2014-05-01 12:00 - Messages

L'Anses publie ses recommandations en vue de réduire l'exposition à cinq substances reprotoxiques et/ou perturbatrices endocriniennes

L'Anses a été saisie en 2009 par le ministère chargé de la santé afin d'identifier et de caractériser des situations d'exposition potentiellement à risque pour la santé liées à l'utilisation de produits de consommation courante et/ou d'articles contenant certaines substances chimiques classées reprotoxiques de catégorie 2 (selon le règlement européen dit CLP) ou considérées comme perturbatrices endocriniennes. L'Anses publie aujourd'hui plusieurs rapports d'expertise et un avis portant sur cinq de ces substances. Les conclusions de l'expertise mettent en évidence des situations d'exposition potentiellement à risque pour le développement fœto-embryonnaire en lien avec une exposition de la femme enceinte au toluène, au n-hexane et au cis-CTAC contenus dans certains articles ou produits. L'Anses formule des recommandations visant à réduire l'exposition des femmes enceintes notamment en milieu de travail à l'ensemble des cinq substances étudiées. Elle formule également des recommandations spécifiques à chacune de ces substances.

Source: http://www.anses.fr/fr/content/lanses-publie-ses-recommandations-en-vue-de-r%C3%A9duire-lexposition-%C3%A0-cinq-substances

Safe Handling of Hazardous Drugs

May is National Oncology Nursing MonthExternal Web Site Icon.  In honor of these nurses and all who work with hazardous drugs (many of which are used in the treatment of cancer) we are posting this blog on how to safely prepare, administer or otherwise handle these drugs.   
About 8 million U.S. healthcare workers are potentially exposed to hazardous drugs.  Inhalation and skin contact or absorption are the most likely routes of exposure.   However, unintentional ingestion from hand to mouth contact and unintentional injection through a needle-stick or sharps injury are also possible.  Hazardous drugs can include those used for cancer therapy, some antiviral drugs, hormone agents, and bioengineered drugs.

Source: http://blogs.cdc.gov/niosh-science-blog/2014/05/21/hazardous-drugs/

Mise à jour de la base de données SOLVEX

La base SOLVEX vient d'être mise à jour. La base, qui regroupe des données d'exposition professionnelle aux solvants et aux composés organiques volatils (COV), s'est enrichie d'informations sur près de 50 nouveaux COV utilisés en milieu de travail.

Source: http://www.inrs.fr/accueil/header/actualites/Mise-a-jour-base-donnees-SOLVEX.html

Occupational exposure to solvents and acute myeloid leukemia

A population-based, case–control study in four Nordic countries
Objective: The aim of the current study was to assess the relation between occupational exposure to solvents and the risk of acute myeloid leukemia (AML).
Methods: Altogether, this study comprises 15 332 incident cases of AML diagnosed in Finland, Norway, Sweden and Iceland from 1961–2005 and 76 660 controls matched by year of birth, sex, and country. Occupational records were linked with Nordic Occupational Cancer Study job exposure matrix (JEM) to estimate quantitative values for 26 occupational exposure factors. Hazard ratios (HR) with 95% confidence intervals (95% CI) were estimated by using conditional logistic regression models.
Results: We did not observe statistically significantly increased risk for exposure to any of the solvents. HR estimates for high levels of toluene (HR 1.35, 95% CI 0.74–2.46), aromatic hydrocarbon solvents (ARHC) (HR 1.18, 95% CI 0.76–1.86), and moderate-to-high levels of trichloroethylene were slightly but non-significantly elevated. We did not observe an association between benzene exposure and AML in this study.
Conclusions: This study did not provide clear evidence for an association between occupational solvent exposure and AML. There was some indication for an excess risk in the groups of workers exposed to toluene, trichloroethylene and ARHC.

Source: Talibov M, Lehtinen-Jacks S, Martinsen JI, Kjærheim K, Lynge E, Sparén P, Tryggvadottir L, Weiderpass E, Kauppinen T, Kyyrönen P, Pukkala E. Scand J Work Environ Health. 2014.
http://dx.doi.org/10.5271/sjweh.3436

Reports of Worker Fatalities during Flowback Operations

Although worker safety hazards in the oil and gas extraction industry are well known, there is very little published data regarding occupational health hazards (e.g., types and magnitude of risks for chemical exposures) during oil and gas extraction operations. To address the lack of information, NIOSH requests assistance from oil and gas stakeholders in further characterizing risks for chemical exposures during flowback operations and, as needed, develop and implement exposure controls. This blog briefly describes flowback operations and addresses reports made known to NIOSH of recent worker fatalities related to or located at flowback operations.

