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- With these data, there will be a contribution to the operation management of the electric utility company
5. REFERENCES Akerstedt, Torbjorn; Landström, Ulf. (1998). Work place countermeasures of night shift fatigue, International Journal of Industrial Ergonomics, Volume 21, Issues 3-4, March, pp. 167-178.
Baulk, S.D. ; Fletcher, A.; Kandelaars, K.J.; Dawson, D.; Roach, G.D. (2009). A field study of sleep and fatigue in a regular rotating 12-h shift system, Applied Ergonomics, Volume 40, Issue 4, July, pp. 694-698.
Carvalho, P. V.R.; Santos, I. L. D.; Vidal, Mario. C. R. (2005). Nuclear power plant shift supervisor’s decision making during microincidents. International Journal of Industrial Ergonomics, 35, 619–644.
Ku, Chia-Hua; Smith, Michael J. (2010). Organisational Factors and Scheduling in Locomotive Engineers and Conductors: Effects on fatigue, health and social well-being. Applied Ergonomics, 41, January, pp. 62-71.
Meijman, T. F. (1997). Mental Fatigue and the Efficiency of Information Processing in relation to Work times. International Journal of Industrial Ergonomics, 20, Issue 1, July, pp. 31-38.
Murata, A; Uetake, A; Takasawa, Y. (2005). Evaluation of Mental Fatigue using Feature Parameter Extracted from Event-related Potential, International Journal of Industrial Ergonomics, 35, Issue 8, August, pp 761-770.
Nasa, TLX Disponible in: http://humansystems.arc.nasa.gov/groups/TLX/computer.php, 2008.
Neves, T. I. (2007). Study of Work Dynamic in Operation and Control Center according Knowledgment Management. MSc.
Dissertation (in Portuguese), Itajubá: Federal University of Itajuba, Brazil.
Oliveira, Ana M. B. (2009). Fatigue Analysis in Operators of the Electrical Substation Control Rooms, MSc. Dissertation, (in Portuguese), Federal University of Paraiba.
Richard, Jean-François. (1990). Les Activités Mentales. Paris: Armand Polin,.
Santos, V.; Zamberlan, M.C. (1992), Ergonomics Design of Control Rooms. (in Portuguese), São Paulo: Fundacion Mapfre.
Indoor Air Microbiological Levels in Portuguese Hospitals Mendes, Anaa; Aguiar, Líviab; Pereira, Cristianac; Neves, Maria Paulad; Teixeira, João Pauloe a, b, c, d, e National Health Institute, Environment Health Department, Rua Alexandre Herculano, 321, 4000-055 Porto a email@example.com; firstname.lastname@example.org; email@example.com;
d firstname.lastname@example.org; email@example.com
1. INTRODUCTION For the past 25 years, there has been growing concern about the presence of fungi and bacteria and their adverse human health effects in indoor environments (Brasel et al., 2005). This concern is due to people spending most of their lives in indoor environments and, therefore, exposed to microbes in these environments. Thus, knowledge about this exposure is important for understanding the impact on human health (Rintala et al., 2008).
Hospitals are places were microorganisms have chance and ability to proliferate despite all the hygiene and disinfection procedures. Poor hospital microbial indoor air quality (IAQ) may lead to hospital-acquired infections, sick hospital syndrome and various occupational hazards (Wan et al., 2011). It is therefore important to assess, regularly, the IAQ in order to better control bacterial and fungal respiratory diseases in hospitals (Araujo et al., 2008).
The present investigation explored annually variations of indoor air microbiological indices in five hospitals, including bacteria and fungi concentrations.
2. MATERIALS AND METHOD
2.1. Sampling sites The study was carried out from 2006 to 2010, in 5 hospitals, located in north and center region of Portugal where 94 areas were evaluated within wards, offices, laboratories, operating rooms and warehouses. Outdoor samples were also collected in each campaign, to compare with indoor contaminant levels.
2.2. Sampling methods Air sampling was carried out with a microbiological air sampler (Merck Air Sampler MAS-100), working at a constant air flow rate of 100 liters per minute, and using the following culture media: Tryptic Soy Agar (TSA) for bacteria, and Malt Extract Agar (MEA) for fungi. It was followed the National Institute for Occupational Safety and Health (NIOSH) 0800 Method - Bioaerosol Sampling (Indoor Air).
