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Sousa-Uva M, Manuel Fonseca A, Nunes B, Sousa-Uva A, Paula Rodrigues A, Matias-Dias C. The modifying role of major cardiovascular risk factors in the association between retirement and cardiovascular disease: Results from SHARE Portugal. Work 2022; 72:577-586. [PMID: 35527592 DOI: 10.3233/wor-205224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Despite the actual demographic trends and the global burden of cardiovascular diseases, there is little knowledge concerning the effects of retirement on this health outcome. OBJECTIVE We aimed to quantify the associations between retirement, and retirement age, with cardiovascular disease (heart disease and stroke) in the Portuguese population. METHODS We used data from the first Portuguese wave of the Survey of Health Ageing and Retirement in Europe. Logistic regression was applied to quantify the associations. The major risk factors for cardiovascular diseases and several features of retirement were considered as possible confounders or effect modifiers. Analysis was restricted to retirees in retirement process (retired for 5 years or less) and not retired because of illness. RESULTS An opposite direction of the association between retirement and heart disease was observed according to hypertension status, although not significant. Early retirement increased the odds of having a stroke, merely in individuals without heart disease (OR = 8.87; 95% CI 1.63-48.26). On the contrary, in individuals with heart disease, decreased the odds of having a stroke in (OR = 0.08; 95% CI 0.01-0.68). CONCLUSIONS Our findings suggest that retirement and retirement age may be beneficial or harmful, respectively, in the presence or absence of major risk factors for heart disease and stroke. We suggest that work-related stress affecting differently workers with and without these risk factors may eventually explain these findings.
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Affiliation(s)
- Mafalda Sousa-Uva
- Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal.,Public Health Research Center, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal.,Comprehensive Health Research Center (CHRC), Lisbon, Portugal
| | - António Manuel Fonseca
- Research Centre for Human Development (CEDH/FEP), Catholic University of Portugal, Portugal
| | - Baltazar Nunes
- Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal.,Public Health Research Center, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal.,Comprehensive Health Research Center (CHRC), Lisbon, Portugal
| | - António Sousa-Uva
- Public Health Research Center, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal.,Comprehensive Health Research Center (CHRC), Lisbon, Portugal.,Occupational and Environmental health Department, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
| | - Ana Paula Rodrigues
- Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
| | - Carlos Matias-Dias
- Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal.,Public Health Research Center, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal.,Comprehensive Health Research Center (CHRC), Lisbon, Portugal
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Santos T, Uva ADS, Rodrigues JF, Ferreira R, Monteiro D, Hernández-Mendo A, Rodrigues F. The Future Looks Good: Examining the Associations Between Coping, Psychological Distress, and Optimism. Front Psychol 2022; 13:838835. [PMID: 35586235 PMCID: PMC9108386 DOI: 10.3389/fpsyg.2022.838835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 04/14/2022] [Indexed: 02/05/2023] Open
Abstract
The recent pandemic and consequent lockdown had a substantial impact on mental health and optimism regarding the future. Previous research showed that levels of depression, anxiety, and stress had increased throughout the pandemic. Nonetheless, how individuals cope when faced with adversity may be associated with positive expectations regarding the future. A sample of 274 Portuguese workers (female = 54) with a mean age of 40.86 (SD = 0.70) and work experience of 19.68 years (SD = 12.07) met inclusion criteria and agreed to participate in the proposed study. They represented a variety of working classes (i.e., arts, engineering, marketers, transportation and logistic, clerks, personal trainers, managers, lawyers, accountants, directors, journalism, health care). We investigated the associations between depression, stress, anxiety, adaptive and maladaptive coping, and optimism while controlling for working experience, gender, and work type. We found that depression was related to lower levels of optimism. However, for participants scoring high on adaptive coping and anxiety, higher scores of optimism were reported. Gender, work type, and experience did not significantly influence the results. These results provide evidence through which positive mental health can be promoted after the pandemic.
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Affiliation(s)
- Tiago Santos
- Sport Sciences School of Rio Maior, Polytechnic Institute of Santarém, Rio Maior, Portugal
- National School of Public Health, New University of Lisbon, Lisbon, Portugal
| | | | - José Fernandes Rodrigues
- Sport Sciences School of Rio Maior, Polytechnic Institute of Santarém, Rio Maior, Portugal
- Quality of Life Research Center (CIEQV), Santarém, Portugal
| | - Regina Ferreira
- Quality of Life Research Center (CIEQV), Santarém, Portugal
- Health Science School, Polytechnic Institute of Santarém, Santarém, Portugal
| | - Diogo Monteiro
- Quality of Life Research Center (CIEQV), Santarém, Portugal
- ESECS Polytechnic Institute of Leiria, Leiria, Portugal
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), Vila Real, Portugal
| | - Antonio Hernández-Mendo
- Department of Social Psychology, Social Work, Anthropology and East Asian Studies, University of Málaga, Málaga, Spain
| | - Filipe Rodrigues
- Quality of Life Research Center (CIEQV), Santarém, Portugal
- ESECS Polytechnic Institute of Leiria, Leiria, Portugal
- *Correspondence: Filipe Rodrigues,
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Monteiro A, Cardoso J, Guerra N, Ribeiro E, Viegas C, Cabo Verde S, Sousa-uva A. Exposure and Health Effects of Bacteria in Healthcare Units: An Overview. Applied Sciences 2022; 12:1958. [DOI: 10.3390/app12041958] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Healthcare units consist of numerous people circulating daily, such as workers, patients, and companions, and these people are vehicles for the transmission of microorganisms, such as bacteria. Bacteria species may have different allergenic, pathogenic, infectious, or toxic properties that can affect humans. Hospital settings foment the proliferation of bacteria due to characteristics present in the indoor hospital environment. This review article aims to identify the potential health effects caused by bacterial contamination in the context of healthcare units, both in patients and in workers. A search was carried out for articles published in PubMed, Web of Science and Scopus, between 1 January 2000 and 31 October 2021, using the descriptor hospital exposure assessment bacteria. This bibliographic research found a total of 13 articles. Bacteria transmission occurs mainly due to the contact between healthcare workers and patients or through the handling of/contact with contaminated instruments or surfaces. The most common bacterial contaminants are Escherichia coli, Pseudomonas aeruginosa, Staphylococcus spp., Staphylococcus aureus and Micrococcus luteus, and the principal health effects of these contaminants are hospital-acquired infections and infections in immunocompromised people. A tight control of the disinfection methods is thus required, and its frequency must be increased to remove the microbial contamination of wards, surfaces and equipment. A better understanding of seasonal variations is important to prevent peaks of contamination.
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Sousa-Uva A, Serranheira F. European Healthy Workplace Campaigns: Is Health and Safety at Work a Real Occupational Health and Safety Policy Concern or Just a Political Topic? Port J Public Health 2022. [DOI: 10.1159/000525788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Santos C, Dixe MDA, Sacadura-Leite E, Astoul P, Sousa-Uva A. Asbestos Exposure and Malignant Pleural Mesothelioma: A Systematic Review of Literature. Port J Public Health 2022. [DOI: https:/doi.org/10.1159/000527971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2023] Open
Abstract
<b><i>Background:</i></b>The relationship between exposure to asbestos and malignant pleural mesothelioma (MPM) is already well established. Nevertheless, much remains to be known about exposure thereto and the incidence and mortality from MPM. <b><i>Objective:</i></b> This systematic review aims to map the relationship between asbestos and MPM by studying the exposure to asbestos and the incidence and mortality of MPM. <b><i>Methods:</i></b> A systematic review was conducted relating asbestos and MPM. Exposure to asbestos, incidence, and mortality by MPM was reviewed. PubMed, Web of Science, Cochrane Library, RCAAP, DART-Europe, and the reference lists of included studies were searched, from January 1, 1960, to December 31, 2020. Methodological quality was checked, the risk of bias analysis was performed, a level of evidence grade was assigned, and descriptive data analysis was performed. <b><i>Results:</i></b> 3,484 unique citations were identified, which included seventeen observational studies that met inclusion criteria with a total of 1,104 patients. Heterogeneity is present between the included studies which range from a case series of 16 retrospective studies and 1 prospective study. Studies were mostly conducted in Europe, particularly in Italy (6), and were published between 1969 and 2020. The mean age of patients is approximately 66 years with a latency period between the first exposure and diagnosis of approximately 42 years. 14 studies present data regarding the occupational context and chrysotile and crocidolite are the most studied types of fibre. The incidence of cases occurred between the interval 1966 and 2014 and in 9 studies the mortality rate was 100% of patients. <b><i>Conclusion:</i></b> There is high evidence to support the relationships between asbestos and MPM. However, the relatively scant information provided by the studies reinforces the need for well-conducted research and implementation of National Mesothelioma Surveillance Centres at a global level.
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Silva AF, Dalri RDCDMB, Eckeli AL, Uva ANPDS, Mendes AMDOC, Robazzi MLDCC. Sleep quality, personal and work variables and life habits of hospital nurses. Rev Lat Am Enfermagem 2022; 30:e3577. [PMID: 35584413 PMCID: PMC9109468 DOI: 10.1590/1518-8345.5756.3577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 02/13/2022] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE to identify the possible associations between sleep quality, personal and work variables and the life habits of hospital nurses. METHOD a cross-sectional, exploratory, correlational and quantitative study, carried out from October to December 2019. The data were collected with the application of a questionnaire that addressed the respondents' personal characteristics, life habits and working conditions. The Pittsburgh Sleep Quality Index (PSQI), Brazilian Portuguese version, was used to assess sleep quality. RESULTS the participants were 42 professionals: 31 (73.8%) women, aged between 26 and 66 years old (mean of 40.2); 61.9% worked overtime; 26.2% had two employment contracts and 40.5% had absences from work. Sleep quality was considered good by 9.5% of the participants, poor by 64.3% and categorized as with sleep disorders by 26.2%. In the population that worked rotating shifts, this quality was identified as poor by 26.2%. The worst results were found in the age group from 30 to 39 years old and there was a statistical significance in the "living with a partner" variable. CONCLUSION there was impairment in the nurses' sleep quality and there is a need to monitor these workers, particularly those who work in shifts, in order to provide preventive measures to mitigate the harms to their health.
