2015-03-01 12:00 - Messages

Risques physiques et travail

Journée de la société française de médecine du travail (SFMT), Paris, 10 octobre 2014
Cette journée de la Société française de médecine du travail (SFMT) a permis de présenter les actualités relatives à plusieurs risques physiques : les rayonnements optiques, les vibrations, les champs électromagnétiques d'origine professionnelle et environnementale et les rayonnements ionisants.

Source: http://www.inrs.fr/media.html?refINRS=TD%20217

Dermatites de contact professionnelles dans le secteur de l'imprimerie

Les dermatites de contact professionnelles sont fréquentes dans le secteur de l'imprimerie. Il s'agit essentiellement de dermatites de contact d'irritation et/ou allergiques et plus rarement d'urticaires de contact.
Les principaux irritants sont les solvants des produits de nettoyage, les acides, les produits alcalins de décapage et de dégravage, ainsi que les constituants des encres. Les principaux allergènes sont les constituants des résines et des vernis (surtout les acrylates) et les biocides.
Le diagnostic étiologique nécessite des tests allergologiques avec la batterie standard europeenne, les batteries spécialisées et les produits professionnels selon les cas.
La prévention technique doit mettre en oeuvre toutes les mesures susceptibles de réduire l'exposition. La prévention médicale repose sur la réduction maximale du contact cutané avec les irritants et l'éviction complète du contact cutané avec les allergènes.
Ces affections sont réparées au titre de plusieurs tableaux de maladies professionnelles, en fonction des substances chimiques entrant dans la composition des produits utilisés.

Source: http://www.inrs.fr/media.html?refINRS=TA%2097

Risk analysis and warning rate of hot environment for foundry industry using hybrid MCDM technique

A person working in extreme hot environment is at greater risk of heat-related disorders and safety problems. Protection of health and safety needs to evaluate the risk and warning rate of hot environment without compromising productivity of the organization. In this paper, a novel hybrid technique was proposed for assessing the work safety in hot environments using multi criteria decision making (MCDM) technique. The proposed model involves analytic network process (ANP) and linguistic fuzzy approach. The ANP approach is used to compute the weights of evaluation factors and triangular fuzzy numbers are used to handle imprecision and uncertainty during the decision making process. In the present study, a total of three main factors and ten sub-factors are considered for the evaluation process. A real case study example is conducted to ascertain the effectiveness of the proposed model. The results show that the criteria "worker" obtained over-all percentage of 64.8%; whereas, "environment" and "work criteria" was 27.8% and 7.4%, respectively. The safety performance of hot environment falls between medium and good. However, the safety grade and warning rate for work is II and I, respectively.

Source: Ilangkumaran M, Karthikeyan M, Ramachandran T, Boopathiraja M, Kirubakaran B. Safety Sci. 2015; 72: 133-143.

Endotoxin in metal working fluid (MWF) mist

The risks to respiratory health from exposure to bacterial endotoxins are well established. The aims of this research were to:
Review the evidence used to develop the health based recommended occupational exposure limit (HBROEL) for endotoxin of 90 endotoxin units per cubic metre (EU/m3) over an 8-hour period proposed by the Health Council for the Netherlands (DECOS); and to assess its relevance as a ‘benchmark' to assess risks to respiratory health caused by endotoxin in metal working fluid mists.
Assess whether the published evidence on endotoxin concentration in metal working fluids provides sufficient evidence that concentrations in mist are sufficient to cause harm to human health
The research concluded that there was a large discrepancy between concentrations of endotoxin and viable bacteria in mist compared to the concentrations in bulk fluid with airborne endotoxin levels generally falling close to or beneath the DECOS recommended level , whilst sump levels generally exceeded these by 100 to 1000 fold. Levels of viable bacteria captured in air were low compared to the levels in the sumps.
Further research is required to determine whether the discrepancy between bulk endotoxin and airborne levels is real or whether this is due to the impact of sampling or analytical methodology.

Source: http://www.hse.gov.uk/research/rrhtm/rr1043.htm

Potential health effects of exposure to electromagnetic fields (EMF)

The results of current scientific research show that there are no evident adverse health effects if exposure remains below the levels recommended by the EU legislation. Overall, the epidemiological studies on radiofrequency EMF exposure do not show an increased risk of brain tumours. Furthermore, they do not indicate an increased risk for other cancers of the head and neck region.
Previous studies also suggested an association of EMF with an increased risk of Alzheimer's disease. New studies on that subject did not confirm this link.
Epidemiological studies associate exposure to Extremely Low Frequency (ELF) fields, from long-term living in close proximity to power lines to a higher rate of childhood leukaemia. No mechanisms have been identified and no support from experimental studies could explain these findings, which, together with shortcomings of the epidemiological studies prevent a causal interpretation.
Concerning EMF hypersensitivity (idiopathic environmental intolerance attributed to EMF), research consistently shows that there is no causal link between self-reported symptoms and EMF exposure.

