Evolution of work conditions for employees driving for work in France based on data from the 2003, 2010 and 2017 SUMER surveys (Surveillance Médicale des expositions aux risques Professionnels).

INTRODUCTION: The occupational road-accident risk on public roads and the work conditions for professional driving is still an important issue in occupational health despite lower road-accident rates. This study presents the evolution over time of the work-related constraints for these employees based on the Sumer surveys carried out in 2003, 2010 and 2017. METHOD: Data from the 2010 and 2017 surveys were restricted to match the scope of the 2003 survey in order to enable prevalence data to be compared in equivalent populations. The main variable of interest was "driving (car, truck, bus, and other vehicles) on public thoroughfares" for work (during the last week of work: yes/no). Work time characteristics, work rhythm, autonomy and scope for initiative, collective work group, standards and evaluations variables were completed by the occupational health physicians. A self-administered questionnaire was also provided to employees and contained the Job Content Questionnaire, which assesses decision latitude, social support and psychological demands, the reward scale of Siegrist questionnaire, the hostile behaviour with inspired questions for Leymann, sick leave and work accidents during the past 12 months and job satisfaction. Finally, prevention in the workplace was also completed by the occupational health physicians. RESULTS: About 25% of employees in France were exposed to work-related driving in 2017, which was stable in comparison with 2003 and 2010. However, the population was older and there were more females, more often from the clerical staff/middle manager category and working in companies with fewer than 10 employees. Employees exposed to work-related driving were also more frequently exposed to sustained work schedules and physical constraints, but less exposed to psychosocial risks. CONCLUSIONS: The percentage of employees exposed to occupational road accident risk, i.e., exposure to work-related driving, remained stable at about 25% in 2017 compared with previous surveys. These employees were also more frequently exposed to sustained work schedules and physical constraints, but less exposed to psychosocial risks. PRACTICAL APPLICATIONS: Prevention campaigns on work-related road accident risk should be provided to all employees in all companies since all jobs can be concerned.

Factors associated with accidents involving biological material among health professionals.

Introduction: Accidents with biological material and cuting/piercing instruments among health professionals have led to increased rates of hospital infection and subsequent patient contamination. Objectives: To compare factors associated with accidents involving biological material among health workers. Methods: This cross-sectional epidemiological study, conducted in 2019-2020, included 229 physicians and non-physicians. Results: The sample was 60.7% physicians and 39.3% non-physicians; 51.5% were women; 48.5% were aged ≥40 years; 55% lived with a partner; 57.6% had a specialist or graduate degree; and 51.5% had ≥ 1 child). he physician group had a higher education level, worked > 1 job, and had a high rate of accidents, in addition to lower rates of pre-employment examinations, specific accident training, and supervisor contact in case of accidents. There was also a positive association in the physician group between accidents, employment length, and operating room experience, while age was inversely correlated with accident risk. Conclusions: Different worker categories had specific risk profiles that involved education level, employment length, a low notification level, and risk underestimation. The results showed that education level and employment length do not guarantee accidents prevention. Both the physician and non-physician groups had significant accident rates and a similar behavior profile when events occurred, including low notification rates and underestimating the risk involved in the accident.

Introdução: Acidentes envolvendo material biológico com instrumentos cortantes e perfurantes entre profissionais de saúde têm sido causa de aumento de infecção hospitalar e, portanto, de contaminação do paciente. Objetivos: Comparar fatores associados ao acidente com material biológico em trabalhadores da saúde. Métodos: Estudo epidemiológico transversal envolvendo 229 profissionais, médicos e não médicos (2019-2020). Resultados: A amostra total foi composta por 229 profissionais (48,1% médicos, 51,9% não médicos, 51,5% mulheres, 48,5% ≥ 40 anos, 55% viviam com companheiro, 57,6% tinham nível educacional de especialização/pós-graduação, 51,5% ≥ um filho). Os profissionais médicos apresentaram maior escolaridade, mais de um emprego e maior proporção de ocorrência de acidentes, bem como menor proporção de exames admissionais, treinamentos específicos e contato com supervisor em casos de acidentes. Ainda, os profissionais médicos apresentaram associação positiva dos acidentes com o tempo de trabalho e o tempo de experiência no bloco cirúrgico, enquanto a idade apresentou relação inversa com as chances de acidentes. Conclusões: Diferentes categorias de trabalho apresentaram perfil específico de riscos envolvendo estudo e tempo de serviço, baixa notificação e risco subestimado. Os resultados deste estudo mostraram que o nível de estudo e o tempo de serviço não foram capazes de garantir a prevenção de acidentes envolvendo material biológico. Além disso, profissionais médicos e não médicos apresentaram não apenas uma incidência significativa de acidentes, mas também um perfil de comportamento semelhante diante do evento, com baixa notificação e risco subestimado do acidente.

