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Faez N, Hmami F, Boujraf S, Kojmane W, Atmani S. Practices for respecting the newborn's sleep-wake cycle: Interventional study in the neonatal intensive care unit. J Neurosci Rural Pract 2024; 15:278-285. [PMID: 38746497 PMCID: PMC11090542 DOI: 10.25259/jnrp_579_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 12/26/2023] [Indexed: 05/16/2024] Open
Abstract
Objectives Premature newborns are exposed to a great deal of over-stimulation, which can affect their cerebral development. For better sleep, certain practices should be recommended. The aim of this study was to evaluate the effect of a professional training program on the improvement of practices promoting respect for the newborn's sleep-wake cycle. Materials and Methods This was an interventional study with a longitudinal, single-group, and before-and-after design. The experimental design followed a three-stage time series: Eight months before, three months after, then eight months after intervention. It targeted a comprehensive sample of 66 professionals. It took place between October 2020 and March 2022 at the Neonatal Intensive Care Unit of the Hassan II University Hospital in Fez, Morocco. It was based on an observation grid and a self-administered questionnaire, validated and tested with a Cronbach's alpha reliability of 0.91. Results The light environment showed significant differences between the 1st and 3rd step (3.3% vs. 45.0%; P = 0.02; confidence interval [CI] = 13.644-10.456) for knowledge and (13.3% vs. 78.3%; P = 0.01; CI = 14.412-10.888) for practices; the noise environment showed a positive improvement between the 2nd and 3rd intervention (31.7% vs. 41.7%; P < 0.001; CI = 5.954-2.913) for knowledge and (65.0% vs. 73.3%; P < 0.001; CI = 3.597-1.236) for practices, with an average of (8.98 ± 0.30-28.15 ± 0.48; CI = 3.806-1.094) between the 1st and 3rd step. Practices surrounding sleep and wakefulness reported significant improvement between the three periods (14.35 ± 0.22 vs. 18.10 ± 0.35 vs. 19.90 ± 0.35; P P < 0.001; CI = 4.647-2.853) for sleep and (13.25 ± 0.48 vs. 22.27 ± 0.59; P < 0.001; CI = 10.563-7.471) for wakefulness with statistically significant correlations between knowledge and practices (0.426**) for sleep and (0.606**) for wakefulness. Conclusion The study demonstrated the positive impact of this sleep management and assessment program on the development of professional skills. Its implementation requires rigorous application of developmental support strategies for individualized care in neonatology.
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Affiliation(s)
- Naima Faez
- Laboratory of Epidemiology and Research in Health Science, Sidi Mohamed Ben Abdelah University, Fez, Morocco
| | - Fouzia Hmami
- Human Pathology, Biomedicine and Environment Laboratory, Sidi Mohamed Ben Abdelah University, Fez, Morocco
| | - Saïd Boujraf
- Clinical Neurosciences Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdelah University, Fez, Morocco
| | - Widade Kojmane
- Laboratory of Epidemiology and Research in Health Science, Sidi Mohamed Ben Abdelah University, Fez, Morocco
| | - Samir Atmani
- Laboratory of Epidemiology and Research in Health Science, Sidi Mohamed Ben Abdelah University, Fez, Morocco
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Sørensen M, Pershagen G, Thacher JD, Lanki T, Wicki B, Röösli M, Vienneau D, Cantuaria ML, Schmidt JH, Aasvang GM, Al-Kindi S, Osborne MT, Wenzel P, Sastre J, Fleming I, Schulz R, Hahad O, Kuntic M, Zielonka J, Sies H, Grune T, Frenis K, Münzel T, Daiber A. Health position paper and redox perspectives - Disease burden by transportation noise. Redox Biol 2024; 69:102995. [PMID: 38142584 PMCID: PMC10788624 DOI: 10.1016/j.redox.2023.102995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/07/2023] [Accepted: 12/10/2023] [Indexed: 12/26/2023] Open
Abstract
