The implications of healthcare professionals wearing jewelry on patient care biosafety: observational insights and experimental approaches.

The use of jewelry among healthcare professionals poses a risk of cross contamination due to potential bacterial accumulation and spread. Through a mixed-method design, this study first analyzed the implications of healthcare professionals wearing jewelry on patient care biosafety as well as on the residual bacterial load of hands and rings after hand hygiene. Firstly, an observational prevalence study to verify whether nursing professionals wear personal accessories during healthcare assistance was carried out. Second, an experimental design involving intentional contamination and hygiene of the hands, with and without a ring, was conducted. The bacterial load of both hands and rings was measured by counting colony forming units. The observational study showed that nursing workers frequently wear jewelry during healthcare assistance. Nonetheless, the experimental study did not indicate differences in bacterial contamination between hands with and without a ring, despite the hand hygiene procedure applied. In conclusion, many nursing workers wear jewelry in the workplace. Although hands with and without a ring exhibited similar microbial load, rings appeared as a potential source of bacterial contamination, reinforcing the need to remove jewelry during working hours. Hand hygiene using alcohol, or soap and water significantly decreased the bacterial load on the participants' hands, with handwashing proving to be the most efficient method for removing intentional contamination.

Customizable Three-Dimensional Printed Earring Tap for Treating Affections Caused by Aesthetic Perforations.

This work aimed to develop a three-dimensional (3D) wearable drug-loaded earring tap to treat affections caused by aesthetic perforations. The initial phase involved a combination of polymers to prepare filaments for fused deposition modeling (FDM) 3D printing using a centroid mixture design. Optimized filament compositions were used in the second phase to produce 3D printed earring taps containing the anti-inflammatory naringenin. Next, samples were assessed via physicochemical assays followed by in vitro skin permeation studies with porcine ear skin. Two filament compositions were selected for the study's second phase: one to accelerate drug release and another with slow drug dissolution. Both filaments demonstrated chemical compatibility and amorphous behavior. The use of the polymer blend to enhance printability has been confirmed by rheological analysis. The 3D devices facilitated naringenin skin penetration, improving drug recovery from the skin's most superficial layer (3D device A) or inner layers (3D device B). Furthermore, the devices significantly decreased transdermal drug delivery compared to the control containing the free drug. Thus, the resulting systems are promising for producing 3D printed earring taps with topical drug delivery and reinforcing the feasibility of patient-centered drug administration through wearable devices.

Environmental assessment in fine jewelry in the U.S.-Mexico's Paso del Norte region: A qualitative study via X-ray fluorescence spectroscopy.

Heavy metal contamination in raw materials has spread widely in the United States. The high increased number of recalls in consumer products and the lack of stricter regulations in the raw materials to be used in the jewelry industry have raised concerns among consumers. Studies in low-cost jewelry have shown the presence and high content of heavy metals; this environmental problem led to a child's death after swallowing a charm containing elevated levels of lead (Pb). Exposure to heavy metals, through inhalation, mouth, and skin contact, causes adverse health effects in children and adults. Exposure to lead affects mainly the nervous system and brain development; exposure to cadmium (Cd) causes damage to liver, kidneys, and lungs, and potentially leads to cancer; exposure to nickel (Ni) causes severe dermatitis. Thus, the importance and impact of studies of this nature cannot be overstated. As heavy metal contamination has increased in the United States, this research fills an important knowledge gap between previous studies conducted on low-cost jewelry and fine jewelry. In this study, conducted in the Paso del Norte region, one hundred and forty-three pieces of fine jewelry were evaluated for the presence of heavy metals using X-ray fluorescence (XRF) spectroscopy. Our study showed that 61 samples (42.7 %) exhibited the presence of Ni in the metal alloy, prevailing in jewelry pieces with lower percentage of gold. Eighteen samples showed the presence of Pb in gemstones, 11 pieces of these samples (7.7 % total) had <33.3 % gold (≤10 K); however, none of the samples showed the presence of Pb in the metal alloy. Further research is needed to evaluate the bioaccessibility of Pb in these gemstones, which may pose a potential health hazard to children and adults in the US Paso del Norte region and throughout the world.

