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Biomarcadores para la vigilancia médica ocupacional a formaldehído: Una revisión sistemática de la literatura

dc.rights.licenseAtribución-NoComercial-SinDerivadas 4.0 Internacional
dc.contributor.advisorCombariza Bayona, David Andrés
dc.contributor.advisorAlzáte Granados, Juan Pablo
dc.contributor.authorVilladiego Molinares, Marisol Margarita
dc.contributor.illustratorCamelo Rodriguez, Julian Felipe
dc.date.accessioned2022-08-08T16:46:25Z
dc.date.available2022-08-08T16:46:25Z
dc.date.issued2022
dc.identifier.urihttps://repositorio.unal.edu.co/handle/unal/81802
dc.descriptionilustraciones, graficas
dc.description.abstractINTRODUCCIÓN: El formaldehído (FA) es una sustancia química clasificada por la Agencia Internacional de Investigación en Cáncer (IARC), como una sustancia grupo I, lo que significa que se ha confirmado que es capaz de originar cáncer en los seres humanos. Se ha identificado como causante de cáncer nasofaríngeo, leucemia mieloide aguda y cáncer sinusoidal, adicionalmente se conoce como genotóxica, mutagénica y sensibilizante de piel y vías áreas. Esta es una sustancia utilizada ampliamente en diferentes ambientes laborales, principalmente en ambientes hospitalarios y en la industria, por sus propiedades como conservante, biocida y producto intermedio para la fabricación de láminas, resinas y madera. Conociendo sus efectos nocivos a la salud es imperativo realizar vigilancia médica sobre los trabajadores a través del control y seguimiento de mediciones ambientales y adicionalmente, un examen médico ocupacional acompañado de biomarcadores que permitan monitorizar de cerca la exposición y así mismo alertar posibles efectos reversibles en salud; sin embargo, aunque se han hecho muchos esfuerzos e investigaciones para identificar uno o varios biomarcadores que permitan monitorear a los trabajadores expuestos, los resultados de la evidencia generada presentan amplias diferencias, lo cual lleva a una situación confusa a la hora de tomar decisiones en la vigilancia ocupacional. OBJETIVO: Revisar de manera sistemática la evidencia disponible para evaluar los diferentes biomarcadores aplicables en la vigilancia médica ocupacional de la exposición a formaldehido METODOLOGÍA: Se realizó una búsqueda en las bases de datos EMBASE, LILACS, MEDLINE, CHOCRANE LIBRARY, PUBCHEM, así como una búsqueda manual a partir de las referencias de los artículos seleccionados y búsqueda en base de datos OPENGREY con las palabras clave formaldehído, monitoreo biológico, exposición ocupacional, y los términos MESH Formaldehyde, biological monitoring, biomarkers, ocuppactional exposure, DNA adducts, protein adducts, antibodies, genotoxicity. Se incluyeron artículos desde enero de 2000 hasta octubre 2020. Se realizó una estrategia de dos pasos. En primer lugar, la lectura de resumen y primera selección de artículos para revisión completa; en segundo lugar, la verificación de criterios de inclusión y exclusión de artículos seleccionados y literatura de búsqueda manual. RESULTADOS: La búsqueda inicial arrojó 108 registros, sin embargo, solo 30 artículos cumplieron los criterios de inclusión y exclusión establecidos. Posteriormente se realizó una calificación de cada estudio por parte de dos investigadores de manera independiente y se calificó el riesgo de sesgos por medio de la herramienta JBI. Unos de los biomarcadores más frecuentemente evaluados fueron los micronúcleos en sangre periférica, los cuales arrojaron un OR 3.21 (IC 95%: 2.39-4.04) entre los expuestos a formaldehído vs los controles, sin embargo, los estudios incluidos eran heterogéneos (I2=99%) entre sí, motivo por el cual se realizó un metanálisis de efectos aleatorios. DISCUSIÓN: Se encontró un riesgo intermedio a alto de sesgos en todos los estudios realizados, lo que dificulta el análisis de los datos y limita contar con homogeneidad en los datos y genera alta variabilidad de cada ítem evaluado en los diferentes grupos de estudio. Además de que no se cuenta con un gold estándar para comparar los biomarcadores propuestos en cada estudio, lo que genera la dificultad de la realización de un análisis cuantitativo de los datos obtenidos. Se encontraron resultados que mostraban asociación de las alteraciones de los biomarcadores con exposición y otros estudios con resultados disímiles. CONCLUSIONES: Es imperioso la ejecución de estudios con mejor calidad metodológica, que usen criterios estandarizados, donde haya control de las diferentes variables para minimizar el sesgo y en el cual se escojan diferentes poblaciones a nivel mundial dado que han sido pocos países se han interesado en evaluar a su población trabajadora. Con los estudios y biomarcadores evaluados, se logra continuar confirmando que las mediciones ambientales hacen parte de la vigilancia y que vigilancia y que no se cuenta con ningún biomarcador específico para FA. (Texto tomado de la fuente)
dc.description.abstractINTRODUCTION: Formaldehyde is a chemical substance classified by the International Agency for Research on Cancer (IARC), as a group I substance, which means that it has been confirmed that it is capable of causing cancer in humans. It has been identified as the cause of nasopharyngeal cancer, acute myeloid leukemia and sinusoidal cancer, it is also known as genotoxic, mutagenic and sensitizing the skin and airways. This is a substance widely used in different work environments, mainly in hospital environments and in industry, for its properties as a preservative, biocide and intermediate product for the manufacture of sheets, resins and wood. Knowing its harmful effects on health, it is imperative to medically carry out workers through control and monitoring of environmental detection and, additionally, an occupational medical examination accompanied by biomarkers that can closely monitor exposure and also alert possible reversible effects on health; However, although many efforts and investigations have been made to