Prostate cancer risk among French farmers in the AGRICAN cohort

Objectives: Prostate cancer is one of the most frequent cancers among men worldwide. Its etiology is largely unknown, but an increased risk has been repeatedly observed among farmers. Our aim was to identify occupational risk factors for prostate cancer among farmers in the prospective cohort study AGRICAN.
Methods: Data on lifetime agricultural exposures (type of crops, livestock and tasks including pesticide use, re-entry and harvesting) were collected from the enrolment questionnaire. During the period from enrolment (2005–2007) to 31 December 2009, 1672 incident prostate cancers were identified. Hazard ratios (HR) were estimated using Cox regression analysis.
Results: We found an increased risk for cattle breeders using insecticides [HR 1.20, 95% confidence interval (95% CI) 1.01–1.42] with a significant dose–response relationship with number of cattle treated (P for trend 0.01). A dose–response relationship was also observed with the number of hogs (P for trend 0.06). We found an excess of prostate cancer risk among people involved in grassland activities, mainly in haymaking (HR 1.18, 95% CI 1.02–1.36). Pesticide use and harvesting among fruit growers were associated with an elevated prostate cancer risk, with a two-fold increased risk for the largest area. For potato and tobacco producers, an elevated prostate cancer risk was observed for almost all tasks, suggesting a link with pesticide exposure since all of them potentially involved pesticide exposure.
Conclusions: Our analysis suggests that the risk of prostate cancer is increased in several farming activities (cattle and hog breeding, grassland and fruit-growing) and for some tasks including pesticide use.

Source: Lemarchand C, Tual S, Boulanger M, Levêque-Morlais N, Perrier S, Clin B, Guizard A-V, Velten M, Rigaud E, Baldi I, Lebailly P. Scand J Work Environ Health, 2016.

Size-resolved characterization of particles and fibers released during abrasion of fiber-reinforced composite in a workplace influenced by ambient background sources

We demonstrate the use of high- to low-resolution microscopy and particle chemical analysis during normal vacuum and cryo-conditions to identify the nature and relative abundances of process-generated particles and fibers from sanding of a glass and carbon fiber epoxy layer-composite in a workplace influenced by both indoor and ambient background sources. The study suggests that a proper exposure characterization requires multiple techniques covering wide size ranges to reach a conclusion. Besides a rise in number concentration due to release of particles during the sanding, a significant contribution of ambient particles to the background in the production facility was observed in the sub-micron size range. Fibers are posing a dominant exposure risk in the micron size range, with carbon fibers dominating in count.

Source: Kirsten I. Kling, Marcus Levin, Alexander C.Ø. Jensen, Keld A. Jensen, Ismo K. Koponen. Aerosol and Air Quality Research, January 2016, Volume 16, No. 1, p. 11-24. 

Magnitude and characteristics of acute paraquat- and diquat-related illnesses in the US: 1998–2013

Background: Paraquat and diquat are among the most commonly used herbicides in the world.
Objectives: Determine the magnitude, characteristics, and root causes for acute paraquat- and diquat-related illnesses in the US
Methods: Illnesses associated with paraquat or diquat exposure occurring from 1998 through 2011 were identified from the Sentinel Event Notification System for Occupational Risks (SENSOR)-Pesticides Program, the California Department of Pesticide Regulation (CDPR) Pesticide Illness Surveillance Program (PISP), and the Incident Data System (IDS). Cases identified by the National Poison Data System (NPDS) were reviewed for the years 1998–2003 and 2006–2013.
Results: A total of 300 paraquat- and 144 diquat-related acute illnesses were identified by SENSOR, PISP, and IDS. NPDS identified 693 paraquat- and 2128 diquat-related acute illnesses. In SENSOR/PISP/IDS, illnesses were commonly low severity (paraquat=41%; diquat=81%); however, SENSOR/PISP/IDS identified 24 deaths caused by paraquat and 5 deaths associated with diquat. Nineteen paraquat-related deaths were due to ingestion, seven of which were unintentional, often due to improper storage in beverage bottles. In SENSOR/PISP/IDS, paraquat and diquat-related acute illnesses were work-related in 68% (n=203) and 29% (n=42) of cases, respectively. When herbicide application site was known, the vast majority of acute paraquat-related illnesses (81%) arose from agricultural applications. Common root causes of illness were failure to use adequate personal protective equipment (PPE), application equipment failure, and spill/splash of herbicide.
Conclusions: Although the magnitude of acute paraquat/diquat-related illnesses was relatively low, several fatalities were identified. Many illnesses could be prevented through stricter compliance with label requirements (e.g. ensuring proper herbicide storage and PPE use), and through enhanced training of certified applicators.

