Contaminants in human nail dust: an occupational hazard in podiatry?

Erythrocyte morphology and fatigue levels in podologists

Aesthetic and clinical care of the feet includes reducing nail thickness and removing calluses which are perfomed by high-speed nail drill machines. These micromotors diffuse skin material, nail dust, and pathogenic fungi into the air, some of which are then inhaled and causes an occupational risk to workers. This study examines occupational risks of inhaling organic dust in the working environment of Podologists (PDL) through their erythrocyte morphologies. Chalder Fatigue Scale was used to determine fatigue symptoms of the participants related to occupational exposures. 25 PDL and 26 control subjects were compared. Peripheral smear technique was used to identify erythrocyte morphologies. The results demonstrated that physical, mental, total fatigue levels, and erythrocyte anomaly amounts of the individuals in the PDL group were higher (p < .05). Findings also revealed that fatigue effectively formed Hypochromic, Stomatocytes, Dacrocytes, Elliptocytes, Spherocytes, and Ovalocytes. This study aims to increase awareness of podologists' occupational risks..

Efficacy of a Newly Developed Inward Airflow Safety Cabinet to Prevent the Spread of Infected Nail Dust Particles During Mechanical Nail Reduction in Onychomycosis

BACKGROUND

Nail thickening is a poor prognostic factor in onychomycosis. Mechanical reduction by micromotor nail grinding is an alternative treatment for onychomycosis. However, this treatment introduces a large amount of infected nail dust particles into the air and can adversely affect other patients and health-care providers. The innovative recirculating airflow safety cabinet (ASC) was developed to prevent the spread of these generated infected nail dust particles. The aim of this study was to determine the efficacy of the ASC in patients with onychomycosis or traumatic onychodystrophy.

METHODS

The ASC was used during the nail-grinding process in 50 patients, including 36 onychomycosis patients and 14 traumatic onychodystrophy patients. For each patient, five Sabouraud dextrose agar plates with chloramphenicol were positioned within the working space of the ASC, and the other five plates were positioned near the area of air exit after the carbon filters within the cabinet. A total of 500 plates were incubated at 25°C and evaluated every 7 days. The results of fungal cultures were analyzed.

RESULTS

In the traumatic onychodystrophy group, all fungal cultures of nail dust particles from both before and after filtration from the ASC were negative in all 14 patients. In the onychomycosis group, 52 fungal cultures (28.9%) from nail particles within the ASC working area tested positive; however, the results of fungal cultures of nail dust particles after filtration were all negative.

CONCLUSIONS

The newly developed ASC was found to be effective for preventing the spread of infected nail dust particles generated by micromotor nail grinding to mechanically reduce nail thickness in patients with onychomycosis.

Fungal Lung

Foot and nail care specialists spend a great portion of their day using nail drills to reduce nail thickness and smooth foot calluses. This process generates a large amount of dust, some of which is small enough to breathe in and deposit into the deepest regions of the respiratory tract, potentially causing health problems. Foot and nail dust often contains fungi, from both fungus-infected and healthy-appearing nails. Although the majority of healthy individuals can tolerate inhaled fungi, the immune systems of older, immunocompromised, and allergy-prone individuals often react using the inflammatory T helper cell type 2 pathway, leading to mucus overproduction, bronchoconstriction, and, in severe cases, lung tissue damage. To protect vulnerable podiatry professionals, wearing a surgical mask, using a water spray suppression system on nail drills, installing air filtration systems, and considering drilling technique can help reduce exposure to nail dust.

Common and Best Nail Practices Among Nail Care Providers: A Descriptive Study

PURPOSE

The purpose of this project was to identify common and best practices for safe nail care among nail care providers.

DESIGN

Descriptive study using online survey.

SUBJECTS AND SETTING

The study was conducted by 2 credentialed foot and wound care nurses within a large Midwest healthcare system. Participants were nurses and physicians who provide nail care to patients and individuals in the hospital and community setting such as private homes and nursing homes and hospice agencies.

METHODS

Email invitations with a link to the survey were sent to eligible individuals and organizations in which wound care specialists were employed. Information about the survey was posted on the Certified Foot Care Specialty homepage, and on the Wound, Ostomy and Continence Nursing (WOCN) Members-only Forum and Facebook page.

RESULTS

An estimated 1000 surveys were sent of which 246 surveys were returned. Fifty-three percent (121/229) of respondents were certified through the WOCN Certification Board and 41% (93/229) were certified through the American Foot Care Nurse Association. Most respondents reported using some form of self-protection when filing (225/246, 91.5%), trimming (215/246; 87.4%), or using a rotary tool (204/246, 82.9%) on patients' nails. However, approximately one-fourth of respondents reported offering some type of protection for patients when filing (63/246, 25.6%), trimming (41/246, 16.7%), or using a rotary tool (64/246, 26.0%). Most of the nurses surveyed provided nail care in outpatient and foot care clinics, acute care settings, private homes, and nursing homes/hospice.

CONCLUSIONS

When providing nail care, the patient/client protections should closely mirror the personal protective equipment used by the nurse. Future research is needed to contribute to a national consensus guideline for best practices and protections at all levels of nail care in the acute care and community settings.