Non-interventional Pilot Study Evaluating the Efficacy and Safety of Lysozymebased Therapy in Patients with Non-infectious Sore Throat.

OBJECTIVE: This study aimed to evaluate the efficacy and safety of lysozyme-based oral antiseptic in the therapy of non-infectious sore throat in teachers. MATERIALS AND METHODS: A non-interventional, prospective, pilot study was conducted with two examinations. The first was performed as part of a general medical examination. If a non-infectious sore throat was confirmed by clinical checkup and all other inclusion and non-exclusion criteria confirmed, patients were offered to be enrolled in the study. After signing the informed consent form, patients were advised to use lysozyme-based lozenges, six times a day, for a period of five days. A telephone call follow-up examination was performed within 24 hours from the therapy completion. RESULTS: This was a pilot study involving 25 adult patients of both genders. Lysozyme-based lozenges showed positive effects in relieving the symptoms of non-infectious sore throat in teachers. At the same time, the lozenges showed excellent tolerability, and no side effects were reported during the study. 92% of patients confirmed they would take the same medicine again due to the same problem. CONCLUSION: The results of this "proof-of-concept" study indicated that lysozyme-based antiseptic could be effective and safe in the treatment of non-infectious sore throat in teachers and should be further evaluated as treatment option in this condition.

Injecting drug users, MSM and people at the older age should be routinely tested for HCV in Poland - data derived from a post-exposure prophylaxis population.

OBJECTIVE: The aim of the study was to identify risk factors for HCV infection and thus identify groups for routine HCV testing in the group of people consulted for post-exposure prophylaxis (PEP). MATERIAL AND METHODS: A retrospective analysis was performed of cross-sectional data available from consultations due to post-exposure prophylaxis in HIV Out-patient Clinic and Emergency Department (ED) of Hospital for Infectious Diseases in Warsaw, Poland. Data were obtained from the electronic database, from 2008-o 2016. For statistical analysis, χ2 and t-tests were used for group comparisons, as appropriate. A total of 3,593 persons were included in the study, 60 (1.7%) were anti-HCV positive. In the first step, univariate models were estimated for each of predictors separately. RESULTS: The results showed that odds of infection are significantly higher in males (OR = 1.92), people after non-professional exposure (OR = 3.82), and increase with age (OR = 1.03). In the next step, a multivariate logistic model was fitted in the group of participants after non-professional exposure with gender, age, and route of exposure as predictors. Obtained results revealed significantly higher odds of infection, both in IDU (OR = 162.6) and gender exposure (OR = 3.59) groups. After including routes of exposure, effects of age remained significant (OR = 1.05), while the effects of gender did not (OR = 1.12). CONCLUSIONS: Based on the study results, it is recommended that routine testing for HCV should be provided for people at older age, and for individual with behavioural risk factors, such as history of injecting drus use or sexual exposure, particularly among men having sex with men (MSM).

