Potential Health Risk of Endocrine Disruptors in Construction Sector and Plastics Industry

A New Paradigm in Occupational Health
Endocrine disruptors (EDs) belong to large and diverse groups of agents that may cause multiple biological effects associated with, for example, hormone imbalance and infertility, chronic diseases such as diabetes, genome damage and cancer. The health risks related with the exposure to EDs are typically underestimated, less well characterized, and not regulated to the same extent as, for example, carcinogens. The increased production and utilization of identified or suspected EDs in many different technological processes raises new challenges with respect to occupational exposure settings and associated health risks. Due to the specific profile of health risk, occupational exposure to EDs demands a new paradigm in health risk assessment, redefinition of exposure assessment, new effects biomarkers for occupational health surveillance and definition of limit values. The construction and plastics industries are among the strongest economic sectors, employing millions of workers globally. They also use large quantities of chemicals that are known or suspected EDs. Focusing on these two industries, this short communication discusses: (a) why occupational exposure to EDs needs a more specific approach to occupational health risk assessments, (b) identifies the current knowledge gaps, and (c) identifies and gives a rationale for a future occupational health paradigm, which will include ED biomarkers as a relevant parameter in occupational health risk assessment, surveillance and exposure prevention.

Source: Fucic, A., Galea, K. S., Duca, R. C., El Yamani, M., Frery, N., Godderis, L., ... et Viegas, S. (2018). International journal of environmental research and public health, 15(6).
https://doi.org/10.3390/ijerph15061229

Risque d'accident exposant au sang lors des prélèvements veineux dans les laboratoires de biologie médicale de ville en 2015

Dix ans après une première étude sur le risque d'accidents exposant au sang (AES) lié aux prélèvements veineux dans les laboratoires de biologie médicale (LBM) de ville, une nouvelle enquête a été réalisée, utilisant la même méthodologie. Ont été inclus 22 LBM totalisant 337 sites. L'incidence des piqûres lors des prélèvements est de 3,5/100 équivalents temps plein préleveurs/an. Tous les matériels utilisés sont des systèmes de prélèvement sous vide et 22 % d'entre eux sont des matériels de sécurité. Le risque d'AES est deux fois plus faible et le pourcentage de matériels de sécurité deux fois plus important que dans l'enquête conduite en 2005.

Source: Pellissier, G., Lolom, I., L'Hériteau, F., Lebascle, K., Suiro, A., Touche, S., ... et Bouvet, E. (2018). Références en santé au travail (154), 65-80.
http://www.rst-sante-travail.fr/rst/pages-article/ArticleRST.html?ref=RST.TF 254

A Systematic Review of the Routes and Forms of Exposure to Engineered Nanomaterials

Background: Establishing the routes of exposure is a fundamental component of the risk assessment process for every dangerous substance. The present study systematically reviews the available literature to assess the relevance of the different routes and forms of exposure that are of concern for the protection of workers during the manufacture, handling, or end-use of engineered nanomaterials (ENMs).
Methods: A systematic review of the peer-reviewed literature published between 2000 and 2015 was completed. Only studies including measurements of inhalation or dermal exposure were selected and used to identify the exposure situations for which the measurements were collected. The identified exposure situations were grouped based on the type of ENM (i.e. carbon nanotubes and fibres, silicon-based, titanium dioxide, other metal oxides, pure elemental metals, and other ENMs) and activity involved. The grouped exposure situations were assessed to provide a conclusion regarding the likelihood, form, and route of exposure. Assessment of the likelihood of exposure was based on well-defined criteria using a previously established decision logic for inhalation exposure and the outputs from measurements and/or conceptual models for dermal/ingestion exposure. For each combination of nano-activity and type of ENM, the aggregated likelihood across all relevant individual assessments was used to draw conclusions about the relevance of both the inhalation and dermal/ingestion routes. Based on the quality of the data, the strength of the evidence was also evaluated.
Results: One hundred and seven studies were identified during the review process, reporting 424 individual exposure assessments. Measurement data were limited for dermal/ingestion exposure and for inhalation exposure for downstream use and end-of-life. However, the data provided high-quality evidence that in occupational settings all three routes can be of relevance for exposure to ENMs. In general, whenever inhalation exposure occurs then dermal and inadvertent ingestion exposure may occur due to surface deposition and transfer due to the ENMs release. However, for some forms of exposure (e.g. suspension/liquids), dermal exposure can occur even when inhalation exposure is unlikely. An increased likelihood of exposure was observed for manual activities such as cleaning and maintenance, collection/harvesting, spraying, and finishing as well as those involving feeding into a process and handling of powders outside enclosures. The likelihood of exposure was affected by the presence of risk management measures and the scale of the production involved.
Conclusion: This literature review provides evidence that for ENMs, as found for other materials, the likelihood of the exposure depends largely on the physical form of the substance as well as the applied process and operational conditions. These results can be used to provide first indications of the likelihood of exposure and guidance for exposure controls in workplaces. However, there is a clear lack of high-quality exposure data, in particular for downstream use and end-of-life scenarios and in low- and medium-income countries.