Transportation noise is a ubiquitous urban exposure. In 2018, the World Health Organization concluded that chronic exposure to road traffic noise is a risk factor for ischemic heart disease. In contrast, they concluded that the quality of evidence for a link to other diseases was very low to moderate. Since then, several studies on the impact of noise on various diseases have been published. Also, studies investigating the mechanistic pathways underlying noise-induced health effects are emerging. We review the current evidence regarding effects of noise on health and the related disease-mechanisms. Several high-quality cohort studies consistently found road traffic noise to be associated with a higher risk of ischemic heart disease, heart failure, diabetes, and all-cause mortality. Furthermore, recent studies have indicated that road traffic and railway noise may increase the risk of diseases not commonly investigated in an environmental noise context, including breast cancer, dementia, and tinnitus. The harmful effects of noise are related to activation of a physiological stress response and nighttime sleep disturbance. Oxidative stress and inflammation downstream of stress hormone signaling and dysregulated circadian rhythms are identified as major disease-relevant pathomechanistic drivers. We discuss the role of reactive oxygen species and present results from antioxidant interventions. Lastly, we provide an overview of oxidative stress markers and adverse redox processes reported for noise-exposed animals and humans. This position paper summarizes all available epidemiological, clinical, and preclinical evidence of transportation noise as an important environmental risk factor for public health and discusses its implications on the population level.
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Affiliation(s)
- Mette Sørensen
- Work, Environment and Cancer, Danish Cancer Institute, Copenhagen, Denmark; Department of Natural Science and Environment, Roskilde University, Denmark.
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jesse Daniel Thacher
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Timo Lanki
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland; School of Medicine, University of Eastern Finland, Kuopio, Finland; Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Benedikt Wicki
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Martin Röösli
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Danielle Vienneau
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Manuella Lech Cantuaria
- Work, Environment and Cancer, Danish Cancer Institute, Copenhagen, Denmark; Research Unit for ORL - Head & Neck Surgery and Audiology, Odense University Hospital & University of Southern Denmark, Odense, Denmark
| | - Jesper Hvass Schmidt
- Research Unit for ORL - Head & Neck Surgery and Audiology, Odense University Hospital & University of Southern Denmark, Odense, Denmark
| | - Gunn Marit Aasvang
- Department of Air Quality and Noise, Norwegian Institute of Public Health, Oslo, Norway
| | - Sadeer Al-Kindi
- Department of Medicine, University Hospitals, Harrington Heart & Vascular Institute, Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH, 44106, USA
| | - Michael T Osborne
- Cardiovascular Imaging Research Center, Massachusetts General Hospital, Boston, MA, USA; Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Philip Wenzel
- Department of Cardiology, Cardiology I, University Medical Center Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany; Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany
| | - Juan Sastre
- Department of Physiology, Faculty of Pharmacy, University of Valencia, Spain
| | - Ingrid Fleming
- Institute for Vascular Signalling, Centre for Molecular Medicine, Goethe University, Frankfurt Am Main, Germany; German Center of Cardiovascular Research (DZHK), Partner Site RheinMain, Frankfurt, Germany
| | - Rainer Schulz
- Institute of Physiology, Faculty of Medicine, Justus-Liebig University, Gießen, 35392, Gießen, Germany
| | - Omar Hahad
- Department of Cardiology, Cardiology I, University Medical Center Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - Marin Kuntic
- Department of Cardiology, Cardiology I, University Medical Center Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - Jacek Zielonka
- Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Helmut Sies
- Institute for Biochemistry and Molecular Biology I, Faculty of Medicine, Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - Tilman Grune
- Department of Molecular Toxicology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Katie Frenis
- Hematology/Oncology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA; Stem Cell Program, Boston Children's Hospital, Boston, MA, USA
| | - Thomas Münzel
- Department of Cardiology, Cardiology I, University Medical Center Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany; Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany
| | - Andreas Daiber
- Department of Cardiology, Cardiology I, University Medical Center Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany; Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany.
