Disorders induced by direct occupational exposure to noise: Systematic review

PPARα suppresses low-intensity-noise-induced body weight gain in mice: the activated HPA axis plays an critical role

BACKGROUND

As the second most risky environmental pollution, noise imposes threats to human health. Exposure to high-intensity noise causes hearing impairment, psychotic disorders, endocrine modifications. The relationship among low-intensity noise, obesity and lipid-regulating nuclear factor PPARα is not yet clear.

METHODS

In this study, male wild-type (WT) and Pparα-null (KO) mice on a high-fat diet (HFD) were exposed to 75 dB noise for 12 weeks to explore the effect of low-intensity noise on obesity development and the role of PPARα. 3T3-L1 cells were treated with dexamethasone (DEX) and sodium oleate (OA) to verify the down-stream effect of hypothalamic-pituitary-adrenal (HPA) axis activation on the adipose tissues.

RESULTS

The average body weight gain (BWG) of WT mice on HFD exposed to noise was inhibited, which was not observed in KO mice. The mass and adipocyte size of adipose tissues accounted for the above difference of BWG tendency. In WT mice on HFD, the adrenocorticotropic hormone level was increased by the noise challenge. The aggravation of fatty liver by noise exposure occurred in both mouse lines, and the transport of hepatic redundant lipid to adipose tissues were similar. The lipid metabolism in adipose tissue driven by HPA axis accorded with the BWG inhibition in vivo, validated in 3T3-L1 adipogenic stem cells.

CONCLUSION

Chronic exposure to low-intensity noise aggravated fatty liver in both WT and KO mice. BWG inhibition was observed only in WT mice, which covered up the aggravation of fatty liver by noise exposure. PPARα mediates the activation of HPA axis by noise exposure in mice on HFD. Elevated adrenocorticotropic hormone (ACTH) promoted lipid metabolism in adipocytes, which contributed to the disassociation of BWG and fatty liver development in male WT mice. Summary of PPARα suppresses noise-induced body weight gain in mice on high-fat-diet. Chronic exposure to low-intensity noise exposure inhibited BWG by PPARα-dependent activation of the HPA axis.

A Scoping Review on Occupational Noise Mitigation Strategies and Recommendations for Sustainable Ship Operations

Environmental and occupational noise has the potential to result in health risks. The presence of high noise levels aboard ships can cause substantial hazards that affect the well-being of those employed in the maritime industry. The study and implementation of occupational noise reduction aboard ships are of the highest priority for ensuring the well-being of marine workers, compliance with regulatory standards, protection of the environment, and improvement of overall operational efficiency and safety within the maritime sector. A scoping study was conducted to collect and summarize the existing scientific literature about approaches to preventing occupational noise in vessel operations. We searched electronic databases for papers published up to June 2024. Initially, 94 articles were identified for screening, and the present research produced 16 studies, which were finally analyzed. Resultantly, noise control may begin with elimination, substitution, engineering, administrative, and hearing protection (ear plugs or muffs). Noise control innovation would be started with engineering techniques. Hearing protection devices (HPDs) could be used to reduce noise and as an instrument of communication between sailors. More research needs to be carried out in order to find the best ways for maritime vessels to reduce noise at work and to see how well they work in lowering the risks that come with noise for workers on board.

The physical and psychological effects of occupational noise among seafarers: a systematic review

The aims were to highlight noise levels on board and the health effects of noise on seafarers. Data was collected from multiple databases: PubMed, Web of Science, Scopus, and Ebsco Host. Initially, the search resulted in a total of 197 articles, 16 were chosen. Several ships were found which most sailors had noise-induced hearing loss (NIHL) (n = 6). The engine room has been defined as having the highest level of noise. In addition, noise exposure was associated with hearing loss, tinnitus, sleep disturbances, communication difficulties, poor concentration, dizziness, depression, anxiety, headache, fatigue, and stress. Noise exposure is not the only factor that causes health problems: the duration of exposure while working, years of career as a maritime worker, age, lifestyle habits (smoking, alcohol consumption), and even hobbies related to loud sound (such as concert/disco attendance, listen to loud music, etc.) were associated with the adverse health effects experienced by seafarers.