Toxicity studies of Aspergillus fumigatus administered by inhalation to B6C3F1/N mice (revised)

Aspergillus fumigatus is a thermotolerant, soil-borne fungal species that is ubiquitous in the environment. Mold was nominated to the National Toxicology Program (NTP) by a private individual due to suspected adverse health effects associated with personal exposure in indoor and occupational settings. A. fumigatus is of particular concern in the biowaste industry as the species can contaminate self-heating compost piles. Because of this potential for personal and occupational exposure and the lack of available toxicity data, toxicity studies were conducted in which male and female B6C3F1/N mice were exposed to A. fumigatus conidia (spores) two times a week for 3 months. All in-life procedures, including inhalation exposure, test article preparation, and hematology analysis, were completed by the National Institute for Occupational Safety and Health (NIOSH, Morgantown, WV). Battelle (Columbus, OH) conducted terminal necropsies, measured terminal body and organ weights, and evaluated gross lesions on-site at NIOSH. Tissue processing and histopathology were completed at Battelle. Grocott's methenamine silver (GMS) staining was performed at NIOSH. Genetic toxicology studies on mouse peripheral blood erythrocytes were conducted by Integrated Laboratory Systems, LLC (Research Triangle Park, NC). (Abstract Abridged).

Tinea pedis-An embarrassing problem for health and beauty-A narrative review

Fungal infections present with a broad spectrum of diseases in humans (from relatively mild superficial infections of the skin and mucous membranes to the invasive or chronic infections of internal organs, which have a high mortality rate). Globally, up to 1.6 million people die each year as a result of various types of mycoses. Currently, many scientific studies focus on the best possible understanding of the aspects of the epidemiology and pathogenesis of invasive mycoses and effective methods to combat them. However, mycoses of the skin and its appendages remain a relatively less explored area. In some communities, superficial mycoses are a frequent problem as they affect nearly 70% of the population, an example of which is the athlete's foot. It involves the nails (onychomycosis) and skin (tinea pedis). It is mainly caused by keratin-decomposing dermatophyte fungi. Less often, infections are caused by non-dermatophyte moulds (Fusarium, Aspergillus, Scopulariopsis) or yeasts. Several factors have been listed as having substantial influence on the development of dermatophytosis, including those related to climate, season, geographical region, as well as to demography, socioeconomic and cultural customs, professions or contact with animals. In this review, we summarise the current knowledge about aetiology, epidemiology, diagnostics and therapy of tinea pedis with a special focus to the role of podologic management in spreading, prevention and therapy of mycoses. The article presents up-to-date knowledge on the management of the patient from the diagnosis, treatment and skincare, to counselling on how to prevent fungal skin infections in the long term.

Fungal burden exposure assessment in podiatry clinics from Ireland

Fungi are amongst the bioaerosols of most importance, as indicated by the growing interest in this field of research. The aim was to characterize the exposure to fungal burden in podiatry clinics using culture-based and molecular methods.

METHODS

Airborne fungi were collected using an impaction air sampler and surface samples were also performed. Fourteen air samples were collected for direct detection of fungal DNA from filamentous fungi and dermatophytes. Overall, 63.6 % of the evening samples and 46 % of the morning samples surpassed the threshold values (150 CFU/m³). Molecular detection, by real time PCR, of the target fungal species/strains (Aspergillus and Stachybotrys species) was negative for all samples collected. Trichophyton rubrum was detected by PCR analysis in one DNA sample collected on day six. Results suggest the use of both culture-based and molecular methodologies are desirable for a complete evaluation of fungal burden in this particular health care setting.

Detection of dermatophytes in human nail and skin dust produced during podiatric treatments in people without typical clinical signs of mycoses

Pedicures are the most common cosmetic foot treatment. Many pedicurists and podiatrists suffer from respiratory infections and diseases such as asthma, sinusitis, chronic cough and bronchitis. Skin and nail dust may play an important role in the development of occupational diseases and the transmission of mycosis to other clients. To examine the presence of dermatophytes in nail and skin dust produced during podiatric treatments of people without typical symptoms of mycosis and to assess the epidemiological hazards of tinea pedis for podiatrists as well as other clients. Seventy-seven samples underwent direct microscopy and culture. The results of direct microscopy were positive in 28/77 samples (36.36%) and doubtful in 3/77 (3.9%). Fungi were cultured from 36/77 samples (46.75%), including 8/77 (10.3%) positive for dermatophytes (Trichophyton rubrum-6 isolates and Trichophyton mentagrophytes-2). Material collected during podiatric treatments is potentially infected by pathogenic fungi; thus, there is a need to protect both workers who perform such treatments, as well as other clients, to prevent the transmission of pathogens in the Salon environment. Exposure to this occupational hazard may increase not only the risk of respiratory infections but also increase asthmatic or allergic reactions to Trichophyton.

Suitability of electrolyzed oxidizing water for the disinfection of hard surfaces and equipment in radiology

BACKGROUND

Hospitals are faced with increasingly resistant strains of micro-organisms. When it comes to disinfection, individual parts of electronic equipment of angiology diagnostics such as patient couches of computer tomography (CT) and magnetic resonance imaging (MRI) scanners prove to be very hard to disinfect. Disinfectants of choice are therefore expected to possess properties such as rapid, residue-free action without any damaging effect on the sensitive electronic equipment. This paper discusses the use of the neutral electrolyzed oxidizing water (EOW) as a biocide for the disinfection of diagnostic rooms and equipment.

METHODS

The CT and MRI rooms were aerosolized with EOW using aerosolization device. The presence of micro-organisms before and after the aerosolization was recorded with the help of sedimentation and cyclone air sampling. Total body count (TBC) was evaluated in absolute and log values.

RESULTS

The number of micro-organisms in hospital rooms was low as expected. Nevertheless, a possible TBC reduction between 78.99-92.50% or 50.50-70.60% in log values was recorded.

CONCLUSIONS

The research has shown that the use of EOW for the air and hard surface disinfection can considerably reduce the presence of micro-organisms and consequently the possibility of hospital infections. It has also demonstrated that the sedimentation procedure is insufficient for the TBC determination. The use of Biocide aerosolization proved to be efficient and safe in all applied ways. Also, no eventual damage to exposed devices or staff was recorded.