RESUMO
BACKGROUND: Medical laboratory workers are frequently exposed to a wide range of chemicals. This exposure can have adverse effects on their health. Furthermore, a knowledge lack of the chemical risk increases the likelihood of exposure. The chemical risk assessment reduces the risk of exposure to hazardous chemicals and therefore, guarantees health and safety of the workers. METHOD: The chemical risk assessment was conducted using a modified INRS method, according to the new CLP Regulation, of 11 unit laboratories in a Moroccan medical laboratory. Observation of each workstation and analysis of safety data sheets are key tools in this study. RESULTS: A total of 144 substances and reagents that could affect the health of the analytical technicians were identified. Among these products, 17% are concerned by the low priority risk score, with 55% concerned by the average priority risk score and 28% concerned by the high priority risk score. This study also enabled to better identify the chemical agents that have restrictive occupational exposure limit value and controls were conducted to this effect. On the basis of the results obtained, several corrective and preventive measures have been proposed and implemented. CONCLUSION: Risk assessment is essential to ensure the health and safety of workers and to meet regulatory requirements. It enables to identify all the risky manipulations and to adopt appropriate preventive measures. However, it is not a one-time activity but it must be continuous in order to master the changes and thus ensure the best safety of all.
RESUMO
BACKGROUND: The correction of serum ferritin (SF) concentrations for inflammation because of infectious or parasitic diseases was recently proposed, especially in developing countries, but in many countries, adiposity has become the main cause of inflammation. OBJECTIVE: We assessed, overall and by adiposity status, the bias in the estimation of iron deficiency (ID) on the basis of uncorrected SF. DESIGN: A cross-sectional survey in 2010 in Rabat-Salé, Morocco, used a random sample of 811 women aged 20-49 y. Adiposity was assessed by body mass index (BMI) (in kg/m²) (normal: BMI <25; overweight: BMI ≥25 to <30; obese: BMI ≥30), waist circumference, and body fat. Inflammation was indicated by a C-reactive protein (CRP) concentration >2 mg/L. ID was indicated by an SF concentration <15 µg/L. The correction factor of SF for inflammation was derived from our sample. Differential effects of SF correction on ID status on the basis of adiposity were assessed by models that included adiposity × correction interactions and accounted for the within-subject correlation. RESULTS: The prevalence of overweight was 33.0% and of obesity was 34.0%. Inflammation (42.3%) was strongly linked with adiposity (20.1%, 37.6%, and 68.4% in normal, overweight, and obese subjects, respectively; P < 0.0001). SF increased from a CRP concentration >2 mg/L. The correction factor of SF was 0.65. The prevalence of ID (37.2% compared with 45.2%; difference -8.0%, P < 0.0001) was underestimated by not correcting SF, and the difference increased with adiposity (-2.9%, -8.5%, and -12.4% in normal, overweight, and obese subjects, respectively; P-interaction < 0.0001). Analogous results were observed for other adiposity measures. CONCLUSION: In developing countries where ID remains prevalent but rates of obesity are already high, corrected SF should be used when assessing ID status, even if infectious or parasitic diseases are no longer widespread. This trial was registered at clinicaltrials.gov as NCT01844349.