Computer programs used in the field of hospital pharmacy for the management of dangerous drugs: systematic review of literature

Background

This review wants to highlight the importance of computer programs used to control the steps in the management of dangerous drugs. It must be taken into account that there are phases in the process of handling dangerous medicines in pharmacy services that pose a risk to the healthcare personnel who handle them. Objective: To review the scientific literature to determine what computer programs have been used in the field of hospital pharmacy for the management of dangerous drugs (HDs).

Methods

The following electronic databases were searched from inception to July 30, 2021: MEDLINE (via PubMed), Embase, Cochrane Library, Scopus, Web of Science, Latin American and Caribbean Literature in Health Sciences (LILACS) and Medicine in Spanish (MEDES). The following terms were used in the search strategy: "Antineoplastic Agents," "Cytostatic Agents," "Hazardous Substances," "Medical Informatics Applications," "Mobile Applications," "Software," "Software Design," and "Pharmacy Service, Hospital."

Results

A total of 104 studies were retrieved form the databases, and 18 additional studies were obtained by manually searching the reference lists of the included studies and by consulting experts. Once the inclusion and exclusion criteria were applied, 26 studies were ultimately included in this review. Most of the applications described in the included studies were used for the management of antineoplastic drugs. The most commonly controlled stage was electronic prescription; 18 studies and 7 interventions carried out in the preparation stage focused on evaluating the accuracy of chemotherapy preparations.

Conclusion

Antineoplastic electronic prescription software was the most widely implemented software at the hospital level. No software was found to control the entire HD process. Only one of the selected studies measured safety events in workers who handle HDs. Moreover, health personnel were found to be satisfied with the implementation of this type of technology for daily work with these medications. All studies reviewed herein considered patient safety as their final objective. However, none of the studies evaluated the risk of HD exposure among workers.

Association between Occupational Noise Exposure and Insomnia among Night-Shift Production Workers: A 4-Year Follow-up Study

Objectives

This study aimed to investigate whether occupational noise exposure is a risk factor for insomnia among male night-shift production workers.

Methods

This study followed 623 male night-shift production workers at a tire manufacturing factory without insomnia for 4 years. Insomnia was evaluated based on the insomnia severity index at baseline and at 4-year follow-up. A score of ≥15 was defined as insomnia. The higher occupational noise exposure group was defined as those individuals exposed to 8-hour time-weighted-average noise above 80 dB (A).

Results

Participants' mean age was 46.3 ± 5.6 years. Of the 623 participants, 362 (58.1%) were in the higher occupational noise exposure group. At 4-year follow-up, insomnia occurred in 3.2% (n = 20) of the participants. In a multiple logistic regression analysis, the odds ratio of insomnia was 3.36 (95% confidence interval 1.083-10.405, P = 0.036) in the higher occupational noise exposure group when compared with the lower noise exposure group after adjusting for confounders.

Conclusion

Our findings suggested that occupational noise exposure affected insomnia in male night-shift production workers. To prevent insomnia, efforts are required to reduce workplace noise exposure levels. Alternatively, moving to a less noisy work environment should be considered for workers with severe insomnia.

Evaluating brain spectral and connectivity differences between silent mind-wandering and trance states

Trance is an altered state of consciousness characterized by alterations in cognition. In general, trance states induce mental silence (i.e., cognitive thought reduction), and mental silence can induce trance states. Conversely, mind-wandering is the mind's propensity to stray its attention away from the task at hand and toward content irrelevant to the current moment, and its main component is inner speech. Building on the previous literature on mental silence and trance states and incorporating inverse source reconstruction advances, the study's objectives were to evaluate differences between trance and mind-wandering states using: (1) electroencephalography (EEG) power spectra at the electrode level, (2) power spectra at the area level (source reconstructed signal), and (3) EEG functional connectivity between these areas (i.e., how they interact). The relationship between subjective trance depths ratings and whole-brain connectivity during trance was also evaluated. Spectral analyses revealed increased delta and theta power in the frontal region and increased gamma in the centro-parietal region during mind-wandering, whereas trance showed increased beta and gamma power in the frontal region. Power spectra at the area level and pairwise comparisons of the connectivity between these areas demonstrated no significant difference between the two states. However, subjective trance depth ratings were inversely correlated with whole-brain connectivity in all frequency bands (i.e., deeper trance is associated with less large-scale connectivity). Trance allows one to enter mentally silent states and explore their neurophenomenological processes. Limitations and future directions are discussed.

