Évaluation du 4,5-dihydrodiol-benzo[a]pyrène et du 7,8-dihydrodiol-benzo[a]pyrène en tant que biomarqueurs spécifiques alternatifs d’exposition au benzo[a]pyrène

Reconnu par le Centre international de recherche sur le cancer (CIRC) comme cancérigène chez l’être humain, le benzo[a]pyrène (BaP) est un des hydrocarbures aromatiques polycycliques (HAP) les plus étudiés. Souvent rencontrés dans de nombreux milieux de travail, les HAP sont un groupe de polluants omniprésents dans l’environnement, formé par des processus de combustion incomplets. Bien que le BaP présente un risque élevé pour la santé des travailleurs, il n’existe aucun biomarqueur spécifique au composé permettant le suivi et la surveillance d’exposition au BaP dans un lieu de travail. Le 3-hydroxybenzo[a]pyrène (3-OHBaP) est le métabolite du BaP le plus développé comme biomarqueur. Ce métabolite est principalement excrété dans les fèces, ainsi qu’une quantité infime dans l’urine, ce qui le rend difficile à mesurer. De plus, le 3-OHBaP montre une certaine rétention rénale, un facteur qui rend plus compliqué son utilisation en tant que biomarqueur car il oblige de prendre plusieurs critères en compte dans l’analyse de sa cinétique temporelle. Par ailleurs, le 1-hydroxypyrène (1-OHP) est un métabolite urinaire du pyrène souvent utilisé comme biomarqueur d’exposition aux HAP. Neanmoins, il s’agit du métabolite d’un HAP non-cancérigène et par conséquent sa capacité de démontrer le risque de cancer associé à une exposition donnée est faible. Ce mémoire visait à détecter et à évaluer l'exposition au BaP en suivant ses métabolites urinaires: le 4,5-dihydrodiol-benzo[a]pyrène et le 7,8-dihydrodiol-benzo[a]pyrène (le 4,5-diolBaP et le 7,8-diolBaP; les diolBaP). L’évaluation du 4,5-diolBaP et du 7,8-diolBaP s’est déroulée dans deux études: La première étude, surnommée « l’expérience du shampooing », portait sur un volontaire qui s’est exposé aux HAP dans un environnement contrôlé en utilisant un shampooing à base de goudron de houille. Cette étude a été conçue afin d’évaluer l'évolution temporelle du 7,8-diolBaP chez l'homme et de vérifier son potentiel en tant que biomarqueur d'exposition par comparaison avec le 1-OHP dans le même cadre expérimental. Elle a été réalisée avec deux expériences. La première portait sur une seule exposition et la seconde sur une exposition multiple. La deuxième étude, surnommée « l’étude des travailleurs », reposait sur une analyse comparative du 4,5-diolBaP, du 7,8-diolBaP, du 1-OHP et du 3-OHBaP dans un milieu de travail. Cette étude avait pour objectif d’évaluer les compétences des diolBaP dans un contexte réel à côté des biomarqueurs établis d'exposition au BaP et aux HAP. Cinq travailleurs d'une usine de production d'anodes en carbone ont accepté de participer à cette étude. Dans le cadre de ces deux études, les échantillons d'urine étaient analysés par la chromatographie en phase liquide à ultra-haute performance (UHPLC) couplée à la fluorescence. « L’expérience du shampooing » : L’expérience de l’exposition unique et celle de l’exposition multiple ont révélé une élimination de façon mono-exponentielle du 7,8-diolBaP, identique à celle du 1-OHP, avec des concentrations dans le même ordre de grandeur. Nous avons également confirmé un taux d’élimination plus rapide pour le 1-OHP en regardant ses pics. Le 7,8-diolBaP augmente en valeur maximale après chaque exposition, et cette découverte a mis en évidence une accumulation tout au long de la semaine, alors que pour le 1-OHP, le deuxième pic est plus grand, mais le troisième est plus petit, montrant ainsi moins d'accumulation pendant la même période temporelle. « L’étude des travailleurs »: Selon les résultats, la méthode analytique utilisée était incapable de discerner correctement le 4,5-diolBaP des autres contaminants urinaires éluant pendant le même temps de rétention. Le 7,8-diolBaP, quant à lui, élue à des concentrations urinaires d'un ordre de grandeur similaire au 1-OHP tel que vu chez tous les travailleurs évalués. Chez certains travailleurs, la concentration urinaire du 7,8-diolBaP était toujours plus élevée avant le début d'un quart de travail avec l'élimination qui avait lieu pendant le quart de travail pour fournir une valeur de concentration inférieure à la fin du quart de travail. Cependant, la concentration du 1-OHP a eu une hausse immédiate avec l'exposition, culminant à la fin de chaque quart de travail. Pour les autres travailleurs, les concentrations du 7,8-diolBaP et du 1-OHP étaient systématiquement plus élevées à la fin du quart de travail. Il est probable que