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- Qualidade do ar interior em jardins-de-infância: relação entre os parâmetros ambientais e os níveis de ocupação dos espaçosPublication . Santos, Joana; Aguiar, Mafalda; Alberto Alves Carvalhais, Carlos; Pereira, Cristiana; Fernandes, Anabela; Vieira Da Silva, Manuela; Santos Baptista, João; Teixeira, João PauloOs edifícios escolares são espaços com características específicas, onde a garantia de condições de trabalho saudáveis é fundamental para a aprendizagem e bem-estar dos ocupantes. Contudo, os novos padrões arquitectónicos têm potenciado o aparecimento de edifícios mais herméticos, com reduzidas taxas de ventilação e problemas relacionados com a qualidade do ar interior (QAI). Com a recente legislação, adoptaram-se valores de referência para os parâmetros químicos e microbiológicos. A concentração de CO2 e microrganismos viáveis pode dar uma boa indicação da eficiência da ventilação. Neste âmbito, efectuou-se um estudo que teve como objectivos relacionar as concentrações de CO2 e microrganismos viáveis com os níveis de ocupação e eficiência da ventilação de salas de aulas. A quantificação dos parâmetros ambientais baseou-se na caracterização estrutural e de funcionamento do edifício. As amostragens foram efectuadas na Primavera, em nove salas de aula de quatro jardins-de-infância (JI) com diferentes tipos de construção. Os resultados demonstraram que os JI recentes apresentaram concentrações médias de CO2 superiores às verificadas nos JI do "plano centenário", atingindo valores máximos de 3400 ppm nos períodos de ocupação. Obtiveram-se concentrações elevadas de bactérias gram positivas nos JI de construção recente, que podem estar relacionadas com a sobrelotação dos espaços e ventilação insuficiente. Os valores de velocidade do ar também revelam a constante estagnação do ar nos espaços. O aumento das taxas de ventilação e sensibilização dos ocupantes são medidas chave para a melhoria da QAI. Contudo, é na fase de projecto do edifício que devem surgir preocupações com a QAI.
- Applied research on environmental and occupational health in hospital contextPublication . Carvalhais, Carlos; Xavier, Ana; Vieira Da Silva, Manuela; Santos, JoanaHospital facilities are normally, very complex, which combined with patient requirements promote conditions for potential development of uncomfortable working conditions. The work in hospitals is likely to damage health resulting in occupational accidents and diseases. In this sense, a project focused on Environmental and Occupational Health in Hospital Context was developed to be a contribution to understand the risk factors to which health professionals and patients are exposed in these environments and how this exposure can be reduced. This research line resulted in 34 publications and 11 oral/poster communications: 6 articles in international scientific journals, 3 book chapters, 13 articles/abstracts in books of international congress proceedings, 4 technical reports, 1 doctoral thesis and 7 final course works. The project allowed the study of data about occupational exposure and accidents in hospital environments in the North of Portugal
- Noise in neonatal intensive care units: a short reviewPublication . Alberto Alves Carvalhais, Carlos; Vieira Da Silva, Manuela; Silva, Joana; Xavier, Ana; Santos, JoanaPrematurity and low birth weight of newborns lead to the need of a special care in neonatal units, and their permanence in these places can be extended for a long period. Indoor environmental conditions, such noise levels above the recommended, may induce some risks, not only for the newborns development, but also for health care staff. This literature review aims to examine the studies related to noise in neonatal intensive care units to understand the sources and effects of noise, as well as some strategies to reduce noise exposure. The search strategy included an electronic search in databases (ISI Web of Knowledge and PubMed) of scientific articles published in English/Portuguese between 2000-2017. Studies providing data on noise levels found in the neonatal units, the effects on health of newborns and staff and the measures to minimize these effects were included. The exclusion criteria were as follows: duplicate printings; nonEnglish/Portuguese language; editorials, letters, patents, errata, meeting abstracts and conference papers. PRISMA methodology was followed to perform the review. Twenty-two articles were considered for full analysis. It is important to note that some potentially relevant studies were rejected due to language criteria. It was found that the noise levels to which the newborns and staff are exposed in NICU, often exceeds the recommended levels for these spaces. Evidence also shows several adverse health effects for newborns and health care staff perceptions of noise. There is no consensus regarding the best intervention to reduce noise levels.
- Noise Reduction and Control in Hospital Environment: Design of the NeoNoise ProjectPublication . Alberto Alves Carvalhais, Carlos; Vieira Da Silva, Manuela; Xavier, Ana; Santos, JoanaThe “NeoNoise Project: Integrated Approach to Minimize Sound Pressure Levels in Neonatal Intensive Care Units” is being conducted by the Research Group on Occupational and Environmental Health of the Research Center on Health and Environment in neonatal intensive care units, since exposure to sound pressure levels in these spaces has been recognized as a factor that influences the quality and well‐being of the occupants (workers and others), as well as the recovery of premature infants who are hospitalized. This work reports the rationale and the design of the NeoNoise project as well as the methods used for data collection. A brief review on the results published and available for the scientific community is also made. In general, NeoNoise project intends to make an integration of all relevant factors, with the intention of presenting a guiding document to change the working practices and occupant's behaviors. So far, this study provided data on sound pressure levels by objective and subjective approaches, as well as information about the exposure factors and sensitivity of the occupants to noise.
- Is there sufficient training of health care staff on noise reduction in neonatal intensive care units? A pilot study from neonoise projectPublication . Alberto Alves Carvalhais, Carlos; Santos, Joana; Vieira Da Silva, Manuela; Xavier, AnaEvidence indicates that exposure to high levels of noise adversely affects human health, and these effects are dependent upon various factors. In hospitals, there are many sources of noise, and high levels exert an impact on patients and staff, increasing both recovery time and stress, respectively. The goal of this pilot study was to develop, implement, and evaluate the effectiveness of a training program (TP) on noise reduction in a neonatal intensive care unit (NICU) by comparing the noise levels before and after the implementation of the program. In total, 79 health professionals participated in the study. The measurements of sound pressure levels took into account the layout of the unit and locations of the main sources of noise.
