Chaque année, plus de 100.000 personnes meurent en Europe du fait d'avoir travaillé avec de telles substances. Le nouveau site, Roadmap on carcinogens, met l'accent sur la nécessité de limiter l'exposition aux agents cancérigènes.
Le projet est soutenu par les partenaires de la campagne « Feuille de route pour les substances cancérigènes » lancée à Amsterdam en mai 2016, à savoir la CES, BusinessEurope, la Commission européenne, l'Agence européenne pour la sécurité et la santé au travail et deux présidences de l'UE (Pays-Bas et Autriche).
Review of challenges and solutions
Seasonal influenza vaccine uptake rate of healthcare workers (HCWs) varies widely from <5% to >90% worldwide. Perception of vaccine efficacy and side-effects are conventional factors affecting the uptake rates. These factors may operate on a personal and social level, impacting the attitudes and behaviours of HCWs. Vaccination rates were also under the influence of the occurrence of other non-seasonal influenza pandemics such as avian influenza. Different strategies have been implemented to improve vaccine uptake, with important ones including the enforcement of the local authority's recommendations, promulgation of practice guidelines, and mandatory vaccination polices. Practised in some regions in North America, mandatory policies have led to higher vaccination rate, but are not problem-free. The effects of conventional educational programmes and campaigns are in general of modest impact only. Availability of convenient vaccination facilities, such as mobile vaccination cart, and role models of senior HCWs receiving vaccination are among some strategies which have been observed to improve vaccination uptake rate. A multi-faceted approach is thus necessary to persuade HCWs to participate in a vaccination programme, especially in areas with low uptake rate.
Source: To, K. W., Lai, A., Lee, K. C. K., Koh, D., & Lee, S. S. (2016). Journal of Hospital Infection, 94(2), 133-142.
The National Institute for Occupational Safety and Health (NIOSH) Alert: Preventing Occupational Exposures to Antineoplastic and Other Hazardous Drugs in Healthcare Settings was published in September 2004 (http://www.cdc.gov/niosh/docs/2004-165/). In Appendix A of the Alert, NIOSH identified a sample list of hazardous drugs. The list was compiled from information provided by four institutions that had generated lists of hazardous drugs for their respective institutions, as well as a list from the Pharmaceutical Research and Manufacturers of America (PhRMA). The 2004 list was updated in 2010, 2012, and 2014. The current update (2016) adds 34 drugs, five of which have safe-handling recommendations from the manufacturers. In 2014, a new format was developed for the list of hazardous drugs, as described below.
Introduction. This study measures the exposure of occupational therapists from a 1.5-T magnetic resonance imaging (MRI) machine. Method. A total of 14 time-series on each of the chest, head and hand were taken before and after different MRI procedures. The peak values were noted in each case together with an average of all data recorded in the time-series. Results. The highest exposure recorded was observed on the hand, followed by the head and the chest. The overall maximum exposure (1479.40 mT) recorded was observed on the hand during a change of coil. It was also observed that the recorded exposure of experienced radiographers working in the MRI environment was less than that of junior staff due to different practices. Conclusion. This study is of significant importance in Malta since it is the first conducted in a MRI environment, especially because the results were compared with limits imposed by EU Directive 2013/35/EU which has to be implemented by July 2016.
Source: Bonello, J., & Sammut, C. V. (2016). International Journal of Occupational Safety and Ergonomics, 1-6.
Introduction. Transcranial magnetic stimulation or repetitive transcranial magnetic stimulation (TMS/rTMS) are currently used in research and treatments of diseases of the central nervous system, such as recurring depression. Strong electric pulses are used to produce strong pulsed magnetic fields that are directed to the patient's cerebral cortex where the fields induce electric pulses. The pulses may be causing unnecessary exposure of the staff. Method. The MagVenture TMS/rTMS system was investigated, without patient presence, through measurements of magnetic field pulses at varying distances from the emitting coil and different power settings (94–127 A/s). Results. Fourteen measurements were done which displayed exposures exceeding the given guidelines up until a distance of 40 cm from the transmitting coil. Discussion. The study shows that the exposure of staff in this type of treatment may exceed the given guidelines for occupational exposure, thus confirming previous findings. This necessitates good routines in information and treatment procedures to avoid this exposure.
Source: Møllerløkken, O. J., Stavang, H., & Mild, K. H. (2016). International journal of occupational safety and ergonomics, 1-16.
Les différents procédés de soudage et techniques connexes ont la particularité de générer des fumées dont la composition et l'intensité d'émission varient selon la technique employée et la nature des métaux travaillés. Si le caractère irritant des fumées de soudage peut en lui-même induire ou aggraver une rhinite ou un asthme, certains de leurs constituants peuvent également être impliqués dans l'apparition de rhinite et d'asthme par l'intermédiaire de mécanismes immunologiques, parfois encore mal définis. Les agents sensibilisants des fumées les plus fréquemment cités sont les oxydes métalliques (nickel, chrome, aluminium, zinc...) et la colophane utilisée dans les flux de brasage.
