Upravljanje zdravstvenim rizicima od mikrobioloških opasnosti pri korištenju voda bazena za kupanje i rekreaciju // The Management of Health Risks From Microbiological Dangers While Using Swimming Pool Water for Swimming and Recreation

Sažetak: Potreba za rekreacijom kao jednim od načina održavanja psihofizičkog zdravlja i radne sposobnosti, je bitna potreba savremanog čovjeka. Značajan broj ljudi, povremeno ili stalno, koristi u te svrhe bazene. Međutim, rekreativne aktivnosti na bazenima, ali i korištenje bazena u svrhu liječenja ili oporavka, mogu da ugroze zdravlje, tako da je neophodno odgovarajuće upravljanje bazenima kako bi se taj uticaj sveo na što manju mjeru.Korisnici bazena izloženi su različitim opasnostima od kojih je rizik obolijevanja prouzrokovan mikrobiološkom kontaminacijom vode bazena najveći. Rizik bolesti ili infekcija zbog korištenja bazena povezan je, u prvom redu, sa fekalnom kontaminacijom vode zbog fecesa kupača ili fekalnom kontaminacijom vode sa kojom se puni bazen. Patogeni mikroorganizmi predstavljaju najčešći i najrašireniji zdravstveni rizik vezan za vodu kao sredinu zbog pojava infektivnih bolesti izazvanih bakterijama, virusima i parazitskim protozoama. Prećišćavanje vode smanjuje dijelom taj rizik, ali se najveća mjera sigurnosti korisnika može ostvariti tek dezinfekcijom vode u bazenu. Kulatura i samodisciplina kupača su doprinosni činioci njenoj bezbijednosti.Razmatranje problema upravljanja mikrobiološkim kvalitetom vode u bazenima, izloženo u ovom radu, bazira se najvećim dijelom na odgovarajućim Preporukama Svjetske zdravstvene organizacije (WHO, 2000)

Drinking Water Safety in Rural Areas of Zagreb County in 2013

The paper analyzes the water supply in the rural part of Zagreb County, which is based mainly on individual water supply sources, i.e. dug or drilled wells and Norton pumps.The aim of the paper is to investigate whether there is a difference in health quality of drinking water taken from the wells and taken from the Norton pumps. The wells are supplied from an aquifer that lies at a depth of 12 to 14 meters, while the Norton pumps reach a depth of 6 and 7 meters.The analysis of water samples taken from the water supply sources revealed that the water does not basically comply with the Ordinance on the parameters of assessment and the methods for the analysis of water intended for human consumption, the Act on Water Intended for Human Consumption. Organoleptic indicators such as color and clarity do not satisfy, while the physical and chemical parameters such as pH and conductivity satisfy the criteria set for both water supply sources. Of all the chemical parameters only the chloride content was within the permitted limits, while the oxidativity, the content of ammonium, nitrite and nitrate were above the allowed limits in water samples taken from the wells and Norton pumps. Microbiological indicators in the analyzed samples, i.e. the number of colonies at 37 ° C and 22 ° C, as well as total coliforms also do not satisfy the requirements of the Ordinance. In order to use the water for drinking it is necessary to perform the conditioning and disinfection of wells, while with the Norton pumps these interventions are almost impossible to perform

Evaluation of results in coronary surgery using EuroSCORE

Introduction. The European System for Cardiac Operative Risk Evaluation (EuroSCORE) was developed in order to predict operative risk in cardiac surgery and to assess the quality of the cardio-surgical care. Introduction of the uniform terminology in result evaluation process leads to the significant improvement in measuring and evaluation of surgical treatment quality. Objective. The aim of the study was to evaluate our results in isolated coronary surgery using the EuroSCORE. Methods. The study was done respectively by analyzing predicted mortality according to the EuroSCORE model and observed operative risk in 4,675 coronary patients operated at our Clinic during the period 2001-2008. For statistical analyses, the Pearson, Chisquare and ANOVA tests were used. Results. The total postoperative mortality predicted by the EuroSCORE was 2.9±2.25, while the observed one was 2.2%. When the scoring system and observed results were compared over the years, a considerably lower observed mortality was found during the last 4 years. Overall average number of distal anastomoses was 2.62±0.84. During the period 2004-2008, the average number of coronary anastomoses increased over the years reaching the value of 2.77±0.88. The difference is at the level of statistical significance with the trend of further increase. Percentage of the patients with single or double graft myocardial revascularization decreases, while the number of the patients with triple or more bypasses increases. Conclusion. During the last years, the results in isolated coronary surgery have considerably improved. The EuroSCORE overestimates operative risk. In order to improve its predictive value, the model should be recalibrated

Trends of risk factors in coronary surgery

Introduction. In current era of widespread use of percutaneous coronary interventions (PCI), it is debatable whether coronary artery by-pass graft (CABG) patients are at higher risk. Objective. The aim of the study was to evaluate trends in risk profile of isolated CABG patients. Methods. By analysing the EuroSCORE and its risk factors, we reviewed a consecutive group of 4675 isolated CABG patients, operated on during the last 8 years (2001-2008) at our Clinic. The number of PCI patients was compared to the number of CABG patients. For statistical analyses, Pearson’s chi-square and ANOVA tests were used. Results. The number of PCI increased from 159 to 1595 (p<0.001), and the number of CABG from 557 to 656 (p<0.001). The mean EuroSCORE increased from 2.74 to 2.92 (p=0.06). The frequency of the following risk factors did not change over years: female gender, previous cardiac surgery, serum creatinine >200μmol/l, left ventricular dysfunction and postinfarct ventricular septal rupture. Chronic pulmonary disease, neurological dysfunction, and unstable pectoral angina declined significantly (p<0.001). Critical preoperative care declined from 3.1% in 2001 to 0.5 % in 2005, than increased and during the last 3 years did not change (2.3%). The mean age increased from 56.8 to 60.7 (p<0.001) and extracardiac arteriopathy increased from 9.2% to 22.9% (p<0.001). Recent preoperative myocardial infarction increased from 11% to 15.1% (p=0.021), while emergency operations increased from 0.9% to 4.0% (p=0.001). Conclusion. The number of CABG increases despite the enlargement of PCI. The risk for isolated CABG given by EuroSCORE increases over years. The risk factors, significantly contributing to higher EuroSCORE are: older age, extracardiac arteriopathy, recent myocardial infarction and emergency operation