

BACKGROUND@#Household air pollution from biomass fuels burning in traditional cookstoves currently appeared as one of the most serious threats to public health with a recent burden estimate of 2.6 million premature deaths every year worldwide, ranking highest among environmental risk factors and one of the major risk factors of any type globally. Improved cookstove interventions have been widely practiced as potential solutions. However, studies on the effect of improved cookstove interventions are limited and heterogeneous which suggested the need for further research.@*METHODS@#A cluster randomized controlled trial study was conducted to assess the effect of biomass-fuelled improved cookstove intervention on the concentration of household air pollution compared with the continuation of an open burning traditional cookstove. A total of 36 clusters were randomly allocated to both arms at a 1:1 ratio, and improved cookstove intervention was delivered to all households allocated into the treatment arm. All households in the included clusters were biomass fuel users and relatively homogenous in terms of basic socio-demographic and cooking-related characteristics. Household air pollution was determined by measuring the concentration of indoor fine particulate, and the effect of the intervention was estimated using the Generalized Estimating Equation.@*RESULTS@#A total of 2031 household was enrolled in the study across 36 randomly selected clusters in both arms, among which data were obtained from a total of 1977 households for at least one follow-up visit which establishes the intention-to-treat population dataset for analysis. The improved cookstove intervention significantly reduces the concentration of household air pollution by about 343 μg/m@*CONCLUSIONS@#The biomass-fuelled improved cookstove intervention significantly reduces the concentration of household air pollution compared to the traditional method. This suggests that the implementation of these cookstove technologies may be necessary to achieve household air pollution exposure reductions.@*TRIAL REGISTRATION@#The trial project was retrospectively registered on August 2, 2018, at the clinical trials.gov registry database ( https://clinicaltrials.gov/ ) with the NCT03612362 registration identifier number.

Environmental factors involved in SARS-CoV-2 transmission: effect and role of indoor environmental quality in the strategy for COVID-19 infection control

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a new zoonotic agent that emerged in December 2019, causes coronavirus disease 2019 (COVID-19). This infection can be spread by asymptomatic, presymptomatic, and symptomatic carriers. SARS-CoV-2 spreads primarily via respiratory droplets during close person-to-person contact in a closed space, especially a building. This article summarizes the environmental factors involved in SARS-CoV-2 transmission, including a strategy to prevent SARS-CoV-2 transmission in a building environment. SARS-CoV-2 can persist on surfaces of fomites for at least 3 days depending on the conditions. If SARS-CoV-2 is aerosolized intentionally, it is stable for at least several hours. SARS-CoV-2 is inactivated rapidly on surfaces with sunlight. Close-contact aerosol transmission through smaller aerosolized particles is likely to be combined with respiratory droplets and contact transmission in a confined, crowded, and poorly ventilated indoor environment, as suggested by some cluster cases. Although evidence of the effect of aerosol transmission is limited and uncertainty remains, adequate preventive measures to control indoor environmental quality are required, based on a precautionary approach, because COVID-19 has caused serious global damages to public health, community, and the social economy. The expert panel for COVID-19 in Japan has focused on the "3 Cs," namely, "closed spaces with poor ventilation," "crowded spaces with many people," and "close contact." In addition, the Ministry of Health, Labour and Welfare of Japan has been recommending adequate ventilation in all closed spaces in accordance with the existing standards of the Law for Maintenance of Sanitation in Buildings as one of the initial political actions to prevent the spread of COVID-19. However, specific standards for indoor environmental quality control have not been recommended and many scientific uncertainties remain regarding the infection dynamics and mode of SARS-CoV-2 transmission in closed indoor spaces. Further research and evaluation are required regarding the effect and role of indoor environmental quality control, especially ventilation.