Source: Basinas, I., Jiménez, A. S., Galea, K. S., Tongeren, M. V. et Hurley, F. (2018). Annals of work exposures and health, 62(6), 639-662.
https://doi.org/10.1093/annweh/wxy048

Cartographie des expositions aux hydrocarbures aromatiques polycycliques (HAP) par secteur d'activité

Focus sur la surveillance biologique des expositions professionnelles
L'analyse des données de surveillance biologique des expositions professionnelles (SBEP) aux hydrocarbures aromatiques polycycliques (HAP) publiées au cours de la dernière décennie permet de dresser une cartographie des expositions par secteur d'activité. La stratégie de SBEP, notamment le choix du ou des biomarqueurs pertinents, est discutée pour certains secteurs d'activité pouvant exposer à des HAP dont certains cancérogènes comme la cokerie, l'électrométallurgie et la cémentation gazeuse basse pression, ainsi que d'autres secteurs comme les travaux de pose de revêtement routier bitumineux où l'exposition aux HAP est significativement moins importante. Les données biométrologiques disponibles par secteur d'activité, voire par tâche ou poste de travail, peuvent être utiles au médecin du travail pour l'interprétation des résultats de campagnes de SBEP chez des salariés dans des secteurs similaires.

Source: Nikolova-Pavageau, N., Pillière, F. (2018). Références en santé au travail (154), 41-63.
http://www.rst-sante-travail.fr/rst/pages-article/ArticleRST.html?ref=RST.TC 162

Évolution de l’exposition professionnelle aux solvants oxygénés, pétroliers et chlorés en France entre 1999 et 2013

Résultats du programme Matgéné
L'évolution de l'exposition professionnelle aux solvants oxygénés, pétroliers et chlorés entre 1999 et 2013 en France est présentée selon le sexe et le secteur d'activité. Les expositions sont évaluées par les matrices emplois-expositions du programme Matgéné. Les données de population issues des recensements de 1999, 2007 et 2013 sont croisées avec les matrices pour estimer les prévalences d'exposition sur les trois années.
Les solvants les plus fréquemment utilisés en milieu professionnel en 2013 étaient les solvants oxygénés (11,4% des travailleurs), devant les solvants pétroliers (5,3%) et les solvants chlorés (0,2%). Les femmes étaient plus exposées aux solvants oxygénés (15,4% des femmes vs 7,7% des hommes), alors que les hommes étaient plus souvent concernés par les solvants pétroliers (9,1% vs 1,1%) et chlorés (0,3% vs 0,1%). L'exposition professionnelle a diminué pour chacune des familles de solvants sur la période d'étude, de même que l'exposition à au moins un solvant de chacune des familles.
Cette étude est la première à présenter l'évolution de l'exposition professionnelle à trois grandes familles de solvants sur une période de 14 ans pour l'ensemble des travailleurs en France, quels que soient leur statut et leur activité. La baisse globale observée pour l'ensemble des solvants est positive compte tenu du fait que certains de ces solvants présentent un caractère cancérogène, mutagène ou reprotoxique. Cependant, cette baisse est à étudier selon les secteurs et le sexe afin d'orienter et cibler au mieux les actions de prévention à mettre en place pour les groupes professionnels restant les plus exposés en 2013.

Source: Pilorget C, Lagarrigue R, Houot M. (2018) Bull Epidémiol Hebd. (12-13), 234-240.?
http://invs.santepubliquefrance.fr/beh/2018/12-13/2018_12-13_4.html

Exposition des travailleurs aux substances chimiques et aux agents biologiques dans les usines de biométhanisation des matières organiques putrescibles

Évaluation exploratoire
La biométhanisation est un procédé de transformation anaérobie des matières organiques putrescibles (MOP) en biogaz et en digestat destiné à l'épandage en milieu agricole. Ce procédé est en forte croissance en raison de la Politique québécoise de gestion des matières résiduelles qui prévoit le bannissement de l'enfouissement des MOP, et ce, dès 2020. L'exposition des travailleurs affectés aux activités de biométhanisation a fait l'objet de peu de publications scientifiques. L'objectif général de cette recherche est donc d'évaluer de manière exploratoire l'exposition de ces travailleurs. Plus spécifiquement, cette étude vise à 1) détecter et à mesurer la présence et les concentrations des agents biologiques (microorganismes pathogènes et totaux) et des substances chimiques dans l'air ambiant; 2) apprécier le risque potentiel pour la santé des travailleurs; 3) hiérarchiser les aires critiques en fonction des risques potentiels.

