RESUMO
This study focused on patients treated at the University of New Mexico Burn Center who sustained burn injuries from contact with environmentally heated pavement. We report on our patient demographics and outcomes as well as describe our institutional staged surgical approach to treatment. We provide a comparison of our results with other case reports as well as other findings. A retrospective review of patients admitted to the University of New Mexico Burn Center with injuries suffered from contact with hot pavement was performed. Patients were stratified on the presence or absence of altered mental status (AMS) and additional inciting factors. A total of six patients were reviewed from 2018 to 2019. We looked at patient demographics and comorbidities, time of contact with hot pavement, inciting factors, total body surface area (TBSA) burned, location of areas burned, depth of burn injury at the time of presentation and at the time of initial operative debridement, percentage of autograft take, complications, length of stay (LOS), and final disposition. The patients in our study had a mean TBSA of 9.82% corresponding to pressure points of the body. All patients had nearly 100% conversion to full-thickness burns at the time of initial operative debridement. With staged excision and split-thickness autografting, our patients had nearly 100% take of their skin grafts with minimal graft loss or related complications. At the time of presentation, 100% of patients had AMS and 66% (4/6) had a drug- or alcohol-related inciting event. Finally, the average LOS was 19.5 days in comparison to 7 to 9 days for uncomplicated burns of equivalent size at our burn center. Despite an initial appearance of a partial-thickness burn, pavement burns had a high propensity to convert to full-thickness burns. Patients with AMS contributed to our patient population being found with pavement burns. Patients with pavement burns had a distinct anatomic pattern corresponding to pressure points of the body which were often areas at high risk for skin and wound breakdown and complications. Staged excision and split-thickness autografting in the treatment of pavement burns yielded excellent results. Finally, our data showed that providers must be prepared for an extended LOS for patients with pavement burns.
Assuntos
Queimaduras/etiologia , Queimaduras/terapia , Materiais de Construção/efeitos adversos , Superfície Corporal , Queimaduras/epidemiologia , Exposição Ambiental/efeitos adversos , Feminino , Temperatura Alta , Humanos , Masculino , Pessoa de Meia-Idade , New Mexico/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Luz SolarRESUMO
Nail gun injuries primarily occur in the extremities of adult males as a consequence of accidental occupational trauma. Such injury involving the thorax is much less common, and penetrating cardiac injury secondary to pneumatic nail gun discharge is rare. Although potentially lethal, most cases with cardiac trauma are survivable with expedient surgical intervention. Despite improvements in engineered safety mechanisms, the incidence of nail gun injuries has risen as use of the devices has increased. The widespread availability of these tools to nonprofessional consumers exposes a broader population to the potential hazards associated with these devices. We describe the presentation and successful management of the first reported case of penetrating cardiac nail gun injury in a young child.
Assuntos
Materiais de Construção/efeitos adversos , Traumatismos Cardíacos/etiologia , Ventrículos do Coração/lesões , Ferimentos Penetrantes/etiologia , Pré-Escolar , Feminino , Armas de Fogo , Humanos , Tomografia Computadorizada por Raios XRESUMO
The goal of the current investigation was to report an unusual case of a worker acutely exposed to big amounts of cement dust. This exposure caused chemical bronchioalveolitis and dermatitis due to chromium contact. This person suffered the exposure when a cement deposit exploded at work. This exposed the worker to big amounts of cement dust. After the accident, the individual suffered dyspnea and bilateral basal pulmonary crackles. The subject also presented an atypical restrictive pattern, which could also be seen on X-rays as 1/1 q/q images of the classification of 2000 of the International Labour Organization (ILO), and a bulging of a pulmonary artery. A restrictive pattern pure atypical was observed, and arterial blood gas with hipoxemia. A treatment with steroids was prescribed and the worker showed some improvement. There is high risk of developing pulmonary fibrosis with the progressive evolution in stages of the bronchioalveolitis, even when the subject is isolated. Therefore, it would be very convenient to create a specialized medical center where workers that have this kind of accidents can have the proper care by qualified personnel.