ces variations indiquent les différentes voies d'exposition. Le présent mémoire a montré le potentiel du 7,8-diolBaP en tant que biomarqueur d'exposition spécifique au BaP et par conséquent, il fournit un point de départ pour explorer la quantification du lien entre l'exposition au BaP et ses effets néfastes sur la santé de l'être humain. L’utilisation de la spectrométrie de masse est nécessaire à confirmer l’identité des diolBaP avant d'aller de l'avant.Benzo[a]pyrene (BaP) is one of the more commonly studied polycyclic aromatic hydrocarbons (PAHs), a group of omnipresent pollutants in the environment formed through incomplete combustion processes. It is listed as a confirmed carcinogen to human beings by the International Agency for Research on Cancer (IARC) and is highly present in many workplaces. Although presenting a significant health risk to workers, there are currently no convenient compound-specific biomarkers that enable the tracking and monitoring of occupational exposure to BaP. 3-Hydroxybenzo[a]pyrene (3-OHBaP) is the most developed, as a biomarker, amongst the metabolites of BaP. It’s mostly excreted with the faeces, presenting in trace amounts in urine, which makes it difficult to measure; it is also demonstrates renal retention, which adds a layer of complexity in its use as a biomarker because there are many factors to take into consideration when looking at its kinetic time course. 1-Hydroxypyrene (1-OHP), in the other hand, is a urinary metabolite of pyrene that serves as a good representative of PAH presence. It is, however, the metabolite of a non-carcinogenic PAH, and is not fully capable of representing the cancer risk posed in a given scenario. This thesis sought to detect and assess BaP exposure through tracking its urinary metabolites: 4,5-dihydrodiol-benzo[a]pyrene and 7,8-dihydrodiol-benzo[a]pyrene (4,5-diolBaP and 7,8-diolBaP; diolBaPs). 4,5-DiolBaP and 7,8-diolBaP were evaluated through two studies: The first study, the “shampoo experiment”, featured a volunteer who self-exposed to PAHs in a controlled setting by using a coal-tar-based shampoo. The study consisted of two experiments. The first focused on a single exposure and the second on multiple exposures. This study was set to evaluate the time course of 7,8-diolBaP in humans and verifying its potential as a biomarker of exposure through a comparison with 1-OHP in the same experimental framework. The second study consisted of a comparative analysis of 4,5-diolBaP, 7,8-diolBaP, 1-OHP and 3-OHBaP in an occupational setting, evaluating the competency of the diolBaPs in a real-world setting alongside established biomarkers of BaP and PAH exposure. Five workers at a carbon anode production plant volunteered to participate in this study. For both of these studies, the urine samples were analysed by ultra-high-pressure liquid chromatography (UHPLC) coupled with fluorescence. “Shampoo Experiment”: The single and multiple exposures revealed a monoexponential elimination on the part of 7,8-diolBaP, identical to 1-OHP, with similar magnitudes of concentration. 1-OHP was also confirmed to undergo a more rapid elimination from the system, where after each exposure for 7,8-diolBaP, the ensuing peak value is higher. This finding demonstrated evidence of accumulation of 7,8-diolBaP throughout the week, whereas with 1-OHP, the second peak is larger, then the third one is smaller, thus showing less accumulation over the same time frame. “Worker Study”: The results showed that the analytical method used was unable to properly discern 4,5-diolBaP from other urinary contaminants eluting during the same retention time. 7,8-DiolBaP, on the other hand, eluted at urinary concentrations that were a similar order of magnitude to 1-OHP, as can be seen in all of the workers evaluated. For some workers, the urinary concentration of 7,8-diolBaP was consistently at its peak prior to the start of a shift and elimination took place during the shift, to provide a lower concentration value at the end of the shift. With 1-OHP, the rise was immediate with exposure, peaking at the end of every shift. For other workers, both 7,8-diolBaP and 1-OHP are consistently higher at the end of the shift. These variations are likely to indicate different routes of exposure. This thesis showed the potential use of 7,8-diolBaP as a compound-specific biomarker of exposure for BaP and thus provides a starting point in exploring the quantification of BaP exposure and negative health effects in humans. Confirmation of the compound’s identity is needed through the use of mass spectrometry

