2017-09-01 12:00 - Messages

Médicaments anticancéreux et médecine vétérinaire

Retour d'expérience du Centre hospitalier universitaire vétérinaire d'Alfort
Le développement des chimiothérapies en médecine vétérinaire expose le personnel à des risques de contamination par les médicaments cytotoxiques. Après une campagne de prélèvements surfaciques montrant une contamination de l'environnement et une exposition des personnels, en particulier au niveau des gants, le Centre hospitalier universitaire vétérinaire d'Alfort a mis en place des actions correctrices, notamment en dédiant une salle à ce type de traitement et en réorganisant le nettoyage. Une nouvelle campagne de prélèvements montre que les niveaux d'exposition se sont réduits et tendent vers un niveau le plus bas techniquement possible.

Source: Béguin, J., Maurey, C., Salvétat, R., Depay, JP., Mazillier, E., Sotirov, N., Ndaw, S. (2017). Références en santé au travail, (151), p. 35-42.
http://www.rst-sante-travail.fr/rst/dms/dmt/ArticleDMT/VuDuTerrain/TI-RST-TF-246/tf246.pdf

Cured-in-Place-Pipe (CIPP): Inhalation and Dermal Exposure Risks Associated with Sanitary Sewer, Storm Sewer, and Drinking Water Pipe Repairs

Cured-in-place-pipe (CIPP) is the most popular water pipe repair method used in the U.S. for sanitary sewer, storm sewer, and is increasingly being used for drinking water pipe repairs. Today, approximately 50% of all damaged pipes are being repaired using CIPP technology. The CIPP procedure involves the chemical manufacture of a new plastic pipe called a CIPP inside a damaged water pipe.
Little is known about CIPP worker exposures and health risks. CIPP manufacturing sites are highly transient, with a single installation location being used from a few hours to a few days. Unlike traditional manufacturing operations, there is not a ‘permanent address’ to visit or inspect. Once the construction process is complete, the workers and equipment move on. The CIPP manufacturing process can expose workers to raw chemicals, forced air, steam, hot water, ultraviolet (UV) light, materials created and released into the air during manufacture, as well as liquids and solids generated by the process and worker activities. To date, CIPP air monitoring studies have been unable to comprehensively characterize occupational exposures because of a narrow focus on VOC vapors and the use of nonspecific detectors.

Source: https://blogs.cdc.gov/niosh-science-blog/2017/09/26/cipp/

De nouvelles recommandations pour améliorer les conditions de travail des égoutiers

Au mois de juin 2016, l'Anses publiait une expertise sur les expositions et les risques sanitaires spécifiques auxquels les égoutiers sont soumis, concluant à l'existence d'effets sanitaires à long terme liés aux conditions de travail dans les égouts. L'Agence présente maintenant des résultats complémentaires, issus d'une campagne de mesures d'agents biologiques potentiellement présents dans l'air des égouts parisiens, réalisée par la Caisse régionale d'assurance maladie d'Ile de France (CRAMIF). Les résultats de cette campagne confirment que le réseau de collecte dans lequel évoluent quotidiennement les égoutiers est un milieu insalubre, constat déjà réalisé lors de l'analyse des données d'exposition à des polluants chimiques publiée dans l'avis de juin 2016. L'Agence recommande une série de mesures techniques et organisationnelles afin de réduire l'exposition des travailleurs.

Source: https://www.anses.fr/fr/system/files/AIR2010SA0196.pdf

Elevation of Circulating Th17/Th22 Cells Exposed to Low-Level Formaldehyde and Its Relevance to Formaldehyde-Induced Occupational Allergic Contact Dermatitis

Objectives: The aim of this study was to investigate the effects of formaldehyde exposure on Th17 and Th22 cells and its relevance to human occupational allergic contact dermatitis (OACD).
Methods: Circulating IL17-/IL22-secreting cells and serum IL17/IL22 levels in formaldehyde-exposed workers at Occupational Exposure Limit and nonexposed controls were assessed.
Results: The IL17+ and IL22+ cell population were detected in both CD3+CD8- and CD3+CD8+ cells. The percentages of circulating IL17+ and IL22+ T cells in the workers with and without ACD history were all elevated, which were more remarkable in the ones with ACD history. Serum levels of IL17 and IL22 between the workers and controls were not significantly different.
Conclusions: Low-level formaldehyde exposure may increase circulating IL17-/IL22-producing T cells (CD8- and CD8+), possibly involved in the development of human OACD. But it may not alter serum levels of IL17/IL22 before the appearance of OACD symptoms.