El objetivo de esta publicación es informar del caso poco habitual de un trabajador expuesto de forma aguda a grandes cantidades de cemento, lo cual le produjo un cuadro de broncoalveolitis química industrial y dermatitis de contacto por cromo. El trabajador sufrió un accidente de trabajo cuando se rompió un depósito de cemento y lo expuso a cantidades muy elevadas del polvo de cemento. Presentó disnea de grandes esfuerzos, con estertores crepitantes basales bilaterales. Tuvo, asimismo, una frecuencia respiratoria de 32 por minuto y rash cutáneo. La espirometría mostró un patrón restrictivo atípico incipiente que se correlacionó radiográficamente con imágenes 1/1 q/q de la Clasificación del 2000 de la Organización Internacional del Trabajo (OIT) y abombamiento de la arteria pulmonar. En la gasometría arterial efectuada al trabajador se encontró hipoxemia en posición de decúbito supino. Se prescribió tratamiento esteroideo con mejoría del padecimiento. Dado que hay un alto riesgo de que la fase aguda de las broncoalveolitis termine en fibrosis pulmonar por su evolución en etapas (pues son progresivas aunque se suspenda la exposición), se sugiere crear un servicio especializado, atendido por personal calificado, para el manejo médico de este tipo de accidentes.
Assuntos
Poluentes Ocupacionais do Ar/efeitos adversos , Bronquite/etiologia , Materiais de Construção/efeitos adversos , Poeira , Doenças Profissionais/etiologia , Exposição Ocupacional/efeitos adversos , Adulto , Bronquite/diagnóstico , Indústria da Construção , Humanos , Masculino , Doenças Profissionais/diagnósticoRESUMO
En varios asentamientos del país se han construido viviendas Petrocasas de policloruro de vinilo, relleno con hormigón sobre balsa y cubierta de lámina de aluminio revestida de papel asfalto por ambas caras. El policloruro de vinilo como material de construcción resulta controversial en relación a sus efectos en la salud. Con el objetivo de caracterizar desde el punto de vista sanitario el ambiente físico en viviendas Petrocasas de Cienfuegos, fue conducido un estudio descriptivo en dos semanas seleccionadas de las estaciones seca y húmeda de 2008 y 2009. Se monitoreó factores de riesgo físico en una muestra de 6 viviendas seleccionadas según la opinión de expertos, del total de las 104 viviendas del asentamiento según su ubicación en las filas de viviendas: centro, culata de fila y fachada. Se estudió el ruido, componente magnético del campo electromagnético de baja frecuencia, iluminación natural, artificial, microclima y penetración del viento. La evaluación del monitoreo se efectuó por descriptores estadísticos, modelos de regresión, varianza y espectro de potencia bivariado con los paquetes estadísticos: SPSS v. 17,0 y Statistica v. 8,0. Durante la estación seca, la temperatura del aire es mayor en la habitación principal de viviendas con fachada al sur. En ambas estaciones, las temperaturas y humedades relativas de las viviendas son más altas que en la intemperie. Las cubiertas y paredes muestran calentamientos ante el asoleamiento. Los coeficientes de iluminación natural presentan elevadas reflexiones. Los valores del campo electromagnético son bajos. En la estación seca los niveles sonoros reflejan una contaminación acústica moderada. Concluimos que el microclima en el interior de las viviendas durante el día es inconfortable(AU)
Petrohouses have been built in several villages in the country. These houses are made of polyvinyl chloride, filled with raft concrete and covered with aluminum sheets coated with asphalt paper on both sides. The health effects of polyvinyl chloride as a construction material is a matter of controversy. With the purpose of carrying out a health characterization of the physical environment in Cienfuegos petrohouses, a descriptive study was conducted during two weeks selected from the dry and wet seasons of 2008 and 2009. Physical risk factors were monitored in a sample of 6 houses selected on the basis of expert opinion, of the total 104 houses in the village, according to their location in the rows: front, mid and end positions. The variables studied were noise, magnetic component of the low frequency electromagnetic field, natural and artificial lighting, microclimate and wind penetration. Monitoring was evaluated with statistical descriptors, regression models, variance and bivariate power spectrum, with the statistical software SPSS v. 17.0 and Statistica v. 8.0. In the dry season, air temperature is higher in the main room of houses with facades facing the south. In both seasons, temperature and relative humidity values are higher inside the houses than outside. Covers and walls heat up when hit by the sun. Natural lighting coefficients show high reflection values. Electromagnetic field values are low. In the dry season, sound levels show moderate acoustic contamination. It is concluded that the microclimate inside houses during the day is uncomfortable(AU)
