NSAID-exacerbated respiratory disease (N-ERD): a population study

BackgroundNonsteroidal anti-inflammatory drugs (NSAIDs) may exacerbate respiratory symptoms. A recent EAACI position paper recommended the use of an acronym, N-ERD (NSAID-exacerbated respiratory disease), for this hypersensitivity associated with asthma or chronic rhinosinusitis (CRS) with or without nasal polyposis. Our aim was to estimate the prevalence of N-ERD and identify factors associated with N-ERD.MethodsIn 2016, a cross-sectional questionnaire survey of a random adult population of 16 000 subjects aged 20–69 years was performed in Helsinki and Western Finland. The response rate was 51.5%.ResultsThe prevalence was 1.4% for N-ERD, and 0.7% for AERD. The prevalence of N-ERD was 6.9% among subjects with asthma and 2.7% among subjects with rhinitis.The risk factors for N-ERD were older age, family history of asthma or allergic rhinitis, long-term smoking and exposure to environmental pollutants. Asthmatic subjects with N-ERD had a higher risk of respiratory symptoms, severe hypersensitivity reactions and hospitalisations than asthmatic subjects without N-ERD. The sub-phenotype of N-ERD with asthma was most symptomatic. Subjects with rhinitis associated with N-ERD, which would not be included in AERD, had the least symptoms.ConclusionWe conclude that the prevalence of N-ERD was 1.4% in a representative Finnish adult population sample. Older age, family history of asthma or allergic rhinitis, cumulative exposure to tobacco smoke, secondhand smoke, and occupational exposures increased odds of N-ERD. N-ERD was associated with significant morbidity.

Occupational Exposure to SARS-CoV-2 and Risk of Infection Among Healthcare Personnel

Objective: To assess the rate and factors associated with healthcare personnel (HCP) testing positive for SARS-CoV-2 after an occupational exposure Design: Retrospective cohort study Setting: Academic medical center with sites in Minnesota, Wisconsin, Arizona, and Florida Subjects: HCP with a high or medium risk occupational exposure to a patient or other HCP with SARS-CoV-2 Methods: We reviewed the records of HCP with significant occupational exposures from March 20th, 2020 through December 31st, 2020. We then performed regression analysis to assess the impact of demographic and occupational variables to assess their impact on the likelihood of testing positive for SARS-CoV-2 Results: A total of 2,253 confirmed occupational exposures occurred during the study period. Employees were the source for 57.1% of exposures. Overall, 101 (4.5%) HCP tested positive in the postexposure period. Of these, 80 had employee sources of exposure and 21 had patient sources of exposure. The post exposure infection rate was 6.2% when employees were the source, compared to 2.2% with patient sources. In a multivariate analysis, occupational exposure from an employee source had a higher risk of testing positive compared to a patient source (OR 3.22 95% CI (1.72-6.04)). Gender, age, high-risk exposure, and HCP role were not associated with increased risk of testing positive. Conclusions: The risk of acquiring COVID-19 following a significant occupational exposure is relatively low, even in the pre-vaccination era. Exposure to an infectious coworker carries a higher risk than exposure to a patient. Continued vigilance and precautions remain necessary in healthcare settings.

Identifying occupational health hazards among healthcare providers and ancillary staff in Ghana: a scoping review protocol

IntroductionThe formation, modification and implementation of occupational health and safety policy for the Ghana healthcare industry hinge on data and reviews on occupational exposures. However, there is no synthesised review to speak to the issues of these occupational exposures. A scoping review on occupational exposures among the health workforce in Ghana will provide a broad overview of exposures, and can guide and assist in making decisions on occupational health issues relating to healthcare workers.Methods and analysisArksey and O’Malley’s scoping review methodology framework will guide the conduct of this scoping review. Primary research studies, government documents and other information on occupational exposures among healthcare workers published in the English language will be retrieved from databases including PubMed, CINAHL, Embase, MEDLINE, Scopus, PsycINFO and Google scholar. A systematic search strategy will be employed to identify articles from 1 January 2010 until 30 November 2021. Also, grey literature sources in Ghana including government and tertiary institutions websites will be searched. A reference list of key studies and other available non-electronic materials will also be screened to identify relevant studies for inclusion. The review will consider studies that address prevalence, knowledge and predisposing factors of occupational exposures along with the use of occupational hazards control/preventive measures. After removal of duplicates, and title and abstract screening, relevant articles will be subjected to full-text analysis. The screening processes will be conducted independently by two reviewers. Data will then be extracted and presented in tabular form with a narrative to aid easy comprehension.Ethics and disseminationThis scoping review does not require ethical approval. The findings will be disseminated through publications, conference presentations and stakeholder meetings.

