Hourly measurement method for radon progeny volumetric activity in air

A method of radon progeny volumetric activity hourly measurement in air was created. A radiometer, which measures the activity of a filter band through which air is sucked, was installed in a hermetic metal frame. Radiometer data was recorded and sent to the computer. The time of suction and the time for the filter band to turn were programmed by electronic stopwatches. This created an opportunity to estimate the hours for self‐contained measurement and to leave the device in a room for any time. This hourly measurement method measured radon and radon progeny volumetric activity and evaluated its change and dependency on meteorological parameters. The radon progeny volumetric activity value varies from 62 Bq/m3 (in the cellar) to 27 Bq/m3 (on the second floor) in the ventilated air, and from 273 Bq/m3 (in the cellar) to 149 Bq/m3 (on the second floor) in the unaired room. The values in the ventilated air and in the unaired rooms differ approximately 4–5 times. It is also determined that volumetric activity depends on wind intensity, temperature and humidity. Radono skilimo produktų tūrinių aktyvumų ore nuolatinių matavimų metodas Santrauka. Sukurtas trumpaamžių radono skilimo produktų tūrinių aktyvumų nenutrūkstamo matavimo metodas. Hermetiniame metaliniame korpuse įtaisytas radiometras, matuojantis slenkančios filtrinės juostos, pro kurią siurbiamas oras, aktyvumą. Radiometro duomenys visą laiką siunčiami ir įrašomi į kompiuterį. Siurbimo ir juostos persukimo laikai užprogramuoti elektroniniais laikmačiais. Taip sudaryta galimybė palikti dirbti prietaisą patalpoje bet kuriam laikui, nustačius, kad matavimai vyktų nustatytomis valandomis. Taikant šį nenutrūkstamo matavimo metodą, išmatuoti radono ir jo trumpaamžių skilimo produktų tūriniai aktyvumai patalpose ir įvertinta jų priklausomybė bei pokyčiai nuo aplinkos meteorologinių parametrų. Išmatuotos trumpaamžių skilimo produktų tūrinių aktyvumų vertės patalpose kinta nuo 62 Bq/m3 (rūsyje) iki 27 Bq/m3 (antrame aukšte) – išvėdintose patalpose, ir nuo 273 Bq/m3 (rūsyje) iki 149 Bq/m3 (antrame aukšte) – neišvėdintose patalpose. Vertės išvėdintose ir neišvėdintose patalpose skiriasi maždaug 4-5 kartus. Nustatyta tiesioginė tūrinio aktyvumo priklausomybė nuo vėjo intensyvumo, temperatūros ir santykinės drėgmės. Reikšminiai žodžiai: radonas, trumpaamžiai radono skilimo produktai, tūrinis aktyvumas, alfa dalelės, matavimo metodas. Метод непрерывного измерения объемной активности продуктов распада радона в воздухе Резюме. Создан метод непрерывного измерения объемной активности короткоживущих продуктов распада радона. В герметичном металлическом корпусе поставлен радиометр, измеряющий активность с помощью скользящего ленточного фильтра, через который засасывается воздух. Данные радиометра все время фиксируются компьютером. Время засасывания воздуха и скольжения ленты запрограммированы электронными счетчиками. Таким образом, создана возможность самостоятельной работы прибора в помещении в течение любого времени, предварительно установив необходимые часы работы. Используя этот метод, в помещении была измерена объемная активность радона и его короткоживущих продуктов распада, определена их зависимость от метеорологических параметров. Измеренные в помещении значения объемной активности короткоживущих продуктов распада колеблются от 62 Бк/м3 (в подвале) до 27 Бк/м3 (на втором этаже) – в проветриваемых помещениях и от 273 Бк/м3 (в подвале) до 149 Бк/м3 (на втором этаже) в непроветриваемых помещениях. Значения в проветриваемых и непроветриваемых помещениях различаются примерно в 4–5 раз. Установлена прямая зависимость объемной активности от интенсивности ветра, температуры и относительной влажности. Ключевые слова: радон, короткоживущие продукты распада радона, объемная активность, альфа-частицы, метод измерения. First Published Online: 14 Oct 201

The investigation of tobacco smoke influence on the changes of indoor radon and its short-lived decay products volumetric activities

The changes of radon and its short-lived decay products were investigated in accommodations under natural living conditions and in tobacco smoke-filled premises. The measured radon and its short-lived decay products volumetric activities, aerosol particle concentration in the air, radioactive equilibrium factor, unattached fraction factor values are presented. It was identified that the increase of aerosol particles concentration in the air (in smoke-filled premises) determines the increase of the unattached nuclides of radon short-lived decay products attached to aerosol particles (the average values of radioactive equilibrium factor varied from 0.35 to 0.72). In this case, larger volumetric activity of the alpha particles is registered. Therefore larger amount of radon progeny is inhaled in smoke-filled premises and there is an increased possibility of damaging the organism. Positive correlation (r = 0.9) between the radioactive equilibrium factor and aerosol particle concentration in the air of accommodation, as well as negative correlation (r = −0.64) between the radioactive equilibrium factor and unattached fraction factor have been determined. Seasonal changes of the radioactive equilibrium factor are presented

Natural radionuclide distribution and radon exhalation rate from the soil in Vilnius city