- Comparison of different methods for work accidents investigation in hospitals: A Portuguese case studyPublication . Nunes, Cláudia; Santos, Joana; Vieira Da Silva, Manuela; Lourenço, Irina; Alberto Alves Carvalhais, CarlosBACKGROUND: The hospital environment has many occupational health risks that predispose healthcare workers to various kinds of work accidents. OBJECTIVE: This study aims to compare different methods for work accidents investigation and to verify their suitability in hospital environment. METHODS: For this purpose, we selected three types of accidents that were related with needle stick, worker fall and inadequate effort/movement during the mobilization of patients. A total of thirty accidents were analysed with six different work accidents investigation methods. RESULTS: The results showed that organizational factors were the group of causes which had the greatest impact in the three types of work accidents. CONCLUSIONS: The methods selected to be compared in this paper are applicable and appropriate for the work accidents investigation in hospitals. However, the Registration, Research and Analysis of Work Accidents method (RIAAT) showed to be an optimal technique to use in this context.
- Newborns Safety at Neonatal Intensive Care Units: Are they Exposed to Excessive Noise during Routine Health Care Procedures?Publication . Alberto Alves Carvalhais, Carlos; Vieira Da Silva, Manuela; Xavier, Ana; Santos, JoanaNeonatal Intensive Care Unit (NICU) noise may be stressful to preterm infants. This research evaluated the newborns exposure to noise during several health care activities of two NICU. The measurements of the equivalent continuous A-weighted sound pressure level and peak sound pressure level were carried were performed with a sound level meter, as close as possible of the newborn. The results showed that sound pressure levels were excessive in all the evaluated tasks, exceeding international guidelines. The levels ranged between 46.6 dBA to 74.6 dBA. There is a need for more research in order to verify the effectiveness of specific strategies to reduce the impact of noise in NICU.
- The impact of structural changes on sound pressure levels in a neonatal intensive care unitPublication . Alberto Alves Carvalhais, Carlos; Rodrigues, Celia; Xavier, Ana; Vieira Da Silva, Manuela; Santos, JoanaThe design of neonatal intensive care units (NICU) influences both patient safety and clinical outcomes as well as the acoustic conditions. In NICU exposure to sound pressure levels above the recommended can affect both neonates and healthcare staff. This study aimed to evaluate the sound pressure levels and to assess noise perception of professionals in a NICU before and after structural modifications and layout redesign. The measurements were performed with a sound level meter. A questionnaire was given to staff before and after the intervention. The opinion of healthcare staff regarding noise in NICU was better after the intervention, when compared with the responses previously given. The results showed that noise levels were excessive in the NICU (before and after), exceeding the inter national recommendations, with the levels ranging between 46.6 dBA to 57.8 dBA before and 52.0 dBA to 54.0 dBA after intervention. Overall, there is a need for more research in order to verify the effectiveness of some actions and strategies to reduce the impact of noise in NICU.
- Integração de estudantes em projetos I&D em Saúde Ambiental: o caso do projeto NeoNoisePublication . Carvalhais, Carlos; Xavier, Ana; Vieira Da Silva, Manuela; Santos, JoanaA exposição ao ruído em unidades de cuidados intensivos tem sido reconhecida como um fator de interferência no bem-estar dos ocupantes e na recuperação dos pacientes. Neste contexto, o projeto ‘NeoNoise: Integrated Approach to Minimize Sound Pressure Levels in Neonatal Intensive Care Units’, pretende contribuir para a compreensão do papel de fatores educacionais, ambientais e infraestruturais na redução do ruído e promoção da saúde em unidades de cuidados intensivos neonatais (UCIN) considerando dois grupos de risco: prematuros e profissionais. Os objetivos específicos são: caracterizar os níveis de ruído em diferentes locais da UCIN; determinar a sua influência na saúde e bem-estar de prematuros e profissionais; desenvolver um guia de boas práticas objetivando reduzir a produção de ruído. Paralelamente, o NeoNoise teve a intenção de criar condições de estímulo ao início da atividade científica e desenvolvimento de sentido crítico e autonomia dos estudantes da licenciatura em Saúde Ambiental, através da sua integração em projetos I&D. De facto, os membros integrados do projeto estão envolvidos não apenas na lecionação de unidades curriculares (UC) de 1º/2º ciclo, como também na coordenação/participação científica de projetos de investigação. A dupla condição de docente e investigador que caracteriza os membros intervenientes, é um fator importante na reflexão sobre as potencialidades de cruzamento entre uma ação que envolve ensino-aprendizagem e outra que passa pelo desenvolvimento de investigação. O NeoNoise teve a particularidade de aliar as componentes científico-pedagógica, pois parte das atividades desenvolvidas pelos estudantes decorreu no âmbito da UC Projeto de Investigação da licenciatura em Saúde Ambiental.
- Good Practices to Reduce Noise Levels in the Neonatal Intensive Care UnitPublication . Alberto Alves Carvalhais, Carlos; Vieira Da Silva, Manuela; Xavier, Ana; Santos, JoanaIndoor environmental conditions in neonatal intensive care units, such noise levels above the recommended, may induce some risks, not only for preterm infants’ development, but also for health care staff. The aim of this work is to summarize some good practices guidelines that can be followed by health care staff in a daily basis, which are intended to promote noise reduction in neonatal intensive care units. It is expected some initial resistance to the implementation of some recommendations, but evidence shows that in general, with training, health care staff should recognize the need of changes.