Source: http://www.irsst.qc.ca/publications-et-outils/publication/i/100997/n/usines-biomethanisation

Développement d’une approche par séquençage de nouvelle génération pour l’étude de la diversité fongique des bioaérosols

Afin d'explorer l'association entre les bioaérosols, l'exposition aux moisissures et les effets sur la santé respiratoire, l'objectif général de cette activité de recherche était de proposer une méthode d'analyse permettant de déterminer, de manière quantitative, la diversité fongique des bioaérosols, sans égard à leur culture. D'une manière plus spécifique, deux marqueurs génomiques fongiques ont été ciblés par l'approche de séquençage de nouvelle génération, soit l'ITS1 et l'ITS2, afin de comparer leur efficacité à décrire la diversité fongique d'un environnement.
Pour ce faire, l'air contaminé particulièrement par la présence de moisissures a été échantillonné dans trois environnements de travail. Les sites de compostage et de biométhanisation ont été utilisés afin de mettre au point la méthodologie de traitement des échantillons ainsi que les régions de l'ADN fongique à cibler pour obtenir une grande diversité. Par la suite, un environnement pilote (fermes laitières) a été utilisé afin de comparer la performance de la méthode à celle des techniques classiques de culture.

Source: http://www.irsst.qc.ca/publications-et-outils/publication/i/100995/n/diversite-fongique-bioaerosols

Evaluation of the Impact of Ambient Temperatures on Occupational Injuries in Spain

Background: Extreme cold and heat have been linked to an increased risk of occupational injuries. However, the evidence is still limited to a small number of studies of people with relatively few injuries and with a limited geographic extent, and the corresponding economic effect has not been studied in detail.
Objectives: We assessed the relationship between ambient temperatures and occupational injuries in Spain along with its economic effect.
Methods: The daily number of occupational injuries that caused at least one day of leave and the daily maximum temperature were obtained for each Spanish province for the years 1994–2013. We estimated temperature–injuries associations with distributed lag nonlinear models, and then pooled the results using a multivariate meta-regression model. We calculated the number of injuries attributable to cold and heat, the corresponding workdays lost, and the resulting economic effect.
Results: The study included 15,992,310 occupational injuries. Overall, 2.72% [95% confidence interval (CI): 2.44–2.97] of all occupational injuries were attributed to nonoptimal ambient temperatures, with moderate heat accounting for the highest fraction. This finding corresponds to an estimated 0.67 million (95% CI: 0.60–0.73) person-days of work lost every year in Spain due to temperature, or an annual average of 42 d per 1,000 workers. The estimated annual economic burden is €370 million, or 0.03% of Spain's GDP (€2,015).
Conclusions: Our findings suggest that extreme ambient temperatures increased the risk of occupational injuries, with substantial estimated health and economic costs. These results call for public health interventions to protect workers in the context of climate change.

Source: Martínez-Solanas, È., López-Ruiz, M., Wellenius, G. A., Gasparrini, A., Sunyer, J., Benavides, F. G. et Basagaña, X. (2018). Environmental health perspectives, 126(6).
https://doi.org/10.1289/EHP2590

Expositions professionnelles à des agents cancérogènes respiratoires chez les salariés en 2010

Introduction – Les cancers respiratoires sont les plus fréquents des cancers professionnels, mais très peu de données sont disponibles pour quantifier l'exposition professionnelle aux cancérogènes respiratoires. L'objectif de ce travail était d'évaluer en France la proportion de salariés exposés à des agents cancérogènes respiratoires et d'identifier les groupes professionnels les plus exposés, à des fins de prévention.
Méthode – À partir des données de l'enquête Sumer 2009-2010 sur l'exposition des salariés en France, Santé publique France a calculé des proportions de salariés exposés à des cancérogènes respiratoires selon
le secteur d'activité et la famille professionnelle. Les agents cancérogènes respiratoires sélectionnés sont les rayonnements ionisants et 15 cancérogènes chimiques respiratoires, différenciés selon leur action au niveau de l'appareil broncho-pulmonaire ou de la sphère ORL.
Résultats – En France, en 2010, environ 2 millions de salariés (environ 1,7 million d'hommes et 300 000 femmes) ont été exposés à au moins un cancérogène de l'appareil respiratoire et 22% d'entre eux avaient au moins une double exposition. Si chez les hommes, les secteurs de la construction, de la réparation automobile et du transport et de l'entreposage sont prépondérants et impliquent essentiellement des agents chimiques, chez les femmes, l'exposition se concentre dans le secteur de la santé où sont présents les rayonnements ionisants en plus des agents chimiques.
Discussion – conclusion – Cette étude a permis de quantifier un effectif important de salariés exposés à des cancérogènes respiratoires en France, en particulier dans certains secteurs et groupes professionnels. Une meilleure connaissance des protections mises en place dans ces secteurs et professions sont nécessaires pour assurer une prévention adéquate à ces risques cancérogènes.

