Workplace Exposures and the National Action Plan for Infertility

Infertility is a significant health issue in the U.S. as well as globally.  In addition to the large health and fiscal impacts of infertility, the inability to conceive can be devastating to individuals or couples. Research suggest that between 12% and 18% of couples struggle with infertility,[1] which may be caused by a wide variety of factors including genetic abnormalities, aging, acute and chronic diseases, treatments for certain conditions, behavioral factors, and exposure to environmental, occupational, and infectious hazards. However, many questions about infertility remain unanswered.
Today, the Centers for Disease Control and Prevention (CDC) released the National Public Health Action Plan for the Detection, Prevention and Management of Infertility. This plan was created in consultation with many governmental and nongovernmental partners.  NIOSH contributed to this Action Plan, specifically related to reducing exposures to occupational agents that can harm reproductive health and fertility in women and men.


The usefulness of compensation statistics to detect heat-related health outcomes in a temperate climate

The experience of Québec
OBJECTIVES: To explore relationships between summer outdoor temperatures in Quebec (Canada) and occupational compensation statistics for heat-related illnesses.
METHOD: Daily compensation counts of heat-related illnesses (heat strain, heatstroke, loss of consciousness, etc.), occurring between May and September, were obtained from the workers' compensation board of Quebec for each health region between 1998 and 2010. Regional daily maximum outdoor temperatures were obtained from Environment Canada. Associations between daily compensation counts and temperature were estimated using negative binomial or Poisson regression models for each region and were adjusted for relative humidity and temporal trends. Pooled effect sizes for Quebec (all health regions combined) were obtained using a fixed effect model for meta-analysis.
RESULTS: In an average population of 3.7 million workers, 259 illnesses classified as heat-related were compensated between 1998 and 2010, giving an average annual rate of 0.11 case per 100 000 workers per summer month. During the study period, 63.0% of heat-related outcomes occurred on days with a maximum daily average temperature below 30(o)C. Occupations with the largest number of compensations were those of labourers (32%), firefighters (11%) and truck drivers (4%). The pooled incidence rate ratio (IRR) was 1.41 (95% CI 1.35-1.46) per 1(o)C increase in daily maximum temperature. Effects of barometric pressure and lag will be explored.
CONCLUSIONS: Heat-related illnesses do occur in temperate climates. Our results suggest that compensation statistics, albeit crude indicators of health effects, can be useful to identify industry sectors and occupations that would benefit from preventive interventions aimed at high risk workers.

Source: Labrèche F, Adam-Poupart A, Busque MA, Duguay P, Fournier M, Zayed J, Smargiassi A. Occup. Environ. Med. 2014; 71(Suppl 1): A40.

Maternal occupational exposure to polycyclic aromatic hydrocarbons and small for gestational age offspring

Objectives: While some of the highest maternal exposures to polycyclic aromatic hydrocarbons (PAHs) occur in the workplace, there is only one previous study of occupational PAH exposure and adverse pregnancy outcomes. We sought to extend this literature using interview data combined with detailed exposure assessment.
Methods: Data for 1997–2002 were analysed from mothers of infants without major birth defects in the National Birth Defects Prevention Study, a large population-based case-control study in the USA. Maternal telephone interviews yielded information on jobs held in the month before conception through delivery. From 6252 eligible control mothers, 2803 completed the interview, had a job, met other selection criteria, and were included in the analysis. Two industrial hygienists independently assessed occupational exposure to PAHs from the interview and reviewed results with a third to reach consensus. Small for gestational age (SGA) was the only adverse pregnancy outcome with enough exposed cases to yield meaningful results. Logistic regression estimated crude and adjusted ORs.
Results: Of the 2803 mothers, 221 (7.9%) had infants who were SGA. Occupational PAH exposure was found for 17 (7.7%) of the mothers with SGA offspring and 102 (4.0%) of the remaining mothers. Almost half the jobs with exposure were related to food preparation and serving. After adjustment for maternal age, there was a significant association of occupational exposure with SGA (OR=2.2, 95% CI 1.3 to 3.8).
Conclusions: Maternal occupational exposure to PAHs was found to be associated with increased risk of SGA offspring.

