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International Journal of Hygiene and... Aug 2016The paper reviews and critically assesses the evidence on the relevance of various skin uptake pathways for engineered nanoparticles, nano-objects, their agglomerates... (Review)
Review
The paper reviews and critically assesses the evidence on the relevance of various skin uptake pathways for engineered nanoparticles, nano-objects, their agglomerates and aggregates (NOAA). It focuses especially in occupational settings, in the context of nanotoxicology, risk assessment, occupational medicine, medical/epidemiological surveillance efforts, and the development of relevant exposure assessment strategies. Skin uptake of nanoparticles is presented in the context of local and systemic health effects, especially contact dermatitis, skin barrier integrity, physico-chemical properties of NOAA, and predisposing risk factors, such as stratum corneum disruption due to occupational co-exposure to chemicals, and the presence of occupational skin diseases. Attention should be given to: (1) Metal NOAA, since the potential release of ions may induce local skin effects (e.g. irritation and contact dermatitis) and absorption of toxic or sensitizing metals; (2) NOAA with metal catalytic residue, since potential release of ions may also induce local skin effects and absorption of toxic metals; (3) rigid NOAA smaller than 45nm that can penetrate and permeate the skin; (4) non rigid or flexible NOAA, where due to their flexibility liposomes and micelles can penetrate and permeate the intact skin; (5) impaired skin condition of exposed workers. Furthermore, we outline possible situations where health surveillance could be appropriate where there is NOAA occupational skin exposures, e.g. when working with nanoparticles made of sensitizer metals, NOAA containing sensitizer impurities, and/or in occupations with a high prevalence of disrupted skin barrier integrity. The paper furthermore recommends a stepwise approach to evaluate risk related to NOAA to be applied in occupational exposure and risk assessment, and discusses implications related to health surveillance, labelling, and risk communication.
Topics: Animals; Environmental Monitoring; Humans; Nanoparticles; Occupational Diseases; Occupational Exposure; Risk Assessment; Skin Absorption
PubMed: 27289581
DOI: 10.1016/j.ijheh.2016.05.009 -
BMC Medical Education Jun 2022Although person-centered care (PCC) ensures high-quality care for patients, studies have shown that it is unevenly applied in clinical practice. The extent to which...
BACKGROUND
Although person-centered care (PCC) ensures high-quality care for patients, studies have shown that it is unevenly applied in clinical practice. The extent to which future health care providers are currently offered education in PCC at their universities is unclear. We aimed to clarify the PCC content offered to students as a basis for their understanding by exploring the PCC content of Swedish national study programs in medicine, nursing, occupational therapy, and physiotherapy.
METHODS
Using a qualitative document analysis design, we sampled the steering documents from all higher education institutions (n = 48) with accreditation in medicine (n = 7), nursing (n = 25), occupational therapy (n = 8), or physiotherapy (n = 8) at a single time point. All national study programs (n = 4), local program syllabuses (n = 48), and local course syllabuses (n = 799) were reviewed using a 10-item protocol.
RESULTS
We found no content related to PCC in the steering documents at the national level. At the local level, however, signs of PCC were identified in local program syllabuses and local course syllabuses. Seven of the 48 local program syllabuses (15%) included PCC in their intended learning outcomes. Eight of the 799 local course syllabuses (1%) contained course titles that included the phrase 'person-centered care,' and another 101 listed 142 intended learning outcomes referring to PCC. A total of 21 terms connected to PCC were found, and the term 'person-centered care' was most commonly used in the nursing programs and least commonly in the medical programs.
CONCLUSIONS
There is a broad range in how the national study programs in Sweden have incorporated PCC. The implementation has been driven by a bottom-up strategy. A deliberate and standardized strategy is needed to ensure full implementation of PCC into clinical curricula in higher education.
Topics: Curriculum; Humans; Occupational Medicine; Occupational Therapy; Patient-Centered Care; Self Care
PubMed: 35739515
DOI: 10.1186/s12909-022-03502-8 -
Annals of Global Health Aug 2018Education and training in Occupational and Environmental Health (OEH) play an important role in building global capacity and contribute to safer working conditions. The...