Contaminantes biológicos del aire interior de la vivienda: factores contribuyentes, afecciones relacionadas y medidas correctivas / Biological indoor air pollutants at home: contributing factors, related diseases and corrective actions

La contaminación biológica del aire interior de las viviendas y locales de uso público constituye una importante causa de morbilidad y malestar frecuente, la que puede interactuar con los efectos de los contaminantes químicos y con los cuales a menudo comparten causas comunes. Los principales contaminantes biológicos incluyen los mohos, el exoesqueleto y heces de ácaros del polvo, cucarachas y otros insectos, la caspa de la piel y el pelo de animales como las mascotas, todos los cuales pueden actuar como alergenos, bacterias como las Legionellas, virus y otros agentes capaces de producir enfermedades infecciosas. Las fuentes y factores contribuyentes incluyen la humedad generada por filtraciones en instalaciones hidráulicas, elevada humedad relativa, ventilación natural e insolación deficientes, inadecuado control técnico de los componentes de sistemas de climatización mecánica, la limpieza deficiente y el hacinamiento. Las medidas de prevención y corrección incluyen la eliminación de las fuentes de humedad y la reducción de la misma, optimización de la ventilación natural y la insolación, correcto mantenimiento de los sistemas de ventilación mecánica, garantizando una adecuada tasa de recambio de aire, limpieza de alfombras con dispositivos de alta eficiencia de remoción de partículas y lavado frecuente del mobiliario y las cortinas (o remoción de éstas si dificultan la ventilación natural)(AU)

Biological indoor air pollution in households and public places is an important cause of morbidity and discomfort. It may interact with chemical pollution, with which it often shares common sources. The main biological pollutants are moulds, exoskeletons and feces of dust acari, cockroaches and other insects, skin flakes, and hair from pets, all of which may act as allergens, bacteria such as Legionella, viruses and other infection disease agents. Contributing sources and factors include the dampness created by leaks in the plumbing, high relative humidity, poor natural ventilation or insolation, inadequate technical control of components of air conditioning equipment, deficient cleaning, and crowding. Prevention and correction measures include the reduction of humidity and elimination of its sources, optimization of natural ventilation and insolation, appropriate maintenance of mechanical ventilation systems ensuring an adequate rate of air renewal, cleaning of carpets with highly efficient particle removal devices, and frequent washing of the furniture and curtains (or removal of the latter if they obstruct natural ventilation)(AU)

Effect of 0.12% chlorhexidine in reducing microorganisms found in aerosol used for dental prophylaxis of patients submitted to fixed orthodontic treatment

OBJECTIVE: This study aimed at assessing, in vivo, whether the prior use of 0.12% chlorhexidine as mouthwash would decrease air contamination caused by aerosolized sodium bicarbonate during dental prophylaxis. The study was conducted with 23 patients aged between 10 and 40 years old who were randomly selected and undergoing fixed orthodontic treatment. METHODS: The study was divided into two phases (T1 and T2) with a 30-day interval in between. In both phases, dental prophylaxis was performed with aerosolized sodium bicarbonate jetted to the upper and lower arches for 4 minutes. In T1, 10 minutes before the prophylaxis procedure, the participants used distilled water as mouthwash for one minute; whereas in T2, mouthwash was performed with 0.12% chlorhexidine. Microbial samples were collected in BHI agar plates for microbiological analysis. Two dishes were positioned on the clinician (10 cm from the mouth) and a third one at 15 cm from the patient's mouth. The samples were incubated for 48 hours at 37°C. Results were expressed in colony-forming units (CFU). RESULTS: Statistical analysis carried out by means of Student's t test, as well as Wilconxon and Kruskal-Wallis tests revealed that the prior use of 0.12% chlorhexidine as mouthwash significantly reduced CFU in the three positions studied (P < 0.001). CONCLUSION: The prior use of 0.12% chlorhexidine as mouthwash significantly reduced contamination caused by aerosolized sodium bicarbonate during dental prophylaxis in the orthodontic clinic. .