Source: http://invs.santepubliquefrance.fr/beh/2018/12-13/pdf/2018_12-13_6.pdf

EU nanomaterials website updated with two searchable databases

The European Union Observatory for Nanomaterials (EUON ) website has been updated with new information about nanomaterials within the EU regulatory framework, how they are used in different sectors, including food, medicine and environmental research, as well as information on how to use nanomaterials safely at work.
In addition, two searchable databases are now accessible in 23 EU languages through the EUON; NanoData, a knowledge base on nano science and technology, and the eNanoMapper, which helps you find safety information about nanomaterials.
The EUON home page has also been revamped with more dynamic content including the latest news and articles on nanomaterials and nanotechnology from the web.

Source: https://osha.europa.eu/fr/oshnews/eu-nanomaterials-website-updated-two-searchable-databases

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. Long-term consequences of cleaning agents on respiratory health are, however, not well described.
Objectives: This study aimed to investigate long-term effects of occupational cleaning and cleaning at home on lung function decline and airway obstruction.
Methods: The European Community Respiratory Health Survey (ECRHS) investigated a multicenter population-based cohort at three time points over 20 years. A total of 6,235 participants with at least one lung function measurement from 22 study centers, who in ECRHS II responded to questionnaire modules concerning cleaning activities between ECRHS I and ECRHS II, were included. The data were analyzed with mixed linear models adjusting for potential confounders.
Measurements and Main Results: As compared with women not engaged in cleaning (ΔFEV1 = −18.5 ml/yr), 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 (ΔFVC = −8.8 ml/yr; −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 FEV1/FVC decline or 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., ... et Kogevinas, M. (2018). American journal of respiratory and critical care medicine, 197(9), 1157-1163.
https://doi.org/10.1164/rccm.201706-1311OC 

Design, Testing, and Modeling of Environmental Enclosures for Controlling Worker Exposure to Airborne Contaminants

Environmental enclosures such as cabs, booths, rooms, etc. are one of the mainstay engineering control methods for reducing operators' exposure to airborne contaminants generated outside the enclosure. In order to achieve a cleaner air environment, air filtration is typically incorporated into the enclosure's heating, ventilation, and air conditioning (HVAC) system. The National Institute for Occupational Safety and Health (NIOSH) has jointly conducted collaborative research efforts with HVAC system manufacturers, cab filtration/pressurization component manufacturers, original equipment manufacturers (OEMs) of industrial vehicles, and companies using these cabs/environmental enclosures. This report summarizes NIOSH's laboratory and field research results, provides key design guidelines for environmental enclosures, shows measurement methods for enclosure performance, and demonstrates mathematical modeling of filtration system designs.
Two key elements of an effective environmental enclosure are a good filtration system and an enclosure with good integrity (sealed isolation from the outside environment). A good filtration system should include filtering out at least 95% or greater of airborne respirable aerosols (dust, diesel particulate matter, liquid droplets, etc.) from the intake airflow with an additional recirculation filtering component for the inside air. Good enclosure integrity is also needed to achieve positive pressure to prevent wind-driven aerosol penetration into the enclosure, as well as to minimize air leakage around the filtration system. Test methods and mathematical modeling of environmental enclosures are also beneficial for quantifying and optimizing filtration system designs, as well as maintaining optimum protection factor (PF) performance for enclosure occupants. Occupational exposure sampling, particle counting methods, airflow measurements, and enclosure pressurization measurements are used to assess the effectiveness of environmental enclosures. Node analysis of filtration system designs are beneficial for examining the effects of filter placement, filter efficiency, airflow quantities, air leakage, and wind penetration on the environmental enclosure's air cleaning performance.

Source: https://www.cdc.gov/niosh/mining/UserFiles/works/pdfs/2018-123.pdf

Standard Terminology for Sampling and Analysis of Asbestos

This terminology standard is a collective vocabulary relating to sampling and analysis of asbestos. As a convenience to general interest, it contains most of the standard terms, definitions, and nomenclature under the jurisdiction of Committee D22.

