ABSTRACT
The occurrence of emerging organic micropollutants (OMPs) in sewage sludge has been widely reported; nevertheless, their fate during sludge treatment remains unclear. The objective of this work was to study the fate of OMPs during mesophilic and thermophilic anaerobic digestion (AD), the most common processes used for sludge stabilization, by using raw sewage sludge without spiking OMPs. Moreover, the results of analytical chemistry were complemented with biological assays in order to verify the possible adverse effects (estrogenic and genotoxic) on the environment and human health in view of an agricultural (re)use of digested sludge. Musk fragrances (AHTN, HHCB), ibuprofen (IBP) and triclosan (TCS) were the most abundant compounds detected in sewage sludge. In general, the efficiency of the AD process was not dependent on operational parameters but compound-specific: some OMPs were highly biotransformed (e.g. sulfamethoxazole and naproxen), while others were only slightly affected (e.g. IBP and TCS) or even unaltered (e.g. AHTN and HHCB). The MCF-7 assay evidenced that estrogenicity removal was driven by temperature. The Ames test did not show point mutation in Salmonella typhimurium while the Comet test exhibited a genotoxic effect on human leukocytes attenuated by AD. This study highlights the importance of combining chemical analysis and biological activities in order to establish appropriate operational strategies for a safer disposal of sewage sludge. Actually, it was demonstrated that temperature has an insignificant effect on the disappearance of the parent compounds while it is crucial to decrease estrogenicity.
Subject(s)
Sewage/chemistry , Waste Disposal, Fluid , Anaerobiosis , Humans , Perfume , Sulfamethoxazole , TemperatureABSTRACT
OBJECTIVES: To determine the prevalence of the health problems included in a multidimensional geriatric assessment (MGA) protocol and to compare them with the problems detected in the clinical histories (CH) of the population consulting at a primary care centre (PCC). DESIGN: Cross-sectional observational. SETTING: Urban PCC (metropolitan area of Barcelona). PATIENTS: Users > or = 65 of a PCC between 01/11/97 and 31/01/98. MEASUREMENTS AND MAIN RESULTS: A random sample of 114 people was chosen. The MGA protocol was used to screen disorders in: hearing, vision, mobility, affective state, cognitive state, social support, functionalism of the instrumental activities of daily life. The clinical histories provided age, sex and information previously recorded on these disorders. 102 people were surveyed (participation: 89.5%). The MGA enabled more problems to be detected, with the difference very marked in some cases such as visual disorders: 55.9% (46.2-65.5) with MGA and 23.5% (15.3-31.8) with CH. There was poor concordance between MGA and CH. For example, neither the 73.3% (54.1-87.7) of the hearing disorders detected with the MGA, nor 94.1% (71.3-99.8) of the cognitive deterioration detected with the MGA had been previously recorded in the CH. CONCLUSIONS: MGA detects more health problems than are normally recorded in primary care clinical histories, which makes this technique relevant to PC consultations with the elderly. However, it would be advisable to identify the population for whom there was better diagnostic performance.
Subject(s)
Geriatric Assessment , Aged , Cross-Sectional Studies , Female , Humans , Male , Medical Records , Prevalence , Primary Health CareABSTRACT
Objetivo. Determinar la prevalencia de los problemas de salud incluidos en un protocolo de valoración geriátrica multidimensional (VGM) y compararlos con los detectados en la historia clínica (HCAP) en población consultante de un centro de atención primaria (CAP). Diseño. Observacional transversal. Emplazamiento: CAP urbano (área metropolitana de Barcelona). Pacientes. Usuarios >= 65 años de un CAP entre 01-XI-1997 y el 31-I-1998. Mediciones y resultados principales. Se seleccionó una muestra aleatoria de 114 individuos. Se cribó con el protocolo VGM las alteraciones en: audición; visión; movilidad; estado afectivo; estado cognitivo; soporte social; funcionalismo de las actividades instrumentales de la vida diaria (AIVD). De la HCAP se recogió: edad, sexo e información previamente registrada sobre estas alteraciones. Se encuestaron 102 sujetos (participación, 89,5 por ciento). La VGM aporta más capacidad de detección de problemas, siendo la diferencia muy acentuada en algún caso, como en las alteraciones visuales, 55,9 por ciento (46,2-65,5) con VGM y 23,5 por ciento (15,3-31,8) con HCAP. La concordancia entre la VGM y la HCAP es baja. Así, por ejemplo, ni el 73,3 por ciento (54,1-87,7) de las alteraciones auditivas detectadas con la VGM ni el 94,1 por ciento (71,3-99,8) de los deterioros cognitivos habían sido registrados previamente en la HCAP. Conclusiones. La VGM detecta prevalencias de problemas de salud superiores al registro habitual de la HCAP, por lo que parece interesante utilizar esta técnica en las consultas de atención primaria a la población anciana. Sin embargo, sería recomendable identificar la población en la que el rendimiento diagnóstico fuera superior (AU)
Subject(s)
Aged , Male , Female , Humans , Geriatric Assessment , Prevalence , Primary Health Care , Cross-Sectional Studies , Medical RecordsABSTRACT
OBJECTIVES: To find the sociodemographic characteristics of patients registered at a Health Centre (HC) who attended a hospital Casualty Department, their reasons for attendance, features of their use of facilities and how justified their attendance was. DESIGN: Descriptive study. SETTING: Urban Health Centre, Llefià (Badalona), between February and June, 1995. PARTICIPANTS: We used a questionnaire composed by the research team to survey 360 patients over 14 who attended the HC with a report from a Casualty Department. MEASUREMENTS AND RESULTS: The variables recorded were: sociodemographic characteristics, reasons for attending Casualty, whether they attended on their own initiative, whether they knew about non-hospital Emergencies, the hospital, day and time, chronic pathology, diagnosis and destination on discharge from Casualty, length of stay and justification. 53.7% were women. 57.8% were married. 95% lived with a partner or intimate family member, 56.9% had completed primary education and 39.4% had jobs. 41% suffered a chronic pathology. Monday was the busiest day and physical trauma was the most frequent diagnosis on discharge. We considered 54.7% of all the consultations non-justified emergencies. CONCLUSIONS: There is a high percentage of users who attend Casualty on their own initiative. Most of the emergencies are unjustified.