Grado de riesgo biológico al manipular toxina botulínica como medicamento / Degree of Biohazard When Handling Botulinum Toxin as A Medication

Introducción: El uso de la toxina como medicamento constituye un riesgo biológico, debido a la presencia de la toxina, así como al uso indebido que se le puede dar. Objetivo: Evaluar el grado de riesgo biológico al manipular toxina botulínica como medicamento. Métodos: Estudio descriptivo transversal en el Centro Internacional de Restauración Neurológica, La Habana, Cuba, en 2017. Se aplicó una lista de chequeo de riesgo biológico a 6 profesionales del área de tratamiento de toxina botulínica. El resultado integrado de la lista de chequeo se analizó a través del método semicuantitativo "ERBIO". Resultados: La probabilidad se catalogó de "media", el cumplimiento de medidas de contención como "aceptable" y la exposición se consideró como "muy frecuente". Conclusiones: Se constató un grado de riesgo biológico "tolerable" al manipular la toxina botulínica como medicamento en el Centro Internacional de Restauración Neurológica. Esto implica que se deben considerar mejoras que no supongan una carga económica importante, que requerirán de comprobaciones periódicas para asegurar el mantenimiento de la eficacia de las medidas de control establecidas(AU)

Introduction: The use of the toxin as a medication constitutes a biological risk, due to the presence of the toxin, as well as the potential improper use. Objective: To evaluate the degree of biological risk when Handling botulinum toxin as a medication. Methods: A cross-sectional descriptive study was carried out at the International Center for Neurological Restoration, Havana, Cuba, in 2017. A biological risk checklist was applied to six professionals from the botulinum toxin treatment area. The integrated result of the checklist was analyzed through ERBIO semi-quantitative method. Results: The probability was classified as medium. Compliance with containment measures was assessed as acceptable and the exposure was considered as very frequent. Conclusions: A tolerable degree of biological risk was found when manipulating botulinum toxin as a medication at the International Center for Neurological Restoration. This implies that improvements should be considered not to imply a significant economic burden, which will require periodic checks to ensure the maintenance of the effectiveness of the established control measures(AU)

Etiological factors of systemic sclerosis in the southeast region of Romania.

Systemic sclerosis (SSc) is a relatively rare autoimmune disease with skin and visceral involvement, having a yet unknown etiopathogenesis. Research has shown that professional exposure to various polluting chemicals such as dyes, aliphatic and aromatic organic solvents, inhalable silica dust or certain heavy metals, can be triggering factors for this disease when they overlap a predisposing genetic profile. Smoking is still a debated factor involved in the etiology of SSc, as authors have divergent opinions on this matter. The present study was designed to analyze the etiological factors identified in the group of 37 patients with diffuse and limited SSc from the southeast region of Romania and the results were compared to the literature data. In the group of patients included in this study, occupational exposure and smoking history were not present in all patients, and a hereditary factor was identified only in an isolated case. The majority of patients suffered from a major negative psychological event or from long-term stressful situations and these factors were associated with smoking history or occupational exposure; this suggests that SSc is initiated in a set of cumulative triggering factors.

Gestión de la atención de salud bucal en tiempos de la COVID-19 / Management of oral health care in the time of COVID-19

Tema a presentar: En tiempos de COVID-19, debido al riesgo de transmisión derivado de varios procederes estomatológicos, se requiere reforzar la protección de los pacientes y de los trabajadores. Por tanto, se hace necesario actualizar a la comunidad científica y a los decisores de políticas en salud pública sobre aspectos esenciales para el perfeccionamiento de la gestión de la atención de salud bucal durante la pandemia. Comentarios principales: Con un enfoque actualizado según las experiencias internacionales, se trató el tema de la evaluación del riesgo laboral en estomatología y la gestión de la atención estomatológica durante la presente pandemia de COVID-19. Consideraciones globales: La profesión estomatológica tiene ante sí la responsabilidad de evitar la transmisión nosocomial de infecciones en los centros laborales, en las áreas de desempeño y que el personal en ejercicio de las acciones de salud esté protegido y no se convierta en trasmisor que ponga en riesgo a sus compañeros de trabajo, a la población que atiende, a su familia y a la población en general. El desempeño de los especialistas debe responder en todo momento a la ética médica y velar por ofrecer alternativas a las necesidades de salud bucal de la población en todas las situaciones de la vida social. La efectividad del accionar dependerá del perfeccionamiento de la gestión de la atención de salud bucal en tiempos de la COVID-19(AU)