Source: http://ec.europa.eu/health/scientific_committees/consultations/public_consultations/scenihr_consultation_19_en.htm

Precautionary Practices of Healthcare Workers Who Disinfect Medical and Dental Devices Using High-Level Disinfectants

BACKGROUND: High-level disinfectants (HLDs) are used throughout the healthcare industry to chemically disinfect reusable, semicritical medical and dental devices to control and prevent healthcare-associated infections among patient populations. Workers who use HLDs are at risk of exposure to these chemicals, some of which are respiratory and skin irritants and sensitizers.
OBJECTIVE: To evaluate exposure controls used and to better understand impediments to healthcare workers using personal protective equipment while handling HLDs.
DESIGN: Web-based survey.
ARTICIPANTS: A targeted sample of members of professional practice organizations representing nurses, technologists/technicians, dental professionals, respiratory therapists, and others who reported handling HLDs in the previous 7 calendar days. Participating organizations invited either all or a random sample of members via email, which included a hyperlink to the survey.
METHODS: Descriptive analyses were conducted including simple frequencies and prevalences.
RESULTS: A total of 4,657 respondents completed the survey. The HLDs used most often were glutaraldehyde (59%), peracetic acid (16%), and ortho-phthalaldehyde (15%). Examples of work practices or events that could increase exposure risk included failure to wear water-resistant gowns (44%); absence of standard procedures for minimizing exposure (19%); lack of safe handling training (17%); failure to wear protective gloves (9%); and a spill/leak of HLD during handling (5%). Among all respondents, 12% reported skin contact with HLDs, and 33% of these respondents reported that they did not always wear gloves.
CONCLUSION: Findings indicated that precautionary practices were not always used, underscoring the importance of improved employer and worker training and education regarding HLD hazards.

Source: Henn, Scott A., Boiano, James M., & Steege, Andre L. (2015). Infection Control & Hospital Epidemiology, 36 (2), p. 180-185. http://dx.doi.org/10.1017/ice.2014.37

Best Practice Engineering Control Guidelines to Control Worker Exposure to Respirable Crystalline Silica during Asphalt Pavement Milling

This document represents more than ten years of collaborative research by labor, industry, and government to reduce respirable crystalline silica exposure during asphalt pavement milling in highway construction. The collaborative research began when the Silica/Asphalt Milling Machine Partnership was formed at the 2003 National Asphalt Pavement Association (NAPA) Annual Meeting, and studies on milling machine dust controls began later that year. The Silica/Asphalt Milling Machine Partnership is coordinated by NAPA and includes all U.S. and foreign manufacturers of heavy construction equipment that currently sell pavement-milling machines to the U.S. market. In addition to NAPA and the equipment manufacturers, the Silica/Asphalt Milling Machine Partnership includes numerous paving contractors, the International Union of Operating Engineers, the Laborers International Union of North America, the Association of Equipment Manufacturers, and government organizations including the Occupational Safety and Health Administration (OSHA), the Federal Highway Administration, and the Centers for Disease Control and Prevention's (CDC's) National Institute for Occupational Safety and Health (NIOSH).

Source: http://www.cdc.gov/niosh/docs/2015-105/

Occupational UV Exposure in French Outdoor Workers

Objectives: Occupational ultraviolet (UV) exposure was evaluated in a population-based sample in France.
Methods: A random survey was conducted in 2012 in individuals aged 25 to 69 years. The median daily standard erythemal UV dose (SED) was estimated from exposure time and place and matched to satellite UV records.
Results: A total of 889 individuals were exposed to solar UV with highest doses observed among gardeners (1.19 SED), construction workers (1.13 SED), agricultural workers (0.95 SED), and culture/art/social science workers (0.92 SED). Information and communication technology, industry, and transport workers were highly exposed (>0.70 SED). Significant factors associated with high occupational UV exposure were sex (P < 0.0001), phototype (P = 0.0003), and taking lunch outdoors (P < 0.0001).
Conclusions: This study identified not only expected occupations with high UV exposure but also unexpected occupations with high exposures. This could serve as a basis for future prevention.

Source: Boniol, Mathieu; Koechlin, Alice; Boniol, Magali; Valentini, Faustine; Chignol, Marie-Christine; Doré, Jean-François; Bulliard, Jean-Luc; Milon, Antoine; Vernez, David. Journal of Occupational & Environmental Médicine, March 2015, Volume 57, Issue 3, p. 315–320.

