Expositions professionnelles à des agents cancérogènes respiratoires chez les salariés en 2010

Introduction – Les cancers respiratoires sont les plus fréquents des cancers professionnels, mais très peu de données sont disponibles pour quantifier l'exposition professionnelle aux cancérogènes respiratoires. L'objectif de ce travail était d'évaluer en France la proportion de salariés exposés à des agents cancérogènes respiratoires et d'identifier les groupes professionnels les plus exposés, à des fins de prévention.
Méthode – À partir des données de l'enquête Sumer 2009-2010 sur l'exposition des salariés en France, Santé publique France a calculé des proportions de salariés exposés à des cancérogènes respiratoires selon
le secteur d'activité et la famille professionnelle. Les agents cancérogènes respiratoires sélectionnés sont les rayonnements ionisants et 15 cancérogènes chimiques respiratoires, différenciés selon leur action au niveau de l'appareil broncho-pulmonaire ou de la sphère ORL.
Résultats – En France, en 2010, environ 2 millions de salariés (environ 1,7 million d'hommes et 300 000 femmes) ont été exposés à au moins un cancérogène de l'appareil respiratoire et 22% d'entre eux avaient au moins une double exposition. Si chez les hommes, les secteurs de la construction, de la réparation automobile et du transport et de l'entreposage sont prépondérants et impliquent essentiellement des agents chimiques, chez les femmes, l'exposition se concentre dans le secteur de la santé où sont présents les rayonnements ionisants en plus des agents chimiques.
Discussion – conclusion – Cette étude a permis de quantifier un effectif important de salariés exposés à des cancérogènes respiratoires en France, en particulier dans certains secteurs et groupes professionnels. Une meilleure connaissance des protections mises en place dans ces secteurs et professions sont nécessaires pour assurer une prévention adéquate à ces risques cancérogènes.

Source: http://invs.santepubliquefrance.fr/beh/2018/12-13/pdf/2018_12-13_6.pdf

Cleaning at Home and at Work in Relation to Lung Function Decline and Airway Obstruction

Rationale: Cleaning tasks may imply exposure to chemical agents with potential harmful effects to the respiratory system, and increased risk of asthma and respiratory symptoms among professional cleaners and in persons cleaning at home has been reported. Long-term consequences of cleaning agents on respiratory health are, however, not well described.
Objectives: This study aimed to investigate long-term effects of occupational cleaning and cleaning at home on lung function decline and airway obstruction.
Methods: The European Community Respiratory Health Survey (ECRHS) investigated a multicenter population-based cohort at three time points over 20 years. A total of 6,235 participants with at least one lung function measurement from 22 study centers, who in ECRHS II responded to questionnaire modules concerning cleaning activities between ECRHS I and ECRHS II, were included. The data were analyzed with mixed linear models adjusting for potential confounders.
Measurements and Main Results: As compared with women not engaged in cleaning (ΔFEV1 = −18.5 ml/yr), FEV1 declined more rapidly in women responsible for cleaning at home (−22.1; P = 0.01) and occupational cleaners (−22.4; P = 0.03). The same was found for decline in FVC (ΔFVC = −8.8 ml/yr; −13.1, P = 0.02; and −15.9, P = 0.002; respectively). Both cleaning sprays and other cleaning agents were associated with accelerated FEV1 decline (−22.0, P = 0.04; and −22.9, P = 0.004; respectively). Cleaning was not significantly associated with lung function decline in men or with FEV1/FVC decline or airway obstruction.
Conclusions: Women cleaning at home or working as occupational cleaners had accelerated decline in lung function, suggesting that exposures related to cleaning activities may constitute a risk to long-term respiratory health.

Source: Svanes, Ø., Bertelsen, R. J., Lygre, S. H., Carsin, A. E., Antó, J. M., Forsberg, B., ... et Kogevinas, M. (2018). American journal of respiratory and critical care medicine, 197(9), 1157-1163.

Standard Terminology for Sampling and Analysis of Asbestos

This terminology standard is a collective vocabulary relating to sampling and analysis of asbestos. As a convenience to general interest, it contains most of the standard terms, definitions, and nomenclature under the jurisdiction of Committee D22.

