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- Sampling methods and assays applied in SARS-CoV-2 exposure assessmentPublication . Pena, Pedro; Morais, Joana; Gomes, Anita Q.; Viegas, CarlaThe SARS-CoV-2 exposure assessment is critical to implement control measures and guarantee the safety of patients and workers from different occupational environments. The aim of this review article was to identify methodologies applied for SARS-CoV-2 sampling and analyses in environmental samples in different occupational and indoor environments. This study reports the search of available data published between May 29th, 2020, and November 1st, 2020. The search strategy used allowed the identification of 48 papers that comply with selected inclusion and exclusion criteria. The most described indoor environment consisted of health care facilities. From all the analyzed studies, 34 sampled surfaces, 27 sampled air (impactors and impingers being the most used), and 9 sampled water. All studies were based on molecular detection by qPCR of viral RNA extracted from collected samples. SARS-CoV-2 was detected in 44 out of the 48 studies. The results suggest that the sampling approach should include both active and passive sampling methods in order to overcome each method's limitations. Concerning the assays used, although most studies were based on qPCR detection, the fact that the digital PCR technique allows SARS-CoV-2 detection at lower concentrations indicates that this should be the chosen method for future detection studies.
- Waste-sorting industry: an (un)assessed occupational environmentPublication . Viegas, Carla; Almeida, Beatriz; Dias, M.; Gomes, Anita Q.; Viegas, Susana
- Occupational exposures to organic dust in Irish bakeries and a pizzeria restaurantPublication . Viegas, Carla; Fleming, Gerard T. A.; Kadir, Abdul; Almeida, Beatriz; Aranha Caetano, Liliana; Gomes, Anita Q.; Twarużek, Magdalena; Kosicki, Robert; Viegas, Susana; Coggins, Ann MarieFor decades, occupational exposure to flour dust has been linked to a range of respiratory diseases, including occupational asthma, thought to result from exposure to fungi present in the flour. Antifungal resistance is of increasing prevalence in clinical settings, and the role of occupational and environmental exposures, particularly for specific fungal species, is of concern. Occupational exposure to flour dust can occur in a range of occupational settings, however, few studies have focused on restaurant workers. The objective of this study was to measure occupational exposure to flour and microbial contamination, including azole resistance screening, in two small commercial bakeries and in a pizzeria. Personal full shift inhalable dust measurements were collected from workers and were analyzed for inhalable dust and fungi, bacteria, azole resistance, and mycotoxins. Samples of settled dust were collected, and electrostatic dust cloths (EDC) were deployed and analyzed for microbial contamination, including azole resistance screening, and mycotoxins. Geometric mean exposures of 6.5 mg m-³ were calculated for inhalable dust, however, exposures of up to 18.30 mg m-³ were measured-70% of personal exposure measurements exceeded the occupational exposure limit for flour dust of 1.0 mg m-³. The air and EDC fungal counts were similar to those reported in previous studies for similar occupational environments. The fungi were dominated by Penicillium genera, however Aspergillus genera, including Fumigati and Flavi sections, were observed using culture-based methods, and the Fumigati section was also observed by molecular tools. Both Aspergillus sections were identified on the azole resistance screening. Mycotoxins were also detected in the settled dust samples, dominated by deoxynivalenol (DON). The role of environmental exposure in both the development of antimicrobial resistance and the total mycotoxin body burden is a growing concern; therefore, the presence of azole-resistant fungi and mycotoxin contamination, although low in magnitude, is of concern and warrants further investigation.
- Microbiological contamination assessment in higher education institutesPublication . Viegas, Carla; Pimenta, Raquel; Dias, Marta; Gomes, Bianca; Brito, Miguel; Caetano, Liliana Aranha; Carolino, Elisabete; Gomes, Anita Q.The higher education sector represents a unique environment and it acts as a work environment, a learning environment for students, and frequently, also a home environment. The aim of this study was to determine the microbial contamination (SARS-CoV-2, fungi, and bacteria) in Higher Education Facilities (HEI) by using active and passive sampling methods and combining culture-based methods with molecular tools targeting Aspergillus section Fumigati. In addition, the resistance to azole profile was also assessed. Surface samples showed a range of total bacterial contamination between 1 × 103 to 3.1 × 106 CFU·m−2, while Gram-negative bacteria ranged from 0 to 1.9 × 104 CFU·m−2. Fungal contamination ranged from 2 × 103 to 1.8 × 105 CFU·m−2 on MEA and from 5 × 103 to 1.7 × 105 CFU·m−2 on DG18. The most prevalent species found on both media was Cladosporium sp. (47.36% MEA; 32.33% DG18). Aspergillus genera were observed on MEA (3.21%) and DG18 (14.66%), but not in the supplemented media used for the azole screening. Aspergillus section Fumigati was detected in 2 air samples (2.22%, 2 out of 90 samples) by qPCR. When testing for SARS-CoV-2 all results were negative. The present study showed that although cleaning and disinfection procedures are done regularly due to the COVID-19 pandemic, being effective in eliminating SARS-CoV-2, surfaces were often contaminated with microorganisms other than SARS-CoV-2. This can be a result of increasing resistance to biocides, and to the wide range of environmental factors that can contribute to the dissemination of microbial contamination indoors.