Source: Peter H Langlois, Adrienne T Hoyt, Tania A Desrosiers, Philip J Lupo, Christina C Lawson, Martha A Waters, Carissa M Rocheleau, Gary M Shaw, Paul A Romitti, Suzanne M Gilboa, Sadia Malik, and the National Birth Defects Prevention Study. Occup Environ Med. 2014;71:529-535 

Mortality and Cancer Incidence in Aluminum Smelter Workers

A 5-Year Update
Objective: To determine the mortality and cancer incidence of aluminum smelter workers.
Method: The experience of 17,089 workers between 1950 and 2004 was studied.
Results: There were 25 deaths/47 female incident cancers and 6350 deaths/3984 male incident cancers. Mortality was significantly elevated for chronic obstructive pulmonary disease, Alzheimer disease (likely influenced by regional factors), all cancers, stomach, bladder, and lung cancers. Incidence was significantly elevated for bladder, lung, and laryngeal cancers. Digestive, lung, and bladder cancer mortality and lung, bladder, and buccal cancer incidence increased significantly with benzo(a)pyrene (B(a)P) exposure. Over time lung cancer risk has diminished but bladder cancer risk has not.
Conclusions: Bladder cancer incidence was not increased at B(a)P exposures below 40 μg/m3·yr. Occupational origins for other cancers occurring above expected rates but probably unrelated to B(a)P exposure cannot be excluded. In the prebake plant, nonsignificant increases of lung cancer were observed between 2000 and 2004.

Source: Gibbs, Graham W. PhD; Labrèche, France PhD; Busque, Marc-Antoine MSc; Duguay, Patrice MSc. Journal of Occupational & Environmental Medicine: July 2014 - Volume 56 - Issue 7 - p 739–764

Work aggravated asthma

A review of reviews
Seven percent of the adult population have asthma, a condition commonly made worse by inhaling irritant exposures at work; termed work-aggravated asthma (WAA). A variety of factors that cause WAA have been identified by this review, including inhaled exposures, physical factors and behavioural issues.
WAA is common. A recent comprehensive review identified that more than 1 in 5 workers with asthma have this condition. There are, however, no GB based prevalence estimates.
WAA is an unpleasant condition. Workers complain of cough, wheeze, chest tightness and shortness of breath that is aggravated at work. These symptoms are likely to influence work absence, presenteeism and work efficiency. Their presence is also associated with significant adverse socio-economic impacts for workers and workplaces.
A variety of medical tests may be needed to help make a diagnosis of WAA, and distinguish this from occupational asthma. These tests are normally only available in specialised units with a particular interest in occupational asthma.
Very little GB data exists about interventions to reduce the associated burdens to the individual and the workplace. These include improving asthma treatments, worker education and training and assessing risks posed by various known hazards with particular relevance to asthma.


Exposition aux produits cosmétiques et risques pour la grossesse chez les professionnelles de la coiffure

Le secteur de la coiffure emploie de nombreuses femmes jeunes susceptibles d'être enceintes. Les conséquences des risques engendrés par les cosmétiques en cas de grossesse soulèvent de nombreuses questions. Après un bilan de l'état des connaissances issues des études épidémiologiques, cet article fait le point sur l'identification et l'évaluation des risques liés aux cosmétiques utilisés dans les salons de coiffure. Des conseils de prévention et des recommandations sont proposés pour protéger les coiffeuses et notamment les femmes enceintes.


Risques associés aux préparations bactériennes et enzymatiques pour le dégraissage et le nettoyage