Source: E. PENVEN. Références en santé au travail, septembre 2016, no 147, p. 105-117.
http://www.rst-sante-travail.fr/rst/pages-article/ArticleRST.html?ref=RST.TR 60 60
A Pilot Study
Objective: We conducted an exposure chamber study in humans using a simulated clinical procedure lasing porcine tissue to demonstrate evidence of effects of exposure to laser-generated particulate matter (LGPM).
Methods: We measured pre- and post-exposure changes in exhaled nitric oxide (eNO), spirometry, heart rate variability (HRV), and blood markers of inflammation in five volunteers.
Results: Change in pre- and post-exposure measurements of eNO and spirometry was unremarkable. Neutrophil and lymphocyte counts increased and fibrinogen levels decreased in four of the five subjects. Measures of HRV showed decreases in the standard deviation of normal between beat intervals and sequential 5-minute intervals.
Conclusion: These data represent the first evidence of human physiologic response to LGPM exposure. Further exploration of coagulation effects and HRV is warranted.
Source: Lopez, Ramon, Farber, Mark O., Wong, Vincent, Lacey, Steven E. (2016). Journal of Occupational & Environmental Médicine, 58(9), 940-945.
Une équipe de la faculté de médecine de l'Université de la Ruhr, à Bochum en Allemagne, a récemment mis au point une nouvelle
technique de chimiothérapie intrapéritonéale : la chimiothérapie intrapéritonéale pressurisée par aérosolisation (CIPPA, PIPAC en anglais). Cette procédure, apparentée à la chimiothérapie hyperthermique intrapéritonéale (CHIP) utilisée depuis plusieurs années, offre de nouvelles perspectives pour la prise en charge de patients atteints de pathologies cancéreuses limitées à la
cavité abdominale. Ses conditions de mise en oeuvre peuvent cependant exposer les intervenants pendant et après la CIPPA à de nouveaux risques. L'introduction de cette technique impose donc au service de soins de renouveler leur évaluation des risques et de définir notamment des mesures adaptées de prévention des risques d'exposition aux médicaments cytotoxiques.
Source: J. PASSERON , A. GUILLEUX, F. PILLIERE. Références en santé au travail, septembre 2016, no 147, p. 29-39.
L'exposition aux fibres aéroportées en milieu de travail est mesurée à l'aide d'une technique de numération par microscopie optique à contraste de phase. La numération des fibres comporte un biais et une très grande variabilité qui peuvent être limités par de bonnes pratiques de contrôle de la qualité. Conformément aux exigences des méthodes officielles, québécoise et internationales, les laboratoires (ou les compteurs) effectuant de telles analyses doivent participer à un programme de contrôle de la qualité interlaboratoires sur des échantillons représentatifs de leurs activités afin d'évaluer le degré de fiabilité de leurs résultats.
Le présent rapport propose un bilan du programme de contrôle de la qualité de l'IRSST, de 1992 à 2011, élaboré à partir d'échantillons prélevés dans différents secteurs d'activité québécois (textile, mines, chantiers d'enlèvement de matériaux contenant de l'amiante, freins et démantèlement de fours industriels) et contenant des fibres minérales artificielles (FMA) et de l'amiante (amosite ou chrysotile ou en mixité - chrysotile + FMA ; chrysotile + gypse fibreux).
ANSI/ASHRAE Standard 62.1-2016
First published in 1973 as Standard 62, Standard 62.1 specifies minimum ventilation rates and other measures for new and existing buildings that are intended to provide indoor air quality that is acceptable to human occupants and that minimizes adverse health effects.
Whereas changes to the 2013 edition of the standard primarily focused on usability and clarity, the 2016 edition includes a major change to the scope of the standard by which residential occupancies are moved from Standard 62.1 to Standard 62.2. Other changes to the 2016 edition include the following:
•A revised definition of "environmental tobacco smoke" (ETS) to include emissions from electronic smoking devices and the smoking of cannabis
•Revised operations and maintenance requirements to better align Standard 62.1 with the requirements in ASHRAE/ACCA Standard 180-2012
•New requirements to the Indoor Air Quality Procedure for determining minimum ventilation rates by considering the combined effects of multiple contaminants of concern on individual organ systems
•A change to explicitly allow environmental health and safety professionals to determine whether a lower air class is appropriate for a particular laboratory exhaust system
•A change to allow ventilation to be reduced to zero through the use of occupancy sensors for spaces of selected occupancy types
•Changes related to demand control ventilation to make clear that the standard is intended to be used for calculations for code review and also for physical operation
In order to improve current working practices in the EU in identifying, evaluating and adopting safer alternatives and to more broadly enhance support for substitution among Member States and the European Commission, ECHA commissioned the Lowell Center for Sustainable Production to undertake a landscape analysis of current capacity and needs. The goal of this project is to identify specific priorities that ECHA and other public authorities could support in the near term in order to advance substitution programs and practices among Member States. A review of select applications for authorisation and restrictions proposals, in addition to surveys and interviews involving industry, Member State and Commission authorities, and NGOs were undertaken to obtain critical insights needed for this research.
