Evidence 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 Units (NICU) by comparing the noise levels before and after the implementation of the program. A total of 79 health professionals participated in the study. The measurements of sound pressure levels took into account the layout of the unit and location of the main sources of noise. General results indicated that LAeq levels before implementation of the training program were often excessive, ranging from 48.7 ± 2.94 dBA to 71.7 ± 4.74 dBA, exceeding international guidelines. Similarly following implementation of the training program noise levels remained unchanged (54.5 ± 0.49 dBA to 63.9 ± 4.37 dBA), despite a decrease in some locations. There was no significant difference before and after the implementation of TP. However a significant difference was found for Lp, Cpeak, before and after training staff, suggesting greater care by healthcare professionals performing their tasks. Even recognizing that a TP is quite important to change behaviors, this needs to be considered in a broader context to effectively control noise in the NICU.

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Abstract. BACKGROUND: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.

Surveillance of drinking water quality is extremely important to human health, assuming greater relevance in hospital environments, especially to those individuals who are immunocompromised. This study is aimed to determine the effect of increasing free chlorine (Cl) concentration in a hospital water network in regard to water quality monitoring and microbial growth control, between 2010 and 2013 in Porto. The average of free Cl concentration in the period under analysis showed some heterogeneity per floor, varying between 0.84 and 1.25 mg/L. In addition, there was a rise in proportion of samples that exceeded WHO guidelines (free Cl 0.5 mg/L), particularly in the last two years of the same period. With respect to microbial analysis, 22.4% of the samples were positive for Legionella spp., 6.4% for Pseudomonas aeruginosa, 15% and 30.4% for aerobic plate counts at 36 and 22 C, respectively. The proportion of positive samples decreased throughout the period under analysis, in particular for Legionella spp. (41.7% in 2010 vs. non-detectable in 2013) and P. aeruginosa (10.8% in 2010 vs. 3.3% in 2013). These results are in accordance with the gradual rise in free Cl concentration (0.78 § 0.94 mg/L in 2010 vs. 1.16 § 0.51 mg/L in 2013). In conclusion, a suitable plan for drinking water quality was instituted which resulted in reducing microbiological growth in the waterwork network, improving public health protection. However, the detection of critical points associated with lower levels of free Cl were found on certain floors/points-of-use, requiring the need to improve the monitoring water treatment system and/or implementation of additional technologies.