Source: https://www.astm.org/Standards/D7712.htm

Development of and Selected Performance Characteristics of CANJEM, a General Population Job-Exposure Matrix Based on Past Expert Assessments of Exposure

Objectives: We developed a job-exposure matrix called CANJEM using data generated in population-based case–control studies of cancer. This article describes some of the decisions in developing CANJEM, and some of its performance characteristics.
Methods: CANJEM is built from exposure information from 31673 jobs held by study subjects included in our past case–control studies. For each job, experts had evaluated the intensity, frequency, and likelihood of exposure to a predefined list of agents based on jobs histories and descriptions of tasks and workplaces. The creation of CANJEM involved a host of decisions regarding the structure of CANJEM, and operational decisions regarding which parameters to present. The goal was to produce an instrument that would provide great flexibility to the user. In addition to describing these decisions, we conducted analyses to assess how well CANJEM covered the range of occupations found in Canada.
Results: Even at quite a high level of resolution of the occupation classifications and time periods, over 90% of the recent Canadian working population would be covered by CANJEM. Prevalence of exposure of specific agents in specific occupations ranges from 0% to nearly 100%, thereby providing the user with basic information to discriminate exposed from unexposed workers. Furthermore, among exposed workers there is information that can be used to discriminate those with high exposure from those with low exposure.
Conclusions: CANJEM provides good coverage of the Canadian working population and possibly that of several other countries. Available in several occupation classification systems and including 258 agents, CANJEM can be used to support exposure assessment efforts in epidemiology and prevention of occupational diseases.

Source: Sauvé, J. F., Siemiatycki, J., Labrèche, F., Richardson, L., Pintos, J., Sylvestre, M. P., ... et Rémen, T. (2018). Annals of Work Exposures and Health.
https://doi.org/10.1093/annweh/wxy044

Association of Parkinson’s disease with industry sectors

A French nationwide incidence study
In order to identify working environments at risk for Parkinson's disease (PD), we investigated the relation between the importance of industry sectors, used as a surrogate for occupational exposures, and PD incidence in French cantons. The number of incident PD cases (2010–2014) in 3689 cantons of metropolitan France was determined using drug claims from French National Health Insurance databases. The proportions of workers in 38 industry sectors in 2006 were calculated for each canton. Associations between the proportions of workers in industry sectors and PD age/sex-standardized incidence ratios were examined using incidence rate ratios (IRR) and 95% confidence intervals (CI) estimated with multilevel negative binomial regressions with a random intercept at the canton-level and adjusted for smoking, deprivation index, and density of neurologists. We then used two-step semi-Bayes hierarchical regression (HR) to include prior information about exposure to pesticides, metals, and solvents in each industry sector. We identified 112,625 incident cases. PD incidence was higher in areas characterized by high proportions of workers in “Agriculture, forestry and fishing” (IRRHR = 1.042; CI 95% = 1.014–1.070; p-TrendHR = 0.004), “Manufacture of textiles, wearing apparel, leather and related products” (IRRHR = 1.024; CI 95% = 1.005–1.044; p-TrendHR = 0.010), and “Manufacture of basic metals and fabricated metal products, except machinery and equipment” (IRRHR = 1.024; CI 95% = 1.003–1.046; p-TrendHR = 0.071). This nationwide study, based on a comprehensive analysis of industry sectors, shows significant associations between high proportions of workers in specific industry sectors (agriculture, metallurgy, textile) and PD incidence that may be targeted in further epidemiological studies to replicate and better understand these associations.

Source: Vlaar, T., Kab, S., Schwaab, Y., Fréry, N., Elbaz, A. et Moisan, F. (2018). European journal of epidemiology.
https://doi.org/10.1007/s10654-018-0399-3

Gestion des médicaments améliorant les performances sur le lieu de travail

Une analyse sous l'angle de la santé et de la sécurité au travail
Cet article fait le point sur les derniers développements relatifs aux risques professionnels pour la santé et la sécurité que présentent les médicaments améliorant les performances sur le lieu de travail.
Il vise à comprendre le contexte plus vaste dans lequel s'inscrit la consommation de ces médicaments par les travailleurs, en analysant par exemple les circonstances économiques et sociales dans lesquelles leur consommation est susceptible de s'inscrire et en en examinant la couverture médiatique.
Les conclusions tirées visent à stimuler le débat et abordent les conséquences de ces phénomènes pour les cadres et les décideurs politiques.