Pattern of medical admissions at the Federal Medical Centre, Asaba - a two year review

Atwo-year retrospective evaluation of the pattern of medical admissions at the FederalMedical Centre (FMC),Asaba,Delta State,Nigeria. Case notes of all admissions and deaths in the medical wards between November 2005 and October 2007 were retrieved and reviewed. Themean, standard deviation and percentages of relevant data were derived and presented in simple descriptive statistics. One thousand, eight hundred and sixty patients were admitted over the study period. One thousand and eight of these [1008; 54.2%], were male, while eight hundred and fifty two [850; 45.8%] were female, making a female/male ratio of 1:1.18.The patients ages ranged between fifteen and ninety years, with amean of 51.56 ± 18.35 years.The age range ofmale patients ranged from16 to 88 years,with amean of 55.55 ± 17.99 years,while that of the female patients ranged from15 to 90 years,with amean of 57.14 ± 13.79.The length of stay in theward ranged from1 to 97 days,with amean of 10.32 ± 10.93 days.Therewere 23.25 patients per bed per year and a bed occupancy rate of 65.74%. There were 240 deaths [12.90% of total admissions]. The interval between admission and death ranged between 1 and 31 days, with a mean of 7.14 ± 6.7 days. One hundred and twenty four patients [124; 6.7%] were referred to other health facilities, while ninety six [96; 5.2%] left against medical advice.The commonest causes of admission in males was hypertension, diabetes mellitus and HIV, while in females, it was HIV, hypertension and diabetes mellitus. Commonest causes of death in males were hypertension, HIV and diabetes, while in female subjects, itwasHIV, hypertension and diabetes. Non-communicable diseases- [hypertension, diabetesmellitus] and HIV/AIDS were themajor causes of admissions and death in both genders.Keywords: Pattern, Medical admissions, Asab

A Case for Adoption of Industry-Wide Application of Solar Disinfection of Packaged Drinking Water Before Distribution in Nigeria

The study makes a case for adoption of an industry-wide application of solar disinfection (SODIS) in the disinfection of packaged water at the production stage. To do this, 60 samples, comprising 12 brands of bottled water and 18 brands of sachet-packaged water were randomly purchased from street vendors in Nsukka, Enugu State, Nigeria and investigated. One sample was hidden from sunlight while the other sample was exposed to a day of sunlight before the two samples were subjected to microbial analysis for the determination of total coliform (TC) using the method of multiple-tube fermentation technique (MPN). Results show that 63% of packaged water vended in Nsukka is not fit for consumption. The risk of contamination is about 44% higher in sachet water when compared with bottled water (relative risk = 1.44). Exposing packaged water to a day of sunlight reduces the risk of consuming contaminated water by about 97% (relative risk reduction value = 0.97). Advocacy of industry-wide application of SODIS may hold the key to ending widespread contamination of packaged water and the resulting life-threatening illnesses that have decimated the population of developing countries

Relationship between School Library Management and Students’ choice of Career in Librarianship.