Assuntos
Humanos , Compostos de Vinila/efeitos adversos , Tubulações de PVC/efeitos adversos , Medição de Risco/estatística & dados numéricos , Materiais de Construção/efeitos adversos , Habitação , Meio Ambiente , /métodos , MicroclimaRESUMO
OBJECTIVE: to identify the association between the exposure of workers to inorganic dust in a quarry and a cement factory and pulmonary diseases. METHODS: a transverse study on data from 32 quarry workers (QWs) and 57 cement production line workers (CFWs) to inorganic-dust exposure was performed. Pulmonary function tests and chest X ray were done in both groups. RESULTS: there were differences between QWs and the CFWs; QWs were younger, shorter and thinner. The number of sick individuals might be considered significantly different, showing a smaller proportion on the cement production line. The quarry workers have been on the company for a shorter period of time and, in the end, they present more serious pulmonary problems with an average of 3 years working. CONCLUSIONS: the amount of free-silica that is managed on the quarry affects the workers in some way, even when literature states that the evolution of industrial bronchitis and silicosis have a period development of approximately 10 years.
Objetivo: asociar la exposición a polvos inorgánicos en trabajadores de una cantera y una cementera y la generación de alteraciones pulmonares. Métodos: estudio transversal con 32 trabajadores expuestos a polvos inorgánicos en una cantera y 57 en una cementera. Se les realizaron pruebas de función respiratoria y telerradiografías de tórax. Se midieron polvos totales. Resultados: existieron diferencias demográficas significativas entre las dos líneas de producción: los empleados de la cantera fueron más jóvenes, menos altos y ligeramente más delgados. La proporción de enfermos fue significativamente diferente entre las dos áreas: en la cementera fue menor que en la cantera. Aun cuando los trabajadores de la cantera tuvieron una antigüedad menor, presentaron problemas pulmonares más graves. Conclusiones: la cantidad de sílice libre que se maneja en la cantera afecta gravemente la salud de los trabajadores, ya que con un promedio de tres años de antigüedad laboral presentaban silicosis. Por ello, deben establecerse mejores programas de higiene industrial para el control de los polvos.
Assuntos
Bronquite/etiologia , Materiais de Construção/efeitos adversos , Poeira , Doenças Profissionais/induzido quimicamente , Exposição Ocupacional/efeitos adversos , Dióxido de Silício/efeitos adversos , Silicose/etiologia , Adulto , Estudos Transversais , Humanos , Masculino , Pós , Estudos RetrospectivosRESUMO
PURPOSE: To evaluate the epidemiology of superficial corneal foreign body. METHODS: Patients who were seen at the Emergency Service of the Federal University of São Paulo, from April/05 to June/05, were screened and those with superficial corneal foreign body were interviewed. Data regarding gender, age, occupation, employment status, availability and use of protective devices and supervision of their use were collected. Awareness of the possible complications was also assessed. Results were analyzed using chi-square or Fisher exact test. RESULTS: One hundred twenty-three patients were interviewed. Only 3 patients were female. The mean age was 36 years. Most injuries occurred at the workplace (86.2%), and 58.4% of the patients did not have a legal employment registration. The occupational activities most frequently reported were construction related activities (44.3%) and welding/soldering (11.3%). In most workplaces (79.8%) protective devices were available and 85.3% of the patients were instructed to use them. A safety device was being used during the accident in 34.2% of the cases and this was more frequent among patients that had legal employment registry (p=0.008) and among those under supervision (p=0.0415). The majority of the patients (68.9%) were aware of the risk of severe complications. CONCLUSIONS: Most patients with superficial corneal foreign body are aware of its severe complications and injuries usually occur in places where safety devices are available and often during their use. Our findings suggest that prevention should focus on supervision and correct use of safety devices.