Source: https://osha.europa.eu/fr/tools-and-publications/publications/managing-performance-enhancing-drugs-workplace-osh-perspective/view

Treatments to prevent hand skin irritation in the workplace

Occupational irritant hand dermatitis (OIHD) is a skin disease that occurs on the hands of employees in certain jobs. The first signs are red and scaly patches in the finger webs and on the knuckle area of the hands. Itchy blisters, painful cracks, and possibly infection are common, and eventually the skin becomes thickened.
Hand skin irritation can affect employees who regularly come into contact with water, detergents, chemicals, and other irritants, or who wear gloves during their working day. People at particular risk include hairdressers, nurses, cleaners, builders, and people who work in the dye, printing, metal, and food industries. The condition is relatively common and affects about 5 to 20 out of 10,000 full-time workers per year. Preventing OIHD from developing is important because it is difficult to clear once it starts.

Source: Bauer, A., Rönsch, H., Elsner, P., Dittmar, D., Bennett, C., Schuttelaar, MLA, Lukács, J., John, SM, Williams, HC. (2018). Cochrane Database of Systematic Reviews (4). 
http://dx.doi.org/10.1002/14651858.CD004414.pub3

Case-control investigation of occupational exposure to chlorinated solvents and non-Hodgkin’s lymphoma

Objectives: Although many studies have investigated the association between trichloroethylene (TCE) exposure and non-Hodgkin's lymphoma (NHL), less is known about other chlorinated solvents. We extended our previous analysis of occupational TCE exposure in a multicentre population-based case-control study of NHL to investigate associations with five additional chlorinated solvents: 1,1,1,-trichloroethane, carbon tetrachloride, chloroform, methylene chloride and perchloroethylene.
Methods: Cases (n=1189) and controls (n=982) provided detailed information on their occupational histories and workplace exposure to chlorinated solvents for selected occupations using job-specific interview modules. An industrial hygienist used this information and a review of the literature to assess occupational exposure to chlorinated solvents. We computed ORs and 95% CIs for different exposure metrics, with the unexposed group as the referent. We also computed ORs by NHL subtype.
Results: High cumulative hours exposed to carbon tetrachloride was associated with NHL (>520 hours: OR 1.9; 95% CI 1.0 to 3.6; Ptrend=0.04). This association remained after restricting to jobs with high-intensity exposure (OR 2.0; 95% CI 1.1 to 3.8; P=0.03) and ≥90% exposure probability (OR 2.1; 95% CI 1.0 to 4.3; P=0.03), adjusting for TCE (OR 2.1; 95% CI 1.0– to 4.1; P=0.04) and incorporating a 15-year lag (OR 1.9; 95% CI 1.0 to 3.6; P=0.06). The other evaluated chlorinated solvents were not associated with NHL.
Conclusions: This is the first study using high-quality quantitative exposure assessment methods to identify a statistically significant elevated association between occupational exposure to carbon tetrachloride and NHL. Our findings, although limited by a small number of exposed cases, offer evidence that carbon tetrachloride may be a lymphomagen.

Source: Callahan, C. L., Stewart, P. A., Friesen, M. C., Locke, S., De Roos, A. J., Cerhan, J. R., ... et Purdue, M. P. (2018). Occup Environ Med, 75(6), 415-420.
http://dx.doi.org/10.1136/oemed-2017-104890

Types and Health Hazards of Fibrous Materials Used as Asbestos Substitutes

The World Health Organization (WHO) estimates that about 125 million people are exposed to asbestos at worksites around the world, and more than 107,000 people die of asbestos-related diseases, including lung cancer, mesothelioma, or asbestosis, due to occupational exposure to asbestos. Substitute materials have been studied and developed for a long time because of the hazards of asbestos, and many people have recently shown interests in the hazards of substitute materials.
Fibrous materials may be considered as an alternative to asbestos. There are many kinds of fiber materials, which can be largely classified into synthetic fibers and natural fibers. Synthetic fibers can be classified into organic and inorganic fibers; synthetic organic fibers include polyamide fiber, polyolefins fiber, polyester fiber, polyurethane fiber, and polyvinyl fiber, and synthetic inorganic fibers include glass filament, glass wool, refractory ceramic fibers, rock wool, and slag wool fiber. Natural fibers include natural organic fibers such as cotton and hemp and natural inorganic fibers such as attapulgite, erionite (zeolite), nemalite (fibrous brucite), sepiolite, and wollastonite.