OBJETIVO: avaliar, in vivo, se a utilização prévia do bochecho com clorexidina a 0,12% diminui a contaminação do ar gerada pelo jato de bicarbonato de sódio durante a profilaxia dentária. O estudo foi realizado com 23 pacientes, na faixa etária entre 10 e 40 anos, escolhidos aleatoriamente, que faziam uso de aparelho ortodôntico fixo. MÉTODOS: o estudo foi dividido em duas fases (T1 e T2), com intervalo de 30 dias entre elas. Em ambas, foi realizada profilaxia dentária com jato de bicarbonato de sódio na arcada superior e inferior, durante quatro minutos. Em T1, 10 minutos antes do procedimento, os participantes realizaram bochecho com água destilada durante um minuto, e, em T2, o bochecho foi realizado com clorexidina a 0,12%. Amostras dos microrganismos foram coletadas em placas de ágar BHI para análise microbiológica, sendo duas placas posicionadas no profissional (a 10cm da boca) e uma terceira a 15cm da boca do paciente. Após a coleta, as placas foram incubadas por 48 horas a 37°C. O resultado foi expresso em número de unidades formadoras de colônias (UFC). RESULTADOS: após análise estatística utilizando teste t de Student, teste de Wilconxon e teste de Kruskal-Wallis, observou-se que o bochecho prévio com clorexidina a 0,12% reduziu significativamente a média de UFC nas três posições estudadas (p < 0,001). CONCLUSÃO: os resultados permitem concluir que o bochecho prévio com clorexidina a 0,12% proporcionou uma redução estatisticamente significativa na contaminação gerada por meio do jato de bicarbonato de sódio durante a profilaxia dentária na clínica ortodôntica. .

Promotion and use of improved cook stoves in the conservation of biomass resources and biomass briquettes from solid wastes in the Gambia

In regions where biomass is a traditional fuel for cooking, improved cook-stoves can enhance indoor air quality, personal health, livelihoods, and the environment-while substantially reducing greenhouse gas [GHG] emissions. Although ongoing efforts have successfully disseminated improved stoves that achieve many of these benefits, substantially greater emissions reductions are needed to comply with international guidelines for indoor air quality and to limit GHG emissions like black carbon. Today, an estimated 2.5 billion people, or about one-third of the world's population, rely on biomass fuel for cooking. According to the World Health Organization [WHO], exposure to smoke from these open fires and cook-stoves leads to pneumonia, chronic respiratory disease, and lung cancer-causing an estimated 1.6 million deaths each yean. In the developing world, the disease burden from indoor smoke is comparable to the burdens from malaria, tuberculosis, HIV/AIDS. Improved cook-stoves with reduced emissions and greater fuel efficiency can achieve the following:- Reduce disease and save lives by decreasing exposure to indoor air pollution [IAP]. - Reduce the risk of violence against women and children gathering fuel in conflict areas.- Reduce the time and cost of procuring fuel, thereby freeing individuals for other productive activities.- Empower women and communities via engagement in the production, use, and distribution of cook stoves.- Mitigate climate change by reducing greenhouse gas [GHG] emissions, including black carbon [BC].- Reduce pressure on forests and other vegetation and facilitate sustainable harvesting of biomass fuels

Informing effective smokefree policies in Argentina: air quality monitoring study in 15 cities (2007-2009) / Políticas efectivas de ambientes libres de humo de tabaco en Argentina: estudio de monitoreo de calidad del aire en 15 ciudades (2007-2009)

Objective. To evaluate indoor air pollution in hospitality venues in Argentina. Material and Methods. PM2.5 levels were measured in a convenience sample of venues in 15 cities with different legislative contexts following a protocol developed by Roswell Park Cancer Institute. Results. 554 samples were collected. Across all 5 smokefree cities the mean PM2.5 level was lower during daytime vs. evening hours, 24 vs. 98 PM2.5 respectively (p=.012). In the three cities evaluated before and after legislation, PM2.5 levels decreased dramatically (p<0.001 each). Overall, PM2.5 levels were 5 times higher in cities with no legislation vs. smokefree cities (p<0.001). In cities with designated smoking areas, PM2.5 levels were not statistically different between smoking and non-smoking areas (p=0.272). Non-smoking areas had significantly higher PM2.5 levels compared to 100 percent smokefree venues in the same city (twofold higher) (p=0.017). Conclusions. Most of the participating cities in this study had significantly lower PM2.5 levels after the implementation of 100 percent smokefree legislation. Hence, it represents a useful tool to promote 100 percent smokefree policies in Argentina.