INTRODUCTION
Education and training in Occupational and Environmental Health (OEH) play an important role in building global capacity and contribute to safer working conditions. The shortage of occupational health professionals, the lack of knowledge and a high number of occupational accidents and diseases stress the demand for providing further education and training in OEH. This need is especially urgent in low and middle-income countries. Three international courses on OEH provide valuable insights on how to develop successful trainings in the field and how to contribute to the creation of healthy and safe workplaces.
METHODOLOGY AND RESULTS
The courses "Global Occupational and Environmental Determinants of Diseases: a multidisciplinary and multicultural approach for prevention" (University of Brescia, Italy), "Advanced International Training Course in OEH" (Chulabhorn Research Institute, Bangkok, Thailand) and "Teaching interventions crossing borders" (Ludwig-Maximillians-Universität, Munich, Germany) offer a unique networking opportunity for health professionals from low-, middle- and high-income countries. Three main characteristics of learning were identified as successful for adult learning in OEH: Interdisciplinary learning allows exchanging skills and knowledge and therefore closes gaps between the several disciplines within OEH. Experiential learning enables participants to reflect on their personal experiences, e.g. through workplace visits. Finally, active learning empowers the learner to take the leading role in the learning process using e.g. problem- or project-based learning approaches.
CONCLUSION
Training and education in OEH should become a higher priority by including it in the standard public health and medical curricula. For this, train the trainer approaches are essential in many countries. Any OEH training should follow the interdisciplinary, experiential and interactive learning approach and should be accessible to participants from all regions.
Topics: Capacity Building; Clinical Competence; Curriculum; Developing Countries; Environmental Health; Germany; Global Health; Humans; Interdisciplinary Communication; Italy; Models, Educational; Needs Assessment; Occupational Health; Occupational Medicine; Problem-Based Learning; Thailand
PubMed: 30835392
DOI: 10.29024/aogh.2328 -
International Journal of Environmental... Jan 2023Sleep deprivation is a significant risk to the health and judgment of physicians. We wanted to investigate whether anesthesiology residents (ARs) who work only one night...
Sleep deprivation is a significant risk to the health and judgment of physicians. We wanted to investigate whether anesthesiology residents (ARs) who work only one night shift per week have different physical and mental health from occupational medicine residents (OMRs) who do not work at night. A total of 21 ARs and 16 OMRs attending a university general hospital were asked to wear an actigraph to record sleep duration, heart rate and step count and to complete a questionnaire for the assessment of sleep quality, sleepiness, fatigue, occupational stress, anxiety, depression and happiness. ARs had shorter sleep duration than OMRs; on average, they slept 1 h and 20 min less ( < 0.001). ARs also had greater daytime sleepiness, a higher heart rate and lower happiness than OMRs. These results should be interpreted with caution given the cross-sectional nature of the study and the small sample size, but they are an incentive to promote sleep hygiene among residents.
Topics: Humans; Occupational Medicine; Cross-Sectional Studies; Anesthesiology; Sleep; Sleep Deprivation; Fatigue; Work Schedule Tolerance
PubMed: 36767721
DOI: 10.3390/ijerph20032356 -
Journal of Preventive Medicine and... Aug 2015The goal of Occupational Medicine and Hygiene is that of ensuring safety, health and well-being at workplaces, mainly assessing and preventing existing occupational...
The goal of Occupational Medicine and Hygiene is that of ensuring safety, health and well-being at workplaces, mainly assessing and preventing existing occupational risks. Scientific research in this field can provide useful arguments and further evidence upon which effective, efficient and sustainable policies and preventive measures have to be chosen and applied by the occupational physician in work-life. This paper summarizes four original studies, conducted in different professional settings across Italy, focusing on critical items, such as stress and violence, biological risks and sleep hygiene. The knowledge obtained can be useful to orientate proper preventive programs aimed at improving workplace health.