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Affiliation(s)
- Andressa Fernanda Silva
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil
- Bolsista da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
| | - Rita de Cássia de Marchi Barcellos Dalri
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil
| | - Alan Luiz Eckeli
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, SP, Brasil
| | | | | | - Maria Lúcia do Carmo Cruz Robazzi
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil
- Universidade Federal da Paraíba, João Pessoa, PB, Brasil
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Silva AF, Dalri RDCDMB, Eckeli AL, Uva ANPDS, Mendes AMDOC, Robazzi MLDCC. Sleep quality, personal and work variables and life habits of hospital nurses. Rev Lat Am Enfermagem 2022. [PMID: 35584413 PMCID: PMC9109468 DOI: 10.1590/1518-8345.5756.3538] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Abstract Objective: to identify the possible associations between sleep quality, personal and work variables and the life habits of hospital nurses. Method: a cross-sectional, exploratory, correlational and quantitative study, carried out from October to December 2019. The data were collected with the application of a questionnaire that addressed the respondents’ personal characteristics, life habits and working conditions. The Pittsburgh Sleep Quality Index (PSQI), Brazilian Portuguese version, was used to assess sleep quality. Results: the participants were 42 professionals: 31 (73.8%) women, aged between 26 and 66 years old (mean of 40.2); 61.9% worked overtime; 26.2% had two employment contracts and 40.5% had absences from work. Sleep quality was considered good by 9.5% of the participants, poor by 64.3% and categorized as with sleep disorders by 26.2%. In the population that worked rotating shifts, this quality was identified as poor by 26.2%. The worst results were found in the age group from 30 to 39 years old and there was a statistical significance in the “living with a partner” variable. Conclusion: there was impairment in the nurses’ sleep quality and there is a need to monitor these workers, particularly those who work in shifts, in order to provide preventive measures to mitigate the harms to their health.
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Affiliation(s)
- Andressa Fernanda Silva
- Universidade de São Paulo, Brazil; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
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Sousa-Uva M, Sousa-Uva A, E Sampayo MM, Serranheira F. Telework during the COVID-19 epidemic in Portugal and determinants of job satisfaction: a cross-sectional study. BMC Public Health 2021; 21:2217. [PMID: 34865641 PMCID: PMC8645416 DOI: 10.1186/s12889-021-12295-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 11/18/2021] [Indexed: 02/08/2023] Open
Abstract
Background Telework satisfaction is a Public Health concern, intensified by the COVID-19 pandemic, and its determinant factors may be related with the negative health effects of teleworking. However, there is still little research exploring this issue. This study aimed to characterize telework during the first wave of the COVID-19 epidemic in Portugal and to identify the major predictors of telework satisfaction. Methods This is a cross-sectional study aimed at all teleworkers working in Portugal, during the first wave of the COVID-19 epidemic. Data were collected through a Google Forms platform online questionnaire distributed by a snowball method on social networks. Descriptive statistics included crude and relative frequency data. The associations between sociodemographic characteristics, self-perceived health, organization of working time, concentration at work, work-life balance, work disconnection, working conditions, and organizational demands (flexibility and organizational trust based on E-work Life Scale) with telework satisfaction were estimated through logistic regression. Results This study included 1004 participants. Teleworkers satisfaction levels were high (69%). Better concentration at work (OR = 1.54; 95%CI 1.01–2.34); the satisfaction with the balance between work life and extra work when teleworking (OR = 1.79; 95%CI 1.17–2.74); and higher work flexibility (OR = 2.26; 95%CI 1.46–3.49) were good predictors of greater levels of satisfaction with telework. However, its major predictors were the company’s trust in teleworkers (OR = 4.50; 95%CI 2.89–7.02) and feeling good in the workspace at home (OR = 3.72; 95%CI 1.46–9.49). Conclusions Our findings point that work environment and organizational culture play a crucial role in affecting telework satisfaction. More studies are needed to monitor telework satisfaction and its effects on physical and mental health, so that Public and Occupational Health (and Safety) can be able to identify and implement the best interventions that allow promoting individual health and foster a healthy work environment for teleworkers.
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Affiliation(s)
- Mafalda Sousa-Uva
- CHRC - Comprehensive Health Research Center; National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal. .,Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal.
| | - António Sousa-Uva
- CHRC - Comprehensive Health Research Center; National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal.,Department of Occupational and Environmental Health of the National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
| | | | - Florentino Serranheira
- CHRC - Comprehensive Health Research Center; National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal.,Department of Occupational and Environmental Health of the National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
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Ajab S, Ádam B, Al Hammadi M, Al Bastaki N, Al Junaibi M, Al Zubaidi A, Hegazi M, Grivna M, Kady S, Koornneef E, Neves R, Uva AS, Sheek-Hussein M, Loney T, Serranheira F, Paulo MS. Occupational Health of Frontline Healthcare Workers in the United Arab Emirates during the COVID-19 Pandemic: A Snapshot of Summer 2020. Int J Environ Res Public Health 2021; 18:11410. [PMID: 34769927 PMCID: PMC8583571 DOI: 10.3390/ijerph182111410] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 02/05/2023]
Abstract
The study aim was to understand the availability of personal protective equipment (PPE) and the levels of anxiety, depression, and burnout of healthcare workers (HCWs) in the United Arab Emirates (UAE). This study was an online-based, cross-sectional survey during July and August 2020. Participants were eligible from the entire country, and 1290 agreed to participate. The majority of HCWs were females aged 30-39 years old, working as nurses, and 80% considered PPE to be available. Twelve percent of respondents tested positive for SARS-CoV-2. Half of HCWs considered themselves physically tired (52.2%), reported musculoskeletal pain or discomfort (54.2%), and perceived moderate-to-high levels of burnout on at least one of three burnout domains (52.8%). A quarter of HCWs reported anxiety (26.3%) or depression (28.1%). HCWs reporting not having musculoskeletal pain, having performed physical activity, and higher scores of available PPE reported lower scores of anxiety, depression, and burnout. UAE HCWs experienced more access to PPE and less anxiety, depression, and burnout compared with HCWs in other countries. Study findings can be used by healthcare organizations and policymakers to ensure adequate measures are implemented to maximize the health and wellbeing of HCWs during the current COVID-19 and future pandemics.
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Affiliation(s)
- Suad Ajab
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (S.A.); (B.Á.); (M.G.); (E.K.); (M.S.-H.)
| | - Balázs Ádam
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (S.A.); (B.Á.); (M.G.); (E.K.); (M.S.-H.)
| | - Muna Al Hammadi
- Tawam Hospital, Al Ain P.O. Box 17666, United Arab Emirates;
| | - Najwa Al Bastaki
- Department of Medical Education and Research, Dubai Health Authority, Dubai P.O. Box 4545, United Arab Emirates;
| | - Mohamed Al Junaibi
- Ministry of Presidential Affairs, Abu Dhabi P.O. Box 280, United Arab Emirates; (M.A.J.); (A.A.Z.); (S.K.)
| | - Abdulmajeed Al Zubaidi
- Ministry of Presidential Affairs, Abu Dhabi P.O. Box 280, United Arab Emirates; (M.A.J.); (A.A.Z.); (S.K.)
| | - Mona Hegazi
- Department of Family Medicine, Mediclinic City Hospital, Dubai P.O. Box 505004, United Arab Emirates;
| | - Michal Grivna
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (S.A.); (B.Á.); (M.G.); (E.K.); (M.S.-H.)
- Department of Public Health and Preventive Medicine, Second Faculty of Medicine, Charles University, 150 06 Prague, Czech Republic
| | - Suhail Kady
- Ministry of Presidential Affairs, Abu Dhabi P.O. Box 280, United Arab Emirates; (M.A.J.); (A.A.Z.); (S.K.)
| | - Erik Koornneef
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (S.A.); (B.Á.); (M.G.); (E.K.); (M.S.-H.)
- Ministry of Presidential Affairs, Abu Dhabi P.O. Box 280, United Arab Emirates; (M.A.J.); (A.A.Z.); (S.K.)
| | - Raquel Neves
- Health Science Faculty, Higher College of Technology Abu Dhabi, Abu Dhabi P.O. Box 25026, United Arab Emirates;
| | - António Sousa Uva
- CHRC, Comprehensive Health Research Center, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal; (A.S.U.); (F.S.)
| | - Mohamud Sheek-Hussein
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (S.A.); (B.Á.); (M.G.); (E.K.); (M.S.-H.)
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai P.O. Box 505055, United Arab Emirates;
| | - Florentino Serranheira
- CHRC, Comprehensive Health Research Center, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal; (A.S.U.); (F.S.)
| | - Marília Silva Paulo
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (S.A.); (B.Á.); (M.G.); (E.K.); (M.S.-H.)
