Factors Affecting Vegetable Growers’ Exposure to Fungal Bioaerosols and Airborne Dust

We have quantified vegetable growers’ exposure to fungal bioaerosol components including (1→3)-β-d-glucan (β-glucan), total fungal spores, and culturable fungal units. Furthermore, we have evaluated factors that might affect vegetable growers’ exposure to fungal bioaerosols and airborne dust. Investigated environments included greenhouses producing cucumbers and tomatoes, open fields producing cabbage, broccoli, and celery, and packing facilities. Measurements were performed at different times during the growth season and during execution of different work tasks. Bioaerosols were collected with personal and stationary filter samplers. Selected fungal species (Beauveria spp., Trichoderma spp., Penicillium olsonii, and Penicillium brevicompactum) were identified using different polymerase chain reaction-based methods and sequencing. We found that the factors (i) work task, (ii) crop, including growth stage of handled plant material, and (iii) open field versus greenhouse significantly affected the workers’ exposure to bioaerosols. Packing of vegetables and working in open fields caused significantly lower exposure to bioaerosols, e.g. mesophilic fungi and dust, than harvesting in greenhouses and clearing of senescent greenhouse plants. Also removing strings in cucumber greenhouses caused a lower exposure to bioaerosols than harvest of cucumbers while removal of old plants caused the highest exposure. In general, the exposure was higher in greenhouses than in open fields. The exposures to β-glucan during harvest and clearing of senescent greenhouse plants were very high (median values ranging between 50 and 1500 ng m−3) compared to exposures reported from other occupational environments. In conclusion, vegetable growers’ exposure to bioaerosols was related to the environment, in which they worked, the investigated work tasks, and the vegetable crop

Xerophilic fungi in museum repositories challenge our perception of healthy buildings and the preservation of cultural heritage

Within the last decade, fungal infestations have emerged in Danish museum repositories challenging museum staff's health and heritage preservation. The growth is unexpected, as most repositories are climate-controlled, according to the international guidelines for heritage collections. This pilot study aims to enlighten unexpected fungal growth in three climate-controlled repositories. The environmental conditions were assessed with measurements of relative humidity (RH), temperature, and material moisture content (MC), showing no evidence of elevated moisture. Morphological and molecular identification showed the growth of A. halophilicus, A. domesticus, A. magnivesiculatus and A. vitricola; four xerophilic fungi able to grow at low water activity. Except for these species, none of the detected airborne species gave rise to growth. The growth of xerophilic fungi is inexplicable but may be associated with a revision of the international environmental guidelines for heritage collections expanding the RH range. The study questions if the revision adequately prevents the risk of fungal growth to ensure heritage preservation and the occupational health of the museum staff.publishedVersio

Does the Finnish intervention prevent obstetric anal sphincter injuries?:a systematic review of the literature

OBJECTIVES: A rise in obstetric anal sphincter injuries (OASIS) has been observed and a preventive approach, originating in Finland, has been introduced in several European hospitals. The aim of this paper was to systematically evaluate the evidence behind the ‘Finnish intervention’. DESIGN: A systematic review of the literature conducted according to the Preferred Reporting for Systematic Reviews and Meta-analyses (PRISMA) guidelines. OUTCOME MEASURES: The primary outcome was OASIS. Secondary outcomes were (perinatal): Apgar scores, pH and standard base excess in the umbilical cord, and (maternal): episiotomy, intact perineum, first and second-degree perineal lacerations, duration of second stage, birth position and women's perceptions/birth experiences. METHODS: Multiple databases (Cochrane, Embase, Pubmed and SveMed) were systematically searched for studies published up to December 2014. Both randomised controlled trials and observational studies were eligible for inclusion. Studies were excluded if a full-text article was not available. Studies were evaluated by use of international reporting guidelines (eg, STROBE). RESULTS: Overall, 1042 articles were screened and 65 retrieved for full-text evaluation. Seven studies, all observational and with a level of evidence at 2c or lower, were included and consistently reported a significant reduction in OASIS. All evaluated episiotomy and found a significant increase. Three studies evaluated perinatal outcomes and reported conflicting results. No study reported on other perineal outcomes, duration of the second stage, birth positions or women's perceptions. CONCLUSIONS: A reduction in OASIS has been contributed to the Finnish intervention in seven observational studies, all with a low level of evidence. Knowledge about the potential perinatal and maternal side effects and women's perceptions of the intervention is extremely limited and the biological mechanisms underlying the Finnish intervention are not well documented. Studies with a high level of evidence are needed to assess the effects of the intervention before implementation in clinical settings can be recommended

Patient-related healthcare disparities in the quality of acute hip fracture care:A 10-year nationwide population-based cohort study

OBJECTIVES: To characterise and quantify possible patient-related disparities in hip fracture care including temporal changes. DESIGN: Population-based cohort study. SETTING: All Danish hospitals treating patients with hip fracture. PARTICIPANTS: 60 275 hip fracture patients from 2007 to 2016. INTERVENTIONS: Quality of care was defined as fulfilment of eligible care process measures for the individual patient recommended by an expert panel. Using yearly logistic regression models, we predicted the individual patient’s probability for receiving high-quality care, resulting in a distribution of adjusted probabilities based on age, sex, comorbidity, fracture type, education, family mean income, migration status, cohabitation status, employment status, nursing home residence and type of municipality. Based on the distribution, we identified best-off patients (ie, the 10% of patients with the highest probability) and worst-off patients (ie, the 10% of patients with the lowest probability). We evaluated disparities in quality of care by measuring the distance in fulfilment of outcomes between the best-off and worst-off patients. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was fulfilment of all-or-none, defined as receiving all relevant process measures. Secondary outcomes were fulfilment of the individual process measures including preoperative optimisation, early surgery, early mobilisation, assessment of pain, basic mobility, nutritional risk and need for antiosteoporotic medication, fall prevention and a postdischarge rehabilitation programme. RESULTS: The proportion of patients receiving high-quality care varied over time for both best-off and worst-off patients. The absolute difference in percentage points between the best-off and worst-off patients for receiving all-or-none of the eligible process measures was 12 (95% CI 6 to 18) in 2007 and 23 (95% CI 19 to 28) in 2016. Disparities were consistent for a range of care processes, including assessment of pain, mobilisation within 24 hours, assessment of need for antiosteoporotic medication and nutritional risk assessment. CONCLUSIONS: Disparity of care between best-off and worst-off patients remained substantial over time