Browsing by Author "Neuparth, Nuno"
Now showing 1 - 10 of 19
Results Per Page
Sort Options
- 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.
- Environment and Health in Children Day Care CentresPublication . Neuparth, Nuno; Papoila, Ana Luísa; Aelenei, Daniel; Cano, Manuela; Paixão, Paulo; Viegas, João; Martins, Pedro; Araújo Martins, José; Leiria Pinto, Paula; Caires, Iolanda; Pedro, Catarina; Nogueira, Susana; Mendes, Ana; Aguiar, Fátima; Teixeira, João Paulo; Proença, Carmo; Piedade, Cátia; Santos, Madalena; Silvestre, Maria José; Brum, Laura; Nunes, Baltazar; Guiomar, Raquel; Curran, Martin D.; Carvalho, Ana; Marques, Teresa; Virella, Daniel; Alves, Marta; Marques, João; Rosado-Pinto, José; Neuparth, Nuno; Aelenei,Daniel; Caires, Iolanda; Teixeira, João Paulo; Viegas, João; Cano, Manuela; Pinto, Paula LeiriaThis project addresses a set of common clinical problems in the context of children attending day care centres. It is common sense that children get sick more often as soon as they start attending a day care centre on a daily basis and this is particularly true for some groups at risk, as wheezing infants and wheezing pre-school children. Concerning this, some questions remain unclear: 1. The role of indoor air quality - what is the health impact of indoor air environment (including indoor pollutants, house dust mite, temperature and humidity) in wheezing children? 2. The role of virus infections - We don’t know the real role of virus infections in respiratory conditions at day care centre level. There is a lack of information concerning how indoor air environment influence virus infections. 3. The role of building ventilation - what is the impact of building ventilation in the health of wheezing and non-wheezing children? How is ventilation affecting indoor air quality? How is ventilation of day care centres affected by the structure of the buildings? 4. Social impact of this study - what should be the recommendations to improve IAQ? What is new in this project is the collaboration of a health team (medical doctors and other health professionals) with environment specialists, mechanical, civil engineers, epidemiologists and statisticians.
- 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.
- Estudo da qualidade do ar interior em creches e infantários (projeto ENVIRH)Publication . Viegas, João; Cano, Manuela; Nogueira, Susana; Papoila, Ana LuísaC; Proença, Maria do Carmo; Aelenei, Daniel; Neuparth, NunoEncontra-se em curso um projeto de investigação, co-financiado pela FCT, que tem por objetivo estudar qual o impacte que a qualidade do ar interior tem na prevalência de doenças do foro respiratório em crianças que frequentam creches e infantários em Lisboa e Porto. Este projeto envolve investigadores do LNEC, do INSA Dr. Ricardo Jorge, da Faculdade de Ciências Médicas (UNL) e da Faculdade de Ciências e Tecnologia (UNL). O faseamento deste estudo enquadrou uma primeira fase de análise das condições construtivas dos edifícios, uma medição sumária do teor de CO2 em salas de atividades e um inquérito relativo ao estado de saúde das crianças, em 45 creches e jardins-de-infância de Lisboa (25) e do Porto (20); numa segunda fase incluiu a medição da qualidade do ar interior, da taxa de ventilação e do estado de saúde das crianças num conjunto mais limitado de escolas (10 em Lisboa e 9 no Porto); numa fase final está a ser desenvolvida a simulação da ventilação em duas escolas. Nesta comunicação apresentam-se os resultados obtidos pelo LNEC e pelo INSA Dr. Ricardo Jorge relativos à análise da qualidade do ar e à ventilação. Estes resultados revelam que na generalidade dos locais os caudais de ventilação são muito baixos, sendo a qualidade do ar interior insuficiente face ao RSECE e a valores recomendados pela literatura.
- 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.
- O impacto do ambiente interior na saúde respiratória dos idosos: resultados preliminares do projeto GERIAPublication . Mendes, Ana; Papoila, Ana Luísa; Martins, Pedro; Caires, Iolanda; Palmeiro, Teresa; Aguiar, Lívia; Pereira, Cristiana; Neves, Paula; Botelho, Amália; Neuparth, Nuno; Teixeira, João Paulo
- 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.