Browsing by Author "Carreiro-Martins, Pedro"
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- Avaliação de idosos institucionalizados por espirometria e condensado brônquico do ar exalado: efeitos da exposição ambientalPublication . Belo, Joana; Carreiro-Martins, Pedro; Papoila, Ana Luísa; Palmeiro, Teresa; Caires, Iolanda; Alves, Marta; Nogueira, Susana; Aguiar, Fátima; Mendes, Ana; Cano, Manuela; Botelho, Maria A.; Neuparth, NunoNo estudo geriátrico dos efeitos na saúde da qualidade do ar interior em lares da 3.ª idade de Portugal (GERIA) foi estabelecido como objetivo principal de estudar os efeitos da qualidade do ar interior (IAQ) de equipamentos residenciais para pessoas idosos (ERPI) na saúde respiratória de idosos institucionalizados. Um total de 269 idosos responderam a um questionário elaborado pela equipa de investigadores do projeto GERIA, realizaram uma espirometria e a 150 idosos foi recolhida uma amostra de condensado brônquico exalado (EBC), para análise do respetivo pH e concentração de nitritos. Em relação aos dados sociodemográficos destaca se uma média de idade de 81,9±7,5 anos e uma maioria (70,6%) de idosos do sexo feminino. Relativamente aos resultados da espirometria, observou se que 14,5% apresentaram uma obstrução das vias aéreas. Os valores medianos das concentrações dos poluentes ambientais não revelaram uma concentração acima do referencial de segurança, porém foram observados valores máximos elevados e acima desse referencial. Da análise multivariada verificou se que cada incremento de 100 µg/m3 nos compostos orgânicos voláteis (TVOCS) se encontrava associado positiva mente a possibilidade acrescida dos idosos terem reportado infeção respiratória nos últimos três meses (=1.05; 95% CI: 1.00 to 1.09). Verificou se que o valor do pH diminuía com uma maior exposição a PM2,5 (= 0.04, 95%: 0.06 to 0.01e por cada aumento de 10 µg/m3). No que concerne à exposição a bactérias, verificou se que esta se associava positivamente à possibilidade dos idosos terem uma FVC diminuída (= 0,53, 95%: 0,87 a 0,20) e uma relação FEV1 /FVC aumentada (=0,22, 95%:0,08 a 0,37)
- Chronic respiratory diseases and quality of life in elderly nursing home residentsPublication . Carreiro-Martins, Pedro; Gomes-Belo, Joana; Papoila, Ana Luísa; Caires, Iolanda; Palmeiro, Teresa; Gaspar-Marques, João; Leiria-Pinto, Paula; Mendes, Ana Sofia; Paulo-Teixeira, João; Botelho, Maria Amália; Neuparth, NunoFew studies have assessed the quality of life (QOL) related to chronic respiratory diseases in the elderly. In the framework of the geriatric study on the health effects of air quality in elderly care centers (GERIA) study, a questionnaire was completed by elderly subjects from 53 selected nursing homes. It included various sections in order to assess respiratory complaints, QOL (World Health Organization QOL (WHOQOL)-BREF), and the cognitive and depression status. The outcome variables were the presence of a score lower than 50 (<50) in each of the WHOQOL-BREF domains (physical health, psychological health, social relationships, and environmental health). Chronic bronchitis, frequent cough, current wheezing, asthma, and allergic rhinitis were considered as potential risk factors. The surveyed sample was (n = 887) 79% female, with a mean age of 84 years (SD: 7 years). In the multivariable analysis, a score of <50 in the physical domain was associated with wheezing in the previous 12 months (odds ratio (OR): 2.03, confidence interval (CI): 1.25-3.31) and asthma (OR: 1.95, CI: 1.12-3.38). The psychological domain was related with a frequent cough (OR: 1.43, CI: 0.95-2.91). A score of <50 in the environmental domain was associated with chronic bronchitis (OR: 2.89, CI: 1.34-6.23) and emphysema (OR: 3.89, CI: 1.27-11.88). In view of these findings, the presence of respiratory diseases seems to be an important risk factor for a low QOL among elderly nursing home residents.
