It may also apply to situations with property or equipment loss, or harmful effects on the environment. These risks are expressed as a probability or likelihood of developing a disease or getting injured, whereas hazard refers to the agent responsible i. Regardless of the terminology used, the critical steps are to make sure the workplace has taken a systematic approach that looks for any hazards existing or potential , has take appropriate steps to determine the level of risk of these hazards, and then taken measures to control the risk or eliminate the hazard.
Hazard control describes the steps that can be taken to protect workers and the workplace. A general definition of adverse health effect is "any change in body function or the structures of cells that can lead to disease or health problems". The effects can be acute, meaning that the injury or harm can occur or be felt as soon as a person comes in contact with the hazardous agent e. Some responses may be chronic delayed. For example, exposure to poison ivy may cause red swelling on the skin two to six hours after contact with the plant.
On the other hand, longer delays are possible: mesothelioma, a kind of cancer in the lining of the lung cavity, can develop 20 years or more after exposure to asbestos. Once the hazard is removed or eliminated, the effects may be reversible or irreversible permanent. For example, a hazard may cause an injury that can heal completely reversible or result in an untreatable disease irreversible.
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Latent TB infection does not cause symptoms and is not contagious. However, without treatment, infected people can lose control of the infection and develop active, clinical disease.
People with active TB have symptoms and can spread the disease. The risk of developing active TB disease is greatest in the first few years after infection, but some risk remains throughout life. TB is preventable and, in most cases, treatable. Infection control practices can help reduce the risk of TB transmission. Treatment of persons with latent TB infection can prevent the subsequent development of active TB, and TB disease can usually be cured by available anti-TB drugs.
Even persons with drug-resistant strains can often be cured by alternative regimens of medications. Skip directly to site content Skip directly to page options Skip directly to A-Z link. Section Navigation. However, in India an incidence of 6. India approved antiretroviral treatment in 41 and implemented it by , and the country has continued to have high TB incidence for many years Similar numbers could be expected in India at present.
In Italy, the incidence was 0. Our observations were thus consistent with the reported incidences in developed countries. However, when considering all TB cases diagnosed at the cohort inception, the incidence then became elevated by around fourfold, which may have reflected a better estimate if we consider the exposure risk period for Mycobacterium tuberculosis infection from seroconversion until HIV diagnosis.
The relative proportions of clinical forms of TB in HIV patients with almost intact immune function are similar to those observed in non-HIV infected patients, i. Most of our patients presented an increased number of extrapulmonary TB forms, with nearly half showing lymph node involvement. These were compatible numbers considering their advanced immunodeficiency.
However, in some patients, doubt persists about clinical TB diagnoses in spite of using appropriate means of evaluation 3. In the present study, patients with no microbiological confirmation were assumed to have had TB if the suspected clinical condition had improved after two months of anti-tuberculosis therapy.
This has been possible up to now because Brazil has been considered to be a country with low multidrug-resistance TB prevalence Until now, there has not been an established period for confirming the TB diagnosis from good responses to anti-TB treatment.
Reports on patients with difficult TB diagnoses have suggested that this period could vary from 3 weeks 30 to 3 months 5. Among patients with good adherence to antiretroviral treatment, the first TB cases appeared more than one year after the cohort inception. Other risk factors have been reported in other countries. In Rio de Janeiro, positive PPD intradermal injection of tuberculin antigen was identified as an important risk factor among advanced immunodeficiency HIV patients In our study, the intermediate TB rates in our city and the methodological limitations of our study may have lowered the sensitivity for detecting other risk factors.
One important limitation was the large number of patients seeking medical attention after their first clinical symptoms of advanced immunodeficiency had occurred. This may have caused selection of the patients who were most vulnerable towards developing TB or other OIs in our study.
It also yielded a limited estimation of the survival rates when the cohort study began at HIV diagnosis rather than at HIV serological conversion. This resulted in a much higher survival rate among patients with less immunodeficiency, thereby increasing the risk of latent TB progression to active disease. The absence of microbiological confirmation in some patients with TB could be another important limitation.
The deaths of some patients from causes other than TB, and patients relocating to another city were also relevant factors to consider. However, we believe that the impact of these factors would have been small because there were many critical patients still at risk by the end of the study period.
Nonetheless, cases of TB appeared several months later in this city, which has low incidence of TB infection. Future prospective adult cohorts need to be established, with the purpose of exploring other risk factors such as social and economic status and TB contact in inpatient or outpatient clinical settings, in order to evaluate their impact on the development of TB among HIV patients. Abrir menu Brasil.
Revista da Sociedade Brasileira de Medicina Tropical. Abrir menu. These guidelines included: Tuberculosis diagnosis : identification of Mycobacterium tuberculosis in cultures or acid-fast smears in sputum or other tissues, compatible histological findings from tissue biopsies or compatible clinical features Tuberculosis in HIV-infected patients: a comprehensive review.
Clinical microbiology and infection , Aerts D, Jobim R. Empiric antituberculosis treatment: benefits for earlier diagnosis and treatment of tuberculosis. Tubercle and Lung Disease , Effect of highly active antiretroviral therapy on incidence of tuberculosis in South Africa: a cohort study. The Lancet , Clinical presentation of abdominal tuberculosis in HIV seronegative adults.
BMC Gastroenterol , Long time due: reducing tuberculosis mortality in the 21st century. Archives of Medical Research , Targeted tuberculin testing and treatment of latent tuberculosis infection. American Thoracic Society. Reported Tuberculosis in the United States, Department of Health and Human Services; Atlanta, The growing burden of tuberculosis: global trends and interactions with the HIV epidemic.
Archives of internal medicine , Outcome of HIV-associated tuberculosis in the era of highly active antiretroviral therapy. The Journal of Infectious Diseases ,
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