[Advanced practice nurses in geriatric traumatology : A scoping review]. / Advanced Practice Nurses in der Alterstraumatologie : Ein Scoping-Review.

BACKGROUND: Older and very old persons have an increased risk of traumatic injuries as well as comorbidities and multimorbidities. The standardized workflow in hospitals can increase the occurrence of typical geriatric complications, such as challenging behavior and delirium, which can result in highly complex care situations. The application of advanced practice nurses (APN) is an international response to such challenges. In Germany, the scientifically based development of APN has so far lagged behind the international standard. METHOD: For this scoping review, a systematic search in the databases PubMed and CINAHL and a supplementary hand search was conducted for the period 2010-2022. RESULTS: Tasks and role profiles for the scope of practice of APN in geriatrics and traumatology already exist in the literature. There is a lack of scientifically proven tasks and role profiles for APN in geriatric traumatology in the literature. DISCUSSION: Based on the current state of research it is not yet possible to derive specific tasks and role profiles for APN in geriatric traumatology. The transferability of tasks and profiles from geriatrics and traumatology seem to be possible. The development of tasks and role profiles for geriatric traumatology APN requires further research, especially to identify the specific needs of geriatric traumatology patients.

Air quality in indoor go-kart facilities in Germany.

Indoor go-kart driving and viewing is enjoyed by people of all ages. However, it may pose health hazards, especially for children, pregnant women, cardiovascular patients, and elderly individuals. Depending on the race length, for example, high concentrations of various contaminants may result in severe health problems. Therefore, this project investigated the Indoor Air Quality of eight indoor go-kart facilities. In general, karts that used regular fuel produced the highest concentrations of CO, benzene, TVOC, and BaP, with maximum levels up to 150 mg/m3 , 170 µg/m3 , 2690 µg/m3 , and 8.7 ng/m3 , respectively. As expected, the maximum CO concentrations at go-kart facilities that used liquid gas and electric karts (20 and <6 mg/m3 , respectively) were significantly lower than those at other facilities. The highest 95th percentile values for NO (2680 µg/m3 ) and NO2 (280 µg/m3 ) were measured for karts with liquid gas. The alkane, alkene, and cycloalkane groups, as well as benzene and the alkyl benzenes, were the predominant components of the measured TVOCs. Overall, owners of indoor go-kart tracks should ensure that the ventilation with regard to combustion products is optimally adapted in any case to reduce the levels of critical air pollutants.

[Electronic Shiazo waterpipes: a new source of indoor air pollutants]. / Elektrische Shiazo-Wasserpfeifen: eine neue Quelle für Innenraumluftschadstoffe.

BACKGROUND: For some time, a new form of waterpipe smoking has been advertised, where steam stones moistened with aroma fluids (Shiazo) are heated electronically. Since there is no combustion of tobacco, it is often assumed that the produced vapor is not harmful to health. To clarify this issue, we performed a comprehensive inner and outer exposure assessment during the use of an electronic Shiazo waterpipe. METHODS: Three volunteers smoked an electronic waterpipe operated with nicotine-free Shiazo stones in a thoroughly ventilated room for 2 h. In three smoking sessions, three fluids with different flavorings were vaporized. In parallel, emissions of particles, volatile organic compounds, polycyclic aromatic hydrocarbons (PAH), and metals were measured in indoor air. Within a biomonitoring study, urinary metabolite profiles of air pollutants were checked. For comparison, the components of the Shiazo fluids were also analyzed. RESULTS: During the smoking sessions, concentrations of formaldehyde, acetaldehyde, glycerine, and propylene glycol rose significantly in the indoor environment. The content of putative carcinogenic PAH in indoor air increased by 42% to 174 ng/m3. Particle number concentrations ranged from 39,968 to 65,610 particles/cm3 (median), with peaks at diameters from 25 to 31 nm. 3­HPMA, the mercapturic acid metabolite of the pyrolysis product acrolein, was strongly elevated in urine samples of the smokers. All fluids contained high amounts of contact allergens. CONCLUSIONS: Electronic Shiazo waterpipes release various harmful substances that considerably impact indoor air quality. Compared to conventional waterpipes, the release of pollutants is lower. Nevertheless, smoking with Shiazo waterpipes is a source of health risks for both users and bystanders.

Use of electronic cigarettes (e-cigarettes) impairs indoor air quality and increases FeNO levels of e-cigarette consumers.

Despite the recent popularity of e-cigarettes, to date only limited data is available on their safety for both users and secondhand smokers. The present study reports a comprehensive inner and outer exposure assessment of e-cigarette emissions in terms of particulate matter (PM), particle number concentrations (PNC), volatile organic compounds (VOC), polycyclic aromatic hydrocarbons (PAH), carbonyls, and metals. In six vaping sessions nine volunteers consumed e-cigarettes with and without nicotine in a thoroughly ventilated room for two hours. We analyzed the levels of e-cigarette pollutants in indoor air and monitored effects on FeNO release and urinary metabolite profile of the subjects. For comparison, the components of the e-cigarette solutions (liquids) were additionally analyzed. During the vaping sessions substantial amounts of 1,2-propanediol, glycerine and nicotine were found in the gas-phase, as well as high concentrations of PM2.5 (mean 197 µg/m(3)). The concentration of putative carcinogenic PAH in indoor air increased by 20% to 147 ng/m(3), and aluminum showed a 2.4-fold increase. PNC ranged from 48,620 to 88,386 particles/cm(3) (median), with peaks at diameters 24-36 nm. FeNO increased in 7 of 9 individuals. The nicotine content of the liquids varied and was 1.2-fold higher than claimed by the manufacturer. Our data confirm that e-cigarettes are not emission-free and their pollutants could be of health concern for users and secondhand smokers. In particular, ultrafine particles formed from supersaturated 1,2-propanediol vapor can be deposited in the lung, and aerosolized nicotine seems capable of increasing the release of the inflammatory signaling molecule NO upon inhalation. In view of consumer safety, e-cigarettes and nicotine liquids should be officially regulated and labeled with appropriate warnings of potential health effects, particularly of toxicity risk in children.