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Bagheri Hosseinabadi M, Khanjani N, Münzel T, Daiber A, Yaghmorloo M. Chronic occupational noise exposure: Effects on DNA damage, blood pressure, and serum biochemistry. MUTATION RESEARCH-GENETIC TOXICOLOGY AND ENVIRONMENTAL MUTAGENESIS 2019; 841:17-22. [PMID: 31138406 DOI: 10.1016/j.mrgentox.2019.04.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/25/2019] [Accepted: 04/25/2019] [Indexed: 12/20/2022]
Abstract
Noise levels experienced by industrial workers may cause both auditory and non-auditory harmful effects. We have studied the effects of chronic industrial noise exposure on DNA damage, blood pressure, and serum biochemistry in factory workers. Male workers (109 individuals) in three parts of a food factory in Shahroud, Iran were enrolled as the exposed group and male office workers (123 individuals) were the unexposed control group. Noise exposure was measured (dosimetry) and the comet assay was used to evaluate DNA damage in peripheral blood mononuclear cells. Glutathione peroxidase (GPx) and ceruloplasmin (Cp) levels were measured in serum samples. GPx levels, systolic and diastolic blood pressure, and DNA damage were significantly higher in the exposed group than in the control group. However, ceruloplasmin levels were not significantly different. Based on multivariate linear regression analysis, noise exposure was the most important predictor of GPx levels, systolic and diastolic blood pressure, and DNA damage.
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Affiliation(s)
| | - Narges Khanjani
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Thomas Münzel
- Center for Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1,55131, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Langenbeckstr. 1,55131, Mainz, Germany
| | - Andreas Daiber
- Center for Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1,55131, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Langenbeckstr. 1,55131, Mainz, Germany
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Santos J, Carvalhais C, Xavier A, Silva MV. Assessment and characterization of sound pressure levels in Portuguese neonatal intensive care units. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2018; 73:121-127. [PMID: 28287931 DOI: 10.1080/19338244.2017.1304883] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 03/06/2017] [Indexed: 06/06/2023]
Abstract
In the NICU, systematic exposure to sound-pressure above the recommended level can affect both neonates and staff. This study aimed to evaluate the sound pressure levels in three Portuguese NICUs and the noise perceptions of staff. The measurements were performed with a sound-level meter, considering the location of the main sources of noise and the layout of the units. A questionnaire was applied to assess noise perceptions of professionals. Among the staff, 41.1% classified the environment (regarding noise) as "slightly uncomfortable"; 48.4% considered it as "acceptable." The majority (55.5%) considered "equipment" the most annoying source of noise. The results showed that noise levels were excessive in all the evaluated areas of the NICUs, exceeding international guidelines, with levels ranging between 48.7 dBA to 71.7 dBA. Overall, there is a need for more research to verify the effectiveness of some actions and strategies to reduce the effect of noise in the NICU.
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Affiliation(s)
- Joana Santos
- a Scientific Area of Environmental Health , Research Centre on Health and Environment (CISA/ESS.PPorto), School of Health of Polytechnic Institute of Porto (ESS.PPorto) , Porto , Portugal
| | - Carlos Carvalhais
- a Scientific Area of Environmental Health , Research Centre on Health and Environment (CISA/ESS.PPorto), School of Health of Polytechnic Institute of Porto (ESS.PPorto) , Porto , Portugal
| | - Ana Xavier
- a Scientific Area of Environmental Health , Research Centre on Health and Environment (CISA/ESS.PPorto), School of Health of Polytechnic Institute of Porto (ESS.PPorto) , Porto , Portugal
| | - Manuela V Silva
- a Scientific Area of Environmental Health , Research Centre on Health and Environment (CISA/ESS.PPorto), School of Health of Polytechnic Institute of Porto (ESS.PPorto) , Porto , Portugal
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