Source: https://www.astm.org/Standards/D7712.htm

Association of Parkinson’s disease with industry sectors

A French nationwide incidence study
In order to identify working environments at risk for Parkinson's disease (PD), we investigated the relation between the importance of industry sectors, used as a surrogate for occupational exposures, and PD incidence in French cantons. The number of incident PD cases (2010–2014) in 3689 cantons of metropolitan France was determined using drug claims from French National Health Insurance databases. The proportions of workers in 38 industry sectors in 2006 were calculated for each canton. Associations between the proportions of workers in industry sectors and PD age/sex-standardized incidence ratios were examined using incidence rate ratios (IRR) and 95% confidence intervals (CI) estimated with multilevel negative binomial regressions with a random intercept at the canton-level and adjusted for smoking, deprivation index, and density of neurologists. We then used two-step semi-Bayes hierarchical regression (HR) to include prior information about exposure to pesticides, metals, and solvents in each industry sector. We identified 112,625 incident cases. PD incidence was higher in areas characterized by high proportions of workers in “Agriculture, forestry and fishing” (IRRHR = 1.042; CI 95% = 1.014–1.070; p-TrendHR = 0.004), “Manufacture of textiles, wearing apparel, leather and related products” (IRRHR = 1.024; CI 95% = 1.005–1.044; p-TrendHR = 0.010), and “Manufacture of basic metals and fabricated metal products, except machinery and equipment” (IRRHR = 1.024; CI 95% = 1.003–1.046; p-TrendHR = 0.071). This nationwide study, based on a comprehensive analysis of industry sectors, shows significant associations between high proportions of workers in specific industry sectors (agriculture, metallurgy, textile) and PD incidence that may be targeted in further epidemiological studies to replicate and better understand these associations.

Source: Vlaar, T., Kab, S., Schwaab, Y., Fréry, N., Elbaz, A. et Moisan, F. (2018). European journal of epidemiology.

Gestion des médicaments améliorant les performances sur le lieu de travail

Une analyse sous l'angle de la santé et de la sécurité au travail
Cet article fait le point sur les derniers développements relatifs aux risques professionnels pour la santé et la sécurité que présentent les médicaments améliorant les performances sur le lieu de travail.
Il vise à comprendre le contexte plus vaste dans lequel s'inscrit la consommation de ces médicaments par les travailleurs, en analysant par exemple les circonstances économiques et sociales dans lesquelles leur consommation est susceptible de s'inscrire et en en examinant la couverture médiatique.
Les conclusions tirées visent à stimuler le débat et abordent les conséquences de ces phénomènes pour les cadres et les décideurs politiques.

Source: https://osha.europa.eu/fr/tools-and-publications/publications/managing-performance-enhancing-drugs-workplace-osh-perspective/view

Treatments to prevent hand skin irritation in the workplace

Occupational irritant hand dermatitis (OIHD) is a skin disease that occurs on the hands of employees in certain jobs. The first signs are red and scaly patches in the finger webs and on the knuckle area of the hands. Itchy blisters, painful cracks, and possibly infection are common, and eventually the skin becomes thickened.
Hand skin irritation can affect employees who regularly come into contact with water, detergents, chemicals, and other irritants, or who wear gloves during their working day. People at particular risk include hairdressers, nurses, cleaners, builders, and people who work in the dye, printing, metal, and food industries. The condition is relatively common and affects about 5 to 20 out of 10,000 full-time workers per year. Preventing OIHD from developing is important because it is difficult to clear once it starts.

Source: Bauer, A., Rönsch, H., Elsner, P., Dittmar, D., Bennett, C., Schuttelaar, MLA, Lukács, J., John, SM, Williams, HC. (2018). Cochrane Database of Systematic Reviews (4). 

Case-control investigation of occupational exposure to chlorinated solvents and non-Hodgkin’s lymphoma