- CO2 concentration in day care centres is related to weezing in attending childrenPublication . Carreiro-Martins, Pedro; Viegas, João; Papoila, Ana Luísa; Aelenei, Daniel; Caires, Iolanda; Araújo-Martins, José; Gaspar-Marques, João; Cano, Maria Manuela; Mendes, Ana Sofia; Virella, Daniel; Rosado-Pinto, José; Leiria-Pinto, Paula; Annesi-Maesano, Isabella; Neuparth, NunoPoor ventilation at day care centres (DCCs) was already reported, although its effects on attending children are not clear. This study aimed to evaluate the association between wheezing in children and indoor CO2 (a ventilation surrogate marker) in DCC and to identify behaviours and building characteristics potentially related to CO2. In phase I, 45 DCCs from Lisbon and Oporto (Portugal) were selected through a proportional stratified random sampling. In phase II, 3 months later, 19 DCCs were further reassessed after cluster analysis for the greatest difference comparison. In both phases, children’s respiratory health was assessed by ISAAC-derived questionnaires. Indoor CO2 concentrations and buildingcharacteristics of the DCC were evaluated in both phases, using complementary methods. Mixed effect models were used to analyze the data. In phase I, which included 3,186 children (mean age 3.1±1.5 years), indoor CO2 concentration in the DCC rooms was associated with reported wheezing in the past 12months (27.5 %) (adjusted odds ratio (OR) for each increase of 200 ppm 1.04, 95 % CI 1:01 to 1:07). In phase II, the association in the subsample of 1,196 children seen in 19 out of the initial 45 DCCs was not significant (adjusted OR 1.02, 95 % CI 0.96 to 1.08). Indoor CO2 concentration was inversely associated with the practices of opening windows and internal doors and with higher wind velocity. A positive trend was observed between CO2 and prevalence of reported asthma (4.7 %). Conclusion: Improved ventilation is needed to achieve a healthier indoor environment in DCC.
- Effect of indoor air quality of day care centers in children with different predisposition for asthmaPublication . Carreiro-Martins, Pedro; Papoila, Ana Luisa; Caires, Iolanda; Azevedo, Susana; Cano, Maria Manuela; Virella, Daniel; Leiria-Pinto, Paula; Teixeira, João Paulo; Rosado-Pinto, José; Annesi Maesano, Isabella; Neuparth, NunoBACKGROUND: Scarce information is available about the relationships between indoor air quality (IAQ) at day care centers (DCC), the estimated predisposition for asthma and the actual wheezing susceptibility. METHODS: In the Phase II of ENVIRH study, 19 DCC were recruited after cluster analysis. Children were evaluated firstly using the ISAAC questionnaire and later by a follow up questionnaire about recent wheezing. A positive asthma predictive index (API) was considered as predisposition for asthma. Every DCC was audited for IAQ and monitored for chemical and biological contaminants. RESULTS: We included 1,191 children, with a median age of 43 (P25 -P75 : 25-58) months. Considering the overall sample, in the first questionnaire, associations were found between CO2 concentration (increments of 200 ppm) and diagnosis of asthma (OR: 1.10; 95% CI: 1.00 - 1.20). Each increment of 100 μg.m-3 of total volatile organic compounds (TVOC) and 1 μg of Der p1/g of dust were associated with wheezing in the previous 12 months (OR: 1.06; 95% CI: 1.01-1.11 and OR: 1.06; 95% CI: 0.99-1.12, respectively). In the follow-up questionnaire, TVOC were again associated with wheezing (OR: 1.05; 95% CI: 1.00-1.11). Children exposed to fungal concentration above the 75th percentile had also higher odds of wheezing at follow-up. TVOC were associated with wheezing in children with either negative or positive API. CONCLUSIONS: IAQ in DCC seems to be associated with wheezing, in children with and without predisposition for asthma. This article is protected by copyright. All rights reserved.
- Environmental and ventilation assessment in Child Day Care Centers in Porto: the ENVIRH ProjectPublication . Mendes, Ana; Aelenei, Daniel; Papoila, Ana Luísa; Carreiro-Martins, Pedro; Aguiar, Lívia; Pereira, Cristiana; Neves, Paula; Azevedo, Susana; Cano, Manuela; Proença, Carmo; Viegas, João; Silva, Susana; Mendes, Diana; Neuparth, Nuno; Teixeira, João PauloChildren attending day care centers (CDCC) have been reported to be more prone to infectious diseases when compared with those cared for at home, and are exposed to conditions that may increase the risk of allergies and asthma. Several studies revealed that consequences of poor ventilation conditions include high levels of carbon dioxide (CO2) and many other indoor pollutants commonly detected in schools. Nine child day care centers were selected randomly to participate in this study. Fifty-two classrooms were assessed for chemical, biological, physical, and allergen parameters in spring and winter seasons in these nine CDCC located in Porto, Portugal. Outdoor measurements were also conducted for comparison. Our results indicated that (i) particulate matter (PM10) median levels were above the national reference levels, both by classroom type and by season; (ii) TVOC kindergarten peak values may raise some concern; (iii) CO2 was present at high median and maximum levels during spring and winter assessment in both nurseries and kindergartens classrooms; (iv) total bacteria concentrations were 57- and 52-fold higher in the nursery and kindergarten than outdoors, respectively, for the spring season; (v) winter and spring median predicted mean vote (PMV)indices were between “neutral” (0) and “slightly cool” (≤ –1) in the thermal sensation scale for comfort situations (−2 to 2) for both types of classrooms; (vi) there were significant differences for both PMV and predicted percentage of dissatisfied (PPD) indices by season; and vii) CO2, total bacteria, and gram-negative bacteria were associated with low airflow rates. These data will help to evaluate the effectiveness of current building operation practices in child day care centers regarding indoor air quality and respiratory health.
