A Review of the Evidence
Objectives: Antineoplastic drugs are known reproductive and developmental toxicants. Our objective was to review the existing literature of reproductive health risks to workers who handle antineoplastic drugs.
Methods: A structured literature review of 18 peer-reviewed, English language publications of occupational exposure and reproductive outcomes was performed.
Results: Although effect sizes varied with study size and population, occupational exposure to antineoplastic drugs seems to raise the risk of both congenital malformations and miscarriage. Studies of infertility and time to pregnancy also suggested an increased risk for subfertility.
Conclusions: Antineoplastic drugs are highly toxic in patients receiving treatment, and adverse reproductive effects have been well documented in these patients. Health care workers with long-term, low-level occupational exposure to these drugs also seem to have an increased risk of adverse reproductive outcomes. Additional precautions to prevent exposure should be considered.
Source: Connor, Thomas H.; Lawson, Christina C.; Polovich, Martha; McDiarmid, Melissa A. Journal of Occupational & Environmental Medicine: September 2014, Volume 56, Issue 9, p 901–910.
Analyse différenciée selon le sexe
Des chercheurs viennent de réaliser une des premières analyses de l'exposition professionnelle à des substances chimiques entre hommes et femmes en utilisant des données épidémiologiques issues de deux études – l'une sur le cancer du poumon et l'autre sur le cancer du sein, qui documentaient de façon détaillée les histoires de travail de 1 657 hommes et de 2 073 femmes de la région de Montréal vers la fin des années 1990. À l'aide des données recueillies et analysées par des experts – chimistes et hygiénistes du travail, les chercheurs ont pu ainsi estimer et comparer la proportion et les niveaux d'exposition entre hommes et femmes par profession en tenant compte ou non de l'activité économique pour 243 substances toxiques qui avaient été codées dans chacune des deux études.
Objective: To investigate proportions and outcomes of isocyanate and other causes of occupational asthma (OA) claims in Ontario, Canada, 2003 to 2007.
Methods: New accepted workers' compensation claims for OA compensated by the Ontario Workplace Safety and Insurance Board were retrospectively reviewed.
Results: There were 112 allowed claims for OA—30 (26.8%) from diisocyanates (ISO) and 82 (73.2%) from other causes (non-diisocyanates [N-ISO]). The most common occupations for ISO OA were production workers (50%). The most common agents in the N-ISO group were flour (13%) and metal dusts/fumes (10%). At a median time of 8 months postdiagnosis, 55% of ISO and 56.4% of N-ISO workers, respectively, were unemployed.
Conclusions: Diisocyanates OA compensation claims in Ontario are recognized at a lower absolute number and proportion of all OA claims than those in earlier periods. More than half from all causes were unemployed at a median of 8 months postdiagnosis.
Source: Ribeiro, Marcos; Tarlo, Susan M.; Czyrka, Andréa; Vernich, Lee; Luce, Carol E.; Liss, Gary M. Journal of Occupational & Environmental Medicine: September 2014, Volume 56, Issue 9, p. 1001–1007
This project identified seven data sources from which to assess ill health problems potentially associated with exposure to harmful chemicals in the chemical and downstream oil industry. Interrogation of these sources allowed insight into the range and type of ill health previously, and currently, associated with certain exposures. A bespoke definition of the chemical and downstream oil industry sector, based on SIC codes, was developed as part of this project in order to assist this process.
The National Institute for Occupational Safety and Health (NIOSH) Alert: Preventing Occupational Exposures to Antineoplastic and Other Hazardous Drugs in Health Care Settings was published in September 2004. In Appendix A of the Alert, NIOSH identified a sample list of major 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 and 2012. The current update (2014) adds 27 drugs and includes a review of the 2004 list and the consequent removal of 12 drugs that did not meet the NIOSH criteria for hazardous drugs. In addition, a new format has been developed for the list of hazardous drugs, as described below.
The inhalation of welding fume is recognised as being a real threat to workers' health due to the development of occupational illnesses such as welding fume fever and asthma. Local exhaust ventilation (LEV) is an effective method to control worker exposure to welding fume and previous work has indicated the merit of the use of on-gun extraction systems.