Objetivo. Evaluar la polución ambiental del sector gastronómico en Argentina. Material y métodos. Se midieron los niveles de partículas respirables (PM2.5) en una muestra por conveniencia de establecimientos de 15 ciudades con diferente legislación, siguiendo un protocolo del Instituto de Cáncer Roswell Park. Resultados. Se recolectaron 554 muestras. En cinco ciudades libres de humo (CLH) la media de PM2.5 durante el día fue baja y menor a la observada durante la noche, 24 vs. 98 PM2.5 respectivamente (p=.012). En las tres ciudades evaluadas antes y después de la legislación, las PM2.5 disminuyeron drásticamente (p<0.001 cada una). Las PM2.5 fueron cinco veces mayores en ciudades sin legislación comparadas con CLH (p<0.001). En ciudades con restricción parcial, no hubo diferencia significativa entre las PM2.5 en el sector fumador y no fumador (p=0.272). Los sectores no fumadores tuvieron niveles PM2.5 significativamente más altos comparados con los lugares 100 por ciento libres de humo de la misma ciudad (p= 0.017). Conclusiones. La mayoría de las ciudades participantes en este estudio tuvieron niveles PM2.5 significativamente más bajos tras la implementación de leyes pro ambientes 100 por ciento libres de humo de tabaco, por lo que representa una herramienta útil para promover legislación 100 por ciento libre de humo en Argentina.

Diversidade da exposição alergênica: implicações na obtenção da eficácia do controle ambiental: [revisão] / Diversity of allergen exposure: implications for the efficacy of environmental control: [review]

As doenças alérgicas, como a asma, rinite, conjuntivite alérgica e a dermatite atópica têm apresentado um aumento na sua prevalência nas últimas décadas. A relação entre exposição alergênica, sensibilização atópica e desenvolvimento de doenças alérgicas são amplamente descrita na literatura. OBJETIVO: Discutir a dificuldade no controle ambiental da exposição alergênica como parte do tratamento das doenças alérgicas. MÉTODOS: Analisar trabalhos de exposição alergênica realizados com metodologia similar na região central do Brasil, incluindo casas, hotéis, cinemas, carros, táxis, ônibus e transporte escolar. RESULTADOS: Níveis elevados dos alérgenos do grupo 1 de Dermatophagoides pteronyssinus (Der p 1) e de D. farinae (Der f 1), capazes de causar sensibilização e exacerbação de sintomas foram encontrados na maioria dos ambientes estudados em uma larga proporção das amostras, enquanto os alérgenos de animais domésticos atingiram maiores níveis em carros e veículos de transporte escolar. CONCLUSÃO: A diversidade da exposição alergênica mostra a necessidade de uma compreensão da doença alérgica pelos pacientes e familiares, e que as medidas de controle do ambiente doméstico fazem parte de uma estratégia global do tratamento das doenças alérgicas, uma vez que os indivíduos vivem em uma sociedade e não isoladas no interior de seus domicílios.

The prevalence of allergic diseases such as asthma, rhinitis, allergic conjunctivitis and atopic dermatitis has increased in the last decades. The relationship between allergen exposure, atopic sensitization and development of allergic diseases is widely described in the literature. AIM: To evaluate measures for reducing allergen exposure as part of the treatment of allergic diseases. METHODS: An analysis was made of previous studies on allergen exposure done with a similar methodology in the central region of Brazil; the study included homes, hotels, cinemas, cars, taxis, buses and scholar transportation. RESULTS: High levels of Der p 1 and Der f 1 mite allergens were found in a large proportion of the sample in most of the environments included in those studies; there were higher levels of pet allergens in cars and school transportation vehicles. CONCLUSION: The diversity of allergen exposure demonstrates the need for education about allergic diseases for patients and their families, as well as measures of reducing allergens in homes. This should be part of a global strategy of the management of allergic diseases, given that individuals live in society, not only in their houses.

