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- Organic dust exposure in veterinary clinics: a case study of a small-animal practice in PortugalPublication . Viegas, Carla; Monteiro, Ana; Ribeiro, Edna; Caetano, Liliana Aranha; Carolino, Elisabete; Assunção, Ricardo; Viegas, SusanaLiterature about occupational health in small-animal veterinary practices is scarce, but most of it has recognised a number of risks to be considered, including organic dust exposure. The aim of this pilot study was to assess organic dust, bacterial, and fungal contamination in the indoor environment of a typical Portuguese veterinary clinic but also to screen for azoleresistant fungi. To complement these findings we also analysed workers' nasal exudates for resistant bacteriota. Particles measurements included mass concentrations (PMC) of five particle sizes (PM0.5, PM1, PM2.5, PM5, PM10) and their counts (PNC). Indoor air samples were obtained from six locations as well as before and during cat dental cleaning and cultured on four media for bacterial and fungal assessment. An outdoor sample was also collected for reference Surface samples were taken from the same indoor locations using swabs and we also use electrostatic dust cloths as passive methods. PM10 showed the highest concentrations across the locations. Indoor air fungal loads ranged from 88 to 504 CFU m-3. The azole-resistant Aspergillus section Nigri was identified in one sample. Indoor air bacterial loads ranged from 84 to 328 CFU m-3. Nasopharyngeal findings in the 14 veterinary clinic workers showed a remarkably low prevalence of Staphylococcus aureus (7.1 %). Our results point to contamination with organic dusts above the WHO limits and to the need for better ventilation. Future studies should combine the same sampling protocol (active and passive methods) with molecular tools to obtain more accurate risk characterisation. In terms of prevention, animals should be caged in rooms separate from where procedures take place, and worker protection should be observed at all times.
- The 1918-1919 Influenza Pandemic in Portugal: a Regional Analysis of Death ImpactPublication . Nunes, Baltazar; Silva, Susana; Rodrigues, Ana; Roquette, Rita; Batista, Inês; Rebelo-de-Andrade, HelenaAlthough the impact of deaths occurring during the 1918-1919 influenza pandemic has been assessed in many archeo-epidemiologic studies, detailed estimates are not available for Portugal. We applied negative binomial models to monthly data on respiratory-related and all-cause deaths at the national and district levels from Portugal for 1916-1922. Influenza-related excess mortality was computed as the difference between observed and expected deaths. Poisson regression was used to estimate the association of geographic and sociodemographic factors with excess mortality. Two waves of pandemic influenza-July 1918 to January 1919 and April to May 1919-were identified, for which the excess all-cause death rate was 195.7 per 10,000 persons. All districts of Portugal were affected. The pandemic hit earlier in southeastern districts and the main cities, but excess mortality was highest in the northeast, in line with the high death burden experienced by northern Spanish provinces. During the period of intense excess mortality (fall/winter 1918-1919), population density was negatively associated with pandemic impact. This pattern changed during the March 1919 to June 1920 wave, when excess mortality increased with population density and in northern and western directions. Portuguese islands were less and later affected. Given the geographic heterogeneity evidenced in our study, subnational sociodemographic characteristics and connectivity should be integrated in pandemic preparedness plans.
- Air pollution: a public health approach for PortugalPublication . Torres, Pedro; Ferreira, Joana; Monteiro, Alexandra; Costa, Solange; Pereira, Maria Carmo; Madureira, Joana; Mendes, Ana; Teixeira, João PauloAt the global level, several epidemiological studies have conclusively pointed out the associations between short-term exposure to air pollution and acute health effects, and long-term exposure with adverse health effects such as premature mortality from severe respiratory and cardiovascular diseases. This study intended to characterize exposures and their adverse health effects. Three independent sets of vectors were analyzed on a nationwide level and annual basis: air pollutant emissions, ambient air concentrations and health indicators of the period 2009 to 2015. The emissions analysis, for the studied pollutants, pointed out the main findings: (i) Lisbon Metropolitan Area presents the most problematic region with regard to the emissions of all the pollutants under study; (ii) the regions of the Alentejo and Algarve showed reduced emissions of the studied pollutants compared to other parts of the country; (iii) Northern regions PM10 concentrations decreased during the two years in analysis. Regarding the analysis of air quality, it was concluded that: (i) regarding ozone, concentration shown a decreasing trend throughout the country; (ii) nitrogen dioxide and particulate matter, concentrations demonstrated an increasing trend in most of the northern part of the country; (iii) the regions of Alentejo and Lisbon Metropolitan Area showed increasing trends for sulfur dioxide and fine particles for the evaluated period. Decreasing trends in mortality associated with cardiovascular and respiratory causes are found mainly in the Alentejo and Algarve regions. In comparison, the North, Central regions, as well as, Lisbon Metropolitan Area exhibited higher mortality values related to this health indicators.