Assuntos
Acidentes de Trabalho/estatística & dados numéricos , Corpos Estranhos no Olho/epidemiologia , Ocupações , Soldagem , Acidentes de Trabalho/prevenção & controle , Adolescente , Adulto , Idoso , Conscientização , Brasil/epidemiologia , Distribuição de Qui-Quadrado , Materiais de Construção/efeitos adversos , Emprego , Corpos Estranhos no Olho/complicações , Corpos Estranhos no Olho/prevenção & controle , Dispositivos de Proteção dos Olhos/estatística & dados numéricos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Local de TrabalhoRESUMO
OBJETIVO: Avaliar a epidemiologia do trauma ocular por corpo estranho superficial de córnea. MÉTODOS: Os pacientes atendidos no Pronto-Socorro da Universidade Federal de São Paulo entre abril e junho de 2005 que apresentaram corpo estranho superficial de córnea foram entrevistados. Foram avaliados: sexo, idade, profissão, registro legal do emprego, uso, disponibilidade e tipo de equipamentos de proteção utilizados e a fiscalização do seu uso. O conhecimento das complicações deste tipo de acidente também foi avaliado. Os resultados foram analisados com teste do qui quadrado ou teste de Fisher. RESULTADOS: Foram entrevistados 123 pacientes. Apenas 3 eram do sexo feminino e a idade média foi de 36 anos. A maioria destes traumas ocorreu no ambiente de trabalho (86,2 por cento) e 58,4 por cento não possuíam registro legal do emprego. As profissões mais freqüentemente envolvidas foram serralheiro, pedreiro e metalúrgico. Em 79,8 por cento dos locais de trabalho havia equipamentos de proteção e 85,3 por cento dos pacientes eram orientados a usá-los. Em 52,4 por cento dos locais sua utilização era fiscalizada, mas apenas 34,2 por cento usavam no momento do trauma. A utilização foi mais freqüente (p=0,008) e fiscalização mais presente (p=0,0415) entre pacientes com registro legal de emprego. Questionados sobre os riscos, 68,9 por cento dos pacientes tinham consciência das complicações graves deste tipo de acidente. CONCLUSÃO: A maioria dos pacientes tem conhecimento sobre a gravidade do trauma ocular e este tipo de lesão ocorre mesmo em locais com equipamentos de proteção disponíveis, alguns deles até durante o seu uso. Os dados sugerem que enfoque maior da prevenção deve ser na fiscalização e utilização de equipamentos adequados.
PURPOSE: To evaluate the epidemiology of superficial corneal foreign body. METHODS: Patients who were seen at the Emergency Service of the Federal University of São Paulo, from April/05 to June/05, were screened and those with superficial corneal foreign body were interviewed. Data regarding gender, age, occupation, employment status, availability and use of protective devices and supervision of their use were collected. Awareness of the possible complications was also assessed. Results were analyzed using chi-square or Fisher exact test. RESULTS: One hundred twenty-three patients were interviewed. Only 3 patients were female. The mean age was 36 years. Most injuries occurred at the workplace (86.2 percent), and 58.4 percent of the patients did not have a legal employment registration. The occupational activities most frequently reported were construction related activities (44.3 percent) and welding/soldering (11.3 percent). In most workplaces (79.8 percent) protective devices were available and 85.3 percent of the patients were instructed to use them. A safety device was being used during the accident in 34.2 percent of the cases and this was more frequent among patients that had legal employment registry (p=0.008) and among those under supervision (p=0.0415). The majority of the patients (68.9 percent) were aware of the risk of severe complications. CONCLUSIONS: Most patients with superficial corneal foreign body are aware of its severe complications and injuries usually occur in places where safety devices are available and often during their use. Our findings suggest that prevention should focus on supervision and correct use of safety devices.