En remplacement des dégraissants et nettoyants traditionnels, qu'ils soient à base de solvants ou de tensioactifs, on retrouve actuellement sur le marché des préparations à base de bactéries et d'enzymes pour le nettoyage de surfaces en milieux industriel et institutionnel. Des préparations enzymatiques sont également utilisées en milieu de soins pour le nettoyage d'instruments chirurgicaux et diagnostiques. Mises à part les fiches de données de sécurité et les fiches techniques fournies par les fabricants, les hygiénistes et les médecins du travail et de l'environnement, ainsi que les autres spécialistes du domaine de la santé et de la sécurité du travail ne possèdent que des données fragmentaires sur la composition de ces préparations. De plus, ces préparations sont souvent publicisées comme des produits idéaux, verts et atoxiques. La présente monographie vise à présenter de façon synthétique et critique les connaissances sur les aspects de la santé, de la sécurité, de l'environnement et techniques de ces produits biotechnologiques, de manière à guider les intervenants qui sont appelés à les évaluer, à les recommander ou à les utiliser. La méthode retenue consiste principalement en une revue de la littérature scientifique et technique. Cette recherche repose aussi sur la consultation d'intervenants représentant divers secteurs d'activité et sur l'observation de quelques milieux dans lesquels les travailleurs sont exposés à ce genre de préparations.


Veille bibliographique sur la surveillance biologique de l'exposition aux produits chimiques au poste de travail

Une veille bibliographique est organisée depuis 2005 sur la surveillance biologique aux produits chimiques en milieu de travail (SBEPC MT). Elle a été mise en place par le réseau francophone multidisciplinaire, composé de l'INRS (France), l'IRSST (Québec) et l'UCL (Belgique). Cet article dresse le bilan de l'information récoltée et analysée, de 2009 à 2012, au travers de 435 articles sélectionnés. Plusieurs thèmes d'intérêt ou d'actualités font l'objet d'une analyse plus approfondie, dont notamment les pesticides, les hydrocarbures aromatiques, le benzène, le manganèse, la variabilité biologique, les dosages cutanés et frottis de surface, les dosages dans l'air expiré ou encore la spectrométrie de masse.

Source: 218

Archaea des bioaérosols de fermes laitières, des poulaillers et des usines d’épuration des eaux usées

Leur rôle dans l'inflammation pulmonaire
Dans la présente étude, afin de définir l'exposition des travailleurs aux bioaérosols, nous avons utilisé des méthodes de biologie moléculaire pour décrire la biodiversité des bactéries et des archaea de l'air de plusieurs environnements de travail. Nous avons donc caractérisé le contenu en bactéries et en archaea des bioaérosols de fermes laitières, de poulaillers et d'établissements de traitement des eaux usées et nous avons déterminé l'exposition des travailleurs de fermes laitières à Saccharopolyspora rectivirgula, l'agent responsable du poumon du fermier. De plus, nous avons caractérisé l'immunogénicité de deux espèces d'archaea retrouvées dans l'air de différents milieux de travail, les Methanobrevibacter smithii (MBS) et les Methanosphaera stadtmanae (MSS), à l'aide d'un modèle murin d'exposition chronique des voies respiratoires.


Asthme professionnel aux sulfites

Cette fiche d'allergologie-pneumologie professionnelle annule et remplace l'ancienne fiche du même nom (TR 17). Elle fait le point sur les sulfites, sels de l'anhydride sulfureux (SO2), qui sont utilisés dans de nombreux secteurs d'activité, notamment pour leurs propriétés antiseptiques et anti-oxydantes.
Si l'intolérance aux sulfites, notamment chez les sujets asthmatiques, est bien connue lors de l'ingestion d'aliments ou de boissons, ou lors de l'administration de produits pharmaceutiques en contenant, seuls quelques cas d'asthme induit par l'usage professionnel de sulfites ont été rapportés dans la littérature ces 25 dernières années. D'un point de vue physiopathologique, plusieurs hypothèses ont été proposées pour expliquer la genèse ou l'aggravation d'un asthme par les sulfites, mais aucune ne semble pouvoir expliquer à elle seule la diversité des manifestations cliniques observées, ni leur variabilité en terme de sévérité ou de sensibilité individuelle.
Les éléments anamnestiques plaident parfois pour une origine purement irritative lorsque la manipulation de solutions de sulfites provoque des dégagements importants de SO2 dans l'environnement de travail. Dans d'autres cas, l'asthme apparaît après un long temps de latence et en dehors de toute exposition accidentelle, ce qui serait plutôt en faveur d'un mécanisme immuno-allergique.
Le diagnostic étiologique repose sur l'histoire médicale, la mise en évidence d'une rythmicité professionnelle et, si possible, sur un test d'exposition réaliste positif. La prévention doit en particulier s'attacher à éviter la création de conditions favorables à la libération atmosphérique de fortes quantités de SO2.