Source: http://blogs.cdc.gov/niosh-science-blog/2014/05/19/flowback/

Time may not fully attenuate solvent-associated cognitive deficits in highly exposed workers

OBJECTIVE: To test the effects of lifetime occupational solvent exposure, as measured by dose and timing, on performance on multiple cognitive tests among retired French utility workers.
METHODS: A total of 2,143 retirees in the GAZEL cohort underwent cognitive testing in 2010. Lifetime exposure to chlorinated solvents, petroleum solvents, and benzene was assessed using a job exposure matrix. We modeled effects of lifetime solvent dose, timing of last exposure, and a combination of these metrics on risk for cognitive impairment.
RESULTS: Thirty-three percent of participants were exposed to chlorinated solvents, 26% to benzene, and 25% to petroleum solvents. High exposure to solvents was significantly associated with poor cognition; for example, those highly exposed to chlorinated solvents were at risk of impairment on the Mini-Mental State Examination (risk ratio 1.18; 95% confidence interval 1.06, 1.31), the Digit Symbol Substitution Test (1.54; 1.31, 1.82), semantic fluency test (1.33; 1.14, 1.55), and the Trail Making Test B (1.49; 1.25, 1.77). Retirees at greatest risk for deficits had both high lifetime exposure to solvents and were last exposed 12 to 30 years before testing. Risk was somewhat elevated among those with high lifetime exposure who were last exposed 31 to 50 years before testing. Those with high, recent exposure exhibited impairment in almost all domains, including those not typically associated with solvent exposure.
CONCLUSIONS: While risk of cognitive impairment among moderately exposed workers may attenuate with time, this may not be fully true for those with higher exposure. This has implications for physicians working with formerly solvent-exposed patients as well as for workplace exposure limit policies.

Source: Sabbath EL, Gutierrez LA, Okechukwu CA, Singh-Manoux A, Amieva H, Goldberg M, Zins M, Berr C. Neurology. 2014 May 13;82(19):1716-23.
http://dx.doi.org/10.1212/WNL.0000000000000413

Evaluation of Chemotherapy Drug Exposure in an Outpatient Infusion Center

We evaluated employee exposure to chemotherapy drugs at an outpatient infusion center. We found low levels of surface contamination of platinum throughout the workplace. Handling platinumcontaining compounds is the likely source of this contamination. Although we cannot definitively link all of the reported symptoms to chemotherapy drug exposures, many were consistent with those reported in the literature. Employees inconsistently used personal protective equipment. We recommended employees use chemotherapy gowns and gloves when handling chemotherapy drugs, and the company implement a medical surveillance program for employees potentially exposed to chemotherapy drugs.

Source: http://www.cdc.gov/niosh/hhe/reports/pdfs/2013-0019-3205.pdf

Avis et rapport de l’Anses relatifs à l’évaluation des risques liés aux nanomatériaux

Enjeux et mise à jour des connaissances
Face à la diversité des nanomatériaux présents au quotidien et aux nombreux questionnements qui les entourent, l'Anses publie ce jour un état des lieux des connaissances sur les enjeux sanitaires et environnementaux des nanomatériaux manufacturés. Celui-ci permet de préciser les connaissances scientifiques et met en évidence des effets toxiques de certains nanomatériaux sur des organismes vivants et sur l'environnement. Il souligne aussi la complexité à appréhender les diverses situations d'exposition pour l'homme et l'environnement, ainsi que les limites des méthodologies existantes en matière d'évaluation des risques. Dans ce contexte, l'évaluation spécifique des risques liés aux nanomatériaux est rendue difficile. Au vu du temps qu'elle nécessiterait, l'Agence recommande de mettre en place sans attendre des outils pour mieux maîtriser les risques par un encadrement réglementaire renforcé au niveau européen.