This study is the examination of the relationship between School Library Management and Students’ choice of Career in Librarianship. The specific objectives of the study were to determine how school library management components such components like staffing, collection development, and library curriculum related or affected the students’ choice of Library and Information Science as a course of study in the University, and Librarianship as Career. To achieve this objective, a survey research method was adopted, and close ended questionnaire was served to the three and four hundred level students of Library and information science, University of Maiduguri, Nigeria as the population for the study. The data were subjected to descriptive analysis using table of frequencies and percentages The study revealed among others that, the School Libraries  Nigeria have not been managed adequately to motivated the students as expected, in their choice of Librarianship as a career. Also, most students came from primary and secondary schools which had no library. Many students had no prior knowledge of Library and Information Science as a course of study, and where given the course even though they did not apply for it. While some of the respondents who had a good school library experience, chose to read the course and to practice Librarianship as a career. It was also revealed most direct entry students who had other background other than Library Science adopted the discipline due to the career opportunities. Based on the finding, recommendations were made towards repositioning Nigerian School Library towards achieving its aims and objectives. Keywords: School Library Management, Relationship, Students, Career Choice and Librarianship

Evaluation of the Effect of Duration of Diabetes Mellitus on Peripheral Neuropathy Using the United Kingdom Screening Test Scoring System, Bio-thesiometry and Aesthesiometry

Background: and Objectives: Risk factors predisposing to foot ulceration in diabetic subjects are multiple. Long duration of diabetes mellitus is a major risk factor, likewise peripheral neuropathy (PN), which globally, is recognized as the commonest risk factor for foot disease in diabetic subjects. Objectives: To evaluate the effect of duration of diabetes mellitus on peripheral neuropathy using the United Kingdom Screening Test (UKST) Scoring System, Bio-thesiometry and Aesthesiometry, in Nigerian diabetic subjects without current or previous foot ulceration. Subjects and methods: One hundred and twenty (120) diabetes mellitus (DM) subjects with and without symptoms of peripheral neuropathy receiving care at the medical outpatient department (MOPD) and the diabetic clinic of the Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria, were recruited consecutively as they presented. Data collected included subjects age (years), gender, age at first diagnosis of DM, duration of DM (years) and baseline fasting venous plasma glucose. The United Kingdom Screening Test (UKST) symptom score was used to separate the participants into two groups those with symptoms of PN and those without and the subjects further assessed by three methods the UKST Signs score, Bio-thesiometry and Aesthesiometry to determine the presence of PN. Results: Among the 120 diabetic participants, 83(69.2%) had neuropathic symptoms (the symptomatic participants) while 37(30.8%) were asymptomatic (the asymptomatic participants). The different methods of diagnosing PN increasingly detected PN with increasing duration of diabetes. For the symptomatic group, the UKST method detected PN least in those with duration of DM 15 years while for the asymptomatic group, it detected PN in 25.0% of those with duration of DM 15 years. For the symptomatic group, Aesthesiometry detected PN in 65.2% of those with duration of DM 15 years. For the asymptomatic group, it  detected PN in 29.2% of those with duration of DM 15 years. Likewise, for the symptomatic group, Bio-thesiometry detected PN in 47.8% of those with duration of DM 15 years. For the asymptomatic group, it detected PN in 16.7% of those with duration of DM 15 years.Conclusion: Long duration of diabetes mellitus and peripheral neuropathy are risk factors for foot complication in Nigerians with diabetes mellitus. Diabetic subjects with long duration of diabetes (>10 years) almost always have associated peripheral neuropathy, and should be recognized as a special group at high risk for foot disease from DM. Specific preventive programs should target this group to reduce the rate of avoidable loss of limbs to diabetes.Key Words: Diabetic foot ulceration, peripheral neuropathy, United Kingdom Screening Test, Aesthesiometry, Biothesiometry

Evaluation of "care of the foot" as a risk factor for diabetic foot ulceration: The role of internal physicians