- CHRC, Comprehensive Health Research Center, Nova Medical School, Universidade NOVA de Lisboa, 1169-056 Lisbon, Portugal
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Sousa-Uva A. Evidence-Based Public Health and the Novel Coronavirus Disease (COVID-19) Pandemic: A Balance Between Science and Art? Port J Public Health 2021. [PMCID: PMC8247829 DOI: 10.1159/000516290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- António Sousa-Uva
- NOVA National School of Public Health, NOVA University Lisbon, Lisbon, Portugal
- NOVA National School of Public Health, Public Health Research Centre, CISP, NOVA University Lisbon, Lisbon, Portugal
- NOVA National School of Public Health, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisbon, Portugal
- *António Sousa-Uva,
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Mendonça-Galaio L, Sacadura-Leite E, Raposo J, França D, Correia A, Lobo R, Soares J, Almeida C, Shapovalova O, Serranheira F, Sousa-Uva A. The COVID-19 Impact in Hospital Healthcare Workers: Development of an Occupational Health Risk Management Program. Port J Public Health 2021. [PMCID: PMC8247828 DOI: 10.1159/000515327] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
As with the SARS-CoV-1 outbreak in 2003–2004 and the MERS outbreak in 2012, there were early reports of frequent transmission to healthcare workers (HCW) in the SARS-CoV-2 pandemic. Our hospital center identified its first COVID-19 confirmed case on March 9, 2020, in a 6-day hospitalized patient. The first confirmed COVID-19 case in a HCW happened 3 days later, in a nurse with a probable epidemiological link related to the first confirmed patient. Our study's first objective is to describe and characterize the impact of the first 3 months of the SARS-CoV-2 pandemic on the Centro Hospitalar Universitário Lisboa Norte (CHULN). Our second objective is to report the performance of the CHULN Occupational Health Department (OHD) and the impact of the pandemic on CHULN HCW and its adaptation across national, regional, and institutional epidemiological evolution. Over the first 3 months, 2,152 HCW were screened (which represent 29.8% of the total HCW population), grouped in 100 separate identifiable clusters, each one ranging from 2 to 98 HCW. The most prevalent profession screened were nurses (n = 800; 37.2%) followed by doctors (n = 634; 29.5%). The main source of potential infection and cluster generating screening procedures was co-worker related (n = 1,216; 56.5%). A patient source or a combined patient co-worker source was only accountable for 559 (26%) and 43 (2%) of cases, respectively. Our preliminary results demonstrate a lower infection rate among HCW than the ones commonly found in the literature. The main source of infection seemed to be co-worker related rather than patient related. New preventive strategies would have to be implemented in order to control SARS-CoV-2 spread.
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Affiliation(s)
- Luís Mendonça-Galaio
- Department of Occupational Health, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
- Public Health Research Centre (PHRC/CISP), Comprehensive Health Research Centre (CHRC), Lisbon, Portugal
- Occupational and Environmental Health Department of NOVA National School of Public Health, Lisbon, Portugal
- *Luís Mendonça-Galaio,
| | - Ema Sacadura-Leite
- Department of Occupational Health, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
- Public Health Research Centre (PHRC/CISP), Comprehensive Health Research Centre (CHRC), Lisbon, Portugal
- Occupational and Environmental Health Department of NOVA National School of Public Health, Lisbon, Portugal
- Institute for Preventive Medicine and Public Health of University of Lisbon School of Medicine, Lisbon, Portugal
| | - João Raposo
- Department of Occupational Health, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - Diana França
- Department of Occupational Health, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - Ana Correia
- Department of Occupational Health, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - Rodrigo Lobo
- Department of Occupational Health, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - Jorge Soares
- Department of Occupational Health, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - Clara Almeida
- Department of Occupational Health, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - Olena Shapovalova
- Department of Occupational Health, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - Florentino Serranheira
- Public Health Research Centre (PHRC/CISP), Comprehensive Health Research Centre (CHRC), Lisbon, Portugal
- Occupational and Environmental Health Department of NOVA National School of Public Health, Lisbon, Portugal
| | - António Sousa-Uva
- Public Health Research Centre (PHRC/CISP), Comprehensive Health Research Centre (CHRC), Lisbon, Portugal
- Occupational and Environmental Health Department of NOVA National School of Public Health, Lisbon, Portugal
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Abstract
Introduction Health professionals who provide clinical care are exposed to patients potentially infected by the severe acute respiratory syndrome coronavirus 2 SARS-CoV-2), namely physicians and nurses; consequently, these professionals face higher risks of infection. Objectives This study aimed to describe the prevalence of coronavirus disease 19 (COVID-19) cases among health professionals and the frequencies of risk factors and psychosocial risk. Methods This is a cross-sectional study targeted at health professionals working in Portugal during the current COVID-19 pandemic. Data were obtained through a self-administered questionnaire available online at the websites of medical and nursing boards, among other sources. We performed a univariate analysis, calculating absolute and relative frequencies, and a bivariate analysis with a Pearson's chi-squared test. Results We studied 4,212 health professionals, of which 36.7% (n = 1,514) worked in areas dedicated to the treatment of sick or suspected COVID-19 patients. Of these, 2.11% tested positive for SARS-CoV-2. Among all participants, 76.7% and 79.1% presented moderate to severe levels of fatigue and anxiety, respectively. Fatigue levels were significantly higher in professionals working in areas dedicated to the treatment of patients with COVID-19 (80.5% p = 0.01), but this difference was not observed regarding anxiety (79.5% p = 0.681). Conclusions The percentage of health professionals who tested positive for SARS-CoV-2 was 2.11%. The reported high levels of fatigue and anxiety should determine a better protection of the health and safety of those who provide health care in the current pandemic.
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Affiliation(s)
- Mafalda Sousa-Uva
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal.,Centro de Investigação em Saúde Pública, Lisboa, Portugal
| | - Antonio Sousa-Uva
- Centro de Investigação em Saúde Pública, Lisboa, Portugal.,Departamento de Saúde Ocupacional e Ambiental, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Florentino Serranheira
- Centro de Investigação em Saúde Pública, Lisboa, Portugal.,Departamento de Saúde Ocupacional e Ambiental, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal
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Monteiro A, Almeida B, Paciência I, Cavaleiro Rufo J, Ribeiro E, Carolino E, Viegas C, Uva AS, Verde SC. Bacterial Contamination in Health Care Centers: Differences between Urban and Rural Settings. Atmosphere 2021; 12:450. [DOI: 10.3390/atmos12040450] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
This study aims to assess the airborne bioburden of rural and urban Portuguese Primary Health Care Centers (PHCC) using active and passive sampling methods and identify the potential differences in airborne microbiota between both environments. The highest total aerobic mesophilic bacterial load in indoor air were found in the Vaccination Room (448 CFU.m−3) in the Rural PHCC and in the Waiting Room (420 CFU.m−3) for Urban PHCC. The total coliforms contamination level in indoor air was detected only in the Cleaning Supplies Room (4 CFU.m−3) in the Urban PHCC. The most frequent bacteria genera identified was Micrococcus (21% Rural PHCC; 31% Urban PHCC). The surface samples showed a highest total aerobic mesophilic bacterial contamination in the Treatment Room (86 × 103 CFU.m−2) from the Rural PHCC and in the Front Office (200 × 103 CFU.m−2) from the Urban PHCC. The electrostatic dust cloth (EDC) samples showed a highest bacterial load in the Urban PHCC. Total aerobic mesophilic bacterial load in settled dust and in the Heating, Ventilating and Air Conditioning (HVAC) filter samples in the Urban PHCC (8 CFU.g−1 and 6 × 103 CFU.m−2) presented higher values compared with the Rural PHCC (1 CFU.g−1 and 2.5 × 103 CFU.m−2). Urban PHCC presented higher bacterial airborne contamination compared with the Rural PHCC for the majority of sampling sites, and when compared with the indoor air quality (IAQ) Portuguese legislation it was the Rural PHCC in two sampling places who did not comply with the established criteria.
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14
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Guerreiro MM, Serranheira F, Cruz EB, Sousa-Uva A. Self-Reported Variables as Determinants of Upper Limb Musculoskeletal Symptoms in Assembly Line Workers. Saf Health Work 2020; 11:491-499. [PMID: 33329916 PMCID: PMC7728709 DOI: 10.1016/j.shaw.2020.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 07/23/2020] [Accepted: 07/27/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Assembly lines work is frequently associated to work-related upper limb musculoskeletal disorders. The related disability and absenteeism make it important to implement efficient health surveillance systems. The main objective of this study was to identify self-reported variables that can determine work-related upper limb musculoskeletal symptoms-discomfort/pain-during a 6-month follow-up. METHODS This was a prospective study with a 6-month follow-up period, performed in an assembly line. Upper limb musculoskeletal discomfort/pain was assessed through the presence of self-reported symptoms. Uni- and multivariate logistic regression analyses were used to evaluate which self-reported variables were associated to upper limb symptoms after 6 months at the present and to upper limbs symptoms in the past month. RESULTS Of the 200 workers at baseline, 145 replied to the survey after 6 months. For both outcomes, "having upper limb symptoms during the previous 6 months" and "education" were possible predictors. CONCLUSION Our results suggest that having previous upper limb symptoms was related to its maintenance after 6 months, sustaining it as a specific determinant. It can be a hypothesis that this population had mainly workers with chronic symptoms, although our results give only limited support to self-reported indicators as determinants for upper limb symptoms. Nevertheless, the development of an efficient health surveillance system for high demanding jobs should implicate self-reported indicators, but also clinical and work conditions assessment should be accounted on the future.