Objectives: Although many studies have investigated the association between trichloroethylene (TCE) exposure and non-Hodgkin's lymphoma (NHL), less is known about other chlorinated solvents. We extended our previous analysis of occupational TCE exposure in a multicentre population-based case-control study of NHL to investigate associations with five additional chlorinated solvents: 1,1,1,-trichloroethane, carbon tetrachloride, chloroform, methylene chloride and perchloroethylene.
Methods: Cases (n=1189) and controls (n=982) provided detailed information on their occupational histories and workplace exposure to chlorinated solvents for selected occupations using job-specific interview modules. An industrial hygienist used this information and a review of the literature to assess occupational exposure to chlorinated solvents. We computed ORs and 95% CIs for different exposure metrics, with the unexposed group as the referent. We also computed ORs by NHL subtype.
Results: High cumulative hours exposed to carbon tetrachloride was associated with NHL (>520 hours: OR 1.9; 95% CI 1.0 to 3.6; Ptrend=0.04). This association remained after restricting to jobs with high-intensity exposure (OR 2.0; 95% CI 1.1 to 3.8; P=0.03) and ≥90% exposure probability (OR 2.1; 95% CI 1.0 to 4.3; P=0.03), adjusting for TCE (OR 2.1; 95% CI 1.0– to 4.1; P=0.04) and incorporating a 15-year lag (OR 1.9; 95% CI 1.0 to 3.6; P=0.06). The other evaluated chlorinated solvents were not associated with NHL.
Conclusions: This is the first study using high-quality quantitative exposure assessment methods to identify a statistically significant elevated association between occupational exposure to carbon tetrachloride and NHL. Our findings, although limited by a small number of exposed cases, offer evidence that carbon tetrachloride may be a lymphomagen.

Source: Callahan, C. L., Stewart, P. A., Friesen, M. C., Locke, S., De Roos, A. J., Cerhan, J. R., ... et Purdue, M. P. (2018). Occup Environ Med, 75(6), 415-420.

Types and Health Hazards of Fibrous Materials Used as Asbestos Substitutes

The World Health Organization (WHO) estimates that about 125 million people are exposed to asbestos at worksites around the world, and more than 107,000 people die of asbestos-related diseases, including lung cancer, mesothelioma, or asbestosis, due to occupational exposure to asbestos. Substitute materials have been studied and developed for a long time because of the hazards of asbestos, and many people have recently shown interests in the hazards of substitute materials.
Fibrous materials may be considered as an alternative to asbestos. There are many kinds of fiber materials, which can be largely classified into synthetic fibers and natural fibers. Synthetic fibers can be classified into organic and inorganic fibers; synthetic organic fibers include polyamide fiber, polyolefins fiber, polyester fiber, polyurethane fiber, and polyvinyl fiber, and synthetic inorganic fibers include glass filament, glass wool, refractory ceramic fibers, rock wool, and slag wool fiber. Natural fibers include natural organic fibers such as cotton and hemp and natural inorganic fibers such as attapulgite, erionite (zeolite), nemalite (fibrous brucite), sepiolite, and wollastonite.

Source: Park, S. H. (2018). Safety and Health at Work.

Work history and radioprotection practices in relation to cancer incidence and mortality in US radiologic technologists performing nuclear medicine procedures

Introduction: Technologists working in nuclear medicine (NM) are exposed to higher radiation doses than most other occupationally exposed populations. The aim of this study was to estimate the risk of cancer in NM technologists in relation to work history, procedures performed and radioprotection practices.
Methods: From the US Radiologic Technologists cohort study, 72 755 radiologic technologists who completed a 2003–2005 questionnaire were followed for cancer mortality through 31 December 2012 and for cancer incidence through completion of a questionnaire in 2012–2013. Multivariable-adjusted models were used to estimate HRs for total cancer incidence and mortality by history of ever performing NM procedures and frequency of performing specific diagnostic or therapeutic NM procedures and associated radiation protection measures by decade.
Results: During follow-up (mean=7.5 years), 960 incident cancers and 425 cancer deaths were reported among the 22 360 technologists who worked with NM procedures. We observed no increased risk of cancer incidence (HR 0.96, 95% CI 0.89 to 1.04) or death (HR 1.05, 95% CI 0.93 to 1.19) among workers who ever performed NM procedures. HRs for cancer incidence but not mortality were higher for technologists who began performing therapeutic procedures in 1960 and later compared with the 1950s. Frequency of performing diagnostic or therapeutic NM procedures and use of radioprotection measures were not consistently associated with cancer risk. No clear associations were observed for specific cancers, but results were based on small numbers.
Conclusion: Cancer incidence and mortality were not associated with NM work history practices, including greater frequency of procedures performed.

Source: Bernier, M. O., Doody, M. M., Van ***, M. E., Villoing, D., Alexander, B. H., Linet, M. S. et Kitahara, C. M. (2018). Occup Environ Med.

