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Open access

Emília Kubiňáková, Lucia Fašková, Eva Králiková, Ján Híveša and Tomáš Mackuľak

Abstract

In recent years, the occurrence of micropollutants (MPs) in sewage-, surface-, ground- and drinking water, and their removal processes are widely discussed. The content of various chemical organic/inorganic pollutants (pharmaceuticals, drugs, pesticides, hormones, heavy metals etc.) has increased over the years. Most of these compounds are not eliminated or biotransformed in traditional wastewater treatment plants. Several advanced oxidation processes (AOPs) for the removal of resistant micropollutants from water sources have been studied. Ferrate (VI) has aroused interest as an alternative oxidizing agent in drinking water preoxidation treatment. Electrochemically prepared potassium ferrate was used to remove the studied organic micropollutants. The effect of ferrate on two widely occurring organic micropollutants in water sources, carbamazepine and caffeine, was investigated. High performance liquid chromatography (HPLC) was used for sample analysis.

Open access

Miroslav Zmeškal, Eva Králíková, Ivana Kurcová, Pavel Pafko, Robert Lischke, Libor Fila, Lucie Valentová Bartáková and Keely Fraser

Abstract

Introduction

Smoking is associated with a higher incidence of post-lung transplantation complications and mortality. Prior to inclusion on the lung transplant waiting list in the Czech Republic, patients are supposed to be tobacco free for at least 6 months. Our aim was to determine the prevalence of smoking, validated by urinary cotinine, among patients post lung transplantation and prior to inclusion on the transplant waiting list.

Methods

Between 2009 and 2012, we conducted a cross-sectional survey of urinary cotinine to assess tobacco exposure in 203 patients in the Lung Transplant Program in the Czech Republic. We measured urinary cotinine in 163 patients prior to inclusion on the transplantation waiting list, and 53 patients post bilateral lung transplantation.

Results

5.1% (95% CI 0.078 to 0.269) of all lung transplant recipients had urinary cotinine levels corresponding to active smoking; and a further 3.8% (95% CI 0.007 to 0.116) had borderline results. Compared to patients with other diagnoses, patients with COPD were 35 times more likely to resume smoking post-transplantation (95% CI 1.92 to 637.37, p-value 0.016). All patients who tested positive for urinary cotinine levels were offered smoking cessation support. Only one Tx patient sought treatment for tobacco dependence, but was unsuccessful.

Conclusion

Smoking resumption may be an underrecognized risk for lung transplantation recipients, particularly among patients with chronic obstructive pulmonary disease. More rigorous screening, as well as support and treatment to stop smoking among these patients are needed.