identify one or several biomarkers that allow monitoring of exposed workers, the results of the evidence showed wide differences, which leads to a confusing situation when making decisions in the industry. occupational surveillance. OBJECTIVE: To systematically review the available evidence to evaluate the different applicable biomarkers in occupational medical surveillance of formaldehyde exposure. METHODOLOGY: A search was carried out in the EMBASE, LILACS, MEDLINE, CHOCRANE LIBRARY, PUBCHEM databases, as well as a manual search based on the references of the selected articles and a search in the OPENGREY database with the keywords formaldehyde, biological monitoring, occupational exposure, and the MESH terms Formaldehyde, biological monitoring, biomarkers, occupational exposure, DNA adducts, protein adducts, antibodies, genotoxicity. Articles from January 2000 to October 2020 were included. A two-step strategy was used. Firstly, the abstract reading and first selection of articles for full review; second, the verification of inclusion and exclusion criteria of selected articles and manual search literature. RESULTS: The initial search yielded 108 records, however, only 30 articles met the established inclusion and exclusion criteria. Subsequently, each study was rated independently by two investigators and risk of bias was rated using the JBI tool. One of the most frequently evaluated biomarkers was micronuclei in peripheral blood, which yielded an OR 3.21 (95% CI: 2.39-4.04) between those exposed to formaldehyde vs. controls, however, the included studies were heterogeneous (I2=99 %) with each other, which is why a random-effects meta-analysis was performed. DISCUSSION: An intermediate to high risk of bias was found in all the studies carried out, which makes data analysis difficult and contributes to the difficulty of their homogeneity and the high variability of each item evaluated in the different study groups. In addition to the fact that there is no gold standard to compare the biomarkers proposed in each study, which makes it difficult to carry out a quantitative analysis of the data obtained. Results were found that showed association of biomarker alterations with exposure and other studies with dissimilar results CONCLUSIONS: It is imperative to carry out studies with better methodological quality, that use standardized criteria, where there is control of the different variables to minimize bias and in which different populations are chosen worldwide, given that few countries have been interested in Assess your working population. With the studies and biomarkers evaluated, it is possible to continue confirming that environmental measurements are part of surveillance and that and there is no specific biomarker for formaldehyde.
dc.format.extentxvi, 152 páginas
dc.format.mimetypeapplication/pdf
dc.language.isospa
dc.publisherUniversidad Nacional de Colombia
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subject.ddc610 - Medicina y salud::613 - Salud y seguridad personal
dc.subject.otherFormaldehído
dc.subject.otherFormaldehyde
dc.subject.otherBiomarcadores
dc.subject.otherBiomarkers
dc.subject.otherExposición Profesional
dc.subject.otherOccupational Exposure
dc.titleBiomarcadores para la vigilancia médica ocupacional a formaldehído: Una revisión sistemática de la literatura
dc.typeTrabajo de grado - Maestría
dc.type.driverinfo:eu-repo/semantics/masterThesis
dc.type.versioninfo:eu-repo/semantics/acceptedVersion
dc.publisher.programBogotá - Medicina - Maestría en Toxicología
dc.contributor.researchgroupToxicología Ambiental y Ocupacional- TOXICAO
dc.description.degreelevelMaestría
dc.description.degreenameMagíster en Toxicología
dc.description.methodsSe realizó una búsqueda en las bases de datos EMBASE, LILACS, MEDLINE, CHOCRANE LIBRARY, PUBCHEM, así como una búsqueda manual a partir de las referencias de los artículos seleccionados y búsqueda en base de datos OPENGREY con las palabras clave formaldehído, monitoreo biológico, exposición ocupacional, y los términos MESH Formaldehyde, biological monitoring, biomarkers, ocuppactional exposure, DNA adducts, protein adducts, antibodies, genotoxicity. Se incluyeron artículos desde enero de 2000 hasta octubre 2020. Se realizó una estrategia de dos pasos. En primer lugar, la lectura de resumen y primera selección de artículos para revisión completa; en segundo lugar, la verificación de criterios de inclusión y exclusión de artículos seleccionados y literatura de búsqueda manual.
dc.description.researchareaIdentificación de biomarcadores en población humana expuesta a sustancias químicas.
dc.identifier.instnameUniversidad Nacional de Colombia
dc.identifier.reponameRepositorio Institucional Universidad Nacional de Colombia
dc.identifier.repourlhttps://repositorio.unal.edu.co/
dc.publisher.departmentDepartamento de Toxicología
dc.publisher.facultyFacultad de Medicina
dc.publisher.placeBogotá, Colombia
dc.publisher.branchUniversidad Nacional de Colombia - Sede Bogotá
dc.relation.indexedRedCol
dc.relation.indexedLaReferencia
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dc.rights.accessrightsinfo:eu-repo/semantics/openAccess
dc.subject.proposalMonitoreo biológico
dc.subject.proposalExposición ocupacional
dc.subject.proposalOcuppactional exposure
dc.subject.proposalGenotoxicity
dc.subject.proposalProtein adducts
dc.subject.proposalDNA adducts
dc.subject.proposalProtein
dc.title.translatedBiomarkers for occupational medical surveillance of formaldehyde: A systematic review of the literature.
dc.type.coarhttp://purl.org/coar/resource_type/c_bdcc
dc.type.coarversionhttp://purl.org/coar/version/c_ab4af688f83e57aa
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dc.type.redcolhttp://purl.org/redcol/resource_type/TM
oaire.accessrightshttp://purl.org/coar/access_right/c_abf2
dcterms.audience.professionaldevelopmentEstudiantes
dcterms.audience.professionaldevelopmentInvestigadores


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