Upotreba živinih mjernih uređaja u zdravstvenim ustanovama u Hrvatskoj

In 2009, we conducted a survey to assess the use of mercury-based thermometers and sphygmomanometers and their disposal in Croatian healthcare facilities. The questionnaire addressing the use of mercury-based medical devices, waste management, preferences between mercury-based and electronic devices, and the knowledge on mercury toxicity was filled by ward nurses affiliated with 40 (71.4 %) out of 56 contacted healthcare facilities. Only one of these facilities had given up the use of mercury-containing medical devices at the time. As many as 84.6 % of the nurses believed that broken devices did not increase the risk of mercury exposure, even though 90 % claimed they were aware of mercury toxicity. In fact, 69.4 % of the nurses preferred mercury-containing devices on account of their precision and reliability and because they received little training in the use of electronic devices. Breaking of thermometers and sphygmomanometers is common in healthcare facilities. The number of broken thermometers and sphygmomanometers was estimated to 278 and fi ve per month, respectively. Only 18 (46.2 %) of the surveyed healthcare facilities claimed to have had a proper disposal procedure for mercury from broken devices. Nurses, who most often handle these devices and collect mercury spills, are primarily exposed to mercury vapours via inhalation. Croatia has adopted the EU Directive 76/769/EEC intended to reduce mercury exposure in the living and working environment. Our survey suggests that all healthcare professionals need training in proper management of broken mercury-based medical devices, nurses in particular. To reduce the risk of exposure, all Croatian healthcare facilities should implement guidelines for staff protection and programmes to gradually replace mercury-based with electronic devices.Živa je štetni čimbenik izravno povezan s provođenjem zdravstvene zaštite. Tijekom 2009. provedeno je istraživanje u zdravstvenim ustanovama RH, s ciljem procjene uporabe živinih mjernih instrumenata, toplomjera i tlakomjera te načina odlaganja razbijenih uređaja. Upitnik o uporabi živinih uređaja, zbrinjavanju otpada, sklonostima uporabi živinih, odnosno elektroničkih mjernih uređaja te pitanja o poznavanju toksičnosti žive, ispunile su odjelne medicinske sestre iz 40 (71,4 %) od 56 zdravstvenih ustanova. Samo u jednoj ustanovi živini se mjerni uređaji uopće ne rabe. Čak 84,6 % ispitanica smatra da nisu dodatno izložene živi iz razbijenih uređaja, iako je 90 % svjesno toksičnosti Hg. Zbog njihove preciznosti, pouzdanosti i nedostatka edukacije o uporabi i održavanju elektroničkih uređaja prednost uporabi živinih uređaja daje 69,4 % medicinskih sestara. Razbijanje toplomjera i tlakomjera čest je incident u zdravstvenim ustanovama. Procijenjeni broj mjesečno razbijenih toplomjera bio je do 278, a razbijenih tlakomjera do 5. U samo 18 (46,2 %) ustanova pravilno se odlagala živa iz razbijenih uređaja. Medicinske sestre koje najčešće rukuju uređajima i prikupljaju živu najizloženije su živinim parama putem inhalacije. U Hrvatskoj su doneseni pravni akti s namjerom smanjenja prisutnosti žive u životnom i radnom okolišu. Time je stupila na snagu EU direktiva 76/769/EEZ-a o smanjenju proizvodnje i prometa uređaja koji ju sadržavaju. Rezultati upućuju na potrebu edukacije svih zdravstvenih radnika, posebno medicinskih sestara, o zbrinjavanju razbijenih živinih mjernih uređaja. Radi smanjenja potencijalne izloženosti i osiguranja boljih zdravstvenih uvjeta na radnome mjestu sve hrvatske zdravstvene ustanove trebaju provoditi smjernice za zaštitu radnika i programe za smanjenje uporabe žive uporabom zamjenskih toplomjera i tlakomjera dostupnih na tržištu

Harmonized human biomonitoring in European children, teenagers and adults: EU-wide exposure data of 11 chemical substance groups from the HBM4EU Aligned Studies (2014-2021)

