EMC - Toxicologie-Pathologie最新文献

The strong reactivity of isocyanates is related to one or several -N= C= O groups. So these compounds are therefore worldwide used in large industrial fields. Likewise they are responsible for human reactivity and are the main cause of chemical occupational asthma in industrial countries, including in France. The severity of the pathology is related to asthma-induced impairment/disability or obstructive bronchiolitis after acute intoxication. Information on the complex pathomechanisms and mutagenic effects still lack. Industrial hygiene has to be more rigorous for better controlled methods of reducing exposure (in particular during spraying of paints…) and substitute products should be used if possible.

The characteristics of main chemical warfare agents are described in this chapter. Pathophysiology, diagnosis and treatment are reported. New trends and recent knowledge are emphasized.

Aluminium is the most abundant metallic element, and the third constituent of the earth’s crust. Aluminium occurs ubiquitously in the environment, in salts and oxides forms. Because of its physical and chemical properties, aluminium metal and compounds have a wide variety of uses: building, transportation, food packaging, beverage cans, cooking utensils, food additives, medicines, surgery materials, cosmetics, water purification. Aluminium determination remains uneasy, and although toxicity assessment partly depends on speciation, only total aluminium is usually analysed in environmental and biological samples. Whatever the way of exposure, absorption of aluminium is weak (under 1 per cent for gastrointestinal and dermal absorption and up to 3 per cent for inhalation). Human exposure is mainly dietary, less than 5 per cent of oral intake is due to drinking water. Antiperspirants can also be a non-negligible source of aluminium absorption. Most exposed populations remain patients on dialysis, long-term antacid consumers and workers in the aluminium industry. Toxic effects of aluminium chronic exposure are mainly neurological effects (encephalopathy, cognitive and motors disorders), bone disease (vitamin D resistant osteomalacia), and blood effects (microcytic anaemia). Aluminium also causes immune and allergic reactions. Other suspected effects are not confirmed, in particular Alzheimer’s disease.

Many injuries can occur during work in a cold environment. In most cases, serious injuries due to cold air may be prevented by elementary prevention. However, for many workers a risk of getting cold injuries is related to their routine activities. Both outdoor work in harsh climate and indoor work in cold environment can constitute a risk for cold injury. Cold injuries may be either systemic or localized. The two main major local injuries consist in two clinically different entities: freezing cold injuries and non-freezing cold injuries. Other minor disorders can also be observed: local pain, cold urticaria, acrocyanosis, effect on finger dexterity…The main systemic injury is the accidental hypothermia which leads to lethargy, coma, and sometimes to death. Some other disorders can also be observed: thermal discomfort, pain, and respiratory, cardiovascular, metabolic, muscular, psychological disorders… A good knowledge of the cold injury and its surroundings, an adequate preparation (physical fitness, feeding, development of adaptation mechanisms), appropriate clothing and a suitable distribution of tasks can prevent cold injury.

After reviewing the basic principles of work in heat, the European regulation and the standards on which it is based, the article approaches the aspects of evaluation of the basic parameters individually and described the indices which make it possible to predict the conditions of comfort and thermal stress. The systematic and a priori quantification of the working conditions is however not recommended and a general strategy for the management of the thermal work environment is proposed, organizing the cooperation between the employees, the technical staff and the occupational health advisers for an effective prevention. The four levels of intervention of this strategy are described, as well as the main prevention methods. The article ends by describing the health risks and the means of preventing them by selection, training, acclimatization and monitoring of the exposed workers.

The accidental intoxications with house produces and domestic use pesticides are usually slight, but sometimes they may be very serious. It is important to know the effects on the body and the management in front of an accident. The decrease in the intoxications depends on a good prevention.

Most of dangerous aquatic animals, vertebrates and invertebrates, are marine species. The venomous species have ability to administer a zootoxin by means of a venom apparatus : sponges, worms, sea urchins, starfish, octopods, and, the most dangerous, medusa, molluscs (Conus family), sea snake (Indopacific region) and hundreds of fishes (stingrays, weever, scorpionfish, stone fish…). The poisonous species are toxic after they are eaten, especially molluscs bivalvia when they have ingested toxic dinoflagellates (unicellular algae) and fish (clupeids, morays, tunas, tetraodons or fugu…). Ciguatera is a poisoning by coral reef animals, especially fish. The bites of some animals is dangerous (sharks, barracudas…). Animals and their biology are presented. The venoms apparatus (spines, stings, teeth) of venomous animals are described. The chemistry and characteristics of venoms are indicated when the are known. The circumstances of the accident, the clinical symptoms and the treatments are described.

Water is as essential to industrial activity as for human life. Inside workrooms, water is necessary for many uses : drinking, refrigeration, various process. Depending on the water resource used for feeding working place, chemical and microbiological qualities may be different. Depending on uses, exposure routes will be various : oral route, respiratory route, cutaneous contact. The microbiological hazards are bacteria, viruses, parasites, characterized by their virulence, their toxicogenesis, or even their resistance against antibiotics. The chemical hazards may be ranged into two categories : non carcinogenic and carcinogenic ; this distinction leads to a different approach for the cohulation of maximal acceptable concentrations for the exposed populations. The radioactive hazard must also be taken into account. The professional exposures are very numerous : drinking, inhalation, contact and include various professions as office workers, wasterwater works amployees, miners, swimming instructors etc. Prevention includes provisions for both technical and sanitary control for insuring a good water quality and its surveillance, a putting into practice of adequate technical procedures and an epidemiological survey.