Attributable risk in men in two French case-control studies on mesothelioma and asbestos

International audiencePleural mesothelioma is a primary tumor of the pleura that is mainly due to asbestos exposure. To study the relationship between mesothelioma and occupational asbestos exposure in France, two case-control studies (A and B) were conducted. A substantial difference in the attributable risk in the population (AR) was observed among men: 44.5% (95% CI: [32.6-56.4]) in study A and 83.2% (95% CI: [76.8-89.6]) in study B. As different exposure assessment expert methods were used, the main objective of this work was to re-estimate the AR men in two case-control studies according to a common standardized exposure assessment by using a Job Exposure Matrix (JEM) and to assess the role of subjects' selection. The initial observed AR difference was maintained: 36.3% (95% CI: [24.3-50.3]) in study A and 69.7% (95% CI: [51.7-83.2]) in study B. Further investigations highlighted the potential selection bias introduced in both studies, especially among controls. The AR could be underestimated in study A and overestimated in study B. After weighting subjects according to distribution of socio-economic status in the general population for controls and according to distribution of socio-economic status of cases registered by the French National Mesothelioma Surveillance Program, re-estimated AR values were 52.4% in study A and 70.2% in study B. These results provide additional information to describe the relationship between pleural mesothelioma and occupational asbestos exposure, but also confirm the importance of subjects' recruitment in case control studies, particularly control selection

Appl Ergon

Despite recent concerns for workers’ health, exposure situations to nanoparticles can occur in numerous workplaces. Understanding how exposures occur considering human work in these transformations remains a crucial issue of nanotechnologies. The objective of this article is to understand exposure situations to nanoparticles, their determinants and the resources to act on them. This understanding was achieved by specific measurement of nanoparticles aerosols, combined with an analysis of work activity (actions performed and physical strain) in a rubber industry. The presentation of real time measurements, associated with the video of work situations, during confrontation interviews becomes a means of making exposing work activities visible, to analyze and transform them from the points of view formulated by the company's stakeholders. In this way, characterized “typical exposure situations” serve to trigger discussions and open up new spaces for debate highlighting how innovation affects work and gives rise to enhanced prevention projects

Proposition de méthode pour identifier et observer des postes de travail potentiellement exposants aux nanomatériaux

Cet article présente la méthode ayant été testée et optimisée dans le cadre du dispositif de surveillance épidémiologique des travailleurs potentiellement exposés aux nanomateriaux en France, EpiNano. Cette méthode intègre les préconisations de l'INRS, de l'INERIS et du CEA dans l'étude dite de situation préalable à une campagne de mesurage. Elle se matérialise par un outil pragmatique : le Carnet d'observation technique (COT). Il s'agit d'un outil de collecte d'informations, conçu pour des épidémiologistes, qui pourrait servir à l'ensemble des acteurs de la santé et prévention au travail impliqués dans la gestion des risques liés aux nanomatériaux

A standardized non-instrumental tool for characterizing workstations concerned with exposure to engineered nanomaterials

International audienceThe French national epidemiological surveillance program EpiNano aims at surveying mid- and long-term health effects possibly related with occupational exposure to either carbon nanotubes or titanium dioxide nanoparticles (TiO2). EpiNano is limited to workers potentially exposed to these nanomaterials including their aggregates and agglomerates. In order to identify those workers during the in-field industrial hygiene visits, a standardized non-instrumental method is necessary especially for epidemiologists and occupational physicians unfamiliar with nanoparticle and nanomaterial exposure metrology. A working group, Quintet ExpoNano, including national experts in nanomaterial metrology and occupational hygiene reviewed available methods, resources and their practice in order to develop a standardized tool for conducting company industrial hygiene visits and collecting necessary information. This tool, entitled "Onsite technical logbook", includes 3 parts: company, workplace, and workstation allowing a detailed description of each task, process and exposure surrounding conditions. This logbook is intended to be completed during the company industrial hygiene visit. Each visit is conducted jointly by an industrial hygienist and an epidemiologist of the program and lasts one or two days depending on the company size. When all collected information is computerized using friendly-using software, it is possible to classify workstations with respect to their potential direct and/or indirect exposure. Workers appointed to workstations classified as concerned with exposure are considered as eligible for EpiNano program and invited to participate. Since January 2014, the Onsite technical logbook has been used in ten company visits. The companies visited were mostly involved in research and development. A total of 53 workstations with potential exposure to nanomaterials were pre-selected and observed: 5 with TiO2, 16 with single-walled carbon nanotubes, 27 multiwalled carbon nanotubes. Among the tasks observed there were: nanomaterial characterisation analysis (8), weighing (7), synthesis (6), functionalization (5), and transfer (5). The manipulated quantities were usually very small. After analysis of the data gathered in logbooks, 30 workstations have been classified as concerned with exposure to carbon nanotubes or TiO2. Additional tool validity as well as inter-and intra-evaluator reproducibility studies are ongoing. The first results are promising

A standardized non-instrumental method for tracking workstations concerned with exposure to nano-objects and their aggregates and agglomerates in companies dealing with engineering nanomaterials

