Exposure to fire smoke in fire training structures: A prospective observational study.

The aim of this study was to assess the level of exposure to and contamination by smoke within a population of firefighter instructors. We performed a prospective observational study from September 17 to September 26, 2018, using environmental samples and urinary biomarker analysis. Occupational exposure limits (OELs) were never exceeded, except for carbon monoxide for the fire attack training chamber and formaldehyde and carbon monoxide for the fire box. As regards to urinary biomarkers, we observed that 1OHP and 1-naphtol did accumulate. The pre-post analysis showed an acute exposure exceeding the BRVs of benzene, 1-hydroxypyrene and naphtol, except for 3-benzo[a]pyrene which was undetectable in half of the cases. Even if values were reassuring, an effort could be made to improve the working conditions and reduce contamination by rethinking the respiratory protection and improving PPE quality.

Lead contamination among Paris Fire Brigade firefighters who fought the Notre Dame Cathedral fire in Paris.

BACKGROUND: On 15th April 2019, the fire at Notre Dame Cathedral, Paris, resulted in the melting of 410 tons of lead. Four hundred fourteen Paris firefighters were involved. For the purpose of preventive medicine, the level of lead contamination among the firefighters was assessed. This study objectives' were to describe the blood lead levels (BLLs) in the firefighters, to study the influence of some parameters such as the function of firefighters and the decrease in BLLs during the follow-up investigations. METHODS: The emission of 138 kg of melted lead from the roof and spire of the Notre Dame Cathedral during the fire was estimated by the National Institute for Industrial Environment and Risks. Three categories were defined according to the estimated levels of external lead exposure and fire proximity: high (category 1, n = 170), medium (category 2, n = 151), and low (category 3, n = 93). Two to three weeks after the fire, blood samples to assess the BLLs were taken from firefighters in category 1 (N = 164) and from every female firefighter in category 1 and 2 (N = 4). When the BLL was above 50 µg/L (95th percentile of reference range concentrations for a sample of the French population), it was checked again at one month later (N = 31) and then, if still above 50 µg/L, at six months later (N = 10). RESULTS: The geometric mean of initial blood lead level was 31.5 µg/L (CI 95% [27.7-35.9]; Min-Max: 7.0-307.6 µg/L). Twenty-five percent (n = 42) of initial BLLs were above 50 µg/L, versus 10% (n = 16) at 1 month, and 2% (n = 3) at 6 months. The French binding biological BLL limit value (400 µg/L for men and 300 µg/L for women was never exceeded and all BLLs decreased over time. BLLs varied according to the function occupied during the extinguishing of the fire: operators', officers' and those of unknown function. BLLs were significantly higher compared to drivers reflecting their lower distance to fire and fume. CONCLUSIONS: The fire at Notre Dame Cathedral, Paris, resulted in moderate lead contamination among firefighters. Individual and collective protection measures probably helped to limit the contamination. Nevertheless, an effort could be made to improve the working conditions by rethinking the respiratory protection.

[Creation of a medical work station for use in community-based care]. / Création d'une station de travail médicale extrahospitalière.

In community-based care, the teams must adapt to the environment and perform a number of technical procedures. Foldable medical equipment has been developed and patented, enabling the care provision to approach hospital standards and improving working conditions in this context.

Time-Temperature Management Along the Food Cold Chain: A Review of Recent Developments.

The cold chain is responsible for the preservation and transportation of perishable foods in the proper temperature range to slow biological decay processes and deliver safe and high-quality foods to consumers. Studies show that the efficiency of the cold chain is often less than ideal, as temperature abuses above or below the optimal product-specific temperature range occur frequently, a situation that significantly increases food waste and endangers food safety. In this work, field studies on time-temperature conditions at each critical stage of the cold chain are reviewed to assess the current state of commercial cold chains. Precooling, ground operations during transportation, storage during display at retail and in domestic refrigerators, and commercial handling practices are identified and discussed as the major weaknesses in the modern cold chain. The improvement in efficiency achieved through the measurement, analysis, and management of time-temperature conditions is reviewed, along with the accompanying technical and practical challenges delaying the implementation of such methods. A combination of prospective experimental and modeling research on precooling uniformity, responsive food inventory management systems, and cold chains in developing countries is proposed for the improvement of the cold chain at the global scale.

Drying of Durum Wheat Pasta and Enriched Pasta: A Review of Modeling Approaches.

Models on drying of durum wheat pasta and enriched pasta were reviewed to identify avenues for improvement according to consumer needs, product formulation and processing conditions. This review first summarized the fundamental phenomena of pasta drying, mass transfer, heat transfer, momentum, chemical changes, shrinkage and crack formation. The basic equations of the current models were then presented, along with methods for the estimation of pasta transport and thermodynamic properties. The experimental validation of these models was also presented and highlighted the need for further model validation for drying at high temperatures (>-100°C) and for more accurate estimation of the pasta diffusion and mass transfer coefficients. This review indicates the need for the development of mechanistic models to improve our understanding of the mass and heat transfer mechanisms involved in pasta drying, and to consider the local changes in pasta transport properties and relaxation time for more accurate description of the moisture transport near glass transition conditions. The ability of current models to describe dried pasta quality according to the consumers expectations or to predict the impact of incorporating ingredients high in nutritional value on the drying of these enriched pasta was also discussed.