The Effects of the Exogenous Melatonin on Shift Work Sleep Disorder in Health Personnel: A Systematic Review

(1) Background: To know the medical documentation related to exogenous melatonin in sleep disorders caused by shift work in health personnel; (2) Methods: Systematic and critical review. Data were obtained by looking up the bibliographic data base: MEDLINE (via Pubmed), Embase, Cochrane Library, Scopus, Web of Science, Latin American and Caribbean literature in Health Sciences (LILACS) and Medicine in Spanish (MEDES). The used terms, as descriptors and text in the title and abstract record fields, were "Health Personnel", "Melatonin" and "Sleep Disorders", Circadian Rhythm, by using the following filters: "Humans", "Adult: 19+ years" and "Clinical Trial". The search update was in December 2021. The documentary quality of the articles was assessed using the CONSORT questionnaire. (3) Results: Having applied the inclusion and exclusion criteria, 10 clinical essays were selected out of 98 retrieved references. CONSORT scores ranged from a minimum of 6.0 to a maximum of 13. 7 with a median of 10.2. According to the SIGN criteria, this review presented "1-"evidence with a grade of recommendation B. The intervention dose via administration of exogenous melatonin ranged between 1 and 10 mg. It was not mentioned whether the route of administration was by fast or slow absorption. The outcomes showed decreased daytime sleepiness, lessened sleep onset latency, diminished night-time awakenings, increased total sleep period and improved daytime attention in the melatonin-treated group; (4) Conclusions: Exogenously administered melatonin is effective in shift worker health personnel that are suffering from sleep disorders, and given its low adverse effects and tolerability, it might be recommended. A great disparity was evidenced in terms of dose, follow-up periods and type of melatonin, small participant population, same age ranges and young age. Therefore, new trials would be needed to amend these observations in order to have full evidence that is able to ensure the efficacy of exogenous melatonin in the studied population.

The effect of occupational exposure to noise on ischaemic heart disease, stroke and hypertension: A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-Related Burden of Disease and Injury

BACKGROUND

The World Health Organization (WHO) and the International Labour Organization (ILO) are developing joint estimates of the work-related burden of disease and injury (WHO/ILO Joint Estimates), with contributions from a large number of individual experts. Evidence from mechanistic data suggests that occupational exposure to noise may cause cardiovascular disease (CVD). In this paper, we present a systematic review and meta-analysis of parameters for estimating the number of deaths and disability-adjusted life years from CVD that are attributable to occupational exposure to noise, for the development of the WHO/ILO Joint Estimates.

OBJECTIVES

We aimed to systematically review and meta-analyse estimates of the effect of any (high) occupational exposure to noise (≥85 dBA), compared with no (low) occupational exposure to noise (<85 dBA), on the prevalence, incidence and mortality of ischaemic heart disease (IHD), stroke, and hypertension.

DATA SOURCES

A protocol was developed and published, applying the Navigation Guide as an organizing systematic review framework where feasible. We searched electronic academic databases for potentially relevant records from published and unpublished studies up to 1 April 2019, including International Trials Register, Ovid MEDLINE, PubMed, Embase, Lilacs, Scopus, Web of Science, and CISDOC. The MEDLINE and Pubmed searches were updated on 31 January 2020. We also searched grey literature databases, Internet search engines and organizational websites; hand-searched reference lists of previous systematic reviews and included study records; and consulted additional experts.

