Évaluation de l'exposition professionnelle à l'éthanol contenu dans les solutions hydroalcooliques utilisées dans la lutte contre les infections nosocomiales

Previous studies have shown that the use of Acohol-Based Hand Rubs (ABHRs) has been associated with reduced rates of nosocomial infections. However, the quality of hand rubbing with ABHRs has rarely been evaluated. The first aim of this work is to evaluate the quality of hand rubbing and skin tolerance to ABHRs in the long term. The consequences of systemic passage of alcohol by inhalation or dermal absorption during intensive use of these products in hospitals remain a subject of debate. The second aim of our work is to assess the exposure of Healthcare Workers (HCWs) to ABHRs, under experimental conditions in the laboratory and under a real situation of work shift in hospital. Our study demonstrated a decrease in the quality of hand rubbing. The use of these products increases skin hydration. ABHRs are well tolerated by HCWs and do not dry the skin.The measurements made in the laboratory showed that exposure to ethanol during ABHRs handling is of short duration but at high concentrations. The quantification of ethanol in ambient air of a patient room for eight hours of ABHRS intensive use showed that the patient and HCW are exposed to the same amount of ethanol vapours. However this amount remains far inferior to the French guidelines for professional exposure limits to ethanol over 8 hours. The hospital study showed that exposure of HCWs to ABHR at short term does not lead to detectable absorption of ethanol and its metabolites. Quantification of ethanol vapour in the inhaled air remains well below the levels known to be toxic in humans. The whole project takes place over 10 years; it will verify the potential side effects associated with the ABHRs use for a long-termDe nombreux travaux ont démontré que l'utilisation des SHA réduit le taux d'infections nosocomiales. Cependant, la qualité de friction avec SHA a été rarement évaluée. Un des objectifs de ce travail est d'évaluer la qualité de friction et la tolérance cutanée aux SHA sur le long terme. Lors d'une utilisation intensive en milieu hospitalier, les conséquences du passage systémique de l'éthanol par pénétration cutanée ou par inhalation restent encore un sujet de débat. Le second objectif est d'évaluer l'exposition aux SHA, dans des conditions expérimentales, et dans les conditions réelles de travail en milieu hospitalier. Ce travail a démontré une baisse de la qualité de friction à trois ans de la formation. L'utilisation des SHA augmente l'hydratation de la peau. Les SHA sont tolérées par les soignants. Les mesures réalisées en laboratoire, ont montré que l'exposition a l'éthanol des SHA est de brève durée mais à des concentrations importantes. La quantification d'éthanol dans l'air ambiant d'une chambre de patient, durant 8 heures d'utilisation intensive de SHA, a montré que le patient et le soignant sont exposés à la même quantité de vapeurs d'éthanol, cependant cette quantité est inférieure à la valeur limite d'exposition professionnelle française. L'étude réalisée au CHU, a montré que l'exposition des soignants aux SHA à court terme, ne conduit pas à une absorption décelable de l'éthanol et de ses métabolites. La concentration d'éthanol dans l'air inhalé, reste inférieure aux valeurs limites réglementaires françaises. L'ensemble de ce projet se déroule sur 10 ans, il permettra de vérifier les possibles effets secondaires liés à l'utilisation des SHA sur le long term

Assessment of professional exposure to ethanol content in alcohol-based hand-rubs used in the prevention of nosocomial infections

