Preventing the contamination of hospital personnel by cytotoxic agents: evaluation and training of the para-professional healthcare workers in oncology units.

This study was specifically focused on para-professional healthcare workers (PHCWs) who handle cytotoxic drugs and contaminated wastes at the Public Teaching Hospitals of Marseille (AP-HM), France. It first aimed at evaluating the knowledge and professional practice of the PHCWs who belong to a personnel category among the less informed and protected in hospitals. In a second time, this study also proposed to raise awareness, educate and train the staff on protective measures to minimise the exposure of the PHCWs to the potential toxicity of anticancer chemotherapy agents (or metabolites) when cleaning and handling both cytotoxic drugs and wastes. Among the 11 oncology units evaluated, 82% completed an assessment survey, 63% of which were PHCWs. Out of nine oncology units assessed, 89% reported limited knowledge of the general risk and of the safe handling of cytotoxic drugs, 89% reported using vinyl gloves which are the less protective ones. Forty-four per cent of the units used wet sweeping techniques for cleaning the floors, and 11% of the units did not have specific procedures for cleaning the equipments used for collecting contaminated excreta. Protective outer apparel was not always worn and chemotherapy wastes were not managed consistently between all units. Standardized procedures and guidelines to prevent occupational exposure were not used by PHCWs. More education and training are needed to improve safety.

[The prevalence of adolescent asthma in Rabat. A survey conducted in secondary schools]. / Prévalence de l'asthme de l'adolescent à Rabat. Enquête dans les établissements de l'enseignement secondaire.

An enquiry was made to determine the prevalence of asthma in adolescents and was achieved using a questionnaire which was filled in by the pupils in secondary schools in Rabat. The sample was determined by a systematic poll of 1,616 pupils of whom 1,464 (90.6%) replied. 88 pupils (6.0%) replied in the affirmative to the question "Have you ever had whistling noises in the chest?", 78 (5.3%) to the question "Have you ever had a sensation of respiratory difficulty or suffocation with a whistling noise in the chest?", 48 (3.3%) to the question "Have you ever had asthma?" and 36 (2.5%) to all 3 questions and 114 (7.8%) to one or other of the questions. After a detailed questionnaire had been carried out on 110 of 114 pupils the diagnosis of asthma was confirmed in 50, which gives an estimation of the accumulative prevalence of 3.4% +/- 0.9%. This prevalence is higher amongst the oldest children in the family (26 out of 349, 7.4%) compared to the birth order of the other brothers and sisters (24 out of 1,112, 2.2%) (p less than 0.001). Pupils from higher social backgrounds (22 out of 256, 8.6% against 28 out of 1,208, 2.3% from more average or more poor social backgrounds, p less than 0.01). A past family history of asthma were more often noted in asthmatics (38 out of 50, 76%) than in non-asthmatics (406 out of 414, 28.7%) p less than 0.001). In the same way cough and phlegm and episodes of bronchitis occurring in autumn and winter and breathlessness on effort are more frequent in asthmatics; 20 out of 50 (40%) against 318 out of 1,414 (22.5%) for the cough (p less than 0.01), 12 out of 50 (24%) against 157 out of 1,414 (11.1%) for phlegm (p less than 0.01), 31 out of 50 (62%) against 337 out of 1,414 (23.8%) for episodes of bronchitis (p less than 0.001) and 15 out of 50 (30%) against 219 out of 1,414 (15.5%) for breathlessness on effort (p less than 0.001). Besides this we have noticed a slight predominance of asthma in boys compared to girls but the difference is not significant.