The French national epidemiological surveillance program EpiNano aims at surveying mid- and long-term health effects possibly related with occupational exposure to either carbon nanotubes (NTC) or titanium dioxide nanoparticles (TiO2). EpiNano is limited to workers potentially exposed to these nanomaterials (NM) including their aggregates and agglomerates. In order to identify those workers during the in-field industrial hygiene (IH) visits, a standardized non-instrumental method is necessary especially for epidemiologists and occupational physicians unfamiliar with ENM exposure metrology. A working group, Quintet ExpoNano, including national experts in NM metrology and occupational hygiene reviewed available methods, resources and their practice in order to develop a standardized tool for conducting company IH visits and collecting necessary information. This tool, entitled “Field technical logbook”, includes 3 parts: company activity, workplace, and workstation allowing a detailed description of each task, process and exposure surrounding conditions. This logbook is intended to be completed during the company IH visit. Each visit is conducted jointly by an occupational hygienist and an epidemiologist of the program and lasts one or two days depending on the company size. When all collected information is computerized in a friendly-using database it is easy to classify workstations with respect to their potential direct and/or indirect exposure. Workers appointed to workstations classified as concerned with exposure are considered as eligible for EpiNano program and invited to participate. Since January 2014, the Field technical logbook has been used in ten company visits. The companies visited were mostly involved in research and development. A total of 53 workstations with potential exposure were pre-selected and observed: 5 with TiO2, 16 with single-walled NTC, 27 multiwalled NTC. Among the tasks observed there were: ENM analysis (8), weighing (7), synthesis (6), functionalization (5), and transfer (5). The manipulated quantities were usually very small. After analysis of the data gathered in logbooks, 30 workstations have been classified as concerned with exposure to NTC or TiO2. Additional tool validity as well as inter-and intra-evaluator reproducibility studies are ongoing. These first results are promising

Proposition d’une méthode de repérage des postes de travail potentiellement exposant aux nano-objets, leurs agrégats ou agglomérats dans les entreprises mettant en oeuvre des nanomatériaux manufacturés

Purpose of the study. To develop an operational method for identifying workers potentially exposed to manufactured nano-objects and their aggregates and agglomerates (NOAA) and assessing their potential exposure in frame of epidemiological surveillance program EpiNano. Method. The method was developed by a multidisciplinary working group. It consists of a company visit guided by a standardized tool "Field technical logbook". This tool enables assessing a set of parameters necessary for identification and characterization of workstations concerned with NOAA exposure, namely a detailed description of tasks and processes, personal and collective protection equipment, NOAA characteristics before and after transformation and other exposure surrounding conditions. The method was tested in ten companies. After each visit, all information collected in the logbook was computerized via a friendly-using application. A pdf copy of data was sent to the company along with proceedings of the visit listing workstations classified as concerned with NOAA exposure, for verification and validation. Results. All proceedings were validated. Among 53 workstations. observed during all the visits, 30 (57 %) were classified as concerned with NOAA exposure, namely workstations dealing with NOAA synthesis, sampling, transfer and functionalization. In private companies, there were 60 % of workstations classified as concerned with NOAA exposure versus 54 % in public companies. Numerous parameters were likely to determine the exposure classification, particularly humidity and dustiness of the NOAA powders. The assessment of these parameters might be useful for all companies since it also serves in implementing exposure control banding. Conclusion. This simple and non-instrumental method (without aerosol sampling and measurements) was developed for epidemiologists but could be useful to all occupational health actors in the field of nanotechnology.Objectif : Proposer une méthode opérationnelle pour identifier les travailleurs potentiellement exposés aux nano-objets manufacturés, leurs agrégats et agglomérats (NOAA) et caractériser leur exposition potentielle dans le dispositif de surveillance épidémiologique EpiNano. Méthode : La méthode a été conçue par un groupe de travail pluridisciplinaire. Elle repose sur une visite d’entreprise, guidée par un outil intitulé carnet d’observation technique (COT). Il permet de relever, dans un ordre logique, des éléments nécessaires au repérage et à la caractérisation des postes exposants, notamment les procédés mis en œuvre, l’aéraulique des ateliers, les équipements de protection, les caractéristiques des NOAA à l’entrée et à la sortie du poste, les conditions de leur manipulation, de la tenue du poste et de sa maintenance. La méthode a été testée au sein de dix entreprises. À l’issue de chaque visite, un compte rendu de mission listant les postes potentiellement exposant aux NOAA était envoyé à l’entreprise visitée. La copie des informations informatisées du COT était jointe au compte rendu pour vérification et validation. Résultats : L’ensemble des comptes rendus des missions a été validé. Parmi les 53 postes observés, 30 (57 %) ont été classés potentiellement exposant, notamment les postes de synthèse, d’échantillonnage, de transfert et de fonctionnalisation des NOAA. La proportion de postes de travail potentiellement exposant aux NOAA était de 54 % dans les entreprises privées et de 60 % dans les entreprises publiques. De nombreux paramètres semblent déterminants dans le classement d’un poste de travail, notamment la pulvérulence et la teneur en humidité des NOAA. La connaissance de ces paramètres peut également servir dans l’application de l’approche de gestion graduée du risque, et par conséquent être utile à l’entreprise. Conclusion : Cette méthode simple et non instrumentale (sans prélèvement et sans mesure de l’aérosol) conçue pour des épidémiologistes pourrait servir à l’ensemble des acteurs en santé et prévention au travail impliqués dans la gestion des risques liés aux nanomatériaux