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Addressing Contending Issues and Embracing Emerging Trends in Library and Information Science Education for Sustainable Development in Nigeria

The emergence of Sustainable Development Goals (SDGs) was largely attributed to the inability of many nations to achieve the Millennium Development Goals. This paper identifies unresolved contending issues in Library and Information Science (LIS) education and training in Nigeria, with case for embracing emerging trends, not only for sustainability of LIS schools, but also to contribute positively towards actualization of the SDGs. With specific references to polytechnic-based and university-based LIS schools, the contending issues range from nomenclature, curriculum, infrastructure and human resources. In polytechnic-based LIS schools, many courses need to be merged so as to create avenue for integration of contemporary courses; and possibly develop specializations such as information resources management, knowledge management, records and information management, and publishing and multimedia technologies at the Higher National Diploma (HND) level. For university-based LIS schools, the development of a new programme tagged ‘BSc. Information Science and Media Studies’ by the National Universities Commission (NUC) with curriculum that reflects information management and multimedia technology, may or may not be a threat to LIS education; however, rebranding and repackaging LIS to Information and Knowledge Management in line with global best practices is a way forward. In addition, a case for Master of Knowledge Management (MKM) programme in universities was made in order to address emerging opportunities. The paper concludes that these contending issues need to be addressed, emerging trends embraced, and university-based LIS schools in Nigeria should work towards ensuring that future master degree holders (MLIS graduates) possess practical computing skills in areas of programming, web design, content development, and library management systems

Systematic Review of Falls Among Older Individuals in the Long- Term Care Settings

Falls are common in the older population and can result in disability, increased dependence, or mortality. Falls have received increased attention in the literature as the most common cause of injuries among older individuals. The incidence of falls in the older population has a positive correlation with adverse health issues necessitating major lifestyle adjustments. The problem is magnified for older patients in long-term care settings where they are 3 times more susceptible to falls. The purpose of this project study was to conduct a systematic review of the literature to understand the impact and incidence of fall rates among older patients in long-term care sites while determining strategies that would be helpful in preventing falls in these care settings going forward. The study was guided by the personality theory framework. The systematic review included 12 peer-reviewed articles, final articles were selected based on recent year of publication, scholarship, and English language. The revised Standards for Quality Improvement Reporting Excellence was used to guide the review of identified literature. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram was used to document the included studies. Results indicated that falls among older patients have been attributed to personal and environmental factors including medication, previous history of falls, and comorbidity risk factors regardless of the setting. Multifactorial interventions including exercise therapy and assistive devices have been more effective in preventing falls compared to stand-alone strategies. Findings support social change by providing information to enhance patient safety practices and improve patient outcomes for older individuals in long-term care settings

The importance of chronic pain education and awareness amongst occupational safety and health professionals

Purpose: Occupational safety and health (OSH) professionals are often the point of contact for health and safety policies derived in the workplace, and the handling of incidents in their aftermath. As chronic pain affects 20% of people, many pain-awareness campaigns and educational activities target healthcare professionals. However, initiatives directed toward OSH professionals are also important to aid in prevention and rehabilitation efforts. The objective of this study was to describe knowledge and attitudes of OSH students with regard to chronic pain. Methods: A web-based cross-sectional study was conducted amongst a convenience sample of 88 students enrolled in the distance learning OSH undergraduate certificate program at the Université du Québec en Abitibi-Témiscamingue (Quebec, Canada). Results: Although 30% of students were already employed within OSH or human resources and 40% reported intervening in cases involving chronic pain in their line of work, 56% of respondents had received no training on chronic pain and its treatment in the past five years. Only 14% chose to take the optional 45 hr course dedicated to pain within the program. OSH students also exhibited poorer knowledge and more negative attitudes toward people suffering from chronic pain when compared to other groups assessed in the province of Quebec, including healthcare professionals, chronic pain patients, and people not suffering from chronic pain (p≤0.0002). Half of the respondents (51.9%) were not aware that chronic pain affects 1 in 5 adults. Conclusion: Our study demonstrates a need for pain education within OSH training programs and through continuing education