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Affiliation(s)
- Marisa M. Guerreiro
- NOVA National School of Public Health, Occupational Health and Environmental Health Department, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Florentino Serranheira
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Comprehensive Health Research Center (CHRC), Lisbon, Portugal
| | - Eduardo B. Cruz
- School of Health Care, Department of Physiotherapy, Setubal, Portugal
| | - António Sousa-Uva
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Comprehensive Health Research Center (CHRC), Lisbon, Portugal
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15
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Guerreiro MM, Serranheira F, Cruz EB, Sousa-Uva A. Working time and upper limb musculoskeletal symptoms: a longitudinal study among assembly line workers. Ind Health 2020; 59:43-53. [PMID: 33250470 PMCID: PMC7855675 DOI: 10.2486/indhealth.2020-0155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
This study followed assembly line workers during 7 months, comprising a 4-wk season
holidays. The main purposes were to determine the potential effect of working time on the
presence and intensity of upper limb musculoskeletal symptoms, as to verify the effect of
4 wk of job interruption in the upper limb musculoskeletal symptoms presence and
intensity. Data was collected during 6 moments. Generalized estimating equations analyses
were used. For the effect estimates, odds ratio with corresponding 95% confidence
intervals were reported for each outcome/model. The upper limb musculoskeletal symptoms
showed a significant increase (p=0.001), especially after
the 4 wk off. In all data collection points there was a significant positive association
between the upper limb musculoskeletal symptoms and general health status
(p<0.001). Considering symptoms’ intensity,
significant relations were found (p<0.001). Work time had
a negative effect on the work-related upper limb musculoskeletal symptoms over 7 months
(OR 0.909, 95% CI 0.861–0.960, p=0.001). For the intensity
of upper limb symptoms, the effect of time was also statistical significant (OR 0.115, 95%
CI 1.031–1.220, p=0.008). A 4-wk job interruption did not
show an immediately positive effect on upper limb musculoskeletal symptoms presence.
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Affiliation(s)
| | - Florentino Serranheira
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Comprehensive Health Research Center (CHRC), Portugal
| | - Eduardo Brazete Cruz
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Comprehensive Health Research Center (CHRC), Portugal.,School of Health Care, Setubal Polytechnic Institute, Portugal
| | - António Sousa-Uva
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Comprehensive Health Research Center (CHRC), Portugal
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16
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Santos C, Dixe MA, Sacadura-Leite E, Astoul P, Sousa-Uva A. Asbestos Exposure and Malignant Pleural Mesothelioma in Portugal: a scoping review. Eur J Public Health 2020. [DOI: https://doi.org/10.1093/eurpub/ckaa040.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Abstract
Introduction Asbestos, widely used for its important chemical and physical characteristics, are recognized in all their varieties as a human carcinogen by the International Agency for Research on Cancer (IARC) and as the leading cause of cancer associated with occupational exposure in industrialized countries. Despite being the most studied occupational hazard since 1965, it is the malignant pleural mesothelioma (MPM), the decisive aspect in the study of the exposure to asbestos.
Objectives Make a state of the art of the relationships between asbestos and MPM in Portugal.
Methodology A scoping review using the Joanna Briggs Institute (JBI) methodology was conducted using five information’s sources: Pubmed, Web of Science, The Cochrane Library, Scopus and Google Scholar and Open Access Scientific Repositories of Portugal and DART-Europe E-theses Portal to search also for gray literature. Data were collected between 1960-2019, with the keywords "Asbestos" and "Mesothelioma” and “Portugal”. Inclusion criteria were defined for types of participants, concept, context and types of studies.
Results Of the 1453 studies reviewed 9 were included. The oldest study is from 1986. Five studies are about incidence and survival, two are case reports, one about exposure and mortality and one about treatment. To analyse incidence and mortality, four authors used hospital data and two the data from the southern regional cancer registry (ROR). In these studies, it is also presented the description of the population in terms of mean age, type of exposure, latency time, histological type and stage.
Conclusion Portugal, such as other industrialized countries, used asbestos in a massive way, but despite this, few studies and data on the relationship between asbestos exposure and MPM are found. Dedicated studies are needed to objectively assess the true dimension of this potential problem in Portugal and characterise the different types of exposures related to MPM.
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Affiliation(s)
- C Santos
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa; Centro Hospitalar de Leiria, Portugal
| | - MA Dixe
- Instituto Politécnico de Leiria; ciTechCare, Portugal
| | - E Sacadura-Leite
- Departamento de Saúde Ocupacional e Ambiental da Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa; CISP - Centro de Investigação em Saúde Pública; Serviço de Saúde Ocupacional do CHLN, Portugal
| | - P Astoul
- Department of Thoracic Oncology, Pleural Diseases, and Interventional Pulmonology; Hôpital Nord – Aix-Marseille University, France
| | - A Sousa-Uva
- Coordenador do Departamento de Saúde Ocupacional e Ambiental da Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa; CISP - Centro de Investigação em Saúde Pública, Portugal
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17
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Ventura C, Vieira L, Silva C, Sousa-Uva A, Silva MJ. Functional effects of differentially expressed microRNAs in A549 cells exposed to MWCNT-7 or crocidolite. Toxicol Lett 2020; 328:7-18. [PMID: 32311379 DOI: 10.1016/j.toxlet.2020.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 03/30/2020] [Accepted: 04/08/2020] [Indexed: 02/06/2023]
Abstract
Multi-walled carbon nanotubes (MWCNT) are engineered nanomaterials widely used in industrial and biomedical applications. Yet, MWCNT inhalation may induce pulmonary adverse effects, and the MWCNT-7 (Mitsui-7) has been classified as possibly carcinogenic to humans. However, its molecular mechanisms of action are poorly understood and there are no biomarkers of exposure for occupational monitoring. Several pulmonary diseases, including lung cancer, have been associated with alterations in microRNA expression that are used as biomarkers of disease progression, and differentially-expressed microRNAs (DE miRNAs) can also allow understanding the molecular effects induced by a toxicant. In this study, we identify DE miRNAs in A549 alveolar epithelial cells following 24 h exposure to MWCNT-7 or crocidolite, as well as their enriched cellular functional pathways. These indicate that both materials change cell survival, differentiation and proliferative properties under the influence of AMPK, FoxO, TGF-β and Hippo pathways, and their metabolic activity and cell-to-cell communication. In addition, MWCNT-7 affects the actin cytoskeleton, ubiquitin mediated proteolysis, and ECM-receptor interactions; crocidolite the PI3K-Akt and mTOR pathways, endocytosis, and central carbon metabolism. Since deregulation of these pathways may be related to carcinogenesis, an interaction network of DE miRNAs and corresponding target cancer-related genes was constructed, highlighting the carcinogenic potential of Mitsui-7.
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18
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Ventura C, Pereira JFS, Matos P, Marques B, Jordan P, Sousa-Uva A, Silva MJ. Cytotoxicity and genotoxicity of MWCNT-7 and crocidolite: assessment in alveolar epithelial cells versus their coculture with monocyte-derived macrophages. Nanotoxicology 2020; 14:479-503. [PMID: 32046553 DOI: 10.1080/17435390.2019.1695975] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
In the past years, several in vitro studies have addressed the pulmonary toxicity of multi-walled carbon nanotubes (MWCNT) and compared it with that caused by asbestos fibers, but their conclusions have been somewhat inconsistent and difficult to extrapolate to in vivo. Since cell coculture models were proposed to better represent the in vivo conditions than conventional monocultures, this work intended to compare the cytotoxicity and genotoxicity of MWCNT-7 (Mitsui-7) and crocidolite using A549 cells grown in a conventional monoculture or in coculture with THP-1 macrophages. Although a decrease in A549 viability was noted following exposure to a concentration range of MWCNT-7 and crocidolite, no viability change occurred in similarly exposed cocultures. Early events indicating epithelial to mesenchymal transition (EMT) were observed which could explain apoptosis resistance. The comet assay results were similar between the two models, being positive and negative for crocidolite and MWCNT-7, respectively. An increase in the micronucleus frequency was detected in the cocultured A549-treated cells with both materials, but not in the monoculture. On the other hand, exposure of A549 monocultures to MWCNT-7 induced a highly significant increase in nucleoplasmic bridges in which those were found embedded. Our overall results demonstrate that (i) both materials are cytotoxic and genotoxic, (ii) the presence of THP-1 macrophages upholds the viability of A549 cells and increases the aneugenic/clastogenic effects of both materials probably through EMT, and (iii) MWCNT-7 induces the formation of nucleoplasmic bridges in A549 cells.
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Affiliation(s)
- Célia Ventura
- Department of Human Genetics, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal.,Department of Occupational and Environmental Health, National School of Public Health, NOVA University of Lisbon (UNL), Lisbon, Portugal.,Center for Toxicogenomics and Human Health (ToxOmics), NOVA Medical School-FCM, UNL, Lisbon, Portugal
| | - Joana F S Pereira
- Department of Human Genetics, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal.,BioISI - Biosystems and Integrative Sciences Institute, Faculty of Sciences, University of Lisbon, Lisbon, Portugal
| | - Paulo Matos
- Department of Human Genetics, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal.,BioISI - Biosystems and Integrative Sciences Institute, Faculty of Sciences, University of Lisbon, Lisbon, Portugal
| | - Bárbara Marques
- Department of Human Genetics, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | - Peter Jordan
- Department of Human Genetics, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal.,BioISI - Biosystems and Integrative Sciences Institute, Faculty of Sciences, University of Lisbon, Lisbon, Portugal
| | - António Sousa-Uva
- Department of Occupational and Environmental Health, National School of Public Health, NOVA University of Lisbon (UNL), Lisbon, Portugal.,CISP - Public Health Research Center, Lisbon, Portugal
| | - Maria João Silva
- Department of Human Genetics, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal.,Center for Toxicogenomics and Human Health (ToxOmics), NOVA Medical School-FCM, UNL, Lisbon, Portugal
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19
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Abstract
BACKGROUND Occupational physical demands are commonly assumed the cause of work-related Low Back Pain (LBP) and absenteeism. OBJECTIVES To analyse relationships between LBP at work, physical demands and absenteeism. METHODS Workers filled out a questionnaire on socio-demographic and work-related factors, general health, LBP (number of episodes in a 12-month period, pain severity and intensity), and occupational hazards related with physical demands. RESULTS 735 workers completed the questionnaire (male n = 359). A high proportion of workers n = 507 (69%), from different occupational backgrounds, reported at least one LBP episode in the previous 12-month period. The highest ratio of subjects with more than 6 episodes of LBP per year was found among public services employees (31.8%) and the lowest ratio among administrative workers (10.3%). The highest ratio of workers (39%) were classified as sedentary workers, 34% of workers having a low or moderate level of physical demands in their work, and 27% reported high levels of physical demands in their work. There was a 4 % absenteeism rate in a 12-month period, which was significantly higher in the group with physically demanding work. Those subjects with higher physical requirements at work have increased odds of having more than 3 episodes of LBP during the previous year (p < 0.05) in comparison with subjects with more sedentary jobs and those with low or moderate physical demands. High intensity work, compared to sedentary work, is associated with an increased probability of being absent of work because of LBP in a previous 12-month period (OR = 3.12; CI 1.23-7.89; p = 0.016). CONCLUSIONS Our findings suggest there is an association between highly physically demanding jobs, LBP and absenteeism. These results may contribute to the improvement of LBP assessment and prevention programs in Occupational Health Services.