Occupational exposure to electromagnetic fields from medical sources

High exposures to electromagnetic fields (EMF) can occur near certain medical devices in the hospital environment. A systematic assessment of medical occupational EMF exposure could help to clarify where more attention to occupational safety may be needed. This paper seeks to identify sources of high exposure for hospital workers and compare the published exposure data to occupational limits in the European Union. A systematic search for peer-reviewed publications was conducted via PubMed and Scopus databases. Relevant grey literature was collected via a web search. For each publication, the highest measured magnetic flux density or internal electric field strength per device and main frequency component was extracted. For low frequency fields, high action levels may be exceeded for magnetic stimulation, MRI gradient fields and movement in MRI static fields. For radiofrequency fields, the action levels may be exceeded near devices for diathermy, electrosurgery and hyperthermia and in the radiofrequency field inside MRI scanners. The exposure limit values for internal electric field may be exceeded for MRI and magnetic stimulation. For MRI and magnetic stimulation, practical measures can limit worker exposure. For diathermy, electrosurgery and hyperthermia, additional calculations are necessary to determine if SAR limits may be exceeded in some scenarios.

Source: Stam, R., Yamaguchi-Sekino, S. (2018). Industrial Health, 56, 96-105.

Interventions for preventing occupational irritant hand dermatitis

Background: Occupational irritant hand dermatitis (OIHD) causes significant functional impairment, disruption of work, and discomfort in the working population. Different preventive measures such as protective gloves, barrier creams and moisturisers can be used, but it is not clear how effective these are. This is an update of a Cochrane review which was previously published in 2010.
Objectives: To assess the effects of primary preventive interventions and strategies (physical and behavioural) for preventing OIHD in healthy people (who have no hand dermatitis) who work in occupations where the skin is at risk of damage due to contact with water, detergents, chemicals or other irritants, or from wearing gloves.

Source: Bauer, A., Rönsch, H., Elsner, P., Dittmar, D., Bennett, C., Schuttelaar, M. A., ... et Williams, H. C. (2018). The Cochrane database of systematic reviews, 4.

Soignants et médicaments cytotoxiques

Place de la biométrologie dans la maîtrise des risques dans le temps
Les médicaments cytotoxiques utilisés dans les traitements des cancers présentent une toxicité intrinsèque, du fait de leurs propriétés génotoxiques, tératogènes et cancérigènes. Les professionnels de santé pouvant y être exposés, il est essentiel de garantir leur sécurité et de mettre en place des programmes d'évaluation des expositions pour documenter les expositions, juger de l'efficacité des mesures de protection et établir des priorités en matière de prévention. Cet article présente les principaux résultats de deux campagnes d'évaluation des expositions aux médicaments cytotoxiques, réalisées en 2010 puis en 2016 dans un même établissement hospitalier en France.
Les expositions des soignants (infirmiers, aides-soignants et agents de service hospitalier) ont été évaluées par la biométrologie et par la mesure de la contamination de leur environnement de travail.
Les analyses réalisées en 2010 ont mis en évidence la présence de médicaments cytotoxiques dans les urines de près de la moitié des infirmiers et aides-soignants suivis, ainsi que sur les surfaces de travail. Malgré la mise en place de plusieurs actions de prévention, la campagne d'évaluation suivante, en 2016, a montré que les expositions perduraient. L'analyse d'un questionnaire sur la prise en charge globale du risque cytotoxique a permis d'apporter un éclairage sur ces résultats. Il apparaît ainsi que les différents déterminants de l'exposition (formation, port des équipements de protection individuelle, gestion des incidents, procédures formalisées…) doivent être identifiés et pris en compte pour une maîtrise du risque cytotoxique. Enfin, cette étude met en évidence le besoin d'un suivi régulier des expositions pour maintenir un niveau de vigilance optimal du personnel et éviter toute dérive au cours du temps.

Source: Ndaw S., Robert A., Ricolfi C., Denis F., Marsan P. (2018). Bulletin Epidémiologique Hebdomadaire (12-13): 252-257.?

Examen des politiques sur la consommation de substances en milieu de travail au Canada