Source: Park, S. H. (2018). Safety and Health at Work.
https://doi.org/10.1016/j.shaw.2018.05.001

Work history and radioprotection practices in relation to cancer incidence and mortality in US radiologic technologists performing nuclear medicine procedures

Introduction: Technologists working in nuclear medicine (NM) are exposed to higher radiation doses than most other occupationally exposed populations. The aim of this study was to estimate the risk of cancer in NM technologists in relation to work history, procedures performed and radioprotection practices.
Methods: From the US Radiologic Technologists cohort study, 72 755 radiologic technologists who completed a 2003–2005 questionnaire were followed for cancer mortality through 31 December 2012 and for cancer incidence through completion of a questionnaire in 2012–2013. Multivariable-adjusted models were used to estimate HRs for total cancer incidence and mortality by history of ever performing NM procedures and frequency of performing specific diagnostic or therapeutic NM procedures and associated radiation protection measures by decade.
Results: During follow-up (mean=7.5 years), 960 incident cancers and 425 cancer deaths were reported among the 22 360 technologists who worked with NM procedures. We observed no increased risk of cancer incidence (HR 0.96, 95% CI 0.89 to 1.04) or death (HR 1.05, 95% CI 0.93 to 1.19) among workers who ever performed NM procedures. HRs for cancer incidence but not mortality were higher for technologists who began performing therapeutic procedures in 1960 and later compared with the 1950s. Frequency of performing diagnostic or therapeutic NM procedures and use of radioprotection measures were not consistently associated with cancer risk. No clear associations were observed for specific cancers, but results were based on small numbers.
Conclusion: Cancer incidence and mortality were not associated with NM work history practices, including greater frequency of procedures performed.

Source: Bernier, M. O., Doody, M. M., Van ***, M. E., Villoing, D., Alexander, B. H., Linet, M. S. et Kitahara, C. M. (2018). Occup Environ Med.
http://dx.doi.org/10.1136/oemed-2017-104559

Occupational exposure to electromagnetic fields from medical sources

High exposures to electromagnetic fields (EMF) can occur near certain medical devices in the hospital environment. A systematic assessment of medical occupational EMF exposure could help to clarify where more attention to occupational safety may be needed. This paper seeks to identify sources of high exposure for hospital workers and compare the published exposure data to occupational limits in the European Union. A systematic search for peer-reviewed publications was conducted via PubMed and Scopus databases. Relevant grey literature was collected via a web search. For each publication, the highest measured magnetic flux density or internal electric field strength per device and main frequency component was extracted. For low frequency fields, high action levels may be exceeded for magnetic stimulation, MRI gradient fields and movement in MRI static fields. For radiofrequency fields, the action levels may be exceeded near devices for diathermy, electrosurgery and hyperthermia and in the radiofrequency field inside MRI scanners. The exposure limit values for internal electric field may be exceeded for MRI and magnetic stimulation. For MRI and magnetic stimulation, practical measures can limit worker exposure. For diathermy, electrosurgery and hyperthermia, additional calculations are necessary to determine if SAR limits may be exceeded in some scenarios.

Source: Stam, R., Yamaguchi-Sekino, S. (2018). Industrial Health, 56, 96-105.
https://doi.org/10.2486/indhealth.2017-0112

Interventions for preventing occupational irritant hand dermatitis

Background: Occupational irritant hand dermatitis (OIHD) causes significant functional impairment, disruption of work, and discomfort in the working population. Different preventive measures such as protective gloves, barrier creams and moisturisers can be used, but it is not clear how effective these are. This is an update of a Cochrane review which was previously published in 2010.
Objectives: To assess the effects of primary preventive interventions and strategies (physical and behavioural) for preventing OIHD in healthy people (who have no hand dermatitis) who work in occupations where the skin is at risk of damage due to contact with water, detergents, chemicals or other irritants, or from wearing gloves.

Source: Bauer, A., Rönsch, H., Elsner, P., Dittmar, D., Bennett, C., Schuttelaar, M. A., ... et Williams, H. C. (2018). The Cochrane database of systematic reviews, 4.
http://dx.doi.org/10.1002/14651858.CD004414.pub3

Soignants et médicaments cytotoxiques

Place de la biométrologie dans la maîtrise des risques dans le temps
Les médicaments cytotoxiques utilisés dans les traitements des cancers présentent une toxicité intrinsèque, du fait de leurs propriétés génotoxiques, tératogènes et cancérigènes. Les professionnels de santé pouvant y être exposés, il est essentiel de garantir leur sécurité et de mettre en place des programmes d'évaluation des expositions pour documenter les expositions, juger de l'efficacité des mesures de protection et établir des priorités en matière de prévention. Cet article présente les principaux résultats de deux campagnes d'évaluation des expositions aux médicaments cytotoxiques, réalisées en 2010 puis en 2016 dans un même établissement hospitalier en France.
Les expositions des soignants (infirmiers, aides-soignants et agents de service hospitalier) ont été évaluées par la biométrologie et par la mesure de la contamination de leur environnement de travail.
Les analyses réalisées en 2010 ont mis en évidence la présence de médicaments cytotoxiques dans les urines de près de la moitié des infirmiers et aides-soignants suivis, ainsi que sur les surfaces de travail. Malgré la mise en place de plusieurs actions de prévention, la campagne d'évaluation suivante, en 2016, a montré que les expositions perduraient. L'analyse d'un questionnaire sur la prise en charge globale du risque cytotoxique a permis d'apporter un éclairage sur ces résultats. Il apparaît ainsi que les différents déterminants de l'exposition (formation, port des équipements de protection individuelle, gestion des incidents, procédures formalisées…) doivent être identifiés et pris en compte pour une maîtrise du risque cytotoxique. Enfin, cette étude met en évidence le besoin d'un suivi régulier des expositions pour maintenir un niveau de vigilance optimal du personnel et éviter toute dérive au cours du temps.