Source: Mai, W., Liu, X., Su, G., Zhou, W., Wen, Z., & Lu, D. (2017). Journal of Occupational and Environmental Medicine, 59(9), 817-821.
http://dx.doi.org/10.1097/JOM.0000000000001074

Workplace exposure and release of ultrafine particles during atmospheric plasma spraying in the ceramic industry

Atmospheric plasma spraying (APS) is a frequently used technique to produce enhanced-property coatings for different materials in the ceramic industry. This work aimed to characterise and quantify the impact of APS on workplace exposure to airborne particles, with a focus on ultrafine particles (UFPs, < 100 nm) and nanoparticles (< 50 nm). Particle number, mass concentrations, alveolar lung deposited surface area concentration, and size distributions, in the range 10 nm–20 μm were simultaneously monitored at the emission source, in the potential worker breathing zone, and in outdoor air. Different input materials (known as feedstock) were tested: (a) micron-sized powders, and (b) suspensions containing submicron- or nano-sized particles. Results evidenced significantly high UFP concentrations (up to 3.3 × 106/cm3) inside the spraying chamber, which impacted exposure concentrations in the worker area outside the spraying chamber (up to 8.3 × 105/cm3). Environmental release of UFPs was also detected (3.9 × 105/cm3, outside the exhaust tube). Engineered nanoparticle (ENP) release to workplace air was also evidenced by TEM microscopy. UFP emissions were detected during the application of both micron-sized powder and suspensions containing submicron- or nano-sized particles, thus suggesting that emissions were process- (and not material-) dependent. An effective risk prevention protocol was implemented, which resulted in a reduction of UFP exposure in the worker area. These findings demonstrate the potential risk of occupational exposure to UFPs during atmospheric plasma spraying, and raise the need for further research on UFP formation mechanisms in high-energy industrial processes.

Source: Viana, M., Fonseca, A. S., Querol, X., López-Lilao, A., Carpio, P., Salmatonidis, A., & Monfort, E. (2017). Science of The Total Environment.
https://doi.org/10.1016/j.scitotenv.2017.05.132

Base de données EFICATT

La base de données EFICATT "Exposition fortuite à un agent infectieux et conduite à tenir en milieu de travail » est un outil créé à l'initiative du département Etudes et assistance médicales de l'INRS, en collaboration avec le GERES (Groupe d'étude sur le risque d'exposition des soignants aux agents infectieux). 
Cet outil, destiné aux professionnels de santé, en particulier aux médecins du travail, leur apporte une aide lorsqu'ils sont confrontés à une situation à risque de transmission d'une maladie infectieuse. EFICATT met en effet à disposition les éléments utiles à l'évaluation du risque, ce qui permet de définir une conduite à tenir immédiate puis de mettre en place les actions et le suivi médical adaptés.
Chaque fiche est élaborée par des experts sollicités par un Comité scientifique multidisciplinaire selon un programme (nouvelles fiches et actualisations) validé et coordonné par le Comité de rédaction.

