EMC - Toxicologie-Pathologie最新文献

The growing number of human activities based on ionising radiation, along with the demonstration of its effects on the human body, has led to the creation of a radiation protection system. This system is based on the recommendations of the International Commission on Radiological Protection (ICRP). Its purpose is to provide a framework for the use of ionising radiation, exclude deterministic effects and restrict stochastic ones. The French regulations follow these recommendations quite closely, via the EURATOM European Directives. The French system constitutes a coherent whole, relevant to the general population, patients and workers, in both normal situations and those involving exceptional exposure or radiological emergencies. It lays down a strict framework for such practices, which makes the implementation of an effective risk control strategy easier. Within this radiation protection organisation, IRSN (the French institute for radiological protection and nuclear safety) supplies expertise, while DGNSR (the French general department for nuclear safety and radiation protection) is in charge of technical and regulatory radiation protection monitoring.

Zoonoses are infections transmitted to the humans by wild or domestic animals. They are characterized by their diversity, their constant evolution and their geographical or time variability. New emergent and older re-emergent diseases need therefore to be surveyed. Occupational exposition to animals constitutes frequently a source of contamination. A good knowledge of the ways of transmission of the diseases -from the source to the host- is useful for proper protection. Many means can be used to protect workers: reduction of the risk at the source when possible (veterinary prophylaxis and sanitary measures), strict respect of hygiene measures (at the individual level and in the workplace), wearing of individual protection equipments. Such devices must be adapted to the way of penetration of responsible micro-organisms. Information about the risk is also important for workers' protection. Some occupational zoonoses and main protection measures are presented in this article.

The organic derivatives of the sulphur include the following substances: mercaptans or thiols, sulphides, sulphoxides, benzothiazoles, sulphates, thioureas, and sulphones. Their uses are multiple (chemical industry, cosmetics, pharmaceutical industry, pesticides…). Some are used as chemical warfare (mustard gas or yperite, for example). Signs of toxicity frequently occur in the occupational field as few of them are in direct contact with the general population. A lot of these substances have a local toxicity due to their irritant properties. Their systemic toxicity is highly variable according to their chemical structure. Some of these compounds are sensitizing (sulfides, sulfoxides, sulfates…), some are mutagens (such as some sulfides); others have shown carcinogenic properties (mustard gas or yperite, for example), or teratogenic properties in animals (dimethyl sulfoxide, for example).

The findings on the toxicological effects of twelve phthalate esters, among the most largely used, are reviewed. This review completes a previous article on six other phthalates. Phthalates are generally distributed into three categories based on their physicochemical and toxicological properties. Low molecular weight phthalates (which include methyl and ethyl phthalates) are commonly used as solvents or in cellulose acetate industry. Their water solubility is slightly greater than other phthalates. High molecular weight phthalates are used nearly exclusively as plasticizers in polyvinyl chloride. They are insoluble in water and have a very low vapour pressure. Transitional phthalates are substances with either linear or branched side chains, with the stipulation that the predominant fraction of the alkyl side chains have a linear portion with carbon numbers ranging from C4-C6. They are characterized by a greater toxicity potential compared to methyl, ethyl, and high molecular weight phthalates, especially regarding their reproductive and developmental effects.

Growing attention is actually paid to post traumatic stress disorders, in relation with the development of emergency traumatic centers where victims of disasters or collective accidents, hostages, or victims of events with high psychological consequences may benefit from adapted therapeutic management. French specialists consider the trauma rather than the related stress as the clinical reference. It is essentially characterized by the intrusive syndrome which is specific of such disorders, associated with non specific symptoms such as psychosomatic or personality disorders. The therapeutic intervention is carried out within the organization implemented by the emergency traumatic centers, consisting of immediate interventions in or near the place where the event occurred, and later of a more appropriate psychotherapeutic post-immediate intervention. Individual victims of aggressions and violence may take opportunity of psychotraumatic consultations.

Keeping in mind the interrogations of clinical practitioners and researchers, the authors present current concepts and data that characterize occupational psychodynamics and psychopathology (psychotraumatology inclusively). Emphasis is put on the subjectivity as it is perceived in a clinical integrative-understanding approach, as opposed to objectivizing behavioural methods. A historical analysis of the literature introduces the review of main clinical categories encountered in occupational psychopathology. Finally, the trans-individual dimension of psychotraumatology and psychodynamics is evoked.

Controlling rodent pests is a continuing goal of mankind. To this end, a multitude of rodenticides have been produced, each designed to kill rodents by exerting their toxic effects on various body systems. But the large domestic use of such toxic chemicals can lead to human unintentional exposure or deliberate self-poisoning. The most commonly reported intoxications are those caused by anticoagulant rodenticides. They act by interrupting cellular recycling of vitamin K and inducing a secondary coagulopathy. Vitamin K therapy is the antidotal treatment. For life-threatening bleeding, the use of clotting factor concentrates is essential for immediate anticoagulation reversal. Other cases of rodenticide hazards are reported with convulsant poisons such as chloralose. Illegally imported foreign products can also result in domestic exposures to unusual toxic chemicals. Therapeutic success in these poisonings is mainly dependant upon symptomatic and supportive care.