Implicações do uso de adornos por profissionais de saúde na biossegurança da assistência ao paciente / Implication of the use of adornments by health professionals in the biosafety of patient care

Introdução: as infecções relacionadas à assistência à saúde (IRAS) são consideradas um problema de saúde global, pois colocam em risco a segurança do paciente e a qualidade assistencial. Considera-se que a principal via de disseminação de microrganismos relacionados a IRAS ocorre pelas mãos dos trabalhadores de saúde, destacando-se a utilização de adornos por profissionais de saúde como um agravante no âmbito a disseminação de microrganismos. Estudos revelam que a utilização desses objetos, principalmente anéis e alianças, propiciam maior impacto na carga bacteriana nas mãos dos trabalhadores. A Norma Regulamentadora 32 (NR32) visa estabelecer as diretrizes básicas para a implementação de medidas de proteção à segurança e à saúde dos trabalhadores dos serviços de saúde, dentre essas medidas está a proibição do uso de adornos por profissionais de saúde que prestam cuidados aos pacientes, principalmente profissionais que mantem contato com materiais biológicos. Objetivos: Analisar o uso de adornos por profissionais de saúde e as suas implicações na carga bacteriana das mãos e anéis após a realização de técnicas de higienização das mãos com uso de preparação alcoólica em gel a 70% ou com água e sabonete líquido. Método: Trata-se de um estudo, realizado em duas etapas. Na primeira realizou-se um estudo observacional e de prevalência por meio de inquérito realizado via mídia social para determinar se o uso de adornos por profissionais de enfermagem no ambiente hospitalar relaciona-se as variáveis sociodemográficas e ocupacionais, e os motivos da não adesão a NR32 por esses profissionais. Na segunda etapa realizou-se um experimento microbiológico por meio de contaminação artificial das mãos e alianças com Lactobacilos casei e posteriormente o protocolo de higienização das mãos para verificar a carga bactéria encontrada nas mãos e anéis de profissionais e estudantes da área da saúde. Resultados: A utilização de adornos por profissionais de enfermagem é frequente, pincipalmente o uso de aliança, relógio e brincos. Embora a 85% dos participantes conheça as normativas da NR32 referentes a remoção de adornos para a realização das atividades laborais, 15% profissionais informaram desconhecimento total ou parcial dessa recomendação o que remete a necessidade de revisão das práticas formativas e do frequente oferecimento de capacitação em serviço/treinamento. Com relação os resultados do experimento sobre o uso de alianças por profissionais de saúde constataram-se que não houve diferença entre a contaminação bacteriana das mãos dos participantes com e sem aliança. Porém, verificou-se que entre os grupos que higienizaram as mãos com o uso de preparação alcoólica em gel a 70% ou com água e sabonete líquido houve redução na carga bacteriana das mãos quando comparados ao grupo controle, grupo que higienizou as mãos com água e sabonete líquido demonstrou uma redução ainda maior das Unidades Formadoras de Colônias (UFC) Conclusão: A utilização de adornos por profissionais da enfermagem ainda é fonte de preocupação para as instituições de saúde devido a frequência do uso desses objetos mesmo diante do desencorajamento de uso e das recomendações legais. Pode-se perceber que a falta de capacitação em serviço/treinamento e de cobrança para remoção dos adornos são fatores dificultadores nesse processo. No que diz respeito ao uso de aliança por profissionais de saúde durante o procedimento de higienização das mãos fica evidente as implicações do seu uso principalmente quando a higienização não é realizada por remoção mecânica da sujidade, como é o caso da higienização das mãos com preparação alcoólica em gel a 70%.

Introduction: healthcare-related infections (HAI) are considered a global health problem, as they put patient safety and quality of care at risk. It is considered that the main way of dissemination of microorganisms related to HAI occurs through the hands of health workers, highlighting the use of adornments by health professionals as an aggravating factor in the scope of the spread of microorganisms. Studies reveal that the use of these objects, especially rings and wedding rings, provide a greater impact on the bacterial load on workers' hands. Regulatory Standard 32 aims to establish the basic guidelines for the implementation of measures to protect the safety and health of workers in health services, among these measures is the prohibition of the use of adornments by health professionals who provide care to patients, especially professionals that maintains contact with biological materials. Objectives: To analyze the use of adornments by health professionals and its implications on the bacterial load on hands and rings after performing hand hygiene techniques with the use of an alcoholic preparation in gel at 70% or with water and liquid soap. Method: This is a carried out in two stages. In the first, an observational and prevalence study was carried out through a survey conducted via social media to determine whether the use of adornments by nursing professionals in the hospital environment is related to sociodemographic and occupational variables, and the reasons for non-adherence to NR32 by these professionals. In the second stage, a microbiological experiment was carried out through artificial contamination of the hands and alliances with Lactobacilli casei and later the hand hygiene protocol to verify the bacterial load found in the hands and rings of health professionals and students. Results: The use of adornments by nursing professionals is frequent, especially the use of wedding rings, watches and earrings. Although 85% of the participants are aware of the NR32 regulations regarding the removal of adornments for the performance of work activities, 15% professionals reported total or partial lack of knowledge of this recommendation, which points to the need to review training practices and the frequent offer of training in service/training. Regarding the results of the experiment on the use of rings by health professionals, it was found that there was no difference between bacterial contamination of the hands of participants with and without rings. However, it was found that among the groups that cleaned their hands using an alcoholic preparation in gel at 70% or with water and liquid soap, there was a reduction in the bacterial load on the hands when compared to the control group, a group that cleaned their hands with water and liquid soap showed an even greater reduction in Colony Forming Units (CFU). Conclusion: The use of adornments by nursing professionals is still a source of concern for health institutions due to the frequency of use of these objects even in the face of discouragement of use and of the legal recommendations. It can be seen that the lack of in-service training/training and charging for the removal of adornments are hindering factors in this process. With regard to the use of a wedding band by health professionals during the hand hygiene procedure, the implications of its use are evident, especially when the cleaning is not carried out by mechanical removal of dirt, as is the case of hand hygiene with alcoholic preparation in 70% gel