Source: http://www.inrs.fr/publications/bdd/eficatt.html

Challenges on the toxicological predictions of engineered nanoparticles

The perceived enormous potential of nanotechnology in contributing to sustainable innovation has led to the growth of investments into new industrial applications and consumer products. However, the lack of tools that are needed to generate early knowledge about the potential adverse effects, combined with the uncertainties regarding the health and safety risks of engineered nanoparticles (ENPs), are a potential threat to the acceptability by society of the nanotechnology innovations, due to the rising societal concerns that are based on generic worries. In order to tackle these issues, it has been necessary to adopt a more proactive approach into nanotechnology safety assessments. Multiple projects have been initiated around the world in order to understand how ENPs interact with living organisms, but the validation of most of the emerging knowledge may take years. This is while robust risk assessment results are urgently needed, in order to support timely regulatory decisions and risk management actions. The goal of this paper has been to review the present knowledge on the physicochemical characteristics of ENPs, focusing on titanium dioxide (TiO2), gold (Au), copper oxide (CuO), and zinc oxide (ZnO), as well as on their biological interactions. In addition, the paper has been aimed at the identification of the main challenges on the current toxicological characterisation of these ENPs. Focus will also be given in this article to those ENPs that have been described by the Consumer Product Inventory as having prevalent nanomaterials present in consumer products, but also, with those having therapeutic and diagnostic applications, due to their physical (ex: confined plasmon resonances) and biological (biocompatibility and antimicrobial) properties.

Source: Ribeiro, A. R., Leite, P. E., Falagan-Lotsch, P., Benetti, F., Micheletti, C., Budtz, H. C., ... & Hristozov, D. (2017). NanoImpact.
https://doi.org/10.1016/j.impact.2017.07.006

Portrait des zoonoses priorisées par l’Observatoire multipartite québécois sur les zoonoses et l’adaptation aux changements climatiques en 2015

Au Québec comme dans le monde, les maladies transmises entre les animaux et les humains (zoonoses), qui représentent environ 60 % des maladies transmissibles à l'humain, sont en émergence. La dynamique complexe des zoonoses peut être influencée par les changements climatiques. Pour répondre à cette complexité, l'Observatoire multipartite québécois sur les zoonoses et l'adaptation aux changements climatiques a initié en 2015 une démarche de priorisation des zoonoses dans le contexte des changements climatiques. Cette démarche a permis de dresser un portrait des zoonoses qui servira de base pour documenter l'évolution de leur situation au Québec, dans un effort de voir venir les problématiques. La documentation des zoonoses a permis également de mieux identifier les enjeux et les manques de connaissances spécifiques aux zoonoses priorisées, servant ainsi d'outil pour orienter et optimiser les activités de recherche, de surveillance, de prévention et de contrôle de ces zoonoses. Douze zoonoses ont été priorisées : le botulisme d'origine alimentaire au Nunavik, la campylobactériose, la cryptosporidiose, l'encéphalite équine de l'Est, les Escherichia coli vérocytotoxinogènes, la fièvre Q, la giardiase, l'influenza aviaire et porcin, la maladie de Lyme, la rage, la salmonellose et le virus du Nil Occidental.

Source: https://www.inspq.qc.ca/publications/2290

Workplace Measurements of Ultrafine Particles

A Literature Review
Workers are exposed to ultrafine particles (UFP) in a number of occupations. In order to summarize the current knowledge regarding occupational exposure to UFP (excluding engineered nanoparticles), we gathered information on UFP concentrations from published research articles. The aim of our study was to create a basis for future epidemiological studies that treat UFP as an exposure factor. The literature search found 72 publications regarding UFP measurements in work environments. These articles covered 314 measurement results and tabled concentrations. Mean concentrations were compared to typical urban UFP concentration level, which was considered non-occupational background concentration. Mean concentrations higher than the typical urban UFP concentration were reported in 240 workplace measurements. The results showed that workers' exposure to UFP may be significantly higher than their non-occupational exposure to background concentration alone. Mean concentrations of over 100 times the typical urban UFP concentration were reported in welding and metal industry. However, according to the results of the review, measurements of the UFP in work environments are, to date, too limited and reported too heterogeneous to allow us to draw general conclusions about workers' exposure. Harmonization of measurement strategies is essential if we are to generate more reliable and comparable data in the future.

Source: Viitanen, A. K., Uuksulainen, S., Koivisto, A. J., Hämeri, K., & Kauppinen, T. (2017). Annals of Work Exposures and Health, 61(7), 749-758.
https://doi.org/10.1093/annweh/wxx049

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