Topic to be presented: In the time of COVID-19, and due to the risk of transmission derived from various dental procedures, it is necessary to enhance the protection of patients and workers. The scientific community and public health policy makers should therefore be updated on essential contents related to the improved management of oral health care during the pandemic. Main remarks: The topic of occupational risk assessment and dental care management during the current COVID-19 pandemic was addressed with an updated approach in keeping with international experiences. General considerations: The dental care profession has the responsibility of preventing nosocomial transmission of infections at work places and performance areas, as well as ensuring the protection of those involved in health actions, so that they do not become infected and transmit the disease to their colleagues, their patients, their family and the population at large. Specialists should always comply with medical ethics and offer alternatives to the oral health care needs of the population in all social life situations. The effectiveness of such actions will depend on improving the management of oral health care in the time of COVID-19(AU)

Sensitization to occupational allergens in hairdressing apprentices diagnosed already before entering vocational training.

BACKGROUND: Hairdressers are occupationally exposed to many allergenic and irritating substances. Additionally, hairdressing apprentices are exposed to the same allergens as professional hairdressers, due to the fact that vocational training starts in the beginning of the education. This study was undertaken to investigate early occurrence of sensitization to occupational allergens in hairdressing apprentices before the onset of the vocational training. MATERIAL AND METHODS: Three hundred and seven hairdressing apprentices were assessed using a questionnaire and skin prick tests (SPTs) to common and occupational allergens. The level of total and serum specific immunoglobulin E (IgE) to occupational allergens was evaluated and spirometry was performed. RESULTS: At least one skin and/or respiratory and/or conjunctival symptom was reported by 29.9% of subjects. Among subjects with at least one symptom, 28.2% of them were atopic whereas among 43.4% of them total IgE level was elevated. Atopy was found in 20% cases. In the case of one apprentice, positive SPT for paraphenylenediamine was found. Nearly 33% of apprentices had elevated total IgE level and 5 of them had specific IgE for occupational allergens. CONCLUSIONS: The study revealed that hairdressing apprentices might be sensitized to occupational allergens even before the beginning of vocational training, due to prior non-professional exposure to hairdressing agents. Furthermore, many of them report skin, respiratory and conjunctival symptoms, often connected with chronic disease diagnosis. Thus, candidates for hairdressers should be examined thoroughly before the start of the education and tests for allergy to hairdressing substances are indicated. Med Pr 2016;67(5):567-575.

Designing of High-Volume PET/CT Facility with Optimal Reduction of Radiation Exposure to the Staff: Implementation and Optimization in a Tertiary Health Care Facility in India.

Positron emission tomography (PET) has been in use for a few decades but with its fusion with computed tomography (CT) in 2001, the new PET/CT integrated system has become very popular and is now a key influential modality for patient management in oncology. However, along with its growing popularity, a growing concern of radiation safety among the radiation professionals has become evident. We have judiciously developed a PET/CT facility with optimal shielding, along with an efficient workflow to perform high volume procedures and minimize the radiation exposure to the staff and the general public by reducing unnecessary patient proximity to the staff and general public.

Neuropsychological Testing in Interventional Cardiology Staff after Long-Term Exposure to Ionizing Radiation.

This study aimed at comparing neuropsychological test scores in 83 cardiologists and nurses (exposed group, EG) working in the cardiac catheterization laboratory, and 83 control participants (non exposed group, nEG), to explore possible cognitive impairments. The neuropsychological assessment was carried out by means of a battery called "Esame Neuropsicologico Breve." EG participants showed significantly lower scores on the delayed recall, visual short-term memory, and semantic lexical access ability than the nEG ones. No dose response could be detected. EG participants showed lower memory and verbal fluency performances, as compared with nEG. These reduced skills suggest alterations of some left hemisphere structures that are more exposed to IR in interventional cardiology staff. On the basis of these findings, therefore, head protection would be a mandatory good practice to reduce effects of head exposure to ionizing radiation among invasive cardiology personnel (and among other exposed professionals).

New models for prediction of micronuclei formation in nuclear medicine department workers.

