Mesures de prévention et de contrôle pour les hôpitaux
Cette fiche présente une mise à jour des recommandations du Comité sur les infections nosocomiales du Québec (CINQ) sur les mesures de prévention et de contrôle de la maladie à virus Ebola pour les hôpitaux du Québec. Les caractéristiques de l'évolution de l'épidémie en Afrique de l'Ouest corroborent la notion de transmission par contact et par gouttelettes. La transmission par voie aérienne, entre autre lors des activités générant des aérosols (AGA), demeure théorique. Toutefois, tenant compte de la létalité élevée et de la contamination de l'environnement par les liquides organiques (sang, vomissements, selles, etc.), le CINQ recommande un niveau de mesures plus élevé. Cette mise à jour tient compte des dernières recommandations émises par les Centers for Disease Control and Prevention (CDC) américains publiées le 20 octobre 2014, ainsi que celles de l'Organisation mondiale de la Santé (OMS) du 31 octobre 2014.
A review of assessment methods
Occupational cancer is a problem that needs to be tackled across the European Union (EU). Estimates of the recent and future burden of occupational diseases indicate that occupational cancer is still a problem and will remain so in the future as a result of exposure of workers to carcinogens.
The goals to which this review aims to contribute are to:
- describe occupational exposure to carcinogens and cancer-causing or -promoting working conditions at European, national and workplace levels;
- evaluate existing sources of information, identify major knowledge gaps and describe some new approaches needed to assess and prevent occupational cancer risks;
- describe occupational cancer prevention measures at European, national and workplace levels; and
- make some recommendations for filling in gaps in relevant knowledge needed to prevent effectively future risks of occupational cancer.
The report looks into relevant occupational factors: chemical, physical and biological exposures, as well as other possibly carcinogenic working environment conditions (such as shift and night work). It also examines opportunities to identify new causes or promoters of cancer.
Objective: The association between occupational exposure to lead and amyotrophic lateral sclerosis (ALS) was examined through systematic review and meta-analyses of relevant epidemiological studies and reported according to PRISMA guidelines.
Methods: Relevant studies were searched in multiple bibliographic databases through September 2013; additional articles were tracked through PubMed until submission. All records were screened in DistillerSR, and the data extracted from included articles were synthesized with meta-analysis.
Results: The risk of developing ALS among individuals with a history of exposure to lead was almost doubled (odds ratio, 1.81; 95% confidence interval, 1.39 to 2.36) on the basis of nine included case-control studies with specific lead exposure information, with no apparent heterogeneity across included studies (I2 = 14%). The attributable risk of ALS because of exposure to lead was estimated to be 5%.
Conclusions: Previous exposure to lead may be a risk factor for ALS.
Source: Wang, Ming-Dong; Gomes, James; Cashman, Neil R.; Little, Julian; Krewski, Daniel. Journal of Occupational & Environmental Medicine: December 2014, Volume 56, Issue 12, p. 1235–1242.
Objective: To study the risk of lung cancer in heavily asbestos-exposed workers after the exposure to asbestos has ended.
Methods: Lung cancer was studied in a cohort of 189,896 Swedish construction workers through a linkage with the Swedish Cancer Registry. Asbestos exposure was estimated by the incidence of malignant mesothelioma in the occupational group.
Results: There were in total 2835 cases of lung cancer. Workers with heavy exposure to asbestos had an increased risk of lung cancer (relative risks = 1.74; 95% confidence interval, 1.25 to 2.41) before exposure ended and a similar risk to those with low exposure 20 years after the exposure had ceased (relative risks = 0.94; 95% confidence interval, 0.77 to 1.15).
Conclusions: Workers with heavy exposure to asbestos have a similar risk of lung cancer as persons with low or no exposure 20 years after the exposure has ended.
Source: Järvholm, Bengt; Åström, Evelina. Journal of Occupational & Environmental Medicine: December 2014, Volume 56, Issue 12, p. 1297–1301.