The MAS-100 was located approximately at one meter above the floor taking into account the characteristics of the evaluated area, far from air intakes, open doors and windows. Five different volumes of air (50, 100, 250, 500 and 1000 L), in duplicate and with one field blank, per culture medium, per day, were collected according with the characteristics and possible contamination of each room. All samples were carried out during hospitals normal activities. For quantification of fungi, the set of collected samples were incubated at 25ºC. Identification of fungal colonies was based upon phenotypic characteristics and followed standard mycological procedures. The culture media for bacteria quantification were incubated at 37ºC. For each room and analysis, the total number of colonies were plotted against volumes of air. Results were expressed as CFU per cubic meter of air (CFU/m3).
Indoor temperature, relative humidity (RH) and carbon dioxide (CO2) concentration were determined using a portable monitor (GasData, model PAQ) with short-term measurements (30 minute average for each one) conducted sequentially, at each site, recording the respective duration. After equipment stabilization, reading values were registered and transferred to an informatics system using PCLogger software.
2.3. Data Analysis The values of the monitored microbiological parameters were compared with the current Portuguese reference levels: (1) total viable bacteria = 500 CFU/m3; (2) total viable fungi = 500 CFU/m3 (Decree-Law no. 79/2006 of April 4th).
3. RESULTS AND DISCUSSIONThe levels of airborne bacteria and fungi are dependent on environmental factors such as CO2, RH and temperature (Araujo et al., 2008). During the monitoring period, the indoor air overall temperature was 18-28ºC, RH ranged from 29 to 79%, and the CO2 concentration was between 376-2290 mg/m3, with 3% of total monitored values above the Portuguese reference levels (1800 mg/m3).
In terms of ventilation systems, 39% of the analyzed rooms were naturally ventilated and 59% had mechanical ventilation systems, with intake and outtake grids.
The overall mean airborne concentrations of indoor bacteria and fungi, for all analyzed rooms, were, respectively, 525 and 349 CFU/m3. These airborne concentrations had high variability ranging 9-10512 CFU/m3 for bacteria and 10-5530 CFU/m3 to fungi. Other studies (Cabral, 2010 and Wan et al., 2011) also refer high ranging variability due to indoor building materials, ventilation rates and human activities.
Table 1 presents the summary of the five years of indoor and outdoor microbiological monitoring data, by hospital. Three hospitals had bacteria concentrations above Portuguese reference levels. Meanwhile, only one hospital had fungi
Occupational Safety and HygieneInternational Symposium on
concentrations above the respective levels. It is important to notice that outdoor concentrations are higher than indoors in three out of five analyzed hospitals. This could show that hospitals may be influenced by outdoor variables, especially those rooms that are naturally ventilated. In hospitals, the use of air filtration systems and other preventive measures limits drastically the access of outdoor microbiological pollutants to such environments, reducing its concentrations (Munoz et al., 2004 and Dascalaki et al., 2009). Also, there is a common high range, both indoor and outdoor, reporting all the seasons and different areas variability throughout the monitoring years.
Table 2 shows the results of indoor microbiological monitoring pointing up the analysis by type of analyzed room.
It is possible to recognize ‘Warehouses’ as the area with higher bacteria and fungi concentration levels, and therefore above the law reference levels, followed by ‘Laboratories’ and ‘Wards’, when it concerns to bacteria concentration levels.
It is not surprising that ‘Operating rooms’ were the areas with lower concentrations of microorganisms, due to sterilization procedures in these types of rooms.
Figure 1 represents the overall evolution of bacteria and fungi concentrations per hospital throughout the monitoring years.
Apart from hospitals code 1 and 3 for bacteria monitoring and hospitals code 3 and 4 for fungi monitoring, which is only available 2008 year data, it is possible to identify an increase of indoor bacteria and fungi concentrations along the years.
Thirty five percent of bacteria concentration are above the Portuguese reference levels and 13% of fungi concentrations had the same performance.
These preliminary results also point out to a prevalence of the following mold species in the analyzed samples:
Aspergillus versicolor and Aspergillus niger, both possibly toxigenic; and more common species such as Penicillium sp.and Alternaria sp.
Ongoing analysis is being carried out to correlate bacteria and fungi concentrations with their possible sources, ventilation characteristics and other environmental IAQ parameters.
Figure 1 – Overall evolution of bacteria and fungi concentrations per hospital
4. CONCLUSIONS The results presented in this work points out to: (i) hospitals concentration levels of bacteria tend to be higher than fungi concentrations; (ii) ‘Warehouses’ is the area with higher microbiological concentrations above law reference levels, followed by ‘Laboratories’ and ‘Wards’; (iii) outdoor concentrations are higher than indoors in three out of five studied hospitals; (iv) it is possible to identify an increase of indoor bacteria and fungi concentrations, per hospital, throughout the years.
