Risk factors – Treatable traits
Vibeke Backer, Peter G. Gibson, Ian D. Pavord in The Asthmas, 2023
Smoke from tobacco combustion is a complex mixture of chemicals that exist in the gas phase or are bound to aerosol particles. Over 5,600 unique components have been identified which are estimated to account for 99% of the mass of whole smoke. The US Food and Drug Administration classifies 93 of these as harmful or potentially harmful, with 25 further classified as respiratory toxicants (Table 4.1). Polycyclic aromatic hydrocarbons (PAHs) constituent >500 of the identified compounds in tobacco smoke, 16 of which are carcinogens/possible carcinogens. Other common compounds in tobacco smoke include nicotine, ammonia, carbon monoxide, carbon dioxide, tar, hydroxyquinone and nitrogen oxides. Amongst chemicals of most concern in a respiratory context are the aldehydes, including acrolein, acetaldehyde and formaldehyde; the heavy metals such chromium and cadmium and hydrogen cyanide. A common mechanism through which many chemicals mediate their cellular toxicity is through oxidative stress and generation of reactive oxygen species (ROS). Generation of species such as hydrogen peroxide, hydroxy radicals and nitrogen dioxide leads to numerous forms of cellular damage including RNA, DNA and protein damage and lipid peroxidation.
Rhinology and Facial Plastics
Adnan Darr, Karan Jolly, Jameel Muzaffar in ENT Vivas, 2023
History: Duration of symptoms (age of onset would indicate a congenital or acquired pathology)Taste disturbances (most flavour perception derived from smell; ask about true taste eg sweet, salty, sour tastes)Recent URTINasal congestion, discharge/rhinorrheaHistory of trauma/fallsPMH: Previous sinonasal surgery (see table of differentials)Medications and illicit drug useSH: SmokingOccupation: Chef?Household protection? Smoke alarms
Lifestyle and Diet
Chuong Pham-Huy, Bruno Pham Huy in Food and Lifestyle in Health and Disease, 2022
Besides cigarette smoking, another type of tobacco addiction is smokeless tobacco. Smokeless tobacco is tobacco that is not burned. Since antiquity, it has been used by Native Americans and Aboriginal peoples of Australia. Consumed either orally or nasally, by chewing, sucking, or sniffing, smokeless tobacco products deliver nicotine without combustion. There are many different forms of smokeless tobacco products consumed globally, but they can be roughly divided into two categories: snuff (finely ground or cut tobacco) and chewing tobacco (whole leaf, plug or twist tobacco) (115). Although all smokeless tobacco products are addictive due to the presence of nicotine, they do not involve combustion, carry no risks associated with smoke inhalation, and are generally accepted to be less hazardous than smoking (115). However, at least 28 chemicals in smokeless tobacco have been found to cause cancer (116). The most harmful chemicals in smokeless tobacco are tobacco-specific nitrosamines, which are formed during the growing, curing, fermenting, and aging of tobacco. The level of tobacco-specific nitrosamines varies by product. Scientists have found that the nitrosamine level is directly related to the risk of cancer (116). Chewing leaf tobacco can lead to nicotine addiction and can cause cancers of the mouth, throat, esophagus, and pancreas. Chewing tobacco products may also cause gum disease, dental problem, pharyngitis, laryngitis, heart disease, stroke, and other health problems (116).
Adopting a portfolio of ultrasonic and advanced bipolar electrosurgery devices from a single manufacturer compared to currently used ultrasonic and advanced bipolar devices: a probabilistic budget impact analysis from a Spanish hospital perspective
Published in Journal of Medical Economics, 2023
Alessandra Piemontese, Lucas Cohen, George W. J. Wright, Natalia Robledinos-Antón, Nadine Jamous, Giovanni A. Tommaselli, Thibaut Galvain
Hospitals are also concerned about OR safety. The application of energy devices to heat and cut tissue can produce surgical smoke, which is a potential hazard to operating room staff10,11. This gaseous byproduct can be absorbed through the skin, lungs, and eyes of the surgical staff and may result in symptoms such as nausea, headache, weakness, and dizziness, among others11. Many organizations have guidelines recommending the use of smoke evacuation systems during electrosurgery procedures to reduce the risk of staff exposure to surgical smoke11–14. A smoke evacuator is a hand-held or trocar-compatible device that allows for the removal of surgical smoke when connected to a smoke evacuation system that filters the smoke particles from the air drawn in by the device. One element to improve patient safety in the OR during electrosurgery is through the use of non-adhesive reusable dispersive patient return electrodes, which reduce the risk of pad site burns compared to adhesive dispersive electrodes15. The large surface area of a reusable capacitive patient return electrode limits the current density at the site of contact thus preventing increases in temperature that could lead to burns, which can occur when smaller adhesive electrodes lose contact with the patient’s skin15. Another benefit of dispersive electrode pads is their reusability, which can help reduce OR waste compared to using disposable dispersive electrodes.
Fatty acids, esters, and biogenic oil disinfectants: novel agents against bacteria
Published in Baylor University Medical Center Proceedings, 2023
Aruna Lamba, Jonathan Kopel, David Westenberg, Shubhender Kapila
Aerosols generated through volatilization and subsequent recondensation of oil vapors have been used as obscurant (smoke) screens during military operations since the early 20th century.30,31 The battlefield obscurant used for impairing view in the visible region produces a dense white cloud, which attenuates light transmission in the visible region of the electromagnetic spectrum, thereby confounding enemy sensors and smart munitions.30,31 For the past four decades, FOG oil (dearomatized middle distillate petroleum [MIL-F-12070E]) has been used by the US military as an obscurant in the battlefield and during training exercises. Recently, use of biogenic (vegetable) oils has been investigated as a substitute for the FOG oil.16,19,26
The effects of inhaled pollutants on reproduction in marginalized communities: a contemporary review
Published in Inhalation Toxicology, 2023
Ramsés Santacruz-Márquez, Alison M. Neff, Vasiliki E. Mourikes, Endia J. Fletcher, Jodi A. Flaws
Marginalized communities in North America experience higher rates of certain diseases and more deaths compared to the general population, indicating a profound disparity in health status (National Institute on Minority Health and Health Disparities 2022). Although several factors place marginalized communities at high risk for poor health outcomes, one important factor is air pollutant exposure. Air pollution is defined as an increase in pollutant substances in the atmosphere due to human activity and natural sources (Mathiarasan and Hüls 2021). Air pollutants derived from human activity include vehicle emissions, fuel oils, gas to heat homes, by-products of manufacturing and power generation, and fumes from chemical production. Natural sources include smoke from wildfires, ash and gases from volcanic eruptions, and gases such as methane that are emitted from decomposing organic matter in soils.
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