Les politiques et pratiques sur la consommation de substances en milieu de travail sont relativement peu développées, et la recherche et l'information sur ce sujet sont limitées. Pour de nombreux secteurs, l'amélioration des connaissances et de la compréhension de ce sujet pourrait être bénéfique pour divers intervenants, particulièrement les employeurs et les employés. En considérant ces faits, les objectifs de la présente étude étaient les suivants :
- Revoir, analyser et résumer de façon générale les politiques en milieu de travail sur la consommation de substances au Canada, leurs composantes communes et uniques et leurs lacunes.
- Déterminer les leçons apprises et les pratiques exemplaires dans l'élaboration et la mise en oeuvre de politiques sur la consommation de substances en milieu de travail d'après l'expérience d'organisations pour lesquelles la sécurité est critique.
- Déterminer quels secteurs stratégiques requièrent davantage de conseils, d'outils et de ressources et, par la suite, formuler des recommandations visant à améliorer l'élaboration de politiques et les réactions des employeurs devant la consommation de substances qui affecte le milieu de travail.
Cette étude est la première en son genre à explorer l'état des politiques canadiennes sur la consommation de substances en milieu de travail. Elle vise d'abord les employeurs et les professionnels des ressources humaines souhaitant élaborer ou améliorer les politiques et les pratiques exemplaires en milieu de travail sur la consommation de substances, puis les autres professionnels travaillant au sein d'organisations (p. ex. personnel médical, PAS/EAS, avocats, etc.).

Source: http://www.ccdus.ca/Resource%20Library/CCSA-Workplace-Substance-Use-Policies-Canada-Report-2018-fr.pdf

Assessment of safe antineoplastic drug handling practices in community pharmacies, veterinary settings and long-term care homes in Ontario

Antineoplastic drugs play an important role in cancer and other chronic disease treatment though a number of these drugs are known to have carcinogenic, mutagenic and teratogenic properties. Healthcare workers in hospitals and cancer treatment centres are typically identified as the largest job group known to be at risk. However, recently other job groups have also been identified as likely at risk due to direct or indirect exposure such as: community pharmacists including retail pharmacy workers, veterinarians and veterinarian technicians, nursing and other healthcare workers employed in long-term care homes, as well as workers involved in related shipping and receiving, waste handling, maintenance, housekeeping and laundry etc.
Studies on exposure levels assessed outside of hospitals and cancer treatment centres revealed that there is a potential hazard present in these settings. Surface contamination of various commonly prescribed antineoplastic drugs was observed in these workplaces at measurable levels comparable to those obtained in human oncology settings. In addition, although best practices for safe drug handling have been defined, little is known about the measures and controls in use for the safe handling of antineoplastic drugs outside of acute care settings.
The purpose of this study was to provide information on the extent of use of antineoplastic drugs in veterinary clinics, long-term care homes and community pharmacies in Ontario. The goal was to present a cross section of current practices and measures in use for safe handling of antineoplastic drugs and minimizing exposure following a request from the Ontario Ministry of Labour for an evaluation of safe work practices in community pharmacies, veterinary clinics and long-term care homes. Barriers to adherence of existing safe drug handling practices were also identified. This study aims to fill the gaps in current knowledge about ongoing practices in these work places which may guide future interventions and future research. This is important because of the likely increase in the number of exposed workers due to increased cancer therapy and treatment from increasing numbers of patients with cancer and other chronic illnesses. Assessing workplaces' safety culture and identifying barriers to adherence to safe work practices can contribute to minimizing worker exposure.

Source: http://www.occupationalcancer.ca/wp-content/uploads/2018/05/Antineoplastic-Drug-Handling-Final-Report-OCRC2018.pdf

Expositions aux champs électromagnétiques

Repères en santé au travail
Omniprésents dans l'environnement quotidien et en milieu de travail, les champs électromagnétiques (CEM) suscitent des interrogations et parfois des inquiétudes quant aux risques qu'ils peuvent faire encourir aux personnes. Si les effets biophysiques avérés sur l'homme sont bien connus, il reste parfois difficile pour un non spécialiste de faire la part des choses entre les effets tels qu'ils peuvent être rapportés par les travailleurs et leur relation avec la présence de CEM. Ce texte se propose d'expliciter les différents effets connus des CEM et les limites d'exposition qui leur sont associées. Il présente également des repères permettant aux professionnels de la santé au travail de faire un lien entre le poste de travail et les effets potentiels associés, et inversement de vérifier si un effet tel qu'il est ressenti par un travailleur est bien en lien avec les CEM présents sur son poste de travail. Ces repères sont complétés par des tableaux qui recensent des exemples d'installations couramment rencontrées en milieu de travail et les effets possibles correspondants.

Source: Moureaux, P. (2018). Références en santé au travail (153), 73-81.