PubMed: 26789987
DOI: No ID Found -
International Journal of Molecular... Apr 2018Medicine, food, and cosmetics represent the new promising applications for silver (Ag) and gold (Au) nanoparticles (NPs). AgNPs are most commonly used in food and... (Review)
Review
Medicine, food, and cosmetics represent the new promising applications for silver (Ag) and gold (Au) nanoparticles (NPs). AgNPs are most commonly used in food and cosmetics; conversely, the main applications of gold NPs (AuNPs) are in the medical field. Thus, in view of the risk of accidentally or non-intended uptake of NPs deriving from the use of cosmetics, drugs, and food, the study of NPs⁻cell interactions represents a key question that puzzles researchers in both the nanomedicine and nanotoxicology fields. The response of cells starts when the NPs bind to the cell surface or when they are internalized. The amount and modality of their uptake depend on many and diverse parameters, such as NPs and cell types. Here, we discuss the state of the art of the knowledge and the uncertainties regarding the biological consequences of AgNPs and AuNPs, focusing on NPs cell uptake, location, and translocation. Finally, a section will be dedicated to the most currently available methods for qualitative and quantitative analysis of intracellular transport of metal NPs.
Topics: Animals; Biological Transport; Cosmetics; Endocytosis; Food; Gold; Humans; Lysosomes; Metal Nanoparticles; Models, Animal; Nanomedicine; Occupational Medicine; Particle Size; Silver
PubMed: 29702561
DOI: 10.3390/ijms19051305 -
International Journal of Ophthalmology 2021Chemical eye burns present an avoidable, but frequent, occupational injury with potentially detrimental consequences for the quality of life and occupational... (Review)
Review
Chemical eye burns present an avoidable, but frequent, occupational injury with potentially detrimental consequences for the quality of life and occupational rehabilitation of the injured. A periodical review of guidelines is required to assure the optimal emergency management. We reviewed the literature with emphasis on current German guidelines, primarily MEDLINE. If the crucial first-line measure, the injury prevention has failed and an eye burn has been sustained, the immediate and copious rinsing of the eye is the pivotal emergency treatment modality. Whereas the immediacy and sufficiency of the emergency rinsing are largely unanimous, there is an ongoing debate about the benefits and risks of specific rinsing solutions, and regular updates on guidelines and recommendations for the emergency treatment are warranted. The easiest and readily available rinsing solution is tap water, which fulfils the crucial criteria conveniently in most industrialized countries: purity, sterility, and neutral pH. Other rinsing solutions are proposing higher osmolality to stabilize the physiological pH, because of their superior buffering capacity. However, there is no compelling evidence for a substantial benefit, and some reports suggest that there could be unwanted side effects. In combination with the substantially increased expenditure and a more complex handling procedure, currently a general recommendation of any other solution than tap water is not warranted.
PubMed: 33614462
DOI: 10.18240/ijo.2021.02.19 -
La Medicina Del Lavoro Feb 2017The entire Italian University system, including the whole field of medical teaching and research, is currently passing through a period of cumbersome changes due to the...
The entire Italian University system, including the whole field of medical teaching and research, is currently passing through a period of cumbersome changes due to the many difficulties encountered in its reform process. Academic occupational medicine is deeply involved in this process that resembles a real crisis. Given this background, this contribution - written as President of the Italian College of Occupational Medicine Full Professors - has the main objective to open a debate about the current generalized crisis of our Academic Discipline and about its possible future developments. Questions that appear most relevant to the nearly forty University Institutes we are working in include: The constantly decreasing number of professors and researchers (presently about 20 full professors, 50 associate professors and 60 researchers); the reduced ability to recruit young researchers; the contraction of resources and funds; the difficult coordination with other clinical and prevention disciplines in teaching activities. Despite this, points of scientific and professional excellence in many fields exist in our Institutes: from toxicology and epidemiology, to respiratory diseases and ergonomics, to evidence based prevention and quality systems promotion. The expected debate should facilitate new organizational links within and across Universities in order to gain critical masses, improve capabilities in new fields of research (as dose and effect indicators and their matrices, epigenetics, exposomics, connection of exposure data with epidemiological evidences), innovate and expand teaching (in Medical Schools courses and in Residency programs), and advance clinical-diagnostic practices in University Hospitals.