These data will help to identify and quantify the relative role of factors that contribute to poor indoor microbiological air quality. The data collected in this study may also be used to evaluate the effectiveness of current building operation practices in hospitals, and can be used to prioritize allocations of resources for reduction of risk associated with air microbiological hazards, reducing occupant’s complaints and enabling their health improvement.
5. ACKNOWLEDGMENTS This research is supported by a PhD Grant (SFRH/BD/72399/2010) from Fundação para a Ciência e Tecnologia (FCT) and through GERIA Project: PTDC/SAU-SAP/116563/2010 from FCT.
6. REFERENCES Araujo, R., Cabral, J. P., Rodrigues, A. G. (2008) Air filtration systems and restrictive access conditions improve indoor air quality in clinical units: Penicillium as a general indicator of hospital indoor fungal levels. American Journal of Infection Control, 36, 129-134.
Brasel, T.L, Martin, J.M., Carriker, C.G, Wilson, S. C., Straus, D. C. (2005). Detection of Airborne Stachybotrys chartarum Macrocyclic Trichothecene Mycotoxins in the Indoor Environment. Applied and Environmental Microbiology, 71, 7376–7388.
Cabral, J.P.S. (2010). Can we use indoor fungi as bioindicators of indoor air quality? Historical perspectives and open questions.
Science of the Total Environment 408:4285–4295.
Dascalaki, E.G., Gaglia, A.G., Balaras, C.A., Lagoudi A. (2008). Indoor environmental quality in Hellenic hospital operating rooms.
Energy and Buildings, 41:551–560.
Decree-Law No. 79/2006 of April 4th, Annex VII - Reference concentration levels of indoor pollutants within the existing buildings.
DR I Série A n.◦ 67 of 4th April 2006, Ministry of Public Works, Transport and Communications.
Munoz, P., Guinea, J., Pelaez, T., Duran, C., Blanco, J.L., Bouza, E. (2004). Nosocomial invasive aspergillosis in a heart transplant patient acquired during a break in the HEPA air filtration system. Transpl Infect Dis;6:50-4.
NIOSH Manual of Analytical Methods (NMAM). (1998). Bioaerosol Sampling (Indoor Air) 0800 Method., National Institute for Occupational Safety and Health (NIOSH).Fourth Edition, Issue 1.
Rintala, H., Pitkäranta, M., Toivola, M., Paulin, L., Nevalainen, A. (2008). Diversity and seasonal dynamics of bacterial community in indoor environment. BMC Microbiology, 8:56.
Wan, G.W., Chung, F.F., Tang C.S., Shan K., Sinjhunag. (2011). Long-term surveillance of air quality in medical center operating rooms. Am J Infect Control, 39:302-8.
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Lighting conditions at an operating room in a Portuguese maternity Monteiro, Anaa, Moreno, Zaidab, Albuquerque, Paulac a Escola Superior de Tecnologia da Saúde de Lisboa, Av. D. João II, Lote 4.69.01, e-mail: firstname.lastname@example.org; b Student finalist in the 2010 Escola Superior de Tecnologia da Saúde de Lisboa, e-mail: email@example.com; c Escola Superior de Tecnologia da Saúde de Lisboa, Av. D. João II, Lote 4.69.01, e-mail: firstname.lastname@example.org
1. INTRODUCTION Lighting is one of the most important factors in human interaction with the environment (Morghen, Turola, Forini, Di Pasquale, Zanatta & Matarazzo, 2009).
Poor lighting may increase the risk of accidents (Veitch, 2001 apud Pais & Melo, 2011; Reinhold & Tint, 2009) and could also cause a variety of symptoms including: rapid fatigue, headaches, eyestrain, tired eyes, dry eyes, ocular surface symptoms (watery and irritated eyes), decreased concentration and stress. Specific disorders: degeneration of the sharpness of vision (blurred and double vision) and slowness in changing focus (Blehm, Vishnu, Khattak, Mitra, Yee, 2005; Woodside, Kocurek, 1997 apud Reinhold & Tint, 2009; Veitch, 2001 apud Pais & Melo, 2011).
Apart from the advantages in the health and welfare for the workers, good lighting also leads to better job performance (faster), less errors, better safety, fewer accidents and less absenteeism. The overall effect is: better productivity (van Bommel, 2006; Veitch et al., 2008 apud Pais & Melo, 2011; Begeman, 1997 apud Morghen et al., 2009).
Good lighting includes quantity and quality requirements, and should necessarily be appropriate to the activity/task being carried out, bearing in mind the comfort and visual efficiency of the worker (Boyce, 2003; Picolli et al., 2004 apud Pais & Melo, 2011).