STUDY ELIGIBILITY AND CRITERIA

We included working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State but excluded children (<15 years) and unpaid domestic workers. We included randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the effect of any occupational exposure to noise on CVD prevalence, incidence or mortality, compared with the theoretical minimum risk exposure level (<85 dBA).

STUDY APPRAISAL AND SYNTHESIS METHODS

At least two review authors independently screened titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. We prioritized evidence from cohort studies and combined relative risk estimates using random-effect meta-analysis. To assess the robustness of findings, we conducted sensitivity analyses (leave-one-out meta-analysis and used as alternative fixed effects and inverse-variance heterogeneity estimators). At least two review authors assessed the risk of bias, quality of evidence and strength of evidence, using Navigation Guide tools and approaches adapted to this project.

RESULTS

Seventeen studies (11 cohort studies, six case-control studies) met the inclusion criteria, comprising a total of 534,688 participants (39,947 or 7.47% females) in 11 countries in three WHO regions (the Americas, Europe, and the Western Pacific). The exposure was generally assessed with dosimetry, sound level meter and/or official or company records. The outcome was most commonly assessed using health records. We are very uncertain (low quality of evidence) about the effect of occupational exposure to noise (≥85 dBA), compared with no occupational exposure to noise (<85 dBA), on: having IHD (0 studies); acquiring IHD (relative risk (RR) 1.29, 95% confidence interval (95% CI) 1.15 to 1.43, two studies, 11,758 participants, I² 0%); dying from IHD (RR 1.03, 95% CI 0.93-1.14, four studies, 198,926 participants, I² 26%); having stroke (0 studies); acquiring stroke (RR 1.11, 95% CI 0.82-1.65, two studies, 170,000 participants, I² 0%); dying from stroke (RR 1.02, 95% CI 0.93-1.12, three studies, 195,539 participants, I² 0%); having hypertension (0 studies); acquiring hypertension (RR 1.07, 95% CI 0.90-1.28, three studies, four estimates, 147,820 participants, I² 52%); and dying from hypertension (0 studies). Data for subgroup analyses were missing. Sensitivity analyses supported the main analyses.

CONCLUSIONS

For acquiring IHD, we judged the existing body of evidence from human data to provide "limited evidence of harmfulness"; a positive relationship is observed between exposure and outcome where chance, bias, and confounding cannot be ruled out with reasonable confidence. For all other included outcomes, the bodies of evidence were judged as "inadequate evidence of harmfulness". Producing estimates for the burden of CVD attributable to occupational exposure to noise appears to not be evidence-based at this time.

PROTOCOL IDENTIFIER

10.1016/j.envint.2018.09.040.

PROSPERO REGISTRATION NUMBER

CRD42018092272.

Vibroacoustical Performance Analysis of a Rigid Device Casing with Piezoelectric Shunt Damping

Noise and vibration are common issues that may have a negative impact on human's' health. To minimize their consequences, several vibroacoustical methods may be employed. One well-known method is Piezoelectric Shunt Damping (PSD). Over the years, many approaches have been investigated, from passive, state switching circuits to active pulse-switching. In this paper, the authors propose three PSD implementations-passive Synchronized Switch Damping on Inductor (SSDI), semi-active SSDI and active Synchronized Switch Damping on Voltage source (SSDV)-for a single-panel structure mounted on a rigid-frame casing. The nine Macro Fiber Composite (MFC) elements were mounted on the plate based on preliminary simulations in FreeFEM. Then, the theoretical results were validated by an identification experiment. The main research is concentrated on the Sound Pressure Level (SPL) and structural vibrations reduction for selected frequencies. The active method provided the highest reduction of vibration-up to 5.5 dB for maximal possible loudspeaker level without overdrive and up to 7.5 dB for lower excitation levels.

