2018-04-01 12:00 - Messages

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.

Survol de la législation concernant l’exposition environnementale à l’amiante au Québec et ailleurs

Le présent document passe en revue les législations environnementales de différentes juridictions pour déterminer si l'amiante y est qualifié de matière dangereuse et en quoi ces législations se comparent à celles du Québec. Les législations étudiées incluent celles du gouvernement fédéral et de toutes les provinces et territoires du Canada, celles du gouvernement fédéral et de quatre États américains, soit la Californie, le Maine, le Montana et le Vermont, ainsi que celles de l'Union européenne.

Source: https://www.inspq.qc.ca/publications/2340

Control of exposure to hexavalent chromium concentration in shielded metal arc welding fumes by nano-coating of electrodes

Background: Cr(VI) is a suspected human carcinogen formed as a by-product of stainless steel welding. Nano-alumina and nano-titania coating of electrodes reduced the welding fume levels.
Objective: To investigate the effect of nano-coating of welding electrodes on Cr(VI) formation rate (Cr(VI) FR) from a shielded metal arc welding process.
Methods: The core welding wires were coated with nano-alumina and nano-titania using the sol-gel dip coating technique. Bead-on plate welds were deposited on SS 316 LN plates kept inside a fume test chamber. Cr(VI) analysis was done using an atomic absorption spectrometer (AAS).
Results: A reduction of 40% and 76%, respectively, in the Cr(VI) FR was observed from nano-alumina and nano-titania coated electrodes. Increase in the fume level decreased the Cr(VI) FR.
Discussion: Increase in fume levels blocked the UV radiation responsible for the formation of ozone thereby preventing the formation of Cr(VI).

Source: Sivapirakasam, S. P., Mohan, S., Santhosh Kumar, M. C., Thomas Paul, A., et Surianarayanan, M. (2018). International journal of occupational and environmental health.

Z1010-18 - Management of work in extreme conditions

The purpose of this Standard is to address the application of occupational health and safety management systems to plans for work performed under heightened-risk conditions presented by extreme environmental temperatures, severe weather, low or high atmospheric pressure, and poor air quality (causing impairment of breathing or visibility). CSA Z1010 is the latest addition to the Z1000 series of OHS management systems standards. It is designed to be used within an OHS management system in conjunction with the other standards in the Z1000 series.

Source: http://shop.csa.ca/en/canada/occupational-health-and-safety-management/z1010-18/invt/27043892018

Diesel engine exhaust exposure in underground mines

Comparison between different surrogates of particulate exposure
Exposure to diesel particulate matter (DPM) is frequently assessed by measuring indicators of carbon speciation, but these measurements may be affected by organic carbon (OC) interference. Furthermore, there are still questions regarding the reliability of direct-reading instruments (DRI) for measuring DPM, since these instruments are not specific and may be interfered by other aerosol sources. This study aimed to to assess DPM exposure in two underground mines by filter-based methods and DRI; and to assess the relationship between the measures of elemental carbon (EC) and the DRI to verify the association of these instruments to DPM. Filter-based methods of respirable combustible dust (RCD), EC and total carbon (TC) were used to measure levels of personal and ambient DPM. For ambient measurements, DRI were used to monitor particle number concentration (PNC; PTrak), particle mass concentration (DustTrak DRX and DustTrak 8520) and the submicron fraction of EC (EC1;Airtec). The association between ambient EC and the DRI was assessed by Spearman correlation. Geometric mean concentrations of RCD, respirable TC (TCR) and respirable elemental EC (ECR) were 170 µg/m3, 148 µg/m3 and 83 µg/m3 for personal samples, and 197 µg/m3, 151 µg/m3 and 100 µg/m3 for ambient samples. Personal measurements had higher TCR:ECR ratios compared to ambient samples (1.8 vs 1.50) and weaker association between ECR and TCR. Among the DRI, the measures of EC1 by the Airtec (ρ = 0.86; P<0.001) and the respirable particles by the DustTrak 8520 (ρ = 0.74; P<0.001) showed the strongest association with EC, while PNC showed a weak and non-significant association with EC. In conclusion, this study provided important information about the concentrations of DPM in underground mines by measuring several indicators using filter-based methods and DRI. Among the DRI, the Airtec proved to be a good tool for estimating EC concentrations and, although the DustTrak showed good association with EC, interferences from other aerosol sources should be considered when using this instrument to assess DPM.