De nombreux travaux ont démontré que l'utilisation des SHA réduit le taux d'infections nosocomiales. Cependant, la qualité de friction avec SHA a été rarement évaluée. Un des objectifs de ce travail est d'évaluer la qualité de friction et la tolérance cutanée aux SHA sur le long terme. Lors d'une utilisation intensive en milieu hospitalier, les conséquences du passage systémique de l'éthanol par pénétration cutanée ou par inhalation restent encore un sujet de débat. Le second objectif est d'évaluer l'exposition aux SHA, dans des conditions expérimentales, et dans les conditions réelles de travail en milieu hospitalier. Ce travail a démontré une baisse de la qualité de friction à trois ans de la formation. L'utilisation des SHA augmente l'hydratation de la peau. Les SHA sont tolérées par les soignants. Les mesures réalisées en laboratoire, ont montré que l'exposition a l'éthanol des SHA est de brève durée mais à des concentrations importantes. La quantification d'éthanol dans l'air ambiant d'une chambre de patient, durant 8 heures d'utilisation intensive de SHA, a montré que le patient et le soignant sont exposés à la même quantité de vapeurs d'éthanol, cependant cette quantité est inférieure à la valeur limite d'exposition professionnelle française. L'étude réalisée au CHU, a montré que l'exposition des soignants aux SHA à court terme, ne conduit pas à une absorption décelable de l'éthanol et de ses métabolites. La concentration d'éthanol dans l'air inhalé, reste inférieure aux valeurs limites réglementaires françaises. L'ensemble de ce projet se déroule sur 10 ans, il permettra de vérifier les possibles effets secondaires liés à l'utilisation des SHA sur le long termePrevious studies have shown that the use of Acohol-Based Hand Rubs (ABHRs) has been associated with reduced rates of nosocomial infections. However, the quality of hand rubbing with ABHRs has rarely been evaluated. The first aim of this work is to evaluate the quality of hand rubbing and skin tolerance to ABHRs in the long term. The consequences of systemic passage of alcohol by inhalation or dermal absorption during intensive use of these products in hospitals remain a subject of debate. The second aim of our work is to assess the exposure of Healthcare Workers (HCWs) to ABHRs, under experimental conditions in the laboratory and under a real situation of work shift in hospital. Our study demonstrated a decrease in the quality of hand rubbing. The use of these products increases skin hydration. ABHRs are well tolerated by HCWs and do not dry the skin.The measurements made in the laboratory showed that exposure to ethanol during ABHRs handling is of short duration but at high concentrations. The quantification of ethanol in ambient air of a patient room for eight hours of ABHRS intensive use showed that the patient and HCW are exposed to the same amount of ethanol vapours. However this amount remains far inferior to the French guidelines for professional exposure limits to ethanol over 8 hours. The hospital study showed that exposure of HCWs to ABHR at short term does not lead to detectable absorption of ethanol and its metabolites. Quantification of ethanol vapour in the inhaled air remains well below the levels known to be toxic in humans. The whole project takes place over 10 years; it will verify the potential side effects associated with the ABHRs use for a long-ter

Évaluation de l'exposition professionnelle à l'éthanol contenu dans les solutions hydroalcooliques utilisées dans la lutte contre les infections nosocomiales