Source: Gamola Z. Fortenberrya, John Beckmanb, Abby Schwartzd, Joanne Bonnar Pradoe, Lucia S. Grahamf, Sheila Higginsg, Michelle Lackovich, Prakash Mulayi, Heidi Bojesj, Justin Waltzk, Yvette Mitchelll, Kathy Leinenkugelm, Michel S. Orielf, Elizabeth Evansn, Geoffrey M. Calvert. Environmental Research, Volume 146, April 2016, p. 191-199.

A review of the evidence for occupational exposure risks to novel anticancer agents

Introduction: Evidence of occupational exposure risks to novel anticancer agents is limited and yet to be formally evaluated from the Australian healthcare perspective.
Methods: From March to September 2013 medical databases, organizational policies, drug monographs, and the World Wide Web were searched for evidence relating to occupational exposure to monoclonal antibodies, fusion proteins, gene therapies, and other unclassified novel anticancer agents.
Results: Australian legislation, national and international guidelines, and drug company information excluded novel agents or provided inconsistent risk assessments and safe handling recommendations. Monoclonal antibody guidelines reported conflicting information and were often divergent with available evidence and pharmacologic rationale demonstrating minimal internalisation ability and occupational exposure risk. Despite similar physiochemical, pharmacologic, and internalisation properties to monoclonal antibodies, fusion proteins were included in only a minority of guidelines. Clinical directives for the safe handling of gene therapies and live vaccines were limited, where available focusing on prevention against exposure and cross-contamination. Although mechanistically different, novel small molecule agents (proteasome inhibitors), possess similar physiochemical and internalisation properties to traditional cytotoxic agents warranting cytotoxic classification and handling.
Conclusion: Novel agents are rapidly emerging into clinical practice, and healthcare personnel have few resources to evaluate risk and provide safety recommendations. Novel agents possess differing physical, molecular and pharmacological profiles compared to traditional cytotoxic anticancer agents. Evaluation of occupational exposure risk should consider both toxicity and internalisation. Evidence-based guidance able to direct safe handling practices for novel anticancer agents across a variety of clinical settings is urgently required.

Source: King, Julie, Alexander, Marliese, Byrne, Jenny, MacMillan, Kent, Mollo, Adele, Kirsa, Sue, & Green, Michael. (2016). Journal of Oncology Pharmacy Practice, 22(1), 121-134.

Statistics Western Australia: Lead levels in blood 1994-2015

The WA Occupational Safety and Health Regulations (1996) require that health surveillance, including blood lead level tests, is provided to workers undertaking lead risk work. This report summarises these results by calendar year for the period 1 January 1994 – 15 May 2015 (date of test).


DEMETER : 14 nouvelles fiches publiées

14 nouvelles fiches ont été publiées dans le guide DEMETER (Documents pour l'évaluation médicale des produits toxiques vis-à-vis de la reproduction), qui en contient désormais près de 150. Destiné en particulier aux médecins du travail, ce guide a pour but de fournir une aide à l'évaluation du risque pour la reproduction lors d'exposition d'hommes ou de femmes en milieu professionnel à des produits chimiques. Chaque fiche contient des informations sur les dangers vis-à-vis de la reproduction, pour permettre au médecin d'évaluer le risque dû à l'exposition en fonction de sa période de survenue (avant la conception, pendant la grossesse ou l'allaitement). Des propositions de conduite à tenir sont fournies.


Mise à jour de la norme servant à mesurer l’exposition aux rayonnements

La récente mise à jour de la norme ISO 15382:2015 "Radioprotection - Procédures pour la surveillance des doses au cristallin, à la peau et aux extrémités" se concentre sur la réalisation d'une mesure juste de l'exposition aux rayonnements ionisants pour une situation donnée. Elle prend en considération les enseignements tirés des plus récentes études et permet d'améliorer les mesurages de routine en matière de dosimétrie.
Les rayonnements ionisants sont utilisés dans nombre d'applications et de secteurs, notamment pour les diagnostics médicaux et la radiothérapie, l'énergie nucléaire, les systèmes de détection à rayons X dans les aéroports, voire la prospection géologique. Les limites de sécurité en matière d'exposition aux rayonnements demeurent une question complexe, car chaque organe du corps réagit différemment. Par exemple, la peau doit être protégée contre les réactions tissulaires, telles que l'ulcération, alors que la surexposition du cristallin peut donner lieu à des cataractes.