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Affiliation(s)
- F Serranheira
- CISP - Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal.,Comprehensive Health Research Center (CHRC), Lisbon, Portugal
| | - M Sousa-Uva
- CISP - Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal.,Comprehensive Health Research Center (CHRC), Lisbon, Portugal
| | - F Heranz
- Clinical Investigator, Occupational Doctor, Lisbon, Portugal
| | - F Kovacs
- Unidad de la Espalda Kovacs. Hospital Universitario HLA-Moncloa, y Red Española de Investigadores en Dolencias de la Espalda, Madrid, Spain
| | - A Sousa-Uva
- CISP - Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal.,Comprehensive Health Research Center (CHRC), Lisbon, Portugal
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20
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Sacadura-Leite E, Sousa-Uva A, Ferreira S, Costa PL, Passos AM. Working conditions and high emotional exhaustion among hospital nurses. Rev Bras Med Trab 2020; 17:69-75. [PMID: 32270106 DOI: 10.5327/z1679443520190339] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 02/17/2019] [Indexed: 02/05/2023] Open
Abstract
Background Healthcare workers are exposed to many different occupational stressors, some of which are related to their working conditions. While the experience of stress seems to depend on individual perceptions, some characteristics of inpatient units might influence the occurrence of emotional exhaustion among nurses. Objective The aim of the present study was to identify characteristics of inpatient units which might be associated with high levels of emotional exhaustion among healthcare workers, nurses in this case. Methods We conducted the present cross-sectional, exploratory and descriptive study with 108 nurses (83.8% female; average age 33 years old) allocated to inpatients units (wards and intensive care) at a university hospital in Portugal. We administered the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) emotional exhaustion subscale and collected the following data relative to the units to which the participants were allocated: 1) mortality rate; 2) number of deceased patients; 3) shortage of nurses compared to national standards; 4) occupancy rate; 5) proportion of elderly patients (>65 years old). Results We found a positive relationship between high levels of emotional exhaustion among nurses and very high number of deceased patients (p=0.012), high fatality rate (p=0.036) and high proportion of elderly patients (p=0.025). Conclusion Very high number of deceased patients, high proportion of elderly patients and high fatality rate in inpatients units were associated with high levels of emotional exhaustion among nurses. These findings suggest that characterizing the objective conditions of inpatient units seems to be an important aspect to be considered in psychosocial risk management programs.
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Affiliation(s)
- Ema Sacadura-Leite
- Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade Nova de Lisboa - Lisboa, Portugal.,Departamento de Saúde Ocupacional e Ambiental - Lisboa, Portugal.,Centro Hospitalar Universitário Lisboa Norte, Serviço de Saúde Ocupacional - Lisboa, Portugal.,Faculdade de Medicina, Universidade de Lisboa - Lisboa, Portugal
| | - Antonio Sousa-Uva
- Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade Nova de Lisboa - Lisboa, Portugal.,Departamento de Saúde Ocupacional e Ambiental - Lisboa, Portugal
| | - Sancha Ferreira
- Centro Hospitalar Universitário Lisboa Norte, Serviço de Saúde Ocupacional - Lisboa, Portugal
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Antão HS, Sacadura-Leite E, Manzano MJ, Pinote S, Relvas R, Serranheira F, Sousa-Uva A. Workplace Violence in Healthcare: A Single-Center Study on Causes, Consequences and Prevention Strategies. ACTA MEDICA PORT 2020; 33:31-37. [PMID: 31928601 DOI: 10.20344/amp.11465] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 07/10/2019] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Workplace violence is one of the main risk factors in the professional world. Healthcare workers are at higher risk when compared to other sectors. Our study aimed to characterize physical and verbal violence in a public hospital and to define occupational health prevention and surveillance strategies. MATERIAL AND METHODS Single center observational cross-sectional study, carried amongst healthcare workers in a public hospital in Lisbon. A qualitative survey was carried out through six in-depth interviews. A quantitative survey was carried through questionnaires delivered to 32 workers. A significance level of 5% was accepted in the assessment of statistical differences. The Mann-Whitney test and the Fisher's exact test were used to calculate p values. RESULTS The main results are: (1) 41 violence incidents were reported in the quantitative phase; (2) 5/21 [23.81%] victims notified the incident to the occupational health department; (3) 18/21 [85.71%] victims reported a permanent state of hypervigilance; (4) 22/28 [78.57%] participants self-reported poor or no familiarity with internal reporting procedures; (5) 24/28 [85.71%] participants believed it is possible to minimize workplace violence. DISCUSSION Workplace violence is favored by unrestricted access to working areas, absence of security guards and police officers or scarce intervention. The low notification rate contributes to organizational lack of action. The state of hypervigilance reported in our study reflects the negative effects of threatening occupational stressors on mental health. CONCLUSION Our results show that workplace violence is a relevant risk factor that significantly impacts workers' health in a noxious manner, deserving a tailored occupational health approach whose priority areas and strategies have been determined.
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Affiliation(s)
- Helena Sofia Antão
- Escola Nacional de Saúde Pública. Universidade NOVA de Lisboa. Lisboa. Emergency Department. Hospital Professor Doutor Fernando da Fonseca. Amadora. Portugal
| | - Ema Sacadura-Leite
- CISP - Centro de Investigação em Saúde Pública. CHRC - Comprehensive Health Research Center. Escola Nacional de Saúde Pública. Universidade NOVA de Lisboa. Lisboa. Portugal
| | - Maria João Manzano
- Occupational Health Department. Centro Hospitalar Universitário de Lisboa Central. Lisboa. Portugal
| | - Sónia Pinote
- Occupational Health Department. Centro Hospitalar Universitário de Lisboa Central. Lisboa. Portugal
| | - Rui Relvas
- Occupational Health Department. Centro Hospitalar Universitário de Lisboa Central. Lisboa. Portugal
| | - Florentino Serranheira
- CISP - Centro de Investigação em Saúde Pública. CHRC - Comprehensive Health Research Center. Escola Nacional de Saúde Pública. Universidade NOVA de Lisboa. Lisboa. Portugal
| | - António Sousa-Uva
- CISP - Centro de Investigação em Saúde Pública. CHRC - Comprehensive Health Research Center. Escola Nacional de Saúde Pública. Universidade NOVA de Lisboa. Lisboa. Portugal
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23
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Ramos S, Serranheira F, Sousa-Uva A. Perceived occupational hazards among cash-in-transit guards. Rev Bras Med Trab 2018; 16:327-335. [PMID: 32270093 DOI: 10.5327/z1679443520180264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 07/24/2018] [Indexed: 02/05/2023] Open
Abstract
Background Given reports of health complaints by cash-in-transit (CIT) guards to their trade union, we conducted a study at private security companies. Objectives To establish the health and safety at work (HSW) conditions to which employees from three companies in Portugal were subjected, characterize their working conditions and tasks, and identify aspects of their activity with influence on their health and safety, as well as self-reported health problems. Methods We performed an exploratory and descriptive study based on a questionnaire with three dimensions corresponding to the study aims. The questionnaire was applied by workers' representatives in the workplace without any participation of employers. Results The job of CIT guards poses several demands as concentration and precision, involves high physical load, atypical schedules, and exposure to emotionally disturbing situations and violence. The workers rated negative the influence of work on their physical and mental health and safety. Conclusion We found considerable variability in working conditions and work demands between the analyzed companies. Such diversity points to the need to intervention on HSW through sensitization toward the legislation in force for the prevention of work-related diseases and accidents.
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Affiliation(s)
- Sara Ramos
- Departamento de Recursos Humanos e Comportamento Organizacional, Instituto Universitário de Lisboa (ISCTE-IUL) - Lisboa, Portugal
| | - Florentino Serranheira
- Departamento de Saúde Ocupacional e Ambiental, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa (ENSP-NOVA) - Lisboa, Portugal
| | - António Sousa-Uva
- Departamento de Saúde Ocupacional e Ambiental, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa (ENSP-NOVA) - Lisboa, Portugal
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Sousa P, Uva AS, Serranheira F, Uva MS, Nunes C. Patient and hospital characteristics that influence incidence of adverse events in acute public hospitals in Portugal: a retrospective cohort study. Int J Qual Health Care 2018; 30:132-137. [PMID: 29309608 PMCID: PMC5890867 DOI: 10.1093/intqhc/mzx190] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 12/18/2017] [Indexed: 02/05/2023] Open
Abstract
Objective To analyse the variation in the rate of adverse events (AEs) between acute hospitals and explore the extent to which some patients and hospital characteristics influence the differences in the rates of AEs. Design Retrospective cohort study. Chi-square test for independence and binary logistic regression models were used to identify the potential association of some patients and hospital characteristics with AEs. Setting Nine acute Portuguese public hospital centres. Participants A random sample of 4250 charts, representative of around 180 000 hospital admissions in 2013, was analysed. Intervention To measure adverse events based on chart review. Main Outcome Measure Rate of AEs. Results Main results: (i) AE incidence was 12.5%; (ii) 66.4% of all AEs were related to Hospital-Acquired Infection and surgical procedures; (iii) patient characteristics such as sex (female 11%; male 14.4%), age (≥65 y 16.4%; <65 y 8.5%), admission coded as elective vs. urgent (8.6% vs. 14.6%) and medical vs. surgical Diagnosis Related Group code (13.4% vs. 11.7%), all with p < 0.001, were associated with a greater occurrence of AEs. (iv) hospital characteristics such as use of reporting system (13.2% vs. 7.1%), being accredited (13.7% vs. non-accredited 11.2%), university status (15.9% vs. non-university 10.9%) and hospital size (small 12.9%; medium 9.3%; large 14.3%), all with p < 0.001, seem to be associated with a higher rate of AEs. Conclusions We identified some patient and hospital characteristics that might influence the rate of AEs. Based on these results, more adequate solutions to improve patient safety can be defined.
