Kocaeli’de evlerde, ofislerde ve okullarda iç ortam hava kalitesinin belirlenmesi

TÜBİTAK ÇAYDAG01.01.2008Bu çalışmada, Kocaeli’de farklı bölgelerde ve farklı mikroçevrelerde (ev, okul, ofis), iç ve dış ortamda yapılan örneklemeler ile aktif ve pasif örnekleme ve ölçüm teknikleri kullanılarak 2 farklı partikül fraksiyonunda (PM2.5 ve PM10) 16 ağır metal (Al, As, Ca, Cr, Cu, Fe, K, Mg, Mn, Ni, Pb, S, Si, Ti, V ve Zn), uçucu organik bileşikler (UOB’ler), SO2, NO2 ve O3 konsantrasyonları belirlenmiştir. Ayrıca, iç ortamda ölçülen konsantrasyonlarla maruziyet arasındaki ilişkiyi kurabilmek için, kişisel örnekleyiciler kullanılarak kişisel maruziyet düzeyleri de belirlenmiştir. NO2 için İç Ortam/Dış Ortam konsantrasyon oranlarının evlerde her 2 mevsimde de okullar ve ofislere nazaran yüksek bulunması evlerin iç ortamlarında NO2 kirletici kaynaklarının ofis ve okullara oranla daha baskın olduğu göstermektedir. İç Ortam/Dış Ortam oranlarının 1’in çok altında bulunması O3 ve SO2’in dış ortam kaynaklı bir kirletici olduğunu ve iç ortamlarda önemli bir kaynağının bulunmadığını göstermektedir. PM2.5 fraksiyonundaki toprak kaynaklı elementlerin iç ve dış ortam konsantrasyonlarının yüksek düzeylerde bulunması bu elementlerin iç ortamlara taşınımının yüksek olduğunu göstermektedir. PM2.5 kişisel maruziyet düzeylerinin As, S, V, Cu ve Cr gibi yanma kaynaklı elementler için iç ortam maruziyet düzeylerinden 2–6 kat daha yüksek olması ve bazı mevsimsel farklılıklar bulunmasına rağmen İç Ortam/Dış Ortam oranlarının genellikle 0.3–0.7 aralığında bulunması gözlenen yüksek kişisel maruziyet düzeylerinde dış ortamların etkisini göstermektedir. PM10 partikül fraksiyonunda belirlenen ağır metallerin büyük bir bölümü için İç Ortam/Dış Ortam oranlarının 1’den küçük bulunması dış ortam kirletici kaynaklarının iç ortam kirletici kaynaklarına daha baskın olduğunu göstermektedir. En yüksek UOB kirlilik düzeylerine örneklenen kişilerde rastlanırken bunu iç ortam ve dış ortam UOB kirlilik düzeyleri takip etmiştir. Her 2 mevsimde de toluen ev, ofis ve okullardaki UOB kirlilik düzeylerine en çok katkıda bulunan bileşik olurken onu etilbenzen, m,p-ksilen, stiren, nonan, hegzan, benzen, o-ksilen ve heptan bileşikleri takip etmektedir. Kentsel alanlarda elde edilen toplam UOB konsantrasyonlarının endüstriyel alanlarda elde edilen değerlerle uyum içinde bulunmuştur. Trafiğin belirteci olan bileşikler (BTEX, 1,2,4-trimetilbenzen) kentsel alanlarda yüksek bulunurken petrokimyanın belirteci olan hexane ve heptane bileşikleri endüstrinin yoğun olduğu alanlarda yüksek bulunmuştur. Ayrıca kentsel ve endüstriyel alanlarda elde edilen UOB konsantrasyonlarının sanayii ve trafikten uzak alanlarda elde edilen konsantrasyonlardan yüksek olması trafik ve sanayiinin tesbit edilen UOBlere olan katkısının ne kadar yüksek olduğunu göstermektedir. İç ortam, dış ortam ve kişisel maruziyet kirlilik düzeylerine etki ederek hava kalitesine olumsuz yönde katkıda bulunan kirletici kaynakların belirlenmesi amacıyla Pozitif Matris Faktörizasyonu (PMF) reseptör modelleme tekniği kullanılmıştır. PMF modellemesi, korelasyon analizi, iç ortam/dış ortam oranları, mikroçevre karakteristikleri, anketler ve zaman aktivite çizelgeleri incelenen kirleticilerin en önemli emisyon kaynaklarının endüstri, trafik ve sigara kullanımı olduğunu göstermektedir. İç ortam, dış ortam ve kişisel maruziyet düzeylerinin dünyanın diğer bölgelerinde yapılan çalışmalarda raporlanan düzeyler ile kıyaslanabilir olduğu bulunmuştur. Kişisel maruziyet konsantrasyonları kullanılarak çalışmada incelenen inorganik ve organik kirleticilerden kaynaklanan sağlık riski değerlendirmesi yapılmıştır. Ev, ofis ve okullarda örneklenen kişiler için hesaplanan “Toplam Kanser Riski” ve “Toplam Tehlike İndeksi” değerleri hem ortalama konsantrasyonlar hem de en kötü senaryo göz önüne alınarak incelendiğinde en yüksek risk altında bulunan kişilerin ev hanımları olduğu bunları öğretmenler ve ofis çalışanlarının takip ettiği söylenebilir. Değerlendirme kentsel, endüstriyel, endüstri ve trafikten uzak alanlar için yapıldığında her 3 alanda da yaşayan kişilerin birbirine yakın ve yüksek kanser riski taşıdıkları söylenebilir. Aynı değerlendirme sigara kullanan ve kullanmayan kişiler için yapıldığında sigara kullanan kişilerin kullanmayanlara nazaran yaklaşık %50 daha fazla kanser riski taşıdıkları gözlenmiştir.In this study, indoor and outdoor