Prevención de accidentes por inhalación de monóxido de carbono en edificios: una intervención comunitaria / Accidents prevention for inhalation of carbon monoxide in buildings. a community intervention

A partir de 2002 se implementó en la comuna de Providencia un proyecto de Prevención de Accidentes por Inhalación de Monóxido de Carbono en Edificios. Objetivos: Minimizar los riesgos de accidentes por inhalación de CO para los habitantes de su territorio; junto con informar y sensibilizar a la comunidad sobre la combustión segura de gas domiciliario, su normativa y la facilitación de las soluciones a los problemas detectados. Metodología: El proyecto se centró en la solución de problemas derivados de las deficiencias en la combustión de gas en edificios, a través de la capacitación de actores relevantes y coordinación entre organismos técnicos y proveedores de soluciones técnicas y financieras, para ayudar a las comunidades a satisfacer las regulaciones de seguridad para sus instalaciones de gas, de modo que pudieran obtener el sello verde, que otorga la Superintendencia de Electricidad y Combustibles (SEC). Resultados: La totalidad de las comunidades que se integraron al proyecto desde 2002 hasta 2008 sumaron 519 con 751 personas capacitadas, que contaron con apoyo en los aspectos técnicos y legales para lograr mejoras en sus sistemas de combustión hasta el logro del sello verde, color que caracteriza edificaciones con una combustión y ventilación seguras. Hasta el año 2008, el 46 por ciento de las comunidades integradas al proyecto habían obtenido sello verde, mientras un 13,2 por ciento regularizó la situación de inspecciones atrasadas o sin inspección. El 7,5 por ciento inició las reparaciones necesarias para ser reevaluado por la SEC. Por lo tanto 342 comunidades con 27.184 departamentos y 62.523 habitantes, que representan el 66,5 por ciento del total de residentes de edificios de la comuna; obtuvieron avances importantes en sus niveles de salud ambiental y seguridad en la combustión de gases al interior de los edificios.

A project of prevention and control of accidents by inhalation of carbon monoxide in buildings of the district of Providencia, Chile, was implemented since 2002 in order to minimize the risks for the inhabitants together with reporting and sensitizing to the community about the topics of combustion of domiciliary gas and their regulations and to help to find solutions to the detected problems. Methodology: The project focused on the solution of problems derived from building´s gas combustion systems deficiencies, by capacitation of relevant actors and acting as a clearing house by means of coordination between technical organisms and suppliers and financers of solutions, in order to help the communities to fulfil the safety regulations for their gas facilities so they could opt to obtain the green stamp that is given by the Superintendence of Electricity and Fuels(SEC). Outcomes: The number of communities that joined the project from 2002 until 2008 were 519, with more than 750 enabled persons. They received support about technical and legal aspects to achieve the green stamp that in Chile is given to buildings with safe ventilation and combustion systems. The project benefits spread to all the residents of the buildings subject to the intervention because until 2008, 46 percent of the communities that were integrated to the project had obtained the green stamp and 13,2 percent the situation of delayed inspections or absence of inspection had been regularized, with the SEC. In addition a 7,5 percent of communities started the improvements of their systems to be reassessed by the national authority (SEC). Therefore, 342 communities with 27.184 apartments and 62523 inhabitants who represented 66,5 percent of building residents of the district, obtained important advances in their levels of environmental health and safety in indoor gas combustion.