Analytical Approaches and Trends in the Determination of Psychoactive Drugs in Air

Understanding of the levels of psychoactive drugs in air is important for assessing both occupational and environmental exposure. Intelligence on the usage and manufacture of illegal drugs can also be gained. Environmental analysis and determination of air quality has recently expanded from its traditional focus to new pollutant categories that include illicit and psychoactive drugs. This is attributed to a greater part on the development of new, advanced techniques, such as liquid chromatography/mass spectrometry (LC/MS), allowing for the trace determination of such compounds down to the parts-per-trillion (ng/L) levels generally reported in air. Studies have also investigated the effects of firsthand and secondhand smoking of drugs, such as cocaine, cannabis and opium. Generally, these have shown secondhand smoke effects to be limited, apart from in the case of opium. Some studies have highlighted ill effects resulting through the exposure of vapors and dusts from the storage of drugs, but this has been shown to result from mould and other fungal contaminates. Investigations into the possible occupational exposures resulting from the use of anesthetic drugs in surgery and accident and emergency have focused on nitrous oxide, sevoflurane, methoxyflurane, isoflurane, propofol and fentanyl. This review focuses on developments and applications for the determination of psychoactive drugs in air.

Environmental and occupational health on the Navajo Nation: a scoping review

A scoping review was performed to answer: what environmental health concerns have been associated with adverse health outcomes in the Navajo Nation? The review focused on occupational and ambient environmental exposures associated with human industrial activities. The search strategy was implemented in PubMed, and two investigators screened the retrieved literature. Thirteen studies were included for review. Data were extracted using the matrix method. Six studies described associations between work in uranium mining and cancer. Six studies focused on environmental exposures to uranium mine waste and other metals, with outcomes that included biological markers, kidney disease, diabetes and hypertension, and adverse birth outcomes. One study explored occupational exposure to Sin Nombre Virus and infection. Most research has focused on the health effects of uranium, where occupational exposures occurred among miners and environmental exposures are a legacy of uranium mining and milling. Gaps exist with respect to health outcomes associated with current occupations and the psychosocial impact of environmental hazards. Other environmental exposures and hazards are known to exist on the Navajo Nation, which may warrant epidemiologic research.

USE OF MICRONUCLEUS EXPERIMENTS FOR THE DETECTION OF HUMAN CANCER RISKS: A BRIEF OVERVIEW

Introduction. Micronuclei (MN) are small extranuclear DNA-containing structures that are formed as a consequence of structural and numerical chromosomal aberrations. The advantage of MN experiments compared to conventional chromosomal analyses in metaphase cells is that the scoring is by far less time consuming and laborious. MN experiments are currently widely used for the routine screening of chemicals in vitro and in vivo but also for environmental control and human biomonitoring Objectives. The purpose of this review was to collect data on the use of MN experiments for the detection of increased cancer risks as a consequence of environmental, lifestyle and occupational exposures and the detection/diagnosis of different forms of cancer. Methods. Analysis of the literature on methods for MN experiments with humans; as well as the use of this technique in different areas of research. Results. To date, a wide range of protocols for human biomonitoring studies has been developed for the measurement of MN formation in peripheral blood cells and in epithelial from different organs (buccal and nasal cavity, cervix and bladder). In addition to MN, other nuclear anomalies can be scored which reflect genetic instability as well as acute toxicity and the division of target cells. Conclusions. The evidence is accumulating that MN can be used as a diagnostic tool for the detection of increased cancer risks as well as for the early diagnosis of cervical and bladder cancer