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Affiliation(s)
- Paulo Sousa
- National School of Public Health, Universidade Nova de Lisboa, Avenida Padre Cruz, 1600-540 Lisboa, Portugal.,CISP-Centro de Investigação em Saúde Pública, ENSP- Universidade Nova de Lisboa, Avenida Padre Cruz, 1600-540, Lisboa, Portugal
| | - António Sousa Uva
- National School of Public Health, Universidade Nova de Lisboa, Avenida Padre Cruz, 1600-540 Lisboa, Portugal.,CISP-Centro de Investigação em Saúde Pública, ENSP- Universidade Nova de Lisboa, Avenida Padre Cruz, 1600-540, Lisboa, Portugal
| | - Florentino Serranheira
- National School of Public Health, Universidade Nova de Lisboa, Avenida Padre Cruz, 1600-540 Lisboa, Portugal.,CISP-Centro de Investigação em Saúde Pública, ENSP- Universidade Nova de Lisboa, Avenida Padre Cruz, 1600-540, Lisboa, Portugal
| | - Mafalda Sousa Uva
- National Institute of Health, Doutor Ricardo Jorge, Avenida Padre Cruz, 1600-540, Lisboa, Portugal
| | - Carla Nunes
- National School of Public Health, Universidade Nova de Lisboa, Avenida Padre Cruz, 1600-540 Lisboa, Portugal.,CISP-Centro de Investigação em Saúde Pública, ENSP- Universidade Nova de Lisboa, Avenida Padre Cruz, 1600-540, Lisboa, Portugal
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Ventura C, Lourenço AF, Sousa-Uva A, Ferreira PJ, Silva MJ. Evaluating the genotoxicity of cellulose nanofibrils in a co-culture of human lung epithelial cells and monocyte-derived macrophages. Toxicol Lett 2018; 291:173-183. [PMID: 29679712 DOI: 10.1016/j.toxlet.2018.04.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 04/12/2018] [Accepted: 04/14/2018] [Indexed: 02/08/2023]
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26
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Sacadura-Leite E, Mendonça-Galaio L, Shapovalova O, Pereira I, Rocha R, Sousa-Uva A. Biological Hazards for Healthcare Workers: Occupational Exposure to Vancomycin-Resistant Staphylococcus aureus as an Example of a New Challenge. Port J Public Health 2018. [DOI: 10.1159/000487746] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Ventura C, Sousa-Uva A, Lavinha J, Silva MJ. Conventional and novel “omics”-based approaches to the study of carbon nanotubes pulmonary toxicity. Environ Mol Mutagen 2018; 59:334-362. [PMID: 29481700 DOI: 10.1002/em.22177] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 01/05/2018] [Accepted: 01/21/2018] [Indexed: 02/05/2023]
Affiliation(s)
- Célia Ventura
- Departamento de Genética Humana; Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA); Lisboa Portugal
- Departamento de Saúde Ocupacional e Ambiental; Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa (UNL); Lisboa Portugal
- Center for Toxicogenomics and Human Health (ToxOmics), NOVA Medical School-FCM, UNL; Lisboa Portugal
| | - António Sousa-Uva
- Departamento de Saúde Ocupacional e Ambiental; Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa (UNL); Lisboa Portugal
- CISP - Public Health Research Center; Lisboa Portugal
| | - João Lavinha
- Departamento de Genética Humana; Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA); Lisboa Portugal
| | - Maria João Silva
- Departamento de Genética Humana; Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA); Lisboa Portugal
- Center for Toxicogenomics and Human Health (ToxOmics), NOVA Medical School-FCM, UNL; Lisboa Portugal
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Rutherford VLZ, Fischer FM, Dias EC, Uva ADS, Alfredo CH, Junior JSS. Prof. Dr. René Mendes: idealizador, mentor, propulsor da Revista Brasileira de Medicina do Trabalho, em seus 15 anos de existência. Rev Bras Med Trab 2018. [DOI: 10.5327/z167944352018v16n3ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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29
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Ferreira E, Pina E, Sousa-Uva M, Sousa-Uva A. Risk factors for health care-associated infections: From better knowledge to better prevention. Am J Infect Control 2017; 45:e103-e107. [PMID: 28549880 DOI: 10.1016/j.ajic.2017.03.036] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 03/30/2017] [Accepted: 03/31/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND Health care-associated infections (HCAIs) are preventable with adoption of recognized preventive measures. The first step is to identify patients at higher risk of HCAI. This study aimed to identify patient risk factors (RFs) present on admission and acquired during inpatient stay which could be associated with higher risk of acquiring HCAI. METHODS A case-control study was conducted in adult patients admitted during 2011 who were hospitalized for >48 hours. Cases were patients with HCAIs. Controls were selected in a ratio of 3:1, case matched by the admission date. The likelihood of increased HCAI was determined through binary logistic regression. RESULTS RFs identified as being the more relevant for HCAI were being a man (odds ratio [OR], 2.4; 95% confidence interval [CI], 1.2-4.7), being aged >50 years (OR, 2.9; 95% CI, 1.3-6.9), and having an insertion of a central venous line during hospital stay (OR, 12.4; 95% CI, 5.0-30.5). CONCLUSIONS RFs that showed statistical significance on admission were the patient's intrinsic factors, and RFs acquired during hospitalization were extrinsic RFs. When a set of RFs were present, the presence of a central venous line proved to be the more relevant one.
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Dzhodzhua V, Serranheira F, Leite ES, Grillo MM, Uva AS. Visual demands and visual fatigue among ophthalmologists. Rev Bras Med Trab 2017; 15:209-216. [PMID: 32270059 DOI: 10.5327/z1679443520170013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 07/26/2017] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Visual demands, especially for near vision, are becoming increasingly more frequent at the workplace, and might cause visual fatigue or asthenopia. The tasks performed by ophthalmologists involve visual effort, raising interest in their study within the context of occupational health. OBJECTIVES To estimate the prevalence of visual complaints and its relationship to work demands among ophthalmologists at a university hospital in Lisbon. METHODS Occurrence of visual fatigue symptoms was assessed by means of a symptom questionnaire - College of Optometrists in Vision Development Quality of Life (COVD-QoL) - and through the identification of near points of accommodation and convergence. Schirmer's test was used to assess tear production. The results were analyzed by means of descriptive statistics, Spearman's coefficient and the Wilcoxon test for p<0.05. RESULTS Most among the 27 analyzed physicians reported visual fatigue (n=25), dry eyes and frequent blinking (n=27). Schirmer's test evidenced differences at the end of the working day and the near points of accommodation and convergence indicated occurrence of visual fatigue. CONCLUSIONS The results showed significant differences between the beginning and the end of the working day among ophthalmologists, with occurrence of visual fatigue at the end of the working day. These findings point to the need to implement a health surveillance program to prevent occupational visual disorders.
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Affiliation(s)
| | - Florentino Serranheira
- Center of Public Health Investigation (Centro de Investigação em Saúde Pública - CISP), National Public Health School, New University of Lisbon - Lisbon, Portugal
| | | | | | - António Sousa Uva
- Center of Public Health Investigation (Centro de Investigação em Saúde Pública - CISP), National Public Health School, New University of Lisbon - Lisbon, Portugal
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Guerreiro M, Serranheira F, Cruz EB, Sousa-Uva A. An analysis on neck and upper limb musculoskeletal symptoms in Portuguese automotive assembly line workers. IJOOES 2017. [DOI: 10.24840/2184-0954_001.001_0006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Assembly lines are related to health risks and work-related musculoskeletal disorders (WMSD), particularly of the neck and upper limbs (WULMSD). The assessment of perceived musculoskeletal symptoms is essential to WULMSD prevention, but studies in this field are lacking. A cross sectional survey on assembly line workers (n=270) was performed. The objective of this study was to analyze the frequency and distribution of upper limb musculoskeletal symptoms in assembly line workers. Participants were predominantly men, with ages between 30 and 40 years. Neck and upper limbs pain/discomfort were the most reported symptoms (35.9%), with intensity predominantly moderate or severe. General Health Status and past musculoskeletal injury were the variables more related to the existence of musculoskeletal symptoms; longer working life in the same company, as under 5 years, were related to higher intensity of symptoms. An early identification of musculoskeletal symptoms and health surveillance over time is of most importance to develop WRULMSD prevention measures.