Antineoplastic drug contamination in the urine of Canadian healthcare workers

Purpose: The purpose of this study was to quantify the urine concentration of non-metabolized cyclophosphamide (CP), a commonly administered antineoplastic drug, among potentially exposed Canadian healthcare workers and to identify factors associated with the drug concentration levels.
Methods: Participants were asked to provide two sets of 24-h urine samples (at two different sampling events), and the level of CP was quantified using high-performance liquid chromatography–tandem mass spectrometry. In addition to demographic information, participants were surveyed regarding their frequency of handling of antineoplastic drugs, safe drug handling training, and known contact with CP on their work shift. Descriptive and inferential statistical analyses were performed. A backward stepwise linear mixed effect model was conducted to identify the factors associated with urine concentration levels.
Results: We collected 201 urine samples, and 55 % (n = 111) had levels greater than the LOD of 0.05 ng/mL. The mean urinary CP concentration was 0.156 ng/mL, the geometric mean was 0.067 ng/mL, the geometric standard deviation was 3.18, the 75th percentile was 0.129 ng/mL, and the range was
Conclusions: The presence of non-metabolized CP in urine confirms that, despite the existence of control measures, a broad range of healthcare workers are at risk of exposure to antineoplastic drugs. A review of the effectiveness of interventions to reduce exposure is warranted and should apply to all healthcare workers involved in some capacity with the hospital medication system. This study identified two factors that are related to the urine CP concentration levels which can serve as an impetus for reducing exposure.

Source: Hon, Chun-Yip, Teschke, Kay, Shem, Hui, Demers, Paul A., & Venners, Scott. (2015). International Archives of Occupational and Environmental Health.

Electromagnetic fields in working life

A guide to risk assessment
Ce guide s'adresse aux employeurs, aux représentants syndicaux et, bien entendu, aux travailleurs potentiellement exposés aux champs électromagnétiques. Il a également été conçu en vue de contribuer à la compréhension de la nouvelle directive de l'UE sur l'exposition des travailleurs aux CEM (2013/35/UE), qui entrera en vigueur en 2016. Ce guide présente un aperçu de l'exposition professionnelle aux champs électromagnétiques en fonction de la fréquence: champs statiques, basses fréquences, fréquences intermédiaires et fréquences radio.
Il se concentre sur certaines professions, sur l'évaluation des risques et sur la détermination de l'exposition, qui doit être effectuée conformément aux dispositions générales de la directive-cadre européenne relative à la santé et à la sécurité au travail (directive 89/391/CEE). Un chapitre spécifique est consacré aux travailleurs qui font face à des risques particuliers, par exemple, les personnes portant des implants médicaux, les femmes enceintes ou les personnes prenant certains médicaments.
Dernier point également important, ce guide présente des recommandations sur la mesure dans laquelle un principe de précaution peut contribuer à réduire une forte exposition.

Source: http://www.etui.org/fr/Publications2/Guides/Electromagnetic-fields-in-working-life.-A-guide-to-risk-assessment

Pulmonary Inflammation in Foundry Workers

Objective: To assess whether cumulative dust exposure in foundry work is associated with airway inflammation measured by the analysis of fractionated exhaled nitric oxide (NO) concentration, or by inflammatory markers in exhaled breath condensate or serum.
Methods: We examined 476 dust-exposed and nonexposed foundry workers, and assessed the individual cumulative exposure to dusts and respirable quartz. Bronchial and alveolar NO production and inflammatory markers in exhaled breath condensate and in serum samples were also analyzed.
Results: After adjusting for pack-years of smoking, increased levels of alveolar NO, serum C-reactive protein, and interleukin-8 were associated with a higher level of cumulative exposure to dust. The referents had higher serum myeloperoxidase levels, bronchial NO output, and 8-isoprostane levels in exhaled breath condensate than in the dust-exposed groups.
Conclusions: Dust exposure in foundry work may induce both systemic and alveolar inflammation.

Source: Koskela, Kirsi; Oksa, Panu; Sauni, Riitta; Linnainmaa, Markku; Toivio, Pauliina; Lehtimäki, Lauri; Moilanen, Eeva; Nieminen, Riina; Luukkonen, Ritva; Uitti, Jukka. Journal of Occupational & Environmental Medicine: February 2015, Volume 57, Issue 2, p. 124–128.

Further validation of the ACE instantaneous source model

ACE (Airborne Concentration Estimate) is a model originally developed by WS Atkins on behalf of HSE for computing source terms arising from instantaneous flashing releases. The model has since been reviewed and enhanced through a series of extensive tests that have been performed by HSL. Inputs to ACE are the substance, its mass and storage conditions and ambient weather conditions. The model then computes the formation of a vapour cloud assuming total loss of containment. This is done in two distinct stages; an explosion phase, which models the initial flashing process and a turbulent growth stage, describing further radial expansion and air entrainment. The resulting cloud properties can be used as the input to an atmospheric dispersion model. This report describes an updated validation of ACE in which overall cloud radius predictions have been compared with those obtained from experiment. In addition, an attempt has been made to further the validation by comparing cloud expansion velocities. This was not previously carried out for ACE and was considered an area where the validation could be enhanced.

Source: http://www.hse.gov.uk/research/rrhtm/rr1028.htm?eban=govdel-research-reports&cr=28-Jan-2015

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