The aim of the present study was to improve and refine the existing on-gun extraction methodology and has resulted in the development of two alternative methods for measuring the efficiency of on-gun fume extraction systems. There are distinct advantages and drawbacks to both methods of measuring on-gun capture efficiency, but a preferred method has been identified.
At the time of drafting this report, working group 4 of Standards committee CEN/TC 121/SC 9 has adopted this preferred method and is currently drafting a new standard for measuring the capture efficiency of on-gun fume extraction systems.
Nouvel outil INRS de prise en compte des multi-expositions dans la prévention du risque chimique
En milieu professionnel, rares sont les situations où les travailleurs ne sont exposés qu'à une seule substance chimique. Pour permettre une évaluation des effets possibles liés aux multi-expositions, l'Institut National de Recherche et de Sécurité (INRS), en partenariat avec l'Université de Montréal et l'IRSST, a mis au point MiXie France, un outil en ligne gratuit et simple à utiliser qui permet d'évaluer le potentiel additif des substances chimiques.
Dans l’intention de soutenir le développement sécuritaire des nanotechnologies au Québec, le présent guide souhaite rassembler les connaissances scientifiques actuelles sur l’identification des dangers, les stratégies d’évaluation du niveau de nanomatériaux retrouvés dans différents milieux de travail, l’évaluation des risques et finalement l’application de différentes approches à la gestion des risques. Ce guide, dont l’utilisation optimale requiert un minimum de connaissances en hygiène du travail, est destiné à soutenir l’ensemble des milieux de travail qui fabriquent ou utilisent des nanomatériaux et à fournir des informations pratiques et des outils de prévention permettant leur manipulation sécuritaire aussi bien dans les laboratoires et les usines pilotes que dans les industries de production ou d’intégration de ces produits.
This blog describes NIOSH evaluations of worker exposures to specific chemicals during oil and gas extraction flowback and production testing activities. These activities occur after well stimulation and are necessary to bring the well into production. Included are descriptions of initial exposure assessments, findings, and recommendations to reduce worker exposures to potential hazards. Further details about these assessments can be read in a recently published peer-reviewed journal article, “Evaluation of Some Potential Chemical Exposure Risks during Flowback Operations in Unconventional Oil and Gas Extraction: Preliminary Results”.
There are specific concerns about occupational exposure to Ebola Virus among health care workers and other workers in health settings, including laboratories, burial sites, cleaners and desinfectors, as well as hunters, animal welfare and wildlife workers. According to Ms Chan, the number of health-care workers who have been infected is unprecedented. To date, nearly 170 health-care workers have been infected, and more than 80 have died. The infections and deaths of health-care workers have three major consequences. First, they diminish one of the most important assets for the response to any outbreak. Second, they can lead to the closure of hospitals and isolation wards, especially when staff refuse to come to work. Third, they drive fear, already very high, to new extremes.
À l'origine d'environ 70 cas de cancers professionnels des sinus déclarés par an, les poussières de bois sont la deuxième cause de cancers professionnels reconnus, après l'amiante. En outre, elles peuvent provoquer des pathologies respiratoires (rhinite, asthme, fibrose pulmonaire…), cutanées (eczéma) ou oculaires (conjonctivite). Sans compter les incendies et les explosions. Ce dossier fait le point sur ces questions :
•« Petites mais nocives » : point sur les risques liés aux poussières de bois.
•« Pas de poussières sur le parquet ». Exemple de mesures d'exposition des salariés.
•« Une matière première explosive ». Retour sur des actions de prévention visant à réduire les risques d'explosion.
•« Captage, s'adapter à l'existant » : Le point sur la mise en place d'un nouveau process de fabrication d'ossatures bois en vue de mieux prendre en compte les risques professionnels.
•« Aspiration sur commande » : Illustration d'un système d'aspiration performant installé dans une menuiserie.
•« La qualité passe par la propreté ». Témoignage sur l'installation de systèmes d'aspiration sur des machines portatives dans un atelier d'ébénisterie.
Source : Travail & Sécurité, N°752, juillet-août 2014.
Objective: We sought to quantify absorption of triclosan, a potential endocrine disruptor, in health care workers with occupational exposure to soap containing this chemical.