Burden of lung cancer attributable to occupational diesel engine exhaust exposure in Canada

Objective: To estimate the population attributable fraction (PAF) and number of incident and fatal lung cancers in Canada from occupational exposure to diesel engine exhaust (DEE).
Methods: DEE exposure prevalence and level estimates were used with Canadian Census and Labour Force Survey data to model the exposed population across the risk exposure period (REP, 1961–2001). Relative risks of lung cancer were calculated based on a meta-regression selected from the literature. PAFs were calculated using Levin's equation and applied to the 2011 lung cancer statistics obtained from the Canadian Cancer Registry.
Results: We estimated that 2.4% (95% CI 1.6% to 6.6%) of lung cancers in Canada are attributable to occupational DEE exposure, corresponding to approximately 560 (95% CI 380 to 1570) incident and 460 (95% CI 310 to 1270) fatal lung cancers in 2011. Overall, 1.6 million individuals alive in 2011 were occupationally exposed to DEE during the REP, 97% of whom were male. Occupations with the highest burden were underground miners, truck drivers and mechanics. Half of the attributable lung cancers occurred among workers with low exposure.
Conclusions: This is the first study to quantify the burden of lung cancer attributable to occupational DEE exposure in Canada. Our results underscore a large potential for prevention, and a large public health impact from occupational exposure to low levels of DEE.

Source: Kim, J., Peters C.E., Arrandale V.H., Labrèche, F., Ge, C.B., McLeod, C.B.,... Demers,P.A. (2018). Occup Environ Med.

Association of hand and arm disinfection with asthma control in US nurses

Objectives: To investigate the association between occupational exposure to disinfectants/antiseptics used for hand hygiene and asthma control in nurses.
Methods: In 2014, we invited female nurses with asthma drawn from the Nurses' Health Study II to complete two supplemental questionnaires on their occupation and asthma (cross-sectional study, response rate: 80%). Among 4055 nurses (mean age: 59 years) with physician-diagnosed asthma and asthma medication use in the past year, we examined asthma control, as defined by the Asthma Control Test (ACT). Nurses were asked about the daily frequency of hand hygiene tasks: ‘wash/scrub hands with disinfectants/hand sanitizers' (hand hygiene) and ‘wash/scrub arms with disinfecting products' (surrogate of surgical hand/arm antisepsis). Analyses were adjusted for age, race, ethnicity, smoking status and body mass index.
Results: Nurses with partly controlled asthma (ACT: 20–24, 50%) and poorly controlled asthma (ACT ≤19, 18%) were compared with nurses with controlled asthma (ACT=25, 32%). In separate models, both hand and arm hygiene were associated with poorly controlled asthma. After mutual adjustment, only arm hygiene was associated with poorly controlled asthma: OR (95% CI) for <1 time/day, 1.38 (1.06 to 1.80); ≥1 time/day, 1.96 (1.52 to 2.51), versus never. We observed a consistent dose–response relationship between frequency of arm hygiene tasks (never to >10 times/day) and poor asthma control. Associations persisted after further adjustment for surfaces/instruments disinfection tasks.
Conclusions: Frequency of hand/arm hygiene tasks in nurses was associated with poor asthma control. The results suggest an adverse effect of products used for surgical hand/arm antisepsis. This potential new occupational risk factor for asthma warrants further study.

Source: Dumas, O., Varraso, R., Boggs, K. M., Descatha, A., Henneberger, P. K., Quinot, C., ... et Camargo Jr, C. A. (2018). Occup Environ Med, 75(5), 378-381.

L’Anses met à disposition une base de données sur plus de 500 valeurs toxicologiques de référence

L'Agence poursuit depuis 2004 la réalisation d'un programme national sur les valeurs toxicologiques de référence (VTR). Les VTR sont des indicateurs biologiques qui permettent de qualifier ou quantifier sur une base scientifique un risque pour la santé humaine lié à l'exposition à une substance chimique. Elles sont utiles pour les différents acteurs de la gouvernance des risques : entreprises, expertise publique et autorités chargées de la gestion du risque. L'Anses publie une base de données regroupant plus de 500 VTR, celles qu'elle a construites (une soixantaine pour presque 40 substances) et celles d'autres organismes qu'elle utilise pour mener ses travaux d'expertise.