BACKGROUND: Ionizing radiation causes detrimental health effects such as cancer and genetic damage. The study aim was to determine predictors for micronuclei (MN) occurrence and frequency in peripheral blood lymphocytes of health workers professionally exposed to radiation. METHODS: Health workers, age matched, selected for the study on regular check-ups, were divided according to the radiation exposure. The exposed group involved nuclear medicine department employees (54) and the control group comprised workers from other departments (36). Data about workers characteristics and habits, received annual doses (AD), total years of service (TYS) and exposed years of service (EYS) were taken from each subject. Blood samples were taken and micronuclei (MN) number in peripheral blood lymphocytes was calculated using CBMN assay according to standard protocols. RESULTS: Most workers were female, technicians, with mean age of 45.67 years and EYS about 15 years. Health workers exposed to radiation had significantly more MN than controls (p = 0.001). Female gender, older age, higher received annual doses, longer EYS and TYS increased the MN number. Technicians and laboratory workers have higher risk for MN occurrence. Significant predictors of MN formation according to constructed model were workers age, sex, AD and EYS. One EYS year increases MN frequency 1.017 times, while receiving 0.1 mSy raises MN frequency by 26 %. EYS accurately predicts 86.30 % of MN frequencies and AD 64.60 %. CONCLUSIONS: The model, developed for the first time in this study, showed that received annual doses and duration of exposure to radiation can be used for prediction of MN numbers.

Pollution in the working place and social status: co-factors in lung cancer carcinogenesis.

INTRODUCTION: Apart from the association with tobacco consumption, other factors of importance for prevention and early diagnosis of lung cancer have received little attention. We present a case-control study focusing on professional exposure to carcinogens and social status. METHODS: A written questionnaire was completed by 551 consecutive patients with lung cancer and 494 patients with large bowel cancer. The groups were balanced regarding gender and age distribution. The questionnaire included data on place of birth, education, smoking history, diet and alcohol intake, body weight and height, occupation, housing conditions and family income. According to standard epidemiological criteria, professional exposure to carcinogens was classified as professions with exposure to confirmed lung cancer carcinogens, professions with exposure to suspected lung cancer carcinogens and other professions. RESULTS: As expected, there were significant differences between the two groups regarding smoking status. While there were no significant differences in educational levels, more immigrants were among patients with lung cancer (17.9% vs 11.6%, p=0.005). On average, lung cancer patients had a lower body mass index (BMI) at 24.77, as compared to 26.14 for large bowel cancer (p=0.000). Lung cancer patients had lower income and poorer housing conditions; the bivariate difference was significant both for income levels (p=0.046) and type of residence (p=0.009). The proportion of patients working in professions with exposures to known carcinogens was 33.5% for lung cancer, and 17.1% for large bowel cancer (p=0.000). In the multivariate analysis, smoking (p=0.000), BMI (p=0.000) and type of occupation (p=0.001) were significant factors. CONCLUSIONS: While there is no doubt about smoking in lung cancer carcinogenesis, professional exposure to carcinogens and belonging to lower socio-economic strata also play an important role.

Health worker exposure risk during inhalation sedation with sevoflurane using the (AnaConDa®) anaesthetic conserving device.

INTRODUCTION AND OBJECTIVE: Occupational exposure to sevoflurane should not exceed 2 ppm. During inhalation sedation with sevoflurane using the anaesthetic conserving device (AnaConDa(®)) in the post-anaesthesia care unit, waste gases can be reduced by gas extraction systems or scavenging devices such as CONTRAfluran™. However, the efficacy of these methods has not been clearly established. To determine the safest scenario for healthcare workers during inhalation sedation with sevoflurane in the post-surgical intensive care unit. MATERIALS AND METHODS: An experimental study on occupational exposure was conducted in a post-cardiothoracic care unit during March-August 2009. The measurements were performed in four post-cardiac surgery sedated adults in post-surgical intensive care unit and four nurses at the bedside, and at four points: scenario A, inhalation sedation without gas extraction system or contrafluran as a reference scenario; scenario B, applying a gas extraction system to the ventilator; scenario C, using contrafluran; and scenario 0, performing intravenous isolation sedation. Sevoflurane concentrations were measured in the nurses' breathing area during patient care, and at 1.5 and 8 m from the ventilator using diffusive passive monitor badges. RESULTS: All badges corresponding to the nurses' breathing area were below 2 ppm. Levels of sevoflurane detected using prevention systems were lower than that in the control situation. Only one determination over 2 ppm was found, corresponding to the monitor placed nearest the gas outlet of the ventilator in scenario A. Trace concentrations of sevoflurane were found in scenario 0 during intravenous sedation. CONCLUSIONS: Administration of sevoflurane through the AnaConDa(®) system during inhalation sedation in post-surgical intensive care units is safe for healthcare workers, but gas extraction systems or scavenging systems, such as CONTRAfluran™ should be used to reduce occupational exposure as much as possible.