Indoor air contamination during a waterpipe (narghile) smoking session.

The smoke of waterpipe contains numerous substances of health concern, but people mistakenly believe that this smoking method is less harmful and addictive than cigarettes. An experiment was performed in a 57 m3 room on two dates with no smoking on the first date and waterpipe smoking for 4h on the second date. We measured volatile organic compounds (VOC), polycyclic aromatic hydrocarbons (PAH), metals, carbon monoxide (CO), nitrogen oxides (e.g. NO), as well as particle mass (PM), particle number concentration (PNC) and particle surface area in indoor air. High concentrations were observed for the target analytes during the 4-h smoking event. The median (90th percentile) values of PM(2.5), PNC, CO and NO were 393 (737 microg/m(3)), 289,000 (550,000 particles/cm(3)), 51 (65 ppm) and 0.11 (0.13 ppm), respectively. The particle size distribution has a maximum of particles relating to a diameter of 17 nm. The seven carcinogenic PAH were found to be a factor 2.6 higher during the smoking session compared to the control day. In conclusion, the observed indoor air contamination of different harmful substances during a WP session is high, and exposure may pose a health risk for smokers but in particular for non-smokers who are exposed to ETS.

Exposure to environmental tobacco smoke in German restaurants, pubs and discotheques.

In contrast to other countries, there is an on-going debate but still no smoke-free legislation in Germany. Exposure to environmental tobacco smoke (ETS) in hospitality venues is assumed to be high, but air quality data are lacking. Therefore, the aim of our study was to perform a comprehensive exposure assessment by analysing the indoor air concentration of toxic or carcinogenic ETS compounds in restaurants, pubs, and discotheques. Active sampling of indoor air was conducted for 4 h during the main visiting hours in 28 hospitality venues. Polycyclic aromatic hydrocarbons (PAH), volatile organic compounds (VOC), aldehydes/ketones, and cadmium were analysed. In addition, particle mass concentration was assessed with two different methods and particle number concentration (PNC) was determined. Median nicotine levels were 15 microg/m(3) in restaurants, 31 microg/m(3) in pubs, and 193 microg/m(3) in discotheques. Across these three sampling site categories median levels of 3-ethenylpyridine ranged from 3 to 24 microg/m(3), median levels of benzene from 8 to 20 microg/m(3), median levels of cadmium from 3 to 10 ng/m(3), and median levels of the sum of 16 PAH according to US-EPA from 215 to 375 ng/m(3), respectively. Median PM(2.5) mass concentration assessed gravimetrically varied between 178 and 808 microg/m(3) and PNC between 120,000 and 210,000 particles per cm(3) in restaurants, pubs, and discotheques. The majority of the particles had a size of 0.01-0.5 microm. Concentrations of ETS compounds were always highest in discotheques. The strong correlation between ETS-specific markers (nicotine, 3-ethenylpyridine) and PM(2.5), PAH, VOC, aldehydes/ketones, and cadmium indicated ETS as main source of these toxic or carcinogenic substances. In conclusion, indoor air concentrations of ETS constituents were high in German hospitality venues and represented a substantial health threat. Effective measures to protect patrons and staff from ETS exposure are necessary from a public health point of view.

Persistent organic pollutants in atmospheric deposition and biomonitoring with Tillandsia usneoides (L.) in an industrialized area in Rio de Janeiro state, southeast Brazil--Part II: PCB and PAH.

Monitoring of immission of persistent organic pollutants in the industrialized area of Volta Redonda (V.R.) and in the National Park of Itatiaia (PNI) in southeast Brazil was performed using an endemic bromeliad species as biomonitor and measuring bulk deposition rates of polychlorinated biphenyls (PCB) and polycyclic aromatic hydrocarbons (PAH). For the sum of PCB, overall deposition rates were between 17 and 314 ng/(m2 day) in winter and between 43 and 81 ng/(m2 day) in summer, respectively. Deposition rates of dioxin-like PCBs ranged from 0.14 to 2.8 pg WHO-TEQ/(m2 day) in winter and from 0.90 to 4.3 pg WHO-TEQ/(m2 day) in summer. PCB deposition rates (total PCB and WHO-TEQ) were in the same range in winter in V.R. and PNI. In summer, contamination levels in V.R. were 6-10-folds higher than in PNI. PCB concentrations in biomonitor samples from V.R. and PNI were in the same range in summer and in winter. Concentrations of total PCB ranged from 14 to 95 microg/kg dry matter (d.m.) in winter and from 18 to 27 microg/kg d.m. in summer, respectively. The TEQ values were between 1.7 and 4.1 ng WHO-TEQ/kg d.m. in winter and between 1.9 and 2.9 ng WHO-TEQ/kg d.m. in summer. PCB concentrations of di-ortho PCB but not of non-ortho PCB were a factor of 2-4 lower in summer in both areas. PCB congener profiles resembled those from technical formulations. The profiles shifted to the higher chlorinated congeners in summer, probable due to revolatilisation of the lighter components at higher temperatures. PCB profiles in biomonitor resembled those from deposition samples and the shift to the heavier congeners in summer was even more pronounced. PAH deposition rates were in a similar range in both areas (131-2415 ng/(m2 day)). PAH levels in biomonitor samples from V.R. were about one order of magnitude higher than in samples from PNI indicating the impact of local sources. PAH profiles revealed stationary thermal processes as main source of contamination in V.R. whereas in PNI, biomass burning seems to be the main contamination source.