A Meta-Analysis of Enriched Pasta: What Are the Effects of Enrichment and Process Specifications on the Quality Attributes of Pasta?

Pasta products enriched with ingredients to improve their nutritional value or functionality have become increasingly popular, and substantial research efforts have been directed towards the development of new enriched pasta products. In this work, a meta-analysis was conducted to quantify the impact of enrichment and process specifications on the quality attributes of pasta. A literature search revealed 66 studies on enriched pasta. Process specifications and quality attributes, namely proximate composition, dough, drying, cooking, and mechanical properties, color, and sensory attributes, were extracted from the studies and compiled in a data set. Analysis of the data set revealed significant differences between pasta enriched with high-fiber ingredients and pasta enriched with pulse flour. High-fiber ingredients generally preserved the quality attributes of pasta more effectively than pulse flour. Comparisons based on the drying temperature showed that high drying temperatures generally improve the cooking properties of enriched pasta. Sensory evaluations indicated that enrichment levels below 10% generally do not affect consumer acceptance, but higher enrichment levels significantly decrease it. Pearson correlation coefficients showed that the gelatinization temperature and Farinograph properties are useful indicators of the mechanical properties and sensory attributes of pasta. The meta-analysis revealed the need to better understand the impact of the processing history of the enrichment ingredient on the quality attributes and the health benefits of enriched pasta.

Secondary care clinic for chronic disease: protocol.

BACKGROUND: The complexity of chronic disease management activities and the associated financial burden have prompted the development of organizational models, based on the integration of care and services, which rely on primary care services. However, since the institutions providing these services are continually undergoing reorganization, the Centre hospitalier affilié universitaire de Québec wanted to innovate by adapting the Chronic Care Model to create a clinic for the integrated follow-up of chronic disease that relies on hospital-based specialty care. OBJECTIVE: The aim of the study is to follow the project in order to contribute to knowledge about the way in which professional and management practices are organized to ensure better care coordination and the successful integration of the various follow-ups implemented. METHODS: The research strategy adopted is based on the longitudinal comparative case study with embedded units of analysis. The case study uses a mixed research method. RESULTS: We are currently in the analysis phase of the project. The results will be available in 2015. CONCLUSIONS: The project's originality lies in its consideration of the macro, meso, and micro contexts structuring the creation of the clinic in order to ensure the integration process is successful and to allow a theoretical generalization of the reorganization of practices to be developed.

Flaxseed-Enriched Cereal-Based Products: A Review of the Impact of Processing Conditions.

The properties of cereals products, bread, pasta, muffins, cookies, cakes, and bars, enriched with flaxseed, were reviewed to highlight suitable processing conditions for the production of high-quality flaxseed-enriched products with the desired health attributes. The review highlights the contrasting effect of flaxseed enrichment on the mechanical and physical properties of cereal products according to product type, flaxseed enrichment level, and processing history. Flaxseed lipids remain stable for most processing and storage conditions, presumably due to the significant antioxidant properties of lignans, but information is lacking on the impact of home-handling, such as bread toasting, on lipid oxidation. Cereal products enriched with flaxseed generally exhibit similar or improved shelf life compared to equivalent products with no flaxseed enrichment, suggesting that flaxseed may limit starch retrogradation, maintain moisture content, and delay microbial growth. Sensory analysis shows lower organoleptic properties of most cereal products containing flaxseed, but similar consumer acceptance for cereal products without and with flaxseed enrichment up to 15% is reported in the literature. This review indicates the need to better understand the impact of flaxseed enrichment on product microstructure and to conduct an extensive assessment of the health effects of flaxseed-enriched products, since very few studies have focused on the quantification of the bioaccessibility, bioavailability, and activity of flaxseed bioactive compounds for a variety of processing conditions and product formulation.

[General practitioners in private practice in the city of Quebec and the application of population responsibility]. / Les médecins omnipraticiens de cabinet privé de la ville de Québec et l'application de la responsabilité populationnelle.

OBJECTIVES: The aim of this study is to examine the way in which general practitioners (GPs) in private practice view the idea of population responsibility, proposed by the Quebec Health and Social Services Ministry in 2004. We then look at how these views impact primary health care practice in Quebec City. METHOD: A qualitative exploratory approach was used; 18 semi-directed interviews were performed with private practice GPs, administrators and health professionals from community health and social services centres (CSSS). A content thematic analysis of the data was performed based on St-Pierre et al.'s model and grounded on Giddens' structuring theory. RESULTS: Because neither the population meant to be served nor the underlying responsibility are perceived the same way by the GPs and the CSSS health professionals, the respective practices do not always converge. Consequently, methods of communication, offers of services and management of resources impact on the operationalization of the concept of population responsibility, which has to be negotiated. DISCUSSION: In these negotiations, because physicians are the ones solicited by the other partners, the application of population responsibility increasingly becomes an opportunity to develop a medically oriented primary care organization.