RESUMEN
Environmental injuries can result in serious neurologic morbidity. This chapter reviews neurologic complications of thermal burns, smoke inhalation, lightning strikes, electric injury, near drowning, decompression illness, as well as heat stroke and accidental hypothermia. Knowing the pathophysiology and clinical presentation of such injuries is essential to proper management of primary and secondary medical complications. This chapter highlights the most frequently encountered neurologic injuries secondary to common environmental hazards, divided into the topics: injuries related to fire, electricity, water, and the extremes of temperature.
Asunto(s)
Enfermedades Ambientales/complicaciones , Contaminación Ambiental/efectos adversos , Enfermedades del Sistema Nervioso/etiología , Humanos , Hipotermia/complicacionesRESUMEN
Household air pollution from biomass fuel use affects 3 billion people worldwide; however, few studies have examined the relationship between biomass fuel use and blood pressure. We sought to determine if daily biomass fuel use was associated with elevated blood pressure in high altitude Peru and if this relationship was affected by lung function. We analyzed baseline information from a population-based cohort study of adults aged ≥ 35 years in Puno, Peru. Daily biomass fuel use was self-reported. We used multivariable regression models to examine the relationship between daily exposure to biomass fuel smoke and blood pressure outcomes. Interactions with sex and quartiles of forced vital capacity were conducted to evaluate for effect modification. Data from 1004 individuals (mean age, 55.3 years; 51.7% women) were included. We found an association between biomass fuel use with both prehypertension (adjusted relative risk ratio, 5.0; 95% confidence interval, 2.6-9.9) and hypertension (adjusted relative risk ratio, 3.5; 95% confidence interval, 1.7-7.0). Biomass fuel users had a higher systolic blood pressure (7.0 mm Hg; 95% confidence interval, 4.4-9.6) and a higher diastolic blood pressure (5.9 mm Hg; 95% confidence interval, 4.2-7.6) when compared with nonusers. We did not find interaction effects between daily biomass fuel use and sex or percent predicted forced vital capacity for either systolic blood pressure or diastolic blood pressure. Biomass fuel use was associated with a higher likelihood of having hypertension and higher blood pressure in Peru. Reducing exposure to household air pollution from biomass fuel use represents an opportunity for cardiovascular prevention.
Asunto(s)
Contaminación del Aire Interior/efectos adversos , Altitud , Biomasa , Enfermedades Ambientales/complicaciones , Hipertensión/epidemiología , Población Rural , Humo/efectos adversos , Adulto , Anciano , Presión Sanguínea , Enfermedades Ambientales/epidemiología , Femenino , Estudios de Seguimiento , Humanos , Hipertensión/etiología , Incidencia , Masculino , Persona de Mediana Edad , Perú/epidemiologíaRESUMEN
Cockroach allergy has been recognized as an important cause of asthma. Exposure to high levels of cockroach allergens in the home is a major risk factor for symptoms in sensitized individuals. Previously identified allergens from Blatella germanica and Periplaneta americana include Bla g 2 (inactive aspartic proteinase), Bla g 4 (calycin), Bla g 5 (glutathione-S-transferase), Bla g 6 (troponin), the Group 1 cross-reactive allergens Bla g 1 and Per a 1, Per a 3 (arylphorin), and Per a 7 (tropomyosin). The primary site of cockroach allergen accumulation is the kitchen. However, lower levels of allergen can be found in bedding, on the bedroom floor, and in sofa dust. Strategies for decreasing exposure to cockroach have been investigated. The results suggest that a sustained decrease in cockroach allergen levels is difficult to accomplish, even after successful extermination of cockroach populations. The use of recombinant cockroach allergens may lead to the development of new approaches to asthma treatment in the future.
Asunto(s)
Alérgenos/efectos adversos , Cucarachas/inmunología , Contaminantes Atmosféricos/efectos adversos , Contaminación del Aire Interior/efectos adversos , Animales , Asma/complicaciones , Asma/etiología , Asma/terapia , Exposición a Riesgos Ambientales/efectos adversos , Enfermedades Ambientales/complicaciones , Enfermedades Ambientales/etiología , Enfermedades Ambientales/terapia , HumanosRESUMEN
Se describen los efectos respiratorios y no respiratorios de los contaminantes aéreos. Los aumentos en O3 y NOx se asocian a obstrucción bronquial e hiperreactividad bronquial. Sin embargo, los estudios comparativos sobre la prevalencia de asma y alergias en niños en Alemania unificada, han demostrado que la exposición a alergenos sería más importante que la exposición a contaminantes aéreos (PM10 y SO2) en la determinación de asma bronquial. El CO interfiere a contaminantes aéreos (PM10 y SO3) en la determinación de asma bronquial. El CO interfiere con el intercambio de O2 en la barrera fetoplacentaria y disminuye la disponibilidad de O2 para el tejido miocárdico y cerebral. Algunos de los compuestos orgánicos del material particulado pueden ser potenciales carcinógenos y mutágenos. El plomo, derivado de la gasolina, puede interferir en la hematopoyesis y en la función renal y cerebral. Los escasos estudios epidemiológicos realizados en América Latina sugieren que la población infantil es la más susceptible a los contaminantes aéreos. Se necesita efectuar más estudios en pacientes cardiorrespiratorios y en embarazadas