ExPOSE: Establishing protocols to assess occupational exposure to microbiota in clinical settings

Summary:

In Portugal, in recent years, there has been an increase in the standardization of procedures for assessing occupational exposure, however, these procedures have not yet been adapted to health care units and the risks they present to the health of their workers, namely by high density of occupation in these places. Thus, and in order to improve public health and reduce health costs, the Polytechnic Institutes of Lisbon and Setúbal and the University of Porto, in close collaboration with public health units, namely the Centro Hospitalar de S. João no. Porto (CHSJ) and the health centers of ARS Lisboa and Vale do Tejo (ARSLVT), develop the ExPOSE project with the objective of evaluating the exposure of workers to the microbiota in health care units, with the aim of developing protocols and standards for the reduction of exposure to microbiological agents and the consequent incidence of occupational diseases, in accordance with the RIS3 Research priority domain of NUTS II Lisbon and the emerging domain of Life Sciences and Health of RIS3 of NUTS II North.

In the present study, exposure to the microbiota will be evaluated in two different interventions: a) CHSJ, in Porto; and b) 10 ARS health centers in Lisbon and Vale do Tejo. In audits to diagnose the situation of exposure to microbiological agents, it will be ensured:

Characterization of workplaces and HVAC filters, through a checklist to be tested, standardized and published within the scope of this study;
Measurement of chemical parameters (CO2, temperature, relative humidity, total VOCs, PM2.5 and PM10);
Characterization of the microbiota and its resistance to antibiotics, quantification of mycotoxins and endotoxins, and evaluation of the cytotoxicity and pro-inflammatory capacity of the sampled agents;
Assessment of occupational exposure to microbiological agents and their metabolites through environmental (including HVAC filters) and biological (workers) collections.
Allergen assessment in HVAC filters and particulate matter.

The study will also target 50 workers from the CHSJ, 50 from the ARSLVT health centers and 50 control subjects, including a history of occupational disease symptoms by questionnaire, as well as comfort conditions measured through transepidermal water loss and pupillometry. Three samples will be collected by nasal swab from each worker to characterize the prevalence of the microbiota.

The results of the audit, together with the clinical assessment of the workers, will help to understand the influence of occupational exposure on the health of workers in clinical settings, will allow the identification of the most relevant microbiological agents and, consequently, the development of protocols and standards aimed at evaluation of exposure to the microbiota in health care units, establishing intervention mechanisms focused on minimizing this exposure.