Costo efectividad del gas natural domiciliario como tecnología sanitaria en localidades rurales del Caribe Colombiano / The cost-effectiveness of installing natural gas as a sanitary alternative for rural communities on the Colombian Caribbean coast burning biomass fuels

Objetivo Valorar el impacto económico del Gas Natural Domiciliario -GND- como tecnología sanitaria sobre la enfermedad respiratoria asociada al humo de biomasa en localidades del caribe colombiano. Métodos Tres estudios combinados: a) carga de enfermedad respiratoria asociada al uso de combustibles de biomasa; b) costos de la enfermedad (Infección Respiratoria Aguda -IRA- y Enfermedad Pulmonar Obstructiva Crónica-EPOC); y c) análisis de costo efectividad del GND para reducir morbilidad por enfermedades respiratorias. Resultados En las localidades se esperarían anualmente 498 (477-560) casos de IRA que generaría 149 (119-196) hospitalizaciones, 6 (4-10) muertes y 7 291 (5 746 -9 696) AVAD. También se esperarían 459 (372-684) casos de EPOC, 138 (93- 239) hospitalizaciones, 11 (5-26) muertes y 1 500 (973-2 711) AVAD. Los costos de esta carga de enfermedad en ausencia del GND son anualmente de 5,2 (3,8-8,3) millones de dólares. De éstos, la mayoría son costos de EPOC (cerca del 85 por ciento). Los costos por IRA y EPOC, luego de instalado el GND, ascienden a 3,5 (2,5-5,7) millones de dólares. Los costos evitados serían 1,6 (1,2-2,6) millones de dólares, (30 por ciento de los costos de la carga). El costo efectividad incremental de introducir el GND sería un poco más de 56 (22-74) mil dólares por muerte evitada y entre 43 y 66 dólares evitar un AVAD. Conclusiones Frente a la no intervención, la instalación del GND resulta ser una tecnología costo efectiva para la reducción de las enfermedades respiratorias asociadas al consumo de combustibles de biomasa.

Objective Evaluating the economic impact of natural gas as a sanitary technology regarding respiratory disease associated with indoor air pollution in rural localities on the Colombian Caribbean coast. Methods Three studies were carried out: the burden of respiratory disease was evaluated (acute lower respiratory infection-ALRI and chronic obstructive pulmonary disease - COPD), disease costs were studied and the cost effectiveness of natural gas was analysed in terms of reducing indoor air pollution. Results Without natural gas in these localities, it would be expected that 498 (477-560) cases of ALRI per year would lead to 149 (119-196) hospitalisations, 6 (4-10) deaths and 7 291 (5,746-9,696) disability adjusted life years (DALY) annually. Furthermore, it is expected that 459 (372-684) cases of COPD per year would lead to 138 (93-239), hospitalisations, 11 deaths (5-26) and 1 500 (973-2 711) DALY annually. Annual disease burden cost was 5,2 (3,8-8,3) million dollars before installing domiciliary natural gas (DNG); most of such cost arose from COPD (around 85 percent). ARI and COPD costs after installing DNG would rise to 3,5 (2,5-5,7) million dollars; avoided costs would be 1,6 (1,2-2,6) million dollars, (30 percent of disease burden cost without DNG). The incremental cost-effectiveness (ICER) of installing DNG would be 56 (22-74) thousand dollars per life saved and ICER per DALY saved would be 43-66 dollars. Conclusion DNG is a sanitary technology which reduces the burden of indoor air pollution-associated respiratory diseases arising from burning biomass fuel in rural localities in a cost-effective way.

Secondhand smoke: facts and lies / Humo de segunda mano: hechos y mentiras

Mexico ratified the Framework Convention for Tobacco Control in 2004 and is obligated to move forward with implementing its provisions, including Article 8 (Protection from exposure to tobacco smoke). The country has already faced opposition from the tobacco industry. This paper addresses industry tactics against tobacco control, describing the general strategies that have been pursued and the evidence relevant to combating these strategies. The approaches taken by the industry in an effort to discredit the scientific foundation for promoting smokefree environments, the efforts by the industry to propose ventilation of indoor spaces and separation of smokers from nonsmokers as an effective alternative to smokefree places, and finally, the strategy of raising fear of economic losses on the part of the hospitality industry and thereby gaining this sector as an ally in campaigning against smokefree policies are considered. As reviewed in this article: 1) There is scientific consensus on the adverse effects of inhaling SHS; 2) Only smokefree places fully protect nonsmokers from inhaling SHS; and 3) Smokefree policies do not bring economic harm to the hospitality industry.