Topics: Academies and Institutes; Forecasting; Italy; Occupational Medicine; Research
PubMed: 28240728
DOI: 10.23749/mdl.v108i1.5994 -
Occupational and Environmental Medicine Nov 2021Exposures leading to irritant-induced asthma (IIA) are poorly documented.
BACKGROUND
Exposures leading to irritant-induced asthma (IIA) are poorly documented.
METHODS
We retrospectively screened the medical records of patients with IIA diagnosed in an occupational medicine clinic during 2000-2018. We classified the cases into acute (onset after single exposure) and subacute (onset after multiple exposures) IIA. We analysed in detail, occupations, causative agents and their air levels in the workplace, exposure events and the root causes of high exposure.
RESULTS
Altogether 69 patients were diagnosed with IIA, 30 with acute and 39 with subacute IIA. The most common occupational groups were industrial operators (n=23, 33%), metal and machinery workers (n=16, 11%) and construction workers (n=12, 8%). Among industrial operators significantly more cases had subacute IIA than acute IIA (p=0.002). Forty cases (57%) were attributable to some type of corrosive acidic or alkaline chemical. Acute IIA followed accidents at work in different types of occupation, while subacute IIA was typical among industrial operators performing their normal work tasks under poor work hygiene conditions. The most common root cause was lack of information or false guidance in acute IIA (n=11, 36%) and neglect of workplace hygiene measures in subacute IIA (n=29, 74%).
CONCLUSIONS
Accidents are the main causes of acute IIA, whereas subacute IIA can develop in normal work in risk trades with poor work hygiene. Airborne strong acids or bases seem to be the most important causative agents of acute and subacute IIA. The different risk profiles of acute and subacute IIA should be considered in the prevention and identification of the cases.
Topics: Accidents, Occupational; Adult; Asthma, Occupational; Construction Industry; Female; Finland; Humans; Irritants; Male; Manufacturing and Industrial Facilities; Middle Aged; Occupational Exposure; Retrospective Studies
PubMed: 33790028
DOI: 10.1136/oemed-2020-107323 -
International Journal of Environmental... Jul 2022This retrospective observational study investigated hospital staff requests for job fitness visits, addressed to occupational medicine. Specific objectives were to... (Observational Study)
Observational Study
This retrospective observational study investigated hospital staff requests for job fitness visits, addressed to occupational medicine. Specific objectives were to analyze: (1) health workers’ requests, sociodemographic characteristics, psychiatric diagnoses, assigned doctor’s fit notes, and (orthopedic, psychiatric) limitations; (2) associations between psychiatric diagnoses, sociodemographic (sex, age), and work-related (job, department) characteristics; (3) associations between the same psychiatric diagnoses/orthopedic limitations, fit notes, and/or psychiatric limitations. Data of St. Orsola-Malpighi Polyclinic health workers (N = 149; F = 73.8%; mean age = 48 ± 9.6 years), visited by both the occupational medicine physician and psychiatrist (January 2016−May 2019), were analyzed. 83.2% of the sample presented with at least one psychiatric diagnosis, including mood (47%), anxiety (13.4%), and anxious-depressive (10.7%) disorders. Significant differences between psychiatric diagnoses according to sex and fit notes (both p < 0.01) have been found, whereas no significant associations based on age and work-related characteristics have been observed. Analysis of frequencies of participants with the same psychiatric diagnosis (orthopedic limitation being equal), according to doctor’s fit notes and psychiatric work limitations, showed a high heterogeneity of assignments. The current occupational medicine procedure for fit notes/job limitations assignments does not allow taking into consideration clinical factors possibly associated with more specific assignments. To standardize the procedure and translate the psychiatrist’s clinical judgment into practice, further studies to test the usefulness of clinimetrics, which might represent a reliable approach in considering different fit notes and job limitations, are needed.
Topics: Adult; Anxiety; Humans; Mental Disorders; Middle Aged; Occupational Medicine; Personnel, Hospital; Retrospective Studies
PubMed: 35897498
DOI: 10.3390/ijerph19159098