A nationwide cohort study
Objectives: Painters' occupational exposure is classified as a group 1 carcinogen by the International Agency for Research on Cancer (IARC). Previous studies have shown increased risk of congenital malformations among children of women exposed to organic solvents and paint emissions during pregnancy. In Denmark, women comprise half of those enrolled in vocational paint training. We investigated the association between maternal and paternal occupational painting, respectively, and the risk of congenital malformations among children.
Methods: National register data were used to link childbirths, malformations, and parental occupation. The cohort included >1 300 000 children born to occupationally active women in Denmark 1980–2010. Cases were hospital-diagnosed with malformations within the first year of life. Odds ratios (OR) with 95% confidence intervals (95% CI) were estimated using multiple logistic regression with adjustment for potential confounders.
Results: Among 3444 children of female construction painters, we found no increased risk of malformations overall (126 cases, OR 0.88, 95% CI 0.74–1.05) or in organ-specific subgroups compared to children of women in all other occupations (55 045 cases). Sensitivity analyses restricted to severe malformations, children of maternal painters with ≥2 years of pre-pregnancy exposure, and firstborn children, and analyses with maternal healthcare assistants and kitchen workers as reference supported the main results. Also, no associations were found when including diagnoses within the first 10 years of life, when stratifying by maternal age, birth year, and sex, or for paternal construction painters.
Conclusions: This nationwide cohort study is reassuring with no indications of increased risk of congenital malformations among children of male or of female construction painters.
Source: Tougaard NH, Bonde JP, Hougaard SK, Jørgensen KT. Scand J Work Environ Health, 2014.
All of the diving Approved Codes of Practice (ACOPs) have been revised following industry consultation:
- Commercial diving projects offshore. The Diving at Work Regulations 1997
- Commercial diving projects inland/inshore. The Diving at Work Regulations 1997
- Recreational diving projects. The Diving at Work Regulations 1997.
- Media diving projects. The Diving at Work Regulations 1997.
- Scientific and Archaeological diving projects. The Diving at Work Regulations 1997
Airline and other workers may be at risk if they are exposed to infected people who have the signs and symptoms of Ebola. Workers are also at risk if they are directly exposed to the blood or other body fluids of a patient with Ebola or to objects such as needles that have been contaminated with infected body fluids.
The CDC has developed guidance and resources for workers in non-healthcare workplace settings including:
•Humanitarian aid workers
•Funeral and mortuary workers
•College and university workers
Ce guide pratique de ventilation propose une démarche de conception d'une installation de ventilation pour des cuves de traitement de surface. Cette démarche comprend 4 étapes :
- l'évaluation du risque (indice de toxicité et indice d'émission combinés conduisent à la définition des niveaux globaux du risque),
- la détermination du dispositif de captage, à l'aide d'un catalogue des dispositifs existants (couvercle, captage enveloppant, aspiration latérale, aspiration-soufflage, hotte), des critères guidant leur choix et, le cas échéant, des facteurs d'influence prépondérants,
- les calculs des débits d'aspiration selon le type de dispositif (avec comparaison des débits sur un cas particulier et des exemples de calcul de débit),
- la réalisation du réseau de ventilation en tenant compte du transport des effluents gazeux, du traitement des rejets gazeux, des règles de ventilation générale et des contraintes dues à la compensation d'air.