Source: http://www.anses.fr/fr/documents/AP2012sa0273Ra.pdf

Brominated flame retardant exposure of aircraft personnel

The use of brominated flame retardants (BFRs) such as polybrominated diphenyl ethers (PBDEs) in aircraft is the result of high fire safety demands. Personnel working in or with aircraft might therefore be exposed to several BFRs. Previous studies have reported PBDE exposure in flight attendants and in passengers. One other group that may be subjected to significant BFR exposure via inhalation, are the aircraft maintenance workers. Personnel exposure both during flights and maintenance of aircraft, are investigated in the present study. Several BFRs were present in air and dust sampled during both the exposure scenarios; PBDEs, hexabromocyclododecane (HBCDD), decabromodiphenyl ethane (DBDPE) and 1,2-bis (2,4,6-tribromophenoxy) ethane. PBDEs were also analyzed in serum from pilots/cabin crew, maintenance workers and from a control group of individuals without any occupational aircraft exposure. Significantly higher concentrations of PBDEs were found in maintenance workers compared to pilots/cabin crew and control subjects with median total PBDE concentrations of 19, 6.8 and 6.6pmolg(-1) lipids, respectively. Pilots and cabin crew had similar concentrations of most PBDEs as the control group, except for BDE-153 and BDE-154 which were significantly higher.

Source: Strid A, Smedje G, Athanassiadis I, Lindgren T, Lundgren H, Jakobsson K, Bergman A. Chemosphere, 2014.
http://dx.doi.org/10.1016/j.chemosphere.2014.03.073

Relationship Between Urinary Nickel and Methylation of p15, p16 in Workers Exposed to Nickel

Objective: The purpose of this study was to investigate the relationship between urinary nickel and methylation of p15, p16 in workers exposed to nickel.
Methods: In this study, 165 nickel-exposed workers and 67 workers without exposure were recruited. The levels of urinary nickel were analyzed using dimethylglyoxime spectrophotometric method. Methylation–specific polymerase chain reaction was used to detect the methylation of p15 and p16.
Results: The median concentration of urinary nickel in the exposed group (4.58 μg/L) was significantly higher than that in the control group (1.78 μg/L; P < 0.01). The rate of methylation of p15 in the exposed group was significantly higher than that in the control group (P = 0.023). The multiple logistic analysis showed that workers having higher urinary nickel were at the higher risk of methylation of p15 (P = 0.024).
Conclusions: The levels of urinary nickel were significantly associated with the methylation of p15.

Source: Yang, Jin, Chen, Wentao, Li, Xin, Sun, Jianya, Guo, Qingfeng, Wang, Zhiwu. Journal of Occupational & Environmental Medicine: May 2014 - Volume 56 - Issue 5 - p 489–492.
http://dx.doi.org/10.1097/JOM.0000000000000168

Expression Levels of Surfactant-Associated Proteins and Inflammation Cytokines in Serum and Bronchoalveolar Lavage Fluid Among Coal Miners

A Case-Control Study
Objective: To investigate whether the Th1/Th2 balance and expressions of surfactant-associated proteins and cytokines in serum and bronchoalveolar lavage fluid (BALF) are associated with the development of coal workers' pneumoconiosis (CWP).
Methods: A case-control study was conducted among 72 CWP cases and 68 controls. Th1 and Th2 populations were measured by flow cytometry. Expressions of surfactant-associated proteins A and D (SPA and SPD) and cytokines in serum and BALF were detected by enzyme-linked-immunosorbent serologic assay. Data were analyzed by t test and logistic regression.
Results: Higher Th2 and lower Th1/Th2 were observed in CWP (P < 0.05). Increased CWP risk was associated with elevated BALF-interleukin-10 (odds ratio [OR]: 25.97; 95% confidence interval [CI]: 2.17 to 49.77), serum-SPA/BALF-SPA (OR: 12.87; 95% CI: 1.11 to 148.72), and serum-SPD/BALF-SPD (OR: 77.91; 95% CI: 5.64 to 161.46), decreased BALF-SPA (OR: 0.06; 95% CI: 0.01 to 0.31) and BALF-SPD (OR: 0.07; 95% CI: 0.02 to 0.36).
Conclusions: The development of CWP might be associated with Th1/Th2 imbalance and increased BALF-interleukin-10, serum-SPA/BALF-SPA, and serum-SPD/BALF-SPD.