Objective: This study investigates the association between occupational exposure to trichloroethylene (TCE) and kidney cancer, as this correlation has been questioned.
Methods: The incidence of cancers was studied in a dynamic cohort of 997 male workers who for many years had been occupationally exposed to TCE.
Results: During a 50-year observation period, 13 cases of kidney cancer were observed (7.5 expected) with a standardized incidence ratio of 1.7 and a 95% confidence interval of 1.0 to 3.0. Four other cases, not included in the SIR analysis, were also observed. Long-term TCE exposure was positively confirmed for 14 of the 17 incident cases. There is reason to assume that the remaining cases also had been exposed to TCE.
Conclusions: The present study supports the view that TCE is a kidney carcinogen.
Source: Buhagen, Morten; Grønskag, Anna; Ragde, Siri Fenstad; Hilt, Bjørn. Journal of Occupational & Environmental Medicine: September 2016, Volume 58, Issue 9, p. 957-959.
Objective: Beryllium workers may better understand their genetic susceptibility to chronic beryllium disease (CBD) expressed as population-based prevalence, rather than odds ratios from case-control studies.
Methods: We calculated CBD prevalences from allele-specific DNA sequences of 853 workers for Human Leukocyte Antigen (HLA)-DPB1 genotypes and groups characterized by number of E69-containing alleles and by calculated surface electronegativity of HLA-DPB1.
Results: Of 18 groups of at least 10 workers with specific genotypes, CBD prevalence was highest, 72.7%, for the HLA-DPB1*02:01:02/DPB1*17:01 genotype. Population-based grouped genotypes with two E69 alleles wherein one allele had –9 surface charge had a beryllium sensitization (BeS) of 52.6% and a CBD prevalence of 42.1%.
Conclusions: The high CBD and BeS prevalences associated with –9-charged E69 alleles and two E69s suggest that workers may benefit from knowing their genetic susceptibility in deciding whether to avoid future beryllium exposure.
Source: Kreiss, Kathleen; Fechter-Leggett, Ethan D.; McCanlies, Erin C.; Schuler, Christine R.; Weston, Ainsley. Journal of Occupational & Environmental Medicine: September 2016, Volume 58, Issue 9, p. 855-860.
In a cohort of 6093 female flight attendants, breast cancer incidence was not associated with cumulative exposure to cosmic radiation or two metrics of circadian rhythm disruption. Positive exposure–response relations were observed only in the small subset of the cohort with parity of three or more. Cautious interpretation of the findings in women with high parity is warranted.
Source: Pinkerton LE, Hein MJ, Anderson JL, Little MP, Sigurdson AJ, Schubauer-Berigan MK. Scand J Work Environ Health, 2016.
Objective: The aim of this study was to investigate the association of single nucleotide polymorphisms (SNPs) within genes involved in inflammation, skin barrier integrity, signaling/pattern recognition, and antioxidant defense with irritant susceptibility in a group of health care workers.
Methods: The 536 volunteer subjects were genotyped for selected SNPs and patch tested with three model irritants: sodium lauryl sulfate (SLS), sodium hydroxide (NaOH), and benzalkonium chloride (BKC). Genotyping was performed on genomic DNA using Illumina Goldengate custom panels.
Results: The ACACB (rs2268387, rs16934132, rs2284685), NTRK2 (rs10868231), NTRK3 (rs1347424), IL22 (rs1179251), PLAU (rs2227564), EGFR (rs6593202), and FGF2 (rs308439) SNPs showed an association with skin response to tested irritants in different genetic models (all at P?<?0.001). Functional annotations identified two SNPs in PLAU (rs2227564) and ACACB (rs2284685) genes with a potential impact on gene regulation. In addition, EGF (rs10029654), EGFR (rs12718939), CXCL12 (rs197452), and VCAM1 (rs3917018) genes showed an association with hand dermatitis (P?<?0.005).
Conclusions: The results demonstrate that genetic variations in genes related to inflammation and skin homeostasis can influence responses to irritants and may explain inter-individual variation in the development of subsequent contact dermatitis.
Source: Yucesoy, Berran; Talzhanov, Yerkebulan; Barmada, M. Michael; Johnson, Victor J.; Kashon, Michael L.; Baron, Elma; Wilson, Nevin W.; Frye, Bonnie; Wang, Wei; Fluharty, Kara; Gharib, Rola; Meade, Jean; Germolec, Dori; Luster, Michael I.; Nedorost, Susan. Journal of Occupational & Environmental Medicine: August 2016, Volume 58, Issue 8, p. 753-759.
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