Potential health risk of endocrine disruptors in construction sector and plastics industry: a new paradigm in occupational health

Endocrine disruptors (EDs) belong to large and diverse groups of agents that may cause multiple biological effects associated with, for example, hormone imbalance and infertility, chronic diseases such as diabetes, genome damage and cancer. The health risks related with the exposure to EDs are typically underestimated, less well characterized, and not regulated to the same extent as, for example, carcinogens. The increased production and utilization of identified or suspected EDs in many different technological processes raises new challenges with respect to occupational exposure settings and associated health risks. Due to the specific profile of health risk, occupational exposure to EDs demands a new paradigm in health risk assessment, redefinition of exposure assessment, new effects biomarkers for occupational health surveillance and definition of limit values. The construction and plastics industries are among the strongest economic sectors, employing millions of workers globally. They also use large quantities of chemicals that are known or suspected EDs. Focusing on these two industries, this short communication discusses: (a) why occupational exposure to EDs needs a more specific approach to occupational health risk assessments, (b) identifies the current knowledge gaps, and (c) identifies and gives a rationale for a future occupational health paradigm, which will include ED biomarkers as a relevant parameter in occupational health risk assessment, surveillance and exposure preventioninfo:eu-repo/semantics/publishedVersio

Expositions professionnelles aux solvants oxygénés, pétroliers et chlorés des femmes en âge de procréer en France en 2013. Résultats du programme Matgéné

This study concerns occupational exposure to oxygenated, petroleum-based and chlorinated solvents in a vulnerable working population: the women of childbearing age (WCA), aged 15 to 44. This exposure is presented by age, occupation and worker status (employed or self-employed). The exposures are assessed by job-exposure matrices from the Matgéné programme. The population data, extracted from the 2013 French census, were linked to matrices in order to estimate the occupational exposure prevalences and the proportion of WCA exposed to solvents. The most frequently used solvents in occupational environment in 2013 by WCA are oxygenated solvents (15.0% of WCA workforce), then petroleum-based solvents (1.0%), and chlorinated solvents (0.1%). Younger women of childbearing age (15-29 years) are more exposed to oxygenated solvents than their elders. Conversely, the oldest WCA (35-44 years) are more exposed to petroleum-based and chlorinated solvents. Self-employed women are more exposed to the three categories of solvents than women employees. This study is the first to present occupational exposure to three major families of solvents for all women of childbearing age workforce in France regardless of their worker status or occupation. A more precise analysis of these results, especially by industry, would provide guidance for preventive measures for women of childbearing age at work.Cette étude s'intéresse à l'exposition professionnelle aux solvants oxygénés, pétroliers et chlorés dans une population vulnérable de travailleurs, les femmes en âge de procréer définies par la classe d'âge 15-44 ans. Cette exposition est déclinée selon l'âge, la catégorie socioprofessionnelle et le statut des travailleuses (salariées ou non-salariées). Les expositions ont été évaluées par les matrices emplois-expositions du programme Matgéné. Les données de population issues du recensement de 2013 ont été croisées avec les matrices pour estimer les prévalences d'exposition ainsi que la part des femmes exposées à ces solvants. Les solvants les plus fréquemment utilisés en milieu professionnel en 2013 par les femmes en âge de procréer sont les solvants oxygénés (15,0% de ces travailleuses), devant les solvants pétroliers (1,0%) et les solvants chlorés (0,1%). Les plus jeunes (15-29 ans) sont plus exposées que leurs aînées aux solvants oxygénés. À l'inverse, les plus âgées (35-44 ans) sont plus exposées aux solvants pétroliers et chlorés. Les non-salariées sont plus exposées aux trois familles de solvants que les salariées. Cette étude est la première à présenter l'exposition professionnelle à trois grandes familles de solvants pour l'ensemble des travailleuses en âge de procréer en France, quels que soient leur statut et leur activité professionnelle. Une analyse plus fine de ces prévalences, notamment par secteur d'activité, permettrait d'orienter et cibler au mieux les actions de prévention à mettre en place pour les femmes en âge de procréer en activité professionnelle

The ED/TEG Indicator for the Identification of Endocrine Disrupting or Toxic Effects on Endocrine Glands of Crop Protection Products Used in Organic and Conventional Agriculture in France

Studying the human health impacts of pesticides and their endocrine disruptor (ED) effects is a public health concern. The aim of this study is to identify phytopharmaceutical active substances (PAS) that are an ED or are toxic on endocrine glands (TEG), and to propose an ED/TEG effect indicator. Five international official databases were analyzed to identify the occurrence of health outcomes for 458 PAS. Health outcomes targeting seven endocrine systems were selected. For each substance, the level of evidence of the collected information and the number of outcomes were used to affect a level of concern about ED/TEG effects. Among the substances studied, 10% had a global ED/TEG effect classified as ‘high concern’, 55% as ‘medium concern’, 9% as ‘low concern’, and 26% as ‘unknown’. Ten of the high ED/TEG concern substances and 170 medium or low concern substances were licensed in 2018 in France. The outcomes were mainly on the reproductive organs, thyroid, and adrenal glands. Eight of the 41 biocontrol products studied were classified: 5 were ‘high’ or ‘medium concern’ and 3 had ‘unknown effect’. Although the proposed ED/TEG indicator is not an official classification, it can be used as an epidemiological tool for classifying the occupational and environmental risks of substances in retrospective population studies and be useful for occupational health physicians