Source: Zhou, Yun, Wang, Haijiao, Xing, Jingcai, Liu, Yuewei, Cui, Xiuqing, Guo, Jiali, Chen, Weihong. Journal of Occupational & Environmental Medicine: May 2014 - Volume 56 - Issue 5 - p 484–488.
http://dx.doi.org/10.1097/JOM.0000000000000169

Mesure, contrôle et caractérisation des nanoparticules

Procédure appliquée à l'usinage et au frottement mécanique
Alors que les nanotechnologies émergentes ouvrent des voies prometteuses dans plusieurs secteurs d'activité, des études suggèrent que les nanoparticules (NPs) qu'elles génèrent pourraient avoir des effets négatifs, notamment sur la santé et sur l'environnement. Celles-ci peuvent être générées lors de la fabrication, de la manutention et de l'assemblage de pièces métalliques ordinaires et de celles à base de nanomatériaux. D'autres activités quotidiennes, telles que le freinage des automobiles, peuvent aussi produire des NPs. Il est donc urgent de trouver des moyens de contrôler ces risques. Cependant, les techniques et méthodes usuelles d'évaluation du risque ne sont pas directement applicables aux NPs. L'objectif de ce projet est d'établir une méthode efficace de mesure, de contrôle et de caractérisation des NPs applicable aux procédés de fabrication industrielle.

Source: http://www.irsst.qc.ca/-publication-irsst-mesure-controle-caract%C3%A9risation-nanoparticules-r-814.html

Farmers' knowledge, practices and injuries associated with pesticide exposure in rural farming villages in Tanzania

BACKGROUND: Pesticides in Tanzania are extensively used for pest control in agriculture. Their usage and unsafe handling practices may potentially result in high farmer exposures and adverse health effects.The aim of this study was to describe farmers' pesticide exposure profile, knowledge about pesticide hazards, experience of previous poisoning, hazardous practices that may lead to Acute Pesticide Poisoning (APP) and the extent to which APP is reported.
METHODS: The study involved 121 head- of-household respondents from Arumeru district in Arusha region. Data collection involved administration of a standardised questionnaire to farmers and documentation of storage practices. Unsafe pesticide handling practices were assessed through observation of pesticide storage, conditions of personal protective equipment (PPE) and through self-reports of pesticide disposal and equipment calibration.
RESULTS: Past lifetime pesticide poisoning was reported by 93% of farmers. The agents reported as responsible for poisoning were Organophosphates (42%) and WHO Class II agents (77.6%).Storage of pesticides in the home was reported by 79% of farmers. Respondents with higher education levels were significantly less likely to store pesticides in their home (PRR High/Low = 0.3; 95%CI = 0.1-0.7) and more likely to practice calibration of spray equipment (PRR High/Low = 1.2; 95%CI = 1.03-1.4). However, knowledge of routes of exposure was not associated with safety practices particularly for disposal, equipment wash area, storage and use of PPE. The majority of farmers experiencing APP in the past (79%) did not attend hospital and of the 23 farmers who did so in the preceding year, records could be traced for only 22% of these cases.
CONCLUSIONS: The study found a high potential for pesticide exposure in the selected community in rural Tanzania, a high frequency of self-reported APP and poor recording in hospital records. Farmers' knowledge levels appeared to be unrelated to their risk. Rather than simply focusing on knowledge-based strategies, comprehensive interventions are needed to reduce both exposure and health risks, including training, improvements in labeling, measures to reduce cost barriers to the adoption of safe behaviours, , promotion of control measures other than PPE and support for Integrated Pest Management (IPM).