Source: da Silveira Fleck A., Couture C., Sauvé J.F., Njanga P.E., Neesham-Grenon E., Lachapelle G., Coulombe H., Hallé S., Aubin S., Lavoué J., Debia M. (2018). Journal of Occupational and Environmental Hygiene.

Cas incidents des maladies à déclaration obligatoire reliées à une exposition professionnelle à l’amiante dans le Système MADO-Chimique, Québec, 2006 – 2015

L'analyse des 2 234 cas incidents de maladies à déclaration obligatoire (MADO) reliées à une exposition professionnelle à l'amiante enregistrés dans le système MADO-Chimique entre 2006 et 2015 montre que :
98 % des cas sont des hommes.
Chez les femmes, les mésothéliomes sont les maladies reliées à l'exposition à l'amiante les plus fréquentes, alors que chez les hommes ce sont les amiantoses qui prédominent.
Près de 60 % des cas d'amiantose, près de 50 % des cas de mésothéliome et 70 % des cas de cancer du poumon ont été exposés à l'amiante dans les secteurs d'activité économique suivants : « Bâtiments et travaux publics », « Mines, carrières et puits de pétrole » et « Fabrication d'équipement de transport ».
Environ 70 % des personnes atteintes d'amiantose ou de mésothéliome ont exercé les professions de travailleurs du bâtiment et de travailleurs de certains secteurs industriels.
Plus de trois quarts des cas de cancer du poumon reliés à l'amiante sont des travailleurs du bâtiment, des mineurs, carriers, foreurs de puits et travailleurs assimilés, ainsi que les travailleurs de certains secteurs industriels.

Source: https://www.inspq.qc.ca/publications/2370

Illicit Drug Exposure

Emergency medical services (EMS) providers, firefighters, and law enforcement personnel are among those who may encounter illicitly-manufactured drugs during their work. Given the potential for exposure to these drugs and the hazardous substances used to produce them, it is important that workers in these industries understand how to protect themselves. The Worker Training Program (WTP) has developed an awareness-level training tool on the prevention of occupational exposure to fentanyl and other opioids. Several WTP awardees have also developed training courses for workers who may be involved in a methamphetamine (meth) lab discovery or a meth lab cleanup. These resources are found below, along with additional health and safety resources related to occupational exposure to opioids and the hazards associated with clandestine meth labs.

Source: https://tools.niehs.nih.gov/wetp/index.cfm?id=2562

Progressive Massive Fibrosis in Coal Miners From 3 Clinics in Virginia

Since 1970, the Coal Workers' Health Surveillance Program (CWHSP), administered by the National Institute for Occupational Safety and Health, has offered periodic chest radiographs to working US coal miners.1 The primary purpose of the CWHSP is early detection of coal workers' pneumoconiosis to prevent progression to disabling lung disease, including progressive massive fibrosis (PMF). By the late 1990s, PMF was rarely identified among miners participating in the CWHSP. However, a 2014 report documented an increase in the prevalence of PMF in Appalachia.2 On February 1, 2017, the director of a network of 3 federally funded black lung clinics (which primarily serve former miners, and are not affiliated with the CWHSP) in Southwest Virginia requested assistance to determine the burden of PMF in patients served by the clinics.

Source: Blackley, D. J., Reynolds, L. E., Short, C., Carson, R., Storey, E., Halldin, C. N., & Laney, A. S. (2018). JAMA, 319(5), 500-501.

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