En 2004 México ratificó el Convenio Marco para el Control del Tabaco y está obligado a implementar sus disposiciones, incluidas el Artículo 8 (Protección contra la exposición al humo de tabaco); esto ha generado oposición de la industria tabacalera. En este artículo se describen las tácticas de la industria para contrarrestar el control del tabaco, sus principales estrategias, y también se presentan las evidencias relevantes para combatirlas. Además, se describen las acciones emprendidas por la industria en el esfuerzo por desacreditar el fundamento científico de la promoción de ambientes libres de humo de tabaco, y su propuesta de usar sistemas de ventilación en espacios interiores y la de separación de áreas para fumadores y no fumadores, como alternativas efectivas a la creación de ambientes libres de humo de tabaco. Por último, las tabacaleras también han creado temor a las perdidas económicas para la industria restaurantera, ello con el objetivo de hacer de este sector un aliado en la lucha contra las políticas de ambientes libres de humo de tabaco. Este artículo concluye que: 1) existe un consenso científico sobre los efectos adversos para la salud causado por la exposición al humo de tabaco; 2) los ambientes libres de humo de tabaco son la única forma de proteger a los no fumadores de la exposición a humo de tabaco; 3) las políticas de ambientes libres de humo de tabaco no afectan económicamente a la industria restaurantera.

Aeromicrobiota do ambiente cirúrgico: o que nos preocupa nos dias atuais ? / Air mirobiology of surgery environmen: what worries us about nowadays ?

O presente estudo, de natureza reflexiva, tem a meta primordial de desencadear questionamentos e sensibilizar os profissionais de saúde no que tange à aeromicrobiologia do ambiente climatizado artificialmente, sobretudo do Centro Cirúrgico. As autoras apresentam uma síntese de fatos relevantes, associados à contaminação biológica do ar em ambientes fechados e climatizados por meio de sistema de ar condicionado...

Smoky indoor cooking fires are associated with elevated hemoglobin concentration in iron-deficient women

OBJETIVO: La contaminación del ambiente doméstico por la combustión de materiales bioorgánicos utilizados como combustible, tales como la madera y los desechos agrícolas, está asociada con un mayor riesgo de padecer problemas respiratorios. Su efecto sobre otros aspectos de la salud, como el crecimiento fetal, no ha sido aún documentado adecuadamente. El objetivo del presente estudio, realizado en mujeres que utilizan combustible bioorgánico para cocinar en el interior de sus viviendas, fue determinar si el empleo de fuego "con humo" se asocia con una mayor concentración de hemoglobina en comparación con el uso de fogones "sin humo," es decir, cocinas diseñadas para reducir el nivel de contaminación del aire en el interior de las viviendas. Esta investigación es parte de una serie de estudios preliminares realizados para determinar la factibilidad y los posibles beneficios para la salud de una intervención aleatorizada dirigida a las cocinas, con el fin de reducir la contaminación del aire doméstico provocada por el empleo de combustibles bioorgánicos para cocinar. MÉTODOS: Entre marzo y agosto de 1994 se realizó un estudio observacional transversal en mujeres indígenas que utilizaban combustible bioorgánico y cocinaban en el interior de sus viviendas en comunidades rurales de las zonas montañosas de Guatemala. Se estudió a 89 mujeres que empleaban fogones sin humo (grupo no expuesto) y 185 mujeres de las mismas comunidades que empleaban fogones que generaban humo (grupo expuesto). Ninguna estaba embarazada. Se tomaron muestras de sangre venosa y se determinaron las concentraciones de hemoglobina y de ferritina. Mediante análisis de regresión lineal múltiple se investigó la relación entre la exposición (fogones sin humo o fogones con humo) y la concentración de hemoglobina, y se hicieron ajustes por posibles factores de confusión. RESULTADOS: No se encontró que la exposición al factor estudiado (fogones sin humo o con humo) tuviera algún efecto en la concentración de hemoglobina, ya fuera mediante análisis con una sola variable o con varias. Durante el análisis post hoc habitual para determinar si algún subgrupo particular presentaba elevación de la concentración de hemoglobina, se encontró que el empleo de fuego con humo para cocinar estaba asociado en grado significativo con la elevación de la concentración de hemoglobina en 5,2 g/L entre las mujeres con concentraciones bajas de ferritina (P < 0,10)...

