Exposição ocupacional a mercúrio: associação com a atividade da paraoxonase humana e vitaminas A e E

Mestrado em Segurança e Higiene no TrabalhoOs trabalhadores da indústria de reciclagem e valorização de lâmpadas encontram-se ocupacionalmente expostos a mercúrio durante o processo de produção. Neste trabalho foi caracterizada essa exposição na totalidade dos trabalhadores de uma empresa portuguesa, determinando a concentração de mercúrio total no sangue. A concentração de mercúrio foi relacionada com a atividade do enzima PON-1 e com as concentrações das vitaminas A e E, no sangue dos trabalhadores. De forma a desenvolver este estudo, efetuaram-se determinações da concentração de mercúrio no sangue por Espectroscopia de Absorção Atómica Termal, tendo trabalhadores apresentado, em média, concentrações significativamente mais elevadas (p=0,000) de mercúrio no sangue (2,25 μg.L-1) que o grupo de controlo (0,864 μg.L-1), o que confirma a exposição ocupacional a este metal. A atividade da PON-1 foi medida por espectrofotometria Ultra Violeta-Visível (UV-Vis), tendo sido obtidos valores médios de 773 mM.min-1 para os trabalhadores e de 663 mM.min-1, para os controlos. As diferenças destas actividades não são estatisticamente significativas (p=0,562), indicando que a proteção das LDL contra a oxidação se mantém eficaz. Havia, todavia, uma correlação negativa fraca, não significativa (r=-0,422; p=0,298), entre a concentração de mercúrio e a atividade da PON-1 nos trabalhadores, sugerindo a possibilidade de inibição da PON-1 pelo mercúrio. Os níveis séricos de Vitaminas A e E foram determinados por Cromatografia Líquida de Alta Performance (HPLC). Relativamente à concentração de vitamina E, foram detetados valores séricos médios de 37.0 μM nos trabalhadores e 43.7 μM nos controlos, valores que não são estatisticamente diferentes (p=0,160) sugerindo que a capacidade antioxidante lipofílica se mantém intacta. Existe uma correlação negativa fraca, não significativa (r=-0,312; p=0,452) entre as concentrações de mercúrio e vitamina no sangue dos trabalhadores, sugerindo uma ligação entre mercúrio e stress oxidativo. Da comparação da concentração média sérica de vitamina A entre trabalhadores (2.00 μM) e controlos (0.980 μM) foram detetadas diferenças estatisticamente significativas das concentrações de vitamina A entre os dois grupos (p=0,007), sugerindo um efeito da exposição ao mercúrio ao nível da metabolização do retinol. Foi detetada uma correlação negativa fraca, estatisticamente não significativa, entre as concentrações de mercúrio e de vitamina A nos trabalhadores (r=-0,239; p=0,568), podendo significar uma ligação entre mercúrio e stress oxidativo. Foram igualmente estudadas as relações entre a concentração de mercúrio nos trabalhadores e o número de horas de exposição a este metal, verificando-se uma correlação positiva fraca não significativa (r=0,134; p=0,775). Da análise da relação entre a concentração do metal e a antiguidade dos trabalhadores em postos de trabalho com exposição ocupacional, constatou-se uma correlação positiva fraca não significativa (r=0,217; p=0,641). Concluiu-se que a exposição ocupacional destes trabalhadores não apresenta, no presente, riscos para a sua saúde. No entanto, os trabalhadores já exibem concentrações de mercúrio superiores aos controlos e alguns efeitos bioquímicos. Dado o mercúrio ser um metal bioacumulável, é possível que com o tempo, a exposição venha a produzir efeitos mais marcados.ABSTRACT - Workers from the light bulb recycling and recovery industry may be exposed to mercury during the production process. In this work we characterized the occupational exposure to mercury all the workers of a Portuguese facility by measuring whole blood mercury levels. Concomitantly, the activity of enzyme PON-1 was measured as well as the serum concentrations of vitamin A and E. Whole blood mercury was determined by atomic absorption spectrometry with thermal decomposition and workers had in average significantly (p=0.000) more mercury (2.25 μg.L-1) than controls (0.864 μg.L-1), thus confirming the occupational exposure. PON-1 activity was measured by UV-VIS Spectrophotometry and the mean activities found were 773 mM.min-1 for the workers and 663 mM.min-1, for the controls. This difference was not significant (p=0,562), showing that LDL protection from oxidation is still effective. There was a poor negative, non-significant correlation (r=-0,422; p=0,298) between mercury levels and PON-1 activity in workers, hinting a possible inhibition of PON-1 by mercury. The serum concentrations of vitamin E and A were determined by High Pressure Liquid Chromatography (HPLC) with diode array detection. The mean values of vitamin E in workers were 37.0 μM and 43.7 μM in controls. These values are not statistically different (p=0,160) suggesting that the lipophilic antioxidant barrier is intact. There was a non significant, weak negative correlation (r=-0,312; p=0,452) between the blood concentrations of mercury and vitamin E in workers, linking mercury and oxidative stress. Comparing the mean values of serum vitamin A of workers (2.00 μM) and controls (0.980 μM), a significant difference was found (p=0,007), suggesting an effect of the mercury at the level of retinol metabolization. It was detected a weak negative correlation, non significant (r=-0,239; p=0,568), between between the blood concentrations of mercury and vitamin A in workers, again linking mercury and oxidative stress. To further characterize the exposure, we studied the possible correlation between blood mercury and the number of daily exposure hours, finding a non significant, weak positive correlation (r=0,134; p=0,775). Moreover, the relationship between blood mercury and the number of years working in the industry also showed a non significant, weak positive correlation (r=0,217; p=0,641). The occupational exposure of these workers does not presently constitute a risk for their health. Nevertheless, mercury bioaccumulates over time, and these workers already have more mercury than the controls. Furthermore, they already show some biochemical effects. Steps should be taken in order to prevent the development of serious occupational mecurialism

