Health risk assessment from exposure to particles during packing in working environments

Packing of raw materials in work environments is a known source of potential health impacts (respiratory, cardiovascular) due to exposure to airborne particles. This activity was selected to test different exposure and risk assessment tools, aiming to understand the effectiveness of source enclosure as a strategy to mitigate particle release. Worker exposure to particle mass and number concentrations was monitored during packing of 7 ceramic materials in 3 packing lines in different settings, with low (L), medium (M) and high (H) degrees of source enclosure. Results showed that packing lines L and M significantly increased exposure concentrations (119-609 μg m-3 respirable, 1150-4705 μg m-3 inhalable, 24755-51645 cm-3 particle number), while nonsignificant increases were detected in line H. These results evidence the effectiveness of source enclosure as a mitigation strategy, in the case of packing of ceramic materials. Total deposited particle surface area during packing ranged between 5.4-11.8x105 μm2 min-1, with particles depositing mainly in the alveoli (51-64%) followed by head airways (27-41%) and trachea bronchi (7-10%). The comparison between the results from different risk assessment tools (Stoffenmanager, ART, NanoSafer) and the actual measured exposure concentrations evidenced that all of the tools overestimated exposure concentrations, by factors of 1.5-8. Further research is necessary to bridge the current gap between measured and modelled health risk assessments

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Role of age and comorbidities in mortality of patients with infective endocarditis.

The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups: A total of 3120 patients with IE (1327  There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in th