Building a European exposure science strategy

Exposure information is a critical element in various regulatory and non-regulatory frameworks in Europe and elsewhere. Exposure science supports to ensure safe environments, reduce human health risks, and foster a sustainable future. However, increasing diversity in regulations and the lack of a professional identity as exposure scientists currently hamper developing the field and uptake into European policy. In response, we discuss trends, and identify three key needs for advancing and harmonizing exposure science and its application in Europe. We provide overarching building blocks and define six long-term activities to address the identified key needs, and to iteratively improve guidelines, tools, data, and education. More specifically, we propose creating European networks to maximize synergies with adjacent fields and identify funding opportunities, building common exposure assessment approaches across regulations, providing tiered education and training programmes, developing an aligned and integrated exposure assessment framework, offering best practices guidance, and launching an exposure information exchange platform. Dedicated working groups will further specify these activities in a consistent action plan. Together, these elements form the foundation for establishing goals and an action roadmap for successfully developing and implementing a 'European Exposure Science Strategy' 2020-2030, which is aligned with advances in science and technology.

Spectral Analysis of Macro-Fiber Composites Measured Vibration of Double-Panel Structure Coupled with Solenoids

Noise may have a negative impact on humans health and well being. Noise is a direct result of the vibration of structures. Many industrial workers and people using household appliances may be exposed to these harmful factors. To minimize their negative consequences, different approaches to noise and vibration reduction may be applied, e.g., active, semi-active or passive methods. In this research, a semi-active approach to vibration reduction of a cubic rigid casing enclosing a noise- and vibration-generating device is presented. One of the casing walls consists of double thin steel panels, coupled with the use of electromagnetic dampers—solenoids installed in the space between the panels. Other casing walls are built of single plywood panels. Vibrations of the outer (radiating) panel of the wall are measured by Macro-Fiber Composite patches. Spectral analysis of structure vibration is carried out to identify the benefits of the proposed coupling solution in terms of vibration reduction of the wall. The frequency range, where vibration reduction is observed, depends on the number of activated solenoids and the duty cycle of a Pulse Width Modulation (PWM) signal. Advantages and drawbacks of the proposed method are discussed and future improvements of the examined setup are suggested.

Associations between multiple occupational exposures and sleep problems: Results from the national French Working Conditions survey

Studies evaluating the effects of multiple occupational exposures on sleep are very rare. We assessed the associations between a wide range of occupational exposures and sleep problems and investigated the cumulative effects of these exposures on this outcome. We used data from the French 2016 Working Conditions survey conducted on a nationally representative sample of workers, including 20,430 employees aged 15-65 yr (8,579 men, 11,851 women). Sleep problems were defined by either sleep disturbances or sleep medication, almost daily or several times a week. Occupational exposures included 21 psychosocial work factors grouped into five dimensions, four factors related to working time/hours and four factors related to the physical work environment. Unadjusted and adjusted weighted robust Poisson regression analyses were performed. Almost all psychosocial work exposures were associated with sleep problems, whereas the only significant working time/hours factor associated with sleep problems was night work among women. Some gender differences in the exposure-outcome associations were found. The prevalence ratio of sleep problems increased with the number of exposures for most dimensions of psychosocial work factors. Physical work exposures were associated with sleep problems, and there was a linear association between the number of these occupational exposures and sleep problems in both genders, although the trend did not reach statistical significance among women. Workplace preventive strategies targeting the work environment comprehensively may be effective in improving sleep among working populations. More attention should be given to multiple exposures in the workplace.

Factors associated with perception of loud occupational noise by school teachers in basic education in Brazil

OBJECTIVE

To determine the prevalence of the perception of loud noise in basic education schools in Brazil and the associated factors.

METHODS

A cross-sectional study with a representative national sample of teachers. The data collection was conducted with 6,510 teachers from October 2015 to March 2016. All teachers answered a telephone questionnaire with questions related to health and working conditions. The measure of association was prevalence ratio, estimated using Poisson regression.