Profesionalna izloženost citotoksičnim lijekovima: koliko je važno čišćenje površina za njezino sprječavanje odnosno smanjenje

Healthcare workers who prepare or administer cytotoxic agents run the risk of exposure, and the risks for health are real even at doses lower than those applied in cancer patients, because, in theory, no dose is safe. The most common and problematic route of exposure is through the skin, especially as work surfaces can remain contaminated even after cleaning. This pilot study aimed to demonstrate the importance of having an effective surface decontamination protocol by determining surface contamination with cyclophosphamide, 5-fluorouracil, and paclitaxel as the most common cytotoxic drugs in an oncology day service. Samples were collected before and after drug handling and analysed with high performance liquid chromatography with diode array detection (HPLC-DAD). Of the 29 samples collected before drug handling 23 were contaminated, five of which with more than one drug. Of the 30 samples collected after drug handling 25 were contaminated, eight of which with more than one drug. The two time points did not significantly differ, which evidences a widespread contamination and ineffective cleaning. This calls for revising the cleaning protocol and handling procedure to place contamination under control as much as possible.U zdravstvenih radnika koji pripremaju ili primjenjuju citotoksične lijekove zdravstveni rizici zbog izloženosti su realni, čak i pri dozama nižima od onih koje se primjenjuju u bolesnika jer, načelno, nijedna doza nije neškodljiva za zdravlje. Najčešći i najproblematičniji put izlaganja jest koža, napose zato što radne površine gdjekad ostanu kontaminirane i nakon njihova čišćenja. Cilj ovoga preliminarnog istraživanja bio je pokazati koliko je važno osmisliti djelotvoran protokol za dekontaminaciju na temelju pokazatelja kontaminacije radnih površina jedinice za pripremu lijekova, jedinice za njihovu primjenu te bolesničkoga zahoda onkološke ambulante trima najčešćim citotoksičnim onkološkim lijekovima: ciklofosfamidom, 5-fluoroacilom i paklitakselom. Uzorke smo prikupljali prije rada s lijekovima te tri sata od početka rada s njima te ih analizirali tekućinskom kromatografijom s detektorom s nizom dioda (engl. high performance liquid chromatography with diode array detection, krat. HPLC-DAD). Od 29 uzoraka prikupljenih prije rada s lijekovima, 23 su bila kontaminirana, od kojih pet s više lijekova. Od 30 uzoraka prikupljenih tri sata nakon početka rada s lijekovima, njih 25 bilo je kontaminirano, od kojih osam s više lijekova. Kontaminacija površina prije i nakon početka rada s lijekovima nije bila značajno različita, što upozorava na raširenu kontaminaciju i nedjelotvorno čišćenje. Stoga bi trebalo revidirati postojeći protokol čišćenja i rukovanja lijekovima te svesti kontaminaciju na najmanju moguću mjeru