Respiratory morbidity in a coffee processing workplace with sentinel obliterative bronchiolitis cases

Rationale: Obliterative bronchiolitis in former coffee workers prompted a cross-sectional study of current workers. Diacetyl and 2,3-pentanedione levels were highest in areas for flavoring and grinding/packaging unflavored coffee.
Methods: We interviewed 75 (88%) workers, measured lung function, and created exposure groups based on work history. We calculated standardized morbidity ratios (SMRs) for symptoms and spirometric abnormalities. We examined health outcomes by exposure groups.
Results: SMRs were elevated 1.6-fold for dyspnea and 2.7-fold for obstruction. The exposure group working in both coffee flavoring and grinding/packaging of unflavored coffee areas had significantly lower mean ratio of forced expiratory volume in 1 s to forced vital capacity and percent predicted mid-expiratory flow than workers without such exposure.
Conclusion: Current workers have occupational lung morbidity associated with high diacetyl and 2,3-pentanedione exposures, which were not limited to flavoring areas.

Source: Rachel L. Bailey, Jean M. Cox-Ganser, Matthew G. Duling, Ryan F. LeBouf, Stephen B. Martin Jr., Toni A. Bledsoe, Brett J. Green and Kathleen Kreiss. Am. J. Ind. Med. Volume 58, Issue 12,  pages 1235-1245, December 2015.

Nanomatériaux dans le secteur des soins de santé

Les risques professionnels et leur prévention
Le domaine de la nanotechnologie connaît une évolution rapide et l'utilisation de nanomatériaux est de plus en plus fréquente. Comme dans un grand nombre de secteurs, la nanotechnologie exerce une influence croissante sur le secteur des soins de santé, ce qui accentue le risque d'exposition des travailleurs aux nanomatériaux dans leur milieu professionnel. La nanotechnologie et les nanomatériaux dans les applications médicales peuvent offrir quantité d'avantages. Par exemple, les techniques et approches de miniaturisation ont convergé avec la synthèse chimique et le contrôle de l'assemblage moléculaire pour offrir de séduisantes opportunités en termes de prévention, diagnostic et traitement des maladies. Toutefois, malgré un effort soutenu de recherches, le domaine de la nanotechnologie se développe plus rapidement que les connaissances sur les aspects liés à la santé et à la sécurité des nanomatériaux. Il existe toujours de nombreuses inconnues, ce qui soulève des questions concernant l'évaluation des risques pour la sécurité et la santé au travail (SST).
Cet e-fact explique comment le personnel des soins de santé peut être exposé aux nanomatériaux sur son lieu de travail durant ses activités quotidiennes. Il fournit également des informations sur les mesures pouvant être prises afin d'empêcher des expositions potentielles.


European Code against Cancer 4th Edition

Environment, occupation and cancer
People are exposed throughout life to a wide range of environmental and occupational pollutants from different sources at home, in the workplace or in the general environment – exposures that normally cannot be directly controlled by the individual. Several chemicals, metals, dusts, fibres, and occupations have been established to be causally associated with an increased risk of specific cancers, such as cancers of the lung, skin and urinary bladder, and mesothelioma. Significant amounts of air pollutants – mainly from road transport and industry – continue to be emitted in the European Union (EU); an increased occurrence of lung cancer has been attributed to air pollution even in areas below the EU limits for daily air pollution. Additionally, a wide range of pesticides as well as industrial and household chemicals may lead to widespread human exposure, mainly through food and water. For most environmental pollutants, the most effective measures are regulations and community actions aimed at reducing and eliminating the exposures. Thus, it is imperative to raise awareness about environmental and occupational carcinogens in order to motivate individuals to be proactive in advocating protection and supporting initiatives aimed at reducing pollution. Regulations are not homogeneous across EU countries, and protective measures in the workplace are not used consistently by all workers all the time; compliance with regulations needs to be continuously monitored and enforced. Therefore, the recommendation on Environment and Occupation of the 4th edition of the European Code against Cancer, focusing on what individuals can do to reduce their cancer risk, reads: “In the workplace, protect yourself against cancer-causing substances by following health and safety instructions.”

Source: Cancer Epidemiology, Volume 39, Supplement 1, December 2015, p. S84-S92.

Fiches toxicologiques : une nouvelle base de données dédiée

Désormais rassemblées dans une nouvelle base de données, les fiches toxicologiques offrent aux préventeurs la synthèse des informations disponibles sur les dangers liés à plus de 300 substances chimiques.
Dotée d’une interface plus intuitive, la nouvelle base Fiches Toxicologiques facilite la navigation des utilisateurs. Elle est également désormais consultable sur tous supports : ordinateur, tablette, smartphone. Ce nouvel outil permet de réaliser une recherche par nom chimique, par numéro de fiche, CAS ou CE mais surtout une recherche plus affinée par terme recherché.
Autre nouveauté, la collection s’enrichit de fiches synthétiques regroupant pour chaque substance les principales informations utiles au poste de travail (étiquette, toxicologie, recommandations techniques et médicales.)