- The impact of indoor air quality and contaminants on respiratory health of older people living in long-term care residences in PortoPublication . Mendes, Ana; Papoila, Ana Luísa; Carreiro-Martins, Pedro; Bonassi, Stefano; Caires, Iolanda; Palmeiro, Teresa; Aguiar, Lívia; Pereira, Cristiana; Neves, Paula; Mendes, Diana; Botelho, Maria Amália Silveira; Neuparth, Nuno; Teixeira, João PauloBackground: persons who are 65 years or older often spend an important part of their lives indoors thus adverse indoor climate might influence their health status. Objective: to evaluate the influence of indoor air quality and contaminants on older people’s respiratory health. Design: cross-sectional study. Setting: 21 long-term care residences (LTC) in the city of Porto, Portugal. Subjects: older people living in LTC with ≥65 years old. Methods: the Portuguese version of BOLD questionnaire was administered by an interviewer to older residents able to participate (n = 143). Indoor air contaminants (IAC) were measured twice, during winter and summer in 135 areas. Mixed effects logistic regression models were used to study the association between the health questionnaire results and the monitored IAC, adjusted for age, smoking habits, gender and number of years living in the LTC. Results: cough (23%) and sputum (12%) were the major respiratory symptoms, and allergic rhinitis (18%) the main selfreported illness. Overall particulate matter up to 2.5 micrometres in size median concentration was above the reference levels both in winter and summer seasons. Peak values of particulate matter up to 10 micrometres in size (PM10), total volatile organic compounds, carbon dioxide, bacteria and fungi exceeded the reference levels. Older people exposed to PM10 above the reference levels demonstrated higher odds of allergic rhinitis (OR = 2.9, 95% CI: 1.1–7.2). Conclusion: high levels of PM10 were associated with 3-fold odds of allergic rhinitis. No association was found between indoor air chemical and biological contaminants and respiratory symptoms.
- The impact of indoor air quality on respiratory health of older people living in nursing homes: spirometric and exhaled breath condensate assessmentsPublication . Belo, Joana; Carreiro-Martins, Pedro; Papoila, Ana L.; Palmeiro, Teresa; Caires, Iolanda; Alves, Marta; Nogueira, Susana; Aguiar, Fátima; Mendes, Ana; Cano, Manuela; Botelho, Maria A.; Neuparth, NunoIn the Portuguese Geriatric Study of the Health Effects of Indoor Air Quality in Senior Nursing Homes, we aimed to evaluate the impact of indoor air contaminants on the respiratory symptoms and biomarkers in a sample of elderly living in nursing homes. A total of 269 elderly answered a health questionnaire, performed a spirometry and 150 out of these collected an exhaled breath condensate sample for pH and nitrites analysis. The study included the evaluation of indoor chemical and microbiological contaminants. The median age of the participants was 84 (78-87) years and 70.6% were women. The spirometric data indicated the presence of airway obstruction in 14.5% of the sample. Median concentrations of air pollutants did not exceed the existing standards, although increased peak values were observed. In the multivariable analysis, each increment of 100 µg/m3 of total volatile organic compounds was associated with the odds of respiratory infection in the previous three months ( OR̂ =1.05; 95% CI: 1.00-1.09). PM2.5 concentrations were inversely associated with pH values ( β̂ = -0.04, 95%: -0.06 to -0.01, for each increment of 10 µg/m3). Additionally, a direct and an inverse association were found between total bacteria and FEV1/FVC and FVC, respectively.
- Volatile organic compounds in day care centers constitute a risk factor for absence due to weezingPublication . Carreiro-Martins, Pedro; Papoila, Ana Luísa; Alves, Marta; Caires, Iolanda; Pedro, Catarina; Manilha, Maria do Carmo; Cano, Maria Manuela; Teixeira, João Paulo; Virella, Daniel; Leiria-Pinto, Paula; Rosado-Pinto, José; Neuparth, Nuno