Hospital surfaces contamination with antineoplastic drugs: influence of cleaning procedures

Introduction: The raising frequency of cancer diseases is leading to a widespread application of antineoplastic drugs, thus increasing the probability of workplace surfaces contamination. Most of these drugs are classified by the International Agency for Research on Cancer as known or suspected human carcinogens. Skin absorption is the main route for antineoplastic drugs exposure in occupational settings, therefore cleaning protocols have paramount influence in surfaces contamination and, consequently, in exposure. The aim of this study was to assess surfaces contamination in a Portuguese chemotherapy unit before and during drug administration, in both preparation and administration facilities. Methods: Samples were collected by wipe-sampling from potentially contaminated surfaces selected by previous protocol observation. Samples were analyzed by HPLCDAD. Cyclophosphamide (CP), 5-fluorouracil (5FU), and paclitaxel (PTX) were used as surrogate markers for surfaces contamination for all cytotoxic drugs. Results: From the 34 samples collected before any preparation and administration activities, 41.2% were contaminated with 5-FU (4.0-84.7 ng/cm2) and 23.5% of the samples were contaminated with CP (19.8-139.6 μg/cm2). Only 2 samples presented contamination by PTX (5.9%) with a maximum value of 3.7 ng/cm2. Of the 37 samples collected during preparation and administration of antineoplastic drugs, 48.7% were contaminated with 5-FU (1.9-88.7 ng/cm2) and 24.3% with CP (12.0-93.9 μg/cm2). None of the samples showed contamination with PTX. Discussion: Data showed differences in contamination levels before and after the handling of antineoplastic drugs in preparation and in administration settings. These results point out the importance of cleaning procedures. This is well in accordance to previous studies that showed how the type of cleaning procedures and products used can be determinant for surfaces decontamination

Toxigenic fungi in coffee samples: a menace to public health

Introduction - Mycotoxin contamination was reported to occur in some food and commodities, such as coffee, particularly due to the presence of toxigenic fungi such as Aspergillus, Penicillium and Fusarium spp. Aspergilli are known to produce high levels of mycotoxins, such as ochratoxin and aflatoxin. Aspergillus ochraceus has been proposed as the major cause of ochratoxin A contamination in coffee beans. Aim of the study - The aim of this work was to evaluate the prevalence of Aspergillus sections Circumdati, Flavi and Fumigati in 28 green coffee samples to be used by Portuguese coffee industry, from Coffea arabica (Arabica coffee) and Coffea canephora (Robusta coffee) species from different origins

Fungi distribution in poultry feed

Feed can easily be contaminated and colonized by fungi that use up the nutrients for their own metabolism and growth, producing secondary metabolites such as mycotoxins that are not eliminated throughout the feed processing. The major problems associated with mycotoxin contaminated animal feed are metabolic disturbances resulting in poor animal productivity. In addition, handling contaminated animal feed can also raise health issues regarding workers exposure to fungi and mycotoxins. The scope of this work was to characterize fungal distribution in 11 poultry feed samples. Twenty grams of feed were suspended in 180 mL of distilled water and homogenized during 20 minutes at 200 rpm. The washed supernatant was plated in malt extract agar (MEA) and dichloran glycerol agar base (DG18) media for morphological identification of the mycobiota present. Using macro- and microscopic analysis of the colonies, fungal contamination was evident in 72.7% of the analyzed poultry feed samples. Fungal load ranged from 0 to 13140 CFU/g, and the most prevalent species/genera were F. graminearum complex (71.1%), Penicillium sp. (11.6%), Cladosporium sp. (8.8%), and Fusarium poae (3.6%). In addition to these species, we also isolated Aspergillus sections Circumdati, Nigri and Aspergilli, and Mucor and Rhizopus genus albeit at a lower abundance. The data obtained showed that, besides high fungal contamination, mycotoxins contamination is probably a reality, particularly in the final product since mycotoxins resist to all the processing operations including thermal treatment. Additionally, data claimed attention for the probable co-exposure to fungi and mycotoxins of the workers in feed industries

Fungal contamination in coffee samples: a public health concern

Introduction - Fungi are natural coffee contaminants and under certain environmental conditions have the potential to produce toxins. Many studies revealed that the important toxigenic fungal genera (Aspergillus and Penicillium) are natural coffee contaminants, and are present from the field to storage. Aspergilli from the Circumdati and Nigri sections are known to produce high levels of ochratoxin A, a mycotoxin known as nephrotoxic for animals and humans. This work aimed to evaluate fungal distribution and also the prevalence of Aspergillus sections Fumigati, Flavi, Nigri and Circumdati from Coffea arabica (Arabica coffee) and Coffea canephora (Robusta coffee) green samples