Source: https://www.anses.fr/fr/content/l%E2%80%99anses-met-%C3%A0-disposition-une-base-de-donn%C3%A9es-sur-plus-de-500-valeurs-toxicologiques-de

Self-reported occupational blood exposure among paramedics in Poland: a pilot study

Introduction. Paramedics are at risk of occupational blood exposure, increased by the immediacy of provided treatment. However, the issue has not been acknowledged to date by any research in Europe. Methods. This research aimed at assessing occupational blood exposure among paramedics in Poland. Respondents represented 21 Polish medical institutions. Their participation was voluntary and anonymous. Paramedics were provided with a self-directed job-specific questionnaire adapted to Polish conditions from an original US version. Results. 118 paramedics participated in the study from institutions constituting the National Emergency Medical System in Poland; including ambulance crews, Helicopter Emergency Medical Services and emergency department employees. Occupational exposure was reported by 18.64% of respondents and the main route of exposure was needlestick events. Conclusions. There is a further need to improve education among paramedics concerning the threat of being infected with blood-borne pathogens through all existing routes. Our findings point to the problem as being hidden and considered a shameful issue.

Source: Naylor, K., Torres, A., Galazkowski, R. et Torres, K. (2018). International Journal of Occupational Safety and Ergonomics.

Handling fumigated containers in ports - health risks and prevention practices

This report reviews the potential safety and health risks arising from handling containers in ports that have been fumigated with pesticides.
The authors review the legislation, identify the risks and describe practical examples of preventive measures and strategies. They conclude that there are important gaps in our knowledge. The problem is also underestimated because of poor record-keeping of adverse health effects and because fumigated containers are rarely labelled.
The authors recommend prioritising control measures such as risk assessment of containers before opening, routine screening of containers arriving in ports, and measures to enforce the regulations on labelling containers.

Source: https://osha.europa.eu/en/tools-and-publications/publications/health-risks-and-prevention-practices-during-handling-fumigated/view

NIOSH Releases New Nanotechnology Workplace Design Recommendations

Realizing the promise of any scientific advancement requires understanding of its potential human health effects, and its safe and responsible development, even at the level of engineered nanomaterials, which can be nearly atomic-sized. The National Institute for Occupational Safety and Health (NIOSH) launched four new products this week intended to provide options to companies for controlling possible exposure of their workers to nanomaterials on the job.
Engineered nanomaterials are intentionally produced to have at least one primary dimension less than 100 nanometers (nm). These very small particles have unique shapes and physical and chemical properties. These materials become desirable for specific product applications in areas including medicine, electronics, biomaterials, and consumer products. Workers in industries that use or make these uniquely engineered nanomaterials may inhale nanoparticles on a daily basis, posing a potential respiratory hazard.

Source: https://www.cdc.gov/niosh/updates/upd-03-12-18.html

Cleaning at Home and at Work in Relation to Lung Function Decline and Airway Obstruction

Rationale: Cleaning tasks may imply exposure to chemical agents with potential harmful effects to the respiratory system, and increased risk of asthma and respiratory symptoms among professional cleaners and in persons cleaning at home has been reported. The long-term consequences of cleaning agents on respiratory health are, however, not well described. Objectives: This paper aims to investigate long-term effects of occupational cleaning and cleaning at home on lung function decline and chronic airway obstruction. Methods: The ECRHS study has investigated a multi-centre population based cohort at three time points over twenty years. 6230 participants with at least one lung function measurements from 22 study centres, who in ECRHS II responded to questionnaire modules concerning cleaning activities between ECRHS I and ECRHS II were included. The data were analysed with mixed linear models adjusting for potential confounders. Main results: As compared to women not engaged in cleaning (FEV1=-18.5 ml/year), FEV1 declined more rapidly in women responsible for cleaning at home (-22.1, p=0.01) and occupational cleaners (-22.4, p=0.03). The same was found for decline in FVC (FVC-=8.8 ml/year; -13.1, p=0.02 and -15.9, p=0.002, respectively). Both cleaning sprays and other cleaning agents were associated with accelerated FEV1 decline (-22.0, p=0.04 and -22.9, p=0.004, respectively). Cleaning was not significantly associated with lung function decline in men or with chronic airway obstruction. Conclusions: Women cleaning at home or working as occupational cleaners had accelerated decline in lung function, suggesting that exposures related to cleaning activities may constitute a risk to long-term respiratory health.

Source: Svanes, Ø., Bertelsen, R. J., Lygre, S. H., Carsin, A. E., Antó, J. M., Forsberg, B., ... Kogevinas, M. (2018). American journal of respiratory and critical care medicine.