RESULTS

The prevalence of reported loud occupational noise was 33.0%. There was a positive association in the outcome of classroom disturbance reports (PR = 3.41; 95%CI 3.07 - 3.75), feeling of working under high-pressure levels (PR = 1.33; 95%CI 1.22-1.45), having suffered verbal abuse from students (PR = 1.21; 95%CI 1.11-1.31), teaching in different teaching modalities (PR = 1.21; 95%CI 1.02-1.42), more than 30 active teachers in the school (PR = 1.28; 95%CI 1.07-1.54). The teachers who reported a pleasant school environment (PR = 0.81; 95%CI 0.75-0.87), along with the teachers who worked in rural areas (PR = 0.84; 95%CI 0.75-0.95), experienced less noise at work.

CONCLUSION

The prevalence of loud noise perception in Brazilian schools reached high levels and showed statistical significance with the characteristics of schools and teacher's work environment. These results demonstrate the need for developing public policies that take into consideration the reduction of noise levels in schools.

WHO/ILO work-related burden of disease and injury: Protocol for systematic reviews of exposure to occupational noise and of the effect of exposure to occupational noise on cardiovascular disease

BACKGROUND

The World Health Organization (WHO) and the International Labour Organization (ILO) are developing a joint methodology for estimating the national and global work-related burden of disease and injury (WHO/ILO joint methodology), with contributions from a large network of experts. In this paper, we present the protocol for two systematic reviews of parameters for estimating the number of deaths and disability-adjusted life years from cardiovascular disease attributable to exposure to occupational noise, to inform the development of the WHO/ILO joint methodology.

OBJECTIVES

We aim to systematically review studies on exposure to occupational noise (Systematic Review 1) and systematically review and meta-analyse estimates of the effect of occupational noise on cardiovascular diseases (Systematic Review 2), applying the Navigation Guide systematic review methodology as an organizing framework, conducting both systematic reviews in tandem and in a harmonized way.

DATA SOURCES

Separately for Systematic Reviews 1 and 2, we will search electronic academic databases for potentially relevant records from published and unpublished studies, including Medline, EMBASE, Web of Science and CISDOC. We will also search electronic grey literature databases, Internet search engines and organizational websites; hand search reference list of previous systematic reviews and included study records; and consult additional experts.

STUDY ELIGIBILITY AND CRITERIA

We will include working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State, but exclude children (<15 years) and unpaid domestic workers. The eligible risk factor will be occupational noise. Eligible outcomes will be hypertensive heart disease, ischaemic heart disease, stroke, cardiomyopathy, myocarditis, endocarditis and other circulatory diseases. For Systematic Review 1, we will include quantitative prevalence studies of exposure to occupational noise (i.e., low: <85 dB(A) and high: ≥85 dB(A)) stratified by country, sex, age and industrial sector or occupation. For Systematic Review 2, we will include randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the relative effect of high exposure to occupational noise on the prevalence of, incidence of or mortality due to cardiovascular disease, compared with the theoretical minimum risk exposure level (i.e., low exposure).

STUDY APPRAISAL AND SYNTHESIS METHODS

At least two review authors will independently screen titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. At least two review authors will assess risk of bias and the quality of evidence, using the most suited tools currently available. For Systematic Review 2, if feasible, we will combine relative risks using meta-analysis. We will report results using the guidelines for accurate and transparent health estimates reporting (GATHER) for Systematic Review 1 and the preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA) for Systematic Review 2. PROSPERO registration number: CRD42018092272.

Will daytime occupational noise exposures induce nighttime sleep disturbance?

BACKGROUND

Nighttime environmental noise affects sleep quality. However, the effects of daytime occupational noise remain unclear.

METHODS

A quasi-experiment of 48 participants who had been employed for at least six months in two hospital cafeterias. The participants were randomly designated to be assessed on high- and low-noise workdays for 8 h or low- and high-noise workdays, separated by a washout period of 14 days. Subsequently, pure tone audiometry, autonomic nervous system (ANS) function tests, serum cortisol tests, and polysomnography were conducted.