De nombreux travaux ont démontré que l'utilisation des SHA réduit le taux d'infections nosocomiales. Cependant, la qualité de friction avec SHA a été rarement évaluée. Un des objectifs de ce travail est d'évaluer la qualité de friction et la tolérance cutanée aux SHA sur le long terme. Lors d'une utilisation intensive en milieu hospitalier, les conséquences du passage systémique de l'éthanol par pénétration cutanée ou par inhalation restent encore un sujet de débat. Le second objectif est d'évaluer l'exposition aux SHA, dans des conditions expérimentales, et dans les conditions réelles de travail en milieu hospitalier. Ce travail a démontré une baisse de la qualité de friction à trois ans de la formation. L'utilisation des SHA augmente l'hydratation de la peau. Les SHA sont tolérées par les soignants. Les mesures réalisées en laboratoire, ont montré que l'exposition a l'éthanol des SHA est de brève durée mais à des concentrations importantes. La quantification d'éthanol dans l'air ambiant d'une chambre de patient, durant 8 heures d'utilisation intensive de SHA, a montré que le patient et le soignant sont exposés à la même quantité de vapeurs d'éthanol, cependant cette quantité est inférieure à la valeur limite d'exposition professionnelle française. L'étude réalisée au CHU, a montré que l'exposition des soignants aux SHA à court terme, ne conduit pas à une absorption décelable de l'éthanol et de ses métabolites. La concentration d'éthanol dans l'air inhalé, reste inférieure aux valeurs limites réglementaires françaises. L'ensemble de ce projet se déroule sur 10 ans, il permettra de vérifier les possibles effets secondaires liés à l'utilisation des SHA sur le long termePrevious studies have shown that the use of Acohol-Based Hand Rubs (ABHRs) has been associated with reduced rates of nosocomial infections. However, the quality of hand rubbing with ABHRs has rarely been evaluated. The first aim of this work is to evaluate the quality of hand rubbing and skin tolerance to ABHRs in the long term. The consequences of systemic passage of alcohol by inhalation or dermal absorption during intensive use of these products in hospitals remain a subject of debate. The second aim of our work is to assess the exposure of Healthcare Workers (HCWs) to ABHRs, under experimental conditions in the laboratory and under a real situation of work shift in hospital. Our study demonstrated a decrease in the quality of hand rubbing. The use of these products increases skin hydration. ABHRs are well tolerated by HCWs and do not dry the skin.The measurements made in the laboratory showed that exposure to ethanol during ABHRs handling is of short duration but at high concentrations. The quantification of ethanol in ambient air of a patient room for eight hours of ABHRS intensive use showed that the patient and HCW are exposed to the same amount of ethanol vapours. However this amount remains far inferior to the French guidelines for professional exposure limits to ethanol over 8 hours. The hospital study showed that exposure of HCWs to ABHR at short term does not lead to detectable absorption of ethanol and its metabolites. Quantification of ethanol vapour in the inhaled air remains well below the levels known to be toxic in humans. The whole project takes place over 10 years; it will verify the potential side effects associated with the ABHRs use for a long-termMETZ-SCD (574632105) / SudocNANCY1-Bib. numérique (543959902) / SudocNANCY2-Bibliotheque electronique (543959901) / SudocNANCY-INPL-Bib. électronique (545479901) / SudocSudocFranceF

Emergence of hand contamination with Aspergillus during demolition work

Hand rubbing with hydro-alcoholic solutions prevent the exogenous nosocomial infection, but the hydro-alcoholic solutions were not sporicidal. A major program of demolition was organized on the area of the University Hospital of Nancy (France) between 2007 and 2010, and this period is often considered as a possible source of suspending Aspergillus spores. This study shows the emergence of Aspergillus on the hands of the medical students during demolition period despite the same quality of hand hygiene

Assessment of exposure to ethanol vapors released during use of Alcohol-Based Hand Rubs by healthcare workers

Summary: Background: Despite the increasing use of Alcohol-Based Hand Rub solutions, few studies have quantified the concentrations of inhaled ethanol. Objective: The aim of this study was to assess ethanol exposure during hygienic and surgical hand disinfection practices. Method: Ethanol concentrations were measured at the nose level of a wooden dummy and human volunteers. Two systems were used in parallel to determine short-term ethanol vapor exposures: activated charcoal tubes followed by gas chromatography analysis and direct reading on a photoionization detector (PID).Exposure was assessed for 4 different sequences (N = 10) reproducing hand rubs for simple surgery, nursing care, intensive care and surgical scrub. Results: The ethanol concentrations measured were of a similar order between the dummy and volunteers. The concentrations obtained by PID were higher than the gas chromatography values for the simple care (45%) and nursing care (27%) sequences and reflected specific exposure peaks of ethanol, whereas ethanol concentrations were continuously high for intensive care (440 mg m−3) or surgical scrub (650 mg m−3). Conclusion: Ethanol concentrations were similar for these two exposure assessment methods and demonstrated a relationship between handled doses and inhaled doses. However, the ethanol vapors released during hand disinfection were safe for the healthcare workers. Keywords: Ethanol, Alcohol-Based Hand Rub, Air exposure, Gas Chromatography, Photoionization detecto

Cancer-related cognitive impairment in non-CNS cancer patients: Targeted review and future action plans in Europe

Cancer-related cognitive impairment (CRCI) has increasingly been identified over the last two decades in non-CNS system cancer patients. Across Europe, researchers have contributed to this effort by developing preclinical models, exploring underlying mechanisms and assessing cognitive and quality of life changes. The ultimate goal is to develop interventions to treat patients experiencing CRCI. To do so, new challenges need to be addressed requiring the implementation of multidisciplinary research groups. In this consensus paper, we summarize the state of the art in the field of CRCI combined with the future challenges and action plans in Europe. These challenges include data sharing/pooling, standardization of assessments as well as assessing additional biomarkers and neuroimaging investigations, notably through translational studies. We conclude this position paper with specific actions for Europe based on shared scientific expert opinion and stakeholders involved in the Innovative Partnership for Action Against Cancer, with a particular focus on cognitive intervention programs