Avaliaçäo de desinfetantes de uso geral quanto à emissäo de formaldeído / Assessment of general-purpose disinfectants with regards to the emission of formaldehyde

Objetivo. Avaliar desinfetantes de uso geral quanto à emissäo de formaldeído, um composto orgânico volátil (COV), altamente irritante e classificado no grupo 2A do IARC como provavelmente carcinogênico para humanos. Métodos. Após a seleçäo do formaldeido como o COV mais tóxico e comum da composiçäo de desinfetantes, através dos dados e informaçöes de rótulo e literatura, procedeu-se à determinaçäo da sua concentraçäo nos produtos, amostragem e mediçäo no ar e após a desinfeçäo de sanitários com produto puro, e analise da legislaçäo brasileira quanto à regulamentaçäo de produtos de limpeza bem como ao controle da Qualidade do Ar Interior. Resultados. O formaldeído foi identificado no 17 produtos coletados nas concentraçöes de 0,1 a 2.2por cento para 16 deles. Um desinfetante apresentou 7,5por cento p/p, resultando em 49mg/m3 no ar (25°C, 760mmHg), tendo sido necessário usar proteçäo respiratória. A concentraçäo no ar durante os 15 minutos inicias para o produto contendo 0,6por cento foi 0,47mg/m3, portanto acima do limite de exposiçäo médio de 0,37mg/m3 (ACGIH/EUA) e do nível de efeito näo observado (NOEL) de 0,25mg/m3 (IARC). Conclusöes. Desinfetantes de uso geral contendo formaldeído podem apresentar riscos à saúde. Recomenda-se retirar o formaldeído da lista de açäo antimicrobiana autorizadas da Portaria- MS N° 15/1988 compatibilizando-a com a Resoluçäo MS N° 176/2000 e definir limites de concentraçäo de COVs totais p/p por categoria de produto. Foi apresentada uma proposta para a criaçäo de um projeto de Prevençäo da Poluiçäo do Ar Interior de abrangência nacional.

Elección de la mejor alternativa de energía para calefacción intradomiciliaria: aplicabilidad de los métodos de decisión multicriterio en problemáticas ambientales / Selecting the most convenient energy alternative for heating system: applied judgement parameters for complex multicriteria environmental problems

Actualmente se sabe que la calidad del aire intradomiciliario puede ser un factor tanto o más importante que la contaminación exterior en términos de salud de la población, lo que se debe principalmente al uso de fuentes de energía altamente contaminantes. Problema que adquiere gran importancia en aquellas ciudades con clima frío y lluvioso en donde las personas permanecen preferentemente en lugares cerrados. Por lo tanto, la elección de una determinada alternativa energética para calefacción debe considerar variables cualitativas y cuantitativas tales como: el beneficio entregado, el costo y los potenciales riesgos en salud y medioambiente. Con el objetivo de integrar la mayoría de los criterios de decisión, definidos sobre la base de su importancia relativa, se aplicó a 10 usuarios (incluidos los autores) una moderna y flexible herramienta de análisis multicriterio usada en la toma de decisiones denominada Analytic Hierarchy Process (AHP). Las alternativas energéticas analizadas fueron: gas, parafina, leña CL (combustión lenta), Leña N (combustión normal), electricidad (sistema oleolítico) y carbón. El análisi del conjunto de los criterios muestra que la electricidad es la mejor alternativa (49 por ciento) seguida del gas (30 por ciento), ambos sistemas fueron significativamente mejores que los otros. este estudio sugiere que el uso de herramientas modernas aplicadas como apoyo en la toma de decisiones en gestión ambiental, permiten evaluar objetivamente un importante problema de salud pública