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Pereira RS, Serranheira F, Lopes F, Ribeiro R, Uva AS. Tendinite do manguito rotador em operadores de caixa de supermercado: contributos para a vigilância de saúde. Rev Bras Med Trab 2017. [DOI: 10.5327/z1679443520176048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Abstract
BACKGROUND Hospital work-related musculoskeletal disorders (WRMSDs) symptoms are highly prevalent and nurses are considered the health care professional group more often affected by WRMSDs. OBJECTIVES Understanding the effects of nursing tasks on WRMSDs symptoms. METHODS Portuguese nurses answered to a modified Nordic Musculoskeletal symptoms Questionnaire. The increased likelihood of having WRMSDs symptoms was estimated from a daily working task schedule and the probability of suffering from lumbar WRMSDs symptoms intensity was also estimated. RESULTS Hospital nurses studied (n= 1.396) were mainly females (75.8%), and most of them reported more than 1 symptom (88%). Low-back pain was the most prevalent complaint (60.9%). Tasks performed more than 10 times a day, such as invasive procedures (OR = 2.142); care of hygiene and patient comfort in bed (OR = 2.484); patient mobilization in bed (OR = 2.022); and patient feeding (OR = 2.186) had an effect on dorsal and lumbar symptoms (p< 0.05).Those tasks involving invasive procedures were just the only ones producing symptoms simultaneously on every studied body part, such as lumbar, dorsal, wrist/hand and ankles/feet areas. CONCLUSIONS Tasks with a greater effect on low-back pain intensity were patient bed feeding and patient hygiene and care. We found, when analysing simultaneously the effects of every task on the likelihood of having low-back symptoms, that involving invasive procedures were that only ones affecting simultaneously the presence of almost all WRMSDs symptoms studied.
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Affiliation(s)
- Florentino Serranheira
- Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisbon, Portugal.,Centro de Malária e Doenças Tropicais - Saúde Pública, Lisbon, Portugal.,Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Mafalda Sousa-Uva
- Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisbon, Portugal
| | - António Sousa-Uva
- Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisbon, Portugal.,Centro de Malária e Doenças Tropicais - Saúde Pública, Lisbon, Portugal.,Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisbon, Portugal
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Tavares JB, Sacadura-Leite E, Matoso T, Neto LL, Biscoito L, Campos J, Sousa-Uva A. The importance of protection glasses during neuroangiographies: A study on radiation exposure at the lens of the primary operator. Interv Neuroradiol 2016; 22:368-71. [PMID: 26842605 PMCID: PMC4984365 DOI: 10.1177/1591019916628322] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 12/26/2015] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND In interventional neuroradiology, few operators routinely use radiation protection glasses. Moreover, in most centers, radiation dose data only accounts for whole body dose without specific information on lens dose. In 2012, the International Commission on Radiological Protection advised that the threshold limit value for the lens should be 20 mSv/year instead of the previous 150 mSv/year limit. The purpose of this study was to compare the radiation dose in the operator's lens during real diagnostic and interventional neuroangiographies, either using or without lead protection glasses. METHODS Using the Educational Direct Dosimeter (EDD30 dosimeter), accumulated radiation dose in the lens was measured in 13 neuroangiographies: seven diagnostic and six interventional. Operators with and without radiation protection glasses were included and the sensor was placed near their left eye, closest to the radiation beam. RESULTS Without glasses, the corrected mean dose of radiation in the lens was 8.02 µSv for diagnostic procedures and 168.57 µSv for interventional procedures. Using glasses, these values were reduced to 1.74 µSv and 33.24 µSv, respectively. CONCLUSION Considering 20 mSv as the suggested annual limit of equivalent dose in the lens, neuroradiologists may perform up to 2,494 diagnostic procedures per year without protecting glasses, a number that increases to 11,494 when glasses are used consistently. Regarding intervention, a maximum of 119 procedures per year is advised if glasses are not used, whereas up to 602 procedures/year may be performed using this protection. Therefore, neuroradiologists should always wear radiation protection glasses.
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Affiliation(s)
- J B Tavares
- Department of Neuroimaging, North Lisbon Medical Center, Lisbon, Portugal Department of Occupational Health, North Lisbon Medical Center, Lisbon, Portugal
| | - E Sacadura-Leite
- Department of Occupational Health, North Lisbon Medical Center, Lisbon, Portugal CISP, National School of Public Health/NOVA, Lisbon, Portugal
| | - T Matoso
- Department of Occupational Health, North Lisbon Medical Center, Lisbon, Portugal
| | - L L Neto
- Department of Neuroimaging, North Lisbon Medical Center, Lisbon, Portugal
| | - L Biscoito
- Department of Neuroimaging, North Lisbon Medical Center, Lisbon, Portugal
| | - J Campos
- Department of Neuroimaging, North Lisbon Medical Center, Lisbon, Portugal
| | - A Sousa-Uva
- CISP, National School of Public Health/NOVA, Lisbon, Portugal
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Pinheiro JPA, de Sousa Uva A. Safety climate in the operating room: Translation, validation and application of the Safety Attitudes Questionnaire. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.rpsp.2015.07.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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36
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Tavares JB, Sacadura-Leite E, Matoso T, Neto LL, Biscoito L, Campos J, Sousa-Uva A. The importance of protection glasses during neuroangiographies: A study on radiation exposure at the lens of the primary operator. Interv Neuroradiol 2016. [DOI: %20doi:%2010.1177/1591019916628322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background In interventional neuroradiology, few operators routinely use radiation protection glasses. Moreover, in most centers, radiation dose data only accounts for whole body dose without specific information on lens dose. In 2012, the International Commission on Radiological Protection advised that the threshold limit value for the lens should be 20 mSv/year instead of the previous 150 mSv/year limit. The purpose of this study was to compare the radiation dose in the operator’s lens during real diagnostic and interventional neuroangiographies, either using or without lead protection glasses. Methods Using the Educational Direct Dosimeter (EDD30 dosimeter), accumulated radiation dose in the lens was measured in 13 neuroangiographies: seven diagnostic and six interventional. Operators with and without radiation protection glasses were included and the sensor was placed near their left eye, closest to the radiation beam. Results Without glasses, the corrected mean dose of radiation in the lens was 8.02 µSv for diagnostic procedures and 168.57 µSv for interventional procedures. Using glasses, these values were reduced to 1.74 µSv and 33.24 µSv, respectively. Conclusion Considering 20 mSv as the suggested annual limit of equivalent dose in the lens, neuroradiologists may perform up to 2,494 diagnostic procedures per year without protecting glasses, a number that increases to 11,494 when glasses are used consistently. Regarding intervention, a maximum of 119 procedures per year is advised if glasses are not used, whereas up to 602 procedures/year may be performed using this protection. Therefore, neuroradiologists should always wear radiation protection glasses.
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Affiliation(s)
- JB Tavares
- Department of Neuroimaging, North Lisbon Medical Center, Lisbon, Portugal
- Department of Occupational Health, North Lisbon Medical Center, Lisbon, Portugal
| | - E Sacadura-Leite
- Department of Occupational Health, North Lisbon Medical Center, Lisbon, Portugal
- CISP, National School of Public Health/NOVA, Lisbon, Portugal
| | - T Matoso
- Department of Occupational Health, North Lisbon Medical Center, Lisbon, Portugal
| | - LL Neto
- Department of Neuroimaging, North Lisbon Medical Center, Lisbon, Portugal
| | - L Biscoito
- Department of Neuroimaging, North Lisbon Medical Center, Lisbon, Portugal
| | - J Campos
- Department of Neuroimaging, North Lisbon Medical Center, Lisbon, Portugal
| | - A Sousa-Uva
- CISP, National School of Public Health/NOVA, Lisbon, Portugal
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Shapovalova O, Sacadura‐Leite E, Mendonça Galaio L, Pereira I, Rocha R, Sousa‐Uva A. Tuberculose latente em profissionais de saúde: concordância entre 2 testes diagnósticos. Revista Portuguesa de Saúde Pública 2016. [DOI: 10.1016/j.rpsp.2015.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Pedro AL, Sousa-Uva A, Pina E. Endemic methicillin-resistant Staphylococcus aureus: Nurses' risk perceptions and attitudes. Am J Infect Control 2014; 42:1118-20. [PMID: 25278407 DOI: 10.1016/j.ajic.2014.07.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 07/11/2014] [Accepted: 07/14/2014] [Indexed: 02/08/2023]
Abstract
Dissemination of methicillin-resistant Staphylococcus aureus (MRSA) remains one of the most difficult challenges for prevention, control, and treatment of health care-associated infections. A survey and interviews were conducted on nurses from a hospital center. We found that most nurses' perceived risk of acquiring MRSA related to themselves (72%), other nurses (88.5%), and patients (97.8%). This perception influences attitudes, leading to compliance with the existing recommendations.
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Sousa P, Uva AS, Serranheira F, Nunes C, Leite ES. Estimating the incidence of adverse events in Portuguese hospitals: a contribution to improving quality and patient safety. BMC Health Serv Res 2014; 14:311. [PMID: 25034870 PMCID: PMC4114085 DOI: 10.1186/1472-6963-14-311] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Accepted: 07/11/2014] [Indexed: 02/08/2023] Open
Abstract
Background Several review studies have shown that 3.4% to 16.6% of patients in acute care hospitals experience one or more adverse events. Adverse events (AEs) in hospitals constitute a significant problem with serious consequences and a challenge for public health. The occurrence of AEs in Portuguese hospitals has not yet been systematically studied. The main purpose of this study is to estimate the incidence, impact and preventability of adverse events in Portuguese hospitals. It is also our aim to examine the feasibility of applying to Portuguese acute hospitals the methodology of detecting AEs through record review, previously used in other countries. Methods This work is based on a retrospective cohort study and was carried out at three acute care hospitals in the Administrative Region of Lisbon. The identification of AEs and their impact was done using a two-stage structured retrospective medical records review based on the use of 18 screening criteria. A random sample of 1,669 medical records (representative of 47,783 hospital admissions) for the year 2009 was analyzed. Results The main results found in this study were an incidence rate of 11.1% AEs, of which around 53.2% were considered preventable. The majority of AEs were associated with surgical procedures (27%), drug errors (18.3%) and hospital acquired infections (12.2%). Most AEs (61%) resulted in minimal or no physical impairment or disability, and 10.8% were associated with death. In 58.6% of the AEs’ cases, the length of stay was prolonged on average 10.7 days. Additional direct costs amounted to €470,380.00. Conclusion The magnitude of these results was critical, reinforcing the need of more detailed studies in this area. The knowledge of the incidence and nature of AEs that occur in hospitals should be seen as a first step towards the improvement of quality and safety in health care.