Prostate cancer surveillance by occupation and industry: the Canadian Census Health and Environment Cohort (CanCHEC)

As there are no well-established modifiable risk factors for prostate cancer, further evidence is needed on possible factors such as occupation. Our study uses one of the largest Canadian worker cohorts to examine occupation, industry, and prostate cancer and to assess patterns of prostate cancer rates. The Canadian Census Health and Environment Cohort (CanCHEC) was established by linking the 1991 Canadian Census Cohort to the Canadian Cancer Database (1969–2010), Canadian Mortality Database (1991–2011), and Tax Summary Files (1981–2011). A total of 37,695 prostate cancer cases were identified in men aged 25–74 based on age at diagnosis. Cox proportional hazards models were used to estimate hazards ratios and 95% confidence intervals. In men aged 25–74 years, elevated risks were observed in the following occupations: senior management (HR = 1.12, 95% CI: 1.04–1.20); office and administration (HR = 1.19, 95% CI: 1.11–1.27); finance services (HR = 1.09, 95% CI: 1.04–1.14); education (HR = 1.05, 95% CI: 1.00–1.11); agriculture and farm management (HR = 1.12, 95% CI: 1.06–1.17); farm work (HR = 1.11, 95% CI: 1.01–1.21); construction managers (HR = 1.07, 95% CI: 1.01–1.14); firefighting (HR = 1.17, 95% CI: 1.01–1.36); and police work (HR = 1.22, 95% CI: 1.09–1.36). Decreased risks were observed across other construction and transportation occupations. Results by industry were consistent with occupation results. Associations were identified for white-collar, agriculture, protective services, construction, and transportation occupations. These findings emphasize the need for further study of job-related exposures and the potential influence of nonoccupational factors such as screening practices.

Source: Sritharan, J., MacLeod, J., Harris, S., Cole, D. C., Harris, A., Tjepkema, M., ... et Demers, P. A. (2018). Cancer medicine.

Protecting Workers during the Handling of Nanomaterials

Engineered nanomaterials (ENMs) are materials that are intentionally produced to have at least one primary dimension less than 100 nanometers (nm). These materials have new or unique properties different from those of larger forms of the same material, making them desirable for specific product applications. The health effects associated with nanomaterials are not yet clearly understood, so it is important for producers and users of ENMs to reduce employee exposure and manage risks appropriately. In 2013, the National Institute for Occupational Safety and Health (NIOSH) published a compendium of control approaches for nanomaterial production and use processes entitled Current Strategies for Engineering Controls in Nanomaterial Production and Downstream Handling Processes. This Workplace Design Solutions document provides guidance on exposure control options for protecting workers during the handling of nanomaterials.

Source: https://www.cdc.gov/niosh/docs/2018-121/default.html

Recent trends in the industrial use and emission of known and suspected carcinogens in Ontario, Canada

BACKGROUND: In 2010, Ontario, Canada's most populous province, implemented its Toxics Reduction Act, Ontario Regulation 455/09 (TRA), which requires four major manufacturing and mineral processing industry groups that already report releases of pollutants federally to the National Pollutant Release Inventory to additionally track, account and report their use and creation. The TRA was modeled after the Massachusetts Toxics Use Reduction Act of 1989, which has been very successful and reported significant reduction in toxic use and carcinogen release.
METHODS: Data from the TRA were retrieved, and the trends in the use and release of 17 known and suspected carcinogens associated with the seven most prevalent cancers diagnosed in Ontario and reported by industrial facilities in Ontario from 2011 to 2015 were examined using methodology adapted from (Jacobs MM, Massey RI, Tenney H, Harriman E. Reducing the use of carcinogens: the Massachusetts experience. Rev Environ Health 2014;29(4):319-40).
RESULTS: Carcinogens associated with lung cancers, leukemia and lymphomas were observed as the most used and released carcinogens in Ontario by amount. Overall, for 2011-2015, there was an observed reduction in the industrial use of carcinogens, except among breast carcinogens, which increased by 20%. An increase in the industrial releases of carcinogens was observed across all cancer sites, except among lung carcinogens, which decreased by 28%.
CONCLUSION: The results of this study highlight the potential for reducing the cancer burden by reducing the use and release of select carcinogens associated with particularly prevalent cancers. Toxics use reduction programs can support cancer prevention initiatives by promoting targeted reductions in exposures to industrial carcinogens.

Source: Slavik, C. E., Kalenge, S., & Demers, P. A. (2018). Reviews on environmental health, 33(1), 99-107.

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