Replacement of a Floor Cleaning Agent
Cleaning agents often emit terpenes that react rapidly with ozone. These ozone-initiated reactions, which occur in the gas-phase and on surfaces, produce a host of gaseous and particulate oxygenated compounds with possible adverse health effects in the eyes and airways. Within the European Union (EU) project OFFICAIR, common ozone-initiated reaction products were measured before and after the replacement of the regular floor cleaning agent with a preselected low emitting floor cleaning agent in four offices located in four EU countries. One reference office in a fifth country did not use any floor cleaning agent. Limonene, α-pinene, 3-carene, dihydromyrcenol, geraniol, linalool, and α-terpineol were targeted for measurement together with the common terpene oxidation products formaldehyde, 4-acetyl-1-methylcyclohexene (4-AMCH), 3-isopropenyl-6-oxo-heptanal (IPOH), 6-methyl-5-heptene-2-one, (6-MHO), 4-oxopentanal (4-OPA), and dihydrocarvone (DHC). Two-hour air samples on Tenax TA and DNPH cartridges were taken in the morning, noon, and in the afternoon and analyzed by thermal desorption combined with gas chromatography/mass spectrometry and HPLC/UV analysis, respectively. Ozone was measured in all sites. All the regular cleaning agents emitted terpenes, mainly limonene and linalool. After the replacement of the cleaning agent, substantially lower concentrations of limonene and formaldehyde were observed. Some of the oxidation product concentrations, in particular that of 4-OPA, were also reduced in line with limonene. Maximum 2 h averaged concentrations of formaldehyde, 4-AMCH, 6-MHO, and IPOH would not give rise to acute eye irritation-related symptoms in office workers; similarly, 6-AMCH, DHC and 4-OPA would not result in airflow limitation to the airways.
Source: Norgaard AW, Kofoed-Sorensen V, Mandin C, et al. Environmental Science & Technology, 2014; 48 (22) :13331-9.
Les situations d'exposition professionnelle aux nanomatériaux sont multiples et variées, que ce soit dans les entreprises ou les laboratoires de recherche. Compte tenu des inconnues qui demeurent quant aux effets potentiels des nanomatériaux sur la santé, il convient de prendre des mesures afin de réduire l'exposition des salariés au niveau le plus bas possible. La ventilation et la filtration de l'air des lieux de travail se révèlent être des moyens de prévention efficaces. Cette brochure fait un point sur le comportement aéraulique des nanomatériaux dispersés dans l'air et sur l'efficacité des filtres à fibres vis-à-vis des nanomatériaux. Elle propose également des recommandations en termes de ventilation et de filtration de l'air des lieux de travail.
The Australian Work Health and Safety Strategy 2012-2022 (the Strategy) describes work-related cancer as a priority disorder and understanding current hazardous exposures and the effectiveness of controls as a research priority. The Australian Work Exposures Study (AWES) was a national survey that investigated work-related exposures among Australian workers to 38 agents classified by the International Agency for Research on Cancer (IARC) as known or suspected carcinogens. Some polycyclic aromatic hydrocarbons (PAHs) are classified as a known or suspected human carcinogens by the IARC and the work described in this report uses AWES data to:
• estimate the prevalence of work-related exposure to polycyclic aromatic hydrocarbons during relatively common workplace activities
• identify the main circumstances of those exposures, and
• identify the use of workplace control measures designed to decrease those exposures.
This report describes those exposures that occur when typical work activities are carried out by Australian workers - it does not specifically focus on industries suspected of high exposures to polycyclic aromatic hydrocarbons.
Source : http://www.safeworkaustralia.gov.au/sites/swa/about/publications/pages/awes-pahs
Background: Greenhouse workers are exposed to dust, endotoxin, fungi, and bacteria potentially causing airway inflammation as well as systemic symptoms. Knowledge about determinants of exposure is a prerequisite for efficient prevention through knowledge-based reduction in exposure. The objective of this study was to assess the occupational exposure in a flower greenhouse and to investigate the impact of work tasks on the intensity and variability in exposure.
Methods: Seventy-six personal full-shift exposure measurements were performed on 38 employees in a Danish flower greenhouse producing Campanula, Lavandula, Rhipsalideae, and Helleborus. The samples were gravimetrically analysed for inhalable dust. Endotoxin was assessed by the Limulus Amoebocyte Lysate test and culture-based quantification of bacteria and fungi was performed. Information on the performed tasks during sampling was extracted from the greenhouse electronic task logging system. Associations between log-transformed exposure outcomes, season, and work tasks were examined in linear mixed-effects regression with worker identity as random effect.
