Expositions occupationnelles

Peaks, Means, and Determinants of Real-Time TVOC Exposures Associated with Cleaning and Disinfecting Tasks in Healthcare Settings

Source : Annals of Work Exposures and Health.
Cleaning and disinfecting tasks and product use are associated with elevated prevalence of asthma and respiratory symptoms among healthcare workers; however, the levels of exposure that pose a health risk remain unclear. The objective of this study was to estimate the peak, average, and determinants of real-time total volatile organic compound (TVOC) exposure associated with cleaning tasks and product-use.

The Occupational Burden of Nonmalignant Respiratory Diseases. An Official American Thoracic Society and European Respiratory Society Statement

Source : American Journal of Respiratory and Critical Care Medicine.
Rationale: Workplace inhalational hazards remain common worldwide, even though they are ameliorable. Previous American Thoracic Society documents have assessed the contribution of workplace exposures to asthma and chronic obstructive pulmonary disease on a population level, but not to other chronic respiratory diseases. The goal of this document is to report an in-depth literature review and data synthesis of the occupational contribution to the burden of the major nonmalignant respiratory diseases, including airway diseases; interstitial fibrosis; hypersensitivity pneumonitis; other noninfectious granulomatous lung diseases, including sarcoidosis; and selected respiratory infections.Methods: Relevant literature was identified for each respiratory condition. The occupational population attributable fraction (PAF) was estimated for those conditions for which there were sufficient population-based studies to allow pooled estimates. For the other conditions, the occupational burden of disease was estimated on the basis of attribution in case series, incidence rate ratios, or attributable fraction within an exposed group.Results: Workplace exposures contribute substantially to the burden of multiple chronic respiratory diseases, including asthma (PAF, 16%); chronic obstructive pulmonary disease (PAF, 14%); chronic bronchitis (PAF, 13%); idiopathic pulmonary fibrosis (PAF, 26%); hypersensitivity pneumonitis (occupational burden, 19%); other granulomatous diseases, including sarcoidosis (occupational burden, 30%); pulmonary alveolar proteinosis (occupational burden, 29%); tuberculosis (occupational burden, 2.3% in silica-exposed workers and 1% in healthcare workers); and community-acquired pneumonia in working-age adults (PAF, 10%).Conclusions: Workplace exposures contribute to the burden of disease across a range of nonmalignant lung conditions in adults (in addition to the 100% burden for the classic occupational pneumoconioses). This burden has important clinical, research, and policy implications. There is a pressing need to improve clinical recognition and public health awareness of the contribution of occupational factors across a range of nonmalignant respiratory diseases.

Over-exposed : standard occupational exposure limits must be reduced for workers on extended work schedules

Source : Canadian Occupational Safety.
In Canada, about 30 per cent of all employees now work non-standard schedules. Increasingly, they require people to work longer days. The move to extended shifts raises the possib ility of increased exposure to chemical hazards over a longer day. By understanding how to use the different adjustment models available, safety professionals can keep the chemical exposure of workers within reasonably safe levels.

Occupational and work-related respiratory disease attributed to cleaning products

Source : Occupational and Environmental Medicine.
Objectives Exposure to cleaning products has been associated with adverse respiratory outcomes. This study aimed to investigate the medically reported incidence, trends in incidence and occupational determinants of work-related respiratory disorders attributed to cleaning agents and to explore the role of ‘Quantitative Structure Activity Relationships’ (QSAR) in corroborating the identification of chemical respiratory sensitisers. Methods Respiratory diagnoses attributed to cleaning agents were extracted from The Health and Occupation Research (THOR) surveillance network, 1989–2017. Incidence, trends in incidence and incidence rate ratios by occupation were investigated. Agents were classified by chemical type and QSAR hazard indices were determined for specific organic chemicals. Results Approximately 6% (779 cases) of the (non-asbestos) THOR respiratory cases were attributed to cleaning agents. Diagnoses were predominantly asthma (58%) and inhalation accidents (27%) with frequently reported chemical categories being aldehydes (30%) and chlorine/its releasers (26%). No significant trend in asthma incidence (1999–2017) was observed (annual average change of −1.1% (95% CI −4.4 to 2.4)). This contrasted with a statistically significant annual decline in asthma incidence (−6.8% (95% CI −8.0 to −5.6)) for non-cleaning agents. There was a large variation in risk between occupations. 7 of the 15 organic chemicals specifically identified had a QSAR generated hazard index consistent with being a respiratory sensitiser. Conclusion Specific occupations appear to be at increased risk of adverse respiratory outcomes attributed to cleaning agents. While exposure to agents such as glutaraldehyde have been addressed, other exposures, such as to chlorine, remain important. Chemical features of the cleaning agents helped distinguish between sensitising and irritant agents.

Current state of knowledge on the health effects of engineered nanomaterials in workers: a systematic review of human studies and epidemiological investigations

Source : Scandinavian Journal of Work, Environment & Health.
L’application généralisée des produits nanotechnologiques et la probabilité croissante d’exposition en milieu de travail font de la compréhension des effets de ces matériaux chez les travailleurs exposés une priorité de santé publique et professionnelle. Cette revue systématique vise à faire le point sur l’état actuel des connaissances sur les effets nocifs possibles induits par les ENM chez les humains afin de déterminer le profil toxicologique de chaque type d’ENM et les biomarqueurs potentiels pour la détection précoce de ces effets chez les travailleurs.

Risk factors of hospitalization for carpal tunnel syndrome among the general working population

Source : Scandinavian Journal of Work, Environment & Health.
Le syndrome du canal carpien (STC) entraîne un nombre considérable de congés de maladie et de frais médicaux. L’étiologie du STC est multifactorielle, impliquant à la fois des facteurs de risque personnels et professionnels. Jusqu’à présent, peu d’études de cohortes prospectives sur les facteurs de risque professionnels du STC ont examiné la population active en général.

Efficiency of degradation or desorption methods in antineoplastic drug decontamination: A critical review

Source : Journal of Oncology Pharmacy Practice.
L’exposition professionnelle aux médicaments antinéoplasiques reste une préoccupation quotidienne, car l’élimination de cette contamination des lieux de travail semble impossible. Bien que plusieurs méthodes de dégradation ou de désorption aient déjà été expérimentées, avec un succès variable, elles n’ont jamais été comparées ni discutées en termes d’efficacité ou de facilité d’utilisation. Cette revue a pour objectif d’analyser et de discuter les résultats de chaque procédure et de les comparer. Cela devrait faciliter la sélection de la méthode à appliquer dans la pratique quotidienne.

Mutagenicity assessment of environmental contaminations in a hospital centralized reconstitution unit

Source : Ecotoxicology and Environmental Safety.
L’exposition aux médicaments cytotoxiques du personnel hospitalier préparant une chimiothérapie par voie intraveineuse est un problème majeur et les risques mutagènes associés devraient être davantage explorés. Le but de cette étude était d’évaluer la mutagénicité de plusieurs mélanges cytotoxiques préparés à des concentrations fixes, ainsi que la mutagénicité d’échantillons environnementaux prélevés dans une unité de reconstitution centralisée hospitalière. Parallèlement, l’exposition cytotoxique dans des échantillons environnementaux a été quantifiée.