Occupational internal monitoring in nuclear medicine service of Sainte-Anne military hospital: previous considerations and results.

The Nuclear Medicine Department of Sainte-Anne military hospital in Toulon uses 99mTc, 123I and 18F unsealed sources to provide therapeutic and diagnostic care. For a few years, only ambient air and surface monitoring were performed to check the absence of internal contamination risk for workers. To verify this risk assessment hypothesis, confirmatory monitoring programme including in vivo and in vitro measurements was performed by the French defence radiation protection service (SPRA, Clamart). Here, due to the short half-life of targeted radionuclides, the analytical sensitivity was determined with estimations of minimal detectable activities and derived recording levels. It was shown that sensitivity was sufficient to detect an internal contamination leading to an effective dose of 0.1 mSv for few days post intake. At the same time, around 20 whole-body countings were performed. Results were below minimal detectable activity and were confirmed by 24-hours urine analysis. So, actual working conditions do not lead to measurable internal contamination for nuclear medicine staff.

Determination of glyphosate and AMPA in indoor settled dust by hydrophilic interaction liquid chromatography with tandem mass spectrometry and implications for human exposure.

The widespread application of glyphosate leads to significant contamination of outdoor environmental compartments, notably air and soil, which can contaminate indoor air and dust. This study assessed the contamination of indoor household dust for the first time in France and potential exposure to glyphosate through the inadvertent ingestion of dust. A specific and new analytical method was developed using HILIC MS/MS (hydrophilic interaction liquid chromatography with tandem mass spectrometry) to measure polar pesticides, such as glyphosate, aminomethylphosphonic acid, and glufosinate, in indoor dust, with a low quantification limit (25 ng/g). The dust from vacuum cleaner bags of 60 rural and urban households (Brittany, France) was analyzed. All samples contained glyphosate (median 1675 ng/g for rural dwellings (n = 29), 457 ng/g for urban dwellings (n = 31)), more than 90 % contained aminomethylphosphonic acid, and none contained glufosinate. Concentrations were influenced by the rural or urban setting, the proximity of crops, and the use of weed killers on driveways or lawns. Glyphosate exposure via indoor dust ingestion was < 1 % of both acceptable daily intake and dietary intake. However, the high quantification limit of the glyphosate concentration in the food analysis method probably leads to overestimation of the dose from food.

Nose-only inhalations of high-dose alumina nanoparticles/hydrogen chloride gas mixtures induce strong pulmonary pro-inflammatory response: a pilot study.

OBJECTIVE: Solid composite propellants combustion, in aerospace and defense fields, can lead to complex aerosols emission containing high concentrations of alumina nanoparticles (Al2O3 NPs) and hydrogen chloride gas (HClg). Exposure to these mixtures by inhalation is thus possible but literature data toward their pulmonary toxicity are missing. To specify hazards resulting from these combustion aerosols, a pilot study was implemented. MATERIALS AND METHODS: Male Wistar rats were nose-only exposed to Al2O3 NPs (primary size 13 nm, 10 g/L suspension leading to 20.0-22.1 mg/m3 aerosol) and/or to HClg aerosols (5 ppm target concentration) following two exposure scenarios (single exposures (SE) or repeated exposures (RE)). Bronchoalveolar lavage fluids (BALF) content and lungs histopathology were analyzed 24 h after exposures. RESULTS: Repeated co-exposures increased total proteins and LDH concentrations in BALF indicating alveolar-capillary barrier permeabilization and cytolysis. Early pulmonary inflammation was induced after RE to Al2O3 NPs ± HClg resulting in PMN, TNF-α, IL-1ß, and GRO/KC increases in BALF. Both exposure scenarios resulted in pulmonary histopathological lesions (vascular congestions, bronchial pre-exfoliations, vascular and interalveolar septum edemas). Lung oxidative damages were observed in situ following SE. CONCLUSION: Observed biological effects are dependent on both aerosol content and exposure scenario. Results showed an important pro-inflammatory effect of Al2O3 NPs/HClg mixtures on the lungs of rat 24 h after exposure. This pilot study raises concerns toward potential long-term pulmonary toxicity of combustion aerosols and highlights the importance for further studies to be led in order to define dose limitations and exposure thresholds for risk management at the work place.

Organophosphorus diisopropylfluorophosphate (DFP) intoxication in zebrafish larvae causes behavioral defects, neuronal hyperexcitation and neuronal death.

With millions of intoxications each year and over 200,000 deaths, organophosphorus (OP) compounds are an important public health issue worldwide. OP poisoning induces cholinergic syndrome, with respiratory distress, hypertension, and neuron damage that may lead to epileptic seizures and permanent cognitive deficits. Existing countermeasures are lifesaving but do not prevent long-lasting neuronal comorbidities, emphasizing the urgent need for animal models to better understand OP neurotoxicity and identify novel antidotes. Here, using diisopropylfluorophosphate (DFP), a prototypic and moderately toxic OP, combined with zebrafish larvae, we first showed that DFP poisoning caused major acetylcholinesterase inhibition, resulting in paralysis and CNS neuron hyperactivation, as indicated by increased neuronal calcium transients and overexpression of the immediate early genes fosab, junBa, npas4b, and atf3. In addition to these epileptiform seizure-like events, DFP-exposed larvae showed increased neuronal apoptosis, which were both partially alleviated by diazepam treatment, suggesting a causal link between neuronal hyperexcitation and cell death. Last, DFP poisoning induced an altered balance of glutamatergic/GABAergic synaptic activity with increased NR2B-NMDA receptor accumulation combined with decreased GAD65/67 and gephyrin protein accumulation. The zebrafish DFP model presented here thus provides important novel insights into the pathophysiology of OP intoxication, making it a promising model to identify novel antidotes.

RECOMMENDATIONS FOR MONITORING AND INTERNAL DOSIMETRY FOR NUCLEAR MEDICINE STAFF EXPOSED TO RADIOPHARMACEUTICALS 223Ra DICHLORIDE.

223Ra is a radiopharmaceutical used as unsealed source in nuclear medicine. In the case of staff inhalation contamination of 223Ra, methods to estimate the committed effective dose should be chosen with care. Three methods are available: whole-body measurement and gamma spectrometry for urine or faeces samples. Considering the analytical performances and uncertainties of these three methods, we propose recommendations for special dose assessment. As a first choice, due to its rapidity and its non-invasiveness, an in vivo analysis (with HPGe detector) is the most appropriate method. However, after 24 h, whole-body counting is not sensitive enough to detect a minimum effective dose of 1 mSv. Sufficient sensitivity can only be reached up to 8 days after contamination by true 24 h faeces samples analyses. Thus, despite its main drawbacks, this method appears to be more appropriate than urine to estimate the committed effective dose in addition to whole-body counting.

[A prevalence study to monitor the consumption of antibiotics]. / Une enquête de prévalence pour suivre la consommation en antibiotiques.

Following the second Antibiotics Plan, in association with the hospital hygiene operational team, the hospital pharmacy department of the Desgenettes military teaching hospital led a study into the prevalence of the prescribing of antibiotics in December 2011. The study highlighted the trends in prescriptions and assessed the effectiveness of corrective or preventive actions implemented following the first prevalence study of 2006, in particular the multidisciplinary antibiotherapy coordination meetings.

[Improving collaboration between the pharmacy and the nurses]. / Améliorer la collaboration entre la pharmacie et les infirmierès.

In hospitals, improving collaboration between the diferent players in the health care chain is an ongoing issue. Numerous tools are available to facilitate interprofessional communication. Satisfaction surveys can be of particular interest.