A cohort study of banana plantation workers in the French West Indies: first mortality analysis (2000-2015)

International audienceChlordecone, an organochlorine insecticide, was widely used in the French West Indies banana plantations. We set up a cohort of banana plantation workers who worked between 1973 and 1993, the period of authorized use of chlordecone. Vital status and causes of death were collected from French national registries. Workers were followed up from 1 January 2000 to 31 December 2015. Cause-specific mortality in the cohort was compared to that of the general population of the French West Indies by computing standardized mortality ratios (SMRs). A total of 11,112 workers (149,526 person-years, 77% men) were included in the mortality analysis, and 3647 deaths occurred over the study period. There was a slight deficit in all-cause mortality, which was statistically significant in men (SMR = 0.93, 95% CI 0.89-0.96), but not in women (SMR = 0.96, 95% CI 0.89-1.04). All-cancer mortality did not differ significantly from that of the general population (men SMR = 0.96, 95% CI 0.90-1.03; women SMR = 1.04, 95% CI 0.89-1.21). Significant excesses of deaths were observed for stomach cancer in women (SMR = 1.94, 95% CI 1.24-2.89) and pancreatic cancer in women farm owners (SMR = 2.31, 95% CI 1.06-4.39). Mortality from prostate cancer was similar to that of the general population in the whole cohort (SMR = 1.00; 95% CI 0.89-1.13) and non-significantly elevated among farm workers (SMR = 1.10, 95% CI 0.87-1.36). Non-significant increases in mortality were also observed for lung cancer in women, leukemia in men, and non-Hodgkin lymphoma in both genders

An innovative method to estimate lifetime prevalence of carcinogenic occupational circumstances: the example of painters and workers of the rubber manufacturing industry in France

International audienceBACKGROUND - Existing methods to estimate lifetime exposure to occupational carcinogenic agents could be improved. OBJECTIVE - We propose a new method to estimate the lifetime prevalence of exposure to occupational carcinogens using the example of painters and workers of the rubber industry in France. METHODS - From census, we calculated the proportion of painters and rubber industry workers using predefined occupational codes related to each occupation by sex and 10-year age group in 1982, 1990, 1999, 2007, and 2013. Using a beta-regression model, we obtained the yearly prevalence of exposure by 10-year age group over the period 1967–2007. We estimated the age- and sex-specific lifetime prevalence of exposure of the population in 2017 over 1967–2007, summing up the estimated prevalence of exposure for years 1967, 1977, 1987, 1997, and 2007 combined with a sex- and age-specific turnover factor. Corresponding population-attributable fractions were estimated for lung and bladder cancers in 2017. RESULTS - In 2017, we estimated that 5.6 and 0.2% of men in France had ever worked as a painter or in the rubber industry, respectively, during their working time. The lifetime prevalence of ever having worked as a painter or in the rubber industry was much lower in women: 1.8% and 0.1%, respectively. We estimated that 950 lung cancer and 40 bladder cancer cases were attributable to these occupations in 2017. SIGNIFICANCE - Based on accurate data and taking into account evolution of specific jobs over time, the proposed method provides good estimates of lifetime prevalence of exposure to occupational carcinogens. It could be applied in any other country with similar data

Estimation de parts de cancers attribuables à certaines expositions professionnelles en France - Utilisation des matrices emplois-expositions développées dans le cadre du programme Matgéné

34e Congrès National de Médecine et Santé au Travail, PARIS, FRANCE, 21-/06/2016 - 24/06/2016Le poids des pathologies d'origine professionnelle, pour la plupart non-spécifiques, est important en France et pourtant, on ne dispose que de peu de travaux français récents permettant de l'objectiver quantitativement. C'est dans ce contexte que des outils spécifiques à la situation française ont été développés, au travers du programme Matgéné, afin d'évaluer les expositions professionnelles aux cancérogènes et l'impact de ces dernières sur la santé de la population. Objectifs La présente étude illustre l'utilisation de ces outils pour quantifier, selon deux scénarii, la part de certains cancers attribuable à une exposition professionnelle à quatre cancérogènes classés groupe 1 par le Circ : l'amiante, la silice, le benzène et le trichloréthylène. Ce travail donne également une estimation du taux de réparation en maladie professionnelle. Méthodes La part attribuable a été calculée à partir de la formule de Levin. Les risques relatifs sont issus de la littérature scientifique nationale et internationale et la prévalence de l'exposition sur l'ensemble de la vie professionnelle est estimée à partir du croisement des matrices emplois-expositions et d'un échantillon d'histoires professionnelles représentatif de la population française. Le nombre de cas attribuable a été calculé pour chacune des pathologies et comparé au nombre de cas de reconnaissance en maladie professionnelle lorsque cela était possible. Résultats Les résultats obtenus pour chacune des 4 nuisances seront présentés. Pour exemple, au total, le nombre de cas (mésothéliome pleural, cancer du poumon, larynx et ovaire) attribuable à une exposition professionnelle à l'amiante est estimé, en 2012, entre 2439 et 6184 chez les hommes et entre 250 et 437 chez les femmes; ainsi, 7,7 % à 19,4 % des cas de ces cancers seraient attribuables à une exposition professionnelle à l'amiante chez les hommes et 1,5 % à 2,6 % chez les femmes. Par ailleurs, on note une sous-réparation : - notable pour les pathologies pour lesquelles un tableau de maladie professionnelle existe (i.e. cancer du poumon en lien avec une exposition à la silice) ; - totale pour les pathologies pour lesquelles il n'existe pas de tableau à ce jour, et ce, alors même que le lien avec une exposition professionnelle est avéré (i.e. cancer du larynx et exposition à l'amiante). Conclusion Nonobstant les limites méthodologiques inhérentes à cet exercice, ces estimations sont importantes pour améliorer les connaissances en santé travail et en santé publique. Elles confirment le poids considérable des expositions professionnelles dans la survenue de certains cancers dans la population française et par là même l'importance de la sous-réparation des pathologies qui leur sont attribuables