Assuntos
Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Acidentes de Trabalho/estatística & dados numéricos , Corpos Estranhos no Olho/epidemiologia , Ocupações , Soldagem , Conscientização , Acidentes de Trabalho/prevenção & controle , Brasil/epidemiologia , Distribuição de Qui-Quadrado , Materiais de Construção/efeitos adversos , Emprego , Corpos Estranhos no Olho/complicações , Corpos Estranhos no Olho/prevenção & controle , Dispositivos de Proteção dos Olhos , Conhecimentos, Atitudes e Prática em Saúde , Sistema de Registros , Local de TrabalhoRESUMO
Pharmacopoeias prescribe tests to determine the levels of arsenic in raw materials and glass containers. In this study, glass ampoules for injectables containing individually the main components of intravenous nutrition formulations were submitted to the hydrolytic resistance test by heating at 121 degrees C for 30 min. As(V) and As(III) levels in these solutions after heating were determined by hydride generation atomic absorption spectrometry. The arsenic content of substances used in these formulations was previously determined, as well as the arsenic content of the glass containers. The results showed that raw substances as well as glass containers contain arsenic. Moreover, arsenic is released during the heating (hydrolytic resistance test). However, the amount released and the arsenic species present in solution depend on the solution composition. While As(V) was the predominant specie in glass, solutions containing reducing substances such as glucose and vitamins had As(III) in higher concentration. Therefore, arsenic is released from glass containers during the heating for sterilization, and reacts with formulation constituents depending on their reducing properties.
Assuntos
Arsênio/administração & dosagem , Materiais de Construção/efeitos adversos , Vidro/química , Substâncias Perigosas/administração & dosagem , Nutrição Parenteral/efeitos adversos , Arsênio/química , Contaminação de Medicamentos , Temperatura Alta , Soluções/efeitos adversos , EsterilizaçãoRESUMO
Objetivos: Este estudo tem por objetivo descrever os principais tipos de queimaduras oculares, assim como relacioná-los com o sexo, a idade, o agente causador, a lateralidade, a profissão e as complicações oculares associadas, atendidos no ambulatório do Serviço de Oftalmologia do Hospital Universitário da Universidade Federal de Santa Catarina (HU/UFSC).Métodos: Foram estudados 162 pacientes, no período de março de 2003 a setembro de 2004. Foram analisadas as queimaduras oculares nas seguintes categorias: sexo, idade, tipo de queimadura ocular, agente causador, lateralidade, profissão e complicações oculares.Trata-se de um estudo transversal, de caráter descritivo, retrospectivo, não intervencionista. Os critérios de inclusão consistiram somente na análise dos prontuários nos quais continham todas as informações necessárias para o preenchimento dos dados da pesquisa, excluindo-se aqueles prontuários com informações incompletas. Resultados: Houve predominância do sexo masculino (79,6%) sobre o feminino (20,4%). A faixa etária mais acometida foi a de 15 a 35 anos, com 57,4% dos casos. O tipo de queimadura mais freqüente foi a química, com 58% dos casos. Os principais agentes causadores foram aqueles relacionados ao ambiente de trabalho: energia radiante (29,6%) e cal associada a cimento (21%). Quanto à lateralidade, em cerca de 50,6% dos casos, os dois olhos foram afetados. Em relação à ocupação profissional, os pacientes mais comprometidos foram aqueles que trabalhavam na construção civil (33,3%). Entre as complicações oculares encontradas, a erosão corneal foi observada em 72,2% dos casos, seguida pelas conjuntivites traumáticas (41,4%). Conclusão: Indivíduos jovens do sexo masculino foram os mais acometidos, sendo que o principal tipo de queimadura encontrada foi a queimadura química. Na maioria dos casos, os acidentes ocorreram no ambiente de trabalho, relacionados com a construção civil. Os principais agentes causadores foram o cimento...
Assuntos
Humanos , Masculino , Feminino , Córnea , Queimaduras Oculares , Saúde Ocupacional , Materiais de Construção/efeitos adversosRESUMO
A frequent practical problem of research in developing countries is the lack of reliable records on occupational hazards. To improve this situation, this article suggests and evaluates a two-phase method for estimating particle exposure. The first phase uses the focal group, or homogeneous group, technique to reconstruct the production process and estimate the level of dust exposure. The second phase applies the technique of individual history of exposure to hazards at work, an index that accumulates current and previous exposure. This method was introduced in a Portland cement plant to assess the dust-exposure levels of workers and to evaluate its usefulness in the association between estimated exposure levels and the frequency of health effects--particularly respiratory effects--that occurred as a result of such exposures. The results obtained from the analysis of the production process and of the exposure levels determined by the cement workers showed that it is possible to reconstruct the history of exposure to cement dust during each worker's occupational history. The results also showed that estimated exposure is related to respiratory damage; higher exposure resulted in more serious diseases. This supports the usefulness of the suggested methodology.