Assessment of toxigenic fungi in poultry feed

Introduction - Feed supplies the necessary nutrients for the growth of healthy animals, which are a part of the human diet. The presence of toxigenic fungi in animal feed such as Aspergillus spp. may contribute to 1) the loss of nutritional value of feedstuff, since fungi will assimilate the most readily available nutrients present in the feed, and 2) the development of mycotoxicoses and chronic conditions, which can raise economic issues due to animal disease and contamination of animal derived products. Aim of the study - The goal of this work was to evaluate the incidence of Aspergilli, particularly from the Circumdati, Flavi and Fumigati sections, through real-time quantitative PCR (qPCR) in 11 feed samples

Case Report Inflammatory Myofibroblastic Tumor of the Bladder: 2 Rare Cases Managed with Laparoscopic Partial Cystectomy

Two cases of inflammatory myofibroblastic tumor (IMT) of the bladder are reported here. Both patients were male and presented with macroscopic hematuria; in the first case terminal hematuria was associated with irritative voiding symptoms. The second case was a smoker with hematuria unresponsive to medical treatment and anemia. Clinical presentation, pathological features, treatment, and prognosis are discussed. Due to rarity of this pathological condition, there are no guidelines concerning treatment and follow-up. We present our follow-up scheme and highlight the use of laparoscopic partial cystectomy as a successful treatment approach

A new approach to assess fungal burden and mycotoxins occupational exposure in waste trucks workers

Este trabalho foi financiado pelo Concurso Anual para Projetos de Investigação, Desenvolvimento, Inovação e Criação Artística (IDI&CA) 2016 do Instituto Politécnico de Lisboa. Código de referência: IPL/2016/W2E_ESTeSLBackground - Waste application facilities are considered critical regarding occupational exposure to fungal burden since provide optimal conditions for fungal growth (moisture and decaying matter). Aspergillus genera dominance was already reported in Portuguese waste industry. Waste-sorting the most critical setting, presenting not only the highest load but also the wider diversity of Aspergillus sections. It is important to consider the co-occurrence of mycotoxins in this occupational environment. In waste management industry it is common to use forklifts for waste transportation and workers can spend all their working hours in a forklift cab. In cars, the bioburden filtered from the air stream by the automobile air conditioner filter could proliferate under high humidity conditions and, consequently, presenting a potential exposure source to bioaerosols. When the air conditioning system is turned on, the air stream passing through the vehicle filtration system could re-aerosolize the bioburden and subsequently carry them into the vehicle cabinet increasing the exposure.info:eu-repo/semantics/publishedVersio

A Lei da Mediação de Conflitos: estudos sobre a sua aplicação

Financiamento de MEDLaw - FCT UIDB/04112/2020.Os dez anos de vigência da Lei da Mediação em Portugal constituíram o mote para a compilação nesta obra de diversos estudos empírico-dogmáticos sobre a sua aplicação, analisando-se questões prementes como a voluntariedade ou obrigatoriedade da mediação, a executoriedade do acordo de mediação e a Convenção de Singapura, as exigências processuais e a suspensão dos prazos de prescrição e caducidade com o recurso à mediação, a organização associativa dos mediadores e a importância da sua formação, o funcionamento dos sistemas públicos de mediação, bem como novas áreas de aplicação da mediação, em especial no domínio administrativo e na recuperação extrajudicial de empresas, e ainda a relevância do desenvolvimento científico sobre este meio de resolução de conflitos. Ao regulamentar num único diploma, pela primeira vez no nosso ordenamento jurídico, a mediação pública e privada, a Lei n.º 29/2013, de 19 de abril, constituiu um marco legislativo. Dez anos volvidos, importava refletir sobre a sua aplicação prático-jurídica, norteados pelo objetivo de promover o estudo e a efetiva implementação da mediação de conflitos em Portugal. Esta obra constitui o output desenvolvido no âmbito do projeto de investigação MEDLAW, com o apoio da Fundação para a Ciência e Tecnologia, no âmbito do financiamento base atribuído ao polo de Leiria do Instituto Jurídico Portucalense, com a ref. UIDB/04112/2020.info:eu-repo/semantics/publishedVersio