Source: Lekei EE, Ngowi AV, London L. BMC Public Health 2014; 14(1): 389.
http://dx.doi.org/10.1186/1471-2458-14-389
 

Occupational asbestos exposure and risk of oral cavity and pharyngeal cancer in the prospective Netherlands Cohort Study

Objectives: The evidence for an association between occupational asbestos exposure and pharyngeal cancer (PhC) is limited, while for oral cavity cancer (OCC) the literature is even sparser. We studied OCC and PhC risk both separately and combined (OCPC) in relation to occupational asbestos exposure, specifically addressing the influence of potential confounders, the existence of an exposure–response relation, and the presence of interaction between asbestos and smoking.
Methods: Using the prospective Netherlands Cohort Study (N=58 279 men, aged 55–69 years), we estimated asbestos exposure by linkage to a general population job-exposure matrix (DOMJEM) and a Finnish job exposure matrix (FINJEM). After 17.3 years of follow-up, 58 OCC and 53 PhC cases were available for analysis.
Results: No association between asbestos and risk of OCC was observed for either JEM. Hazard ratios (HR) of PhC and OCPC increased after adjusting for confounders, particularly alcohol consumption and socioeconomic status. For PhC, a multivariable-adjusted increased HR was observed for “ever” versus “never” exposed to asbestos [HR 2.20, 95% confidence interval (95% CI) 1.08–4.49] when using FINJEM, but a trend of increased risks with higher cumulative exposure could not be demonstrated for either JEM. Results for OCPC showed patterns similar to those observed for PhC. None of the cancers showed a significant interaction between asbestos and smoking.
Conclusions: This prospective population-based study showed no convincing evidence of an association between asbestos and risk of OCC, PhC, and OCPC as an exposure–response relation was lacking, and results were not robust against the use of different JEM. However, the potentially increased HR of PhC and OCPC observed in this and previous studies warrant further research.

Source: Offermans NSM, Vermeulen R, Burdorf A, Goldbohm RA, Keszei AP, Peters S, Kauppinen T, Kromhout H, van den Brandt PA. Scand J Work Environ Health , 2014.  
http://dx.doi.org/10.5271/sjweh.3434

Surveillance biologique de l'exposition professionnelle

Quel mode de correction urinaire choisir lors de prélèvements ponctuels?
L'utilisation de prélèvements ponctuels pour la mesure de la concentration urinaire de biomarqueurs est une pratique courante dans le cadre des activités de surveillance biologique de l'exposition professionnelle. Afin de tenir compte du degré de dilution des urines, les concentrations urinaires mesurées dans ce type de prélèvements sont généralement corrigées en fonction de la créatinine ou de la densité spécifique urinaire. Cependant, certains auteurs remettent en question l'un ou l'autre de ces modes de correction en raison de leur trop grande variabilité ou parce qu'ils ne reflètent pas fidèlement les mécanismes d'excrétion des indicateurs biologiques.
L'objectif de cette recherche visait à déterminer le meilleur mode d'ajustement pour tenir compte du degré de dilution des urines lors d'un prélèvement ponctuel.

Source: http://www.irsst.qc.ca/-publication-irsst-surveillance-biologique-correction-urinaire-r-821.html

Asbestos-related Disease Indicators 2014

This is the third Safe Work Australia report on Asbestos-related Disease Indicators. In this report,  mesothelioma and asbestosis have been used to indicate the extent of asbestos-caused disease in Australia. The report uses data from the Australian Institute of Health and Welfare, New South Wales Dust Diseases Board, National Data Set for Compensation-based Statistics, and the Australian Bureau of Statistics.

Source: http://www.safeworkaustralia.gov.au/sites/swa/about/publications/pages/asbestos-related-disease-indicators-2014

Mesure de l'exposition aux moisissures et atteintes respiratoires chez les affineurs de fromages

L'affinage de fromages nécessite des conditions d'humidité et de température favorables à la présence de moisissures, parfois typiques d'une région. Le travail en cave d'affinage va exposer les salariés à ces moisissures dont certaines espèces, nécessaires à la qualité du produit fini, sont connues pour être allergisantes. Certains de ces salariés peuvent développer des signes respiratoires plus ou moins marqués (rhinite...) qui pourront conduire à des pathologies quelques années plus tard (asthme...). Des niveaux élevés de contamination fongique sont néanmoins nécessaires. Cet article rapporte les résultats d'une enquête associant des prélèvements d'atmosphère et des prélèvements individuels en les rapprochant des données médicales figurant au dossier des salariés exposés et des données bibliographiques récentes.

Source: http://www.rst-sante-travail.fr/rst/pages-article/ArticleRST.html?ref=RST.TF%20215

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