Valeurs limites d'exposition professionnelles (VLEP),valeurs toxicologiques de référence (VTR) :objectifs et méthodes

International audienceFrench toxicological reference values (VTR) and French occupational exposure limit values (VLEP) are indicators that are widely used in risk assessment for, respectively, human and occupational health. Neither value can replace the other. However, the information obtained for one can be very useful for the other. We propose to clarify the fundamental differences and similarities between these two values. To achieve this, we review first their history and then the methods used to derive them; we conclude by proposing some improvements to harmonize them. A case study of formaldehyde illustrates our analysis.Les valeurs limites d'exposition professionnelle et les valeurs toxicologiques de référence sont des indicateurs très utilisés dans les évaluations du risque sanitaire et professionnel, respectivement. Si ces deux valeurs ne sont pas substituables l'une à l'autre, elles sont, dans certains cas, susceptibles de s'enrichir l'une l'autre. Nous proposons d'expliciter les différences fondamentales mais aussi les points de convergence entre ces deux valeurs. Pour cela, nous nous sommes plongés dans leur historique,dans la méthodologie de leur élaboration, pour, dans un deuxième temps proposer quelques pistes d'harmonisation. Nous illustrons notre analyse par un cas d'étude consacré au formaldéhyd

Surveillance biologique des expositions professionnelles aux agents chimiques. Recommandation de bonne pratique.

National audienceCes recommandations de bonne pratique sur la surveillance biologique des expositions professionnelles aux agents chimiques ont pour finalité de guider le médecin dans sa décision de mettre en place une telle surveillance, le choix des modalités de son exécution, l'interprétation et la restitution tant individuelles que collectives et les modalités de collecte et de conservation des données en vue de leur exploitation collective à visée de prévention

Recommandations de bonne pratique pour la surveillance biologique de l’exposition professionnelle aux agents chimiques (SBEP) : recommandations de la Société française de médecine du travail, associée à la Société française de toxicologie analytique et à la Société de toxicologie clinique

International audienc

Biomonitoring of occupational exposure to phthalates: a systematic review

Introduction: Phthalates, a group of ubiquitous industrial chemicals, have been widely used in occupational settings, mainly as plasticizers in a variety of applications. Occupational exposure to different phthalates has been studied in several occupational settings using human biomonitoring (HBM). Aim: To provide a comprehensive review of the available literature on occupational exposure to phthalates assessed using HBM and to determine future data needs on the topic as part of the HBM4EU project. Methods: A systematic search was carried out in the databases of Pubmed, Scopus, and Web of Science for articles published between 2000 and September 4, 2019, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 22 studies on the occupational HBM of phthalates was considered suitable for review. Results and discussion: Among the reviewed studies, 19 (86%) focused on DEHP, an old phthalate that is now subject to authorization and planned to be restricted in the EU. Concentrations of MEHHP, one of its metabolites, varied up to 13-fold between studies and across sectors when comparing extreme geometric means, ranging from 11.6 (similar to the general populations) to 151 μg/g creatinine. Only 2 studies focused on newer phthalates such as DiNP and DPHP. Concerning the geographical distribution, 10 studies were performed in Europe (including 6 in Slovakia), 8 in Asia, and 4 in North America, but this distribution is not a good reflection of phthalate production and usage levels worldwide. Most HBM studies were performed in the context of PVC product manufacturing. Future studies should focus on: i) a more uniform approach to sampling timing to facilitate comparisons between studies; ii) newer phthalates, and iii) old phthalates in waste management or recycling. Conclusion: Our findings highlight the lack of recent occupational HBM studies on both old and new phthalate exposure in European countries and the need for a harmonized approach. Considering the important policy actions taken in Europe regarding phthalates, it seems relevant to evaluate the impact of these actions on exposure levels and health risks for workers.info:eu-repo/semantics/publishedVersio