In the territory of Vilnius city radioisotopic composition of different soils was experimentally determined and radon exhalation rate from the soil was evaluated using these data. Specific activitys of natural radionuclides 226Ra, 232Th and 40K were measured. From identified natural radionuclides the biggest quantities were for 40K (263 Bq/kg), the smallest values ‐ for 232Th (5 Bq/kg), average 226Ra values reached 13 Bq/kg. Radon exhalation rate from the soil in Vilnius city was calculated and evaluated. Distribution of radon exhalation rate values in the whole territory of the city is stated. The received values vary from 15 Bq/m2·h (in clay loam) to 23 Bq/m2·h (in sand). It is assessed that of the most important parameters, which determine radon exhalation rate from the soil, are the quantity of radium and the porosity of the soil. It is observed that radon exhalation rate from the soil is bigger than that from building materials. This difference is determined by a bigger porosity of the soil. Gamtinių radionuklidų pasiskirstymas ir radono ekshaliacijos iš dirvos greitis Vilniaus mieste Santrauka Vilniaus miesto teritorijoje eksperimentais nustatyta skirtingo dirvožemio tipo radioizotopinė sudėtis ir, remiantis šiais duomenimis, įvertintas radono ekshaliacijos iš dirvos intensyvumas. Išmatuoti gamtinių radionuklidų 226Ra, 232Th ir 40K savitieji aktyvumai. Iš identifikuotų gamtinių radionuklidų didžiausi kiekiai yra 40K – 263 Bq/kg, mažiausi – 232Th – 5 Bq/kg, vidutinės 226Ra vertės siekė 13 Bq/kg. Apskaičiuotas bei įvertintas radono ekshaliacijos iš dirvos greitis Vilniaus mieste. Nustatytas radono ekshaliacijos greičio verčių pasiskirstymas visoje miesto teritorijoje. Gautos vertės kinta nuo 15 Bq/m2 ·h (priemolyje) iki 23 Bq/m2 ·h (smėlyje). Nustatyta, kad vieni iš svarbiausių parametrų, lemiančių radono ekshaliacijos intensyvumą iš dirvos, yra radžio kiekis ir dirvos porėtumas. Pastebėta, kad radono ekshaliacijos greitis iš dirvos yra daug didesnis nei iš statybinių medžiagų. Šį skirtumą lemia didesnis dirvos porėtumas. Распределение естественных радионуклидов и скорость эксгаляции радона из почвы в городе Bильнюсе Резюме На территории города Вильнюса экспериментально установлен радиоизотопный состав почв различного типа и на основании этих данных определена интенсивность эксгаляции радона из почвы. Измерена удельная активность естественных радионуклидов 226Ra, 232Th и 40K. Из идентифицированных природных радионуклидов наибольшие количества у 40K – 263 Бк/кг, наименьшие у 232Th – 5 Бк/кг, средние значения 226Ra достигают 13 Бк/кг. В Вильнюсе рассчитана и определена скорость эксгаляции радона из почвы. Определено также распределение величин скорости его эксгаляции по всей территории города. Полученные значения колеблются от 15 Бк/м2 ·ч (суглинок) до 23 Бк/м2 ·ч (песок). Установлено, что одними из важнейших параметров, побуждающих интенсивность эксгаляции радона из почвы, являются количество радия и пористость почвы. Замечено, что интенсивность скорости эксгаляции радона из почвы значительно выше, чем из строительных материалов. Это различие обусловлено большей пористостью почвы. Ключевые слова: естественные радионуклиды, удельная активность, радон, скорость эксгаляции, концентрация радона, альфа-частицы. Reikšminiai žodžiai: gamtiniai radionuklidai, savitasis aktyvumas, radonas, ekshaliacijos greitis, tūrinis aktyvumas, alfa dalelės

Assessment of Air Pollution with Polychlorinated Dibenzodioxins (PCDDs) and Polychlorinated Dibenzofuranes (PCDFs) in Lithuania

Polychlorinated dibenzodioxins and polychlorinated dibenzofurans (PCDD/F) are highly bioavailable in humans, either through direct inhalation or indirectly by trophic transfer from contaminated food or water. The main sources of pollution with PCDD/F include industrial and non-industrial combustion sources, like domestic contaminated wood burning, house fires, burning of leaves from trees, etc. When looking for alternative energy sources and reduced energy costs, solid waste incineration plants are intended to be built in the vicinity of urbanized areas, and thus, the need emerges for examination and prediction of to what extent the solid waste incineration plants might affect the surrounding ecosystem, air pollution, and human health. Polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) (or simply PCDD/F congeners) belong to the group of semi-volatile organic compounds with environmental stability and long-range transfer in the ambient air. Dioxin isomers are highly toxic and may have carcinogenic and mutagenic effects in humans. PCDD/F is detected in air, water, sediment, plants and animals. PCDD/F is generally distributed in the particulate phase in ambient air. For solid waste incineration plant emissions, the distribution of PCDD/F particles into particles with a diameter of <10 μm is more than 81% of the total particulate matter, and more than 54% of the PCDD/F is distributed into particles with a diameter of <2.5 μm. The aim of this study is to investigate the sources of PCDD/F, emissions and potential hazards, i.e., a toxic equivalent in Lithuania. The measurements were performed in two largest cities of Lithuania Vilnius and Kaunas, where the level of PCDD/F discovered was from 0.015 to 0.52 pg/m3 and from 0.02 to 0.05 pg/m3, respectively. The sites for the monitoring were selected based on their proximity to the locations of the planned cogeneration power plants in these cities.This article belongs to the Section Air Quality and Human Healt

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe