23 research outputs found

    BMJ Open

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    INTRODUCTION: Antineoplastic drugs (AD) are potentially carcinogenic and/or reprotoxic molecules. Healthcare professionals are increasingly exposed to these drugs and can be potentially contaminated by them. Internal contamination of professionals is a key concern for occupational physicians in the assessment and management of occupational risks in healthcare settings. Objectives of this study are to report AD internal contamination rate in nursing staff and to identify factors associated with internal contamination. METHODS AND ANALYSIS: This trial will be conducted in two French hospital centres: University Hospital of Bordeaux and IUCT-Oncopole of Toulouse. The target population is nurses practicing in one of the fifteen selected care departments where at least one of the five studied AD is handled (5-fluorouracil, cyclophosphamide, doxorubicin, ifosfamide, methotrexate). The trial will be conducted with the following steps: (1) development of analytical methods to quantify AD urine biomarkers, (2) study of the workplace and organization around AD in each care department (transport and handling, professional practices, personal and collective protection equipments available) (3) development of a self-questionnaire detailing professional activities during the day of inclusion, (4) nurses inclusion (urine samples and self-questionnaire collection), (5) urine assays, (6) data analysis. ETHICS AND DISSEMINATION: The study protocol has been approved by the French Advisory Committee on the Treatment of Information in Health Research (CCTIRS) and by the French Data Protection Authority (CNIL). Following the opinion of the Regional Committee for the Protection of Persons, this study is outside the scope of the provisions governing biomedical research and routine care (n degrees 2014/87). The results will be submitted to peer-reviewed journals and reported at suitable national and international meetings. TRIAL REGISTRATION NUMBER: NCT03137641

    BMJ Open

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    INTRODUCTION: Guidelines concerning the follow-up of subjects occupationally exposed to lung carcinogens, published in France in 2015, recommended the setting up of a trial of low-dose chest CT lung cancer screening in subjects at high risk of lung cancer. OBJECTIVE: To evaluate the organisation of low-dose chest CT lung cancer screening in subjects occupationally exposed to lung carcinogens and at high risk of lung cancer. METHODS AND ANALYSIS: This trial will be conducted in eight French departments by six specialised reference centres (SRCs) in occupational health. In view of the exploratory nature of this trial, it is proposed to test initially the feasibility and acceptability over the first 2 years in only two SRCs then in four other SRCs to evaluate the organisation. The target population is current or former smokers with more than 30 pack-years (who have quit smoking for less than 15 years), currently or previously exposed to International Agency for Research on Cancer group 1 lung carcinogens, and between the ages of 55 and 74 years. The trial will be conducted in the following steps: (1) identification of subjects by a screening invitation letter; (2) evaluation of occupational exposure to lung carcinogens; (3) evaluation of the lung cancer risk level and verification of eligibility; (4) screening procedure: annual chest CT scans performed by specialised centres and (5) follow-up of CT scan abnormalities. ETHICS AND DISSEMINATION: This protocol study has been approved by the French Committee for the Protection of Persons. The results from this study will be submitted to peer-reviewed journals and reported at suitable national and international meetings. TRIAL REGISTRATION NUMBER: NCT03562052; Pre-results

    Arch Mal Prof Environ

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    MalgrĂ© les efforts rĂ©alisĂ©s en prĂ©vention pour rĂ©duire l’exposition professionnelle aux mĂ©dicaments anticancĂ©reux (MAC), ce problĂšme reste d’actualitĂ©. La littĂ©rature Ă  ce sujet pointe le besoin de caractĂ©riser et d’évaluer les risques et les dangers et de former les professionnels. GrĂące Ă  l’ergotoxicologie, mĂȘlant des prĂ©lĂšvements d’essuyages de mains et des entretiens d’autoconfrontation, nous chercherons Ă  savoir comment la poly-exposition et les moyens de protection associĂ©s se manifestent dans l’activitĂ© des soignants. Les essuyages de mains, rĂ©alisĂ©s avant/aprĂšs des actions dĂ©terminĂ©es comme potentiellement exposantes, montrent la prĂ©sence de MAC sur l’ensemble des prĂ©lĂšvements (n = 20). La molĂ©cule manipulĂ©e le jour du prĂ©lĂšvement ne se retrouve que sur 25 % des prĂ©lĂšvements. Deux prĂ©lĂšvements (sur 9) montrent une augmentation du niveau de contamination des mains aprĂšs une action potentiellement exposante. Les donnĂ©es d’entretiens montrent que malgrĂ© le manque de formation, les soignants sont capables d’identifier des sources et des espaces d’exposition potentielle. Nos rĂ©sultats ne montrent qu’une partie de l’énigme de l’exposition aux MAC et ne permettent pas, encore, de la caractĂ©riser. NĂ©anmoins, ils montrent des dĂ©terminants de la contamination Ă  diffĂ©rents niveaux de l’activitĂ© qu’il reste Ă  approfondir. Aussi, nos rĂ©sultats nous laissent penser que, par nos mĂ©thodes, les soignants sont rentrĂ©s dans une « zone potentielle de dĂ©veloppement », oĂč une partie de leurs connaissances sur les risques biologiques pourraient leur servir de ressources pour mieux gĂ©rer le risque chimique et penser une prĂ©vention propre aux spĂ©cificitĂ©s des MAC. En effet, au vu, des voies d’exposition et des modes de transmission des contaminations aux risques biologiques, les actions de protection dĂ©veloppĂ©es pour ce risque pourraient permettre l’élaboration d’une nouvelle forme d’intervention pour les MAC. Cette derniĂšre considĂšrerait les soignants comme agissant face aux poly-expositions et producteurs de leurs actions de protection, qui vont au-delĂ  des Ă©quipements de protection prescrits.Despite preventive efforts to reduce occupational exposure to antineoplastic drugs (ADs), the problem remains. The literature on the subject points to the need to characterize, assess and train professionals. In this article, using ergotoxicology as a tool, we will look at how multiple exposures to multiple nuisances and the associated protective measures arise in the work of healthcare workers, by means of hand -wiping samples and self -confrontation interviews. Hand wiping carried out before and after actions identified as potentially exposing, revealed the presence of ADs in all samples (n = 20). The compound handled on the sampling day was found in only 25% of the samples. Only two samples (out of 9) showed an increase in the level of hand contamination after a potentially exposing action. Although these data have helped to reveal part of the enigma of exposure to ADs, they do not yet allow us to characterize it. Nonetheless, our methods have enabled us to identify the determinants of contamination at different activity levels, which still need to be examined in greater depth in the rest of the prevention project. The interview data show that, despite a lack of training, carers can identify potential sources and areas of exposure. Our results lead us to believe that our methods have enabled carers to enter a "zone of proximal development", where their knowledge of biological risks could serve as a resource for better chemical risk management. These data also show that carers take action on a daily basis in the face of multiple exposures, and produce protective measures that go beyond the prescribed protective equipment. Given the routes of exposure and modes of transmission of biological risk contamination, the protective actions developed for this risk could contribute to the development of a new form of intervention for ADs.Innovation and Transformation for Prevention Activity of Professional Risk

    Arguments pour une possible transmission par voie aérienne du SARS-CoV-2 dans la crise COVID-19

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    International audienceLa connaissance des modes de transmission du SARS-CoV-2 est un Ă©lĂ©ment fondamental dans l’élaboration des stratĂ©gies de prĂ©vention en santĂ© au travail et en santĂ© publique dans le cadre de la gestion de crise du Covid-19. Le SARS-CoV-2 est retrouvĂ© dans les voies aĂ©riennes des patients, y compris asymptomatiques. Les donnĂ©es rĂ©centes de la littĂ©rature suggĂšrent un risque de transmission du SARS-CoV-2 par voie aĂ©rienne qui a probablement Ă©tĂ© sous-estimĂ©, notamment via des aĂ©rosols gĂ©nĂ©rĂ©s par la toux ou les Ă©ternuements, mais aussi plus simplement la parole et la respiration, et donc la composition est majoritairement le fait de particules dont le diamĂštre est infĂ©rieur ou Ă©gal Ă  1 ÎŒm. Des donnĂ©es prĂ©liminaires montrent la prĂ©sence d’ARN viral dans l’air et sur des surfaces distantes des patients sources. Cependant, il est important de noter que la dĂ©tection de matĂ©riel gĂ©nĂ©tique viral par RT-PCR ne signifie pas que le virus soit vivant et infectant. En fonction de donnĂ©es sur la quantification du pouvoir infectant des aĂ©rosols de petite taille et si l’hypothĂšse d’une telle transmission Ă©tait confirmĂ©e, les indications de port des protections respiratoires de type FFP2 mĂ©riteraient d’ĂȘtre Ă©largies, notamment en milieu de soin
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