Methods: A cross-sectional convenience sample of two groups of 38 health care workers at separate inpatient medical centers: hospital 1 uses 0.3% triclosan soap in all patient care areas; hospital 2 does not use triclosan-containing products. Additional exposure to triclosan-containing personal care products was assessed through a structured questionnaire. Urine triclosan was quantified and the occupational contribution estimated through regression modeling.
Results: Occupational exposure accounted for an incremental triclosan burden of 206 ng/mL (P = 0.02), while triclosan-containing toothpaste use was associated with 146 ng/mL higher levels (P < 0.001).
Conclusions: Use of triclosan-containing antibacterial soaps in health care settings represents a substantial and potentially biologically relevant source of occupational triclosan exposure.
Source: MacIsaac, Julia K.; Gerona, Roy R.; Blanc, Paul D.; Apatira, Latifat; Friesen, Matthew W.; Coppolino, Michael; Janssen, Sarah. Journal of Occupational & Environmental Medicine: August 2014, Volume 56, Issue 8, p. 834–839.
Objective: To assess the importance of occupational history for beryllium-exposed workers.
Methods: Beryllium BioBank data were analyzed for 532 subjects in the following three groups: beryllium-exposed, beryllium-sensitized, and chronic beryllium disease. Predictor variables were several questionnaire-derived exposure indices.
Results: Cumulative exposure estimated from a standardized interview contributes to differentiating beryllium-exposed from chronic beryllium disease. The likelihood of progression from sensitization to disease was associated with peak-level weighted exposure hours.
Conclusions: Selecting workers for extensive diagnostic testing should consider each worker's duration and characteristics of exposure. The intensity and total hours of exposure should be evaluated rather than relying on only the total years.
Source: Harber, Philip; Su, Jing; Alongi, Gabriela. Journal of Occupational & Environmental Medicine: August 2014, Volume 56, Issue 8, p. 852–856.
United States, 2012–2013
Exposure to heat and hot environments puts workers at risk for heat stress, which can result in heat illnesses and death. This report describes findings from a review of 2012?2013 Occupational Safety and Health Administration (OSHA) federal enforcement cases (i.e., inspections) resulting in citations under paragraph 5(a)(1), the "general duty clause" of the Occupational Safety and Health Act of 1970. That clause requires that each employer "furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees" (1). Because OSHA has not issued a heat standard, it must use 5(a)(1) citations in cases of heat illness or death to enforce employers' obligations to provide a safe and healthy workplace. During the 2-year period reviewed, 20 cases of heat illness or death were cited for federal enforcement under paragraph 5(a)(1) among 18 private employers and two federal agencies. In 13 cases, a worker died from heat exposure, and in seven cases, two or more employees experienced symptoms of heat illness. Most of the affected employees worked outdoors, and all performed heavy or moderate work, as defined by the American Conference of Governmental Industrial Hygienists (2). Nine of the deaths occurred in the first 3 days of working on the job, four of them occurring on the worker's first day. Heat illness prevention programs at these workplaces were found to be incomplete or absent, and no provision was made for the acclimatization of new workers. Acclimatization is the result of beneficial physiologic adaptations (e.g., increased sweating efficiency and stabilization of circulation) that occur after gradually increased exposure to heat or a hot environment (3). Whenever a potential exists for workers to be exposed to heat or hot environments, employers should implement heat illness prevention programs (including acclimatization requirements) at their workplaces.
Objective: To investigate whether suicide risk among agricultural workers is higher in regions with heavier pesticide use and/or presence of tobacco farming.
Methods: Suicide mortality data were gathered from residents of the Brazilian state of Alagoas. Agricultural census data were used to arrange and classify Alagoas cities into distribution groups on the basis of variables concerning pesticide use and/or tobacco farming. Mortality odds ratio calculations were then used to compare suicide risk among agricultural and nonagricultural workers in different groups.
Results: Suicide risk was higher among agricultural workers than among nonagricultural workers, elevated in regions that used more pesticides, and greatest in regions that produced more tobacco.
Conclusions: This is one of the first studies of its kind to suggest that combined effects of pesticide and tobacco exposure may be linked to higher suicide risk among agricultural workers.
Source: Krawczyk N, Meyer A, Fonseca M, Lima J. J. Occup. Environ. Med. September 2014, Volume 56, Issue 9, p. 993–1000.
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