Incendie et explosion lors du travail mécanique de l'aluminium

Le travail mécanique de l'aluminium est un process au cours duquel les risques d'incendie et d'explosion liés aux poussières générées ou à l'hydrogène éventuellement émis par réaction de ce métal avec l'eau sont élevés. La mise en place des moyens de prévention et des mesures de protection est complexe et requiert une étude approfondie qui, outre l'évacuation des poussières et gaz, devra prévoir la réduction des sources d'inflammation. Ces mesures techniques devront être complétées par des mesures organisationnelles et par une formation continue du personnel.
Cette brochure s'adresse aux entreprises mettant en oeuvre des procédés d'usinage de l'aluminium ou de ses alliages, ainsi qu'aux préventeurs souhaitant préconiser des mesures de prévention et de protection pour réduire les risques incendie / explosion liés à ces activités.


Ecotoxicologie des nanomatériaux

Nouvelles approches analytiques
Quatre ans après la publication de la note ayant pour titre « Écotoxicologie des nanoparticules : avancées méthodologiques dans l'évaluation des risques» (1), cette note a pour objectif de refaire le bilan sur les progrès réalisés dans le domaine. En effet, la période de veille écoulée a été marquée par la publication de nombreuses revues de la littérature contenant notamment le mot-clef « analytical » : concept analytique, approche analytique, technique analytique, méthode analytique (2-5). Ainsi, après une dizaine d'années d'investigations en écotoxicologie des nanomatériaux, les chercheurs font un point en termes de techniques utilisées pour la caractérisation, la détection et la détermination des effets des nanoparticules (NPs). Lorsque les premières études ont débuté, les outils et approches classiques d'écotoxicologie ont été appliqués à ce contaminant émergent qu'étaient les NPs. L'expérience a permis de démontrer que certaines méthodes pouvaient être appliquées telles quelles, que d'autres étaient biaisées par la nature des NPs et donc non utilisables ou encore que certaines autres devaient être adaptées. Malgré ces progrès, la constatation reste la même : le manque d'outils performants limite toujours la prédiction et la gestion des risques, notamment dans le cas de problématiques environnementales (échantillons complexes, dilués,…). Cette note s'intéresse donc au développement de nouvelles techniques (marquage isotope stable, KED ICP-MS1) ainsi qu'à l'émergence de la modélisation des risques à partir de modèles préexistants originaux ou adaptés.

Source: Bulletin de Veille Scientifique, Numéro 27. 

Assainissement de l'air des cabines d'engins mobiles

Le recours à une cabine pressurisée à air épuré est recommandé pour limiter l'exposition des conducteurs d'engins évoluant dans des atmosphères susceptibles d'être dangereuses pour la santé. L'objectif de cet aide-mémoire technique est d'édicter des recommandations pour les cabines pressurisées à air épuré en termes de performances, de réception, d'utilisation, de contrôle et de maintenance. Il est destiné à toute personne chargée de concevoir, d'acheter ou d'utiliser une cabine pressurisée à air épuré à installer sur un engin neuf ou existant.


Pollutant exposures and health symptoms in aircrew and office workers: Is there a link?

Sensory effects in eyes and airways are common symptoms reported by aircraft crew and office workers. Neurological symptoms, such as headache, have also been reported. To assess the commonality and differences in exposures and health symptoms, a literature search of aircraft cabin and office air concentrations of non-reactive volatile organic compounds (VOCs) and ozone-initiated terpene reaction products were compiled and assessed. Data for tricresyl phosphates, in particular tri-ortho-cresyl phosphate (ToCP), were also compiled, as well as information on other risk factors such as low relative humidity.
A conservative health risk assessment for eye, airway and neurological effects was undertaken based on a “worst-case scenario” which assumed a simultaneous constant exposure for 8 h to identified maximum concentrations in aircraft and offices. This used guidelines and reference values for sensory irritation for eyes and upper airways and airflow limitation; a tolerable daily intake value was used for ToCP. The assessment involved the use of hazard quotients or indexes, defined as the summed ratio(s) (%) of compound concentration(s) divided by their guideline value(s).
The concentration data suggest that, under the assumption of a conservative “worst-case scenario”, aircraft air and office concentrations of the compounds in question are not likely to be associated with sensory symptoms in eyes and airways. This is supported by the fact that maximum concentrations are, in general, associated with infrequent incidents and brief exposures. Sensory symptoms, in particular in eyes, appear to be exacerbated by environmental and occupational conditions that differ in aircraft and offices, e.g., ozone incidents, low relative humidity, low cabin pressure, and visual display unit work. The data do not support airflow limitation effects. For ToCP, in view of the conservative approach adopted here and the rareness of reported incidents, the health risk of exposure to this compound in aircraft is considered negligible.

Source: Wolkoff P, Crump DR, Harrison PTC. Environment International, Volume 87, February 2016, p. 74-84.

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