Oral exfoliative cytology and corrosion of metal piercings. Tissue implications.

OBJECTIVES: A group of adolescents with oral piercings was studied to determine the presence of metallic particles in cells exfoliated from the mucosa surrounding their metal oral piercings and the association between such particles and the metal jewelry, and to evaluate subsequent tissue implications. MATERIALS AND METHODS: Sixteen teenage patients who had tongue and/or lip piercings were included. The clinical features of the oral mucosa and lip skin were evaluated. Exfoliative cytology was performed in the area surrounding the piercing. The surface of used and unused jewelry was studied by scanning electron microscopy and energy dispersive X-ray analysis. RESULTS: Hyperplastic, leukoedematous, and lichenoid lesions were observed in the mucosa, as well as lesions associated with metallosis of the lip skin. Cytological smears showed the presence of particles inside the epithelial cells; the particles were found to contain aluminum, tungsten, and molybdenum. In one case requiring surgical removal of the piercing, histological examination of the tissue associated with the piece of jewelry showed the presence particles containing aluminum, iron, and tin inside multinucleated giant cells. Although surface finish defects were observed on both unused and used piercing jewelry, they were more evident on the used pieces. CONCLUSIONS: Ion particles are released from the metal piercings and could have been adjuvant factors in the development of the observed lesions. Cells exfoliated from the oral mucosa surrounding metal piercings may serve as bioindicators of corrosion processes. CLINICAL RELEVANCE: We propose the use of exfoliative cytology to monitor corrosion processes and for routine clinical follow up.

Os nós da rede para erradicação do trabalho infanto-juvenil na produção de joias e bijuterias em Limeira - SP / The knots of the child labor eradication network within the jewelry and costume jewelry production in Limeira, São Paulo, Brazil

INTRODUÇÃO: A cidade de Limeira, em São Paulo, abriga o maior polo de produção de joias e bijuterias do país caracterizado pela terceirização, destacando-se a exploração de trabalho infantil, em condições de nocividade para a saúde do trabalhador. Para enfrentar este problema, articulou-se uma rede intersetorial. OBJETIVO: descrever as ações da rede e destacar limites e potencialidades de seu processo de formação e consolidação. MÉTODOS: realizou-se estudo de caso, combinando a análise documental e a participação direta dos pesquisadores nas atividades no período de 2007 a 2011. RESULTADOS: analisaram-se aspectos culturais, ideológicos e institucionais que determinavam a situação e as ações que propiciaram mudanças. Coube destaque à construção do Termo de Ajustamento de Conduta, que assegurou a implantação de ações coordenadas, a realização de diversos eventos de sensibilização, a mobilização da população, a implantação do Programa de Saúde do Trabalhador e a criação de grupos de trabalho que discutem a temática constantemente com a finalidade de articular a rede intersetorial. CONCLUSÃO: a governança em rede propicia o estabelecimento de um processo de transformação cultural e institucional para o enfrentamento do trabalho infantil. É imprescindível realizar novas intervenções neste fluxo produtivo de modo a implicar o empresariado em um processo de mudança.

INTRODUCTION: The city of Limeira, in the state of São Paulo, Brazil, is the largest cluster of companies producing jewelry and costume jewelry in the country. It features outsourcing and child labor exploitation, bringing harm to workers' health. To address this problem an Inter-sectorial Network was organized. OBJECTIVE: Describe actions and highlight the limits and potentialities of the Network building and consolidation processes. METHODS: The authors conducted a case study, combining documental analysis, and researchers' direct participation in the activities carried out between 2007 and 2011. RESULTS: They analyzed the cultural, ideological and institutional aspects that determined the situation as well as the actions that produced changes. An important action was the settlement of an agreement called "Termo de Ajustamento de Conduta" (Conduct Adjusting Terms), which ensured implementing the coordinated actions and the Occupational Health Program, organizing events to raise awareness and mobilize the population, as well as working groups with permanent discussions aiming at articulating the Network. CONCLUSION: The Network has encouraged an ongoing process of cultural and institutional transformation to deal with child labor. However, it is crucial that new contributions are offered to involve the entrepreneurs in this process of change.