RESULTS

For the 40 participants in the study, the 8-h time-weighted average of personal noise exposed on high- and low-noise workdays was 76.8 dBA (standard deviation, SD: 6.2) and 61.0 dBA (SD: 7.1), respectively. Participants with higher personal noise exposure during the day were found to have a lower percentage of slow wave sleep (percent change of mean value: -1.287%; 95% CI: -2.602%, -0.037%) and lower sleep efficiency (-0.267%; 95% CI: -0.525%, -0.008%). In addition, after work, personal noise exposure was revealed to be related to increased serum cortisol levels (1.698%; 95% CI: 0.887%, 2.528%), and sympathetic activity as measured by low frequency/high frequency (3.000%; 95% CI: 1.294%, 4.706%) and blood pressures by cold pressor test (systolic: 5.163%; 95% CI: 2.780%, 7.537%) (diastolic: 3.109%; 95% CI: 1.604%, 4.614%).

CONCLUSIONS

Daytime occupational noise exposure had sustained effects on nighttime sleep quality, specifically on slow wave sleep and sleep efficiency. These disturbances could be partially explained by post-shift elevated cortisol and ANS activity. The psychosocial and metabolic consequences of poorer sleep quality induced by occupational noise exposure warrant further investigation.

Guidelines for safe handling of hazardous drugs: A systematic review

Objective

To review the scientific literature related to the safe handling of hazardous drugs (HDs).

Method

Critical analysis of works retrieved from MEDLINE, the Cochrane Library, Scopus, CINHAL, Web of Science and LILACS using the terms "Hazardous Substances", "Antineoplastic Agents" and "Cytostatic Agents", applying "Humans" and "Guidelines" as filters. Date of search: January 2017.

Results

In total, 1100 references were retrieved, and from those, 61 documents were selected based on the inclusion and exclusion criteria: 24 (39.3%) documents related to recommendations about HDs; 27 (44.3%) about antineoplastic agents, and 10 (33.3%) about other types of substances (monoclonal antibodies, gene medicine and other chemical and biological agents). In 14 (23.3%) guides, all the stages in the manipulation process involving a risk due to exposure were considered. Only one guide addressed all stages of the handling process of HDs (including stages with and without the risk of exposure). The most described stages were drug preparation (41 guides, 67.2%), staff training and/or patient education (38 guides, 62.3%), and administration (37 guides, 60.7%). No standardized informatics system was found that ensured quality management, traceability and minimization of the risks associated with these drugs.

Conclusions

Most of the analysed guidelines limit their recommendations to the manipulation of antineoplastics. The most frequently described activities were preparation, training, and administration. It would be convenient to apply ICTs (Information and Communications Technologies) to manage processes involving HDs in a more complete and simpler fashion.

Web 2.0 Tools in the Prevention of Curable Sexually Transmitted Diseases: Scoping Review

Background

The internet is now the primary source of information that young people use to get information on issues related to sex, contraception, and sexually transmitted infections.

Objective

The goal of the research was to review the scientific literature related to the use of Web 2.0 tools as opposed to other strategies in the prevention of curable sexually transmitted diseases (STDs).

Methods

A scoping review was performed on the documentation indexed in the bibliographic databases MEDLINE, Cochrane Library, Scopus, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Literatura Latinoamericana y del Caribe en Ciencias de la Salud, PsycINFO, Educational Resources Information Center, the databases of Centro Superior de Investigaciones Científicas in Spain, and the Índice Bibliográfico Español de Ciencias de la Salud from the first available date according to the characteristics of each database until April 2017. The equation search was realized by means of the using of descriptors together with the consultation of the fields of title register and summary with free terms. Bibliographies of the selected papers were searched for additional articles.

Results

A total of 627 references were retrieved, of which 6 papers were selected after applying the inclusion and exclusion criteria. The STDs studied were chlamydia, gonorrhea, and syphilis. The Web 2.0 tools used were Facebook, Twitter, Instagram, and YouTube. The 6 papers used Web 2.0 in the promotion of STD detection.

Conclusions

Web 2.0 tools have demonstrated a positive effect on the promotion of prevention strategies for STDs and can help attract and link youth to campaigns related to sexual health. These tools can be combined with other interventions. In any case, Web 2.0 and especially Facebook have all the potential to become essential instruments for public health.