- Mechanic protection gloves used in waste sorting industry: suitable as passive method to sample for fungal burdenPublication . Viegas, Carla; Dias, Marta; Almeida, Beatriz; Gomes, Anita Q.; Twarużek, Magdalena; Kosicki, Robert; Grajewski, Jan; Viegas, SusanaBackground: The high prevalence of airborne bacterial and fungal species in forklift cabinets from waste sorting units has already been described. Aspergillus spp. species are filamentous fungi commonly found in different environmental compartments, where they thrive as saprophytes. Several sections are reported as being mycotoxins producers. In Portuguese waste industries, personal protective equipment, such as mechanical protection gloves (MPG) are of mandatory use. During their use, sweat is released, and consequently, the material humidity and temperature inside the glove increase leading to favorable conditions for the microorganism’s growth. This study intends to assess the fungal and mycotoxins contamination present in MPG as a potential passive sampling method to assess occupational exposure.
- Towards an integrated approach on occupational health to tackle COVID-19 pandemicPublication . Ribeiro, Edna; Oliveira, Ketlyn; Dias, Marta; Gomes, Bianca; Pimenta, Raquel; Delgadinho, Mariana; Ginete, Catarina; Abreu, Renato; Almeida-Silva, Marina; Almeida, Ana; Gomes, Anita Q.; Brito, Miguel; Viegas, CarlaBackground: Serological screening is crucial for the prevention of infection, ensuring the maintenance of the worker’s health, and thus promoting occupational health. It was reported that SARS-CoV-2 can survive in aerosols and on dry surfaces for several days to weeks. Objectives: We aimed to apply an integrated approach to Occupational Health to tackle the COVID-19 pandemic. Materials and methods: We performed a rapid immunoglobulin IgM-IgG immunoassay, ELISA, and hematologic profile among workers (N = 740), in a Public Higher Education Institution from Portugal and an environmental assessment by two sampling methods (Air N = 49; Surfaces N = 101) and RT-PCR. Results: Regarding workers' serologic surveillance, 1.89% of rapid test positivity was observed for SARS-CoV-2 IgM antibodies and a low prevalence of positivity for IgG (1.21%) in which only 33.3% were confirmed by ELISA. Hematologic surveillance data revealed the presence of 10.44% of abnormal hematological profiles, being anemia (3.78%) being the most relevant. All the environmental samples analyzed were negative regarding SARS-CoV-2 detection. Discussion: Low SARS-CoV-2 immunization and the negative environmental samples strongly indicate the effectiveness of the preventive measures. Nevertheless, COVID-19 disease alters hematologic parameters. Conclusion: In this study, it was possible to implement an integrated approach to Occupational Health combining efforts with the Occupational Health Services.
- Bioburden assessment by passive methods on a clinical pathology service in one central hospital from Lisbon: what can it tell us regarding patients and staff exposure?Publication . Viegas, Carla; Twarużek, Magdalena; Lourenço, Raquel; Dias, Marta; Almeida, Beatriz; Aranha Caetano, Liliana; Carolino, Elisabete; Gomes, Anita Q.; Kosicki, Robert; Soszczyńska, Ewelina; Viegas, SusanaThe assessment and control of microbial contamination in healthcare facilities is presently a mandatory and vital part of strategies to prevent and control hospital-acquired infections. This study aims to assess the bioburden with two passive sampling methods (30 ventilations grids swabs and 16 electrostatic dust collectors (EDCs)) at Clinical Pathology Services. The fungal burden was characterized through molecular tools, antifungal resistance, and the mycotoxins and cytotoxicity profile. Total bacteria presented the highest prevalence in both matrixes, whereas Gram-bacteria presented the lowest. Swabs presented a higher prevalence (27.6%) for fungal burden. Chrysonilia sitophila presented the highest prevalence in swabs, whereas for EDCs, C. sitophila and Mucor sp. were the most prevalent. Concerning Aspergillus genera on swabs, section Flavi was the one with the highest prevalence (58.02%), whereas, for EDCs, section Versicolores was the only section observed (100%). Aspergillus section Fumigati was detected in 10 swabs and 7 EDC samples and Aspergillus section Versicolores were detected in one EDC sample. Fungal growth on azole-supplemented media was observed in eight EDC samples. No mycotoxins were detected in any of the samples. A low cytotoxic effect was observed in two sites upon incubation of collected samples with A549 and SK cells and in two other sites upon incubation of collected samples with SK cells only. A medium cytotoxic effect was observed with one EDC sample upon incubation with A549 cells. This study reinforces the need for determination of the azole resistance profile for fungal species and allowed a preliminary risk characterization regarding the cytotoxicity. An intervention including the use of ultraviolet with a wavelength between 200 nm and 280 nm (UVC)—emitting device and increased maintenance and cleaning of the central heating, ventilation, and air conditioning (HVAC) systems should be ensured to promote the reduction of microbial contamination.