environment samples were taken from different regions and microenvironments (home, school, office) in Kocaeli. Through active and passive sampling and measurement techniques, 16 heavy metals (Al, As, Ca, Cr, Cu, Fe, K, Mg, Mn, Ni, Pb, S, Si, Ti, V and Zn) at 2 different particle fractions (PM2.5 and PM10), volatile organic compounds (VOCs), and SO2, NO2 and O3 concentrations were determined. Moreover, in an effort to establish the relationship between exposure and the indoor concentrations measured, personal samplers were used to determine personal exposure levels. Indoor/outdoor concentration ratios for NO2 were higher in homes than in schools or offices in both summer and winter, which shows that sources of NO2 pollutants in indoor environments of homes are more dominant than those found in offices or schools. The indoor/outdoor ratios were far below 1, indicating that O3 and SO2 are pollutants originating from outdoor environments and that they do not have significant sources in indoor environments. The presence of high levels of indoor and outdoor concentrations of crustal elements at PM2.5 fractions indicates that these elements are transported into indoor environments at high levels. PM2.5 personal exposure levels were 2–6 times higher than indoor levels for combustion-related elements such as As, S, V, Cu and Cr, and although there were some seasonal differences, the indoor/outdoor environment ratios generally ranged between 0.3–0.7 and indicated the effect of outdoor environments on the observed high personal exposure levels. The indoor/outdoor ratios for a major portion of the determined heavy metals at PM10 particle fractions were smaller than 1, showing that outdoor pollutants are more dominant than indoor pollutants. The highest VOC pollution levels were encountered in individuals in the sample, and this was followed by VOC pollution levels in indoor and outdoor environments. In both seasons, toluene levels were the highest pollutants for homes, offices and schools, followed by ethylbenzene, m/p-xylene, styrene, nonane, hexane, benzene, o-xylene and heptane. Total VOC concentrations obtained from urban areas were consistent with values obtained from industrial areas. Components that are indicators of traffic (BTEX, 1,2,4-trimethylbenzene) were measured at high levels in urban areas, while hexane and heptane components, which are indicators of petrochemistry, were recorded at high levels in high- industry areas. Moreover, VOC concentrations obtained from urban and industrial areas were higher than concentrations found in areas far from industry and traffic, which demonstrates the high contribution of traffic and industry to measured VOCs. This study investigated the summer and winter concentrations of selected pollutants and the relationship between indoor and outdoor environments. In order to determine pollutant sources that negatively contribute to air quality by affecting the degree of indoor, outdoor and personal exposures, the Positive Matrix Factorization (PMF) receptor modeling technique was used, which is a multivariate statistical analysis method. PMF, correlation analyses, indoor/outdoor ratios, microenvironment characteristics, responses to questionnaires, and time activity information suggested that industry, traffic and smoking represent the main emission sources of pollutants investigated. Indoor, outdoor and personal exposure concentration values were compared to values measured in different parts of the world, thereby evaluating consistency with the observed pollution level. Based on personal exposure concentrations, an assessment was conducted concerning the health risks associated with the inorganic and organic pollutants investigated in this study. When the calculated values for “Total Health Risk” and “Total Hazard Index” for people sampled in homes, offices and schools were examined by considering both the average concentrations and the worst scenarios, it was revealed that housewives are at the highest risk, followed by teachers and office workers. An examination of urban, industrial and far from urban, industrial and traffic areas revealed that people living in all of these three areas are subjected to high cancer risks, which are at similar levels. When the same evaluation was carried out for smokers and non-smokers, it was observed that smokers have a 50% higher risk of cancer compared to non-smokers