Results: Measured concentrations ranged between 0.04 and 2.41mg m−3 for inhalable dust and between 0.84 and 1097 EU m−3 for endotoxin exposure, with the highest mean levels measured during Lavandula and Campanula handling, respectively. Personal exposure to fungi ranged between 1.8×102 and 3.4×106 colony-forming units (CFU) m−3 and to bacteria between 1.6×101 and 4.2×105 CFU m−3. Exposure to dust, endotoxin, fungi, and bacteria differed between seasons. Packing Lavandula, sticking, potting, and grading Rhipsalideae, and all examined tasks related to Campanula production except sticking increased dust exposure. Endotoxin exposure was increased during sticking Campanula and pinching or packing Rhipsalideae, and fungi exposure was elevated by subtasks performed in the research and development area for Campanula, and by potting, packing/dumping Campanula. Sticking and working with subtasks in the research and development area for Campanula increased bacteria exposure.
Conclusion: This study revealed moderate dust exposure levels compared to the levels observed in other greenhouse productions and other occupations with organic dust exposure such as farming. However, high exposures to bacteria and fungi were detected during selected tasks and the proposed health-based endotoxin exposure limit of 90 EU m−3 was exceeded in 30% of the samples, which may have health implications for the employees. Exposure levels were found to vary depending on the tasks performed, and thereby results can be used to direct task-based initiatives to reduce workplace exposures.
Source: Thilsing T, Madsen AM, Basinas I, et al. Annals of Occupational Hygiene, 2014.
The Australian Work Health and Safety Strategy 2012-2022 (the Strategy) describes work-related cancer as a priority disorder and understanding current hazardous exposures and the effectiveness of controls as a research priority. The Australian Work Exposures Study (AWES) was a national survey that investigated work-related exposures among Australian workers to 38 agents classified by the International Agency for Research on Cancer (IARC) as known or suspected carcinogens. Formaldehyde is classified as a known human carcinogen by the IARC and the work described in this report uses AWES data to:
• estimate the prevalence of work-related exposure to formaldehyde during relatively common workplace activities
• identify the main circumstances of those exposures, and
• identify the use of workplace control measures designed to decrease those exposures.
This report describes those exposures that occur when typical work activities are carried out by Australian workers—it does not specifically focus on industries suspected of high formaldehyde exposure.
Des micro-organismes ou des échantillons contenant des micro-organismes sont manipulés dans les laboratoires de biologie et peuvent contaminer les surfaces (paillasses, équipements, sols...). Cette brochure présente tout d'abord les modes de colonisation des surfaces par les micro-organismes et les voies de contamination des opérateurs. Elle décrit ensuite les techniques et les produits utilisables pour nettoyer et désinfecter les surfaces, ainsi que les mesures de prévention des risques liés à ces pratiques : utilisation de détergents ou de désinfectants, traitement par application manuelle, désinfection des surfaces par voie aérienne (DSVA). Les principes de nettoyage et de désinfection doivent être connus et respectés afin d'effectuer ces opérations de façon efficace, en toute sécurité pour les personnes. En annexe figurent des indications sur la normalisation européenne des désinfectants de surface.
Objective: We report the results of our angiosarcoma of the liver (ASL) registry to assess the occurrence, the impact of exposures to vinyl chloride, and to quantify latency.
Methods: We examined more than 73,000 death certificates of North American workers employed between 1940 and 2008.
Results: We found 13 deaths of ASL among workers with vinyl chloride exposure. All 13 occurred at single plant among workers with high vinyl chloride exposure. The mean latency after first exposure was 36.5 years ranging from 24 to 56 years. No ASL deaths occurred among workers with vinyl chloride exposures after 1974, when exposures were reduced.
Conclusions: We may have seen the last case of ASL among workers exposed to vinyl chloride. Nevertheless, given the long latency of this cancer, continued surveillance seems prudent.
Source: Collins, James J.; Jammer, Brenda; Sladeczek, Frank M.; Bodnar, Catherine M.; Salomon, Sergio S. Journal of Occupational & Environmental Medicine: November 2014, Volume 56, Issue 11, p. 1207-1209.
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