Cancer-related cognitive impairment in non-CNS cancer patients: Targeted review and future action plans in Europe

International audienceCancer-related cognitive impairment (CRCI) has increasingly been identified over the last two decades in non-CNS system cancer patients. Across Europe, researchers have contributed to this effort by developing preclinical models, exploring underlying mechanisms and assessing cognitive and quality of life changes. The ultimate goal is to develop interventions to treat patients experiencing CRCI. To do so, new challenges need to be addressed requiring the implementation of multidisciplinary research groups. In this consensus paper, we summarize the state of the art in the field of CRCI combined with the future challenges and action plans in Europe. These challenges include data sharing/pooling, standardization of assessments as well as assessing additional biomarkers and neuroimaging investigations, notably through translational studies. We conclude this position paper with specific actions for Europe based on shared scientific expert opinion and stakeholders involved in the Innovative Partnership for Action Against Cancer, with a particular focus on cognitive intervention programs

“Chronic fatigue, quality of life and long-term side-effects of chemotherapy in patients treated for non-epithelial ovarian cancer: national case-control protocol study of the GINECO-Vivrovaire rare tumors INCa French network for rare malignant ovarian tumors”

Abstract Background Germ cell tumors and sex cord stromal tumors are rare cancers of the ovary. They mainly affect young women and are associated with a high survival rate. The standard treatment mainly involves conservative surgery combined with chemotherapy [bleomycin, etoposide and cisplatin (BEP)] depending on the stage and the prognostic factors, as for testicular cancers. As reported in testicular cancer survivors, chemotherapy may induce sequelae impacting quality of life, which has not yet been evaluated in survivors of germ cell tumors and sex cord stromal tumors. The GINECO-VIVROVAIRE-Rare tumor study is a two-step investigation aiming to assess i) chronic fatigue and quality of life and ii) long-term side-effects of chemotherapy with a focus on cardiovascular and pulmonary disorders. Methods Using self-reported questionnaires, chronic fatigue and quality of life are compared between 134 ovarian cancer survivors (cancer-free ≥2 years after treatment) treated with surgery and chemotherapy and 2 control groups (67 ovarian cancer survivors treated with surgery alone and 67 age-matched healthy women). Medical data are collected from patient records. In the second step evaluating the long-term side-effects of chemotherapy, a subgroup of 90 patients treated with chemotherapy and 45 controls undergo the following work-up: cardiovascular evaluation (clinical examination, non-invasive cardiovascular tests to explore heart disease, blood tests), pulmonary function testing, audiogram, metabolic and hormonal blood tests. Costs of sequelae will be also assessed. Patients are selected from the registry of the INCa French Network for Rare Malignant Ovarian Tumors, and healthy women by the ‘Seintinelles’ connected network (collaborative research platform). Discussion This study will provide important data on the potential long-term physical side-effects of chemotherapy in survivors of Germ Cell Tumors (GCT) and Sex Cord Stromal Tumors (SCST), especially cardiovascular and pulmonary disorders, and neurotoxicity. The identification of long-term side-effects can contribute to adjusting the treatment of ovarian GCT or SCST patients and to managing follow-up with adapted recommendations regarding practices and chemotherapy regimens, in order to reduce toxicity while maintaining efficacy. Based on the results, intervention strategies could be proposed to improve the management of these patients during their treatment and in the long term. Trial registration This trial was registered at clinicaltrials.gov : 03418844 , on 1 February 2018. This trial was registered on 25 October 2017 under the unique European identification number (ID-RCB): 2017-A03028–45. Recruitment Status: Recruiting. Protocol version Version n° 4.2 dated from Feb 19, 2021. Trial sponsor Centre François Baclesse, 3 avenue du Général Harris, F-14076 Caen cedex 05, France