Clinical characteristics and outcomes of nosocomial COVID-19 in Turkey: A retrospective multicenter study

Objective: To identify the clinical characteristics and outcomes of hospital-acquired SARS-CoV-2 infection during the vaccination period nationwide in Turkey. Methods: COVID-19 patients followed in the pandemic services across Turkey between January 1, 2021, and March 31, 2022 were investigated retrospectively. Nosocomial COVID-19 was defined as a patient neither diagnosed with COVID-19 nor suspected COVID-19 at the hospital admission and was confirmed COVID-19 ≥5 days after hospital admission. The primary outcome of this study was in-hospital mortality; demographic features and vaccination status was compared between survivors and non-survivors. Results: During the study period, 15 573 COVID-19 patients were followed in 18 centers and 543 (3.5%) patients were nosocomial COVID-19. Most patients with nosocomial COVID-19 (80.4%) were transferred from medical wards. 162 (29.8%) of the patients with nosocomial COVID-19 admitted to the intensive care unit due to disease severity and 138 (25.4%) of the patients died during hospital stay. Advanced age (≥65 years) and number of comorbid diseases (≥2) was found to be associated with mortality in nosocomial COVID-19 (OR 1.74, 95% Cl 1.11-2.74 and OR 1.60, 95% Cl 1.02-2.56, respectively). Vaccination was associated with survival in nosocomial COVID-19 (OR 0.25, 95% Cl 0.16-0.38). Conclusions: Patients with nosocomial COVID-19 had increased admission to intensive care units and higher mortality rate. Vaccination can decrease the in-hospital mortality rate

Characteristics of pediatric multiple sclerosis: The Turkish pediatric multiple sclerosis database

Objective To document the clinical and paraclinical features of pediatric multiple sclerosis (MS) in Turkey. Methods Data of MS patients with onset before age 18 years (n = 193) were collected from 27 pediatric neurology centers throughout Turkey. Earlier-onset (<12 years) and later-onset (?12 years) groups were compared. Results There were 123 (63.7%) girls and 70 (36.3%) boys aged 4–17 years, median 14 years at disease onset. Family history of MS was 6.5%. The first presentation was polysymptomatic in 55.4% of patients, with brainstem syndromes (50.3%), sensory disturbances (44%), motor symptoms (33.2%), and optic neuritis (26.4%) as common initial manifestations. Nineteen children had facial paralysis and 10 had epileptic seizures at first attack; 21 (11%) were initially diagnosed with acute disseminated encephalomyelitis (ADEM). Oligoclonal bands were identified in 68% of patients. Magnetic resonance imaging revealed periventricular (96%), cortical/juxtacortical (64.2%), brainstem (63%), cerebellum (51.4%), and spinal cord (67%) involvement. Visual evoked potentials (VEP) were abnormal in 52%; serum 25-hydroxyvitamin D levels were low in 68.5% of patients. The earlier-onset group had a higher rate of infection/vaccination preceding initial attack, initial diagnosis of ADEM, longer interval between first 2 attacks, and more disability accumulating in the first 3 years of the disease. Conclusion Brainstem and cerebellum are common sites of clinical and radiological involvement in pediatric-onset MS. VEP abnormalities are frequent even in patients without history of optic neuropathy. Vitamin D status does not appear to affect the course in early disease. MS beginning before 12 years of age has certain characteristics in history and course