Source : 56

A review of the data on efficacy of hand cleaning products in industrial use as alternatives to hand washing

The aim of the project was to review available data on the efficacy of currently available alternatives to soap and water for hand washing in the context of removal of contamination typical of that experienced in a range of outdoor activities, workplaces and related environments. Consideration to include commercial waste and recycling activity, agriculture including animal visitor attractions, outdoor events, construction sites and other work away from permanent welfare facilities.
The use of soap and warm running water for hand washing remains an effective method for reducing the levels of hand borne microbiological contamination. The use of soap and cold running water has also been shown as effective for hand decontamination, though is likely to be marginally less effective than soap and warm water.
Alcohol preparations based on either gels or liquid hand rubs can offer a significant reduction in microbiological hand contamination, with some studies claiming multi-log reductions under specified conditions that are greater than hand washing approaches. However, there are important limitations to how alcohol rubs and gels should be used, and these may introduce uncertainties regarding their efficacy.
Little published data exists on the performance of hand hygiene methods in the context of variable to heavy organic loading.


Champs électromagnétiques : la nouvelle directive européenne

Une directive européenne vient préciser les seuils d'exposition aux champs électromagnétiques. La démarche d'évaluation des risques qu'elle propose doit permettre une meilleure prise en compte de la santé des salariés. Tour d'horizon des nouvelles dispositions.


Produits chimiques au travail

L'ETUI met en ligne la base de données RISCTOX
L'Institut syndical européen (ETUI) a développé avec l'institut syndical espagnol Istas la base de données RISCTOX sur les produits chimiques. Via le site web de l'ETUI, les travailleurs ont désormais accès à des fiches d'information sur quelque 100.000 substances chimiques.


Pertinence et conditions d'utilisation des indices thermiques dans le contexte québécois

Cette étude s’intéresse à l’ensemble des contraintes thermiques, depuis les grands froids typiques du nord du Québec, jusqu’aux ambiances excessivement chaudes retrouvées dans certaines industries. Six indices thermiques ont été analysés en détail; trois d’entre eux s’appliquent au froid, un au confort thermique et deux visent les conditions excessivement chaudes.


Assessing the effectiveness of the Pesticides and Farmworker Health Toolkit

A curriculum for enhancing farmworkers' understanding of pesticide safety concepts
Among agricultural workers, migrant and seasonal farmworkers have been recognized as a special risk population because these laborers encounter cultural challenges and linguistic barriers while attempting to maintain their safety and health within their working environments. The crop-specific Pesticides and Farmworker Health Toolkit (Toolkit) is a pesticide safety and health curriculum designed to communicate to farmworkers pesticide hazards commonly found in their working environments and to address Worker Protection Standard (WPS) pesticide training criteria for agricultural workers. The goal of this preliminary study was to test evaluation items for measuring knowledge increases among farmworkers and to assess the effectiveness of the Toolkit in improving farmworkers' knowledge of key WPS and risk communication concepts when the Toolkit lesson was delivered by trained trainers in the field. After receiving training on the curriculum, four participating trainers provided lessons using the Toolkit as part of their regular training responsibilities and orally administered a pre- and post-lesson evaluation instrument to 20 farmworker volunteers who were generally representative of the national farmworker population. Farmworker knowledge of pesticide safety messages significantly (P <.05) increased after participation in the lesson. Further, items with visual alternatives were found to be most useful in discriminating between more and less knowledgeable farmworkers. The pilot study suggests that the Pesticides and Farmworker Health Toolkit is an effective, research-based pesticide safety and health intervention for the at-risk farmworker population and identifies a testing format appropriate for evaluating the Toolkit and other similar interventions for farmworkers in the field.

Source: Leprevost CE, Storm JF, Asuaje CR, Arellano C, Cope WG. J. Agromed. 2014; 19(2): 96-102.

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