3 research outputs found
Ăvaluation des risques pour la santĂ© humaine et lâenvironnement et recommandations pour leurmaĂźtrise, dans le cadre de lâadministration des mĂ©dicaments vĂ©tĂ©rinaires antiparasitaires externes sous forme de bains, douches et pulvĂ©risations en Ă©levages de ruminants
Citation suggĂ©rĂ©e : Anses. (2022). Evaluation des risques pour la santĂ© humaine et lâenvironnement et recommandations pour leur maĂźtrise, dans le cadre de lâadministration des mĂ©dicaments vĂ©tĂ©rinaires antiparasitaires externes sous forme de bains, douches et pulvĂ©risations en Ă©levages ruminants. (Saisine n° 2018-SA-0269). Maisons-Alfort : Anses, 282 p.LâĂ©mergence ou la rĂ©Ă©mergence de maladies vectorielles dont les agents pathogĂšnes sonttransmis par des insectes ou des tiques, lâaugmentation de la prĂ©valence de la galepsoroptique chez les ruminants, conduisent les vĂ©tĂ©rinaires Ă prescrire entre autres destraitements antiparasitaires externes (APE) sous forme de bains, douches, pulvĂ©risations(BDP). Ces antiparasitaires sont des organophosphorĂ©s (OP), des pyrĂ©thrinoĂŻdes ou encoreun inhibiteur de la croissance larvaire.Ces traitements occasionnent une exposition des travailleurs aux Ă©mulsions antiparasitairesavec des risques potentiels pour lâutilisateur (pulvĂ©risations et inhalation, bains/douches etĂ©claboussuresâŠ) et pour lâenvironnement (ruissellements des Ă©mulsions lors de pulvĂ©risation,douche, Ă©pandage des reliquats de baignoireâŠ). De plus, des dĂ©fauts dâefficacitĂ© observĂ©svis-Ă -vis de certaines myiases (Wohlfahrtia magnifica) conduisent Ă des pratiques Ă©loignĂ©esdes recommandations de prescription (surconcentrations, mĂ©langes de diffĂ©rentes molĂ©cules,applications localesâŠ).Les recommandations peuprĂ©cises des rĂ©sumĂ©s des caractĂ©ristiques du produit (RCP)induisent un questionnement de la part des utilisateurs en termes de prĂ©vention de la santĂ©des professionnels, dâimpact environnemental notamment liĂ© Ă lâĂ©limination des effluents desĂ©levages. Il en dĂ©coule une nĂ©cessitĂ© de prĂ©ciser davantage les pratiques dâutilisation de cesmĂ©dicaments vĂ©tĂ©rinaires
High Risk of Anal and Rectal Cancer in Patients With Anal and/or Perianal Crohnâs Disease
International audienceBackground & AimsLittle is known about the magnitude of the risk of anal and rectal cancer in patients with anal and/or perineal Crohnâs disease. We aimed to assess the risk of anal and rectal cancer in patients with Crohnâs perianal disease followed up in the Cancers Et Surrisque AssociĂ© aux Maladies Inflammatoires Intestinales En France (CESAME) cohort.MethodsWe collected data from 19,486 patients with inflammatory bowel disease (IBD) enrolled in the observational CESAME study in France, from May 2004 through June 2005; 14.9% of participants had past or current anal and/or perianal Crohnâs disease. Subjects were followed up for a median time of 35 months (interquartile range, 29â40 mo). To identify risk factors for anal cancer in the total CESAME population, we performed a case-control study in which participants were matched for age and sex.ResultsAmong the total IBD population, 8 patients developed anal cancer and 14 patients developed rectal cancer. In the subgroup of 2911 patients with past or current anal and/or perianal Crohnâs lesions at cohort entry, 2 developed anal squamous-cell carcinoma, 3 developed perianal fistulaârelated adenocarcinoma, and 6 developed rectal cancer. The corresponding incidence rates were 0.26 per 1000 patient-years for anal squamous-cell carcinoma, 0.38 per 1000 patient-years for perianal fistulaârelated adenocarcinoma, and 0.77 per 1000 patient-years for rectal cancer. Among the 16,575 patients with ulcerative colitis or Crohnâs disease without anal or perianal lesions, the incidence rate of anal cancer was 0.08 per 1000 patient-years and of rectal cancer was 0.21 per 1000 patient-years. Among factors tested by univariate conditional regression (IBD subtype, disease duration, exposure to immune-suppressive therapy, presence of past or current anal and/or perianal lesions), the presence of past or current anal and/or perianal lesions at cohort entry was the only factor significantly associated with development of anal cancer (odds ratio, 11.2; 95% CI, 1.18-551.51; P = .03).ConclusionsIn an analysis of data from the CESAME cohort in France, patients with anal and/or perianal Crohnâs disease have a high risk of anal cancer, including perianal fistulaârelated cancer, and a high risk of rectal cancer