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Affiliation(s)
- Paulo Sousa
- National School of Public Health, Universidade Nova de Lisboa, Avenida Padre Cruz, 1600-540 Lisboa, Portugal.
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Sacadura-Leite E, Sousa-Uva A, Rebelo-de-Andrade H, Ferreira S, Rocha R. Association between chronic stress and immune response to influenza vaccine in healthcare workers. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.rpsp.2013.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Serranheira F, Cotrim T, Rodrigues V, Nunes C, Sousa-Uva A. Lesões musculoesqueléticas ligadas ao trabalho em enfermeiros portugueses: «ossos do ofício» ou doenças relacionadas com o trabalho? ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.rpsp.2012.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Serranheira F, Cotrim T, Rodrigues V, Nunes C, Sousa-Uva A. Nurses’ working tasks and MSDs back symptoms: results from a national survey. ACTA ACUST UNITED AC 2012; 41 Suppl 1:2449-51. [PMID: 22317085 DOI: 10.3233/wor-2012-0479-2449] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Florentino Serranheira
- National Public Health School, New University of Lisbon, Avenida Padre Cruz, 1600-560 Lisbon, Portugal and CMDT – Malaria and Tropical Diseases Research Center – Public Health, Lisbon, Portugal
| | - Teresa Cotrim
- Human Kinetic Faculty, Technical University of Lisbon, Estrada da Costa, 1499-002 Cruz Quebrada - Dafundo, Lisbon, Portugal
| | - Victor Rodrigues
- Nursing College of Vila Real/CIDESD/University of Trás-os-Montes and Alto Douro, Lugar do Tojal, Lordelo, 5000-232 Vila Real, Portugal
| | - Carla Nunes
- National Public Health School, New University of Lisbon, Avenida Padre Cruz, 1600-560 Lisbon, Portugal and CMDT – Malaria and Tropical Diseases Research Center – Public Health, Lisbon, Portugal
| | - António Sousa-Uva
- National Public Health School, New University of Lisbon, Avenida Padre Cruz, 1600-560 Lisbon, Portugal and CMDT – Malaria and Tropical Diseases Research Center – Public Health, Lisbon, Portugal
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Sacadura-Leite E, Sousa-Uva A, Rebelo-de-Andrade H. Antibody response to the influenza vaccine in healthcare workers. Vaccine 2011; 30:436-41. [PMID: 22064268 DOI: 10.1016/j.vaccine.2011.10.061] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Revised: 10/13/2011] [Accepted: 10/24/2011] [Indexed: 02/05/2023]
Abstract
People vaccinated against influenza develop hemagglutination inhibition (HAI) antibodies (Ab) that bind to the virus and neutralize it. Ab titer levels are variable depending on factors insufficiently studied, and tend to decrease over time. In the present study, we analyzed antibodies responses before and after influenza vaccination in nurses working in a hospital, with the aim of: - identifying seroconversion rates to trivalent influenza vaccine one month after immunization; - evaluating if, six months after vaccination, influenza HAI Ab titer fall comparing to one-month post vaccination HAI Ab titer; - studying the association between the lack of HAI Ab response (seroconversion) assessed one month after immunization and: ◦ past influenza vaccinations, ◦ baseline (before vaccination) HAI Ab titer, ◦ baseline (before vaccination) HAI Ab titer ≥ 40 (considered as a protection titer). Hemagglutination inhibition reaction was used to assess specific HAI Ab titers against influenza A(H(1)N(1)), A(H(3)N(2)) and B virus strains included in the influenza vaccine and we used progressive dilutions of two times, starting on 1:10 until 1:20.480. Seroconversion rates, one month after vaccination, were 66.7% for A(H(1)N(1)) strain, 63.2% for A(H(3)N(2)) strain and 56.3% for B strain. The most immunogenic strain used in 2007/08 influenza vaccine was A(H(1)N(1)). Seroconversion rates after one month were negatively associated with past influenza vaccinations, baseline HAI Ab titers ≥ 40 and baseline HAI Ab titers. Six months after vaccination, 50% of participants showed a drop in HAI Ab titers to an half, for each of the considered strains, but they remain high enough to protect against the disease.
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Affiliation(s)
- Ema Sacadura-Leite
- Occupational Health Department, Hospital de Santa Maria/CHLN, Av. Prof Egas Moniz, 1649-035 Lisbon, Portugal.
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Sousa P, Uva AS, Belo A, Pinto FJ. Constructing risk adjustment models for percutaneous coronary intervention: implications for quality assessment. Rev Port Cardiol 2011; 29:1807-28. [PMID: 21428137 DOI: pmid/21428137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Quality standards, and subsequently benchmarking, based on patient outcome data are a rational means of assessing the quality of health care. However, variation in patients' baseline clinical risk precludes direct comparison of outcomes across operators, institutions and health care plans. In the years since the advent of interventional cardiology, there has been an enormous increase in the volume of activity and number of operators and centers performing percutaneous coronary intervention (PCI), together with considerable developments in the techniques, materials and adjunctive therapy associated with PCI. PCI outcomes depend on various factors, particularly patient characteristics and disease severity. The use of risk adjustment models to quantify differences in patient outcomes in interventional cardiology has been shown to provide a reliable and balanced comparison of performance and to lead to improvements in quality and safety in this area. OBJECTIVES The aim of this study was to develop a risk adjustment model for in-hospital major adverse cardiac and cerebrovascular events (MACCE) and for a single adverse event (in-hospital mortality) following PCI, using data from a national multicenter registry. METHODS This was a cohort study of all patients who underwent PCI in the centers that participate in the National Registry of Interventional Cardiology of the Portuguese Society of Cardiology between June 30, 2003 and June 30, 2006, in a total of 10,399 procedures. RESULTS Factors associated with in-hospital MACCE included: age > 80 years; female gender; acute myocardial infarction; cardiogenic shock; renal failure; severely reduced ejection fraction; three or more diseased vessels; use of intra-aortic balloon pump; no stenting; and urgent/emergent PCI. The same variables were associated with the adverse event of in-hospital mortality. The area under the receiver operating characteristics (ROC) curve and the Hosmer-Lemeshow goodness-of-fit statistic, for both multivariate prediction models, were 0.83 and 0.69 (in-hospital MACCE) and 0.93 and 0.53 (in-hospital mortality), respectively, which indicates that these models have good discrimination and real clinical value and were well calibrated. CONCLUSIONS A risk adjustment model for in-hospital MACCE and for in-hospital mortality after PCI was successfully developed using a large national multicenter registry. This is a powerful tool for quality assessment and represents a significant step towards credible and reliable comparison of results between providers.
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Affiliation(s)
- Paulo Sousa
- Registo Nacional de Cardiologia de Intervenção da Sociedade Portuguesa de Cardiologia, Lisboa, Portugal.
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Sousa P, Uva AS, Pinto F. Risk-adjustment model in health outcomes evaluation: a contribution to strengthen assessment towards quality improvement in interventional cardiology. Int J Qual Health Care 2008; 20:324-30. [PMID: 18621777 DOI: 10.1093/intqhc/mzn029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE The aim of this study was to develop a risk adjustment model for major adverse cardiac and cerebrovascular events following percutaneous coronary intervention (PCI), using data from a national registry, and to highlight the use of the risk adjustment when we evaluate the quality of care in interventional cardiology. DESIGN The STUDY DESIGN was based on a Coorte study. Bivariate and multivariate logistic regression models were used to identify independent risk factors for these major adverse events. SETTING A total of 19 hospitals from the Portuguese National Registry of Interventional Cardiology. PARTICIPANTS Data from 10.641 consecutives procedures collected between June 30, 2003 and June 30, 2006. INTERVENTION Build a risk adjustment model for these major adverse events, following percutaneous coronary intervention. MAIN OUTCOME MEASURE Factors that were associated with major adverse cardiac and cerebrovascular events following percutaneous coronary intervention. RESULTS The rate of in-hospital major adverse cardiac and cerebrovascular events was 1.9%. Factors associated with major adverse cardiac and cerebrovascular events included, among others: age >80 years (adjusted odds ratio = 3.91); female gender (1.72); and cardiogenic shock (6.05). Overall, a good discrimination was achieved with receiver operating characteristics curve = 0.84 and Hosmer-Lemeshow goodness of fit statistic across groups of risk was not significant (P = 0.18) indicating little departure from a perfect fit. CONCLUSIONS These findings will represent an important contribution to quality and safety improvement and should help driving new research and innovative approaches to different subgroups of patients who have higher chances of having an adverse event or poorer outcomes following this intervention.
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Affiliation(s)
- Paulo Sousa
- School of Health Technologies of Lisbon, Lisbon, Portugal.
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Uva ADS. [Aircraft cabin air quality: exposure to ozone]. ACTA MEDICA PORT 2002; 15:143-51. [PMID: 15524159 DOI: pmid/15524159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Ozone is the principal component involved in photochemical pollution of the air. As an irritant of the respiratory system, its effects on the health of those exposed to it are characterised essentially by coughing, shortness of breath, chest pain or tightness and alterations to the pulmonary mechanical function. Additionally, a higher frequency and severity of asthmatic exacerbation and the occurrence of eye irritation are linked to environmental exposure to O3. In the early 1960s the first studies on the exposure to O3 in aircraft cabins appeared, prompted by the occurrence of clinical complaints of irritation of the respiratory tract in crewmembers and passengers. The symptoms had hitherto been attributed to the action of other factors, such as the ventilation system and low level of humidity in the air. An updating is done by author of some factors related to the quality of air inside aircraft cabins, namely the exposure to ozone in crewmembers and passengers.
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Affiliation(s)
- António De Sousa Uva
- Departamento de Saúde Ocupacional, Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisboa
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