The preventive strategies for HIV exposure among medical staff / 中国实用护理杂志

Objective To give a clear definition of professional exposure to HIV and map out the preventive strategies. Methods To propose the preventive strategies for preventing professional exposure to HIV according to the relative knowledge and the practical nursing measures. Results The preventive strategies include the recognition from the administrative authority, care about the exposure suits for preventing HIV , the establishment of a reasonable by law, properly handling the wound when exposure happen and report the accident to local CDC and arrange HIV test at 4,8,12 week and 6 month after exposures. Conclusions The medical staff lack the knowledge of preventing professional exposure to HIV, the intensive training is urgently needed. It is better to involve the professional HIV exposure as one of the professional injuries by law in order to relieve the medical staff′s anxieties about HIV exposure during the course of working.

Professional Exposure of Dental Health Personnel:A Prevention Research / 中华医院感染学杂志

OBJECTIVE To discuss the risk factors of professional exposure of dental health personnel and treatment measures. METHODS The management system of standardization,systematization,science and universal prevention were carried out and realized to maximally prevent the onset of dental hospital infection. RESULTS A set of feasible management system and measures about professional exposure for dental health personnel were drafted to make dental staff master the management standards of dental infection,realize the sterilization procedures of dental device and prevent dental infection maximally in dental hospital by implementing universal preventive measures during dental treatment. CONCLUSIONS The preventive measures and programs about professional exposure for dental health personnel must be structuralized.

Risk Factors of Professional Exposure among Medical Staff:Analysis and Preventive Strategies / 中华医院感染学杂志

OBJECTIVE To investigate the risk factors of professional exposure among medical staff and explore the preventive strategies.METHODS The influence of factors including profession,exposure process,exposed materials,treatment process,and follow-up among 110 medical staff with professional exposure was analyzed.RESULTS The general incidence of professional exposure was 52.73%,35.45% and 6.36% for clinical doctors,nures,and workers,respectively.Among all exposure cases,we found the incidence was 62.73% for pricking wound,20% for various liquid contamination,4.55% for glass injury,2.73% for scalpel cutting,and 4.55% for other instrument related damage.The reasons leading to exposure were treatment and nursing care,surgery assistance,and instrument and materials manipulation,which accounted for 40%,31.82%,and 18.18% of total incidence,respectively.All of the exposure cases had been properly treated.None of the investigated cases had been found illed with blood derived transmitted disease caused by professional exposure.CONCLUSIONS It is critical to intensify the training of medical staff for the knowledge of professional exposure and to improve their personal protective awareness,so that the incidence of professional exposure could be reduced.

Professional Exposing Risks and Preventive Strategies for Dental Staff / 中华医院感染学杂志

OBJECTIVE To evaluate the exposing risks among dental staff and improve their concerns for prevention. METHODS By checking and evaluating the various risk factors,including HIV,HBV,HCV,SARS infectious antigens,and mercury contamination in our hospital,we found and formulated effective ways for preventing occupational disease. RESULTS Most dental staff in our hospital effectively decreased the professional exposing risks by practising preventive strategies. CONCLUSIONS Accurate evaluation and practical preventive strategies are key factors to reduce the professional exposing risks for dental staff.