Percorrer por autor "Leiria-Pinto, Paula"
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- 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.
- Factores de Risco para sibilância: resultados da Fase1 do Projecto "Ambiente e Saúde em Creches e Infantários" (ENVIRH)Publication . Martins, Pedro; Papoila, Ana Luísa; Marques, João; Caires, Iolanda; Martins, José; Pedro, Catarina; Manilha, Maria do Carmo; Cano, Manuela; Silva, Ana Sofia; Aelenei, Daniel; Nogueira, Susana; Paixão, João Paulo; Teixeira, João Paulo; Viegas, João; Rosado-Pinto, José; Leiria-Pinto, Paula; Neuparth, NunoMuitas crianças com idade inferior a 6 anos apresentam sibilância no decurso de infecções respiratórias. O projecto ENVIRH tem como parte integrante dos seus objectivos identificar factores de risco para sibilância relacionados com as características construtivas / qualidade do ar interior das creches e infantários. Métodos: No âmbito do Projecto ENVIRH foram seleccionadas aleatoriamente 46 Instituições Particulares de Solidariedade Social (IPSS) das cidades de Lisboa e Porto, estratificadas por freguesia e número de alunos. As escolas seleccionadas corresponderam a metade das IPSS destas duas cidades. Em Outubro de 2010 foi entregue aos pais de todas as crianças uma versão resumida do questionário do estudo ISAAC (n=5161). Efectuou-se no mesmo período uma avaliação sumária das características construtivas e da qualidade do ar de todas as escolas participantes. Para a análise dos dados foram utilizadas Equações de Estimação Generalizadas (GEE), de forma considerar a estrutura de correlação dos indivíduos de cada IPSS. Resultados: Foram devolvidos 3185 questionários. A idade média foi de 3.1 ± 1.5 anos, sendo 50.5% do sexo masculino. A prevalência reportada de sibilância nos 12 meses anteriores foi de 27.5% (IC 95%: 25.9% - 29.0%). Das diversas varáveis consideradas - idade, sexo, escolaridade dos pais, tabagismo passivo, existência de irmãos mais velhos, antecedentes de eczema na criança, antecedentes de asma ou rinite nos pais, idade e área da IPSS, número de alunos, existência de bolores na instituição, temperatura, humidade relativa e concentração de CO2 médias do ar interior durante o período de ocupação - somente persistiram significativas na análise multivariável (p<0.05) a idade (OR: 0.74; IC 95: 0.70 - 0.78; p<0.001), antecedentes de eczema (OR: 1.35; IC 95: 1.14 - 1.60; p<0.001), e antecedentes de asma ou rinite nos pais (OR: 1.99; IC 95: 1.67 - 2.38; p<0.001). Um aumento médio de 100 ppm de CO2 também se associou com sibilância nos 12 meses anteriores (OR: 1.02; IC 95: 1.01 - 1.03; p=0.008). Conclusão: Tratando-se a concentração de CO2 um marcador indirecto da ventilação e da qualidade do ar interior, os resultados alcançados sugerem a necessidade de introduzir melhorias nestes parâmetros, ao nível das creches e infantários, dado existir uma associação muito significativa das concentrações de CO2 com sibilância.
- Indoor Air Quality in Portuguese Day Care Centers - ENVIRH ProjectPublication . Cano, Manuela; Nogueira, Susana; Papoila, Ana Luísa; Aguiar, Fátima; Martins, Pedro; Marques, João; Caires, Iolanda; Martins, José; Pedro, Catarina; Paixão, Paulo; Rosado-Pinto, José; Leiria-Pinto, Paula; Aelenei, Daniel; Mendes, Ana; Teixeira, João Paulo; Proença, Carmo; Neuparth, NunoThis paper describes field measurements of indoor air quality (IAQ) parameters, performed in 19 Portuguese Children Day Care Centers (CDCC) during the springtime of 2011 and aims to characterize the indoor environment. The results demonstrate an association between carbon dioxide and bacterial concentrations, which in turn are affected by the number of children present in each classroom. Indoor PM10 concentrations were higher than outdoor levels (I/O ratio>1) and was also found statistically significant association between PM10 concentrations and the type of floor covering materials. These results provide evidence that IAQ is inadequate and, as a consequence, human source contaminants such as bacteria and carbon dioxide accumulate indoors. This study suggests that it is necessary to improve ventilation in order to achieve a healthier indoor environment.
- 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