Source: Ndaw S., Robert A., Ricolfi C., Denis F., Marsan P. (2018). Bulletin Epidémiologique Hebdomadaire (12-13): 252-257.?
http://invs.santepubliquefrance.fr/beh/2018/12-13/2018_12-13_7.html

Examen des politiques sur la consommation de substances en milieu de travail au Canada

Les politiques et pratiques sur la consommation de substances en milieu de travail sont relativement peu développées, et la recherche et l'information sur ce sujet sont limitées. Pour de nombreux secteurs, l'amélioration des connaissances et de la compréhension de ce sujet pourrait être bénéfique pour divers intervenants, particulièrement les employeurs et les employés. En considérant ces faits, les objectifs de la présente étude étaient les suivants :
- Revoir, analyser et résumer de façon générale les politiques en milieu de travail sur la consommation de substances au Canada, leurs composantes communes et uniques et leurs lacunes.
- Déterminer les leçons apprises et les pratiques exemplaires dans l'élaboration et la mise en oeuvre de politiques sur la consommation de substances en milieu de travail d'après l'expérience d'organisations pour lesquelles la sécurité est critique.
- Déterminer quels secteurs stratégiques requièrent davantage de conseils, d'outils et de ressources et, par la suite, formuler des recommandations visant à améliorer l'élaboration de politiques et les réactions des employeurs devant la consommation de substances qui affecte le milieu de travail.
Cette étude est la première en son genre à explorer l'état des politiques canadiennes sur la consommation de substances en milieu de travail. Elle vise d'abord les employeurs et les professionnels des ressources humaines souhaitant élaborer ou améliorer les politiques et les pratiques exemplaires en milieu de travail sur la consommation de substances, puis les autres professionnels travaillant au sein d'organisations (p. ex. personnel médical, PAS/EAS, avocats, etc.).

Source: http://www.ccdus.ca/Resource%20Library/CCSA-Workplace-Substance-Use-Policies-Canada-Report-2018-fr.pdf

Assessment of safe antineoplastic drug handling practices in community pharmacies, veterinary settings and long-term care homes in Ontario

Antineoplastic drugs play an important role in cancer and other chronic disease treatment though a number of these drugs are known to have carcinogenic, mutagenic and teratogenic properties. Healthcare workers in hospitals and cancer treatment centres are typically identified as the largest job group known to be at risk. However, recently other job groups have also been identified as likely at risk due to direct or indirect exposure such as: community pharmacists including retail pharmacy workers, veterinarians and veterinarian technicians, nursing and other healthcare workers employed in long-term care homes, as well as workers involved in related shipping and receiving, waste handling, maintenance, housekeeping and laundry etc.
Studies on exposure levels assessed outside of hospitals and cancer treatment centres revealed that there is a potential hazard present in these settings. Surface contamination of various commonly prescribed antineoplastic drugs was observed in these workplaces at measurable levels comparable to those obtained in human oncology settings. In addition, although best practices for safe drug handling have been defined, little is known about the measures and controls in use for the safe handling of antineoplastic drugs outside of acute care settings.
The purpose of this study was to provide information on the extent of use of antineoplastic drugs in veterinary clinics, long-term care homes and community pharmacies in Ontario. The goal was to present a cross section of current practices and measures in use for safe handling of antineoplastic drugs and minimizing exposure following a request from the Ontario Ministry of Labour for an evaluation of safe work practices in community pharmacies, veterinary clinics and long-term care homes. Barriers to adherence of existing safe drug handling practices were also identified. This study aims to fill the gaps in current knowledge about ongoing practices in these work places which may guide future interventions and future research. This is important because of the likely increase in the number of exposed workers due to increased cancer therapy and treatment from increasing numbers of patients with cancer and other chronic illnesses. Assessing workplaces' safety culture and identifying barriers to adherence to safe work practices can contribute to minimizing worker exposure.

Source: http://www.occupationalcancer.ca/wp-content/uploads/2018/05/Antineoplastic-Drug-Handling-Final-Report-OCRC2018.pdf

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