As one of the core elements of the European Human Biomonitoring Initiative (HBM4EU) a human biomonitoring (HBM) survey was conducted in 23 countries to generate EU-wide comparable HBM data. This survey has built on existing HBM capacity in Europe by aligning national or regional HBM studies, referred to as the HBM4EU Aligned Studies. The HBM4EU Aligned Studies included a total of 10,795 participants of three age groups: (i) 3,576 children aged 6-12 years, (ii) 3,117 teenagers aged 12-18 years and (iii) 4,102 young adults aged 20-39 years. The participants were recruited between 2014 and 2021 in 11-12 countries per age group, geographically distributed across Europe. Depending on the age group, internal exposure to phthalates and the substitute DINCH, halogenated and organophosphorus flame retardants, per- and polyfluoroalkyl substances (PFASs), cadmium, bisphenols, polycyclic aromatic hydrocarbons (PAHs), arsenic species, acrylamide, mycotoxins (deoxynivalenol (total DON)), benzophenones and selected pesticides was assessed by measuring substance specific biomarkers subjected to stringent quality control programs for chemical analysis. For substance groups analyzed in different age groups higher average exposure levels were observed in the youngest age group, i.e., phthalates/DINCH in children versus teenagers, acrylamide and pesticides in children versus adults, benzophenones in teenagers versus adults. Many biomarkers in teenagers and adults varied significantly according to educational attainment, with higher exposure levels of bisphenols, phthalates, benzophenones, PAHs and acrylamide in participants (from households) with lower educational attainment, while teenagers from households with higher educational attainment have higher exposure levels for PFASs and arsenic. In children, a social gradient was only observed for the non-specific pyrethroid metabolite 3-PBA and di-isodecyl phthalate (DiDP), with higher levels in children from households with higher educational attainment. Geographical variations were seen for all exposure biomarkers. For 15 biomarkers, the available health-based HBM guidance values were exceeded with highest exceedance rates for toxicologically relevant arsenic in teenagers (40%), 3-PBA in children (36%), and between 11 and 14% for total DON, Sigma (PFOA + PFNA + PFHxS + PFOS), bisphenol S and cadmium. The infrastructure and harmonized approach succeeded in obtaining comparable European wide internal exposure data for a prioritized set of 11 chemical groups. These data serve as a reference for comparison at the global level, provide a baseline to compare the efficacy of the European Commission's chemical strategy for sustainability and will give leverage to national policy makers for the implementation of targeted measures

Harmonized human biomonitoring in European children, teenagers and adults: EU-wide exposure data of 11 chemical substance groups from the HBM4EU Aligned Studies (2014–2021)

As one of the core elements of the European Human Biomonitoring Initiative (HBM4EU) a human biomonitoring (HBM) survey was conducted in 23 countries to generate EU-wide comparable HBM data. This survey has built on existing HBM capacity in Europe by aligning national or regional HBM studies, referred to as the HBM4EU Aligned Studies. The HBM4EU Aligned Studies included a total of 10,795 participants of three age groups: (i) 3,576 children aged 6–12 years, (ii) 3,117 teenagers aged 12–18 years and (iii) 4,102 young adults aged 20–39 years. The participants were recruited between 2014 and 2021 in 11–12 countries per age group, geographically distributed across Europe. Depending on the age group, internal exposure to phthalates and the substitute DINCH, halogenated and organophosphorus flame retardants, per- and polyfluoroalkyl substances (PFASs), cadmium, bisphenols, polycyclic aromatic hydrocarbons (PAHs), arsenic species, acrylamide, mycotoxins (deoxynivalenol (total DON)), benzophenones and selected pesticides was assessed by measuring substance specific biomarkers subjected to stringent quality control programs for chemical analysis. For substance groups analyzed in different age groups higher average exposure levels were observed in the youngest age group, i.e., phthalates/DINCH in children versus teenagers, acrylamide and pesticides in children versus adults, benzophenones in teenagers versus adults. Many biomarkers in teenagers and adults varied significantly according to educational attainment, with higher exposure levels of bisphenols, phthalates, benzophenones, PAHs and acrylamide in participants (from households) with lower educational attainment, while teenagers from households with higher educational attainment have higher exposure levels for PFASs and arsenic. In children, a social gradient was only observed for the non-specific pyrethroid metabolite 3-PBA and di-isodecyl phthalate (DiDP), with higher levels in children from households with higher educational attainment. Geographical variations were seen for all exposure biomarkers. For 15 biomarkers, the available health-based HBM guidance values were exceeded with highest exceedance rates for toxicologically relevant arsenic in teenagers (40%), 3-PBA in children (36%), and between 11 and 14% for total DON, Σ (PFOA + PFNA + PFHxS + PFOS), bisphenol S and cadmium. The infrastructure and harmonized approach succeeded in obtaining comparable European wide internal exposure data for a prioritized set of 11 chemical groups. These data serve as a reference for comparison at the global level, provide a baseline to compare the efficacy of the European Commission's chemical strategy for sustainability and will give leverage to national policy makers for the implementation of targeted measures